APSC 2021 Abstract Book

Table of Content

YIA-EI-01 Aortic Valve Calcium Scoring In Various Etiologies Of Aortic Stenosis Among Thai Patients

Dr Wisarut Wanchaitanawong 1 , Dr Rungsrit Kanjanavanit 1 , Asst. Prof. Tanop Srisuwan 2 , Dr Wanwarang

Wongcharoen 1 , Dr Arintaya Phrommintikul 1

1 Cardiovascular Unit, Department of Internal Medicine, Faculty of Medicine, Chiangmai University, Thailand, Muang

Chiang Mai, Thailand, 2 Department of Radiology, Faculty of Medicine, Chiangmai University, Thailand,

YIA-BS-02 Identification Of Candidate Biomarkers For Early Risk Stratification Of STEMI And Prediction Of

Post-STEMI Heart Failure Via Gene Expression Analysis

Mr Jing Xu 1

1 Fuwai Hospital, National Center For Cardiovascular Diseases, Chinese Academy Of Medical Sciences And Peking Union

Medica, Beijing, China

YIA-II-03 Real Time U/S Guidance CFA Access Compared With Fluoroscopic Guidance To Improve The First

Pass Successful Rate

Dr Settapong Phetkua 1

1 Phramongkutklao hospital, Phayathai, Thailand

YIA-GC-04 Clinical, Echocardiographic And Prognostic Outcomes Of Patients With Concordant And

Discordant High-Gradient Aortic Stenosis In An Asian Cohort

Mr Yeung Jek Ho 1 , Dr Nicholas WS Chew 2 , Mr Cheng Han Ng 1 , Asst Prof William KF Kong 1,2 , Assoc Prof Kian-

Keong Poh 1,2

1 Yong Loo Lin School Of Medicine, National University of Singapore, Singapore, 2 Department of Cardiology, National

University Heart Centre, National University Hospital, Singapore

YIA-EI-05 “The Effects Of Trastuzumab Therapy On The Right Ventricular Function Of Filipino Breast Cancer

Patients Tn A Tertiary Teaching Hospital”

Dr John Levi Daluz 1 , Dr. Arnold De Guzman 1 , Dr Jose Donato Magno 1 , Dr. Josephus Sibal 1

1

Angeles University Foundation Medical Center, Angeles City, Pampanga, Philippines, 2 Philippine General Hospital,

Manila, Philippines

OP-BS-01 A Tale Of Ice And Fire: Dexmedetomidine-induced Hyperthermia After Complex Coronary Artery

Revascularization For Cardiogenic Shock

Dr Gwen Marcellana 1 , Terence Cuezon 2 , Fabio Enrique Posas 2

1 Department of Medicine, St. Luke’s Medical Center Global City, Taguig, Philippines, 2 Center for Structural Heart and

Vascular Interventions, St. Luke's Medical Center Global City, Taguig, Philippines

OP-BS-02 Bioequivalence Of Two Ticagrelor 90mg Formulations Under Fasting Conditions In Healthy

Subjects: A Randomized, Two-Period Crossover Trial

Dr Anjali Virani 1 , Mr Ravi Verma 1 , Mr Ajay Shiwalkar 1 , Mr Pradeep Labana 1

1 Torrent Research Centre, Torrent Pharmaceuticals Ltd, Ahmedabad, India

OP-BS-04 Expression Of MicroRNA 145 Across Age And Risk Factor Profiles And It’s Correlation With Severity

Of Coronary Artery Disease

Dr Arnab Banerjee 1 , Dr. Debabrata Roy 1 , Mr Hindol Majumdar 2 , Mr Rudranil Bhowmik 2 , Dr. Prof. Sanmoy

Karmakar 2 , Dr. Abhishek Roy 1 , Dr. Kaushik Manna 1 , Dr. Navanil Biswas 1

1

NH - Rabindranath Tagore International Institute Of Cardiac Sciences, Kolkata, Kolkata, India, 2 Department of

Pharmaceutical Technology, Jadavpur University, Kolkata, India

OP-BS-05 Expression of MicroRNA 155 Across Different Age Groups With/Without Cardiac Risk Factors and

