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High prevalence of familial hypercholesterolemia in patients with coronary heart disease at a Brazilian quaternary healthcare center
Abstracts / Atherosclerosis 263 (2017) e111ee282
Aim: Prevalence of type 2 diabetes is increasing throughout the world. With his asymptomatic character during the first years, its screening becomes a priority in order to make an early care and prevent its cardiovascular complications. Aim: To determine clinical and biological features of an asymptomatic population and assess the prevalence of diabetes and cardiovascular risk factors among them. Methods: it’s a Cross-sectional study on 389 unknown diabetic patients among the paramedical and administrative staff of Charles Nicolle hospital during 3 months. Results: The population was divided into 95 men and 294 women with average age 41.91+9.53 years. Among the population, 42.93% were obese and 80.98% had abdominal obesity. Diabetes was found in 4.37% of the population, 9.22% were intolerant to glucose and 1.46% had moderate hyperglycemia. One-third of diabetics screened were hypertensive, but there were no significant differences between systolic and diastolic blood pressures between the diabetic group and the non-diabetic one. Hypercholesterolemia was found in 16.59%, hypertriglyceridemia in 11.37%, hyperLDLemia in 7.96% and hypoHDLemia in 44.61% of the population. The metabolic syndrome was found in 49.76% of the population. Its prevalence increased significantly with age (p¼0.004) and body mass index (p¼0.001). It was common in subjects suffering from glycoregulation disorders: 100% of those with moderate fasting hyperglycemia, 78.9% of glucose intolerant and 66.66% of diabetics. It was significantly associated with hypertriglyceridemia (p¼0.0001) and hypoHDLemia (p¼0.004). Conclusions: Diabetes screening and the various components of the metabolic syndrome are important as our study shows. It is necessary to encourage targeted opportunistic screening.
PO229. CHARACTERIZATION OF METABOLIC SYNDROME IN PLIC COHORT Chiodo1, Andrea Baragetti2, Katia Manuela Casula1, Lorenzo Grigore2, Giuseppe Danilo Norata2, Fabio Garlaschelli2, Liliana Pellegatta2, Laura Redaelli2, Cristina Tidone2, Elena Tragni1, Alberico Luigi Catapano1, 2, 3. 1 Epidemiology and Preventive Pharmacology Centre (SEFAP), University of Milan, Milan, Italy; 2 Center for the Study of Atherosclerosis, E. Bassini Hospital, Cinisello Balsamo (MI), Italy; 3 IRCCS MultiMedica, Sesto S. Giovanni (MI), Italy Aim: Metabolic Syndrome (MetS) is considered a “cluster” of risk factors (hypertension, visceral obesity, impaired glucose metabolism, atherogenic dyslipidemia) that occur simultaneously in the individuals and results in increased cardiovascular risk. The aim of this study was to determine the prevalence of MetS and its determinants in a cohort of healthy Italian adults, evaluating their temporal trends. Methods: Among patients enrolled in the PLIC (studio sulla Progressione delle Lesioni Intimali Carotidee) cohort, the prevalence of MetS was defined by the harmonized definition of previous criteria (IDF, NHLBI, AHA, ATP-III) for each of the four planned visits. Results: At baseline, 21.6% suffered from MetS,reaching 25.2% in visit 4. The prevalence was higher in men than in women in all visits (V1 24.3% M; F 19.7%), and in the age group >¼65 years (V1 29.2%). In each visit, the most prevalent determinant was BP higher than the cut-off (95.5% in MetS patients at baseline; 69.3% in the total sample). MetS patients with glucose values higher than the cut-off increased during the study, from 52.6% at baseline (18.8% in the total sample), reaching 77,2% at visit 4 (30.6% in the total sample); the same trend was observed for waist circumference, while the prevalence of determinants related to HDL-c and TGs decreased during the visits. Conclusions: The high prevalence of subject with MetS and its increasing trend should call the attention of health care professionals on the management and prevention of cardiometabolic risk factors which, individually or in combination, can lead to an increased incidence of cardiovascular events.
