057 A simple prediction score for significant renal artery stenosis in patients with coronary artery disease

BackgroundRenal artery stenosis (RAS) is a strong independent predictor of mortality in patients (pts) with coronary artery disease (CAD).Aim of studyTo develop and validate a score predicting RAS in patients with CAD.MethodsThree hundred consecutive pts (50 females) with significant CAD underwent abdominal aortography following coronary angiography to screen for significant RAS defined as luminal narrowing of > 50%. Univariate and multivariate analyses were performed comparing pts with and without RAS. Significant factors associated with RAS were included in constructing a score that predicts RAS.The score was internally validated in pts randomly selected from the entire study group (validation group; n=103), using ROC curves and the Hosmer-Lemeshow goodness-of-fit test.ResultsTwenty-seven pts (9%) had a significant RAS. Univariate predictors of significant RAS were: age > 65 years (OR=4.5, p < 0.0001), hypertension (OR=3.6, p=0.001), and female gender (OR=3.6, p=0.015). We found a tendency of more prevalent renal insufficiency (37.1% vs. 21.5%; p=0.05) and the presence of 2 or more significant CAD lesions (70.4% vs. 50.9%; p=0.05) in pts with RAS.Multivariate analysis showed that age > 65 years (OR=4.1%, 95% CI=1.6-10.3, p=0.003) and hypertension (OR=3.1, 95% CI=1.2-7.7, p=0.015) were independent predictors of RAS. The ranged from 0 to 7: 2 points for age > 65 years and hypertension 1 point for female gender, renal insufficiency, and > 3-vessel disease). Internal validation showed a good performance (ROC curve = 0.79 and Chi2 Lemeshow = 3.45). For a score < 2, the negative predictive value is 98%. Applying this criteria, 48.3% of our population would not require systematic abdominal angiography.ConclusionThe performance of our predictive score was good, and significant reduction in the need to perform systematic abdominal aortography could be expected with the use of this score

0425: Predictive factors of side effects of amiodarone in the amiotox registry

BackroundAmiodarone is a widely used antiarrhythmic drug in Tunisia and worldwide. However, its side effects are quite frequent hampering its use despite its efficacy.ObjectiveThe purpose of our study was to determin the prevalence of amiodarone side effects and to analyse its predictors in our population.ResultsFrom May 1st 2010 to April 30th 2012, 200 consecutive patients (mean age: 61.9±12.9 years) were included. Mean duration of amiodarone therapy was 51.9±48.4 months with a mean dose of 288.1±274.2g. Atrial fibrillation (81.5%) was the most common indication. Amiodarone side effects occurred in 144 patients (72%). Refering to multivariate analysis, independent predictors were:–Advanced age (p=0.02), treatment duration (p<0.001) and cumulative dose (p<0.001) for occurrence of all side effects.–Treatment duration > 6 months (p=0.008) for corneal deposits.–Age >70 years (p=0.001) and cumulative dose (p<0.00.1 with a logarithmic correlation) for thyroid toxicity.–Cumulative dose (p<0.001) and thyroid disease history (p=0.047) for hypothyroidism.–Age >70 years (p=0.002) and treatment duration (p<0.001 with a linear correlation) for cutaneous toxicity.–Cumulative dose >300g (p=0.012) and heart failure (p= 0.05) for bradycardia.–Cumulative dose >100g (p= 0.012) for QT prolongation–Treatment duration (p<0.001 with a linear correlation) and betablokers concomittent use (p=0.046) for PR elongation.–Treatment duration (p<0.001 with an exponential correlation) and concomittent VKA use (p=0.018) for hepatic toxicity.–Treatment duration > 18 months (p=0.009) and concomittent CCB use (p<0.001) for neurological toxicity.ConlusionThe results of our study confirmed that amiodarone side effects are quite frequent in our population, and that in addition to treatment dose and duration, other predictors for these effects were identified such as age and some drug associations

Analysis of the Effects of Drought on Vegetation Cover in a Mediterranean Region through the Use of SPOT-VGT and TERRA-MODIS Long Time Series

The analysis of vegetation dynamics and agricultural production is essential in semi-arid regions, in particular as a consequence of the frequent occurrence of periods of drought. In this paper, a multi-temporal series of the Normalized Difference of Vegetation Index (NDVI), derived from SPOT-VEGETATION (between September 1998 and August 2013) and TERRA-MODIS satellite data (between September 2000 and August 2013), was used to analyze the vegetation dynamics over the central region of Tunisia in North Africa, which is characterized by a semi-arid climate. Products derived from these two satellite sensors are generally found to be coherent. Our analysis of land use and NDVI anomalies, based on the Vegetation Anomaly Index (VAI), reveals a strong level of agreement between estimations made with the two satellites, but also some discrepancies related to the spatial resolution of these two products. The vegetation’s behavior is also analyzed during years affected by drought through the use of the Windowed Fourier Transform (WFT). Discussions of the dynamics of annual agricultural areas show that there is a combined effect between climate and farmers’ behavior, leading to an increase in the prevalence of bare soils during dry years

Effects of Ramadan fasting on aspirin resistance in type 2 diabetic patients

<div><p>Aims</p><p>Ramadan fasting (RF) may affect aspirin resistance. We conducted this study in patients with cardiovascular risk (CVR) factors to assess the effect of RF on aspirin resistance and explore whether type 2 diabetes mellitus (DM) would influence this effect.</p><p>Methods</p><p>A total of 177 stable patients with ≥2 CVR factors were recruited. All patients observed RF and were taking aspirin. Physical exam and standard biological tests including glycaemia and serum lipids data were performed before Ramadan (Pre-R), at the last week of Ramadan (R) and four weeks after the end of Ramadan (Post-R). In the same visits caloric intake was calculated and platelet reactivity to aspirin was assessed using Verify Now point-of-care assay.</p><p>Results</p><p>In the overall population, there was no significant change in absolute aspirin reaction unit (ARU) values and in metabolic parameters. In DM patients (n = 127), ARU change from Pre-R values was+19.7 (p = 0.01) and +14.4 (p = 0.02) respectively at R and Post-R. During Ramadan, glycaemia, triglycerides, and cholesterol levels increased significantly and returned to Pre-R values thereafter. These changes were not observed in non-DM patients.</p><p>Conclusions</p><p>During RF aspirin resistance increased only in DM patients. This effect persisted one month after Ramadan. Simultaneous alteration of glycemic control and increase of serum lipids levels could potentially be a favorable factor.</p><p>Study registration</p><p>The protocol was registered at clinicaltrials.gov under: <a href="https://clinicaltrials.gov/ct2/show/NCT02720133" target="_blank">NCT02720133</a>.</p></div