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PM271 Plasma lipidomic analysis predicts soft coronary artery plaque in asymptomatic patients at intermediate risk of coronary artery disease
PM267
The epidemiological profile of first-ever hospitalisations for atrial fibrillation in Aboriginal and non-Aboriginal Western Australians, 2000-2009
Effects Of Listening To Joyful Music On Endothelial Function In Rehabilitation Of Patients After Myocardial Infarction
Judith M. Katzenellenbogen*1, Tiew-Hwa Katherine Teng1, Derrick Lopez1, Frank Sanfilippo2, Matthew Knuiman2, Michael Hobbs2, Joseph Hung3, Sandra C. Thompson1 1 Combined Universities Centre for Rural Health, 2School of Population Health, 3Sir Charles Gairdner Hospital Unit, The University of Western Australia, Perth, Australia
Marina Deljanin Ilic*1, Stevan Ilic1, Gordana Kocic2, Radmila Pavlovic2, Viktor Stoickov1, Dejan Simonovic1 1 Cardiology, Institute of Cardiology, Medical Faculty University of NIS, 2Institute of Biochemistry, Medical Faculty University of NIS, NIS, Serbia
Introduction: The epidemiology of atrial fibrillation (AF) is poorly described for Aboriginal Australians, despite AF being a major determinant of heart failure and stroke. Objectives: To compare the epidemiological profile of first-ever hospitalised AF between Aboriginal and non-Aboriginal Western Australians aged 20-84 years (2000-09) with respect to incidence, demography, co-morbidity, 28-day and 1-year mortality. Methods: Incident public and private hospital AF admissions (AF hospital admission-free for 15 years) were identified from all diagnosis fields, and subsequent mortality determined using person-based linked hospital and mortality data. Comorbidity histories of specific chronic conditions were ascertained using a 10-year look-back from index AF admission. Age-standardised incidence rates were estimated using the WHO standard and the adjusted risk of 28-day and 1-year mortality calculated using logistic and Cox regression. Results: Aboriginal patients comprised 923 (2.5%) of the 37,097 incident AFs. Compared with non-Aboriginal patients, Aboriginal patients had lower proportions of AF diagnoses in the primary diagnosis field (24% vs 33%) but higher emergency presentations (85% vs 65%); lower mean age (54.8 vs 69.3 years); more females (45.9% vs 40.8%) and rural admissions (50% vs 14%); higher comorbidity prevalence of heart failure, diabetes and CKD (all p<¼0.001). Age-specific AF incidence rates were higher in Aboriginals than nonAboriginal in all age groups <70 years. The Aboriginal to non-Aboriginal age-standardised AF incidence rate ratios for men and women 20-54 years were 3.6 and 6.4 respectively and 1.3 and 1.8 respectively for 55-84 years. Crude and adjusted 28-day mortality was similar in both groups. Crude 1-year mortality in 28-day survivors with a primary AF diagnosis was significantly higher in Aboriginal patients (7.5% vs 3.5%), while fully adjusted mortality was significantly higher in Aboriginal women (HR¼1.7: CI 1.23-2.34) but not men (HR¼1.28: CI 0.93-1.76). The adjusted HR for 1-year mortality in Aboriginal patients with a secondary AF diagnosis was 1.30 (CI 1.02-1.65). Conclusion: The incidence of hospitalised AF is significantly higher in Aboriginal people, particularly at younger ages. The high proportion being admitted with AF as a secondary diagnosis and as an emergency suggests that AF is under-diagnosed and undertreated in this population. The higher 1-year mortality implies the need for better post-discharge management. Disclosure of Interest: None Declared
Introduction: In the setting of cardiovascular disease the endothelium loses its normal function. Exercise training has been shown to improve endothelial function, however little is known about the role of music in cardiovascular rehabilitation or the effects of listening to favourite music on endothelial function. Objectives: To evaluate the effects of listening to joyful music on the endothelial function, assess through changes of circulating blood markers of endothelial function: the stable end products of nitric oxide (NOx), S – nitrosothiols (RSNO – reservoir for bioavailable nitric oxide), and asymmetric dimethylarginine (ADMA) in patients (pts) after myocardial infarction (MI). Methods: 50pts after MI were studied. At baseline and 3 weeks later, in all pts values of NOx, RSNO and ADMA were evaluated and exercise test was performed. After the initial study, patients were randomized to music (M,n¼20) and control (C,n¼30) group. Patients in both groups underwent a supervised 