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AS-272 The Research Of The Association Among Plasma Concertration Of Cystatin C, C-reactive Protein And Coronary Artery Disease
Wednesday, April 27 - Friday April 29, 2011 (Poster Abstract Zone)
Unstable Angina and NSTEMI Wednesday, April 27, 2011 2:00 PM ⬃ 6:00 PM (Abstract nos. AS-270 –AS-273) AS-270 Factors Associated with Early Invasive Strategy in Patients with Non–ST-Segment Elevation Acute Coronary Syndrome in Taiwan. Tsung-Hsien Lin, Wen-Ter Lai. Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
P O S T E R A B S T R A C T S
Background: Patients with new ST-segment depression (STD), symptoms of heart failure (HF) or history of coronary artery bypass grafting (CABG) are at increased risk for cardiovascular events in non–STsegment elevation acute coronary syndrome (NSTEACS). Early invasive strategy (EIS) is suggested to be beneficial in these high-risk patients. However, there were limited reports discussing factors related to EIS in the real world, especially in the Asian population. Methods: Total of 1119 NSTEACS patients enrolled in the ACute CORonary Syndrome Descriptive Taiwan study (ACCORD-Taiwan) were evaluated. Differences in clinical presentations and clinical management were compared between patients receiving EIS or early conservative strategy (ECS). EIS is defined as the time between admissions to catheterization in less than 48 hours. Results: In comparison with patients receiving ECS (n ⫽ 329), those receiving EIS (n ⫽ 790) were younger, more often male, had longer time between symptom onset to hospital admission, had higher percentage of history of myocardial infarction (MI), unstable angina (UA) and percutaneous coronary intervention (PCI), but with lower percentage of new STD and history of CABG, HF, diabetes and chronic kidney disease. There were also higher percentages of clopidogrel loading and aspirin usage after discharge in the group of patients receiving EIS. Logistic regression analysis showed that age (OR ⫽ 0.982, 95% CI ⫽ 0.970 – 0.995, p ⫽ 0.0059), history of CABG (OR ⫽ 0.432, CI ⫽ 0.216 – 0.867, p ⫽ 0.0181), HF (OR ⫽ 0.209, CI ⫽ 0.098 – 0.444, p ⬍ 0.001), STD (OR ⫽ 0.440, CI ⫽ 0.320 – 0.605, p ⬍ 0.0001), history of MI (OR ⫽ 1.611, CI ⫽ 1.060 –2.450, p ⫽ 0.0257) and history of UA (OR ⫽ 1.894, CI ⫽ 1.277⬃2.807, p ⫽ 0.0015) were found to be independent factors in making decision for patients receiving EIS. Conclusion: Despite higher risk, elderly patients with STD, HF or CABG history received less EIS. Given the relationship between highrisk profiles and poor prognosis, it is essential that physician education and training should be strengthened, in order to improve medical practices and treatment outcomes in the management of NSTEACS.
AS-271 Usefulness of N-Terminal Pro-B-Type Natriuretic Peptide for Predicting Infarct Size in Non-Anterior Myocardial Infarction. Ji Hyun Sohn. Keimyung University Dongsan Hospital, Daegu, Korea (Republic of). Background: N-terminal Pro-B-Type Natriuretic Peptide (NT-proBNP) is known as a predictor of prognosis in patients with acute myocardial infarction (AMI). A recent study showed the association of NT-
116A
proBNP with left ventricular dysfunction in non-anterior MI. There is little data about estimation of infarct size in anterior or non-anterior MI. Methods: 87 patients diagnosed AMI and underwent percutaneous coronary intervention were included in this study. Infarct size of myocardium was measured by F-18 FDG PET at 14 days after PCI. NT-proBNP level at baseline was compared with infarct size in F-18 FDG PET in each anterior or non-anterior MI. Results: Area of non-viable myocardium (% of left ventricle) was not correlated with NT-proBNP in overall AMI (r ⫽ 0.096, r ⫽ 0.377). NT-proBNP was also not related with infarct size in anterior MI (r ⫽ 0.041, r ⫽ 0.777). However, there was significant correlation between infarct size and NT-proBNP in non-anterior MI (r ⫽ 0.416, r ⫽ 0.013). Compared with left ventricular ejection fraction, NT-proBNP has no significant correlation in both anterior and non-anterior MI. Conclusion: NT-proBNP is useful in predicting infarct size in nonanterior MI.
