11 - 14 JUNE 2013

Tuesday, 11 June 2013

Flame of Science... CardioAlexNEWSLETTER

Bibliotheca AlexandrinaAlexandria - Egypt

CardioAlex

www.cardio-alex.com

Dear Guests,It is with great pleasure that we welcome you to participate in CardioAlex 2013; this conference is organized by the Egyptian society of Cardiology & the Cardi-ology department – Alexandria University. We are delighted to announce that it is taking place in Alexandria, Bibliotheca Alexand-rina, from 11th to 14th June 2013. CardioAlex is undoubtedly the most comprehensive event and the meeting point of cardiolo-gists, not only from Egypt, but

from Middle East area and North Africa region. The 2013 edition is certainly one not to miss as, for the first time ever, CardioAlex 2013 will be held alongside 13 international bodies, so we encourage you to be part of this unique learning and networking experience. The aim of the confer-ence is to arm you with the latest practice-changing advice in cardiovascular field, bringing you up-to-date with all the develop-ments in primary and secondary care. The Scientific Program

includes an exciting mix of joint state of the Art lectures, personal practice sessions, International Live cases, courses, workshops, symposia and tech-Nurse sessions. Prestigious speakers from all over the world will show case their expertise and offer updates on key clinical issues and the latest cardiovascular science. Our intention is to create an opportunity for all delegates to actively participate in the confer-ence in a variety of ways. There

fore, we will be happy to evaluate your abstracts and cases and offer you a chance to present your work. Taking this opportu-nity we proudly announce Cardio-Alex 2013 Prize in imaging science “ Magdy Rashwan Prize”, this great man who shared during the last years our success and empowered us by his inspired vision . We are welcoming you in our beautiful Alexandria & we wish you an informative and enjoyable week.

CardioAlex Chairman

Prof. Mohamed Sobhy

Head of Cardiology Department,

Alexandria University

Prof. Moustafa Nawar

Professor of Cardiology

Alexandria University

CardioAlex - Executive board

Prof. Mahmoud Hassanein

Professor of Cardiology

Alexandria University

Prof. Tarek El Zawawy

Professor of Cardiology

Alexandria University

President of EgySC

Prof. Sherif El Tobgi

Professor of Cardiology,

Cairo University

رية

كندكلية طب االس

ALEXANDRIA FACULTY OF MEDICIN

E

“Magdi Rashwan”will remain in our hearts foreverWe would like to express our sincere condolences for the unexpected death of our colleague Prof. Magdy Rashwan. On behalf of the entire depart-ment; please accept our sympa-thy; we can imagine what a difficult loss this will be for the entire medical field and for his

family as he was a valuable asset to the medical field.

With loving memories of “Magdi Rashwan”

For whom who didn’t meet Prof. Magdy Rashwan, except for few occasions; they didn’t have the chance to know his kindness and his great prospect of life. We must be proud that God had blessed us with such amazing

personality, the words are not enough to heel this great loss but we need to keep patience.All the members of CardioAlex board send their sincere sympa-thy to his family. We will greatly Miss Prof. Magdy Rashwan. It is a national tragedy that this amazing Doctor has been lost. God bless his Soul.

2

CardioAlexNEWS

Tuesday, 11 JUNE 2013

www.cardio-alex.com

* What is new at ACC.13: heart failure and hypertension* New ESC guidelines on Valvular Heart Disease* Added value of echocardiography in acute coronary syndromes* ESC Guideline Sessions* Heart Failure* Acute Coronary Syndrome* Silent Atrial Fibrillation: Implication for medical, ablative and surgical management* Renal denervation step by step, tips and tricks* LAA closure* Acute stroke interventions for cardiologists?* Update in antithrombotic therapy in ACS* FFR and IVUS .. step by step, tips and tricks* TEVAR in acute type-b aortic dissection; Prerequisites for program success* Great cases in nuclear cardiology* Risk stratification with nuclear cardiology: making the cath no cath decision* Practical implementation of the ESC heart failure Guidelines.* The latest ESC Hypertension Guidelines update. What is new?* How to optimize heart failure drug therapy. A tricky task.* The renal denervation therapy using the second generation cathters.* Bioabsorbable scaffold update where to go ?* WHERE ARE WE IN ECHO IN THE CARDIAC IMAGING ERA 2013 ?* Sudden Cardiac Death 2013: Scientific, Social, and Economic Issues* "25 by 25" - the new global agenda for prevention of cardiovascular disease.* Diabetes mellitus and prevention of cardiovascular disease: new treatment targets.* Current pharmaco-mechanic approach to STEMI patients* Stent For Life Initiative* STEMI/ACS transfer strategies 2013* How to diagnose and treat peripheral arterial disease (PAD) for cardiologists* Endovascular treatment of arterial occlusive disease* Diagnosis and treatment of chronic venous insufficiency by cardiologists* Current limitations of Primary PCI in STEMI* Innovative protocols and technology to reduce radiation in nuclearcardiology and cardiovascular CT

