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Chabrak S, Haggui A, Allouche E, Ouali S, Ben Halima A, Kacem S, Krichen S, Marrakchi S, Fehri W, Mourali MS, Jabbari Z, Ben Halima M, Neffati E, Heraiech A, Slim M, Kachboura S, Gamra H, Hassine M, Kraiem S, Kammoun S, Bezdah L, Jridi G, Bouraoui H, Kammoun S, Hammami R, Chettaoui R, Ben Ameur Y, Azaiez F, Tlili R, Battikh K, Ben Slima H, Chrigui R, Fazaa S, Sanaa I, Ellouz Y, Mosrati M, Milouchi S, Jarmouni S, Ayadi W, Akrout M, Razgallah R, Neffati W, Drissa M, Charfeddine S, Abdessalem S, Abid L, Zakhama L. National Tunisian Study of Cardiac Implantable Electronic Devices: Design and Protocol for a Nationwide Multicenter Prospective Observational Study. JMIR Res Protoc 2024; 13:e47525. [PMID: 38588529 PMCID: PMC11036188 DOI: 10.2196/47525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 10/29/2023] [Accepted: 10/31/2023] [Indexed: 04/10/2024] Open
Abstract
BACKGROUND In Tunisia, the number of cardiac implantable electronic devices (CIEDs) is increasing, owing to the increase in patient life expectancy and expanding indications. Despite their life-saving potential and a significant reduction in population morbidity and mortality, their increased numbers have been associated with the development of multiple early and late complications related to vascular access, pockets, leads, or patient characteristics. OBJECTIVE The study aims to identify the rate, type, and predictors of complications occurring within the first year after CIED implantation. It also aims to describe the demographic and epidemiological characteristics of a nationwide sample of patients with CIED in Tunisia. Additionally, the study will evaluate the extent to which Tunisian electrophysiologists follow international guidelines for cardiac pacing and sudden cardiac death prevention. METHODS The Tunisian National Study of Cardiac Implantable Electronic Devices (NATURE-CIED) is a national, multicenter, prospectively monitored study that includes consecutive patients who underwent primary CIED implantation, generator replacement, and upgrade procedure. Patients were enrolled between January 18, 2021, and February 18, 2022, at all Tunisian public and private CIED implantation centers that agreed to participate in the study. All enrolled patients entered a 1-year follow-up period, with 4 consecutive visits at 1, 3, 6, and 12 months after CIED implantation. The collected data are recorded electronically on the clinical suite platform (DACIMA Clinical Suite). RESULTS The study started on January 18, 2021, and concluded on February 18, 2023. In total, 27 cardiologists actively participated in data collection. Over this period, 1500 patients were enrolled in the study consecutively. The mean age of the patients was 70.1 (SD 15.2) years, with a sex ratio of 1:15. Nine hundred (60%) patients were from the public sector, while 600 (40%) patients were from the private sector. A total of 1298 (86.3%) patients received a conventional pacemaker and 75 (5%) patients received a biventricular pacemaker (CRT-P). Implantable cardioverter defibrillators were implanted in 127 (8.5%) patients. Of these patients, 45 (3%) underwent CRT-D implantation. CONCLUSIONS This study will establish the most extensive contemporary longitudinal cohort of patients undergoing CIED implantation in Tunisia, presenting a significant opportunity for real-world clinical epidemiology. It will address a crucial gap in the management of patients during the perioperative phase and follow-up, enabling the identification of individuals at particularly high risk of complications for optimal care. TRIAL REGISTRATION ClinicalTrials.gov NCT05361759; https://classic.clinicaltrials.gov/ct2/show/NCT05361759. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR1-10.2196/47525.
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Affiliation(s)
- Sonia Chabrak
- Pasteur Clinic, General and Cardiovascular Clinic of Tunis, Tunis, Tunisia
| | - Abdeddayem Haggui
- Military Hospital, Faculty of Medicine of Tunis, University of Tunis, Tunis, Tunisia
| | - Emna Allouche
- Cardiology Department, Faculty of Medicine of Tunis, Charles Nicole Hospital, University of Tunis, Tunis, Tunisia
| | - Sana Ouali
- Cardiology Department, Faculty of Medicine of Tunis, La Rabta Hospital, University of Tunis, Tunis, Tunisia
| | - Afef Ben Halima
- Abderrahmen Mami Hospital, Faculty of Medicine of Tunis, University of Tunis, Tunis, Tunisia
| | | | | | - Sonia Marrakchi
- Cardiology Department, Versailles Cardiology Center, Paris, France
| | - Wafa Fehri
- Cardiology Department, Faculty of Medicine of Tunis, Military Hospital, University of Tunis, Tunis, Tunisia
| | - Mohamed Sami Mourali
- Cardiology Department, Faculty of Medicine of Tunis, La Rabta Hospital, University of Tunis, Tunis, Tunisia
| | - Zeineb Jabbari
- Cardiology Department, Faculty of Medicine of Tunis, La Rabta Hospital, University of Tunis, Tunis, Tunisia
| | - Manel Ben Halima
- Cardiology Department, Faculty of Medicine of Tunis, Abderrahmen Mami Hospital, University of Tunis, Tunis, Tunisia
| | - Elyes Neffati
- Cardiology Department, Faculty of Medicine of Sousse, Sahloul Hospital, University of Sousse, Sousse, Tunisia
| | - Aymen Heraiech
- Cardiology Department, Faculty of Medicine of Sousse, Sahloul Hospital, University of Sousse, Sousse, Tunisia
| | - Mehdi Slim
- Cardiology Department, Faculty of Medicine of Sousse, Sahloul Hospital, University of Sousse, Sousse, Tunisia
| | - Salem Kachboura
- Cardiology Department, Faculty of Medicine of Tunis, Abderrahmen Mami Hospital, University of Tunis, Tunis, Tunisia
| | - Habib Gamra
- Cardiology A Department, Fattouma Bourguiba Hospital, Monastir, Tunisia
| | - Majed Hassine
- Cardiology A Department, Fattouma Bourguiba Hospital, Monastir, Tunisia
| | - Sondes Kraiem
- Cardiology Department, Faculty of Medicine of Tunis, Habib Thameur Hospital, University of Tunis, Tunis, Tunisia
| | - Sofien Kammoun
- Cardiology Department, Faculty of Medicine of Tunis, Habib Thameur Hospital, University of Tunis, Tunis, Tunisia
| | - Leila Bezdah
- Cardiology Department, Faculty of Medicine of Tunis, Charles Nicole Hospital, University of Tunis, Tunis, Tunisia
| | - Gouider Jridi
- Cardiology Department, Faculty of Medicine of Sousse, Farhat Hached Hospital, University of Sousse, Sousse, Tunisia
| | - Hatem Bouraoui
- Cardiology Department, Faculty of Medicine of Sousse, Farhat Hached Hospital, University of Sousse, Sousse, Tunisia
| | - Samir Kammoun
- Cardiology Department, Faculty of Medicine of Sfax, Hedi Chaker Hospital, University of Sfax, Sfax, Tunisia
| | - Rania Hammami
- Cardiology Department, Faculty of Medicine of Sfax, Hedi Chaker Hospital, University of Sfax, Sfax, Tunisia
- Tunisian Society of Cardiology and Cardiovascular Surgery, Tunis, Tunisia
| | - Rafik Chettaoui
- Pasteur Clinic, General and Cardiovascular Clinic of Tunis, Tunis, Tunisia
| | - Youssef Ben Ameur
- Cardiology Department, Faculty of Medicine of Tunis, Mongi Slim Hospital, University of Tunis, Tunis, Tunisia
| | - Fares Azaiez
- Cardiology Department, Faculty of Medicine of Tunis, Mongi Slim Hospital, University of Tunis, Tunis, Tunisia
| | - Rami Tlili
- Cardiology Department, Faculty of Medicine of Tunis, Mongi Slim Hospital, University of Tunis, Tunis, Tunisia
