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Cardiovascular risk: assessment

Aim: To clarify the relationship between the levels of urinary albumin-creatinine

ratio (UACR) and incident hypertension among subjects without diabetes and renal insufficiency.
Methods: We conducted a cohort study of 459 normotensives without diabetes
and renal insufficiency (eGFR 60 ml/min/1.73m2 ) in a community-based study in
Japan and followed for 7 years (median 6.7 years). We examined the incidence of
hypertension depending on the UACR levels at baseline. The incident hypertension was defined as new onset of systolic blood pressure 140 mmHg or diastolic
blood pressure 90 mmHg or taking any anti-hypertensive drugs.
Results: During follow-up period, 256 subjects (55.8%) developed hypertension.
The incidence of hypertension was increased along with the increase in UACR at
baseline (41.5% in UACR <5mg/g, 59.1% in 5-14 mg/g and 66.0% in 15-29 mg/g,
P<0.05). Multivariate logistic regression analysis after adjustment with age, sex,
obesity, smoking status, alcohol consumption, and estimated 24-hour urinary excretion of sodium showed that UACR 5-14 mg/g and 15-29 mg/g were independent risk for incident hypertension, compared with UACR <5 mg/g (odds ratio
[OR] 1.99, 95% confidence interval [CI] 1.20-3.30 and OR 2.12, 95% CI 1.014.54, respectively). Subgroup analysis showed that UACR 5-29 mg/g was a significant risk for incident hypertension compared with UACR <5 mg/g, especially
in the subjects conventionally regarded as low risk, such as women, young (<60
years), non-obese, non-smoker, no habitual drinker, and subjects on low sodium
diet (NaCl <10 g/day).
Conclusions: This study showed that a slight increase of urinary albumin excretion might predict incident hypertension in the Japanese general population,
especially in the subjects conventionally regarded as low risk group.

P1548 | BEDSIDE
Cardiovascular risk assessment in women: prediction of
short-term and long-term risk; the Rotterdam study

Background: To improve cardiovascular disease (CVD) prevention and management in women, attention has recently been directed towards a broader CVD
outcome- rather than solely coronary heart disease (CHD)- and a longer-term
horizon than 10 years. We aimed to evaluate the impact of these new principles
in a large European population-based cohort.
Methods: Our study included 2,916 asymptomatic women from the populationbased Rotterdam Study. We computed short-term (10-year) and long-term (20year) CHD and CVD risk estimates. Based on 10% and 25% cut-points for defining high short-term and long-term CVD risk respectively, the participants were
classified into three categories; low short-term/low long-term, low short-term/high
long-term, high short-term risk. We examined levels of some biomarkers and subclinical atherosclerosis measures across the three strata.
Results: Use of the new 10% cut-point for 10-year broad CVD classified a
larger group of women at high short-term risk. 25.4% of subjects initially categorized at low-intermediate (5%-10%) short-term risk moved to the high risk
category at longer-term. Women at low short-term/high long-term CVD risk had
higher carotid intima-media thickness (mean:0.94-vs-0.91 mm), higher carotid
plaque prevalence (48.6%-vs-38.5%) and lower ankle-brachial index (mean:1.09vs-1.12), compared to women at low short-term/low long-term CVD risk.
Conclusion: Application of the recent recommendations for cardiovascular prevention in women classifies a large group of women earlier in the high-risk category, where they qualify for timely treatment. Moreover, a group of women at
low-intermediate (5%-10%) short-term CVD risk are highlighted that move to the
high-risk category at longer-term. Assessing subclinical atherosclerosis burden
can potentially identify this group that calls for more intensive prevention.

P1549 | BEDSIDE
Red blood cell distribution width and the risk of cardiovascular
morbidity and all-cause mortality: a population-based study
Y. Arbel 1 , R. Raz 2 , D. Weitzman 2 , A. Steinvil 1 , D. Zeltser 1 , S. Berliner 1 ,
G. Chodick 1 , V. Shalev 1 . 1 Tel Aviv Sourasky Medical Center, Tel Aviv, Israel;
2
Medical division, Maccabi Healthcare Services, Tel Aviv, Israel
Introduction: Red blood cell distribution width (RDW) has been shown to predict
cardiovascular mortality in various populations, but studies were less conclusive
regarding cardiovascular morbidity. We aimed at evaluating the prognostic effect
of RDW on cardiovascular morbidity and all-cause mortality in the largest community cohort to date.
Methods: We utilized the computerized database of a large community based
healthcare maintenance organization (HMO)in Israel to identify a cohort of
254,473 eligible patients aged 40 or above that performed a blood count during 2006. We evaluated the relationship of RDW values for major adverse cardiac
events (MACE) and all-cause mortality over a period of 5 years.
Results: During a total of 1.4 million person-years, a total of 23,949 incident
cases of MACE and 5236 deaths were documented In a multivariable model, a
positive dose response relationship between RDW level and all caused mortality
or MACE was found. Compared to patients with a RDW of 12% or lower, patients

