Predictors of acute coronary syndrome in pre hospital patients with chest pain.

Background: Non-traumatic chest pain is a common cause in pre hospital emergency medicine. The objective of our study was to identify predictive factors of STEMI in patients with acute chest pain, on telephone interview.

Methods: We conducted a prospective observational study over a period of one year (december 2017 to november 2018) in the Emergency Care System of the North Est (SAMU 01) of Tunisia.

The measurement of circulating matrix metalloproteinase-8 and its tissue inhibitor and their association with inflammatory mediators in patients with acute coronary syndrome.

Background: The aim of the present study was to investigate differences of matrix metalloproteinase-8 and tissue inhibitor of metalloproteinase-1 in the peripheral blood of patients admitted with acute coronary syndrome (ACS) and its correlation with the widely accepted markers of inflammatory activity, C-reactive protein, fibrinogen, and white blood cell number.

Methods: 315 patients with ACS (165 unstable angina pectoris/non-ST-elevation myocardial infarction, 150 ST elevation myocardial infarction), 111 stable angina (SA) patients, and 296 control subjects were enrolled in the study. All biochemical analyses were carried out using a Hitachi 912 analyzer (Roche).

Peripheral blood levels of matrix and inflammatory mediators are elevated in Tunisian patients with acute coronary syndromes.

Background: The aim of the present study was to investigate differences of matrix metalloproteinase-9 and tissue inhibitor of metalloproteinase-1 in the peripheral blood of patients admitted with acute coronary syndrome (ACS), in correlation with the widely accepted markers of inflammatory activity, C-reactive protein, fibrinogen, and white blood cell number.

Methods: 315 patients with ACS (165 unstable angina pectoris/non-ST-elevation myocardial infarction, 150 ST-elevation myocardial infarction), 111 stable angina (SA) patients, and 296 control subjects were enrolled in the study. All biochemical analyses were carried out using a Hitachi 912 analyzer (Roche).

Association of a DNA polymorphism of the apolipoprotein AI-CIII-AIV gene cluster with myocardial infarction in a Tunisian population.

Background: Apolipoproteins AI-CIII-AIV play important roles in the metabolism of triglycerides and high-density lipoprotein cholesterol. However, whether genetic variations in the ApoAI-CIII-AIV gene cluster are associated with the risk of myocardial infarction (MI) remains uncertain. In the present study, we examined a possible association of the ApoCIII SacI polymorphism in the ApoAI-CIII-AIV gene cluster with lipid parameters and MI in a sample of the Tunisian population.

Cardiac arrhythmia induced by interferon beta-1a.

Cardiac adverse effects have never been reported with interferon (INF) beta. We report a case of left bundle branch block in a 35-year-old woman treated with INF beta-1a for multiple sclerosis. Five years after INF therapy, she presented loss of consciousness, retrosternal pains, short breath and lowered tolerance of effort.

[Late stent thrombosis in a young patient who had ulcerative colitis].

Background: Arterial and venous thrombosis are well recognized systemic complications of inflammatory bowel disease predominantly in patients with crohn's colitis and in those with ulcerative colitis (UC). Aim : report a new case.

Case: We describe the case of a 35 years old man presenting previously an anterior infarct with a tighten stenosis in the middle part of the left anterior descending artery (LAD).

[Assessment of endothelial function reliably predicts the existence and the severity of coronary disease].

Background: Endothelial dysfunction has been proven to be a cornerstone of atherosclerosis occurrence, development and progression. However, its use in clinical practice is still unclearly defined.

Aim: To prospectively assess how accurately endothelial function assessment predicts the existence and the extensiveness of significant coronary artery disease.

[Immediate and 12-month outcomes of an interventional reperfusion strategy in acute ST elevation myocardial infarction. Report of 208 successive patients].

Background: Percutaneous coronary intervention (PCI) has been proven to be the gold standard of reperfusion therapies in acute ST-elevation myocardial infarction (STEMI) in the western world. Highly trained teams and good logistical management of cathlabs may be limiting factors in developing countries and data about outcomes following PCI in such areas is scarce.

Aim: The objectives of this study were to describe the procedural and clinical outcomes of patients undergoing PCI for STEMI at a university hospital in Tunisia and make a comparison with outcomes from the West.

Radial access for concomitant coronary, subclavian and renal artery angioplasty: one case report.

Background: Concomitant coronary and peripheral angioplasty is a more frequently reported situation. Patient's outcome is significantly conditioned by access site complications especially in femoral and brachial approaches. The radial artery access is a safe and a well established alternative in coronary interventions and could be suitable for many peripheral angioplasty cases, thanks to devices enhancement.

Association between the 2756A> G variant in the gene encoding methionine synthase and myocardial infarction in Tunisian patients.