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PO230. SCREENING FOR UNKNOWN HYPERCHOLESTEROLEMIA IN A HOSPITAL POPULATION: A MODEL FOR PREVENTIVE MEDICINE Roberto Scicali1, Roberta Platania1, Giacomo Purrazzo1, Alberto Giannone1, Viviana Ferrara1, Francesca Urbano1, Agnese Filippello1, Salvo Piro1, Maria Agata Rabuazzo1, Emanuele Farrugia2, Venerando Purrello1. 1 Department of Clinical and Rapisarda3, Francesco Experimental Medicine, Catania, Italy; 2 ARNAS Garibaldi Hospital, Catania, Italy; 3 Policlinico-Vittorio Emanuele Hospital, Catania, Italy Aim: The autosomal dominant hypercholesterolemia (ADH) is one of the most frequent monogenic diseases and it’s strongly related to cardiovascular disease (myocardial infarction, stroke).Genes classically associated with ADH are LDL receptor gene (Familial hypercholesterolemia or FH), Apo B gene (Familial Detective ApoB or FDB) and PCSK9 (FH3). The frequency of heterozygous FH is estimated to be approximately 1/200 - 1/500 in general population; so, this disease is one of the most common monogenic syndromes. We aimed to investigate the percentage of unknown possible familial hypercholesterolemia in a small population. Methods: From January 2015, 1300 subjects were studied. Data were taken from Garibaldi hospital’s employees and internal medicine day hospital’s patient medical records. We assessed lipid profile of each subject and we excluded secondary hypercholesterolemia through second level blood tests. Possible familial hypercholesterolemia was calculated by Dutch Clinic Lipid Network score; a three-five ranging score (LDL-cholesterol >190 mg/dl) was considered. Furthermore, in a subgroup analysis (33 subjects), we performed genetic analysis. Results: 135 subjects (10,4 %) didn’t know they have elevated LDLcholesterol plasma levels. These patients had a three-five ranging score (LDL-cholesterol >190 mg/dl), defined as possible familial hypercholesterolemia levels. In the subgroup analysis, 12 patients (36,4%) had a heterozygous genetic mutation to LDL receptor. Conclusions: Nowadays, many subjects don’t know they have elevated LDL-cholesterol plasma levels. So, It’s crucial to identify these subjects to make an accurate cardiovascular prevention.
PO231. HIGH PREVALENCE OF FAMILIAL HYPERCHOLESTEROLEMIA IN PATIENTS WITH CORONARY HEART DISEASE AT A BRAZILIAN QUATERNARY HEALTHCARE CENTER ~ es Souza, Abdo Latif Fares, Adnan Ahmad Hussein El Bacha, Caio Simo Anto ^ nio Garcia De Carvalho, Marco Anto ^ nio Freitas De Queiro z, Jose ^ nica Serrano Francischini, Adriana Bertolami, Andre Arpad Faludi. Mo Instituto Dante Pazzanese de Cardiologia, S~ ao Paulo, Brazil Aim: Familial Hypercholesterolemia (FH) is an autosomal, dominant genetic disorder that leads to elevated blood cholesterol and an increased risk of atherosclerosis. It affects 1 in 250 to 1 in 500 of the population globally, increasing risk for cardiac events such as premature myocardial infarction and early death from coronary heart disease (CHD). The aim of this study was to evaluate de prevalence of FH in patients with coronary heart disease at Dante Pazzanese’s Institute of Cardiology, a quaternary healthcare center in S~ ao Paulo, Brazil. Methods: A retrospective patient record study was conducted, including patients with CHD clinically manifested or confirmed through coronarography. Data were analyzed for 357 patients using the Dutch Lipid Clinic Network diagnostic tool. Record screening was performed by cardiology residency trainees. Results: A prevalence of 8% for Probable FH and 10% for Definite FH was found, per the dutch tool model. Definite FH participants had an mean average age of 49 years at the first atherosclerotic event, 53% of the them were male, 93% had arterial hypertension and 62% had type 2 diabetes mellitus. Highest score’s were found in lower aged patients (under 55 years old).