P1550 | BEDSIDE
The relationship between fasting triglyceride level and prevalence
and severity of angiographic coronary artery disease in 16,650
patients from the TRUST study in the statins era
Y. Liu 1 , B. Zhang 2 , J.Y. Chen 1 , P.Y. Chen 2 on behalf of TRUST Investigators.
1 Guangdong General Hospital, Guangdong Cardiovascular Institute, Department
of Cardiology, Guangzhou, China, Peoples Republic of; 2 Southern Medical
University, Department of Biostatistics, Guangzhou, China, Peoples Republic of
Background: Few studies have investigated the relationship between fasting hypertriglyceridemia and with coronary atherosclerosis in the era of the universal
use of statins.
Objectives: To assess the association of levels of fasting triglycerides was associated with prevalence and severity of angiographic coronary artery disease
(CAD).
Methods: We retrospectively analysised 16,650 patients with complete data
of fasting triglycerides and angiographic characters of coronary artery from
the TRUST Study of 17,513 consecutively enrolled patients undergoing cardiac catheterization at 63 centers in China. Prevalence and severity of
CAD (no angiographic CAD, n=3009, 18.07%, single vessel disease, n=6206,
two vessels, n=3176, triple vessels or/and left main disease, n=4259)
were investigated according to the quartile of fasting triglycerides, Q1:0.804
(0.798,0.810) mmol/L,n=4181, Q2: 1.288 (1.284,1.292) mmol/L,n=4179, Q3:
1.771 (1.766,1.775) mmol/L,n=4129, Q4: 2.884 (2.851,2.916) mmol/L,n=4161.
Results: The patients with angiographic CAD had higher level of fasting triglycerides, [1.700.95 vs 1.600.94, P<0.0001], total cholesterol [4.521.19 vs
4.451.06, P=0.0013] than those without angiographic CAD. The receiver operator characteristic (ROC) curve analysis showed mildly predictive value of fasting
triglycerides for angiographic CAD (AUC:0.549,95% CI:0.537,0.561,P<0.001),so
did total cholesterol (AUC:0.519, 95% CI:0.508,0.530,P=0.006). Logistic Regression showed that after adjusting for other known traditional predictors of CAD,
compared with the Q1 triglycerides group patients, the odds ratio of Q2, Q3,
Q4 for CAD were 1.297 (95% CI: 1.157,1.454), 1.619 (95% CI: 1.432,1.830),
1.298 (95% CI: 1.150,1.466) respectively, all P<0.0001. Polytomous Logistic Regression for Ordinal Response showed that after adjustment for other factors
(family history, diabetes, hypertension, total cholesterol, age, male, LVEF), compared with the Q1 triglycerides group patients, the odds ratio of Q2, Q3, Q4 for
CAD were 1.186 (95% CI: 1.094,1.286, P<0.0001), 1.165 (95% CI: 1.072,1.266,
P=0.0003), 1.183 (95% CI: 1.085,1.288, P=0.0001) respectively.
Conclusions: In this general population cohort, elevated fasting triglyceride levels may be mildly associated with increased risk and the severity of angiographic
CAD in the statins era.

P1551 | BEDSIDE
Risk factors associated with recurrent cardiovascular events at 1
and 3 years following acute coronary syndrome: longitudinal
analysis 2006-2011
V.S. Reddy 1 , R. Luthra 2 , K. Wilhelm 1 , T. Power 3 , M. Fisher 2 , M.J. Cziraky 2 .
1
Genentech Inc., San Francisco, United States of America; 2 HealthCore Inc.,
Delaware, United States of America; 3 AIM Specialty Health, Chicago, United
States of America
Purpose: Currently, there is a paucity of real-world long-term outcomes data

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M. Kavousi 1 , M. Leening 1 , A. Ikram 1 , J. Heeringa 1 , P. Koudstaal 2 , A. Hofman 1 ,

E. Steyerberg 3 , O. Franco 1 , J. Witteman 1 . 1 Erasmus Medical Center,
Department of Epidemiology, Rotterdam, Netherlands; 2 Erasmus Medical
Center, Department of Neurology, Rotterdam, Netherlands; 3 Erasmus Medical
Center, Department of Public Health, Rotterdam, Netherlands

with RDW>17% had a hazard ratio of 8.2 (95% CI: 4.4-15.2, P<0.001) for allcause mortality and 1.32 (95% CI: 1.09-1.64, p<0.001) for MACE.
Conclusion: RDW level of 12% and above is significantly associated with an
increased risk of cardiovascular morbidity and all-cause mortality