| | | | - Hedi Ben Slima
- Cardiology Department, Faculty of Medicine of Tunis, Menzel Bourguiba Hospital, University of Tunis, Bizerte, Tunisia
| | - Rim Chrigui
- Pasteur Clinic, General and Cardiovascular Clinic of Tunis, Tunis, Tunisia
| | - Samia Fazaa
- Pasteur Clinic, General and Cardiovascular Clinic of Tunis, Tunis, Tunisia
| | - Islem Sanaa
- General & Cardiovascular Clinic, Tunis, Tunisia
| | - Yassine Ellouz
- Pasteur Clinic, General and Cardiovascular Clinic of Tunis, Tunis, Tunisia
| | | | - Sami Milouchi
- Tunisian Society of Cardiology and Cardiovascular Surgery, Tunis, Tunisia
- Cardiology Department, Habib Bourguiba Hospital, University of Sfax, Medenine, Tunisia
| | - Soumaya Jarmouni
- Pasteur Clinic, General and Cardiovascular Clinic of Tunis, Tunis, Tunisia
| | | | | | | | | | - Meriem Drissa
- Tunisian Society of Cardiology and Cardiovascular Surgery, Tunis, Tunisia
- Cardiology Department, Faculty of Medicine of Tunis, Mongi Slim Hospital, University of Tunis, Tunis, Tunisia
| | - Selma Charfeddine
- Cardiology Department, Faculty of Medicine of Sfax, Hedi Chaker Hospital, University of Sfax, Sfax, Tunisia
- Tunisian Society of Cardiology and Cardiovascular Surgery, Tunis, Tunisia
| | - Salem Abdessalem
- Tunisian Society of Cardiology and Cardiovascular Surgery, Tunis, Tunisia
| | - Leila Abid
- Cardiology Department, Faculty of Medicine of Sfax, Hedi Chaker Hospital, University of Sfax, Sfax, Tunisia
| | - Lilia Zakhama
- Cardiology Department, Hospital of the Interior Force Security, University of Tunis, Tunis, Tunisia
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Abid L, Hammami R, Abdesselem S, Boudiche S, Hédi BS, Sayahi K, Bahloul A, Chamtouri I, Charfeddine S, Rais L, Drissa M, Ben Kaab B, Ibn Hadj Amor H, Ben Fatma L, Garbaa R, Boukhris S, Emna A, Ben Halima M, Amdouni N, Ghorbel S, Soudani S, Khaled I, Triki S, Bouazizi F, Jemai I, Abdeljalil O, Ammar Y, Farah A, Neji A, Oumaya Z, Seghaier S, Mokrani S, Thawaba H, Sarray H, Ouaghlani K, Thabet H, Mnif Z, Fatma BM, Sghaier M, Khalifa R, Fourati S, Kammoun Y, Abid S, Hamza C, Ben Jeddou S, Sabbah L, Lakhdhar R, Dammak N, Sellami T, Herbegue B, Koubaa A, Triki F, Ellouze T, Hmoudi A, Ben Ameur I, Boukhchina MM, Abid N, Ouechtati W, Nasrallah N, Houidi Y, Mghaieth Zghal F, Elhem G, Chayeb M, Sarra C, Kaabachi S, Saadaoui N, Ben Ameur I, Affes M, Ouali S, Chaker M, Naana H, Meriem D, Jarrar M, Mnif J, Turki A, Zairi I, Langar J, Dardouri S, Hachaichi I, Chettaoui R, Smat W, Chakroun A, Mzoughi K, Mechmeche R, Ben Halima A, Ben Kahla Koubaa S, Chtourou S, Mohamed Abdelkader M, Ayari M, Hadrich M, Rami T, Azaiez F, Bouhlel I, Sahnoun S, Jerbi H, Imtinene BM, Riahi L, Sahnoun M, Ben Jemaa A, Ben Salem A, Rekik B, Ben Doudou M, Boujnah MR, Joulak A, Omar A, Razgallah R, Sami M, Neffati E, Gamra H, Ben Youssef S, Sdiri W, Ben Halima N, Ben Ameur Y, Kachboura S, Kraiem S, Fehri W, Zakhama L, Bezdah L, Mohamed Sami M, Drissa H, Maatouk MF, Kammoun S, Addad F. Design and Rationale of the National Observational Multicentric Tunisian Registry of Hypertension: Protocol for Evaluating Hypertensive Patient Care in Clinical Practice. JMIR Res Protoc 2022; 11:e21878. [PMID: 36053572 PMCID: PMC9482066 DOI: 10.2196/21878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Revised: 12/27/2020] [Accepted: 07/30/2021] [Indexed: 11/23/2022] Open
Abstract
Background This study was designed to evaluate the care of hypertensive patients in daily clinical practice in public and private centers in all Tunisian regions. Objective This study will provide us an overview of hypertension (HTN) management in Tunisia and the degree of adherence of practitioners to international recommendations. Methods This is a national observational cross-sectional multicenter study that will include patients older than 18 years with HTN for a duration of 4 weeks, managed in the public sector from primary and secondary care centers as well as patients managed in the private sector. Every participating patient signed a consent form. The study will exclude patients undergoing dialysis. The parameters that will be evaluated are demographic and anthropometric data, lifestyle habits, blood pressure levels, lipid profiles, treatment, and adherence to treatment. The data are collected via the web interface in the Dacima Clinical Suite. Results The study began on April 15, 2019 and ended on May 15, 2019. During this period, we included 25,890 patients with HTN. Data collection involved 321 investigators from 24 Tunisian districts. The investigators were doctors working in the private and public sectors. Conclusions Observational studies are extremely useful in improving the management of HTN in developing countries. Trial Registration ClinicalTrials.gov NCT04013503; https://clinicaltrials.gov/ct2/show/NCT04013503 International Registered Report Identifier (IRRID) DERR1-10.2196/21878
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Affiliation(s)
- Leila Abid
- Tunisian Society of Cardiology and Cardiovascular Surgery, Tunis, Tunisia
| | - Rania Hammami
- Tunisian Society of Cardiology and Cardiovascular Surgery, Tunis, Tunisia.,Cardiology Department, Hedi Chaker-Sfax University Hospital, Faculty of Medecine of Sfax, University of Sfax, Sfax, Tunisia
| | - Salem Abdesselem
- Tunisian Society of Cardiology and Cardiovascular Surgery, Tunis, Tunisia
| | - Selim Boudiche
- Cardiology Department, La Rabta 1 (Pr Mourali) University Hospital, Faculty of Medecine of Tunis, University of Tunis, Tunis, Tunisia
| | - Ben Slima Hédi
- Cardiology Department, Hospital of Menzel Bourguiba, Bizerte, Tunisia
| | - Khaled Sayahi
- Cardiology Department, ElKef Hospital, Elkef, Tunisia
| | - Amine Bahloul
- Cardiology Department, Hedi Chaker-Sfax University Hospital, Faculty of Medecine of Sfax, University of Sfax, Sfax, Tunisia
| | - Ikram Chamtouri
- Cardiology Department B, Fattouma Bourguiba University Hospital, Faculty of Medecine of Monastir, University of Monastir, Monastir, Tunisia
| | - Salma Charfeddine
- Cardiology Department, Hedi Chaker-Sfax University Hospital, Faculty of Medecine of Sfax, University of Sfax, Sfax, Tunisia
| | - Lamia Rais
- Nephrology Department, La Rabta University Hospital, Faculty of Medecine of Tunis, University of Tunis, Tunis, Tunisia
| | - Meriem Drissa
- Cardiology Department, La Rabta 2 (Pr Drissa) University Hospital, Faculty of Medecine of Tunis, University of Tunis, Tunis, Tunisia
| | - Badreddine Ben Kaab
- Nephrology Department, La Rabta University Hospital, Faculty of Medecine of Tunis, University of Tunis, Tunis, Tunisia
| | | | - Lilia Ben Fatma
- Nephrology Department, La Rabta University Hospital, Faculty of Medecine of Tunis, University of Tunis, Tunis, Tunisia
| | - Riadh Garbaa
- Tunisian Society of Cardiology and Cardiovascular Surgery, Tunis, Tunisia
| | - Sabrine Boukhris
- Cardiology Department, La Rabta 2 (Pr Drissa) University Hospital, Faculty of Medecine of Tunis, University of Tunis, Tunis, Tunisia
| | - Allouche Emna
- Cardiology Department, Charles Nicole University Hospital, Faculty of Medecine of Tunis, University of Tunis, Tunis, Tunisia
| | - Manel Ben Halima
- Cardiology Department, La Rabta 1 (Pr Mourali) University Hospital, Faculty of Medecine of Tunis, University of Tunis, Tunis, Tunisia