3 weeks aerobic exercise training at residential center. Additionaly to exercise training patients in M group were listening their favorite music for half an hour every day. Results: Baseline values of NOx, RSNO and ADMA were similar in M and C group. After 3 weeks value of NOx increased significantly in M group (from 32.7 9.0 to 49.0 10.5 mmol/l, P<0.001), as well as in C group (from 32.512.0 to 42.011.0 mmol/l, P<0.005), however increase in NOx was higher in M than in C group (49%vs 30%) compared to baseline values. In both groups, value of RSNO increased after 3 weeks: in M group RSNO increased from 3.21.3 to 5.31.3 mmol/l (P<0.001) and in C group from 3.11.6 to 4.51.4 mmol/l (P<0.001). After 3 weeks increase in RSNO was higher in M than in C group (65% vs 45%), compared to baseline values. Value of ADMA decreased in both groups (ns) after 3 weeks, and this reduction was greater in M than in C group (13.7% vs 8.2%). Conclusion: Listening to joyful music in combination with regular exercise training program leads to more pronounced benefit and improvement of endothelial function than exercise training alone. Therefore, listening to joyful music may be an adjunct method in the rehabilitation of patients after myocardial infarction. Disclosure of Interest: None Declared
PM266 Predicting 30-years cardiovascular disease in riverside communities in the Brazilian Amazon Raitany C. Almeida*1, Otavio R. Coelho2, Diego J. Dias1, Carlos H. Spesia1, Karime Deguchi1, Victor H. Motta JR1, Vinicius R. Grillo3, Manoel G. Souza Neto1, Marcella S. Martello1 1 Universidade Federal Rondonia, Porto Velho, 2UNICAMP, Campinas, 3LIGA Rondoniense de Cardiologia, Porto Velho, Brazil Introduction: Cardiovascular diseases (CVD) remain the leading cause of mortality in Brazil and worldwide. Estimate CVD risk in the next 30 years tends to improve the primary prevention. Objectives: To determine the risk of developing CVD in the next 30 years in riverside communities in the Brazilian Amazon and to evaluate the percentage of the population above normal risk comparing gender and age. Methods: Between April and July 2013, household visits was conducted in four riverside the communities at Madeira River – Amazon. The study was cross-sectional, descriptive, quantitative and qualitative. Standardized questionnaires were used, measured blood pressure (BP), weight, height, waist circumference. The 30-years CVD risk was observed in patients aged 20 to 59 years and assessed the following predictors: gender, age, systolic blood pressure, smoking, use of antihypertensive drugs, body mass index and diabetes. The risk of developing CVD in 30 years was calculated based on the Framingham risk score and all the data analyzed in the statistical program Epiinfo. Results: Included 637 subjects, 44.58% were male (M). The median age was 37.62 years (SD: + / -13.38). Of female (F) subjects between 20-29 years, 45.53% were above normal risk for 30 years -CVD, while 65.21% male (p <0,05). Between 30 to 39 years had 56.55%(F) vs. 73.61%(M)( p <0.05). Between 40-49 years had 85.33%(F) vs. 81.81% (M) (p> 0.05); and 50-59 years had 90.90%(F) vs. 92.42%(M) (p> 0.05) were higher than normal risk for 30-years CVD. About the age, in female, by comparing the average risk CVD found and average risk CVD expected in the group: 20-29 years (4%vs.3%) (p> 0.05); 30-39 years (12%vs.9%) (p> 0.05); 40-49 years (27%vs.15%)(p <0.05); 50-59 years (46%vs.24%) (p <0.05). About the age, in male, by comparing the average risk CVD found and average risk CVD expected in the group: 20-29 years (9%vs.6%) (p <0.05); 3039 years (20%vs.13%) (p <0.05); 40-49 years (37%vs.24%) (p <0.05); 50-59 years (56% vs.36%) (p <0.05). Conclusion: In the age group 20 to 40 years male had higher 30-years CVD risk than female. The average found for 30-years CVD risk was higher than the average expected in all age male groups and female groups over 40 years.. Therefore, it is necessary to improve preventive care in riverside communities. Disclosure of Interest: None Declared
GHEART Vol 9/1S/2014
j
March, 2014
j
POSTER/2014 WCC Posters