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Abstracts / Atherosclerosis 263 (2017) e111ee282
Abstracts / Atherosclerosis 263 (2017) e111ee282
Conclusions: This approach offers the opportunity to enhance detection of FH in the presence of CHD by identifying individuals with greatest probability of having the condition.
PO232. GENETIC POLYMORPHISM IN TCF7L2 AND RISK OF HYPERTENSION IN THAI ELDERLY SUBJECTS Rujikorn Rattanatham1, Nongnuch Settasatian2, Chatri Settasatian3, Nisa Decharatchakul1, Ingkarat Sarutipaiboon1, Sakda Kanyalert4, Nuthatai Boonpalit5. 1 Postgraduate Program in Biomedical Sciences and Cardiovascular Research Group, Khon Kaen University, Khon Kaen, Thailand; 2 Department of Clinical Chemistry, Faculty of Associated Medical Sciences, and Cardiovascular Research Group, Khon Kaen U, Khon Kaen, Thailand; 3 Department of Pathology, Faculty of Medicine and Cardiovascular Research Group, Khon Kaen University, Khon Kaen, Thailand; 4 Postgraduate Program in Pathology, Faculty of Medicine and Cardiovascular Research Group, Khon Kaen University, Khon Kaen, Thailand; 5 Undergraduate Student in Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand Aim: Genetic variation in TCF7L2 has been associated with type 2 diabetes (T2DM), a complex pathophysiology characterized by chronic hyperglycemia. T2DM is associated with both micro- and macro- vascular complications affecting several organs. Hypertension has been known to increase the risk of these vascular complications in T2DM. TCF7L2 encodes a transcription factor in the Wnt signaling pathway. A T2DM associated polymorphism, rs7903146, in TCF7L2 has also been reported to increase the incidence of hypertension in the European cohorts aged 30-65. The aim of the present study was to investigate whether there is an association between genetic variation in TCF7L2 and the risk of hypertension in Thai elderly population. Methods: Three TCF7L2 polymorphisms (rs7903146, rs11196218 and rs290487) were genotyped in Thai subjects aged 60 and above who attended for annual health checkup at Health Center, Bangkok. Genotypes were evaluated for their association with T2DM and the risk of hypertension. Results: The percentage of individuals with hypertension was significantly higher in diabetic than in non-diabetic groups (65.8 and 57.6 respectively, p¼0.043). However, there were no associations of these polymorphisms with T2DM in these subjects. Regarding hypertension, only TCF7L2 rs290487 showed significant association, by which the CT and CC genotypes increased the risk of hypertension with respective adjusted ORs¼1.59 (95%CI: 1.07-2.36) p¼0.022 and 2.05 (95%CI: 1.28-3.29) p¼0.003, when compared with TT genotype. Conclusions: Genetic polymorphism rs290487 in TCF7L2 may contribute to the risk of hypertension in Thai elderly regardless of T2DM.
PO233. CAUSE FOR CONCERN IN THE USE OF NON-STEROIDAL ANTIINFLAMMATORY DRUGS BY THE CARDIOVASCULAR POPULATION Maria Suciu1, Lavinia Vlaia1, Liana Suciu1, Liana Dragan1, Vicentiu Vlaia1, Mirela Voicu1, Valentina Buda1, Minodora Andor2, Cristiana Proks1, Carmen Cristescu1. 1 Victor Babes University of Medicine and Pharmacy, Faculty of Pharmacy, Timisoara, Romania; 2 Victor Babes University of Medicine and Pharmacy, Faculty of Medicine, Timisoara, Romania
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Results: 60% people using NSAIDs had cardiovascular disease, 19% diabetes mellitus, 9% chronic kidney disease and they reported a concurrent use of corresponding medication (ACE inhibitors, sartans, diuretics, etc). In cardiovascular NSAIDs users were prevalent: women (51%), age>45 (62%), unmarried statute (56%) and medium educational level (53%). The NSAIDs used more by the cardiovascular patients than by the non-cardiovascular ones were diclofenac (Odds ratio (OR): 2.674; 95% (Confidence interval) CI: 1.822-3.924)), ketoprofen (OR: 1.585; 95% CI: 0.893-2.811) and etoricoxib (OR: 0.533; 95% CI: 0.353-0.804). The main conditions motivating NSAIDs use were: joint pain (46%), low back pain (38%) and headache (7%). 243 cardiovascular patients acquired NSAIDS by self-medication, 102 with medical prescription and 99 have requested the pharmacist's recommendation. Conclusions: There is a high prevalence of NSAIDs use among the patients with potential for significant drug-related adverse events or which have major chronic conditions that are relative contraindications to NSAIDs use.