| | - Nesrine Amdouni
- Cardiology Department B, Fattouma Bourguiba University Hospital, Faculty of Medecine of Monastir, University of Monastir, Monastir, Tunisia
| | - Shayma Ghorbel
- Cardiology Department, Habib Bourguiba Hospital, Medenine, Tunisia
| | - Sabrine Soudani
- Cardiology Department, La Rabta 2 (Pr Drissa) University Hospital, Faculty of Medecine of Tunis, University of Tunis, Tunis, Tunisia
| | | | - Syrine Triki
- Cardiology Department, Hedi Chaker-Sfax University Hospital, Faculty of Medecine of Sfax, University of Sfax, Sfax, Tunisia
| | | | - Imen Jemai
- Habib Bourguiba Hospital, Medenine, Tunisia
| | - Ouday Abdeljalil
- Cardiology Department B, Fattouma Bourguiba University Hospital, Faculty of Medecine of Monastir, University of Monastir, Monastir, Tunisia
| | | | - Amani Farah
- Cardiology Department B, Fattouma Bourguiba University Hospital, Faculty of Medecine of Monastir, University of Monastir, Monastir, Tunisia
| | | | - Zeineb Oumaya
- Cardiology Department, Charles Nicole University Hospital, Faculty of Medecine of Tunis, University of Tunis, Tunis, Tunisia
| | | | | | - Hamza Thawaba
- Tunisian Society of Cardiology and Cardiovascular Surgery, Tunis, Tunisia
| | - Hela Sarray
- Cardiology Department, Hedi Chaker-Sfax University Hospital, Faculty of Medecine of Sfax, University of Sfax, Sfax, Tunisia
| | - Khalil Ouaghlani
- Cardiology Department, Charles Nicole University Hospital, Faculty of Medecine of Tunis, University of Tunis, Tunis, Tunisia
| | - Houssem Thabet
- Cardiology Department, Farhat Hached Hospital, Faculty of Medecine of Sousse, University of Sousse, Sousse, Tunisia
| | - Zeineb Mnif
- National Social Security Fund, Sfax, Tunisia
| | | | - Mohamed Sghaier
- Tunisian Society of Cardiology and Cardiovascular Surgery, Tunis, Tunisia
| | - Roueida Khalifa
- Cardiology Department B, Fattouma Bourguiba University Hospital, Faculty of Medecine of Monastir, University of Monastir, Monastir, Tunisia
| | - Sami Fourati
- Tunisian Society of Cardiology and Cardiovascular Surgery, Tunis, Tunisia
| | - Yassmine Kammoun
- Cardiology Department, Hedi Chaker-Sfax University Hospital, Faculty of Medecine of Sfax, University of Sfax, Sfax, Tunisia
| | - Syrine Abid
- Tunisian Society of Cardiology and Cardiovascular Surgery, Tunis, Tunisia
| | - Chiheb Hamza
- Tunisian Society of Cardiology and Cardiovascular Surgery, Tunis, Tunisia
| | - Syrine Ben Jeddou
- Cardiology Department, La Rabta 2 (Pr Drissa) University Hospital, Faculty of Medecine of Tunis, University of Tunis, Tunis, Tunisia
| | | | - Rim Lakhdhar
- Tunisian Society of Cardiology and Cardiovascular Surgery, Tunis, Tunisia
| | - Najla Dammak
- Nephrology Department, Hedi Chaker-Sfax University Hospital, Faculty of Medecine of Sfax, University of Sfax, Sfax, Tunisia
| | - Tarak Sellami
- Tunisian Society of Cardiology and Cardiovascular Surgery, Tunis, Tunisia
| | - Basma Herbegue
- Tunisian Society of Cardiology and Cardiovascular Surgery, Tunis, Tunisia
| | | | - Faten Triki
- Cardiology Department, Hedi Chaker-Sfax University Hospital, Faculty of Medecine of Sfax, University of Sfax, Sfax, Tunisia
| | - Tarek Ellouze
- Cardiology Department, Hedi Chaker-Sfax University Hospital, Faculty of Medecine of Sfax, University of Sfax, Sfax, Tunisia
| | | | - Ikhlas Ben Ameur
- Tunisian Society of Cardiology and Cardiovascular Surgery, Tunis, Tunisia
| | | | | | - Wejdene Ouechtati
- Cardiology Department, Charles Nicole University Hospital, Faculty of Medecine of Tunis, University of Tunis, Tunis, Tunisia
| | | | | | - Fathia Mghaieth Zghal
- Cardiology Department, La Rabta 1 (Pr Mourali) University Hospital, Faculty of Medecine of Tunis, University of Tunis, Tunis, Tunisia
| | | | | | - Chenik Sarra
- Cardiology Department, The Main Military Instruction Hospital of Tunis, Faculty of Medecine of Tunis, University of Tunis, Tunis, Tunisia
| | - Samira Kaabachi
- Cardiology Department, La Rabta 2 (Pr Drissa) University Hospital, Faculty of Medecine of Tunis, University of Tunis, Tunis, Tunisia
| | - Nizar Saadaoui
- Tunisian Society of Cardiology and Cardiovascular Surgery, Tunis, Tunisia
| | - Ines Ben Ameur
- Tunisian Society of Cardiology and Cardiovascular Surgery, Tunis, Tunisia
| | | | - Sana Ouali
- Cardiology Department, La Rabta 1 (Pr Mourali) University Hospital, Faculty of Medecine of Tunis, University of Tunis, Tunis, Tunisia
| | - Mouna Chaker
- Cardiology Department, Hedi Chaker-Sfax University Hospital, Faculty of Medecine of Sfax, University of Sfax, Sfax, Tunisia
| | - Hela Naana
- Tunisian Society of Cardiology and Cardiovascular Surgery, Tunis, Tunisia
| | - Dghim Meriem
- Cardiology Department, The Main Military Instruction Hospital of Tunis, Faculty of Medecine of Tunis, University of Tunis, Tunis, Tunisia
| | - Mourad Jarrar
- Tunisian Society of Cardiology and Cardiovascular Surgery, Tunis, Tunisia
| | - Jihen Mnif
- Tunisian Society of Cardiology and Cardiovascular Surgery, Tunis, Tunisia
| | - Ahmed Turki
- Cardiology Department, Hedi Chaker-Sfax University Hospital, Faculty of Medecine of Sfax, University of Sfax, Sfax, Tunisia
| | - Ihsen Zairi
- Cardiology Department, Habib Thameur Hospital, Faculty of Medecine of Tunis, University of Tunis, Tunis, Tunisia
| | - Jamel Langar
- Tunisian Society of Cardiology and Cardiovascular Surgery, Tunis, Tunisia
| | - Safa Dardouri
- Cardiology Department, Farhat Hached Hospital, Faculty of Medecine of Sousse, University of Sousse, Sousse, Tunisia
| | | | - Rafik Chettaoui
- Tunisian Society of Cardiology and Cardiovascular Surgery, Tunis, Tunisia
| | - Wajih Smat
- Tunisian Society of Cardiology and Cardiovascular Surgery, Tunis, Tunisia
| | | | - Khadija Mzoughi
- Cardiology Department, Habib Thameur Hospital, Faculty of Medecine of Tunis, University of Tunis, Tunis, Tunisia
| | - Rachid Mechmeche
- Tunisian Society of Cardiology and Cardiovascular Surgery, Tunis, Tunisia
| | - Afef Ben Halima
- Cardiology Department, Abderrahmen Mami-Ariana Hospital, Faculty of Medecine of Tunis, University of Tunis, Ariana, Tunisia
| | - Sahar Ben Kahla Koubaa
- Cardiology Department, Mahres Hospital, Faculty of Medecine of Sfax, University of Sfax, Sfax, Tunisia
| | - Slim Chtourou
- Tunisian Society of Cardiology and Cardiovascular Surgery, Tunis, Tunisia
| | | | | | - Moufid Hadrich
- Tunisian Society of Cardiology and Cardiovascular Surgery, Tunis, Tunisia
| | - Tlili Rami
- Cardiology Department, Mongi Slim Hospital, Faculty of Medecine of Tunis, University of Tunis, Tunis, Tunisia
| | - Fares Azaiez
- Cardiology Department, Mongi Slim Hospital, Faculty of Medecine of Tunis, University of Tunis, Tunis, Tunisia
| | - Imen Bouhlel
- Cardiology Department, Farhat Hached Hospital, Faculty of Medecine of Sousse, University of Sousse, Sousse, Tunisia
| | | | | | - Ben Mrad Imtinene
- Cardiology Department, Habib Thameur Hospital, Faculty of Medecine of Tunis, University of Tunis, Tunis, Tunisia
| | - Leila Riahi
- Cardiology Department, The Main Military Instruction Hospital of Tunis, Faculty of Medecine of Tunis, University of Tunis, Tunis, Tunisia
| | - Mohamed Sahnoun
- Tunisian Society of Cardiology and Cardiovascular Surgery, Tunis, Tunisia
| | - Abdelhamid Ben Jemaa
