Table 1. The characteristics of the cases and controls.

Cases Controls p value

Hypertensive 34.2% 12.5% <0.00

Diabetics 40.0% 20.0% <0.00

Waist Hip Ratio 0.95�0.06 0.92�0.07 <0.00

Total Chol (mean) (mg/dl) 194.1� 62.8 177.5�38.1 0.01

HDL Chol (mean) (mg/dl) 39.1�9.9 40.3�10.4 0.3

LDL Chol (mean) (mg/dl) 123.7�56.3 108.3�38.5 0.01

25 (OH)VitD levels (ng/ml) (median) 6.0(3.9-9.0) 11.1(6.5-18.3) <0.00

* in mg/dl; Chol¼Cholesterol

POST

ERABST

RACTS

PT247

High Density Lipoprotein Cholesterol Level and Severity of Coronary Artery Diseasein Asian People

Sang-Hyun Kim*1, Young-Joon Seong1, Hyang Lim Lee2, Hack-Lyoung Kim1, Jae Bin Seo1,Woo-Young Chung1, Joo-Hee Zo1, Myung-A. Kim1

1Cardiology, Internal Medicine, Seoul Boramae Hospital, Seoul National University College ofMedicine, 2Internal Medicine, Seoul Bukbu Hospital, Seoul, Korea, Republic Of

Introduction: Blood level of low density lipoprotein cholesterol (LDL cholesterol) is themajor risk factor of coronary artery disease (CAD). Low high density lipoprotein cholesterol(HDL cholesterol) level is one of risk factors of CAD in western countries. Mean HDLcholesterol level of Korean people is much lower than those of western or other Asiancountries. But the prevalence of CAD is lower than those of western or other Asian countries.Objectives: The aim of this study was to investigate impact of HDL cholesterol level onprevalence and severity of CAD diagnosed in Korean People whose prevalence of CAD wasmuch lower than those of western or other Asian countries.Methods: The subjects were 1884 Korean patients received the coronary angiography. Theseverity of CAD was determined by the number of involved vessels and Friesinger Score onangiography. The effects HDL cholesterol level on the development and severity of CADwere analyzed according to stratified subgroup and mean HDL cholesterol level.Results: As HDL cholesterol level decreased, the odds ratio of CAD prevalence increasedproportionally. The patients with HDL cholesterol < 30mg/dL had 3.4 times higher riskthan patients with HDL cholesterol � 60mg/dL. The mean HDL cholesterol level was43.5mg/dL, 41.0mg/dL, 38.5mg/dL, 37.5mg/dL respectively in the control group (withoutCAD), 1-vessel disease (VD), 2VD, 3VD. Even the subgroup analysis among patients withLDL cholesterol < 100mg/dL showed the significant correlation between HDL cholesterollevel and the severity of coronary artery disease. The HDL cholesterol level was found tohave significant negative association with Friesinger score (r¼-0.201, P<0.001).Conclusion: HDL cholesterol level was significantly associated with the prevalence andseverity of CAD on coronary angiography in Korean people whose prevalence of CAD wasmuch lower than those of western or other Asian countries.Disclosure of Interest: None Declared

PT250

Impact of Insulin Treatment vs Oral Anti Diabetic Drugs on Coronary LesionsMorphology and Severity A Preliminary Study

Vekky Sariowan*1, Bambang Budiono2, Reggy Lefrandt1, Agnes L. Panda1, Janry Pangemanan1,Benny Setiadi1, Steven R. Utomo1, Hariman Kristian11Departement Cardiology and Vascular Medicine, Sam Ratulangi University, Manado,2Departement Cardiology and Vascular Medicine, Awal Bros Hospital, Makassar, Indonesia

Introduction: It had been known that diabetic patients tend to have more severe and difusepattern of CAD as compared to non diabetic patients, but no previous study has been doneto investigate the relation between type of diabetic treatment to the morphology andseverity of coronary artery lesion.Objectives: The aim of this study is to investigate the association of diabetes treatment(insulin vs oral anti diabetic drugs) to the morphology and severity of coronary arterylesions in type 2 diabetes mellitus patients.Methods: This is a cross sectional study which include type 2 diabetic patients who un-derwent coronary angiography between October 2012 to August 2013. Patients weredivided into two groups, which include oral anti diabetic drugs (OAD) group and insulingroup. The association between diabetes treatment to the morphology of coronary arterylesion assessed by Society of Coronary Angiography and Intervention (SCAI) lesion classand the number of vessel disease were analyzed. Statistical analysis was done using SPSS16.0 software. P value <0.05 was considered statistically significant.Results: A total 49 patients were included in this study, in which 25 patients (51%) belong tothe OAD group and 24 patients (49%) belong to the insulin group. The only difference foundbetween the two group was the value of fasting blood glucose in the OAD group and insulingroup (194.5� 56 vs 163.2 � 42.7, P ¼ 0.021, respectively). Diabetic patients with insulintherapy significantly have a higher risk to develop SCAI class IV lesion classification (OR 4.2,P ¼ 0.045) and three vessel disease (OR 4.43, P ¼ 0.035). From the multivariate analysis,insulin treatment is an independent predictor of class IV SCAI lesion classification (OR 7.73,P¼ 0.028). However, insulin therapy is not an independent predictor of three vessel disease.Conclusion: Diabetic patients with insulin therapy have a significant risk to develop classIV SCAI lesion classification and three vessel disease. Insulin therapy is an independentpredictor to develop class IV SCAI lesion. This finding may explain why diabetic patientswho undergo PCI and treated with insulin has the worst outcomes.Disclosure of Interest: None Declared

PT251

Does Seasonal Variation Impacts on Acute Myocardial Infarction InducedHospitalization and Deaths Rates in Lithuania?