Hot topics from the top

InterventionInternational Session

Memorial Symposium

Live Transmission

Electrophysiology

Endovascular

Special TopicsState of the Art

Hypertension Valvular

ImagingNuclear Imaging

Basic Science

Echocardiography

Clinical Seminar

Research & Present

Clinical CasesPediatric

Small Theatre Delegate HallLecture HallIntervention 1 10:00 - 11:00ACC @ CardioAlex 1 11:00 - 12:00Rashwan Memorial Symposium 12:00 - 12:30French Session 01:30 - 02:30TCT Live @ CardioAlex 1 04:30 - 05:30Tips & Tricks 2 05:30 - 06:30

Electrophysiology 1 10:00 - 11:00Why did it Complicate ? 1 11:00 - 12:00Endovascular 1 01:30 - 02:30Japanese JCC 02:30 - 03:30Special Topics 1 04:30 - 05:45TAVI 1 05:45 - 07:00

State of the Art 1 10:00 - 11:30Hypertension 1 11:30 - 12:30Tips & Tricks 1 01:30 - 02:30Valvular 2 02:30 - 03:30Electrophysiology 2 04:30 - 06:00Special Topics 2 06:00 - 07:15

Auditorium HallMulti Purpose Hall Hall AImaging 1 10:00 - 11:00Nuclear Imaging 1 11:00 - 12:00

Valvular 1 01:30 - 02:30Basic Science 1 02:30 - 03:30Echocardiography 1 04:30 - 06:00Clinical Seminar 06:00 - 07:00

Research & Present @ CardioAlex 1 10:00 - 11:00Research & Present @ CardioAlex 2 11:00 - 12:00

Clinical Cases 1 12:00 - 12:30Research & Present @ CardioAlex 4Research & Present @ CardioAlex 3

Research & Present @ CardioAlex 5Research & Present @ CardioAlex 6Research & Present @ CardioAlex 7

01:30 - 02:3002:30 - 03:3004:30 - 05:3005:30 - 06:30

Workshop Neonatal ICU 10:00 - 11:15Workshop Neonatal ICU 2 11:15 - 12:30Pediatric Lecture 1Pediatric Lecture 2Symposium 1 General Cardiology

Symposium 3 Aswan Heart CenterSymposium 2 MRI & MSCT

01:30 - 02:0002:00 - 02:3002:30 - 03:3004:30 - 05:4505:45 - 07:00

12:00 - 12:30

Tuesday 11 June 2013

CardioAlex 2013

3www.cardio-alex.com

Mark G. DaviesMartin GilardMohamed AlamiMohamed KurdiMohamed ShenasaMostafa YoussefImad AlHadadMouaz Al-Mallah Olaf FranzenOmar GalalOmer GoktekinOscar MendizPanos E. Vardas Petr KalaSamih LawandShakeel QureshiShunichi MIYAZAKITarek el Maghraby Tarek HelmyThomas UngerWael ChalakZiyad Ghazal

Abbas ShehadehAbdel Hadi El KadikiAbdullah ShehabAhmed KhattabAlessandro Salustri Alfred A. Bove Ali El NeihoumAli OtoAntoine La font Bernard ChevalierChristian SpauldingChuwa TEIDavid CapodonnaDavid WoodDimitrios AlexopoulosDipti ItchhaporiaFadi BitarFausto PintoGassan KiwanGeorge SaadeGregory ThomasHabib Gamra