- Cardiology Department, Hedi Chaker-Sfax University Hospital, Faculty of Medecine of Sfax, University of Sfax, Sfax, Tunisia
| | - Amal Ben Salem
- Cardiology Department, Charles Nicole University Hospital, Faculty of Medecine of Tunis, University of Tunis, Tunis, Tunisia
| | - Bassem Rekik
- Cardiology Department, Charles Nicole University Hospital, Faculty of Medecine of Tunis, University of Tunis, Tunis, Tunisia
| | - Maroua Ben Doudou
- Cardiology Department, Habib Thameur Hospital, Faculty of Medecine of Tunis, University of Tunis, Tunis, Tunisia
| | | | - Anissa Joulak
- Tunisian Society of Cardiology and Cardiovascular Surgery, Tunis, Tunisia
| | - Abid Omar
- Cardiology Department, Hedi Chaker-Sfax University Hospital, Faculty of Medecine of Sfax, University of Sfax, Sfax, Tunisia
| | | | - Milouchi Sami
- Cardiology Department, Habib Bourguiba Hospital, Medenine, Tunisia
| | - Elyes Neffati
- Cardiology Department, University Hospital Sahloul, Faculty of Medecine of Sousse, Sousse, Tunisia
| | - Habib Gamra
- Cardiology Department A, Fattouma Bourguiba University Hospital, Faculty of Medecine of Monastir, University of Monastir, Monastir, Tunisia
| | - Soraya Ben Youssef
- Cardiology Department, Internal Security Forces Hospital, Faculty of Medecine of Tunis, University of Tunis, Tunis, Tunisia
| | - Wissem Sdiri
- Cardiology Department, Bougatfa Hospital, Bizerte, Tunisia
| | - Nejeh Ben Halima
- Cardiology Department, Ibn El Jazzar Hospital, Kairouan, Tunisia
| | - Youssef Ben Ameur
- Cardiology Department, Mongi Slim Hospital, Faculty of Medecine of Tunis, University of Tunis, Tunis, Tunisia
| | - Salem Kachboura
- Cardiology Department, Abderrahmen Mami-Ariana Hospital, Faculty of Medecine of Tunis, University of Tunis, Ariana, Tunisia
| | - Sondes Kraiem
- Cardiology Department, Habib Thameur Hospital, Faculty of Medecine of Tunis, University of Tunis, Tunis, Tunisia
| | - Wafa Fehri
- Cardiology Department, The Main Military Instruction Hospital of Tunis, Faculty of Medecine of Tunis, University of Tunis, Tunis, Tunisia
| | - Lilia Zakhama
- Cardiology Department, Internal Security Forces Hospital, Faculty of Medecine of Tunis, University of Tunis, Tunis, Tunisia
| | - Leila Bezdah
- Cardiology Department, Charles Nicole University Hospital, Faculty of Medecine of Tunis, University of Tunis, Tunis, Tunisia
| | - Mourali Mohamed Sami
- Cardiology Department, La Rabta 1 (Pr Mourali) University Hospital, Faculty of Medecine of Tunis, University of Tunis, Tunis, Tunisia
| | - Habiba Drissa
- Cardiology Department, La Rabta 2 (Pr Drissa) University Hospital, Faculty of Medecine of Tunis, University of Tunis, Tunis, Tunisia
| | - Mohamed Faouzi Maatouk
- Cardiology Department B, Fattouma Bourguiba University Hospital, Faculty of Medecine of Monastir, University of Monastir, Monastir, Tunisia
| | - Samir Kammoun
- Cardiology Department, Hedi Chaker-Sfax University Hospital, Faculty of Medecine of Sfax, University of Sfax, Sfax, Tunisia
| | - Faouzi Addad
- Tunisian Society of Cardiology and Cardiovascular Surgery, Tunis, Tunisia.,Cardiology Department, Abderrahmen Mami-Ariana Hospital, Faculty of Medecine of Tunis, University of Tunis, Ariana, Tunisia
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Abid L, Hammami R, Chamtouri I, Drissa M, Boudiche S, Bahloul M, BenSlima H, Sayahi K, Charfeddine S, Allouche E, Rais L, Kaab B, IbnHadjamor H, BenFatma L, Garbaa R, Boukhris S, Halima MB, Amdouni N, Ghorbel C, Soudani S, Khaled I, Triki S, Bouazizi F, Jemai I, Abdeljalil O, Ammar Y, Farah A, Neji A, Oumayma Z, Seghaier S, Mokrani S, Thawaba H, Sarray H, Ouaghlani K, Thabet H, Mnif Z, Boujelban F, Sghaier M, Khalifa R, Fourati S, Kammoun Y, Abid S, Hamza C, Jeddou SB, Sabbah L, Lakhdhar R, Dammak N, Sellami T, Herbegue B, Koubaa A, Triki F, Ellouz T, Hmoudi A, BenAmeur I, Boukhchina M, Abid N, Wachtati W, Nasrallah N, Houidi Y, Meghaieth F, Ghodhbane E, Chayeb M, Chenik S, Kaabachi S, Saadaoui N, BenAmeur I, Affes M, Ouali S, Chaker M, Naanaa H, Dghim M, Jarrar M, Mnif J, Turki A, Zairi I, Langar J, Dardouri S, Hchaichi I, Chettaoui R, Essmat W, Chakroun A, Mzoughi K, Mechmeche R, BenHalima A, BenKhala S, Chtourou S, Maalej A, Ayari M, Hadrich M, Tlili R, Azaiez F, Bouhlel I, Sahnoun S, Jerbi H, BenMrad I, Riahi L, Sahnoun M, BenJemaa A, BenSalem A, Rekik B, BenDoudou M, Boujneh R, Joulak A, Mejdoub Y, Gtif I, Jribi G, Naffeti E, Gamra H, BenYousef S, Sdiri W, BenHalima N, BenAmeur Y, Kachboura S, Kraiem S, Fehri W, Bazdeh L, Mourali M, Milouchi S, Drissa H, Maatouk F, Zakhama L, Addad F, Kammoun S, Abdesselem S. Epidemiologic features and management of hypertension in Tunisia, the results from the Hypertension National Registry (NaTuRe HTN). BMC Cardiovasc Disord 2022; 22:131. [PMID: 35351007 PMCID: PMC8966189 DOI: 10.1186/s12872-022-02584-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Accepted: 03/10/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Hypertension is the leading cause of morbi-mortality in our country. Thus, we conducted this national survey on hypertension to analyze the profile of the Tunisian hypertensive patient and to assess the level of blood pressure control. METHODS Nature HTN is an observational multicentric survey, including hypertensive individuals and consulting their doctors during the period of the study. Blood pressure measurements were conducted during consultation, using a standardized auscultatory or oscillometric sphygmomanometer after at least 15 min of rest. The diagnosis of new hypertension is based on the 2018 ESC/ESH criteria. The primary endpoint of our study was uncontrolled hypertension defined by a systolic blood pressure ≥ 140 mmHg and/or diastolic blood pressure ≥ 90 mmHg. RESULTS Three hundred twenty-one investigators participated in the study. We enrolled 25,890 patients with a female predominance (Sex ratio, 1.21) and an average age of 64.4 ± 12.2 years. Most individuals were treated in the public sector (74%), 39.4% of patients were diabetic, 25.8% were obese, 44.6% were overweight and 14% were smokers. Hypertension was controlled in 51.7% of cases if we consider 140/90 as a BP target, and only in 18.6% if we consider 130/80 as a target. The independent predictors of uncontrolled blood pressure were male sex (OR = 1.09, 95%CI [1.02-1.16]), age > 65 year-old (OR = 1.07, 95% CI[1.01-1.13], diabetes (OR = 1.18, 95% CI [1.11-1.25], Smoking (OR = 1.15, 95% CI [1.05-1.25]), Obesity (OR = 1.14, 95% CI[1.07-1.21]), management in public sector (OR = 1.25, 95% CI [1.16-1.34]), and Heart rate > 80 bpm (OR = 1.59, 95% CI [1.48-1.71]). Contrarily, high educational level (OR = 0.9, 95% CI [0.84-0.97], absence of history of coronary disease (OR = 0.86, 95% CI [0.8-0.93]), salt restriction (OR = 0.48, 95% CI [0.45-0.51]), drug compliance (OR = 0.57, 95% CI[0.52-0.61]), and regular physical activity (OR = 0.77, 95% CI[0.71-0.84]) are strong predictors of blood pressure control. CONCLUSION NaTuRe HTN showed that blood pressure control was reached in more than half of the Tunisian people. The control remains low in patients with high cardiovascular profiles and in those treated in the public sector. A national health program based on therapeutic education, regular control and continuous support to the public institutions is needed to decrease the burden of hypertension incidence rate.
