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2018 Southern Regional Meeting Abstracts J Investig Med: first published as 10.1136/jim-2017-000697.1 on 1 February 2018. Downloaded from Cardiovascular club I Purpose of study Coronary artery disease (C.A.D.) is one of the highest causes of death in the world. The purpose of this 11:00 AM study is to compare Puerto Rico (P.R.), Hispanic, U.S.A. coun- try, with the U.S.A., in coronary artery disease. Thursday, February 22, 2018 Methods used Compare a population of Hispanics with the high LDL levels with normal total cholesterol and HDL in P. R. and the U.S.A. The study population was 1000 patients. 1 A POSSIBLE ROLE FOR GENETICS IN CARDIOVASCULAR The U.S.A. health statistics and P.R. Department of Health DISEASE AMONG THE ACADIANS was used for comparison. AE Tedesco*, Z Haq, KL Di Losa, MJ Ali, P Gregory. LSUHSC – New Orleans, New Orleans, Summary of results Studying the lipid profile of Puerto Rico LA population, we found that the mean value of LDL lipoprotein is high (±104 mg/dl) with similar cholesterol and HDL levels 10.1136/jim-2017-000697.1 in both societies; still the coronary disease (CAD) incidence is lower than the U.S.A. (20%–30%). Investigators from the U.P. Purpose of study It is well documented that the Louisiana Aca- R. reported the genetic admixture of this Hispanic population. ‘ ’ dians ( Cajuns ) experience a disproportionate risk for some They reported the admixture consisted of 3 genes called pro- genetic diseases due to a genetic founder effect.Furthermore, cer- tective against C.A.D. tain founder populations show a predisposition for developing Conclusions C.A.D. is an inflammatory process involving heart disease.The current study was designed to determine both inflammation of the endothelial cells, macrophages and other the population prevalence of cardiovascular disease in the Acadian cells. Probably, this admixture protects the endothelial cells region and to determine whether the prevalence of early cardio- against an aggressive inflammatory process and excessive oxi- vascular disease is increased among the Cajun population. dative stress. The observation of stitziel-Washington University Methods used We obtained descriptive information via the which described ANGPTL3 gene which produces low choles- electronic medical record of 345 consecutive patients previ- terol levels and absent plaques in the coronary arteries sup- ously diagnosed with early onset (age <50) cardiovascular dis- port our hypothesis. ease (CVD) who presented to University Hospital and Clinics Cardiology Clinic (June 2015–July 2016). The patients con- sisted of 184 African Americans (97 females and 87 males) and 161 Caucasians (74 females and 87 males).For this study, 3 OBESITY IS ASSOCIATED WITH AORTIC DIALATION IN cardiovascular diseases included: coronary artery disease, MARFAN’S SYNDROME HTN, myocardial infarction, and CHF. Demographics, vital signs, lipid panel results, medications, family history, date of SD Grado*, C Watson, WF Campbell, S Kiparizoska, A Thibodeaux, C Richards, TA Skelton, CVD diagnosis, and past medical history were collected for all MR McMullan, ME Hall. University of Mississippi Medical Centre, Jackson, MS patients.The data on the (161) Caucasian patients were then 10.1136/jim-2017-000697.3 stratified into either Cajun-identified or non-Cajun by compar- ing each patient’s last name to a standardised list of most ’ Purpose of study Marfan s Syndrome (MS), a connective tissue http://jim.bmj.com/ popular Cajun last names. Means for each variable between disorder characterised by a slender build and long limbs, is the two groups were compared using independent t-tests. associated with aortopathy and aortic dissection. Obesity is Summary of results The results of our analysis revealed that associated with haemodynamic and metabolic abnormalities Cajun-identified patients were diagnosed with a CVD at a signifi- such as hypertension, hyperglycemia, inflammation and aortic cantly younger age (40±8 years) than were non-Cajun patients stiffness that may adversely affect the aorta. We aimed to (44±4 years,p=0.03).There were no significant differences determine if obesity is associated with aortic dilation in MS between the Cajun-identified and non-Cajun groups with regard patients living in an obese environment. on September 25, 2021 by guest. Protected copyright. to BMI, blood pressure, HDL and LDL levels, family history of Methods used We retrospectively analysed anthropometric and CVD, or smoking/alcohol use history. Cajun patients had lower tri- echocardiographic data from 61 MS patients from the Univer- glyceride levels (184.6±140.4) than non-Cajun whites (210.3 sity of Mississippi Medical Centre from the past 5 years. Mul- ±153.1) although whis was not statistically significant. tivariable linear regression was used to assess the association Conclusions Our results show that patients of Cajun ancestry of body mass index (BMI) with aortic root diameter