With/Without Overt Atherosclerotic Cardiovascular Disease

Dr Arnab Banerjee 1 , Dr Debabrata Roy 1 , Mr. Hindol Mazumdar 2 , Prof. Dr. Sanmoy Karmakar 2 , Mr. Rudranil

Bhowmik 2

1 NH - Rabindranath Tagore International Institute Of Cardiac Sciences, Kolkata, India, 2 Department of Pharmaceutical

Technology, Jadavpur University, Kolkata, India

OP-CS-01 Successful Repair Of Subclavian Artery Aneurysm And Off Pump Coronary Artery Bypass Graft Of

Coronary Artery Disease With Horner’s Syndrome

Dr Frederick Gavril Leyson 1 , Dr Maidenlove Paner 1 , Dr Gay Marjorie Obrado 1 , Dr Camilo Jr. Te 1 , Jezreel

Taquiso 1

1 Manilamed Medical Center Manila-Section of Cardiology, Manila, Philippines

OP-CS-02 Predictors Of New Renal Dialysis After Off-Pump Coronary Artery Bypass Grafting

Dr Permyos Ruengsakulrach 1 , Dr. Vitoon PITIGUAGOOL 1 , Dr. Piyapan PAMORNSING 1 , Dr. Jamorn

UDOMKUSONSRI 1 , Assistant Professor Dr. Pairote SATIRACOO 2,3

1 Bangkok Heart Hospital, Bangkok, Thailand, 2 Department of Mathematics, Faculty of Science, Mahidol University,

Bangkok, Thailand, 3 Centre of Excellence in Mathematics, CHE, Bangkok, Thailand

OP-CS-03 Outcomes Of Hybrid Prothesis In Treatment Of Acute Stanford A- DeBakey I Aortic Dissection

Dr An Thai Nguyen, Dr An Nguyen Thai 1

1

Cho Ray Hospital, Ho Chi Minh, Viet Nam

OP-CS-04 Direct Oral Anticoagulation Versus Vitamin K Antagonists With Or Without Antiplatelets In Post-

Transcatheter Aortic Valve Implantation Patients

Ms Vanessa Teo, Ms Vanessa Xin Yi Teo 1 , Mr Gabriel Sheng Jie Lee 1 , Ms Hannah Si En Tay 1 , Mr Cheng Han

Ng 1 , Mr Nicholas WS Chew 2

1 National University Of Singapore, Yong Loo Lin School Of Medicine, Singapore, 2 Department of Cardiology, National

University Heart Centre, National University Health System, Singapore, Singapore

OP-EI-01 Correlation Of NT-proBNP And Echocardiographic Parameters in Patients With Heart Failure With

Preserved Left Ventricular Systolic Function

Dr Shailyn Catungal 1

1 Chong Hua Hospital Heart Institute, Cebu, Philippines

OP-EI-03 Global Longitudinal Strain Right Ventricle And Mean Pulmonary Artery Pressure As A Predictor For

severity of Atrial Septal Defect

Nia Dyah Rahmianti 1 , dr, PhD Lucia Krisdinarti 2 , Hasanah Mumpuni 2

1 Cardiology and Vascular Medicine Department, Airlangga University, Surabaya, Indonesia, 2 Cardiology and Vascular

Medicine Department, Gadjah Mada University, Jogjakarta, Indonesia

OP-EI-04 Short-Term Prognostic Impact Of Tricuspid Annular Plane Systolic Excursion In Acute Inferior ST-

Elevation Myocardial Infarction

Dr Nadine Nurani Shabrina, Dr Nadine Shabrina 1 , Daniel Tobing 2

1 Research Associate, National Cardiovascular Center Harapan Kita, Jakarta, Indonesia, 2 National Cardiovascular Center

Harapan Kita, Jakarta, Indonesia

OP-EP-01 Heart Rate Variability And Its Role To Predict Atrial Fibrillation In Patients Undergoing Coronary

Artery Bypass Grafting

Dr Pham Truong Son, Dr Truong Son Pham 1 , Dr Van Chien Do 2 , Dr Thanh Binh Nguyen 3

1 108 Military Central Hospital, Hanoi, Viet Nam, 2 108 Military Central Hospital, Hanoi, Viet Nam, 3 108 Military Central

Hospital, Hanoi, Viet Nam

OP-GC-01 Efficacy Of Extracorporal Shock Wave Therapy For Chronic Coronary Artery Diseases With

Refractory Angina Pectoris.

