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Characteristics of Lipid Profiles in Indigenous Cardiac Outreach Program Cohort in Rural and Remote Communities in Queensland: A Snapshot After 10 years of Service
Abstracts
S330
665 Characteristics of Lipid Profiles in Indigenous Cardiac Outreach Program Cohort in Rural and Remote Communities in Queensland: A Snapshot After 10 years of Service M. Abdul Halim 1,2,3,4,∗ , M. Abdul Halim 2,4 , D. Abdul Halim 2,4 , A. Goodman 3,4 , R. Corpus 3,4 , S. McKenzie 2,4 1 Gold
Coast University Hospital, Gold Coast, Australia 2 University of Queensland, Brisbane, Australia 3 The Prince Charles Hospital, Brisbane, Australia 4 Indigenous Cardiac Outreach Programme, Brisbane, Australia Background: Remote and rural communities, especially Australian Indigenous communities, suffer from high burden of cardiovascular diseases and health care access disparity. Indigenous Cardiac Outreach Programme (ICOP) is an innovative culturally sensitive initiative to bridge the gap. We report a snapshot study into lipid profiles of our Indigenous Cardiac Outreach Programme cohort. Method: Point-of-care lipid profile results from 229 sequential patients in ICOP cohort were acquired between August 2016 to December 2016 across 21 ICOP clinic sites. The results were cross-referenced against medical records. Result: The mean age 53.8 years ranging from 15 to 99 years old with nearly half of the cohort is male (52%). Indigenous Australians represent a majority of our cohort (67.2%). Cardiovascular risk factors are highly prevalent (diabetes, 63%, hypertension 65.1%, dyslipidaemia 63.3% and current smoker, 29.7%) Approximately one-third (35.4%) already have established atherosclerotic cardiovascular diseases (ASCVD). Our cohort has significantly less atherogenic lipid profile compared to the lipid profile of each of National, Queensland and Remote areas. (TC, 4.35; LDL 2.16; HDL1.23)
The most encouraging result is 57% of our cohort who have established ASCVD achieved target LDL (LDL ≤ 1.8 mmol/L). This is comparable to multiple follow-up studies from developed countries. Conclusion: We believe an intensive and culturally appropriate community engagement and follow-up provides a
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strong platform for cardiovascular risk factor modifications, in this case, lipid management. http://dx.doi.org/10.1016/j.hlc.2017.06.666 666 Delayed Diagnosis of Acute Rheumatic Fever Presentation in a Regional Tertiary Hospital: How Can We Do Better? M. Abdul Halim 1,2 1 Queensland 2 University
Health, Brisbane, Australia of Queensland, Brisbane, Australia
Background: A timely diagnosis of acute rheumatic fever would aid identification, follow-up and appropriate management in order to prevent recurrent episodes and complications. We attempt to identify demographics, clinical presentations and outcomes of delayed diagnosis of acute rheumatic fever in our hospital. Method: Five cases of retrospective diagnosis of acute rheumatic fever have been identified from medical records from January 2015 to January 2016. Additional clinical data were extracted from hospital medical records. Result: Mean age was 18.2 years. (Range 6-25). All were of Indigenous Australian background. The most common presentation was articular (60%). All arthritis presentations were atypical. 60% had objective evidence of carditis at presentation. Mean time to diagnosis 10.5 days (6-36 days). 80% had at least 1 re-presentation to medical care. 60% had either prior history of acute rheumatic fever or family history of acute rheumatic fever. 60% (n = 3) can be classified as definite acute rheumatic fever at presentation and the rest as probable acute rheumatic fever (in accordance with the Australian guideline for prevention, diagnosis and management of acute rheumatic disease (RHD Australia)). Unfortunately, one case was lost to follow-up in context of retrospective diagnosis. Conclusion: In high-risk populations, despite atypical presentation, clinicians should be alert to the diagnosis of acute rheumatic fever to achieve a timely diagnosis. Guideline driven clinical assessment would be of benefit in aiding diagnosis. http://dx.doi.org/10.1016/j.hlc.2017.06.667 667 This abstract has been withdrawn