PO234. HYPERTENSIVES AND WHITE COAT HYPERTENSIVES: POPULATIONS WITH EXTREMELY UNCONTROLLED LDL LEVELS Christina Antza1, Ioannis Doundoulakis2, Stiliani Stabouli3, Vasilios Kotsis1. 1 3rd Department of Internal Medicine,Papageorgiou Hospital, 24H Abpm Center, Aristotle University, Thessaloniki, Greece; 2 Aristotle University, Thessaloniki, Greece; 3 Pediatric Intensive Care Unit, Hippokration Hospital, Thessaloniki, Greece Aim: To identify the regulation of LDL levels in hypertensive population compared to normotensive population. Methods: A physician measured SBP three times in each subject using a mercury sphygmomanometer. All subjects underwent 24h-ABPM on a usual working day. Patients with both ambulatory and clinic BP values in the hypertensive or normotensive range were defined as confirmed hypertensives (H) and normotensives (N) respectively. White coat hypertension (WCH) was defined as office hypertension with ambulatory normotension. Subjects were never treated before for hypertension or cholesterol. LDL levels were measured in each subject. Results: 610 consecutive subjects (48% male) aged 48.2± 22.6 years were included in the study. LDL levels were 109.5± 2.5 mg/dl in normotensives, 123.1± 3.4 mg/dl in white coat hypertensives and 131.0± 3.3 mg/dl in hypertensives. The difference between hypertensives and normotensives, as well as between white coat hypertensives and normotensives was statistically significant at the level of 0.05, after Bonferroni's adjustment for multiple comparisons. The percentage of LDL levels >¼130mg/dl was 23,35 in normotensives, 40.98 in white coat hypertensives and 49,88 in hypertensives. Conclusions: Hypertension is associated with uncontrolled LDL levels, resulting in a high risk population. Regular LDL levels control and intensification of lipids therapy are necessary in hypertensives and white coat hypertensives in order to lower the cardiovascular risk.
PO235. EVALUATION OF LIPID MANAGEMENT IN SECONDARY PREVENTION OF ACS PATIENTS WITH REFERENCE TO NON-HDL-CHOLESTEROL REDUCTION-A UK CARDIAC CENTRE EXPERIENCE M. Toba Obafemi1, Dan Garner1, Akbari Abullah2, Gershan Davis1. Aintree University Hospital, Liverpool, United Kingdom; 2 University of Liverpool, Liverpool, United Kingdom
1
Aim: Increased use of NSAIDs drugs in the cardiovascular population is a cause for concern in terms of drug safety. This study aimed to investigate the share of patients with cardiovascular pathology, consumers of NSAIDs drugs, among the general population, the relationship between socio-demographic and behaviors’ variables with NSAIDs drugs use. Methods: A self-administered questionnaire was given to 735 NSAIDs users, which were presented at three community pharmacies. The questionnaire assessed their socio-demographic characteristics, symptoms, and chronic diseases. SPSS for Windows version 17.0 was used to examine associations between different variables and the use of NSAIDs by the cardiovascular versus non-cardiovascular population.