Dr Le Duy Thanh, Dr Le Duy Thanh 1 , Dr Pham The Tho 2 , Dr Bui Thi Huong Lan 3

1

108 Military Central Hospital, Hanoi, Viet Nam, 2 108 Military Central Hospital, Hanoi, Vietnam, 3 108 Military Central

Hospital, Hanoi, Vietnam

OP-GC-02 A Significant Ten-Year Risk Of Fatal Cardiovascular Disease Estimation To Predict Length Of Stay

Of Hospitalized COVID19 Patients

Dr Yosua Cristo 1 , dr Bertha Napitupulu 1 , dr Mutiara Simanjuntak 1

1 Methodist Susanna Wesley General Hospital, Medan, Indonesia

OP-GC-03 A Significant Ten-Year Risk Of Fatal Cardiovascular Disease Estimation To Predict D-Dimer Level In

Hospitalized COVID-19 Patients



OP-GC-04 BDMS Acute Coronary Syndrome Registry

Dr Kriengkrai Hengrussamee 1 , Damras Tresukosol 1 , Dr Rapin Kukreja 1 , Dr. Wichai Jiraroj-ungkun 1 , Dr Pradub

Sukhum 1

1 Bangkok Heart Hospital, Bangkok, Thailand

OP-GC-05 Prevalence And Associated Factors Of Abnormal Cardio-Ankle Vascular Index In Patients With

Type 2 Diabetes Mellitus In Tertiary Care Hospital

Dr Pantaree Jaigla 1 , Dr. Surapun Pongsuthana 2 , Chaicharn Deerochanawong 3

1 Department of Internal medicine, Rajavithi Hospital, Bangkok, Thailand, 2 Division of Cardiology, Department of Internal

medicine, Rajavithi hospital, College of Medicine, Rangsit university, Bangkok, Thailand, 3 Division of Endocrinology,

Department of Internal medicine, Rajavithi hospital, College of Medicine, Rangsit university, Thailand

OP-GC-06 Infected Femoral Artery Pseudoaneurysm With Klebsiella Pneumoniae Bacteremia In Injected

Drug Abuser: A Case Report

Ms Hana Khairunnisa, Ms Idzni Mardhiyah, Mr Andi Mahavira, Mr Franky Zeplin Pasaribu

OP-GC-07 Baseline Characteristics of 277 Venous Thromboembolism Patients From Taiwan And Korea

Treated With Edoxaban In Routine Clinical Practice

Prof Kuan-Ming Chiu 1,2 , Dr Won-Il Choi 3 , Dr Pei-Ying Pai 4 , Dr Jung-Hyun Choi 5 , Dr Wei-Tien Chang 6 , Dr Kye-Hun

Kim 7 , Dr Paul-Egbert Reimitz 8 , Dr Martin Unverdorben 9 , Dr Alexander Cohen 10 , Dr Giancarlo Agnelli 11

1

Far Eastern Memorial Hospital, Cardiovascular Center, New Taipei City, Taiwan, 2 Yuan Ze University, Electrical

Engineering, Taoyuan City, Taiwan, 3 Hanyang University Myongji Hospital, Division of Pulmonary and Critical Care

Medicine, Goyang, Republic of Korea, 4 China Medical University Hospital, Taichung, Taiwan, 5 Pusan National University

Hospital, Division of Cardiology, Busan, Republic of Korea, 6 National Taiwan University Hospital, Taipei, Taiwan,

7

Chonnam National University Hospital, Department of Cardiovascular Medicine, Gwangju, Republic of Korea, 8 Daiichi

Sankyo Europe GmbH, Medical Affairs Europe, Munich, Germany, 9 Daiichi Sankyo, Inc., Global Medical Affairs, Basking

Ridge, United States, 10 Guy's and St Thomas' NHS Foundation Trust, King's College London, London, United Kingdom,