PM271 Plasma lipidomic analysis predicts soft coronary artery plaque in asymptomatic patients at intermediate risk of coronary artery disease Andris H. Ellims*1, Gerard Wong2, Jacquelyn M. Weir2, Philip Lew3, Peter J. Meikle2, Andrew J. Taylor1 1 Heart Centre, Alfred Hospital and Baker IDI Heart & Diabetes Institute, 2Baker IDI Heart & Diabetes Institute, 3Department of Radiology, Alfred Hospital, Melbourne, Australia Introduction: The optimal management of asymptomatic subjects at intermediate risk of coronary artery disease (CAD) is often uncertain. Re-stratification to a high or low risk category may enable optimization of preventative strategies. Coronary computed tomographic angiography (CCTA) enables a minimally invasive assessment of coronary artery plaque quantity and composition. Soft plaque by CCTA is lipid-rich and more vulnerable to rupture and resultant acute coronary syndromes. Objectives: To determine whether novel approaches to CAD risk stratification, such as plasma lipid profiling, may predict soft plaque burden in intermediate risk subjects. Methods: CCTA and several markers of CAD (including plasma lipid profiling, carotid intima-media thickness, aortic pulse wave velocity, and C-reactive protein) were prospectively performed in 100 asymptomatic patients at intermediate CAD risk according to the Framingham risk score. Segment stenosis scores (SSS) were calculated to evaluate the burden of total, calcified, and soft coronary artery plaque. Results: Soft plaque was observed in 66 subjects and 158 of 1425 (11%) coronary artery segments. 18 lipid species demonstrated significant associations with soft plaque burden, but not with total plaque or calcified plaque burden. No other marker of CAD was found to predict coronary artery plaque burden. Conclusion: Plasma lipidomic analysis can predict the burden of soft coronary artery plaque in asymptomatic subjects at intermediate risk of CAD. Given that soft plaque is linked to an increased risk of future acute coronary events, plasma lipid profiling may allow re-stratification of these patients to a higher or lower risk category and, thereby, enable more appropriate and effective primary prevention management strategies. Disclosure of Interest: None Declared
PM272 Could Routine Laboratory Parameters Predict The Severity Of Coronary Artery Lesions? Preliminary Study Benny M. Setiadi*1, Hariman Kristian1, Bambang Budiono2, Agnes L. Panda1, Janry Pangemanan1, Reggy Lefrandt1 1 Cardiology and Vascular Medicine, Sam Ratulangi University, Manado, 2Cardiology and Vascular Medicine, Awal Bros Hospital, Makassar, Indonesia Introduction: Several studies have reported the association between several laboratory parameters to severity of coronary artery lesions; however each of those parameters were analyzed in different population.
e115
POSTER ABSTRACTS
PM265
The epidemiological profile of first-ever hospitalisations for atrial fibrillation in Aboriginal and non-Aboriginal Western Australians, 2000-2009
Effects Of Listening To Joyful Music On Endothelial Function In Rehabilitation Of Patients After Myocardial Infarction
Judith M. Katzenellenbogen*1, Tiew-Hwa Katherine Teng1, Derrick Lopez1, Frank Sanfilippo2, Matthew Knuiman2, Michael Hobbs2, Joseph Hung3, Sandra C. Thompson1 1 Combined Universities Centre for Rural Health, 2School of Population Health, 3Sir Charles Gairdner Hospital Unit, The University of Western Australia, Perth, Australia
Marina Deljanin Ilic*1, Stevan Ilic1, Gordana Kocic2, Radmila Pavlovic2, Viktor Stoickov1, Dejan Simonovic1 1 Cardiology, Institute of Cardiology, Medical Faculty University of NIS, 2Institute of Biochemistry, Medical Faculty University of NIS, NIS, Serbia
Introduction: The epidemiology of atrial fibrillation (AF) is poorly described for Aboriginal Australians, despite AF being a major determinant of heart failure and stroke. Objectives: To compare the epidemiological profile of first-ever hospitalised AF between Aboriginal and non-Aboriginal Western Australians aged 20-84 years (2000-09) with respect to incidence, demography, co-morbidity, 28-day and 1-year mortality. Methods: Incident public and private hospital AF admissions (AF hospital admission-free for 15 years) were identified from all diagnosis fields, and subsequent mortality determined using person-based linked hospital and mortality data. Comorbidity histories of specific chronic conditions were ascertained using a 10-year look-back from index AF admission. Age-standardised incidence rates were estimated using the WHO standard and the adjusted risk of 28-day and 1-year mortality calculated using logistic and Cox regression. Results: Aboriginal patients comprised 923 (2.5%) of the 37,097 incident AFs. Compared with non-Aboriginal patients, Aboriginal patients had lower proportions of AF diagnoses in the primary diagnosis field (24% vs 33%) but higher emergency presentations (85% vs 65%); lower mean age (54.8 vs 69.3 years); more females (45.9% vs 40.8%) and rural admissions (50% vs 14%); higher comorbidity