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APACHE III score predicts mortality in out of hospital cardiac arrest (OOHCA) patients with ST elevation myocardial infarction (STEMI)
e41
Abstracts
world were at target LDL-c <1.8mmolo/l (54.1% vs. 41.3%), and HbA1c <7% (34.5% vs. 31.3%). Similarly, New Zealand patients compared to the rest of the world were less likely to have achieved a target systolic blood pressure < 140 mmHg at baseline (65.8% vs. 75.3%), but this also improved by study end (70.2% vs. 74.2%) Conclusion: In the STABILITY study NZ participants were less likely to achieve secondary prevention targets than the rest of the world at study entry, but treatment goals improved during follow-up. These observations suggest clear treatment targets and regular review may improve secondary prevention of cardiovascular disease. http://dx.doi.org/10.1016/j.hlc.2014.04.233
Bleeding
Non bleeding
P value
Age (years)
61.6 12.4
58.3 11.4
0.301
Haemoglobin (g/L)
139 17.7
145.5 15.3
0.158
Weight (kgs)
84 22.3
83.7 15.8
0.958
Creatinine Clearance (ml/min)
103.7 47.6
100.4 35.9
0.775
Diabetes
5/32
27/32
0.557
Subgroup
http://dx.doi.org/10.1016/j.hlc.2014.04.234
P65 Bleeding risk and incidence in real world percutaneous coronary intervention patients with ticagrelor
P66
I. Subiakto *, A. Ul Haq, W. Van Gaal
APACHE III score predicts mortality in out of hospital cardiac arrest (OOHCA) patients with ST elevation myocardial infarction (STEMI)
The Northern Hospital, Epping, Sydney, Australia Corresponding author.
C. Tie *, T. Kuang, J. Loubser, C. Frampton, D. Knight, D. Smyth
Background: To investigate the incidence and severity of bleeding at discharge and 30 days in real world clinical practice with Ticagrelor in patients undergoing PCI. Methods: The first 100 patients prescribed Ticagrelor following PCI at our hospital in 2013 were analysed. All participants also took Aspirin 100 mg daily. Bleeding was defined according to TIMI criteria. Results: For demographics and TIMI bleeding, see tables.Most bleeding (13/22) was minimal bleeding from the access site.The only major bleeding source was gastrointestinal. There was no intracerebral bleeding, minor bleeding or mortality. The major bleeding incidence was half compared to the PLATO study and its subgroup analysis (1.0% VS 2.5%) at 30 days. Overall, bleeding risk was higher in females (P value <0.05). Age, weight, diabetes,hemoglobin and creatinine clearance did not predict bleeding risk. Conclusion: Our experience shows that Ticagrelor use in a real world population following PCI is associated with a low risk of bleeding comparable to, or better than, that seen in the PLATO study. We found women undergoing PCI are three times more likely to bleed compared with males.
Canterbury District Health Board, Christchurch * Corresponding author.
*
Demographics
Values
Female vs Males
28/100 (28%) vs 72/100 (72%)
Gender distribution of
10/28 (35%) vs 9/72 (12%),
bleeding: Females vs Males
P:0.01
TIMI Bleeding Incidence: -Minimal
13/100 (13%)
-Bleeding Requiring Medical Attention
5 /100 (5%)
-Minor
0
-Major
1/100 (1%)
-Fatal
0
Background: Coronary angiogram and percutaneous coronary intervention (PCI) is established treatment for STEMI. However, in patients who have OOHCA and STEMI, its efficacy is less certain. Methods: Between January 2010 and December 2012, all patients admitted to intensive care unit (ICU) at Christchurch Hospital after OOHCA and STEMI were analysed. APACHE III score was extracted from medical records. APACHE III score is widely used in ICU to determine prognosis. We compared the outcome of the group who went for coronary angiogram +/- PCI within 12 hours of hospital arrival to those who did not. The primary endpoint is mortality at 6 months. Results: 24 patients presented to ICU with OOHCA and STEMI within this time frame. 71% were male and the mean age was 60 +/- 14 years old. The mean APACHE III score was 0.64 +/- 0.26. Of these patients, 18 (75%) underwent coronary angiogram within 12 hours and 14 (78%) of these underwent culprit-lesion PCI. The APACHE III score was not significantly different in groups who did and did not undergo angiogram and PCI (0.65 +/- 0.27 vs. 0.63 +/- 0.27, p = 0.93) but it predicted survival (0.54 +/- 0.29 vs. 0.77 +/- 0.13, p = 0.02). There was a trend to improve survival in group undergoing coronary angiogram and PCI [6/18 (33%) vs. 4/6 (67%), p = 0.19] although difference did not reach statistical significance. Conclusion: APACHE III score predicts the survival in patients with OOHCA and STEMI. All of these patients should have angiogram and PCI as the chance of finding a culprit lesion is high and there was a trend to improve survival. This did not reach statistical significance likely due to the small number in this group. Larger studies are needed to definitively answer these hypotheses. http://dx.doi.org/10.1016/j.hlc.2014.04.235
