Risk factors

% LAVI > 28 ml/m2

N[778 p value OR CI

No risk 12.6 0.30 - -

1 risk or more 87.4

Diabetes mellitus 0.27 - -

Yes 12.9

No 87.1

Hypertension < 0.001 0.7 0.57-0.88

Yes 32.0

No 68.0

Dyslipidemia 0.50 - -

Yes 60.2

No 39.8

Obese 0.85 - -

Yes 59.4

No 40.6

Area < 0.001 1.6 1.28-1.89

Urban 35.3

Rural 64.7

POST

ERABST

RACTS

Results: A total 34 patients was included in this study, in which 17 patients (50%), 13patients (38%) and 4 patients (11%) belongs to the control group, low ABI group and verylow ABI group respectively. The overall mean ABI is 0.93 with minimum and maximumABI value is 0.71 and 1.31 respectively. There is significant difference in the mean modifiedgensini score between the three groups (5.24�4.35 vs 13.62�3.31 vs 16�9.83 in control,low ABI and very low ABI respectively, P value <0.001). From Pearson correlation test,there is significant corelation between ABI and modified gensini score ( r ¼ -0.612 andp value < 0.001). ABI <0.9 significantly have higher odds of having severe coronary arterystenosis (modified gensini score >13), with odd ratio (OR) 9.07, P value 0.003. Low ABI(OR 8.67 P value 0.03) and very low ABI (OR 5.15 P value 0.023), both have a higher oddsof having severe coronary artery stenosis compared to control. On multivariate logisticregression analysis, ABI remained an independent predictor of CAD severity after correctingfor other conventional risk factors for CAD.Conclusion: ABI <0.9 have a higher risk to have severe coronary artery stenosis. DecreasedABI value associated with the increased of severity coronary artery stenosis. ABI is a simpleand noninvasive method that can predict severity of coronary artery stenosis patient withcoronary artery disease. This association is independent of other conventional cardiovas-cular risk factors.Disclosure of Interest: None Declared

PT296

Patterns of cardiovascular risk factors in asymptomatic diabetics and pre-diabeticsfrom South East Asia

Ismail R. Johan*1, Ibrahim Zubin1, Arshad Kamal1, Abd Rahman Effarezan1,Zainal Abidin Hafisyatul1, Lim Chiao Wen1, Kasim Sazzli11Cardiology, UiTM, Sungai Buloh, Malaysia

Introduction: Diabetes mellitus increases the risk of heart failure independent of coronaryheart disease and hypertension. It is also associated with diabetic cardiomyopathy of whichthe epidemiology is not well defined. We sought to study the pattern of cardiovascular riskfactors in an asymptomatic diabetic population from Malaysia.Objectives: To assess cardiovascular risk factors in diabetic and pre-diabetic patients.Methods: Subjects were recruited as part of a community study on cardiovascular diseasesbetween the years 2007 to 2011. Demographic details, cardiovascular risk factors alongwith echocardiogram were obtained.Results: A total of 1932 subjects with echocardiogram were analyzed. Mean age was 54.6� 11.6. Majority of the subjects were male 98.3% (1899). Mean systolic ejection fraction(EF) was 64.5% � 7.0. Prevalenve of diastolic dysfunction was 52.8% (1021). Of all thesubjects with diastolic dysfunction, 29.9% (578) had impaired relaxation, 21.0% (406)pseudonormal and 1.9% (37) restrictive defect. Among subjects with diastolic dysfunction,13.8% (266) were diabetic and 9.6% (185) were pre-diabetic (impaired fasting glucose).Table below summarize the cardiovascular risk factors among the subjects with diabetesand pre-diabetes. In univariate analysis only age and hypertension found to be significantpredictor for diastolic dysfunction among diabetes mellitus subjects. However in multi-variate analysis, age was the only the strong predictor for a diabetic patients to have dia-stolic dysfunction with OR 0.57 (CI:1.01-1.10).