11

University of Perugia, Internal and Cardiovascular Medicine-Stroke Unit, Perugia, Italy

OP-GC-08 Major Bleeding, Stroke And Mortality In 3,359 Atrial Fibrillation Patients From Korea, Taiwan,

Hong Kong, And Thailand Treated With Edoxaban

Prof Songsak Kiatchoosakun 1 , Dr Bunjong Saejueng 2 , Dr Hung Fat Tse 3 , Dr Yannie Oi Yan Soo 4 , Dr Chun-Chieh

Wang 5 , Dr Chang Hoon Lee 6 , Dr Paul-Egbert Reimitz 7 , Dr Martin Unverdorben 8 , Dr Raffaele De Caterina 9 , Dr

Paulus Kirchhof 10

1 Srinagarind Hospital, Khon Kaen, Thailand, 2 Central Chest Institute of Thailand, Nonthaburi, Thailand, 3 The University of

Hong Kong, Hong Kong, Hong Kong, 4 The Chinese University of Hong Kong, Hong Kong, Hong Kong, 5 Chang Gung

Memorial Hospital-Linkou, Taoyuan, Taiwan, 6 Veterans Health Service Medical Center, Seoul, Republic of Korea, 7 Daiichi

Sankyo Europe GmbH, Munich, Germany, 8 Daiichi Sankyo, Inc., Basking Ridge, USA, 9 Pisa University Hospital - University

of Pisa, Pisa, Italy, 10 University Heart and Vascular Center Hamburg, Hamburg, Germany

OP-GC-09 A Case Of A 60 Y/O Filipino Female With Myocardial Infarction With Nonobstructive Coronary

Artery Disease: Exercise-Induced Coronary Artery Vasospasm



Vascular Interventions, St. Luke’s Medical Center Global City, Taguig City, Philippines

OP-GC-10 Risk Score To Predict In-Hospital Mortality In Cardiac Care Unit Patients

Dr Ittipon Preechawettayakul 1 , Dr Sarunyou Suwanagsorn 1 , Dr Ply Chichareon 1

1 Prince Of Songkla University, Songkla, Thailand

OP-GC-11 In-hospital Mortality Of Acute Coronary Syndrome (ACS) Patients After Implementation Of

National Health Insurance In Indonesia

Dr Nurul Qalby 1 , Mr Dian Sidik Arsyad 2 , Andriany Qanitha 3 , Dr Maarten J Cramer 4 , Dr Yolande Appelman 5 , Dr

Dara Rosmailina Pabittei 3 , Prof Pieter AFM Doevendans 4 , Dr Akhtar Fajar Muzakkir 6 , Dr Idar Mappangara 6

1 Department of Public Health, Faculty of Medicine, University of Hasanuddin, Makassar, Indonesia, 2 Department of

Epidemiology, Faculty of Public Health, University of Hasanuddin, Makassar, Indonesia, 3 Department of Physiology,

Faculty of Medicine, University of Hasanuddin, Makassar, Indonesia, Makassar, Indonesia, 4 Department of Cardiology,

University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands, 5 Department of Cardiology, Amsterdam

UMC- Location VU University, Amsterdam, Netherlands, 6 Department of Cardiology and Vascular Medicine, Faculty of

Medicine, University of Hasanuddin, Makassar, Indonesia

OP-GC-12 The Prevalence Of Electrocardiographic Abnormalities In The Mongolian Population.

Dr Natsagdorj Ulziijargal, Dr Natsagdorj Ulziijargal 1 , Ms Sodgerel Batjargal 1 , Ms Yondonjamts Pilmaa 1

1

Institute Of Medical Sciences, Ulaanbaatar, Mongolia

OP-GC-13 Acute Coronary Syndrome After Inactivated SARS-COV-2 Vaccine: A Case Report And Literature

Review

Dr Sowitchaya Panthong 1 , Dr Thanrada Vimonsuntirungsri 1 , Dr Mananchaya Thapanasuta 2 , Dr Chaisiri

Wanlapakorn 1,2,3 , A/Prof Wasan Udayachalerm 3 , Dr Aekarach Ariyachaipanich 1,2,3

