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The value of metabolic syndrome (Mets) in the identification of high cardiovascular risk subjects remains questionable. We sought to examine the association among Mets and the occurrence of a coronary heart disease (CHD). Methods Between 2006 and 2008, 540 patients were screened for the Mets according to the NCEP-ATP III definition. The mean age was 61 ± 12.3 years, 63.3% were men. Mets was diagnosed in 60% of the population. 276 had CHD confirmed by angiocoronarography (51,1%). Results Patients characteristics are presented in the table. CHD(+) (n=276) CHD(-) (n=264) P Age (years) 62 ± 10,2 60 ± 15,2 Men 75,4% 50,8% Smokers 48,9% 24,2% BMI (kg/m2) 28,5 ± 4,6 28,3 ± 6,5 Waist (cm) 100,2 ± 12,6 98 ± 14 0,08 SBP (mmHg) 133 ± 20,2 132 ± 24,2 0,06 Diabetes 52,9% 23,1% Hypertension 52,8% 46% TG (mmol/l) 1,96 ± 1,1 1,63 ± 1 HDLc (mmol/l) 1,06 ± 0,5 1,2 ± 0,5 CHD (+) patients had a higher prevalence of metabolic syndrome: 74,6% versus 44,7% (p=0.05). Multivariate analyses revealed that only Mets was significantly associated with CHD (OR: 1.48 95% CI: 1.10-2.4, p=0.05). Conclusion Our study indicates that MetS is highly prevalent and that it seems to be correlated to CHD.

Background The sixth Joint National Committee (JNC-VI) classification system of blood pressure emphasizes both systolic blood pressure (SBP) and diastolic blood pressure (DBP) for cardiovascular disease risk assessment. Pulse pressure (PP) = [SBP-DBP], may also be a valuable risk assessment tool. Objectives In this study, we examined the association of cardiovascular events with arterial pulse pressure in elderly as well as their correlations within diabetes. Patients & methods A Population based survey supported by WHO and FNUAP, was undertaken in 2008-2009 to investigate health behaviours and health status of elderly living in their home in Monastir. This study was carried out in a representative sample of elderly aged more than 65 years. Standardized techniques were used for blood pressure (BP). Hypertension was defined as BP more than 140/90 mmHg. Diabetes was defined as known diabetics. Regression analyses were used to examine the relationships among pulse pressure age, diabetes and cardiovascular events (myocardial infarction, arteritis and stroke).This project was approved by the research Ethics Committee, CHU F Bourguiba, university of Monastir Results The study included 598 participants (396 women and 202 men) who were aged ≥65 years. The prevalence of hypertension and diabetes was respectively 52% (n=311) and 27,4% (n= 164). Pulse pressure was more than 65 mmHg for 132 subjects (22%), only 43 subjects without a history of hypertension. The mean of PP is significantly high in hypertensive elderly (52.3 vs 58.4 mmHg), with cardiovascular events (55 vs 58 mmHg), diabetic subjects (53 vs 58 mmHg), with comorbidity (54 vs 58 mmHg) and polymedication (52 vs 57 mmHg). Using pulse pressure (high PP ≥65 mmHg) as dependent variable, the multiple regression analysis reveals the independent influence of diabetes and cardiovascular events on PP. Conclusion This study has confirmed that subjects with the widest PP have the greatest risk of cardiovascular events. Elderly diabetic patients have a higher PP than non diabetic elderly. These hemodynamic changes may contribute to the increase risk of cardiovascular disease associated with diabetes.

In the setting of acute myocardial infarction (AMI), early resolution of ST-segment elevation was a useful predictor of final infarct size, left ventricular function and clinical outcome.Aimto determine the predictive factors of ST-segment resolution immediately following primary coronary angioplasty for AMI.Methodsprimary angioplasty was performed in 270 consecutive patients with first AMI, they were divided into 2 groups according to whether ST-segment resolution occurred 1 hour after the procedure. ST-segment resolution ≥70% was considered as ‘complete’ ST-segment resolution, whereas ST-segment resolution < 70% was considered as ‘incomplete’ ST-segment resolution.Resultsof the 270 patients, 156 (57.8%) had complete ST-segment resolution. Patients with pre-infarction angina had a greater degree of ST-segment resolution than those without angina (71 ± 21% vs. 49 ± 43%, p

In the setting of acute myocardial infarction (AMI), early resolution of ST-segment elevation was a useful predictor of final infarct size, left ventricular function and clinical outcome.Aimto determine the predictive factors of ST-segment resolution immediately following primary coronary angioplasty for AMI.Methodsprimary angioplasty was performed in 270 consecutive patients with first AMI, they were divided into 2 groups according to whether ST-segment resolution occurred 1 hour after the procedure. ST-segment resolution ≥ 70% was considered as ‘complete’ ST-segment resolution, whereas ST-segment resolution < 70% was considered as ‘incomplete’ ST-segment resolution.Resultsof the 270 patients, 156 (57.8%) had complete ST-segment resolution. Patients with pre-infarction angina had a greater degree of ST-segment resolution than those without angina (71 ±21% vs. 49± 43%, p

PurposeThe purpose of our study is to investigate the presence of anemia among patients admitted for acute heart failure and to evaluate its short and medium term prognostic value.MethodsThis is a retrospective study of 234 patients admitted in the cardiology department of Fattouma Bourguiba Monastir hospital between January 2010 and March 2011. Anemia was defined according to the criteria of the World Health Organization (WHO): Haemoglobin

The influence of sex on the prevalence of certain forms of valvular heart disease was known. Although the clinical characteristics and prognosis of infective endocarditis (IE) have been widely studied, little information was available concerning the possible differences between men and women. The aim of this study was to assess the clinical Characteristics and the Prognosis of Infective Endocarditis in Women. Methods Comparative analysis of 220 patients diagnosed with IE according to the Duke University criterea between 1997 and 2007. Of these 95 (42,7%) were women. Results Mean age was similar in the 2 sexes, 34,8 ± 18 years for men and 37,2 ± 18 years for women. Infection occurred more frequently in the mitral valve in women (62% vs 43% p = 0,03) and more frequently in the aortic valve in men (36,3% vs 20,2%, p=0,05). The incidence of IE on prosthesis was similar in both groups: 22, 8% in the men and 23,3% in the women (p=0,8). The rate of positive blood cultures was similar in both groups (52,2% in men and 51% in women, p = 0.9) and no significant differences were found regarding the causative pathogen. The rates of heart failure, peripheral emboli, abscesses and neurologic complications were all similar in the 2 groups. Concerning surgical treatment, women had more frequently mitral valve replacement (29,3% vs 20,8%, p= 0,05), and men had more freqently aortic or mitro-aortic valve prothesis (23,8% vs 9,8%, p=0,001, and 4% vs 1,2%, p= 0,05). Death during the hospital phase was similar: 20, 2% for women and 18,1% for men (p=0,7). Conclusion Despite the differences in the valvular localisation of IE between men and women, it seems that the clinical characteristics and the prognosis of infective endocarditis were similar.