ABSTRACT
Indications for permanent pacing are currently well codified. This treatment may, however, present complications. To report the results of cardiac pacing and to identify predictive factors of pacing's complication. We conducted a retrospective study of 188 consecutive patients admitted to the cardiology department of Mongi Slim university hospital in La Marsa between January 2005 and June 2011 and implanted with a single or dual chamber pacemaker. In our study, we had 92 men and 96 women [sexratio= 0.95]. The mean age was 70.21 +/- 13 years. The indication for cardiac pacing was a high degree heart block in 74.46% of cases and a sick sinus syndrome in 15.95% of cases. The degeneration conduction tissue was the main etiology [72.34% of patients]. Success implantation was obtained in 98.4%of cases. The main operative complication was the pneumothorax in 3 patients [1.59% of cases]. At Long term, cumulative survival rate was 78.95%. Only operating time affects significantly the rate of early complications [p<0.001]. Late complications were related to the valvular heart disease [p = 0.007], the ischemic etiology [p = 0.05], the oral antivitamine K treatment [p = 0.04] and the occurrence of early complication [p = 0.002]. Our hospital, which is considered as a small Center of cardiac pacing [less than 80 procedures/year] had a low complication rate as well as big centers
ABSTRACT
Myocardial reperfusion is the " corner stone " in the treatment of myocardial infarction. Primary percutaneous coronary intervention has proved its superiority upon intravenous thrombolysis. To evaluate in hospital mortality of acute myocardial infarction treated with primary angioplasty and to determine its predictive factors. We performed a retrospective study including 250 patients admitted to Mongi Slim university Hospital at la Marsa between January the 1st, 2006 and June the 30th, 2011. All these patients had an ST segment elevation myocardial infarction and underwent primary percutaneous coronary intervention within 24 hours after symptom onset. In our study, males were predominant with a sex-ratio of 4.55. Our patients were aged 59.8 +/- 11.19 years old. Diabetes mellitus was present in 42% of our population. In 60.4% of the cases, myocardial infarction was located in the anterior wall. Cardiogenic shock was present in 13.6% of patients. The culprit coronary artery was the left anterior descending artery in 57.6% of the cases. The coronary flow in the culprit artery was TIMI 0 in 64% of the patients and TIMI 1 in 13.2% of the patients. Angiographic success [TIMI 3 flow and residual stenosis <20%] was achieved in 84% of cases. Our in-hospital mortality rate [cardiogenic shock excluded] was 6.9%. Predictive factors of in-hospital mortality were: female gender, diabetes mellitus, hypertension, renal failure, multi-vessel lesion,TIMI flow before percutaneous coronary intervention, proximal left anterior descending artery lesion, initial cardiogenic shock and acute stent thrombosis. In our local context, primary percutaneous coronary intervention is an efficient and safe treatment of myocardial infarction with persistent ST-segment elevation
ABSTRACT
Non-alcoholic fatty liver disease [NAFLD] is frequently diagnosed in daily practice. This condition is represented by a large spectrum of chronic liver diseases going from pure hepatic steatosis to cirrhosis and its complications, including hepatocellular carcinoma. NAFLD is usually associated to glucose and lipoproteins metabolism increasing the cardiovascular risk. To review new advances in the knowledge of the pathophysiological links between NAFLD and cardiovascular risk, evaluation of cardiovascular risk in this special situation and the different therapeutics proposed. Systematic review of the literature using medical data bases [Medline] with the following key words: non-alcoholic fatty liver disease, hepatic steatosis, cardiovascular risk, metabolic syndrome. We'll report pathophysiological links between NAFLD and cardiovascular risk, propose an evaluation of cardiovascular risk in this special situation and expose a therapeutic strategy. The discovery of a non alcoholic fatty liver disease should lead to a cardiovascular risk evaluation