Aim: Some evidence indicates that lipid therapy to prevent further cardiac event in ACS patients is suboptimal. NICE guideline (CG-181-2014) recommends greater than 40% reduction in Non-HDL-C, 3 months after treatment for ACS. We assessed the lipid management of patients admitted into Aintree University Hospital in Liverpool after ACS. Methods: A retrospective analysis of patients’ hospital records including demographic data, CVD risk factors and lipid profiles was done. Results: 285 patients diagnosed with ACS between March and October 2015 were analysed. 61% were male and 39% female, with mean age of 71
Aim: Prevalence of type 2 diabetes is increasing throughout the world. With his asymptomatic character during the first years, its screening becomes a priority in order to make an early care and prevent its cardiovascular complications. Aim: To determine clinical and biological features of an asymptomatic population and assess the prevalence of diabetes and cardiovascular risk factors among them. Methods: it’s a Cross-sectional study on 389 unknown diabetic patients among the paramedical and administrative staff of Charles Nicolle hospital during 3 months. Results: The population was divided into 95 men and 294 women with average age 41.91+9.53 years. Among the population, 42.93% were obese and 80.98% had abdominal obesity. Diabetes was found in 4.37% of the population, 9.22% were intolerant to glucose and 1.46% had moderate hyperglycemia. One-third of diabetics screened were hypertensive, but there were no significant differences between systolic and diastolic blood pressures between the diabetic group and the non-diabetic one. Hypercholesterolemia was found in 16.59%, hypertriglyceridemia in 11.37%, hyperLDLemia in 7.96% and hypoHDLemia in 44.61% of the population. The metabolic syndrome was found in 49.76% of the population. Its prevalence increased significantly with age (p¼0.004) and body mass index (p¼0.001). It was common in subjects suffering from glycoregulation disorders: 100% of those with moderate fasting hyperglycemia, 78.9% of glucose intolerant and 66.66% of diabetics. It was significantly associated with hypertriglyceridemia (p¼0.0001) and hypoHDLemia (p¼0.004). Conclusions: Diabetes screening and the various components of the metabolic syndrome are important as our study shows. It is necessary to encourage targeted opportunistic screening.
PO229. CHARACTERIZATION OF METABOLIC SYNDROME IN PLIC COHORT Chiodo1, Andrea Baragetti2, Katia Manuela Casula1, Lorenzo Grigore2, Giuseppe Danilo Norata2, Fabio Garlaschelli2, Liliana Pellegatta2, Laura Redaelli2, Cristina Tidone2, Elena Tragni1, Alberico Luigi Catapano1, 2, 3. 1 Epidemiology and Preventive Pharmacology Centre (SEFAP), University of Milan, Milan, Italy; 2 Center for the Study of Atherosclerosis, E. Bassini Hospital, Cinisello Balsamo (MI), Italy; 3 IRCCS MultiMedica, Sesto S. Giovanni (MI), Italy Aim: Metabolic Syndrome (MetS) is considered a “cluster” of risk factors (hypertension, visceral obesity, impaired glucose metabolism, atherogenic dyslipidemia) that occur simultaneously in the individuals and results in increased cardiovascular risk. The aim of this study was to determine the prevalence of MetS and its determinants in a cohort of healthy Italian adults, evaluating their temporal trends. Methods: Among patients enrolled in the PLIC (studio sulla Progressione delle Lesioni Intimali Carotidee) cohort, the prevalence of MetS was defined by the harmonized definition of previous criteria (IDF, NHLBI, AHA, ATP-III) for each of the four planned visits. Results: At baseline, 21.6% suffered from MetS,reaching 25.2% in visit 4. The prevalence was higher in men than in women in all visits (V1 24.3% M; F 19.7%), and in the age group >¼65 years (V1 29.2%). In each visit, the most prevalent determinant was BP higher than the cut-off (95.5% in MetS patients at baseline; 69.3% in the total sample). MetS patients with glucose values higher than the cut-off increased during the study, from 52.6% at baseline (18.8% in the total sample), reaching 77,2% at visit 4 (30.6% in the total sample); the same trend was observed for waist circumference, while the prevalence of determinants related to HDL-c and TGs decreased during the visits. Conclusions: The high prevalence of subject with MetS and its increasing trend should call the attention of health care professionals on the management and prevention of cardiometabolic risk factors which, individually or in combination, can lead to an increased incidence of cardiovascular events.
