0410 : Validation of the GRACE risk score for predicting death within 6 months of follow-up in a contemporary cohort of patients with acute coronary syndrome: Algerian cohort

Introduction and ObjectivesThe Global Registry of Acute Coronary Events (GRACE) risk score provides an estimate of the probability of death within 6 months of hospital discharge in patients with acute coronary syndrome (ACS). Our aim was to assess the validity of this risk score in a contemporary cohort of patients admitted to an Algerian hospital.MethodsThe study involved 383 consecutive patients with ACS evaluated between January 2010 and January 2014. Their vital status was determined 6 months after hospital discharge and the validity of the GRACE risk score was evaluated by assessing its calibration and its discriminatory capacity.ResultsIn total, 142 (37%) patients were admitted for ST-elevation myocardial infarction (STEMI) and 241 (67%) for non-ST-elevation myocardial infarction (NSTEMI). Percutaneous revascularization was performed in 249 (65%). The median GRACE risk score was 121 [interquartile range, 96-144]. Mortality 6 months after discharge was 4.9%. The calibration of the GRACE risk score was acceptable and its discriminatory capacity was excellent.ConclusionsThe GRACE risk score for predicting death within 6 months of hospital discharge was validated and can be used in patients with ACS. It would be wise to include the GRACE risk score in the medical records of these patients

0264: Short- and long-term prognosis of previous and new-onset atrial fibrillation in ST-segment elevation acute myocardial infarction in Algeria

Introduction and objectivesThe impact of atrial fibrillation on the prognosis of myocardial infarction is still the subject of debate. We analyzed the influence of previous and new-onset atrial fibrillation on in-hospital and long-term prognosis in patients with acute myocardial infarction.MethodsProspective study of 1265 patients with ST-segment elevation acute myocardial infarction (military hospitals of Algiers and Constantine). We studied all-cause in-hospital and long-term mortality (median 4.2 years) using adjusted models.ResultsIn total, 4.5% of patients had previous atrial fibrillation and 10.6% had new-onset atrial fibrillation. In general, both groups of patients had a high baseline risk profile and an increased likelihood of in-hospital complications. The crude in-hospital mortality rate was higher in patients with previous atrial fibrillation than in those with new-onset atrial fibrillation (22% vs 12%; P<.001; 30% vs 10%; P<.001). The long-term mortality rate was 11.11/100 patient-years in patients with previous atrial fibrillation and 5.35/100 patient years in those with new-onset atrial fibrillation (both groups, P<.001). New-onset fibrillation alone (odds ratio=1.55; 95% confidence interval, 1.08-2.22) was an independent predictor of in-hospital mortality. Previous atrial fibrillation (hazard ratio=1.24; 95% confidence interval, 0.94-1.64) and new-onset atrial fibrillation (hazard ratio=0.98; 95% confidence interval, 0.80-1.21) were not independent predictors of long-term mortality.ConclusionNew-onset atrial fibrillation during hospitalization is an independent risk factor for in-hospital mortality in acute myocardial infarction

0250: Prognostic value of body mass index and waist circumference in patients with chronic heart failure: Algerian experience

Introduction and objectivesTo analyze the association between higher body mass index and waist circumference, and the prognostic values of both indicators in total and cardiac mortality in patients with chronic heart failure.MethodsThe study included 1954 patients who were followed up for 4 years in military hospitals of Algeria. Obesity was classified as a body mass index>30 and overweight as a body mass index of 25.0-29.9. Central obesity was defined as waist circumference>88cm for women and>102cm for men. Independent predictors of total and cardiac mortality were assessed in a multivariate Cox model adjusted for confounding variables.ResultsObesity was present in 38% of patients, overweight in 46%, and central obesity in 63%. Body mass index and waist circumference were independent predictors of lower total mortality: hazard ratio=0.84 (P<.001) and hazard ratio=0.97 (P=.01), respectively, and lower cardiac death (body mass index, hazard ratio=0.84, P<.001; waist circumference, hazard ratio=0.97, P=.01). The interaction between body mass index and waist circumference (hazard ratio=1.001, P<.01) showed that the protective effect of body mass index was lost in patients with a waist circumference>120cm.ConclusionsMortality was significantly lower in patients with a high body mass index and waist circumference. The results also showed that this protection was lost when these indicators over a certain limit