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comparison to non-CAD, patientswith CADwere older (62�12 vs 53�17 yrs), more likely tohave DM (75% vs 45%), diabetic nephropathy (61% vs 34%) and PAD (60% vs 35.5 %),(p¼0.001 for all). There was no significant difference for hypertension (81% vs 86%), dys-lipidemia (28% vs 23%) and smoking (4% vs 6%). The presence of diabetic retinopathy (77%vs 42%) and foot ulcer (26% vs 7%) was significantly higher among CAD patients. Thenumber of vascular access for HDwas higher in the CAD patients (median 3[1-19] vs 2[1-12].Logistic regression multivariate analysis showed that independent predictors for CAD in

HD patients were presence of foot ulcer (aOR 3.0; 95% CI 1.23-7.55), retinopathy (aOR2.05; 95% CI 1.04-4.04) and age (aOR1.02; 95% CI 1.001-1.051).Conclusion: Our study confirms and expands the impact of ESRF on regular HD therapyon the incidence and outcome of CAD disease.Disclosure of Interest: None Declared

PM162

Short and intermediate-term prognostication of the Canada Acute CoronarySyndrome Risk Score in the Gulf RACE-2 registry

Hussam Alfaleh*1, Khalid AlHabib1, Tarek Kashour1, ahmed Hersi1, anhar ullah1,Jassim AlSuwaidi2, Kadhim Sulaiman3, Alawi AlsheikhAli4, Ahmed Al-Motarreb5,Haitham Amin6, Wael Almahmeed7, Nidal Alasaad2, Shukri Alsaif81Cardiac Sciences, King Saud University, King Khalid university Hospital, riyadh, Saudi Arabia,2Department of Cardiology, Hamad Medical Corporation (HMC), Doha, Qatar, 3Department ofCardiology, Royal Hospital, Muscat, Oman, 4Division of Cardiology, Institute of Cardiac Sciences,Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates, 5Faculty of Medicine, Sana’sUniversity, sanaa, Yemen, 6Mohammed Bin Khalifa Cardiac Center, Cardiac Center, manama,Bahrain, 7Department of Cardiology, SheikhKhalifaMedical City, abu dhabi, United Arab Emirates,8Saud AlBabtain Cardiac Center, Saud AlBabtain Cardiac Center, dammam, Saudi Arabia

Introduction: The use of acute coronary syndrome (ACS) prognostic risk scoresis limited bytheir complexity and their inability to be used atfirstmedical contact either at pre-hospital or inthe emergency room. The Canada Acute Coronary Syndrome (C-ACS) Risk Score is a simplerisk assessment tool that was recently shown to provide early and rapid risk assessment.Objectives: Our objective was to test whether C-ACS risk score can predict short andintermediate-term mortality in real world ACS registryMethods: 7929 patients enrolled in the Gulf RACE-2 registry, from 6 Arab gulf countrieswere prognosticated using the C-ACS risk score. The score ranged from 0 to 4, with 1 pointassigned for the presence of each of these variables: age �75 years, Killip >1, systolic bloodpressure <100 mm Hg, and heart rate >100 beats/min. C-Statistic was used to test thepredictive power of the C-ACS risk score for 30-day and 1-year mortality in the entire ACScohort, and in STEMI and NSTEMI groups separately.Results: The C-ACS score predicated 30 days, and 1-year mortality. The predictive powerof C-ACS for 30-day mortality in all ACS patients, STEMI and NSTEMI groups washowever modest (C-Statistic 0.69 95% CI 0.66-0.71, 0.68 95% CI 0.65-0.71, and 0.7095% CI 0.66-0.73 respectively). The predictive power for 1-year mortality for all ACSpatients, STEMI and NSTEMI groups was also modest (C-Statistic 0.67 95% CI 0.65-0.69,0.68 95% CI 0.65-0.71, 0.67 95% CI 0.64-0.70 respectively).Conclusion: Although the simple C-ACS risk score possessed good predictive values forshort and intermediate mortality in a western ACS registry, its predictive power in acontemporary Middle Eastern ACS population was suboptimal. This raises concerns aboutthe accuracy and generalizability of this ACS risk assessment tool.Disclosure of Interest: None Declared