AS-272 The Research Of The Association Among Plasma Concertration Of Cystatin C, C-reactive Protein And Coronary Artery Disease. Qi Qian, zhu Shu, qiu Min, zhang Yan, xu Hua, guo Yu, jiang Hai, long Zhi. The Second Affiliated Hospital of NJMU, Nanjing, China. Background: The aim of this study was to determine the predictive value of cystatin C for the presence and severity of coronary artery disease(CAD) and the association between this protein and other biochemical risk factors for atherosclerosis in patients with suspected CAD. Methods: One hundred and eighty five patients with CAD were included in the study .Health volunteers served as control (n ⫽ 227). Serum levels of cystatin C was measured by nephelometric immunoassay. Subjects were divided into four groups according to their cystatin C, C reactive protein(CRP) quartile respectively. Cystatin C and CRP groups were analyzed for the association with CAD characteristics. Results: The number of patients with CAD increased as the quartile of cystatin C and CRP increased, and there were remarkable differences between quartiles (p ⬍ 0.001). Logistic regression analysis revealed independent predictors of incident CAD as cystatin C, hs-CRP (p ⬍ 0.001, respectively). Moreover, cystatin C predicted incident CAD with a sensitivity and specificity of 61.1% and 46.7% respectively, while CRP was with a sensitivity and specificity of 46.5% and 96.9% respectively. Cystatin C concentration also correlated well with the atherosclerotic inflammatory risk factor CRP(r ⫽ 0.628, p ⬍ 0.01). Conclusion: Cystatin C could be a useful laboratory tool in predicting the presence and severity of CAD in daily practice. It also correlates significantly with risk factors for CAD, namely CRP. But the predicting value of Cystatin C is weaker than CRP.
AS-273 Routine Follow Up Coronary Angiography versus Clinical Follow Up only in Acute Non ST-segment Elevation Myocardial Infarction Patients Undergoing Percutaneous Coronary Intervention with Drug-Eluting Stents. Seung-Woon Rha, Kanhaiya L. Poddar, Meera Kumari, Byoung Geol Choi, Yun Kyung Kim, Jin Oh Na, Cheol Ung Choi, Hong Euy Lim, Jin Won Kim, Eung Ju Kim, Chang Gyu Park, Hong Seog Seo, Dong Joo Oh. Cardiovascular Center Korea Uiversity Guro Hospital, Seoul, Korea (Republic of). Background: It is unclear whether the routine follow up (FU) coronary angiography (CAG) regardless of patient’s symptoms after successful
The American Journal of Cardiology姞 APRIL 27–29, 2011 ANGIOPLASTY SUMMIT ABSTRACTS/Poster
Unstable Angina and NSTEMI Wednesday, April 27, 2011 2:00 PM ⬃ 6:00 PM (Abstract nos. AS-270 –AS-273) AS-270 Factors Associated with Early Invasive Strategy in Patients with Non–ST-Segment Elevation Acute Coronary Syndrome in Taiwan. Tsung-Hsien Lin, Wen-Ter Lai. Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
P O S T E R A B S T R A C T S
Background: Patients with new ST-segment depression (STD), symptoms of heart failure (HF) or history of coronary artery bypass grafting (CABG) are at increased risk for cardiovascular events in non–STsegment elevation acute coronary syndrome (NSTEACS). Early invasive strategy (EIS) is suggested to be beneficial in these high-risk patients. However, there were limited reports discussing factors related to EIS in the real world, especially in the Asian population. Methods: Total of 1119 NSTEACS patients enrolled in the ACute CORonary Syndrome Descriptive Taiwan study (ACCORD-Taiwan) were evaluated. Differences in clinical presentations and clinical management were compared between patients receiving EIS or early conservative strategy (ECS). EIS is defined as the time between admissions to catheterization in less than 48 hours. Results: In comparison with patients receiving ECS (n ⫽ 329), those receiving EIS (n ⫽ 790) were younger, more often male, had longer time between symptom onset to hospital admission, had higher percentage of history of myocardial infarction (MI), unstable angina (UA) and percutaneous coronary intervention (PCI), but with lower percentage of new STD and history of CABG, HF, diabetes and chronic kidney disease. There were also higher percentages of clopidogrel loading and aspirin usage after discharge in the group of patients receiving EIS. Logistic regression analysis showed that age (OR ⫽ 0.982, 95% CI ⫽ 0.970 – 0.995, p ⫽ 0.0059), history of CABG (OR ⫽ 0.432, CI ⫽ 0.216 – 0.867, p ⫽ 0.0181), HF (OR ⫽ 0.209, CI ⫽ 0.098 – 0.444, p ⬍ 0.001), STD (OR ⫽ 0.440, CI ⫽ 0.320 – 0.605, p ⬍ 0.0001), history of MI (OR ⫽ 1.611, CI ⫽ 1.060 –2.450, p ⫽ 0.0257) and history of UA (OR ⫽ 1.894, CI ⫽ 1.277⬃2.807, p ⫽ 0.0015) were found to be independent factors in making decision for patients receiving EIS. Conclusion: Despite higher risk, elderly patients with STD, HF or CABG history received less EIS. Given the relationship between highrisk profiles and poor prognosis, it is essential that physician education and training should be strengthened, in order to improve medical practices and treatment outcomes in the management of NSTEACS.