http://dx.doi.org/10.1016/j.hlc.2017.06.668
S330
665 Characteristics of Lipid Profiles in Indigenous Cardiac Outreach Program Cohort in Rural and Remote Communities in Queensland: A Snapshot After 10 years of Service M. Abdul Halim 1,2,3,4,∗ , M. Abdul Halim 2,4 , D. Abdul Halim 2,4 , A. Goodman 3,4 , R. Corpus 3,4 , S. McKenzie 2,4 1 Gold
Coast University Hospital, Gold Coast, Australia 2 University of Queensland, Brisbane, Australia 3 The Prince Charles Hospital, Brisbane, Australia 4 Indigenous Cardiac Outreach Programme, Brisbane, Australia Background: Remote and rural communities, especially Australian Indigenous communities, suffer from high burden of cardiovascular diseases and health care access disparity. Indigenous Cardiac Outreach Programme (ICOP) is an innovative culturally sensitive initiative to bridge the gap. We report a snapshot study into lipid profiles of our Indigenous Cardiac Outreach Programme cohort. Method: Point-of-care lipid profile results from 229 sequential patients in ICOP cohort were acquired between August 2016 to December 2016 across 21 ICOP clinic sites. The results were cross-referenced against medical records. Result: The mean age 53.8 years ranging from 15 to 99 years old with nearly half of the cohort is male (52%). Indigenous Australians represent a majority of our cohort (67.2%). Cardiovascular risk factors are highly prevalent (diabetes, 63%, hypertension 65.1%, dyslipidaemia 63.3% and current smoker, 29.7%) Approximately one-third (35.4%) already have established atherosclerotic cardiovascular diseases (ASCVD). Our cohort has significantly less atherogenic lipid profile compared to the lipid profile of each of National, Queensland and Remote areas. (TC, 4.35; LDL 2.16; HDL1.23)
The most encouraging result is 57% of our cohort who have established ASCVD achieved target LDL (LDL ≤ 1.8 mmol/L). This is comparable to multiple follow-up studies from developed countries. Conclusion: We believe an intensive and culturally appropriate community engagement and follow-up provides a
.. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. ..
strong platform for cardiovascular risk factor modifications, in this case, lipid management. http://dx.doi.org/10.1016/j.hlc.2017.06.666 666 Delayed Diagnosis of Acute Rheumatic Fever Presentation in a Regional Tertiary Hospital: How Can We Do Better? M. Abdul Halim 1,2 1 Queensland 2 University
Health, Brisbane, Australia of Queensland, Brisbane, Australia
Background: A timely diagnosis of acute rheumatic fever would aid identification, follow-up and appropriate management in order to prevent recurrent episodes and complications. We attempt to identify demographics, clinical presentations and outcomes of delayed diagnosis of acute rheumatic fever in our hospital. Method: Five cases of retrospective diagnosis of acute rheumatic fever have been identified from medical records from January 2015 to January 2016. Additional clinical data were extracted from hospital medical records. Result: Mean age was 18.2 years. (Range 6-25). All were of Indigenous Australian background. The most common presentation was articular (60%). All arthritis presentations were atypical. 60% had objective evidence of carditis at presentation. Mean time to diagnosis 10.5 days (6-36 days). 80% had at least 1 re-presentation to medical care. 60% had either prior history of acute rheumatic fever or family history of acute rheumatic fever. 60% (n = 3) can be classified as definite acute rheumatic fever at presentation and the rest as probable acute rheumatic fever (in accordance with the Australian guideline for prevention, diagnosis and management of acute rheumatic disease (RHD Australia)). Unfortunately, one case was lost to follow-up in context of retrospective diagnosis. Conclusion: In high-risk populations, despite atypical presentation, clinicians should be alert to the diagnosis of acute rheumatic fever to achieve a timely diagnosis. Guideline driven clinical assessment would be of benefit in aiding diagnosis. http://dx.doi.org/10.1016/j.hlc.2017.06.667 667 This abstract has been withdrawn
http://dx.doi.org/10.1016/j.hlc.2017.06.668