POST

ERABST

RACTS

PM200

Australian Experience with AbsorbTM Bioresorbable Scaffold Technology in "Real-World" Coronary Disease

Michael C. Nguyen*1, Nigel Jepson2, Paul Chia1, Mark Pitney2,3, Alan Whelan1, Liam Back2,Randall Hendriks4, Sze-yuan Ooi5, Rajesh Kanna1, Arman Ahmadi61Cardiology, Fremantle Hospital, Perth, 2Prince of Wales Hospital, 3Cardiology, SutherlandHospital, Sydney, 4Fremantle Hospital, Perth, 5Cardiology, Prince of Wales Hospital, Sydney,6Medicine, Notre Dame University, Perth, Australia

Introduction: Coronary metallic stents have been the cornerstone of treatment for coro-nary arterial disease. Bioabsorbable coronary scaffolds represent a novel treatment optionthat allows the initial restoration of coronary flow and support of the vessel, however withsubsequent resorption of the scaffold, the risks of stent thrombosis and need for long- termantiplatelet therapy can be potentially reduced. “Real world” data on the use of thistechnology in a more complex subset of patients and lesions is lacking.Objectives: We aimed to study the safety and efficacy of the Absorb� bioabsorbablescaffold (ABRS) out to 30 days for the treatment of patients presenting with acute coronarysyndrome (ACS) and stable angina, in a wide range of lesion subsets including primary PCI,chronic total occlusions (CTOs), bifurcations, long lesions and multi-vessel disease.Methods: Data was prospectively collected from 3 major tertiary hospitals in Australia(Fremantle Hospital, Western Australia, and Prince of Wales Public Hospital and Suther-land Hospital, New South Wales) between December 2010 and August 2013. Baselinedemographics, presentation, as well as procedural data were collected. Both in-hospital and30 day safety and efficacy outcomes were analysed.Results: In total, 155 patients were treated with 245 scaffolds (mean age 60yrs, 60% male)with 52% presenting with ACS (6% STEMI) and 10% undergoing multi-vessel interven-tion. There was a mean of 1.6 scaffolds/patient (range 1 to 5) with LAD, LCX, RCA andSVG treated in 39%, 22%, 35%, and 2.3% respectively. There was 100% proceduralsuccess and 99% device success (2 device delivery failures with subsequent successfultreatment with drug-eluting stents). There were 2 in-hospital myocardial infarcts (Non Qwave, 1.3%) with no mortality. At 30 days, there were a total of 3 myocardial infarcts(1.9%) including 1 scaffold thrombosis (0.6%) requiring target vessel revascularization(0.6%). There was no mortality.Conclusion: This early local experience has demonstrated ABRS therapy to be highly safeand efficacious in a cohort of real-world patients with complex presentations and disease(including ACS, long lesions, multi-vessel disease and CTOs).Disclosure of Interest: None Declared

PM202

Establishing Chronic Total Occlusion Programme in a Tertiary Australian Centre -Description of Early Experience

Vimalraj Bogana Shanmugam*1, Dennis Wong2, Peter Psaltis2, Sujith Seneviratne3,Ian Meredith2, Yuvaraj Malaiapan21Monash Heart, Interventional Cardiology, Monash Health, Monash Medical Centre, 2MonashHeart, Interventional Cardiology, 3Monash Health, Monash Medical Centre, Melbourne,Australia

Introduction: Chronic total occlusions (CTO) represent a unique set of lesions forpercutaneous coronary intervention (PCI) because of the complexity of techniques requiredto treat them, prompting recommendations for institutions to adopt dedicated CTOrevascularisation programs.Objectives: The aim of our study was to investigate the baseline, Procedural characteristicsand in-hospital outcomes during the initiation phase of establishment of a dedicated CTOprogramme.Methods:We retrospectively reviewed the CTO-PCI experience between January 2010 andDecember 2012 in a multi-operator single centre, which is one of the largest volume PCIcentres in Australia. Data were collected for patient, lesional and procedural characteristics,including procedural success and in-hospital outcomes.Results: 82 CTO-PCI procedures were performed. Mean age of the overall cohort was62.6�11.3 years with 85% males. Multivessel disease was present in 78%. The mostcommon site of CTO was RCA (44%), followed by LCX (30%) and LAD (26%). By lesionalQCA analysis, the frequencies of complex CTO angiographic features were: 13% formoderate-to-severe calcification, 26% for blunt or ambiguous proximal cap, 16% forangulation of the distal vessel greater than 45� and 34% for the presence bridging collat-erals. Mean lesional length was 10.1+7.7 mm. Retrograde Rentrop grade III collaterals wereobserved in 30%. Adopting the Japanese CTO scoring system, 34% of lesions were clas-sified as easy, 37% intermediate, 23% difficult and 6% very difficult. Procedures wereundertaken by ten different operators with varying levels of experience, with all casesperformed by antegrade guide-wire approach. Selected procedural characteristics included:re-attempt procedure,10%; mutiple access sites, 21%; more than one guide wire, 77%;additional support modality, 60%; DES, 97%; stent number, 1.6�0.9; total stent length,40.1�24.5mm; fluroscopy time, 31.7�17.5 min; contrast volume, 257.2�110.9 mL.Overall CTO success rate was 60%. In-hospital adverse outcomes, included: 3% mortality,28% peri-procedural myocardial infarction, 17% emergency bypass surgery, 3% tampo-nade and 7% contrast-induced nephropathy.Conclusion: Modest success rates were achieved in a relatively conservative CTO cohort,in this single centre experience, prior to the initiation of a dedicated CTO revascularisationprogram. These results emphasise the need for Australian centres to adopt a systematic andspecialised approach to CTO-PCI.Disclosure of Interest: None Declared

e104

PM203

The Protective Effect Of Ischemic Postconditioning On Reperfusion Injury In PatientsWith St-Segment Elevation Acute Myocardial Infarction