Background: Elevated plasma total homocysteine (tHcy), a risk factor for coronary artery disease (CAD), is due to defects in genes encoding for enzymes involved in tHcy metabolism or from inadequate status of vitamins involved in tHcy disposal. Methionine synthase (MS), a vitamin B(12)-dependent enzyme, catalyses the remethylation of homocysteine to methionine using a methyl group donated by 5-methyltetra-hydrofolate, which is the major circulating form of folate in the body. Functional genetic variants of the MS may alter tHcy as well as folate levels which are independent risk factors for CAD.

[Esophageal abnormalities in patients with chest pain and normal coronary angiograms].

Aims: To evaluate the frequency and the variety of esophageal abnormalities in patients with chest pain and normal coronary angiograms.

Patients And Methods: : We have conducted a prospective study including patients with noncardiac chest pain based on normal coronary angiograms. We performed for all patients an upper gastrointestinal endoscopy, 24-hour esophageal pH monitoring and stationary esophageal manometry.

Acute myocarditis and myocardial infarction induced by Paraphenylenediamine poisoning. Interest of angiocoronarography.

We present 2 cases of myocardial damage induced by Paraphenylenediamine (PPD) poisoning in young patients without any history of cardiovascular disease. ECG findings revealed the presence of localized ST segment elevation in precordial leads (V1-V4) in the first case and (V3-V6) in the second associated to an increase of the serum troponine T level at 23 ng/ml (case 1) and 29.7 ng/ml (case 2).

[Anomalous origin of coronary arteries from the aorta].

The authors report the series of 9 patients (6 male and 3 female, aged from 32 to 64 years) with anomalous origin of coronary arteries from the aorta discovered at coronary arteriography. In 4 cases, the circumflex, artery aries from the right coronary sinus and in 5 cases, the right coronary artery arises from the left coronary sinus. Severe atherosclerotic coronary disease was discovered in 5 cases.

[Twenty years result of a corrective surgery of tetralogy of Fallot in a 50 years old woman].

The authors report the case of a woman operated at a 50 years of age for a tetralogy of Fallot with a good late result.

[Multiple coronary artery-left ventricular fistulae. A case report].

The authors report the case of a patient with multiple coronary artery-left ventricular fistulae discovered in coronary angiography for exertional angina.

[The immediate effect of Rashkind's atrioseptostomy on systemic saturation in transposition of the great arteries].

The purpose of this prospective study is to analyse the immediate effect of Rashkind's atrioseptostomy on systemic saturation in transposition of the great arteries (TGA). Thirteen neonates and infants (10 males and 3 females) with TCiA underwent balloon atrial septostomy (BAS) at a median age of 20 days (range 2 and 60 days). The mean atrial septal defect diameter after BAS was 6.

[Congenital aortic valve stenosis with left ventricular dysfunction: effect of percutaneous valvuloplasty].

Two girls aged 6 and 15 years with severe congenital valvular aortic stenosis and left ventricular (LV) dysfunction underwent successful balloon aortic valvotomy (BAV). Both patients had severe symptoms at the time of initial evaluation. The electrocardiograms showed LV hypertrophy and cardiac enlargement (cardiothoracic ratio 0.

[Pulmonary hypertension in sickle cell anemia. A case report].

We report the case of a 33-years-girl with SCA and severe PH. She developed six month before admission, non productive cough and dyspnea. Physical examination at admission revealed shortness of breath and right heart ventricular failure.

[Percutaneous mitral commissurotomy and left ventricular function in severe mitral stenosis].

The purpose of this study was to determine the immediate effect of percutaneous mitral commissurotomy (PMC) on left ventricular (LV) performance. We studied 30 patients with severe mitral stenosis undergoing successful PMC by cardiac catheterization and angiography before and 5 minutes after PMC. All patients were in sinus rhythm and no patient had hypertension or clinical coronary artery disease.

[Cardiac retrograde arterial catheterization in children under 2 years of age. Indications, techniques and complications].

Thirty children (15 males and 15 females) under 2 years of age (mean age 14 +/- 6 months, range 1 to 24 months, mean weight was 8.3 +/- 2.5 kg) underwent diagnostic cardiac percutaneous femoral arterial and venous catheterization for congenital heart disease.

[Coronary-pulmonary arterial fistula in the adult: report of 6 cases and review of the literature].

Six new patients and 33 previously reported with coronary-to-pulmonary artery fistula were reviewed. The mean age at the time of diagnosis was 51 years. A male predominance was found (65%).

[Immediate and mid-term results of balloon valvuloplasty in congenital aortic stenosis. Ten case reports].

From 1987 to 2000, 10 patients aged 0.5 to 20 years with congenital valvular aortic stenosis underwent percutaneous balloon aortic valvuloplasty. In one patient, balloon valvuloplasty was unsuccessful, this patient had acute artery thrombosis requiring surgical intervention.

[Stratification of cardiac risk in unstable angina: value of troponin measurements].

Recent studies have identified patients with unstable angina and increased troponin I or T as a high risk population gaining benefit from adjunctive treatment with glycoprotein IIb/IIIa receptor antagonists and early reperfusion by coronary interventions.