AS-226: The Level of B-Type Natriuretic Peptide Relates to Left Ventricular Hypertrophy After Acute Myocardial Infarction

Wednesday, April 22 - Friday, April 24, 2009 (E-Poster Abstract Zone) (10.0% vs 6.6% vs 4.1% vs 3.3%, respectively; p ⫽ 0.003). In a Cox proportional hazard regression analysis, there were no significant differences in composite major adverse cardiac events and all-cause mortality, but patients in group I had 2.7 times more risk of TLR than those in group IV (relative risk, 2.651; 95% confidence interval, 1.008 – 6.972; p ⫽ 0.048). Other risk factors, such as sex difference (p ⫽ 0.357), using bare metal stents (p ⫽ 0.065), LDL cholesterol level (p ⫽ 0.518), and triglyceride level (p ⫽ 0.137) were adjusted. Conclusion: Low serum Lp(a) accompanied with low apoB/apoA-I ratio was an independent predictor for TLR after PCI in patients with AMI.

AS-226 The Level of B-Type Natriuretic Peptide Relates to Left Ventricular Hypertrophy After Acute Myocardial Infarction. Ji Sun Lee, Hyun Ju Yoon, Myung Ho Jeong, Sang Chun Lim, Suk Hee Cho, Jae Yun Sim, Jung Ok Lim, Suk Ja Lee, Young Ja Choi, Kye Hun Kim, Youngkeun Ahn, Jeong Gwan Cho, Jong Chun Park, Jung Chaee Kang, Ock Kyu Park. Chonnam National University Hospital, Gwangju, Republic of Korea.

EP O S T E R A B S T R A C T S

Background: Left ventricular hypertrophy (LVH) is a strong risk factor for future cardiovascular events of blood pressure levels in patients with essential hypertension and is a part of progressive morphologic LV change after myocardial infarction (MI). The objective of this study was to assess the factors associated with LVH in the first 6 months after acute myocardial infarction (AMI). Methods: A total of 531 consecutive patients (age, 63.4 ⫾ 12 years; 388 men) with AMI were examined by echocardiography at admission and after 6 months. LVH was defined by calculating from LV mass index and relative wall thickness at 6 months. Subjects were divided into LVH (n ⫽ 226; age, 66.4 ⫾ 12 years) and non-LVH (n ⫽ 305; age, 62.1 ⫾ 10 years) groups. The LVH group included patients with concentric remodeling (n ⫽ 26; age, 60.6 ⫾ 11 years), concentric hypertrophy (n ⫽ 126; age, 66.7 ⫾ 11 years), and eccentric hypertrophy (n ⫽ 74; age, 70.1 ⫾ 10 years). Various clinical, laboratory, echocardiographic parameters and coronary angiographic findings were compared among groups. Results: Old age, diabetes mellitus, and hypertension comprised a higher percentage in the LVH group than in the non-LVH group. B-type natriuretic peptide (BNP) and serum glucose levels were significantly increased in the LVH group, especially in the concentric subtype (p ⬍0.05). A low ejection fraction and high ratio of mitral inflow divided by septal annulus tissue Doppler velocity was closely related with LVH. Ischemic mitral regurgitation at admission was more frequently found in the LVH group than the non-LVH group. Inhospital early complications were significantly associated with LVH, whereas there was no significant difference in 1-year major adverse cardiac events between groups. By multivariate analysis, BNP was independently related with LVH (odds ratio, 1.965; p ⫽ 0.003; confidence interval, 1.268 –3.045). Conclusion: Elevated serum BNP level affects left ventricular morphologic change in patients with AMI.

AS-227 Clinical Effects of Hypertension on the Mortality of Patients with Acute Myocardial Infarction. Dong Ku Kang1, Myung Ho Jeong2, YangKeun Ahn2, Shung Chull Chae3, Jong Hyun Kim4, Seung Ho Hur5, Taek Jong Hong6, Young Jo Kim7, In Whan Seong8, Jei Keon Chae9, Jay Young Rhew10, In Ho Chae11, Myeong Chan Cho12, Jang Ho Bae13, Seung Woon Rha14, Chong Jin Kim15, Yang Soo Jang16, Junghan Yoon17, Ki Bae Seung18, Seung Jung Park19. 1Kwangju Christial Hospital, Gwangju, Republic of Korea; 2Chonnam National University Hospital, Gangju, Republic of Korea; 3Kyungpook National University Hospital, Daegu, Republic of