CV risk factors

Impaired fasting glucose (%)

N[185

Diabetes (%)

N[266

Diastolic dysfunction 61.6 58.6

Hypertension 35.1 37.2

Dyslipidemia 55.7 57.1

Obesity 73.0 77.4

Conclusion: The prevalence of diastolic dysfunction in diabetic and impaired glucosetolerance subjects in our population was suprisingly higher than reported. Age and hy-pertension remain a significant risk factor associated with risk of developing diastolicdysfunction in patients with diabetes mellitus, however after adjusted only age is the strongpredictor.Disclosure of Interest: None Declared

PT297

Echocardiographic left atrial volume index (LAVI) in a heterogenous Asianpopulation

Ismail R. Johan*1, Ibrahim Zubin1, Arshad Kamal1, Abd Rahman Effarezan1,Zainal Abidin Hafisyatul1, Lim Chiao Wen1, Kasim Sazzli11Cardiology, UiTM, Sungai Buloh, Malaysia

Introduction: The left atrium (LA) is a complex structure and is frequently involved indisease affecting the left ventricle. LA dilation is related to an increased filling pressure andis a strong predictor of heart failure, stroke and death. Assessment of LAVI in asymptomaticpatients may help in aggressive risk factors control and prevent further complication as it isan inexpensive and readily available tool.Objectives: To describe LAVI in normal and diseased states in an asymptomatic Asianpopulation.Methods: Between 2007 and 2011, subjects participating in a longitudinal populationstudy looking at cardiovascular diseases were enrolled. Demographic data, cardiovascular

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risk factors and echocardiograph were obtained. LA volume was calculated by the area-length method in the apical 2-chamber and apical 4-chamber view and indexed to bodysurface area (BSA). Descriptive, univariate and multivariate analysis were performed usingSPSS version 16.Results: A total of 1932 subjects with echocardiogram were analyzed. Mean age was 54.6� 11.6. Majority of the subjects were male 98.3% (1899). Mean systolic ejection fraction(EF) was 64.5% � 7.0. Majority was Malay ethnic 81.9% (1582), 13.8% (266) were di-abetics and 9.6% (185) had impaired fasting glocose (IFG). 60.6% (1170) had high LDLlevel of more than 3.4mmol/L. 26.1% (505) were hypertensive and 59.1% (142) wereobese. Mean left atrial volume index was 28.0 � 9.1 ml/m2. Total of 40.3% (778) had LAVI> 28 ml/m2. For those with LAVI > 28 ml/m2, 12.6% (98) were in the healthy subjectswhile the remaining 87.4% (680) had at least 1 risk factor (diabetes, hypertension, dysli-pidemia or obesity). Table below summarized the prevalence of LAVI > 28 ml/m2 innormal and disease subjects. For subjects with LAVI 28 ml/m2, hypertension, and live inurban area remained the strong predictors for LAVI > 28 ml/m2 after univariate andmultivariate analysis with age adjusted.

Conclusion: Our findings supported previous study that LAVI measurement is a potentialtool to be used in assessment of asymptomatic patients with cardiovascular risk factors asthese subclinical patients might benefit from aggresive risk factor control to prevent furthercomplication.Disclosure of Interest: None Declared

PT298

Combination Therapy With Pravastatin And Valsartan Has Additive Effects ToImprove Vascular And Metabolic Phenotypes Over Monotherapy InHypercholesterolemic Patients

Kwang Koh*1, Pyung Oh21Cardiology, 2Gil Hospital, Incheon, Korea, Republic Of

Introduction: Statin and angiotensin II type 1 receptor blocker therapy improve endo-thelial dysfunction using distinct mechanisms.Objectives: We evaluated simultaneous vascular and metabolic responses to pravastatinand valsartan therapy, alone or in combination, in hypercholesterolemic patients.Methods: Forty-eight hypercholesterolemic patients (23 had metabolic syndrome) weregiven pravastatin 40 mg and placebo, pravastatin 40 mg and valsartan 160 mg, or valsartan160 mg and placebo daily during each 2 month treatment period in a randomized, single-blind, placebo-controlled cross-over trial with three treatment arms and two washoutperiods (each 2 months).Results: Of note, brachial artery flow-mediated dilation improved to a greater extent withcombined therapy vs. either monotherapy (P<0.001 by ANOVA). Interestingly, whencompared with monotherapy, combined therapy significantly reduced hs-CRP levels to agreater extent (P¼0.019 byANOVAonRanks).We also observed simultaneous improvementin metabolic phenotypes with all three treatments causing increased plasma adiponectinlevels, reduced fasting plasma insulin levels, and increased insulin sensitivity (determined byQUICKI) relative to baseline measurements. For the first time in a statin combination trial,pravastatin combined with valsartan therapy increased plasma adiponectin, lowered fastinginsulin, and improved insulin sensitivity in an additive manner when compared with eithermonotherapy alone (P¼0.003, P¼0.049, and P¼0.049 by ANOVA on Ranks, respectively).Overall, we observed similar results in 23 patients with metabolic syndrome.Conclusion: Pravastatin combined with valsartan improved endothelial function andmetabolic phenotypes in an additive fashion in patients with hypercholesterolemia ormetabolic syndrome.Disclosure of Interest: None Declared

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