prevalence of heart failure, diabetes and CKD (all p<¼0.001). Age-specific AF incidence rates were higher in Aboriginals than nonAboriginal in all age groups <70 years. The Aboriginal to non-Aboriginal age-standardised AF incidence rate ratios for men and women 20-54 years were 3.6 and 6.4 respectively and 1.3 and 1.8 respectively for 55-84 years. Crude and adjusted 28-day mortality was similar in both groups. Crude 1-year mortality in 28-day survivors with a primary AF diagnosis was significantly higher in Aboriginal patients (7.5% vs 3.5%), while fully adjusted mortality was significantly higher in Aboriginal women (HR¼1.7: CI 1.23-2.34) but not men (HR¼1.28: CI 0.93-1.76). The adjusted HR for 1-year mortality in Aboriginal patients with a secondary AF diagnosis was 1.30 (CI 1.02-1.65). Conclusion: The incidence of hospitalised AF is significantly higher in Aboriginal people, particularly at younger ages. The high proportion being admitted with AF as a secondary diagnosis and as an emergency suggests that AF is under-diagnosed and undertreated in this population. The higher 1-year mortality implies the need for better post-discharge management. Disclosure of Interest: None Declared
Introduction: In the setting of cardiovascular disease the endothelium loses its normal function. Exercise training has been shown to improve endothelial function, however little is known about the role of music in cardiovascular rehabilitation or the effects of listening to favourite music on endothelial function. Objectives: To evaluate the effects of listening to joyful music on the endothelial function, assess through changes of circulating blood markers of endothelial function: the stable end products of nitric oxide (NOx), S – nitrosothiols (RSNO – reservoir for bioavailable nitric oxide), and asymmetric dimethylarginine (ADMA) in patients (pts) after myocardial infarction (MI). Methods: 50pts after MI were studied. At baseline and 3 weeks later, in all pts values of NOx, RSNO and ADMA were evaluated and exercise test was performed. After the initial study, patients were randomized to music (M,n¼20) and control (C,n¼30) group. Patients in both groups underwent a supervised 3 weeks aerobic exercise training at residential center. Additionaly to exercise training patients in M group were listening their favorite music for half an hour every day. Results: Baseline values of NOx, RSNO and ADMA were similar in M and C group. After 3 weeks value of NOx increased significantly in M group (from 32.7 9.0 to 49.0 10.5 mmol/l, P<0.001), as well as in C group (from 32.512.0 to 42.011.0 mmol/l, P<0.005), however increase in NOx was higher in M than in C group (49%vs 30%) compared to baseline values. In both groups, value of RSNO increased after 3 weeks: in M group RSNO increased from 3.21.3 to 5.31.3 mmol/l (P<0.001) and in C group from 3.11.6 to 4.51.4 mmol/l (P<0.001). After 3 weeks increase in RSNO was higher in M than in C group (65% vs 45%), compared to baseline values. Value of ADMA decreased in both groups (ns) after 3 weeks, and this reduction was greater in M than in C group (13.7% vs 8.2%). Conclusion: Listening to joyful music in combination with regular exercise training program leads to more pronounced benefit and improvement of endothelial function than exercise training alone. Therefore, listening to joyful music may be an adjunct method in the rehabilitation of patients after myocardial infarction. Disclosure of Interest: None Declared
PM266 Predicting 30-years cardiovascular disease in riverside communities in the Brazilian Amazon Raitany C. Almeida*1, Otavio R. Coelho2, Diego J. Dias1, Carlos H. Spesia1, Karime Deguchi1, Victor H. Motta JR1, Vinicius R. Grillo3, Manoel G. Souza Neto1, Marcella S. Martello1 1 Universidade Federal Rondonia, Porto Velho, 2UNICAMP, Campinas, 3LIGA Rondoniense de Cardiologia, Porto Velho, Brazil Introduction: Cardiovascular diseases (CVD) remain the leading cause of mortality in Brazil and worldwide. Estimate CVD risk in the next 30 years tends to improve the primary prevention. Objectives: To determine the risk of developing CVD in the next 30 years in riverside communities in the Brazilian Amazon and to evaluate the percentage of the population above normal risk comparing gender and age. Methods: Between April and July 2013, household visits was conducted in four riverside the communities at Madeira River – Amazon. The study was cross-sectional, descriptive, quantitative and qualitative. Standardized questionnaires were used, measured blood pressure (BP), weight, height, waist