AS-271 Usefulness of N-Terminal Pro-B-Type Natriuretic Peptide for Predicting Infarct Size in Non-Anterior Myocardial Infarction. Ji Hyun Sohn. Keimyung University Dongsan Hospital, Daegu, Korea (Republic of). Background: N-terminal Pro-B-Type Natriuretic Peptide (NT-proBNP) is known as a predictor of prognosis in patients with acute myocardial infarction (AMI). A recent study showed the association of NT-
116A
proBNP with left ventricular dysfunction in non-anterior MI. There is little data about estimation of infarct size in anterior or non-anterior MI. Methods: 87 patients diagnosed AMI and underwent percutaneous coronary intervention were included in this study. Infarct size of myocardium was measured by F-18 FDG PET at 14 days after PCI. NT-proBNP level at baseline was compared with infarct size in F-18 FDG PET in each anterior or non-anterior MI. Results: Area of non-viable myocardium (% of left ventricle) was not correlated with NT-proBNP in overall AMI (r ⫽ 0.096, r ⫽ 0.377). NT-proBNP was also not related with infarct size in anterior MI (r ⫽ 0.041, r ⫽ 0.777). However, there was significant correlation between infarct size and NT-proBNP in non-anterior MI (r ⫽ 0.416, r ⫽ 0.013). Compared with left ventricular ejection fraction, NT-proBNP has no significant correlation in both anterior and non-anterior MI. Conclusion: NT-proBNP is useful in predicting infarct size in nonanterior MI.
AS-272 The Research Of The Association Among Plasma Concertration Of Cystatin C, C-reactive Protein And Coronary Artery Disease. Qi Qian, zhu Shu, qiu Min, zhang Yan, xu Hua, guo Yu, jiang Hai, long Zhi. The Second Affiliated Hospital of NJMU, Nanjing, China. Background: The aim of this study was to determine the predictive value of cystatin C for the presence and severity of coronary artery disease(CAD) and the association between this protein and other biochemical risk factors for atherosclerosis in patients with suspected CAD. Methods: One hundred and eighty five patients with CAD were included in the study .Health volunteers served as control (n ⫽ 227). Serum levels of cystatin C was measured by nephelometric immunoassay. Subjects were divided into four groups according to their cystatin C, C reactive protein(CRP) quartile respectively. Cystatin C and CRP groups were analyzed for the association with CAD characteristics. Results: The number of patients with CAD increased as the quartile of cystatin C and CRP increased, and there were remarkable differences between quartiles (p ⬍ 0.001). Logistic regression analysis revealed independent predictors of incident CAD as cystatin C, hs-CRP (p ⬍ 0.001, respectively). Moreover, cystatin C predicted incident CAD with a sensitivity and specificity of 61.1% and 46.7% respectively, while CRP was with a sensitivity and specificity of 46.5% and 96.9% respectively. Cystatin C concentration also correlated well with the atherosclerotic inflammatory risk factor CRP(r ⫽ 0.628, p ⬍ 0.01). Conclusion: Cystatin C could be a useful laboratory tool in predicting the presence and severity of CAD in daily practice. It also correlates significantly with risk factors for CAD, namely CRP. But the predicting value of Cystatin C is weaker than CRP.
AS-273 Routine Follow Up Coronary Angiography versus Clinical Follow Up only in Acute Non ST-segment Elevation Myocardial Infarction Patients Undergoing Percutaneous Coronary Intervention with Drug-Eluting Stents. Seung-Woon Rha, Kanhaiya L. Poddar, Meera Kumari, Byoung Geol Choi, Yun Kyung Kim, Jin Oh Na, Cheol Ung Choi, Hong Euy Lim, Jin Won Kim, Eung Ju Kim, Chang Gyu Park, Hong Seog Seo, Dong Joo Oh. Cardiovascular Center Korea Uiversity Guro Hospital, Seoul, Korea (Republic of). Background: It is unclear whether the routine follow up (FU) coronary angiography (CAG) regardless of patient’s symptoms after successful
The American Journal of Cardiology姞 APRIL 27–29, 2011 ANGIOPLASTY SUMMIT ABSTRACTS/Poster