myocardial infarction, and unstable angina during the follow-up period that ... tients, and 3 of cardiac death, 1 of acute myocardial infarction, and 10 of unstable.
Acute coronary syndromes (P=0.536)) were statistically associated with major adverse cardiovascular events during the FU (mortality, AMI, need for revascularization). Figure 1 compares event-free survival by the Kalpan-Meyer method between patients that needed revascularization at index event and those who did not, and shows no difference on mean event-free survival (Log rank P=0.969).
797
tests were carried out by method of a polymerase chain reaction on the BioRad CFX96TM Real-Time PCR Detection Systems device on the genomic DNA received from leukocytes of whole venous blood. Results: At discharge, decreased sensitivity to clopidogrel was detected in 37 pts (21%), in this case the results of aggregatogram area under the curve (AUC) ADP- test was 71,6±7,7 U after 7 days of treatment with clopidogrel. According to an aggregatogram pts were divided on sensitive (G1, n=139) and resistant (G2, n=37) to a clopidogrel. The analysis of distribution of polymorphic CYP2C19*2 option has revealed existence of all three possible genotypes in both selections: GG, GA and AA. The favorable option of a genotype of GG in G1 was 3,54 times higher than in G2 (p=1,073*10–3). Pts with a carriage allele G or option of a genotype of GG (in G1-at 129 pts (92,8%), in G2-at 18 (48,6%) persons) are characterized by suppression of platelets aggregation in pts receiving 75 mg of clopidogrel and do not need correction antiplatelet therapy. Marked association between carriage of allele A, one for genotype AA and GA high residual platelet reactivity in response to clopidogrel 75 mg (in G1-at 10 (7,2%) pts of a genotype of GA, in G2- at 5 (13,5%) persons of a genotype AA and in 14 (37,8%) ptsGA). Repeated cardiovascular complications (recurrent UA, myocardial infarction, death) for 1 year of observation developed at 18 (12,9%) pts of G1 and at 21 (56,75%) pts in G2. Conclusion: All pts with UA and polymorphism of a gene of CYP2C19*2 and a genotype of AA and GA are characterized by high residual reactivity of platelets and among these pts cardiovascular complications developed in 3,5 times more often than persons with a genotype GG.
Survival analysis by Kaplan-Meier method
Conclusions: We conclude that revascularization at index event did not proved to change the prognosis of our sample during our FU period. This study highlights the low frequency of short-term adverse cardiovascular events in an UA sample and reinforces clinical decision-making regarding early discharge.
P3677 | BEDSIDE Prognostic implication of gender difference in patients with coronary spasm M. Ishii, K. Kaikita, E. Yamamoto, Y. Izumiya, S. Kojima, S. Hokimoto, K. Tsujita. Kumamoto University Hospital, Kumamoto, Japan Background: Few studies have reported the gender differences in the clinical characteristics and outcomes in patients with coronary spasm. Purpose: The purpose of this study was to investigate the prognostic differences and correlated factors of cardiovascular events by genders in patients with coronary spasm. Methods: This was a retrospective, observational study. After exclusion of 117 from 1,877 consecutive patients undergoing acetylcholine (ACh)-provocation test between January 1991 and December 2010, the remaining 1,760 patients were enrolled. ACh-provoked coronary spasm was observed in 873 (male; n=386, female; n=487) of 1,760 patients and analyzed. The primary endpoint was major adverse cardiac events (MACE), including cardiac death, hospitalization for acute myocardial infarction, and unstable angina during the follow-up period that began from the date of the diagnosis of VSA to the date of the first event or until December 2012. Results: As compared with male patients, female patients were older non-smoker with multivessel spasm, diffuse spasm, non-significant organic stenosis and less ST-segment elevation, and had no diabetes mellitus, the high levels of total cholesterol and HDL cholesterol, and the low level of triglyceride. There were 5 cases of acute myocardial infarction, and 24 of unstable angina in male patients, and 3 of cardiac death, 1 of acute myocardial infarction, and 10 of unstable angina in female during the follow-up period. Kaplan–Meier survival curve indicated equal 5-year survival rates free from MACE in female patients with coronary spasm compared to male patients (95.9% vs. 92.8%, P=0.071). Multivariate Cox hazard regression analysis identified differential predictors of MACE by genders; female patients were significantly correlated with chronic kidney disease (defined as eGFR