1 Department of Medicine, Chulalongkorn University, Bangkok, Thailand, 2 Division of Cardiovascular medicine,

Department of Medicine Chulalongkorn University, Bangkok, Thailand, 3 Cardiac Center, King Chulalongkorn Memorial

Hospital, Thai Red Cross Society, Bangkok, Thailand

OP-GC-14 Prognostic Outcomes In Acute Coronary Syndrome Patients Without Standard Modifiable Risk

Factors: A Multi-Ethnic Study Of 8680 Patients

Ms Gwyneth Kong 1 , Mr Cheng Han Ng 1 , Dr Nicholas WS Chew 2 , A/Prof Mark Y Chan 2 , Poay Huan Loh 2

1 Yong Loo Lin School Of Medicine, National University Of Singapore, Singapore, 2 Department of Cardiology, National

University Heart Centre, National University Health System, Singapore

OP-GC-15 The Atypical Presentation And Clinical Outcomes Of Non-ST-Segment Elevation acute coronary

syndromes in chronic kidney disease patients

A/Prof Praew Kotruchin 1 , Kodchakorn Tharawadee 1 , Thanat Tangpaisarn 1 , Pariwat Phungern 1

1 Department of Emergency Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand

OP-GC-16 Prevalence, Risk Factors And Intervention For Depression And Anxiety In Pulmonary

Hypertension: A Systematic Review And Meta-Analysis

Mr Aaron Mai 1 , Mr. Oliver Zi Hern Lim 1 , Mr Yeung Jek Ho 1 , Mr. Cheng Han Ng 1 , Dr. Nicholas WS Chew 2

1 Yong Loo Lin School of Medicine, National University Of Singapore, Singapore, 2 Deparment of Cardiology, National

University Heart Centre, Singapore

OP-GC-17 Young (<40 years old) Coronary Artery Disease Patients In Brunei; Differences In Clinical

Characteristics And Outcomes Compared To Older Patients

Izyan Mohammad 1 , Rajinikanth Rajagopal 2 , Dr Sofian Johar 1

1 RIPAS hospital, Bandar Seri Begawan, Brunei Darussalam, 2 Gleneagles JPMC, Jerudong, Brunei Darussalam

OP-GC-18 Blood Glucose Reduction By Diabetic Drugs With Minimal Hypoglycemia Risk For Cardiovascular

Outcomes: Meta-regression Analysis Of Randomized Controlled Trials

Dr Weiting Wang 1

1 Taipei Veterans General Hospital, Taipei, Taiwan

OP-GC-19 Clinical Characteristics And Outcomes Of Myocardial Infarction With Non-Obstructive Coronary

Arteries In A Southeast Asian Cohort

Dr Cheney Wong 1 , Jonathan Yap 1 , Fei Gao 1 , Weiting Huang 1 , A/Prof Khung Keong Yeo 1

1

National Heart Centre Singapore, Singapore

OP-GC-21 The Importance Of Detailed Evaluation Of Airway Obstruction By Computed Tomography In

Patients With Congenital Heart Disease

Dr Sakti Damba Dwisepto Aulia, MD Damba Dwisepto Aulia Sakti 1 , MD Budi Rahmat 2 , Oktavia Lilyasari 1

1 Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Indonesia, National Cardiovascular

Center Harapan Kita, Jakarta, Indonesia, 2 Department of Surgery, Pediatric and Congenital Cardiothoracic and Vascular

Surgery Division, Faculty of Medicine, Universitas Indonesia, National Cardiovascular Center, Harapan Kita, Jakarta,

Indonesia

OP-HF-01 Predictors of Trastuzumab-Induced Cardiotoxicity In Breast Cancer Patients

Dr Nichanan Osataphan 1 , Dr Wanwarang Wongcharoen 1 , Dr Arintaya Phrommintikul 1

1 Faculty of Medicine, Chiang Mai University, Chiangmai, Thailand

OP-HF-02 Correlation Between NT-proBNP Within The First 24 Hours And 30-Day In-Hospital Survival Rate In

