Massive Audio PAT50 User Manual download pdf (Page 39)

ÖKG-Jahrestagung – Abstracts

J KARDIOL 2008; 15 (5–6)

183

Conclusion The proportion of patients with stable CAD who meet

current lipid treatment goals is low and has only marginally im-

proved during the last 7 years. This in particular holds true for the

very high risk patients with CAD plus diabetes.

Aortic, but not Brachial Systolic Blood Pressure Pre-

dicts Survival in Cardiomyopathy 002

T. Weber, M. F. O’Rourke, M. Ammer, M. Rammer, E. Lassnig, B. Eber

Department of Cardiology, Klinikum Wels-Grieskirchen

Rationale Blood pressure (BP) has been inversely linked to mor-

tality in patients with impaired systolic function. Recently, a supe-

rior prognostic value of the aortic as compared to the brachial BP has

been suggested in hypertensives. We tested the prognostic implica-

tions of aortic versus brachial BP in patients with cardiomyopathy.

Methods In 150 patients with impaired systolic function and

known coronary anatomy, brachial BP was measured, and aortic BP

was derived non-invasively, using radial applanation tonometry and

a validated transfer function. Patients were followed prospectively,

primary endpoint was all-cause mortality, secondary endpoint car-

diovascular mortality. Statistics was univariate and multivariate

Cox proportional hazards regression analysis.

Results Mean age was 65.1 ± 10.9 years, 30.6 % were female,

82.6 % had ischemic etiology. Mean ejection fraction was 40.3 ±

10.9 %. After a follow-up of 45.9 ± 16.0 months, 39 patients had

died (29 of cardiovascular causes). Analyzing BP as a continuous

variable revealed a 17.3 % (95 %-CI: 0.2–31.4 %) decrease in all-

cause mortality (p = 0.49) as well as a 23.1 % (95 %-CI: 4.0–

38.4 %) decrease in cardiovascular mortality (p = 0.02) for every

10 mmHg increase in aortic systolic BP. In contrast, brachial systo-

lic BP did not predict total (p = 0.16) or cardiovascular (p = 0.10)

mortality. After adjustment for age, gender, presence of coronary

artery disease, and degree of systolic impairment, a 10 mmHg

higher aortic systolic BP was associated with a 19.2 % (95 %-CI:

1.1–33.9 %) lower all-cause mortality (p = 0.04) and a 25.5 %

(95 %-CI: 5.1–41.6 %) lower cardiovascular mortality (p = 0.02).

Conclusions Aortic systolic BP, the pressure that is actually

“seen” by the heart, is a better predictor of outcome than brachial

systolic BP in cardiomyopathy patients.

Plasma Levels of Asymmetric Dimethylarginine

(ADMA) Predict All-Cause Mortality in Patients

Undergoing Coronary Angiography 003

T. Weber, R. Maas, M. Ammer, M. Rammer, E. Lassnig, R. H. Böger, B. Eber

Department of Cardiology, Klinikum Wels-Grieskirchen; Department of Clinical

Pharmacology, Universitätsklinik Hamburg-Eppendorf

Background Asymmetric dimethylarginine (ADMA) is an inde-

pendent cardiovascular risk factor in renal patients. We aimed to

study the association between ADMA and mortality in patients un-

dergoing coronary angiography.

Methods In 255 patients, we measured plasma levels of ADMA,

using a validated ELISA assay, at the time of the angiogram. Pa-

tients were followed prospectively, primary endpoint was all-cause

mortality. Statistics was univariate and multivariate Cox propor-

tional hazards regression analysis.

Results Mean age 65.7 ± 9.5 years, 51.7 % were men, 15.7 % had

diabetes, 51 % coronary artery disease, 87.8 % normal systolic

function, 19.6 % underwent coronary interventions. Mean ADMA

levels were 0.63 ± 0.16 micromol/l. During a follow-up of 52.5 ±

8.2 months, 12 patients died. Analyzing ADMA as a continuous

variable revealed a 44.8 % increase in mortality (95 %-CI: 5.5–

98.7 %; p = 0.2) for every 0.1 micromol/l increase in ADMA levels.