USALibyaUAE

SwitherlandUkranie

USALibya

TurkeyFranceFranceFranceJapan

UKUK

CyprusUSA

LebanonPortugalLebanonLebanon

USATunisia

USAFrance

MorroccoKSAUSAKSA

JordanKSA

DenmarkKSA

TurkeyArgentina

GreeceCzech Republic

KSAUK

JapanKSAUSA

NetherlandsLebanonLebanon

International Guests

JordanMorocco

KSA

UKGermany

Netherlands

Hadi M. Abu HantashHalima BENJELLOUNHani Najm

Hany EteibaHorst SievertJose PS Henriques

SpainLebanon

Tunisia

KSAUSA

UK

Josepa MauriJoseph EliasKais Battikh

Khalid Al NemerKhusrow Niazi Magdi Saba

Mohammad ShenasaMD PHD, FACC, FESC, FAHA, FHRS, O’Conner Hospital San Jose, CACompetitive athletes are among the healthiest and most fit groups in society therefor sudden cardiac death is a very tragic event to the community including family, friends, teams, physicians, coaches, social media influence as well as legal issues that are involved etc. The overall incidence of sudden cardiac death in athletes is low and is estimated at 0.3-3/100,000 per year. The ratio of sudden cardiac death between men and women is 10 to 1 and it is more common among basketball players in the United States and soccer players in Europe. Sudden cardiac death in most athletes is probably due to undiagnosed structural or electrical (and often congenital or genetic abnormalities). The pie graph below shows the incidence and causes of sudden cardiac death in athletes. Since individu-als who participate in competitive

Athletic Heart and Sport Participation Work upsports have a 2.5 fold increase in risk of sudden death, everyone agrees that athletes need screen-ing. The question that remains is how. One debate is whether including electrocardiogram in the screening process is useful and cost effective or not. It is very important to be able to differenti-ate between physiological adapta-tions and pathological condi-tions. The physiological effects of endurance exercise include struc-tural changes such as chamber enlargement and ventricular hypertrophy and electrical changes such as increased QRS voltage, abnormal Q waves and T-wave inversions. Currently these changes are regarded as benign. On the other hand long-term endurance exercise can trigger acute events in the presence of structural or electri-cal abnormalities or cause remod-eling of the cardiovascular system, over time.Hypertrophic cardiomyopathy is the most common cause of sudden cardiac death in North America and arrhythmogenic right ventricular dysplasia is the most common cause in Europe and the Mediterranean. The Italian model of mandating prepar-ticipation ECG screening as part

of the workup over 25 years demonstrated a decrease in the incidence of sudden death whereas in the United States the model showed that adding ECGs did not make a difference and was not cost effective. A recent Danish study concurred with the US findings. Both the AHA and the ESC consensus panel recom-mendations agree that cardiovas-cular screening for young competitive athletes is justifiable and compelling on ethical, legal

and medical grounds. Screening that relies solely on a history and physical examination has limited sensitivity to identify athletes at risk because most individuals with undetected cardiovascular diseases are asymptomatic and cardiac arrest most often repre-sents the first manifestation of disease in athletes with SCD. Figure 1 demonstrates the five common causes of sudden cardiac death in athletes. After all safety is the number one issue.

Crestor 20 AD.indd 1 2/10/2013 12:39:48 PM4

CardioAlexNEWS

Tuesday, 11 JUNE 2013

www.cardio-alex.com

CardioAlex 2013

5www.cardio-alex.com

Mohammed Omar GalalM.D., PhD, MBAPrince Salman Heart Center, Riyadh, Saudi ArabiaBackgroundPatients with valvar pulmonary stenosis have increased density and responsiveness of alpha 2 adrenoceptors on the circulating cells [1]. After balloon dilation there is an immediate drop in these values to normal levels. It was speculated that alpha2 adrenoceptors on the circulating cells represent distribution of these receptors on cardiac, systemic and pulmonary vascular myocytes [1]. Occasionallyalpha2 adrenoceptors do not decrease after balloon valvuloplasty and elevated alpha2 receptor activity could explain oxygen desatura-tion in a subset of these patients, despite successful balloon valvu-loplasty [2].Hypothesis

Alpha-Blocker and Angiotensin Converting Enzyme Inhibitor in themanagement of critical pulmonary valve stenosis. From bench to bedside.

Alpha2 blocker and Angiotensin Converting Enzyme inhibitor (ACE-I) have a role in the treatment of critical pulmonary valve stenosis.Methods / ResultsBased on this speculation, phen-tolamine infusion has been used successfully in two neonates who remained critically ill after a successful intervention. Phentol-amine application improved their clinical status dramatically [2]. Alpha2 blocker showed also effective in a patient who remained prostaglandin and oxygen dependent for 2 weeks post successful pulmonary valvu-loplasty. [3]. Before discontinuing phentolamine, oral (ACE-I) was initiated assuming its similar effect on pulmonary vasculature and right ventricular compliance. Encouraged by this experience [3],in a case with oxygen depen-dency in the absence of major clinical distress, the patient received oral ACE-I. Within 12 hrs, the patient was weaned off oxygen completely. [4].DiscussionStimulating alpha adrenergic