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Affiliation(s)
- Leila Abid
- Tunisian Society of Cardiology and Cardiovascular Surgery, Tunis, Tunisia.
| | - Rania Hammami
- Cardiology Department, Hedi Chaker-Sfax University Hospital, Sfax, Tunisia
| | - Ikram Chamtouri
- Cardiology Department B, Fattouma Bourguiba University Hospital, Monastir, Tunisia
| | - Meriam Drissa
- Cardiology Department, La Rabta 2 (Pr Drissa) University Hospital, Tunis, Tunisia
| | - Selim Boudiche
- Cardiology Department, La Rabta 1 (Pr Mourali) University Hospital, Tunis, Tunisia
| | | | - Hedi BenSlima
- Cardiology Department, Hospital of Menzel Bourguiba, Bizerte, Tunisia
| | - Khaled Sayahi
- Cardiology Department, ElKef Hospital, Elkef, Tunisia
| | - Selma Charfeddine
- Cardiology Department, Hedi Chaker-Sfax University Hospital, Sfax, Tunisia
| | - Emna Allouche
- Cardiology Department, Charles Nicole University Hospital, Tunis, Tunisia
| | - Lamia Rais
- Nephrology Department, La Rabta University Hospital, Tunis, Tunisia
| | - Badr Kaab
- Nephrology Department, La Rabta University Hospital, Tunis, Tunisia
| | | | - Lilia BenFatma
- Nephrology Department, La Rabta University Hospital, Tunis, Tunisia
| | | | - Sabrine Boukhris
- Cardiology Department, La Rabta 2 (Pr Drissa) University Hospital, Tunis, Tunisia
| | - Manel Ben Halima
- Cardiology Department, La Rabta 1 (Pr Mourali) University Hospital, Tunis, Tunisia
| | - Nesrine Amdouni
- Cardiology Department B, Fattouma Bourguiba University Hospital, Monastir, Tunisia
| | - Chaima Ghorbel
- Cardiology Department, Habib Bourguiba Hospital, Medenine, Tunisia
| | - Sabrine Soudani
- Cardiology Department, La Rabta 2 (Pr Drissa) University Hospital, Tunis, Tunisia
| | | | - Syrine Triki
- Cardiology Department, Hedi Chaker-Sfax University Hospital, Sfax, Tunisia
| | | | - Imen Jemai
- Habib Bourguiba Hospital, Medenine, Tunisia
| | - Ouday Abdeljalil
- Cardiology Department B, Fattouma Bourguiba University Hospital, Monastir, Tunisia
| | | | - Amani Farah
- Cardiology Department B, Fattouma Bourguiba University Hospital, Monastir, Tunisia
| | | | - Zeineb Oumayma
- Cardiology Department, Charles Nicole University Hospital, Tunis, Tunisia
| | | | | | | | - Hela Sarray
- Cardiology Department, Hedi Chaker-Sfax University Hospital, Sfax, Tunisia
| | - Khalil Ouaghlani
- Cardiology Department, Charles Nicole University Hospital, Tunis, Tunisia
| | - Houssem Thabet
- Cardiology Department, Farhat Hached Hospital, Sousse, Tunisia
| | | | | | | | - Roueida Khalifa
- Cardiology Department B, Fattouma Bourguiba University Hospital, Monastir, Tunisia
| | | | - Yasmin Kammoun
- Cardiology Department, Hedi Chaker-Sfax University Hospital, Sfax, Tunisia
| | | | | | - Syrine Ben Jeddou
- Cardiology Department, La Rabta 2 (Pr Drissa) University Hospital, Tunis, Tunisia
| | | | | | - Najla Dammak
- Nephrology Department, Hedi Chaker-Sfax University Hospital, Sfax, Tunisia
| | | | | | | | - Faten Triki
- Cardiology Department, Hedi Chaker-Sfax University Hospital, Sfax, Tunisia
| | - Tarek Ellouz
- Cardiology Department, Hedi Chaker-Sfax University Hospital, Sfax, Tunisia
| | | | | | | | | | - Wejdene Wachtati
- Cardiology Department, Charles Nicole University Hospital, Tunis, Tunisia
| | | | | | - Fathia Meghaieth
- Cardiology Department, La Rabta 1 (Pr Mourali) University Hospital, Tunis, Tunisia
| | | | | | - Sarra Chenik
- Cardiology Department, The Main Military Instruction Hospital of Tunis, Tunis, Tunisia
| | | | | | | | | | - Sana Ouali
- Cardiology Department, La Rabta 1 (Pr Mourali) University Hospital, Tunis, Tunisia
| | - Mouna Chaker
- Cardiology Department, Hedi Chaker-Sfax University Hospital, Sfax, Tunisia
| | | | - Meriem Dghim
- Cardiology Department, The Main Military Instruction Hospital of Tunis, Tunis, Tunisia
| | | | | | - Ahmed Turki
- Cardiology Department, Hedi Chaker-Sfax University Hospital, Sfax, Tunisia
| | - Ihsen Zairi
- Cardiology Department, Habib Thameur Hospital, Tunis, Tunisia
| | | | - Safa Dardouri
- Cardiology Department, Farhat Hached Hospital, Sousse, Tunisia
| | | | | | | | | | - Khadija Mzoughi
- Cardiology Department, Habib Thameur Hospital, Tunis, Tunisia
| | | | - Afef BenHalima
- Cardiology Department, Abderrahmen Mami-Ariana Hospital, Ariana, Tunisia
| | | | | | | | | | | | - Rami Tlili
- Cardiology Department, Mongi Slim Hospital, Tunis, Tunisia
| | - Fares Azaiez
- Cardiology Department, Mongi Slim Hospital, Tunis, Tunisia
| | - Imen Bouhlel
- Cardiology Department, Farhat Hached Hospital, Sousse, Tunisia
| | | | | | | | - Leila Riahi
- Cardiology Department, The Main Military Instruction Hospital of Tunis, Tunis, Tunisia
| | | | | | - Amel BenSalem
- Cardiology Department, Charles Nicole University Hospital, Tunis, Tunisia
| | - Bassem Rekik
- Cardiology Department, Charles Nicole University Hospital, Tunis, Tunisia
| | | | | | | | - Yosra Mejdoub
- Community Medicine Department, Hedi Chaker-Sfax University Hospital, Sfax, Tunisia
| | - Imen Gtif
- Laboratory of Screening Cellular and Molecular Process, Centre of Biotechnology of Sfax, Sfax, Tunisia
| | - Gouider Jribi
- Cardiology Department, Farhat Hached Hospital, Sousse, Tunisia
| | - Elyes Naffeti
- Cardiology Department, University Hospital Sahloul, Sousse, Tunisia
| | - Habib Gamra
- Cardiology Department A, Fatouma Bourguiba Hospital, Monastir, Tunisia
| | - Soraya BenYousef
- Cardiology Department, Internal Security Forces Hospital, Tunis, Tunisia
| | - Wissem Sdiri
- Cardiology Department, Bougatfa Hospital, Bizerte, Tunisia
| | - Najeh BenHalima
- Cardiology Department, Ibn El Jazzar Hospital, Kairouan, Tunisia
| | | | - Salem Kachboura
- Cardiology Department, Abderrahmen Mami-Ariana Hospital, Ariana, Tunisia
| | - Sondes Kraiem
- Cardiology Department, Habib Thameur Hospital, Tunis, Tunisia
| | - Wafa Fehri
- Cardiology Department, The Main Military Instruction Hospital of Tunis, Tunis, Tunisia
| | - Leila Bazdeh
- Cardiology Department, Charles Nicole University Hospital, Tunis, Tunisia
| | - MohamedSami Mourali
- Cardiology Department, La Rabta 1 (Pr Mourali) University Hospital, Tunis, Tunisia
| | - Sami Milouchi
- Cardiology Department, Habib Bourguiba Hospital, Medenine, Tunisia
| | - Habiba Drissa
- Cardiology Department, La Rabta 2 (Pr Drissa) University Hospital, Tunis, Tunisia
| | - Faouzi Maatouk