In a multivariable regression model (p < 0.0001), ADMA (47.7 %

increase in mortality per 0.1 micromol/l increase in ADMA levels;

CI: 3.1–111.7 %; p = 0.03), log NT-proBNP, and age predicted the

primary endpoint, whereas gender, presence of coronary artery dis-

ease, and systolic function did not.

Conclusions In relatively low risk patients undergoing coronary

angiography, plasma levels of ADMA are independent predictors of

all-cause mortality.

Plasma Levels of Matrix Gla protein are Inversely

Associated with Mortality and Severe Cardiovascu-

lar Events in Patients Undergoing Coronary Inter-

ventions 004

T. Weber, S. Kapiotis, M. Ammer, M. Rammer, E. Lassnig, B. Eber

Department of Cardiology, Klinikum Wels-Grieskirchen; Institute of Laboratory

Medicine, KH Göttlicher Heiland, Wien

Background Matrix Gla protein (MGP) is a potent inhibitor of tis-

sue calcification. Serum levels of MGP have been inversely corre-

lated with the extent of coronary artery calcification. However, it is

unknown whether MPG levels are predictive for severe clinical car-

diovascular events including mortality in patients undergoing per-

cutaneous coronary interventions (PCI).

Methods Plasma levels of MGP were measured, using a validated

ELISA, in 234 patients at the time of the PCI. Patients were fol-

lowed prospectively, primary endpoint was total mortality, second-

ary endpoint mortality, nonfatal myocardial infarction, and resteno-

sis. Statistics were logrank test and multivariate Cox proportional

hazards regression analysis.

Results 30.8 % were female, mean age was 65.6 ± 10.4 years,

23.9 % were diabetic and 70.9 % hypertensive. Systolic function

was preserved in 66.2 %. Median plasma level of MGP was

6.61 nmol/l (CI: 6.29–7.11 nmol/l). During a follow-up of 49.9 ±

11.5 months, 22 patients died, and 69 patients reached the second-

ary endpoint. MGP levels above the median were associated with

improved survival (HR for total mortality 0.27, CI: 0.13–0.71;

p = 006, as compared to MPG values below the median) and with a

54 % reduction of the risk of death, myocardial infarction, and

restenosis (HR 0.46; CI: 0.28–0.76; p = 0.002, as compared to MPG

values below the median). In multivariable models, MGP and age

predicted all cause mortality, whereas MGP, extent of coronary ar-

tery disease, and diabetes mellitus predicted the secondary end-

point.

Conclusions MGP is a powerful, independent predictor of severe

cardiovascular events and total mortality in patients undergoing

PCI.

Safety and Efficacy of Endothelial Progenitor Cell

Capture Stent Implantation (Genous

Bio-Engi-

neered R Stent) in Higher Risk Patients: A Single

Center Experience with Intermediate- to Long-term

Clinical Follow-up 110

S. Winkler, M. Heidinger, M. Gyöngyösi, I. M. Lang, G. Kreiner, G. Christ, D. Glogar

Department of Cardiology, Medical University of Vienna

Background The Genous

Bio-engineered R stent is coated with

an antibody (antihuman CD 34) that captures endothelial progenitor

cells (EPCs) to accelerate the natural healing process and reendo-

thelialisation. Rapid recovery of a functional endothelium after

stent implantation is believed to be protective against stent throm-

bosis and to reduce the occurrence of restenosis. Increasing circulat-

ing EPCs by statin therapy seems to be of potential benefit.

Objectives The aim of this study was to evaluate the safety and

efficacy of Genous

stent implantation in higher risk patients with

acute coronary syndrome (ACS) or selected elective patients with

atrial fibrillation, mechanical valve replacement or scheduled non

cardiac surgery regarding major adverse cardiac events (MACE) at

1 year follow-up and the impact of statin therapy.

Methods and Results From November 2005 to August 2007

129 Genous

stents were successfully implanted in 98 patients.

Mean age was 62 ± 12 years, 77 % were male and 26 % had diabe-

tes. 67 % of patients presented with an (ACS; STEMI: 82 %,

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