receptors on the peripheral vessels as well as in pulmonary vessels leads to vasoconstriction. The blocking of these receptors with phentolamine leads to vasodilation. Also angiotensin II leads to vasoconstriction of the peripheral as well as the pulmo-nary vascularity. ACE-I blocks the conversion of angiotensin I to angiotensin II. This does not only lower arteriolar resistance and increases venous capacity, but also can lower the resistance in the pulmonary vasculature. In the rat model ACE inhibitor decreases pulmonary arterial pressure through preservation of endothelial nitric oxide synthase. [5] It has been also shown that ACE-I increases bradykinin, an agonist of Nitric oxide synthase (NOS). Nitric oxide is a well known vasodilator of the pulmo-nary vascularity [6].By facilitating forward flow into the lung as well as reducing the afterload, through vasodilation, cardiac output is increased and hence perfusion and overall oxygenation improved. The other effect of nitric oxid e (NO) is to

modulate cardiac function by abbreviating the systolic contrac-tion = enhancement of diastolic relaxation, which was seen in patients with severe pressure-overload hypertrophy. Addition-ally, NO exerts a decrease in left ventricular end-diastolic pressure without affecting left ventricular systolic pump function [7]. If this mechanism is also effective in the right ventricle, this would facilitate right ventricular inflow and would add to the noticed improvement of oxygenation in our patient.All the different reports of alpha blocker as well as ACE-I could explain their beneficial actions and potential important role in the management of patients with critical pulmonary stenosis described by us.ConclusionsUsing this therapeutic approach as early as possible, may shorten oxygen / PGE dependency in these patients and save them from further interventions. Unfor-tunately, awaiting a controlled study is very difficult to achieve, as the disease is extremely rare.

OSPEDALE SAN RAFFAELEVIA OLGETTINA, 60 - 20132 MILANO

Live with Dr. Antonio Colombo@ Middle Hall 14:30From

Dr. Antonio Colombo MD practices Cardiovascular Medicine since 1978. He works in Milano, Italy, as a Director of Cardiovascular Interventions in San Raffaele Scientific Institute (a major University Hospital in Italy), in Columbus Hospital as well as in New York, USA at Columbia Medical Center as a Visiting Professor of Medicine

CASE 2Demographics• 57 year-old• HTN• DM II (on insulin)• Ex-smokerPresentation• Exertional chest painInvestigations• +ve ETT with anterior ischaemic changes• ECHO – apical hypokinesis, preserved LV function• Angiogram – Significant diffuse LAD disease and significant discrete lesions in mid and distal RCARisk scores• EuroSCORE – 0.71%• SYNTAX - 18• SYNTAX II -22

CASE 1Demographics• 69 year-old• Hypercholesterolaemia• Previous MIPresentation• Exertional chest painInvestigations & initial treatment• ECHO - Normal LV function• Angiogram revealed 3-vessel disease with diffuse disease in LAD and significant diffuse disease in dominant RCA

• Patient preference and poor quality of LAD for grafting led to decision to treat with PCI• LAD treated with 4 ABSORB BVS (3.5/12, 3/28, 3/28 and 2.5/28) 6 weeks agoRisk scores• EuroSCORE – 0.69%• SYNTAX - 16• SYNTAX II - 20

Strategy – BVS implantation on LADA Initial angiographic image of LAD Final result in LAD after 4 BVS

Proximal and mid RCA Distal RCA

LIVE TRANSMISSION FROM THE JIM

6

CardioAlexNEWS

Tuesday, 11 JUNE 2013

www.cardio-alex.com

Editor in Cheif:Prof. Mahmoud Hassanein

Visit us and Subscribe at our stand at Level 1

Sanaa AshourCardiology department, Faculty of MedicineAlexandria UniversityIsolated left ventricular apical hypoplasia is a newly recognized type of cardiomyopathy, it was first described in 2004 by Frenandz Valls etal.* A truncated and spherical left ventricle.

Left Ventricular Apical* Fatty material into left ventricu-lar apex.* Abnormal origin of papillary muscle from the flattened apical left ventricle.* An elongated right ventricle wrapping around the deficient apex.Clinical presentation vary widely from asymptomatic to congestive heart failure.Pathophysiological basis and natural history of this entity remain unknown.When cardiologists become familiar with this new cardiomy-opathy, more insights may become available.