- Cardiology Department B, Fattouma Bourguiba University Hospital, Monastir, Tunisia
| | - Lilia Zakhama
- Cardiology Department, Internal Security Forces Hospital, Tunis, Tunisia
| | - Faouzi Addad
- Cardiology Department, Abderrahmen Mami-Ariana Hospital, Ariana, Tunisia
| | - Samir Kammoun
- Cardiology Department, Hedi Chaker-Sfax University Hospital, Sfax, Tunisia
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Ouali S, Ben Halima A, Chabrak S, Chettaoui R, Ben Halima M, Haggui A, Krichane S, Noureddine L, Marrakchi S, Charfeddine S, Hassine M, Sayahi K, Abbes Mohamed F, Nasraoui W, Ajmi H, Ben Miled M, Jebbari Z, Meghaieth MA, Allouche E, Mechmeche R, Zakhama L, Sdiri W, Ben Khalfallah A, Gharbi A, Milouchi S, Neji A, Antit S, Battikh K, Drissa M, Kaabachi S, Najar T, Tlili R, Chahbani I, Charfeddine H, Ben MM, Braham S, Maatouk F, Abdesselem S, Ayari M, Garbaa R, Hamrouni N, Mbarek D, Rekik H, Zaghdoudi H, Ayadi W, Baraket F, Ben Brahim K, Ben Romdhane M, Bousadia H, Brahim W, Mezri M, Guesmi A, Ounissi T, Kammoun S, Smati W, Tlili S, Zoughi K, Zemni J, Cheikh Bouhlel M, Islem S, Jemli R, Joulak A, Mzoughi K, Naanea H, Hached L, Hadrich M, Hmem M, Kacem S, Kammoun I, Othmani R, Ouerghi A, Abid S, Ennouri R, Haidar S, Heraiech S, Jammali M, Jarrar M, Riahi L, Trimech B, Azaiez MA, Azzouzi F, Ben Jemaa K, Ben Rejab O, Chrigui R, Wechtati W, Boughzela E, Jridi G, Bezdah L, Kraiem S, Drissa H, Ben Youssef S, Fehri W, Kachboura S, Gamra H, Kammoun S, Mourali MS, Addad F, Abid L. Epidemiological characteristics, management, and outcomes of atrial fibrillation in TUNISIA: Results from the National Tunisian Registry of Atrial Fibrillation (NATURE-AF). Clin Cardiol 2021; 44:501-510. [PMID: 33704830 PMCID: PMC8027580 DOI: 10.1002/clc.23558] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 01/18/2021] [Accepted: 01/27/2021] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Contemporary registries on atrial fibrillation (AF) are scare in North African countries. HYPOTHESIS In the context of the epidemiological transition, prevalence of valvular AF in Tunisia has decreased and the quality of management is still suboptimal. METHODS NATURE-AF is a prospective Tunisian registry, involving consecutive patients with AF from March 1, 2017 to May 31, 2017, with a one-year follow-up period. All the patients with an Electrocardiogram-documented AF, confirmed in the year prior to enrolment were eligible. The epidemiological characteristics and outcomes were described. RESULTS A total of 915 patients were included in this study, with a mean age of 64.3 ± 22 years and a male/female sex ratio of 0.93. Valvular AF was identified in 22.4% of the patients. The mean CHA2 DS2 VASC score in nonvalvular AF was 2.4 ± 1.6. Monotherapy with antiplatelet agents was prescribed for 13.8% of the patients. However, 21.7% of the subjects did not receive any antithrombotic agent. Oral anticoagulants were prescribed for half of the patients with a low embolic risk score. In 341 patients, the mean time in therapeutic range was 48.87 ± 28.69%. Amiodarone was the most common antiarrhythmic agent used (52.6%). During a 12-month follow-up period, 15 patients (1.64%) had thromboembolism, 53 patients (5.8%) had major hemorrhage, and 52 patients (5.7%) died. CONCLUSIONS NATURE-AF has provided systematic collection of contemporary data regarding the epidemiological and clinical characteristics as well as the management of AF by cardiologists in Tunisia. Valvular AF is still prevalent and the quality of anticoagulation was suboptimal.
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Affiliation(s)
| | - Afef Ben Halima
- Abderrahman Mami Pneumology and Phthisiology Hospital, Ariana, Tunisia
| | | | | | | | | | | | | | - Sonia Marrakchi
- Abderrahman Mami Pneumology and Phthisiology Hospital, Ariana, Tunisia
| | | | - Majed Hassine
- Fattouma Bourguiba University Hospital, Monastir, Tunisia
| | | | | | | | | | | | | | | | | | | | - Lilia Zakhama
- La Marsa Internal Security Forces Hospital, La Marsa, Tunisia
| | | | | | | | | | - Ali Neji
- Ben Guerdane Hospital, Medenine, Tunisia
| | - Saoussen Antit
- La Marsa Internal Security Forces Hospital, La Marsa, Tunisia
| | | | | | | | | | - Rami Tlili
- University Hospital Center Mongi Slim, La Marsa, Tunisia
| | | | | | | | | | - Faouzi Maatouk
- Fattouma Bourguiba University Hospital, Monastir, Tunisia
| | | | | | | | | | - Dorra Mbarek
- University Hospital Center Mongi Slim, La Marsa, Tunisia
| | | | | | | | | | | | | | | | | | | | - Ali Guesmi
- Mohamed Ben Sassi Hospital, Gabes, Tunisia
| | - Taha Ounissi
- Mohamed Taher Al Maamouri Hospital, Nabeul, Tunisia
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Ikram Kammoun
- Abderrahman Mami Pneumology and Phthisiology Hospital, Ariana, Tunisia
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Wafa Fehri
- Hôpital Militaire Principal d'instruction de Tunis, Tunis, Tunisia
| | - Salem Kachboura
- Abderrahman Mami Pneumology and Phthisiology Hospital, Ariana, Tunisia
| | - Habib Gamra
- Fattouma Bourguiba University Hospital, Monastir, Tunisia
| | | | | | - Faouzi Addad
- Abderrahman Mami Pneumology and Phthisiology Hospital, Ariana, Tunisia
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Ben Halima A, Ouali S, Chabrak S, Chettaoui R, Allouche E, Marrakchi S, Ben Halima M, Hassine M, Charfeddine S, Haggui A, Milouchi S, Kacem S, Krichen S, Sayahi K, Ben Miled M, Zakhama L, Addad F, Abid L. National Tunisian Registry of Atrial Fibrillation (NATURE-AF): Baseline results. Archives of Cardiovascular Diseases Supplements 2020. [DOI: 10.1016/j.acvdsp.2019.09.264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Ben Halima A, Ouali S, Mourali MS, Chabrak S, Chettaoui R, Ben Halima M, Haggui A, Larbi N, Krichène S, Marrakchi S, Kacem S, Chrigui R, Abbes MF, Baccar H, Baraket N, Ben Halima N, Ben Khalfallah A, Ben Mbarek M, Ben Youssef S, Boughzala E, Boujnah MR, Drissa H, Gamra H, Gasmi A, Haouala H, Harrath Y, Issa I, Jeridi G, Kachboura S, Kammoun S, Kraiem S, Maatouk F, Milouchi S, Nasraoui W, Neji A, Sayahi K, Sdiri W, Smati W, Tlili S, Abid L, Abdesselem S, Zakhama L, Mahdhaoui A, Kammoun H, Ben Omrane S, Addad F. Design and Rationale of the National Tunisian Registry of Atrial Fibrillation: Protocol for a Prospective, Multicenter Trial. JMIR Res Protoc 2018; 7:e181. [PMID: 30322836 PMCID: PMC6231898 DOI: 10.2196/resprot.8523] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2017] [Accepted: 11/17/2017] [Indexed: 12/18/2022] Open
