PT219 The Canadian Cardiovascular Society Grading of Angina in Patients With Refractory Angina: Is it Reproducible?

The Canadian Cardiovascular Society Grading of Angina in Patients With Refractory Angina: Is it Reproducible? L. H. Wolff Gowdak*1, M. Silva1, L. Dourado1, E. Adam1, T. Leite1, N. Poppi1, J. Matos1, G. Trindade1, J. E. Krieger1, L. A. César1 1 Heart and Lung Disease, Heart Institute (InCor-HCFMUSP), Sao Paulo, Brazil Introduction: The Canadian Cardiovascular Society (CCS) grading of angina is a clinical useful tool to assess the physical limitations imposed by coronary artery disease (CAD). However, it relies only on the perception by the physician of such limitations and, therefore, although widely used, may not completely reflect the overall extension of the disease and its impact on affected patients. Moreover, it may be subjected to intra-observer variablity. Objectives: To compare the CCS grading of angina with the number of episodes of angina in a special population of patients with refractory angina due to advanced CAD, as well as the intra-observer variability assessed in 4 time-points. Methods: 81 patients (58
6 years; 65% men) with refractory angina were included. The weekly number of angina attacks were recorded using an angina log during 4 time-points (weeks 0, 4, 8 and 12). Patients were put on maximally tolerated doses of a combination of beta-blockers, calcium channel blockers, long-acting nitrates, and trimetazidine. We then determined the association between CCS functional class (I to IV) with the frequency of angina attacks for each visit and the reproducibility of this association between visits using the qui-square test. Each patient was assessed by the same investigator during all timepoints. Results: The table shows the mean number of angina attacks per month in each visit according to the CCS functional class. In each visit, the number of angina attacks was higher among patients with more advanced CAD as expected. However, there was an association between Visits and distribution of angina attacks in different CCS categories, showing a lack of reproducibility.

Variable

Mean number of angina attacks/month

CCS Grading

V0

V4

I

1.0

2.2

4.9

3.4

II

12.2

14.7

13.3

13.3

III

42.7

37.1

60.0

22.7

IV

27.2

27.5

29.5

48.3

P value

0.003

0.005

V8

V12

0.0001

P value 0.003

0.0001

Conclusion: The frequency of angina attacks correlates well with the CCS grading of angina. However, there is intra-observer variability between different assessments. This finding should prompt for a careful evaluation of the CCS grading system when using to evalaute, for instance, the temporal effects of any therapeutic intervention. Disclosure of Interest: None Declared

PT222 Intracardiac Leiomyoma. A 28 Years Experience L. L. Rodríguez*1, A. Aranda2, N. Avila3, R. Cano4, A. Meave4, V. G. Gomez5 1 Adult hospitalization, 7th Floor, 2Pathology, 3Echocardiography, 4Magnetic Resonance, 5 Cardiothoracic Surgery, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico Introduction: Intracardiac Leiomyoma (ICLM) is a tumour originated from the uterus extending through the cava vein to the cardiac cavities. Objectives: To describe the clinical presentation, diagnosis, treatment and follow up of all the cases of ICLM in our hospital from1987 to 2015. Methods: A descriptive, prospective study from 2014 to October 2015 and retrospective from 1987 to 2013 of all the cases with histopathological diagnosis of ICLM. Results: We identified four women (1987, 1997, 2014 and 2015), mean age 43 years old. All had uterine myomatosis, three histerectomy. All had symptoms: three with dyspnoea, oedema and syncope; two with arrhythmia: case 1 with atrial fibrillation and case 3 with paroxysmal atrial flutter. A heart murmur was heard in 3 cases. Two had thrombocytopenia. All had echocardiogram; case 3 and 4 had computed tomography (CT) and case 4 also magnetic resonance (MR). The tumour came from the inferior cava vein and were in right atrium prolapsing to right ventricle; in case 4 even to pulmonary infundibulum. Surgical approach was one-stage operation in all; case 3 with thoracotomy and simultaneous laparotomy. Incomplete removal occurred in case 1 because was diagnosed as recidivant atrial myxoma twice. Case 4 required cryoprecipitates transfusion before cardiac surgery for severe thrombocytopenia (29000); at discharge, with normal platelets, she was sent to another hospital to perform hysterectomy and bilateral oophorectomy. The histopathological diagnosis in all was compatible with leiomyoma confirmed with immunohistochemical techniques. Postoperative hospital stay was 18 days. Average follow up was 4.5 years. Case 1 was diagnosed as ICLM after