PM163

Affectation of The Anterior Descending Artery In Patients With Chronic StableAngina And Coronary Angioplasty Multivessels

Ricardo A. Costantini*1, Cristian García1, Juan M. Telayna11Interventional Cardiology, Austral University Hospital, Pilar, Argentina

Introduction: The compromises of the anterior descending artery in the context of cor-onary multiple diseases can make determine the strategy of revascularization.Objectives: Determines the results of the treatment under coronary angioplasty in multiplevessels and compromise of anterior descending artery (ADA) in patients with chronic stableangina.Methods: Patient (n¼331) with chronic stable angina received consecutively percutaneuscomplete revascularization. Of these there was presenting affectation of ADA 59 patients(Group A) and without affectation of ADA 272 patients (Group B). Presented the followingbasal characteristics, A and B n (%), respectively: age 64,8 � 10 years vs 63,6 � 10 years;diabetes 17pts (29) vs 88pts (32); prior infarct 19pts (32) vs 90pts (33); previous coronaryangioplasty 18pts (30) vs 103pts (38), previous by pass surgery 6pts (10) vs 56pts (20);media left ventricular function 59,9 � 16,6% vs 60,5 � 18,4%. The clinical status was:silent ischemia 42pts (71) vs 196pts (72); chronic stable angina CF II: 12pts (20) vs 57pts(21); CF III 4pts (7) vs 16pts (6); CF IV stabilized 1 pt (2) vs 3pts (1). The angiographicfindings was: media length lesion 19,9 � 4,6 mm vs 21,2 � 9 mm; media length stent 53,9� 33,7mm vs 47,9 � 31,7mm, stent / patient 2,4 vs 2,1; use drugs eluting stents 36 (61) vs161 (59); dye volume 311,7 � 99,5 ml vs 273,1 � 98,2 ml – p¼ 0,007 – and fluoroscopytime 26,5 � 15,1 vs 23 � 14,2 minutes p¼ 0,09.Results: Intrahospitalary results, A vs B, respectively n(%): technical success 58 (98) vs 261(96); totalmortality0 vs0; totalmyocardial infarct 3 (5) vs7 (2,5) - p¼0,3.During the follow-upto 22� 15months of 86%of the population: totalmortality 1 (1,6) vs 4 (1,4); cardiacmortality0 vs 0; myocardial infarct 0 vs 1 (0,3) and coronary total reintervention 10 (17) vs 45 (16).Conclusion: The strategy of percutaneous multivessels revascularization with affectation theADA, in patients with chronic stable angina did not demonstrate superior cardiovascular

GHEART Vol 9/1S/2014 j March, 2014 j POSTER/2014 WCC Posters

major events in opposite of patients with disease of multiple vessels without affectation ofADA. Therefore, the decision of the strategy of revascularization in this clinical statusmust notbe weighed according to the affectation the ADA.Disclosure of Interest: None Declared

PM164

Left Main Coronary Artery Disease: Comparison of Coronary Artery Bypass Surgery,Percutaneous Coronary Intervention, And Medical Therapy In “Real-World” ClinicalPractice

Vadim Kuznetsov*1, Ivan Bessonov1, Igor Zyrianov1, Elena Samoylova1, Elena Gorbatenko11Tyumen Cardiology Center, Tyumen, Russian Federation