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PO230. SCREENING FOR UNKNOWN HYPERCHOLESTEROLEMIA IN A HOSPITAL POPULATION: A MODEL FOR PREVENTIVE MEDICINE Roberto Scicali1, Roberta Platania1, Giacomo Purrazzo1, Alberto Giannone1, Viviana Ferrara1, Francesca Urbano1, Agnese Filippello1, Salvo Piro1, Maria Agata Rabuazzo1, Emanuele Farrugia2, Venerando Purrello1. 1 Department of Clinical and Rapisarda3, Francesco Experimental Medicine, Catania, Italy; 2 ARNAS Garibaldi Hospital, Catania, Italy; 3 Policlinico-Vittorio Emanuele Hospital, Catania, Italy Aim: The autosomal dominant hypercholesterolemia (ADH) is one of the most frequent monogenic diseases and it’s strongly related to cardiovascular disease (myocardial infarction, stroke).Genes classically associated with ADH are LDL receptor gene (Familial hypercholesterolemia or FH), Apo B gene (Familial Detective ApoB or FDB) and PCSK9 (FH3). The frequency of heterozygous FH is estimated to be approximately 1/200 - 1/500 in general population; so, this disease is one of the most common monogenic syndromes. We aimed to investigate the percentage of unknown possible familial hypercholesterolemia in a small population. Methods: From January 2015, 1300 subjects were studied. Data were taken from Garibaldi hospital’s employees and internal medicine day hospital’s patient medical records. We assessed lipid profile of each subject and we excluded secondary hypercholesterolemia through second level blood tests. Possible familial hypercholesterolemia was calculated by Dutch Clinic Lipid Network score; a three-five ranging score (LDL-cholesterol >190 mg/dl) was considered. Furthermore, in a subgroup analysis (33 subjects), we performed genetic analysis. Results: 135 subjects (10,4 %) didn’t know they have elevated LDLcholesterol plasma levels. These patients had a three-five ranging score (LDL-cholesterol >190 mg/dl), defined as possible familial hypercholesterolemia levels. In the subgroup analysis, 12 patients (36,4%) had a heterozygous genetic mutation to LDL receptor. Conclusions: Nowadays, many subjects don’t know they have elevated LDL-cholesterol plasma levels. So, It’s crucial to identify these subjects to make an accurate cardiovascular prevention.
PO231. HIGH PREVALENCE OF FAMILIAL HYPERCHOLESTEROLEMIA IN PATIENTS WITH CORONARY HEART DISEASE AT A BRAZILIAN QUATERNARY HEALTHCARE CENTER ~ es Souza, Abdo Latif Fares, Adnan Ahmad Hussein El Bacha, Caio Simo Anto ^ nio Garcia De Carvalho, Marco Anto ^ nio Freitas De Queiro z, Jose ^ nica Serrano Francischini, Adriana Bertolami, Andre Arpad Faludi. Mo Instituto Dante Pazzanese de Cardiologia, S~ ao Paulo, Brazil Aim: Familial Hypercholesterolemia (FH) is an autosomal, dominant genetic disorder that leads to elevated blood cholesterol and an increased risk of atherosclerosis. It affects 1 in 250 to 1 in 500 of the population globally, increasing risk for cardiac events such as premature myocardial infarction and early death from coronary heart disease (CHD). The aim of this study was to evaluate de prevalence of FH in patients with coronary heart disease at Dante Pazzanese’s Institute of Cardiology, a quaternary healthcare center in S~ ao Paulo, Brazil. Methods: A retrospective patient record study was conducted, including patients with CHD clinically manifested or confirmed through coronarography. Data were analyzed for 357 patients using the Dutch Lipid Clinic Network diagnostic tool. Record screening was performed by cardiology residency trainees. Results: A prevalence of 8% for Probable FH and 10% for Definite FH was found, per the dutch tool model. Definite FH participants had an mean average age of 49 years at the first atherosclerotic event, 53% of the them were male, 93% had arterial hypertension and 62% had type 2 diabetes mellitus. Highest score’s were found in lower aged patients (under 55 years old).