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June, 2016

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POSTER/WCC_2016-POSTERS

a retrospective histopathological review, but she rejected a third surgery and abandoned the hospital. Conclusion: In our hospital ICLM is very rare. Only the first case was misdiagnosed initially as cardiac myxoma. Advances in cardiac image has helped to improve the diagnosis accuracy not only with echocardiogram, but CT and MR. The diagnosis is confirmed with histopathology. The complete resection of the tumour is curative. Disclosure of Interest: None Declared PT223 Change of Serum Total Cholesterol Among Urban Adults Aged 18 and Above in China From 2002 To 2012 P. Song*1, H. Li2, S. Jia1, Q. Man1, L. Li1, L. Zhao3, J. Zhang1, on behalf of Corresponding author 1 Elderly and Clinical Nutrition, Institute for Nutrition and Health, China CDC, 2Central Laboratory, Beijing CDC, 3Department of Nutrition Surveillance, Institute for Nutrition and Health, China CDC, Beijing, China Introduction: Elevated blood cholesterol (TC) is one of the important risk factors of atherosclerosis, which can induce to coronary heart disease, stroke and other cardiovascular diseases. Recently, with the great development of economy, there was great changes on dietary structure and the way of life dramatically. In 2010, the Ministry of Health carried out the project of nutrition and health surveillance, here we analyzed serum TC level, hypercholesterolemia and borderline high cholesterolemia prevalence, which will provide a scientific basis for the state formulates relevant policies. Objectives: To analyze the serum total cholesterol level and the prevalence of hypercholesterolemia among urban residents aged 18 and above in China from 2010 to 2012. Methods: Data was from Chinese Nutrition and Health Surveillance in 2010-2012. Serum total cholesterol was measured by cholesterol oxidase method. Hypercholesterolemia (upper than 6.22mmol/L) and borderline high cholesterolemia (between 5.18 to 6.19mmol/L) were evaluated by Guidelines on Prevention and Treatment of Blood Lipid Abnormality in Chinese Adults-2007 edition. Standardized prevalence of hypercholesterolemia and borderline high cholesterolemia were calculated through weighted complex sampling processing by population data released by the National Bureau of Statistics in 2009. Results: The valid samples of urban adult residents was 54 042. The mean level of serum total cholesterol was (4.58
0.05) mmol/L, (4.58
0.05) mmol/L for both male and female. The prevalence hypercholesterolemia and borderline high cholesterolemia were 5.6% (95%CI:4.5% to 6.6%) and 24.7%(95%CI:21.6% to 27.9%) totally; 5.1%(95%CI:4.1% to 6.1%) and 24.4% (95%CI:21.0% to 27.6%) for male, 6.0%(95% CI:4.7% to 7.3%) and 25.1%(95%CI:21.8% to 28.4%)for female.The cholesterol level increased by 15.6% compared with that in 2002, and hypercholesterolemia and borderline high cholesterolemia increased 3 times and 2.3 times compared with that in 2002. Conclusion: The serum total cholesterol level and the prevalence of hypercholesterolemia and borderline high cholesterolemia were high among urban adults in China from 2010 to 2012, and more attention should be paid for high serum total cholesterol level among older adults. Disclosure of Interest: P. Song Grant/research support from: Major Projects on Medical Reform of the Ministry of Health-China nutrition and health surveillance(2010-2012), H. Li Grant/research support from: Major Projects on Medical Reform of the Ministry of Health-China nutrition and health surveillance(2010-2012), S. Jia Grant/research support from: Major Projects on Medical Reform of the Ministry of Health-China nutrition and health surveillance(2010-2012), Q. Man Grant/research support from: Major Projects on Medical Reform of the Ministry of Health-China nutrition and health surveillance(20102012), L. Li Grant/research support from: Major Projects on Medical Reform of the Ministry of Health-China nutrition and health surveillance(2010-2012), L. Zhao Grant/ research support from: Major Projects on Medical Reform of the Ministry of Health-China nutrition and health surveillance(2010-2012), J. Zhang Grant/research support from: Major Projects on Medical Reform of the Ministry of Health-China nutrition and health surveillance(2010-2012) PT224 Cardiovascular Nursing Interventions Based on Evidence: Analysis of Interventions and Outcomes Through the Nursing Outcomes Classification, NOC O. V. Carolina*1, M. Sierra Pacheco1, C. Leija Hernandez1 Dirección de enfermería, Instituto Nacional de Cardiologia Ignacio chávez, Mexíco, Mexico

1

Introduction: Cardiovascular nursing interventions based on evidence integrate scientific evidence from the systematic research with the clinical experience, to implement individualized care. It the Instituto Nacional de Cardiología Ignacio Chavez the nursing care interventions are based on Guidelines of Cardiovascular Nursing (GPCCE). Objectives: Analyze cardiovascular nursing interventions based on GPCCE and results through the Nursing Outcomes Classification (NOC). Methods: It is a descriptive and prospective study, an analysis will be performed of the interventions on GPCCE and the human responses at result of the interventions. The instrument can to define the prevalent nursing diagnoses, the GPCCE interventions and valid results using NOC. The sample is a convenience and consist of 75 adult patients in critical

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POSTER ABSTRACTS

PT219