Patients With Acute Heart Failure

Mr Kay Powpuree 1 , Dr. Surapun Pongsuthana 1

1 Rajavithi Hospital, Bangkok, Thailand

OP-II-01 The Outcome And Importance Of Initial Hemoglobin Management During Veno-Arterial

Extracorporeal Membrane Oxygenation And Percutaneous Ventricular Assist Device Therapy (ECPELLA)

Dr Nobuyuki Kuroiwa 1 , Dr Hikaru Ishiwaki 1 , Dr Shinichi Okino 1 , Dr Shigeru Fukuzawa 1

1 Funabashi Municipal Medical Center, Funabashi, Japan

OP-II-02 Comparison Of Bivalirudin, Heparin Plus Eptifibatide, And Unfractionated Heparin Monotherapy

For Acute Coronary Syndrome (ACS) Patients Undergoing Percutaneous Coronary Intervention

Dr A B M Golam Mostofa 1 , Dr Tanjima Parvin 1 , Dr Rayhan Masum Mandal 1 , Dr Rawnak Afrin 2 , Professor Syed

Ali Ahsan 1

1 Bangabandhu Sheikh Mujib Medical University, Dhaka, Dhaka, Bangladesh, 2 Dhaka Medical College Hospital, Dhaka,

Dhaka, Bangladesh

OP-II-03 Safety And Efficacy Of Bivalirudin In Diabetic Acute Coronary Syndrome (ACS) Patients Undergoing

Percutaneous Coronary Intervention (PCI)

Dr A B M Golam Mostofa, Dr. A. B. M. Golam Mostofa 1 , Dr Tanjima Parvin 1 , Dr. Mohammad Rayhan Masum

Mandal 1 , Professor Syed Ali Ahsan 1

1 Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh

OP-II-04 Endovascular Aneurysm Repair (EVAR) With Endoanchors: For Tandem Aortic Abdominal Aneurysm

(AAA) With Hostile Neck & Proximal Penetrating Atherosclerotic Ulcer

Dr Von Jerick Tenorio 1 , Jonald Lucero 1 , Dr Marivic Vestal 1 , Dr Edwin Tiempo 1

1

Perpetual Succour Hospital - Cebu Heart Institute, Cebu City, Philippines

OP-II-05 post-Angioplasty Myocardial Blush Grade For Long Term Prognostication In Acute Coronary

Syndrome: A Systematic Review And Meta-Data Analysis

Dr Patrick Vera Cruz 1,2 , Dr. Nadine Bacalangco-Suerte 1 , Dr. Patricio Palmes 1

1 West Visayas State University Medical Center, Iloilo City, Philippines, 2 St. Luke's Medical Center - Heart and Vascular

Institute, Quezon City, Philippines

OP-II-07 Efficacy And Safety Of Different Dual Antiplatelet Strategies In Patients Undergoing Percutaneous

Coronary Intervention: A Systematic Review And Network Meta-Analysis

Dr Chaisiri Wanlapakorn 1

1 Chulalongkorn university, Bangkok, Thailand

OP-PC-01 Pharmacology Management In Improving Exercise Capacity Of Patients With Fontan Circulation: A

Systematic Review And Meta-Analysis

Dr Brian Mendel 1 , Christianto Christianto 2 , Moira Setiawan 2 , Sisca Natalia Siagian 1 , Radityo Prakoso 1

1 National Cardiovascular Centre Harapan Kita, Jakarta, Indonesia, 2 Faculty of Medicine Universitas Indonesia, Jakarta,

Indonesia

OP-PR-01 Reduce Cardiometabolic Risk By Reducing Sitting Time Among Overweight And Obese Adults: A

Meta-Analysis

Mr Hendsun Hendsun 1 , Mr Hendsun Hendsun 2

1 Tarakan Regional General Hospital, Tarakan, Indonesia, 2 Tarumanagara University, Jakarta, Indonesia

OP-PR-02 Association Between Smoking Status And Outcomes In ST-Segment Elevation And Non-ST-

Segment Elevation Myocardial Infarction Patients Undergoing Percutaneous Coronary Intervention