Abstract
Background Atrial fibrillation (AF) is an important health problem in Tunisia. A significant change in the epidemiological pattern of heart disease has been seen in the last 3 decades; however, no large prospective multicenter trial reflecting national data has been published so far. Robust data on the contemporary epidemiological profile and management of AF patients in Tunisia are limited. Objective The aim of this study is to analyze, follow, and evaluate patients with AF in a large multicenter nationwide trial. Methods A total of 1800 consecutive patients with AF by electrocardiogram, reflecting all populations of all geographical regions of Tunisia, will be included in the study, with the objective of describing the epidemiological pattern of AF. Patients will be officially enrolled in the National Tunisian Registry of Atrial Fibrillation (NATURE-AF) only if an electrocardiogram diagnosis (12-lead, 24-hour Holter, or other electrocardiographic documentation) confirming AF is made. The qualifying episode of AF should have occurred within the last year, and patients do not need to be in AF at the time of enrollment. Patients will be followed for 1 year. Incidence of stroke or transient ischemic attack, thromboembolic events, and cardiovascular death will be recorded as the primary end point, and hemorrhagic accidents, measurement of international normalized ratio, and time in therapeutic range will be recorded as secondary end points. Results Results will be available at the end of the study; the demographic profile and general risk profile of Tunisian AF patients, frequency of anticoagulation, frequency of effective treatment, and risks of thromboembolism and bleeding will be evaluated according to the current guidelines. Major adverse events will be determined. NATURE-AF will be the largest registry for North African AF patients. Conclusions This study would add data and provide a valuable opportunity for real-world clinical epidemiology in North African AF patients with insights into the uptake of contemporary AF management in this developing region. Trial Registration ClinicalTrials.gov NCT03085576; https://clinicaltrials.gov/ct2/show/NCT03085576 (Archived by WebCite at http://www.webcitation.org/6zN2DN2QX) Registered Report Identifier RR1-10.2196/8523
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Affiliation(s)
- Afef Ben Halima
- Tunisian Society of Cardiology and Cardiac Surgery, Tunis, Tunisia.,La Rabta Hospital, Tunis, Tunisia
| | - Sana Ouali
- Tunisian Society of Cardiology and Cardiac Surgery, Tunis, Tunisia.,La Rabta Hospital, Tunis, Tunisia
| | - Mohamed Sami Mourali
- Tunisian Society of Cardiology and Cardiac Surgery, Tunis, Tunisia.,La Rabta Hospital, Tunis, Tunisia
| | - Sonia Chabrak
- National Tunisian Registry of Atrial Fibrillation Steering Committee, Tunisian Society of Cardiology and Cardiac Surgery, Tunis, Tunisia
| | - Rafik Chettaoui
- National Tunisian Registry of Atrial Fibrillation Steering Committee, Tunisian Society of Cardiology and Cardiac Surgery, Tunis, Tunisia
| | - Manel Ben Halima
- La Rabta Hospital, Tunis, Tunisia.,National Tunisian Registry of Atrial Fibrillation Steering Committee, Tunisian Society of Cardiology and Cardiac Surgery, Tunis, Tunisia
| | - Abdeddayem Haggui
- National Tunisian Registry of Atrial Fibrillation Steering Committee, Tunisian Society of Cardiology and Cardiac Surgery, Tunis, Tunisia.,Principal Military Hospital, Tunis, Tunisia
| | - Noureddine Larbi
- La Rabta Hospital, Tunis, Tunisia.,National Tunisian Registry of Atrial Fibrillation Steering Committee, Tunisian Society of Cardiology and Cardiac Surgery, Tunis, Tunisia
| | - Salma Krichène
- National Tunisian Registry of Atrial Fibrillation Steering Committee, Tunisian Society of Cardiology and Cardiac Surgery, Tunis, Tunisia
| | - Sonia Marrakchi
- National Tunisian Registry of Atrial Fibrillation Steering Committee, Tunisian Society of Cardiology and Cardiac Surgery, Tunis, Tunisia.,Abderrahman Mami Hospital, Ariana, Tunisia
| | - Slim Kacem
- National Tunisian Registry of Atrial Fibrillation Steering Committee, Tunisian Society of Cardiology and Cardiac Surgery, Tunis, Tunisia
| | - Rim Chrigui
- National Tunisian Registry of Atrial Fibrillation Steering Committee, Tunisian Society of Cardiology and Cardiac Surgery, Tunis, Tunisia
| | | | | | | | | | | | | | | | | | | | | | - Habib Gamra
- Fattouma Bourguiba Hospital, Monastir, Tunisia
| | - Ali Gasmi
- Mohamed Ben Sassi Hospital, Gabes, Tunisia
| | | | | | | | | | | | | | | | | | | | | | - Ali Neji
- Ben Guerdane Hospital, Ben Guerdane, Tunisia
| | | | | | | | | | - Leila Abid
- Tunisian Society of Cardiology and Cardiac Surgery, Tunis, Tunisia.,Hédi Chaker Hospital, Sfax, Tunisia
| | - Salem Abdesselem
- Tunisian Society of Cardiology and Cardiac Surgery, Tunis, Tunisia
| | - Lilia Zakhama
- Tunisian Society of Cardiology and Cardiac Surgery, Tunis, Tunisia.,Hospital of the Internal Security Forces, La Marsa, Tunisia
| | - Abdallah Mahdhaoui
- Tunisian Society of Cardiology and Cardiac Surgery, Tunis, Tunisia.,Farhat Hached Hospital, Sousse, Tunisia
| | - Helmi Kammoun
- Tunisian Society of Cardiology and Cardiac Surgery, Tunis, Tunisia.,National Tunisian Registry of Atrial Fibrillation Steering Committee, Tunisian Society of Cardiology and Cardiac Surgery, Tunis, Tunisia
| | - Skander Ben Omrane
- Tunisian Society of Cardiology and Cardiac Surgery, Tunis, Tunisia.,La Rabta Hospital, Tunis, Tunisia
| | - Faouzi Addad
- Tunisian Society of Cardiology and Cardiac Surgery, Tunis, Tunisia.,Abderrahman Mami Hospital, Ariana, Tunisia
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Ben Ameur Y, Rajhi M, Naccache S, Guerram H, Chettaoui R, Tlili R, Boujnah MR. [Cardiomyopathy induced by an aortic cusp ventricular tachycardia: Case report]. Presse Med 2016; 46:130-134. [PMID: 27856125 DOI: 10.1016/j.lpm.2016.06.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Accepted: 06/06/2016] [Indexed: 10/20/2022] Open
Affiliation(s)
- Youssef Ben Ameur
- Faculté de médecine de Tunis, hôpital Mongi-Slim, service de cardiologie, 2046, Sidi Daoud, La Marsa, Tunisie
| | - Monoom Rajhi
- Faculté de médecine de Tunis, hôpital Mongi-Slim, service de cardiologie, 2046, Sidi Daoud, La Marsa, Tunisie.