SymposiumTuesday, 11 June

12:30 - 13:30Hall: Small Theatre

ChairpersonAdel El Etriby

Khalifa Abdalla12:30 - 12:50

12:50 - 13:10

13:10 - 13:30

Evidence based approach in managingdiabetic dyslipidaemiaYehia Ghanem - AlexandriaNew Paradigm in hypertension managementAhmed Abdel Aty - AlexandriaDiscussion

Look closer

With XIENCE, the rate of stent thrombosis in patients interrupting DAPT* after 3 months is no higher than in those with no interruption out to 2 years.1

of which 40% were high risk

some point

Safety – supported by the evidence

1. Source: Based on data from the Mega-Meta Analysis of 7 XIENCE trials. Jan 2012. Data on file at Abbott Vascular.

Abbott Vascular International BVBAPark Lane, Culliganlaan 2B, B-1831 Diegem, Belgium. Tel: 32.2.714.14.11 Fax: 32.2.714.14.12

XIENCE is a trademark of the Abbott Group of Companies.

Products intended for use by or under the direction of a physician. Prior to use, it is important to read the package insert thoroughly for instructions for use, warnings and potential complications associated with use of this device. Information contained herein is for distribution for Europe, Middle East and Africa ONLY. Please check the regulatory status of the device before distribution in areas where CE marking is not the regulation in force. All drawings are artist’s representations only and should not be considered as engineering drawings or photographs.

For more information, visit our website at www.AbbottVascular.com© 2012 Abbott. All rights reserved. 1-EH-2-2529-01 08/2012

*DAPT Interruption: aspirin and/or thienopyridine not taken for at least 1 day, for any reason

3.0

1.0

0

ST

th

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2 y

ea

rs (

%)

No DAPTInterruption

0.66%

44/6648

DAPT Interruptionwithin 90 days

16/613

0.69%

2.61%

DAPT Interruptionafter 90 days

23/3314

2.0

Timing of First DAPT Interruption and ALL Stent Thrombosis (ARC Definite/Probable)

Through 2 Years

8

CardioAlexNEWS

Tuesday, 11 JUNE 2013

www.cardio-alex.com

Editor in Cheif:Prof. Mahmoud Hassanein

Dr. George D. Dangas, MD, PhD is Profes-sor of Medicine at the Mount Sinai School of Medicine and Director of Cardiovascu-lar Innovation at the Zena and Michael A. Weiner Cardiovascular Institute of the Mount Sinai Medical Center in New York City.

Dr. Annapoorna Kini is a Professor of Medicine and the Director of Cardiac Catheterization Laboratory at The Mount Sinai Medical Center. Dr. Kini is an interna-tional leader in the field of percutaneous coronary intervention and heart valve therapy.

Complex Coronary Disease High Risk PCI Live Case

Transmission From: Mount Sinai Hospital, NewYork, USA Icahn School of Medicine @ Mount Sinai The Mount Sinai

Medical CenterPresentation: Late presentation. Episode of CP 1 week prior. Presented to ER in pulmonary edema. Troponin 2None. LVEFStress Test: None. LVEF 40% on TTE.Past History: HTN, s/p PPM, CKD with Serum Creatinine 2.5mg/dl ( eGFR<30ml /mon.1 .73m2) , Hyperlipidemia, Ex-Smoker,

MountSinaiHeart

LIVE TRANSMISSION FROM TCTLive with Dr. George D. Dangas and Dr. Annapoorna Kini@ Middle Hall 16:15From

From

paroxysmal AFib, Gout, s/p Fall episode(s)Medications: Aspirin, Plavix, Rosuvastatin, Lopressor, ISDN, PepcidCath: R+L H Cath on 6.3.13 with 3V CAD Left main: < 30%Syntax score: LAD: Ca++, prox 80-90%, D1 total occlusion (1,1,1)31: LCx: prox 30-50%, OM1 subtotal occlusionSTS 9.9%: RCA: ostium 30-50%, mid with a subtotal occlusionProgress: 6/3/13 Rota/PCI of prox. LAD (too high risk for CABG)Plan: RCA PCI today

GFR stages GFR (mL/min/1.73m

2)

Terms

G1 >90 Normal or high

G2 60-90 Mildly decreased

G3a 45-59 Mild to moderately decreased

G3b 30-44 Moderately to severely decreased

G4 15-29 Severely decreased

G5 <15 Kidney failure (add D if on dialysis)