measured were diagnosed with cardiovascular disease at a younger age on the parasternal long axis view at the sinuses of Valsalva on than their non-Cajun counterparts.This intriguing finding sug- transthoracic echocardiogram. gests that genetic predisposition may contribute to environ- Summary of results The mean BMI of our MS patients was mental/behavioural factors in development of CVD. Further higher compared with historically published data on MS study is needed to determine the generalizability and the cause patients (24.5 kg/m2 vs 20.1 kg/m2). This corresponds with of this pathology. the high prevalence of overweight (BMI 25.0 to <30 kg/m2) and obesity (BMI 30.0 kg/m2) in the state of Mississippi and suggests that it extends to the congenital heart population. 2 STILL WITH HIGHER LDL LEVELS-HISPANICS IN PUERTO Mean aortic root dimensions were increased in overweight RICO SHOWS A LOWER CORONARY ARTERY DISEASE (40.9±5.1 mm) and obese MS patients (51.5±12.0 mm) com- THAN THE USA-EXPLAINED BY GENETIC ADMIXTURE pared to normal weight (37.0±6.8 mm) or underweight (38.1 ±8.6 mm) patients. Aortic root diameter increased with 1JE Muñoz*, 1P Elosegui, 1C Melendez, 1,2PI Altieri, 1,2HL Banchs. 1University of Puerto Rico, Medical Sciences Campus, San Juan, PR; 2Cardiovascular Centre of Puerto Rico and increasing BMI, independent of age, sex, race, systolic blood the Caribbean, San Juan, PR pressure and height (p=0.06). Conclusions Patients with MS tend to be tall and lean; how- 10.1136/jim-2017-000697.2 ever, in Mississippi, a state with high rates of obesity, they 354 J Investig Med 2018;66:351–640 Abstracts J Investig Med: first published as 10.1136/jim-2017-000697.1 on 1 February 2018. Downloaded from have higher mean BMIs when compared to published data. Abstract 4 Table 2 Chi square analysis; patients admitted on a Higher BMI was associated with larger aortic root diameters weekend/holiday versus weekday in our single-centre study. Further assessment of rates of aortic Admitted on a Weekend or 20 24 dilation in MS patients with differing BMIs is needed to Holiday determine if overweight and obesity exacerbate aortic dilation in MS. Admitted on a Weekday 26 103 4 BARRIERS TO EARLY CARDIAC CATHETERIZATION IN HIGH RISK NSTEMI PATIENTS 5 INTRAVENOUS IRON ADMINISTRATION REDUCES C Basman*, A Bhandary, J Daibes, P Sayegh, S Lebrun, N Coplan. Lenox Hill Hospital, New FIBROBLAST GROWTH FACTOR 23 LEVELS IN CHRONIC York, NY KIDNEY DISEASE B Panwar*, O Gutierrez. University of Alabama, Hoover, AL 10.1136/jim-2017-000697.4 10.1136/jim-2017-000697.5 Purpose of study The purpose of this study is to analyse bar- riers for patients with high risk NSTEMI to receive an early Purpose of study Higher fibroblast growth factor 23 (FGF23) invasive treatment strategy. is associated with higher risk of heart disease and mortality in Methods used We conducted a retrospective chart review chronic kidney disease (CKD). Recently, iron deficiency has designed to evaluate whether patients with high risk NSTEMI been linked to elevated FGF23 levels. We examined whether are receiving an early invasive (within 1 day of admission) or treatment with intravenous iron reduces FGF23 in individuals – delayed invasive (1 3 days after admission) strategy. with CKD. Summary of results The study included 173 patients that pre- Methods used 10 participants with stage 3/4 CKD (eGFR 15– sented to the Emergency Department with high risk NSTEMI. 59 ml/min) and scheduled to receive intravenous iron (Feru- There were 46 patients (average age 64.5 years) in the moxytol) were enrolled in a single-arm study. The primary delayed invasive arm, and 127 patients (average age 63.2 outcome variable was change in intact FGF23 (iFGF23) or c- years) in the early invasive arm analysed. Patients receiving a terminal FGF23 (cFGF23) levels. Study samples were drawn delayed invasive strategy were more likely to have a history at baseline and 2 weeks after iron administration. Paired t-test of atrial fibrillation (AF) and to be on anticoagulation (table analysis was used to examine change in log transformed 1). Patients admitted on weekend/holiday were more likely to iFGF23 and cFGF23 over time. have delayed invasive compared to patients admitted during Summary of results At baseline, mean estimated glomerular fil- the week (table 2). tration rate, mean serum haemoglobin, mean serum ferritin, Conclusions It is important to recognise barriers to prompt mean percent transferrin saturation and mean serum phospho- cardiac catheterization and to make hospital system adjust- rus were 29.5 (±0.5) ml/min, 8.8 (±1.5) g/dL, 54.8 (±41.6) ments for optimal treatment of patients with NSTEMI. ng/ml, 14(±11.4)%, and 3.9 (±0.5) mg/dL respectively. There http://jim.bmj.com/ was a significant reduction in mean serum iFGF23 concentra- Abstract 4 Table 1 Chi square analysis; baseline features tion (17.7%) at 2 weeks post iron infusion (two tailed p=0.022).
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