Introduction: Coronary artery bypass surgery is considered as the gold standard treatmentof unprotected left main coronary artery (ULMCA) disease. Recent data suggest that ULMCApercutaneous coronary interventions (PCI) with drug-eluting stents may be safe and effec-tive. However, in "real-world" clinical practice some patients receive medical therapy only.Objectives: To evaluate long-term results in patients with ULMCA disease in a "real-world"practice.Methods: Between January 2006 and June 2011, 218 stable patients were diagnosed withde novo ULMCA stenosis. 52 (23.9%) patients received medical therapy only, CABG wasperformed in 106 (48.6%) patients, PCI in 60 (27.5%) patients. The composite of death,myocardial infarction, and stroke were defined as major adverse cardiac and cerebrovas-cular events (MACCE) and target vessel revascularization (TVR) were defined as primaryendpoints. The median follow-up period was 4 years.Results: Baseline clinical and descriptive morphology of coronary artery disease revealedmore comorbidities and more complex anatomies in the medical therapy group comparedwith CABG and PCI groups. Revascularization might not have been used due to physician’sdecision (operative risk considered excessive) in 24 (46.2%) cases or when patients refusedrevascularization in 28 (53.8%) cases. The median time from diagnosed ULMCA disease torevascularization was significant shorter in PCI group compared with CABG group (4 daysvs 68 days; p<0.001). At 4-year follow-up MACCE rate was higher in nonsurgical groupcompared with CABG (34.6% vs 13.2%; p¼0.002) and PCI (34.6% vs 14.5%; p¼0.016)groups, but there was no difference between CABG and PCI groups. Survival in CABG(4.7%; p<0.001) and PCI (5.5%; p¼0.009) groups was higher compared with nonsurgicalgroup (23.1%). According to the multivariable Cox regression analysis, coronary revas-cularization (CABG and PCI) was independent predictor of long-term survival (HR 3.49;95% CI 1.39-8.75; p <0.001).Conclusion: PCI like CABG improves survival for patients with unprotected left maincoronary artery disease compared with medical therapy only in "real-world" clinicalpractice. Unprotected left main coronary artery disease requires mandatory, fastest possiblerevascularization strategy.Disclosure of Interest: None Declared

PM165

Association between CYP2C19*2/*3 Polymorphism and Cardiovascular Events in aChinese Han Population

Ying-Ying Zhang1, Xin Zhou1, Wen-Jie Ji1, Rui-Yi Lu1, Rui Shi1, Shan Zeng1, Tie-Min Jiang1,Yu-Ming Li1, Zhao-Zeng Guo*11Institute of Cardiovascular Disease and Heart Center, Tianjin Key Laboratory of CardiovascularRemodeling and Target Organ Injury, Pingjin Hospital, Logistics University of CPAPF, Tianjin,China

Introduction: The dual antiplatelet therapy using aspirin and clopidogrel is now thecornerstone to prevent the ischemic cardiovascular events in coronary heart disease (CHD).Cytochrome P450 (CYP) enzymes play a vital role in the metabolism of clopidogrel, howevermultiple cohort studies have linked the CYP2C19*2, CYP2C19*3 polymorphism and otherloss-of-function allelic variants of this gene to major adverse cardiovascular events in patientstaking clopidogrel. The distributions of CYP2C19 polymorphisms in whites, blacks, EastAsians are approximately 30%, 40%, and 55%, respectively. Additionally, CYP2C19*3 allelehad been regarded as an Asian-specific variant allele that accounts for the poor metabolismand a risk factor influencing CHD in Chinese Uighur population.Objectives: To explore the relationship between Cytochrome P450 2C19 (CYP2C19)*2/*3polymorphism and cardiovascular events in Chinese Han people.Methods: A total of 231 consecutive patients underwent coronary angiography who weresuspected for CHD were enrolled. Genotyping for CYP2C19*2(681G>A) and*3(636G>A) alleles were performed by polymerase chain reaction restriction fragmentlinked polymorphism method. The adverse clinical events were defined as cardiovasculardeath, myocardial infarction, stent thrombosis, stroke and rehospitalization for acutecoronary syndrome (ACS) during a 14-month follow-up period.Results: Compared with CYP2C19*2 non-carriers, the CHD% was significantly higher(P¼0.025) in CYP2C19*2 carriers group, and similar result was also observed in theincidence of adverse cardiovascular events (21.6% vs. 6.3%, P¼0.019). No difference ofCHD% was observed in CYP2C19*3 determined groups. Stepwise binary logistic regres-sion analysis showed that CYP2C19*2 carries (OR 1.94, P¼0.028, 95%CI 1.076 to 3.504)and male gender (OR 2.74, P¼0.001, 95%CI 1.577 to4.758) were independent predictors,and CYP2C19*2 loss-of-function was the only independent factor to predict the coronaryevents via multivariate Cox proportional hazards analysis (HR¼3.653, P¼0.036, 95% CI1.089 to 12.248). CYP2C19*3 genotype had no obvious impact on cardiovascular events.Conclusion: CYP2C19*2 polymorphism independently predictor adverse cardiovascularevents in a Chinese Han population.Disclosure of Interest: None Declared

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