Albuminuria Stages

AER (mg/day) Terms

A1 <30 Normal to mildly increased

A2 30-300 Moderately increased

CKD classificationRevised CKD Classification based upon GFR and albuminuria

Appropriateness Criteria for Coronary Revascularization

Tuesday, 11 June15:30 - 16:30

Hall: Small TheatreChairperson

Adel El EtribyKhaled ShoukryMohamed Sobhy

15:30 - 15:50

15:50 - 16:0016:00 - 16:15

16:15 - 16:25

16:25 - 16:30

From unplanned dual antiplatelet therapydiscontinuation to complex bifurcation lesions: Newinsights into stent selectionAyman Abul Magd - Al azharDiscussionRDN Case presentationHazem Khamis - Sixth of OctoberSymplicity is the challengeHazem Khamis - Sixth of OctoberDiscussion

Symposium

CardioAlex 2013

9www.cardio-alex.com

New Technology

Pharmaceutical ArticleEffectiveness and tolerability of fixed dose combination of amlodipine/valsartan in treatment of hypertension in real-life setting among Egyptian patients

Nabil El Kafrawy1. Magdy Rashwan2. Khaled Lion3. Kawkab Khedr4. Nashwa Nashaat51-Head of internal medicine department, Menofya University 2-Professor of cardiology, Alex University 3- Consultant cardiologist, NHI 4-Professor of cardiology, Alex University 5-Novartis Pharma S.A.E

Aim: To evaluate the effective-ness, safety and tolerability of the single-pill combination of amlodipine/valsartan among Egyptian patients with arterial hypertension in the real-life setting.Methods and Results: This prospective, open-label, multi-center, non-comparative post-marketing surveillance study enrolled adults with arterial hypertension (systolic BP >140 mmHg and/or diastolic BP >90 mmHg) treated with single-pill combination (SPC) of amlodipine/valsartan 5/160 or 10/160 mg once daily dose. Patients were observed over a 3-months period with approxi-mately monthly intervals between clinic visits.Primary objectives were comparison of systolic and diastolic blood pressure and heart rate at study start and after

12 weeks of therapy. Secondary objectives were evaluation of the blood pressure lowering effect in terms of response rates, evalua-tion of safety and tolerability of study medication.The results showed: a total of 2489 patients were evaluated. Mean age was 54 years and 85% of patients had received prior antihypertensive therapy. At study end, a significant mean BP reduction of -39.4/-21.7 mmHg (baseline: 171.5/103.4 mmHg; p<0.001) was seen in the overall population (Fig 1).The corresponding mean BP reduction for patients on amlodipine/valsartan 5/160 mg was -34.6/-19.2 mmHg (baseline: 166/101 mmHg; p<0.001) and for patients on amlodipine/valsartan 10/160 mg was -47.1/-24.3 mmHg (baseline: 178.6/106.4 mmHg; p<0.001).In a post-hoc analysis for

subgroups with important co-morbid conditions, the corre-sponding mean BP reductions were: patients with diabetes, -41.1/-21.6 mmHg (baseline 173.2/103.5 mmHg; p=0.00001); patients with heart failure, -45.2/-22.8 mmHg (baseline 175.9/104.6 mmHg; p=0.00001); patients with history of coronary heart diseases, -43/22.7 mmHg (baseline: 175.8/105 mmHg; p=0.00001). A small change in the heart rate was noticed (82 bpm at baseline and 78.4 bpm at the end of study; p<0.001). 70.3% of patients had their blood pressure controlled (BP<140/90 mmHg).

Subjective investigators assess-ment as “excellent to very good” for amlodipine/valsartan SPC was 97.3% for effectiveness and 96.8% for tolerability. The corre-

sponding investigators and patients assessment for compli-ance was 96.6% and 93.3% respectively.Adverse events were reported in 4.4% of patients mainly due to edema in 3.6%. Amlodipine/valsartan SPC was generally well tolerated.Conclusion: In a large cohort of uncontrolled hypertensive patients, SPC of amlodipine/valsartan provided effective blood pressure reduc-tion and control with good tolerability. This data provides beneficial evidence of this combi-nation in Egyptian hypertensive patients.

Fig 1: Mean BP reduction in overall population after 12 weeks.*p<0.001.

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CardioAlex 2013

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Full prescribing information is available upon requestNovartis Pharma S.A.ESawah St., El-AmiriaP.Code: 11511Cairo, Egypt Tel:24567200 Fax: 22574616www.novartis.com

AGENTSSINGLE PILLIN A