Dr Junsuk Ko 1 , Dr Ching-Hui Sia 2,3 , Ms. Huili Zheng 4 , Dr. Jack Wei Chieh Tan 5 , Dr. Derek J Hausenloy 3,6,7,8,9

1 Duke-nus Medical School, Singapore, 2 Department of Cardiology, National University Heart Centre Singapore, Singapore,

3 Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 4 Health Promotion Board, National

Registry of Diseases Office, Singapore, 5 Department of Cardiology, National Heart Centre Singapore, Singapore, 6 National

Heart Research Institute Singapore, National Heart Centre Singapore, Singapore, 7 Cardiovascular & Metabolic Disorders

Program, Duke-National University of Singapore Medical School, Singapore, 8 The Hatter Cardiovascular Institute,

University College London, London, United Kingdom, 9 Cardiovascular Research Center, College of Medical and Health

Sciences, Asia University, Taiwan

OP-PR-03 Factors Associated With Participation In Cardiac Rehabilitation Programme Among Coronary

Heart Disease Patients

Ms Mei Sin Chong 1 , Associate Professor Dr. Janet Wing Hung Sit 2 , Dr. Kai Chow Choi 3 , Dr. Anwar Suhaimi 4 ,

Professor Dr. Sek Ying Chair 5

1 The Chinese University Of Hong Kong, Hong Kong SAR, China, 2 The Chinese University Of Hong Kong, Hong Kong SAR,

China, 3 The Chinese University Of Hong Kong, Hong Kong SAR, China, 4 Department of Rehabilitation Medicine, University

Malaya Medical Centre, Kuala Lumpur, Malaysia, 5 The Chinese University Of Hong Kong, Hong Kong SAR, China

PP-CS-01 Early Results of Operated Giant Coronary Aneurysm Patients


1


PP-EI-01 Time-To-Notch RVOT Doppler: Non-Invasive Parameter To Detect Pulmonary Vascular Disease In

Adult With Secundum Atrial Septal Defect

Dr Muhamad Adrin Aefiansyah 1 , Oktavia Lilyasari 2 , Dr Amiliana Mardiani Soesanto 2 , Radityo Prakoso 2 , Dr

Arwin Saleh Mangkuanom 2 , Dr Aditya Agita Sembiring 2 , Dr Nurnajmia Curie Proklamartina 3 , Anwar Santoso 2 ,

Renan Sukmawan 2

1

Bumiayu Regional Hospital, Brebes, Indonesia, 2 Department Cardiology and Vascular Medicine, National Heart Centre

Harapan Kita, Indonesia, 3 Banten Regional Hospital, Indonesia

PP-EI-02 Scimitar Syndrome : A Rare Entiety Of Congenital Heart Disease

Mr Dya Andryan 1 , Rina Ariani 1 , Oktavia Lilyasari 1

1 National Cardivascular Center Harapan Kita, Bandung, Indonesia

PP-EI-03 Isolated Partial Anomalous Pulmonary Vein Drainage : A Rare Cardiac Anomaly

Mr Dya Andryan 1 , Oktavia Lilyasari 1


Center Harapan Kita, Jakarta, Indonesia, Jakarta, Indonesia

PP-EI-05 Correlation Between Left Ventricular Torsion Assessed By 3-Dimensional Speckle Tracking

Echocardiography And Left Ventricular Ejection Fraction In Chronic Heart Failure

Dr Nguyen Kieu Ly, Dr Kieu Ly Nguyen Thi 1 , Dr Van Chien Do 2 , Dr Truong Son Pham 3



PP-EI-06 Acute Pulmonary Emboli With Deep Vein Thrombosis In Young Woman Pregnancy: Case Report

Dr Rivhan Fauzan 1 , Hilfan Ade Putra Lubis 1 , Dr Teuku Bob Haykal 1 , Harris Hasan 1

1 Department of Cardiology and Vascular Medicine, University of Sumatera Utara, Medan, Indonesia, Cardiac Center

General Hospital H. Adam Malik, Medan, Indonesia, Medan, Indonesia

PP-EI-07 Comparison Of Right Ventricular Systolic Function Assessment Between Echocardiographic Method

