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S264 Heart, Lung and CirculationAbstracts 2009;18S:S1–S286

Social Aspects of Cardiovascular Disease

605ACTUAL CARDIAC RISK IN SELF DEEMED ‘NORMAL’POPULATION

Rebecca Perry, Majo X. Joseph, Amy Penhall, LynnBrown, Derek P. Chew, Philip E. Aylward, Carmine G.De Pasquale

Flinders Medical Centre, Adelaide, South Australia, Australia

Background: Coronary artery disease (CAD) is a majorcause of mortality and morbidity in Australia and otherwestern countries. The common CAD risk factors aregenerally well known at a community level; however, per-ceived risk by individuals is often skewed. Our aim wasto determine the actual risk in a population who definedthemselves as normal.

Methods: One hundred and nineteen subjects whoconsidered themselves very low risk for cardiovasculardisease underwent complete risk factor analysis includ-ing blood pressure, cholesterol testing and questioningon cardiac history. This data was used to calculate eachsubject’s 10-year Framingham risk index.

Results: The majority (87%) of subjects were deemed tohave a low cardiac risk (less than 10% over the next 10years), however 13% were deemed to have moderate orhigh cardiac risk. Results are shown below.

Total cohort(n = 119)

Low riskgroup(n = 104)

Moderate/highrisk group(n = 15)

Age (years) 52 ± 14 50 ± 13 67 ± 11ab

Males 34 (27%) 20 (19%) 14 (92%)ab

Total cholesterol(mmol/L)

5.2 ± 1.0 5.2 ± 1.0 5.5 ± 0.8

Systolic bloodpressure(mmHg)

127 ± 20 126 ± 19 142 ± 23ab

Current smokers 17 (14%) 13 (13%) 4 (27%)ab

Carotid IMT (cm) 0.63 ± 0.14 0.61 ± 0.14 0.74 ± 0.12ab

ap < 0.05 compared to low risk group; bp < 0.05 compared to total cohort.

Conclusion: In a self-deemed low cardiac risk popula-tion we have found 13% with moderate to high cardiac riskindex. This suggests that community based primary pre-vention screening has the potential to positively impact onoutcome with targeted therapies, further education andlifestyle modifications.

doi:10.1016/j.hlc.2009.05.651

606DELAYS IN PATIENTS WAITING FOR IN-HOSPITALANGIOGRAPHY AND CABG RESULTS IN SIGNIFI-CANT HEALTH CARE COST

K.L. Looi 1, K.L. Chow 1, J.L. Looi 1, S. Haliday 1, M. Lee 1,G. Gamble 2, H.D. White 1, C.J. Ellis 1

1 Green Lane Cardiovascular Service, Auckland City Hospital,Auckland, New Zealand2 Department of Medicine, Auckland University, Auckland,New Zealand

Background: Patients (pts) presenting with an acutecoronary syndrome (ACS) are at high risk of death andmorbidity. In-hospital invasive assessment with cardiacangiography is essential for many pts, and revascularisa-tion with coronary artery bypass graft (CABG) surgery,before hospital discharge, is needed for those with themost severe coronary artery disease. Undue delay forangiography and CABG surgery renders pts at increasedrisk of complications, including death, and imposes a sig-nificant economic burden to both pts and the hospital.We assessed the situation at the Auckland City Hospital(ACH).

Methods: Using a prospective database of all pts admit-ted to ACH Coronary Care Unit (CCU) from 1/6/06 to31/7/07 we retrospectively assessed pt admissions, andtime delays for cardiac angiography and CABG surgery.We considered that good service would be to receive anangiogram within 48 h of admission, and CABG surgerywithin 3 days of the diagnostic cardiac angiogram; wecalculated the cost of pt delays at $2000/day of CCU admis-sion.

Results: We recorded 1580 admissions from 1474 pts. 902patients presented with an ACS, 274 pts were transferredfrom other hospitals. Hence 628 pts were admitted fromthe ACH catchment area, with a mean age of 66.1 ± 13.7years, 62.9% pts were male. The mean length of stay inthe hospital was 7 ± 6.9 days, the median 5 (IQR 3-8). Intotal, 540 (86.0%) pts had cardiac angiography, with wait-ing times from admission to angiogram of 2.7 ± 2.8 days(mean) and 2 (IQR 1-4) (median). 47% of pts waited >48 hours, with the total pt days delayed of 684 days: a costof $1,368,000.

In total, 44 (7%) pts received a CABG in hospital, withwaiting from angiogram to CABG surgery of 4.8 + 3.4 days(mean) and 4.5 (IQR 2–7) days (median). 61% of pts waited>3 days, with the total pt days delayed of 103 days: a costof $206,000.

Conclusion: Significant delays are seen for ACS ptsaccessing cardiac angiography and even longer delays forCABG surgery. Quality health care for ACS pts includesefficient service provision, which would also significantlyreduce hospital costs.

doi:10.1016/j.hlc.2009.05.652