circumference. The 30-years CVD risk was observed in patients aged 20 to 59 years and assessed the following predictors: gender, age, systolic blood pressure, smoking, use of antihypertensive drugs, body mass index and diabetes. The risk of developing CVD in 30 years was calculated based on the Framingham risk score and all the data analyzed in the statistical program Epiinfo. Results: Included 637 subjects, 44.58% were male (M). The median age was 37.62 years (SD: + / -13.38). Of female (F) subjects between 20-29 years, 45.53% were above normal risk for 30 years -CVD, while 65.21% male (p <0,05). Between 30 to 39 years had 56.55%(F) vs. 73.61%(M)( p <0.05). Between 40-49 years had 85.33%(F) vs. 81.81% (M) (p> 0.05); and 50-59 years had 90.90%(F) vs. 92.42%(M) (p> 0.05) were higher than normal risk for 30-years CVD. About the age, in female, by comparing the average risk CVD found and average risk CVD expected in the group: 20-29 years (4%vs.3%) (p> 0.05); 30-39 years (12%vs.9%) (p> 0.05); 40-49 years (27%vs.15%)(p <0.05); 50-59 years (46%vs.24%) (p <0.05). About the age, in male, by comparing the average risk CVD found and average risk CVD expected in the group: 20-29 years (9%vs.6%) (p <0.05); 3039 years (20%vs.13%) (p <0.05); 40-49 years (37%vs.24%) (p <0.05); 50-59 years (56% vs.36%) (p <0.05). Conclusion: In the age group 20 to 40 years male had higher 30-years CVD risk than female. The average found for 30-years CVD risk was higher than the average expected in all age male groups and female groups over 40 years.. Therefore, it is necessary to improve preventive care in riverside communities. Disclosure of Interest: None Declared
GHEART Vol 9/1S/2014
j
March, 2014
j
POSTER/2014 WCC Posters
PM271 Plasma lipidomic analysis predicts soft coronary artery plaque in asymptomatic patients at intermediate risk of coronary artery disease Andris H. Ellims*1, Gerard Wong2, Jacquelyn M. Weir2, Philip Lew3, Peter J. Meikle2, Andrew J. Taylor1 1 Heart Centre, Alfred Hospital and Baker IDI Heart & Diabetes Institute, 2Baker IDI Heart & Diabetes Institute, 3Department of Radiology, Alfred Hospital, Melbourne, Australia Introduction: The optimal management of asymptomatic subjects at intermediate risk of coronary artery disease (CAD) is often uncertain. Re-stratification to a high or low risk category may enable optimization of preventative strategies. Coronary computed tomographic angiography (CCTA) enables a minimally invasive assessment of coronary artery plaque quantity and composition. Soft plaque by CCTA is lipid-rich and more vulnerable to rupture and resultant acute coronary syndromes. Objectives: To determine whether novel approaches to CAD risk stratification, such as plasma lipid profiling, may predict soft plaque burden in intermediate risk subjects. Methods: CCTA and several markers of CAD (including plasma lipid profiling, carotid intima-media thickness, aortic pulse wave velocity, and C-reactive protein) were prospectively performed in 100 asymptomatic patients at intermediate CAD risk according to the Framingham risk score. Segment stenosis scores (SSS) were calculated to evaluate the burden of total, calcified, and soft coronary artery plaque. Results: Soft plaque was observed in 66 subjects and 158 of 1425 (11%) coronary artery segments. 18 lipid species demonstrated significant associations with soft plaque burden, but not with total plaque or calcified plaque burden. No other marker of CAD was found to predict coronary artery plaque burden. Conclusion: Plasma lipidomic analysis can predict the burden of soft coronary artery plaque in asymptomatic subjects at intermediate risk of CAD. Given that soft plaque is linked to an increased risk of future acute coronary events, plasma lipid profiling may allow re-stratification of these patients to a higher or lower risk category and, thereby, enable more appropriate and effective primary prevention management strategies. Disclosure of Interest: None Declared
PM272 Could Routine Laboratory Parameters Predict The Severity Of Coronary Artery Lesions? Preliminary Study Benny M. Setiadi*1, Hariman Kristian1, Bambang Budiono2, Agnes L. Panda1, Janry Pangemanan1, Reggy Lefrandt1 1 Cardiology and Vascular Medicine, Sam Ratulangi University, Manado, 2Cardiology and Vascular Medicine, Awal Bros Hospital, Makassar, Indonesia Introduction: Several studies have reported the association between several laboratory parameters to severity of coronary artery lesions; however each of those parameters were analyzed in different population.
e115
POSTER ABSTRACTS
PM265