Pranas Serpytis*1,2, Jonas Misiura1,2, Egidijus Berukstis1,2, Simona Pelanyte2, Rokas Serpytis1,Robertas Katliorius11Clinic of Cardiac and Vascular Diseases, Vilnius University Hospital Santariskiu Klinikos,2Faculty of Medicine, Vilnius University, Vilnius, Lithuania

Introduction: The first data on enviromental and seasonal effect on human health waspublished in 1926. Though the data on the seasonal variation effect on cardiac health isvery scarce.

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Objectives: Aim of the study was to evaluate possible seasonal variantion in men andwomen hospitalization and case-fatality rates of acute myocardial infarction in VilniusUniversity Hospital Santariskes Clinics, Cardiac and Intensive Care unit during the 2000 –

2010 years period.Methods: We analysed 15333 hospitalized due to acute myocardial infarction patientscases. Median age was 72 � 1,5 years. 931 patients deaths were caused by the acutemyocardial infarction during the exploring period. There were estimated hospitalizationand deaths from acute myocardial infarction rates through the four seasons.Results: There were observed 7 % - 10% more men died from acute myocardial infarctionin spring and 8% - 11% more in autumn, rather than number of the deaths in winter orsummer. In the women group 10% – 11% more died in spring and 12% – 13% in autumn,compare with other seasons.Conclusion: Study demonstrated the significant seasonal variation in the hospitalizationsrates and deaths from acute myocardial infarction, with more common morbidity in March –

April – May and higher mortality rate in March - April and in September – October –

Noverber months. Patients older than 55 years have approximately 3,5 – 4,5 times highermortality due to acute myocardial infarction risk, compare with younger patients.Disclosure of Interest: None Declared

PT252

Independent Association of Severe Vitamin D Deficiency As a Risk of AcuteMyocardial Infarction in Indians

Ambuj Roy*1, D. Prabhakaran2, R. Lakshmy3, N. Tandon4, Tariq Rana3, V. K. Bahl1,K. S. Reddy51Cardiology, All India Institute of Medical Sciences, 2Centre for Chronic Disease Control,3Cardiac Biochemistry, 4Endocrinology, All India Institute of Medical Sciences, 5Public healthFoundation of India, New Delhi, India

Introduction: Vitamin D deficiency has been associated with coronary heart disease(CHD). Emerging data from India has shown high prevalence of vitamin D deficiencydespite abundant sunshine in large parts of India.Thus it would be useful to determine therole of this novel and potentially reversible risk factor of CHD in Indians.Objectives: To study the association of vitamin D with acute myocardial infarction (MI) inIndians by analyzing 25 hydroxy vitamin D (25(OH) D) levels in cases of MI and age andgender matched healthy controls.Methods: Consecutive cases of first incident MI (n¼120) and controls (n¼120) were recruitedin the study at All India Institute of Medical Sciences, New Delhi. The clinical and biochemicalrisk factorswere assessed for both cases andcontrols. 25 (OH)D assaywasmeasured from storedsamples for cases and controls using standard gold procedure radioimmunoassay.Results: The mean age of cases and controls was 51.9� 11.4 and 52.1� 11.0 yearsrespectively. 25(OH) D deficiency (< 30ng/ml) was extremely common in cases andcontrols (98.3% and 95.8% respectively) with median levels significantly lower in cases(Table 1). The cases were more frequently diabetic, hypertensive, tobacco and alcoholconsumers. They had higher mean waist hip ratio (WHR), total and LDL cholesterol (Table1).Severe vitamin D deficiency (<10ng/ml) was strongly associated with a risk of MI withan odds ratio of 4.6 (95% CI 2.3-9.4), even after adjusting for known confounders likehypertension, diabetes, cholesterol, smoking, alcohol use and WHR.

Conclusion: This study shows that vitamin D deficiency is very common among patientsof acute MI and healthy controls, with levels of 25 (OH) D being significantly lower amongcases. It for the first time reveals that severe vitamin D deficiency is associated with a strongrisk of acute MI in Indians. This association needs to be tested in larger cross-sectional andcohort studies. Population awareness of vitamin D deficiency must be created and itsskeletal and possible cardiovascular harm should be mitigated by encouraging sun expo-sure and food fortification.Disclosure of Interest: None Declared

PT253

Understanding the impact of a multifaceted quality improvement intervention toimprove cardiovascular disease risk management in Australian Primary Health Care:The TORPEDO study process evaluation

Bindu Patel*1,2, Tim Usherwood3, Mark Harris4, Katie Panaretto5, Julie Redfern1, Jesse Jansen2,Shannon McKinn2, Marilyn Lyford1, Anushka Patel2,6,7, David Peiris2,81Cardiovascular Division, The George Institute for Global Health, 2School of Medicine, Universityof Sydney, Camperdown, 3Department of General Practice, Sydney Medical School-Westmead,

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