Yue-Xi Wang*1, Rong A11Cardiology, 1th Hospital affiliated to Inner Mongolia Medical University, Huhhot, China

Introduction: To observe the protective effect of ischemia postconditioning.Objectives: To observe the protective effect of ischemia postconditioning during the firstminutes of reperfusion for the myocardial reperfusion injury in ST segment elevation acutemyocardial infarction(STEMl) patients undergoing emergency percutaneous coronaryintervention(PCI).Methods: STEMI patients undergoing emergency PCI in affiliated hospital of InnerMongolia Medical University between Jan.2005 and Jan.2012, Were randomly divided intothe control group(n¼40) without any intervention after PCI and the postconditioning(PocsC) group(n¼50) with ischemia postconditioning within first 5 minutes of fellow by 3episodes of 30 seconds inflation and 30 seconds deflation with the angioplasty balloon.Reperfusion arrhythmias, cTnT and CK-MB. corrected TIMI frame count(CTFC), wallmotion score index(WMSI) and left ventricular ejection fraction(LVEF) by echocardiog-raphy were compared between the two groups. MI areas were evaluated with the ECT andmyocardial blush grade(MBG) was measured.Results: The incidence of reperfusion arrhythmias-frequent ventricular premature 30%(12/40)in Pocs C group vs 46%(23/50) in control group, P<0.05, and short array ventriculartachycardia beat22.5%(9/40) vs 38%(19/50) in the two groups, P<0.05, as well as values ofpeaks cTnt[(0.84�0.21)ng/;L vs(1.27�0.48)u/L, P<0.01], CK-MB[(94.5�51.4)u/L vs(171.8�79.3)u/L, P<0.01]. CTFC(34.1�8.7vs29.2�7.5, P<0.05). WMSI(1.74�0.9 vs2.1�0.6, P<0.05), and infarction area determined by ECT (17.2%�3.6% vs 25.5%�2.9%,P<0.05) were all significantly higher in the control group than in PostC group, whileLVEF(49.3%�4.7% vs 43.4%�5.2%, P<0.05) and MBG(2.54�1.3 vs 1.41�1.1, P<0.05)were significantly higher in the PostC group than in control group.Conclusion: Ischemic postconditioning can significantly reduce myocardial reperfusioninjury in patients with STEMI.Disclosure of Interest: Y.-X. Wang Consultancy for: No, R. A: None Declared

PM204

Association Of Cardiac Ischemic Score And Coronary Collateral Circulation

Jahanara Arzu*1, Abu Siddique1, Sajal K. Banerjee1, Akm F. Rahman1, Syed A. Ahsan1,MdMukhlesur Rahman1, Md A. Salim1, Manzoor Mahmood11Cardiology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh

Introduction: Coronary collateral circulation maintains myocardial perfusion in coronaryatherosclerotic disease. The indicators of cardiac ischemia: -Angina pectoris (AP) onexertion, during emotion, previous myocardial infarction (MI) and prior coronary inter-vention are associated with presence of coronary collateral circulation.Objectives:

1) To assess the correlation between cardiac ischemic score and coronary collaterals.2) To provide an attractive treatment option, in patients with ischemic heart disease,

who are unsuitable for conventional revascularization therapies.

Methods: In this observational cross sectional study in Bangabandhu Sheikh Mujib MedicalUniversity, 128 patients with history of angina pectoris (AP) on exertion, emotion and orMI and or previous coronary intervention were enrolled. The cardiac ischemic score (range1-4) was calculated by adding 1 point for each of the above four clinical factors, which canbe easily assessed. Presence of coronary collaterals in coronary angiogram was defined asRentrop grade �1. Patients were divided into two groups. Group A patients having Rentropgrade 0 and Group B patients are with collateral circulation, having Rentrop grade 1-3.Patients having cardiac ischemic score (range 1-4) are compared in these groups.Results: Maximum (83.3%) patients of Group B with coronary collateral circulation hadcardiac ischemic score 2-4, but majority (86.4%) of Group A patients without collateralsshowed the score only 1 (p < 0.001). All the components of cardiac ischemic score like APon exertion, during emotions, previous MI and h/o PTCA or CABG were significantlyhigher in Group-B than those in Group-A (p ¼ 0.005, p < 0.001, p ¼ 0.007 and p ¼0.048 respectively). The mean duration of AP until index CAG or PTCA was also stag-geringly higher in Group-B than that in Group-A (40.8 � 25.8 vs. 13.1 � 17.4, p < 0.001).The mean duration since MI until index CAG or PTCA was also much higher in the formergroup than that in the later group (39.6 � 32.9 vs. 11.6 � 23.0, p ¼ 0.003). The incidenceof multi vessel coronary disease was significantly higher in Group-B (66.7%) than that inGroup-A (40.9%) (p ¼ 0.005).Conclusion: The cardiac ischemic score is strongly associated with the presence of coro-nary collaterals.Disclosure of Interest: None Declared

PM205

Is there a long-term prognostic significance of the new-onset atrial arrhythmias inpatients with acute myocardial infarction treated with thrombolytic therapy? 15-yearfollow-up

Branislav S. S. Stefanovic*1, Predrag Mitrovic1, Gordana Matic2, Aleksandra Milosevic2,Mina Radovanovic1, Nebojsa Radovanovic1, Gordana Krljanac1, Ana Karadzic2,Ana Novakovic2, Aleksandra Janicijevic21Cardiology Clinic, Belgrade University Medical Faculty, 2Cardiology Clinic, Clinical Center ofSerbia, Belgrade, Serbia

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