Abstracts
world were at target LDL-c <1.8mmolo/l (54.1% vs. 41.3%), and HbA1c <7% (34.5% vs. 31.3%). Similarly, New Zealand patients compared to the rest of the world were less likely to have achieved a target systolic blood pressure < 140 mmHg at baseline (65.8% vs. 75.3%), but this also improved by study end (70.2% vs. 74.2%) Conclusion: In the STABILITY study NZ participants were less likely to achieve secondary prevention targets than the rest of the world at study entry, but treatment goals improved during follow-up. These observations suggest clear treatment targets and regular review may improve secondary prevention of cardiovascular disease. http://dx.doi.org/10.1016/j.hlc.2014.04.233
Bleeding
Non bleeding
P value
Age (years)
61.6 12.4
58.3 11.4
0.301
Haemoglobin (g/L)
139 17.7
145.5 15.3
0.158
Weight (kgs)
84 22.3
83.7 15.8
0.958
Creatinine Clearance (ml/min)
103.7 47.6
100.4 35.9
0.775
Diabetes
5/32
27/32
0.557
Subgroup
http://dx.doi.org/10.1016/j.hlc.2014.04.234
P65 Bleeding risk and incidence in real world percutaneous coronary intervention patients with ticagrelor
P66
I. Subiakto *, A. Ul Haq, W. Van Gaal
APACHE III score predicts mortality in out of hospital cardiac arrest (OOHCA) patients with ST elevation myocardial infarction (STEMI)
The Northern Hospital, Epping, Sydney, Australia Corresponding author.
C. Tie *, T. Kuang, J. Loubser, C. Frampton, D. Knight, D. Smyth
Background: To investigate the incidence and severity of bleeding at discharge and 30 days in real world clinical practice with Ticagrelor in patients undergoing PCI. Methods: The first 100 patients prescribed Ticagrelor following PCI at our hospital in 2013 were analysed. All participants also took Aspirin 100 mg daily. Bleeding was defined according to TIMI criteria. Results: For demographics and TIMI bleeding, see tables.Most bleeding (13/22) was minimal bleeding from the access site.The only major bleeding source was gastrointestinal. There was no intracerebral bleeding, minor bleeding or mortality. The major bleeding incidence was half compared to the PLATO study and its subgroup analysis (1.0% VS 2.5%) at 30 days. Overall, bleeding risk was higher in females (P value <0.05). Age, weight, diabetes,hemoglobin and creatinine clearance did not predict bleeding risk. Conclusion: Our experience shows that Ticagrelor use in a real world population following PCI is associated with a low risk of bleeding comparable to, or better than, that seen in the PLATO study. We found women undergoing PCI are three times more likely to bleed compared with males.
Canterbury District Health Board, Christchurch * Corresponding author.
*
Demographics
Values
Female vs Males
28/100 (28%) vs 72/100 (72%)
Gender distribution of
10/28 (35%) vs 9/72 (12%),
bleeding: Females vs Males
P:0.01
TIMI Bleeding Incidence: -Minimal
13/100 (13%)
-Bleeding Requiring Medical Attention
5 /100 (5%)
-Minor
0
-Major
1/100 (1%)
-Fatal
0
Background: Coronary angiogram and percutaneous coronary intervention (PCI) is established treatment for STEMI. However, in patients who have OOHCA and STEMI, its efficacy is less certain. Methods: Between January 2010 and December 2012, all patients admitted to intensive care unit (ICU) at Christchurch Hospital after OOHCA and STEMI were analysed. APACHE III score was extracted from medical records. APACHE III score is widely used in ICU to determine prognosis. We compared the outcome of the group who went for coronary angiogram +/- PCI within 12 hours of hospital arrival to those who did not. The primary endpoint is mortality at 6 months. Results: 24 patients presented to ICU with OOHCA and STEMI within this time frame. 71% were male and the mean age was 60 +/- 14 years old. The mean APACHE III score was 0.64 +/- 0.26. Of these patients, 18 (75%) underwent coronary angiogram within 12 hours and 14 (78%) of these underwent culprit-lesion PCI. The APACHE III score was not significantly different in groups who did and did not undergo angiogram and PCI (0.65 +/- 0.27 vs. 0.63 +/- 0.27, p = 0.93) but it predicted survival (0.54 +/- 0.29 vs. 0.77 +/- 0.13, p = 0.02). There was a trend to improve survival in group undergoing coronary angiogram and PCI [6/18 (33%) vs. 4/6 (67%), p = 0.19] although difference did not reach statistical significance. Conclusion: APACHE III score predicts the survival in patients with OOHCA and STEMI. All of these patients should have angiogram and PCI as the chance of finding a culprit lesion is high and there was a trend to improve survival. This did not reach statistical significance likely due to the small number in this group. Larger studies are needed to definitively answer these hypotheses. http://dx.doi.org/10.1016/j.hlc.2014.04.235