Korea; 4Hanseo Hospital, Pusan, Republic of Korea; 5Keimyung University Dongsan Medical Center, Daegu, Republic of Korea; 6Pusan National University Hospital, Pusan, Republic of Korea; 7Yeungnam University Hospital, Daegu, Republic of Korea; 8Chungnam National University Hospital, Daejon, Republic of Korea; 9Chonbuk National University Hospital, Jeonju, Republic of Korea; 10Jeonju Presbyterian Medical Center, Jeonju, Republic of Korea; 11Seoul National University Bundang Hospital, Seongnam, Republic of Korea; 12Chungbuk National University Hospital, Cheongju, Republic of Korea; 13Konyang University Hospital, Daejon, Republic of Korea; 14Korea University Guro Hospital, Seoul, Republic of Korea; 15Kyunghee University Hospital, Seoul, Republic of Korea; 16Yonsei University Hospital, Seoul, Republic of Korea; 17Wonju University Hospital, Wonju, Republic of Korea; 18Catholic University Hospital, Seoul, Republic of Korea; 19 Asan Medical Center, Seoul, Republic of Korea. Background: The incidence of ischemic heart disease has increased rapidly in Korea. However, the clinical effects of antecedent hypertension on acute myocardial infarction (AMI) have not been clearly identified. Methods: We assessed the relation between antecedent hypertension and clinical outcomes in 7,784 patients with AMI in the Korea Acute Myocardial Infarction Registry during 1-year follow-up. Results: Diabetes mellitus, hyperlipidemia, cerebrovascular disease, heart failure, and peripheral artery disease were more prevalent in patients with hypertension (n ⫽ 3,775) than in those without (n ⫽ 4,009). During hospitalization, patients with hypertension had acute renal failure, shock, and cerebrovascular events more frequently than in those without hypertension. During a follow-up of 1 year, the incidence of major adverse cardiac events was higher in those with hypertension. In multivariate adjustment, old age (hazard ratio [HR], 1.937; 95% confidence interval [CI], 1.465–2.577; p ⬍0.001), Killip class II (HR, 10.157; 95% CI, 4.948 –20.850; p ⬍0.001), left ventricular ejection fraction ⬍0.45 (HR, 2.902; 95% CI, 2.107–3.997; p ⬍0.001), low systolic blood pressure on admission (HR, 2.993; 95% CI, 2.246 –3.990; p ⬍0.001), postprocedural TIMI flow grade £2 (HR, 4.602; 95% CI, 3.190 – 6.639; p ⬍0.001), female sex (HR, 1.375; 95% CI, 1.070 –1.768; p ⫽ 0.013), and a history of hypertension (HR, 1.312; 95% CI, 1.022–1.684; p ⫽ 0.033) were independent predictors for in-hospital mortality. Conclusion: Hypertension at the time of AMI is associated with an increased rate of in-hospital mortality. However, long-term prognosis would be related with other multifactorial risk factors.

AS-228 Midterm Clinical Outcomes of Left Main Bifurcation Lesions Versus Non–Left Main Bifurcation Lesions. kanhaiya lal Poddar, seung woon Rha, kang yin Chen, yong jian Li, yoshiyasu Minami, zhe Jin, jae hyoung Park, cheol ung Choi, jin oh Na, hong euy Lim, jin won Kim, eung ju Kim, chang gyu Park, hong seog Seo, dong joo Oh. Korea University Guro Hospital, Seoul, Republic of Korea. Background: Depending on the lesion location, vessel size, and type of lesions, bifurcation lesions may be associated with different early and midterm outcomes. We sought to evaluate whether there are different early and midterm clinical outcomes between inpatients who underwent percutaneous coronary intervention (PCI) for left main (LM) and non-LM bifurcation lesions. Methods: A total of 515 (men, 69.7%; age, 61.6 ⫾ 10.6 years) patients who underwent PCI for bifurcation lesions (LM, n ⫽ 44 patients; or non-LM, n ⫽ 471 patients) between October 2003 and December 2007 were evaluated for major adverse cardiac events (MACE) in a 1-month and 6-month period. Results: Baseline characteristics were similar between the LM and non-LM groups. Difference in MACE at 1 month after PCI was not significant (3 of 44 [6.8%] vs 10 of 471 [2.1%], p ⫽ 0.116; odds ratio [OR], 3.317; confidence interval [CI], 0.755–13.030). At 6 months, pa-

96B The American Journal of Cardiology姞 APRIL 22–24 2009 ANGIOPLASTY SUMMIT ABSTRACTS/E-Poster