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Abstracts / Atherosclerosis 263 (2017) e111ee282
Abstracts / Atherosclerosis 263 (2017) e111ee282
Conclusions: This approach offers the opportunity to enhance detection of FH in the presence of CHD by identifying individuals with greatest probability of having the condition.
PO232. GENETIC POLYMORPHISM IN TCF7L2 AND RISK OF HYPERTENSION IN THAI ELDERLY SUBJECTS Rujikorn Rattanatham1, Nongnuch Settasatian2, Chatri Settasatian3, Nisa Decharatchakul1, Ingkarat Sarutipaiboon1, Sakda Kanyalert4, Nuthatai Boonpalit5. 1 Postgraduate Program in Biomedical Sciences and Cardiovascular Research Group, Khon Kaen University, Khon Kaen, Thailand; 2 Department of Clinical Chemistry, Faculty of Associated Medical Sciences, and Cardiovascular Research Group, Khon Kaen U, Khon Kaen, Thailand; 3 Department of Pathology, Faculty of Medicine and Cardiovascular Research Group, Khon Kaen University, Khon Kaen, Thailand; 4 Postgraduate Program in Pathology, Faculty of Medicine and Cardiovascular Research Group, Khon Kaen University, Khon Kaen, Thailand; 5 Undergraduate Student in Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand Aim: Genetic variation in TCF7L2 has been associated with type 2 diabetes (T2DM), a complex pathophysiology characterized by chronic hyperglycemia. T2DM is associated with both micro- and macro- vascular complications affecting several organs. Hypertension has been known to increase the risk of these vascular complications in T2DM. TCF7L2 encodes a transcription factor in the Wnt signaling pathway. A T2DM associated polymorphism, rs7903146, in TCF7L2 has also been reported to increase the incidence of hypertension in the European cohorts aged 30-65. The aim of the present study was to investigate whether there is an association between genetic variation in TCF7L2 and the risk of hypertension in Thai elderly population. Methods: Three TCF7L2 polymorphisms (rs7903146, rs11196218 and rs290487) were genotyped in Thai subjects aged 60 and above who attended for annual health checkup at Health Center, Bangkok. Genotypes were evaluated for their association with T2DM and the risk of hypertension. Results: The percentage of individuals with hypertension was significantly higher in diabetic than in non-diabetic groups (65.8 and 57.6 respectively, p¼0.043). However, there were no associations of these polymorphisms with T2DM in these subjects. Regarding hypertension, only TCF7L2 rs290487 showed significant association, by which the CT and CC genotypes increased the risk of hypertension with respective adjusted ORs¼1.59 (95%CI: 1.07-2.36) p¼0.022 and 2.05 (95%CI: 1.28-3.29) p¼0.003, when compared with TT genotype. Conclusions: Genetic polymorphism rs290487 in TCF7L2 may contribute to the risk of hypertension in Thai elderly regardless of T2DM.
PO233. CAUSE FOR CONCERN IN THE USE OF NON-STEROIDAL ANTIINFLAMMATORY DRUGS BY THE CARDIOVASCULAR POPULATION Maria Suciu1, Lavinia Vlaia1, Liana Suciu1, Liana Dragan1, Vicentiu Vlaia1, Mirela Voicu1, Valentina Buda1, Minodora Andor2, Cristiana Proks1, Carmen Cristescu1. 1 Victor Babes University of Medicine and Pharmacy, Faculty of Pharmacy, Timisoara, Romania; 2 Victor Babes University of Medicine and Pharmacy, Faculty of Medicine, Timisoara, Romania
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Results: 60% people using NSAIDs had cardiovascular disease, 19% diabetes mellitus, 9% chronic kidney disease and they reported a concurrent use of corresponding medication (ACE inhibitors, sartans, diuretics, etc). In cardiovascular NSAIDs users were prevalent: women (51%), age>45 (62%), unmarried statute (56%) and medium educational level (53%). The NSAIDs used more by the cardiovascular patients than by the non-cardiovascular ones were diclofenac (Odds ratio (OR): 2.674; 95% (Confidence interval) CI: 1.822-3.924)), ketoprofen (OR: 1.585; 95% CI: 0.893-2.811) and etoricoxib (OR: 0.533; 95% CI: 0.353-0.804). The main conditions motivating NSAIDs use were: joint pain (46%), low back pain (38%) and headache (7%). 243 cardiovascular patients acquired NSAIDS by self-medication, 102 with medical prescription and 99 have requested the pharmacist's recommendation. Conclusions: There is a high prevalence of NSAIDs use among the patients with potential for significant drug-related adverse events or which have major chronic conditions that are relative contraindications to NSAIDs use.