| | - Soufia Naccache
- Faculté de médecine de Tunis, hôpital Mongi-Slim, service de cardiologie, 2046, Sidi Daoud, La Marsa, Tunisie
| | - Hela Guerram
- Faculté de médecine de Tunis, hôpital Mongi-Slim, service de cardiologie, 2046, Sidi Daoud, La Marsa, Tunisie
| | - Rafik Chettaoui
- Faculté de médecine de Tunis, cliniques les Berges du Lac, rue du Lac de Constance, Tunis, Tunisie
| | - Rami Tlili
- Faculté de médecine de Tunis, hôpital Mongi-Slim, service de cardiologie, 2046, Sidi Daoud, La Marsa, Tunisie
| | - Mohammed Rachid Boujnah
- Faculté de médecine de Tunis, hôpital Mongi-Slim, service de cardiologie, 2046, Sidi Daoud, La Marsa, Tunisie
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Addad F, Gouider J, Boughzela E, Kamoun S, Boujenah R, Haouala H, Gamra H, Maatouk F, Ben Khalfallah A, Kachboura S, Baccar H, Ben Halima N, Guesmi A, Sayahi K, Sdiri W, Neji A, Bouakez A, Battikh K, Chettaoui R, Mourali S. [Management of patients treated for acute ST-elevation myocardial infarction in Tunisia: Preliminary results of FAST-MI Tunisia Registry from Tunisian Society of Cardiology and Cardiovascular Surgery]. Ann Cardiol Angeiol (Paris) 2015; 64:439-45. [PMID: 26547525 DOI: 10.1016/j.ancard.2015.09.064] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
UNLABELLED FAST-MI Tunisian registry was initiated by the Tunisian Society of Cardiology and Cardio-vascular Surgery to assess characteristics, management, and hospital outcomes in patients with ST-elevation myocardial infarction (STEMI). METHODS We prospectively collected data from 203 consecutive patients (mean age 60.3 years, 79.8 % male) with STEMI who were treated in 15 public hospitals (representing 68.2 % of Tunisian public centres treating STEMI patients) during a 3-month period at the end of 2014. The most common risk factor was tobacco (64.9 %), hypertension (38.6 %), diabetes (36.9 %) and dyslipidemia (24.6 %). RESULTS Among these patients, 66 % received reperfusion therapy, 35 % with primary percutaneous coronary interventions (PAMI), 31 % with thrombolysis (28.6 % of them by pre-hospital thrombolysis). The median time from symptom onset to thrombolysis was 185 and 358 min for PAMI, respectively. The in-hospital mortality was 7.0 %. Patients enrolled in interventional centers (n=156) were more likely to receive any reperfusion therapy (19.8 % vs 44.6 %; p<0.001) than at the regional system of care with less thrombolysis (26.9 % vs 44.6 %; p=0.008) and more PAMI (52.8 % vs 8.5 %; p<0.0001). Also the in-hospital mortality was lower (6.4 % vs 9.3 %) but not significant. CONCLUSIONS Preliminary results from FAST-MI in Tunisia show that the pharmaco- invasive strategy should be promoted in non-interventional centers.
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Affiliation(s)
- F Addad
- Service de cardiologie, CHU Abderrahmen Mami, Ariana, Tunisie.
| | | | | | | | | | - H Haouala
- Hôpital Militaire Principal d'Instruction de Tunis, Tunis, Tunisie
| | - H Gamra
- Cardio A CHU Fattouma Bourguiba, Monastir, Tunisie
| | - F Maatouk
- Cardio B CHU Fattouma Bourguiba, Monastir, Tunisie
| | | | - S Kachboura
- Service de cardiologie, CHU Abderrahmen Mami, Ariana, Tunisie
| | - H Baccar
- Hôpital Chrales Nicolles, Tunis, Tunisie
| | - N Ben Halima
- Hôpital régional Ibn El Jazzar, Kairouan, Tunisie
| | - A Guesmi
- Hôpital régional Mohamed Ben Sassi, Gabes, Tunisie
| | - K Sayahi
- Hôpital régional M'Hamed Bourguiba, Kef, Tunisie
| | - W Sdiri
- Hôpital régional Habib Bougatfa, Bizerte, Tunisie
| | - A Neji
- Hôpital régional Ben Guerdene, Médenine, Tunisie
| | - A Bouakez
- Hôpital régional Jendouba, Jendouba, Tunisie
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Abstract
Countries in Africa and the Middle East bear a heavy burden from cardiovascular disease. The prevalence of coronary heart disease is promoted in turn by a high prevalence of cardiovascular risk factors, particularly smoking, hypertension, dyslipidemia, diabetes, and sedentary lifestyles. Patients in Africa and the Middle East present with myocardial infarction at a younger age, on average, compared with patients elsewhere. The projected future burden of mortality from coronary heart disease in Africa and the Middle East is set to outstrip that observed in other geographical regions. Recent detailed nationally representative epidemiological data are lacking for many countries, and high proportions of transient expatriate workers in countries such as Saudi Arabia and the United Arab Emirates complicate the construction of such datasets. However, the development of national registries in some countries is beginning to reveal the nature of coronary heart disease. Improving lifestyles (reducing calorie intake and increasing physical activity) in patients in the region will be essential, although cultural and environmental barriers will render this difficult. Appropriate prescribing of pharmacologic treatments is essential in the prevention and management of cardiovascular disease. In particular, recent controversies relating to the therapeutic profile of beta-blockers may have reduced their use. The current evidence base suggests that beta-blockers are as effective as other therapies in preventing cardiovascular disease and that concerns relating to their use in hypertension and cardiovascular disease have been overstated.
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Affiliation(s)
- Wael Almahmeed
- Heart and Vascular Institute, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates
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Chettaoui R, Kouakam C, Klug D, Marquie C, Lacroix D, Kacet S. [Contribution of the implantable ECG monitor in the etiologic diagnosis of syncope and unexplained recurrent syncopal attacks. Initial experience with 32 patients]. Arch Mal Coeur Vaiss 2002; 95:29-36. [PMID: 11901885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
UNLABELLED Following an exhaustive aetiological investigation, 10 to 26% of syncopal attacks remain unexplained. In these cases the correlation between symptoms and rhythm is a deciding step for the aetiological diagnosis. We report our initial experience using an implantable electrocardiographic monitor, a new diagnostic tool in patients suffering from syncope and recurrent unexplained syncopal attacks. RESULTS The study included 32 patients (average age 55 +/- 22 years; 23 males) suffering from syncope and/or recurrent syncopal attacks remaining unexplained following an exhaustive aetiological investigation. The average follow up was 10.2 +/- 2.5 months. No case of sudden death was registered, and the device was removed in only one patient due to poor tolerance. During follow up, 21 recordings were memorized and analysed in 15 patients (45%), giving an average of 1.4 recordings per patient. The average interval for recurrence of symptoms after implantation was from 84 +/- 104 days, 75% of the episodes coming in the first 2 months following implantation. An arrhythmia was detected on 10 occasions: a malignant ventricular arrhythmia in 2 patients, a non-sustained ventricular tachycardia in 1 patient, a junctional tachycardia in 1 patient, entry into paroxysmal atrial fibrillation in 4 patients, a sinus bradycardia in 1 patient, and a sinus pause for 19 seconds in 1 patient. In one patient ST segment depression was documented following anterior chest pain. The tracing was normal with sinus rhythm recorded on 10 occasions, representing the only documented information in 4 patients. In total, an aetiology was found in 11 of the 32 patients evaluated (34%). Once the aetiological diagnosis was established and a specific treatment initiated, all the patients became asymptomatic. CONCLUSIONS Our preliminary results underline the significance of the implantable ECG monitor in the diagnostic approach to recurrent unexplained syncopal attacks. The exact place of this tool in the decisional algorithm for syncope remains to be defined with further studies.
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Affiliation(s)
- R Chettaoui
- Service de cardiologie A, hôpital cardiologique, CHRU de Lille, boulevard du Pr J. Leclercq, 59037 Lille
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Ben Ameur Y, Essafi N, Chettaoui R, Terras M, Fennira S, Kraiem S, Slimane ML. [Endocavitary implantation of a permanent pacemaker in the contralateral side of right pneumonectomy: a case report]. Ann Cardiol Angeiol (Paris) 2001; 50:151-4. [PMID: 12555506 DOI: 10.1016/s0003-3928(01)00015-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The definitive endocardial stimulation is easy to install, allows a stable position of the leads, and a satisfactory stimulation thresholds for a long period. The epicardial approach is reserved for some rare indications including infectious contexts. The endocardial approach has been considered for a 67 years man with a complete AV block and an atrial fibrillation. This patient had undergone a right pneumonectomy 15 years before. A VVIR pacemaker has been implanted successfully by an internal jugular vein approach, and connected to a passively fixed unipolar lead. Because of the right ventricle deformation which made it unrecognizable, even by angiography means, we had to face major difficulties to position the lead. The epicardial approach should be considered even if a direct unique lung controlateral approach is easier than homolateral, because it allows us a quick ventricular access under the view control.
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Affiliation(s)
- Y Ben Ameur
- Service de cardiologie, hôpital Habib Thameur, Montfleury, CP 1008, Tunisie
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