PO234. HYPERTENSIVES AND WHITE COAT HYPERTENSIVES: POPULATIONS WITH EXTREMELY UNCONTROLLED LDL LEVELS Christina Antza1, Ioannis Doundoulakis2, Stiliani Stabouli3, Vasilios Kotsis1. 1 3rd Department of Internal Medicine,Papageorgiou Hospital, 24H Abpm Center, Aristotle University, Thessaloniki, Greece; 2 Aristotle University, Thessaloniki, Greece; 3 Pediatric Intensive Care Unit, Hippokration Hospital, Thessaloniki, Greece Aim: To identify the regulation of LDL levels in hypertensive population compared to normotensive population. Methods: A physician measured SBP three times in each subject using a mercury sphygmomanometer. All subjects underwent 24h-ABPM on a usual working day. Patients with both ambulatory and clinic BP values in the hypertensive or normotensive range were defined as confirmed hypertensives (H) and normotensives (N) respectively. White coat hypertension (WCH) was defined as office hypertension with ambulatory normotension. Subjects were never treated before for hypertension or cholesterol. LDL levels were measured in each subject. Results: 610 consecutive subjects (48% male) aged 48.2± 22.6 years were included in the study. LDL levels were 109.5± 2.5 mg/dl in normotensives, 123.1± 3.4 mg/dl in white coat hypertensives and 131.0± 3.3 mg/dl in hypertensives. The difference between hypertensives and normotensives, as well as between white coat hypertensives and normotensives was statistically significant at the level of 0.05, after Bonferroni's adjustment for multiple comparisons. The percentage of LDL levels >¼130mg/dl was 23,35 in normotensives, 40.98 in white coat hypertensives and 49,88 in hypertensives. Conclusions: Hypertension is associated with uncontrolled LDL levels, resulting in a high risk population. Regular LDL levels control and intensification of lipids therapy are necessary in hypertensives and white coat hypertensives in order to lower the cardiovascular risk.
PO235. EVALUATION OF LIPID MANAGEMENT IN SECONDARY PREVENTION OF ACS PATIENTS WITH REFERENCE TO NON-HDL-CHOLESTEROL REDUCTION-A UK CARDIAC CENTRE EXPERIENCE M. Toba Obafemi1, Dan Garner1, Akbari Abullah2, Gershan Davis1. Aintree University Hospital, Liverpool, United Kingdom; 2 University of Liverpool, Liverpool, United Kingdom
1
Aim: Increased use of NSAIDs drugs in the cardiovascular population is a cause for concern in terms of drug safety. This study aimed to investigate the share of patients with cardiovascular pathology, consumers of NSAIDs drugs, among the general population, the relationship between socio-demographic and behaviors’ variables with NSAIDs drugs use. Methods: A self-administered questionnaire was given to 735 NSAIDs users, which were presented at three community pharmacies. The questionnaire assessed their socio-demographic characteristics, symptoms, and chronic diseases. SPSS for Windows version 17.0 was used to examine associations between different variables and the use of NSAIDs by the cardiovascular versus non-cardiovascular population.
Aim: Some evidence indicates that lipid therapy to prevent further cardiac event in ACS patients is suboptimal. NICE guideline (CG-181-2014) recommends greater than 40% reduction in Non-HDL-C, 3 months after treatment for ACS. We assessed the lipid management of patients admitted into Aintree University Hospital in Liverpool after ACS. Methods: A retrospective analysis of patients’ hospital records including demographic data, CVD risk factors and lipid profiles was done. Results: 285 patients diagnosed with ACS between March and October 2015 were analysed. 61% were male and 39% female, with mean age of 71