And Cardiac Magnetic Resonance Method

Mr Rapee Pongsamart 1

1 Pmk Hospital, Bangkok, Thailand

PP-EI-09 Systolic Global Longitudinal Strain : A Novel Predictor Of Myocardial Fibrosis Extent In Patients

With Hypertrophic Cardiomyopathy

Dr Punchanit Wanichsetakul 1 , A/Prof Adisai Buakhamsri 1 , Dr Ing-orn Arunakul 1

1

Division of Cardiology, Department of Internal Medicine, Faculty of Medicine, Thammasat University, Pathumthani,

Thailand

PP-EP-01 Ventricular Late Potentials And Its Association With Ventricular Arrythmias In Chronic Coronary

Artery Patients

Dr Nguyen Dung, Dr Dung Nguyen 1 , Dr Truong Son Pham 2 , Dr Thanh Binh Nguyen 3



PP-EP-02 Incidence Of Arrhythmic Risks After Acute ST Elevation Myocardial Infarction In Chinese Patients In

The Era Of Early Revascularization.

Dr Stephanie Quek 1 , Dr Irene Chung 1

1 National Health Group, Tan Tock Seng Hospital, Singapore

PP-EP-03 Electrocardiography Risk Markers Associated With Appropriate ICD Therapy In Symptomatic

Brugada Syndrome Patients Receiving ICD Therapy

Dr Chayanis Trakulthong, A/Prof Pattarapong Makarawate

1 queen sirikit heart center khon kaen university, khon kaen, Thailand

PP-EP-04 One-Year Recurrence Rate And Clinical Outcomes After Catheter Ablation In Atrial Fibrillation

Patients

Dr Naruepon Yamsai 1

1 Phramongkutklao Hospital, Bangkok, Thailand

PP-GC-01 Primary Results Of The Improve Sudden Cardiac Arrest Bridge Study

A/Prof Shu Zhang 1 , Prof Wen-jone Chen 2 , Dr. Mullasari Ajit Sankardas 3 , Dr. Waqar Habib Ahmed 4 , Dr. Houng-

Bang Liew 5 , Hyeon-Cheol Gwon 6 , Dr. Fazila Tunn Nesa Malik 7 , Dr. Baopeng Tang 8 , Dr. Abdeddayem Haggui 9 ,

Dr. Il-Young Oh 10 , Tiong Kiam Ong 11 , Dr. Cheng-I Cheng 12 , Dr. Xingbin Liu 13 , Dr. Francesca Lemme 14 , Dejia

Huang 13 , Dr Amy Molan

1 Fu Wai Hospital Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China, 2 National

Taiwan University Hospital, Taipei, Taiwan, 3 Madras Medical Mission, Chennai, India, 4 King Fahad Armed Forces Hospital,

Jeddah, Saudi Arabia, 5 Clinical Research Centre, Queen Elizabeth Hospital II, Sabah, Malaysia, 6 Samsung Medical Center,

Seoul, South Korea, 7 National Heart Foundation Hospital and Research Institute, Dhaka, Bangladesh, 8 The First Affiliated

Hospital of Xinjiang Medical University, Ürümqi, China, 9 The Military Hospital of Tunis, Tunis, Tunisia, 10 Seoul National

University Bundang Hospital, Seongnam, South Korea, 11 Sarawak Heart Centre, Sarawak, Malaysia, 12 Kaohsiung Chang

Gung Memorial Hospital of CGMF, Kaohsiung, Taiwan, 13 West China Hospital, Sichuan University, Chengdu, China,

14 Medtronic Bakken Research Center, The Netherlands

PP-GC-03 The Role Of N-Terminal Pro-Brain Type Natriuretic Peptide To Predict Cardiovascular Events In Hip

Fracture Patients: A Systematic Review

Mr Jordan Budiono 1 , Mr Anthony Ekaputra 1 , Miss Karina Sylvana 1

1 Faculty of Medicine and Health Sciences Atma Jaya Catholic University of Indonesia, North Jakarta, Indonesia

PP-GC-04 Comparison Of Revised Cardiac Risk Index (RCRI) Versus Clinician Quoted Pre-Operative Risk

Assessment Of Major Adverse Cardiovascular Events (MACE)

Dr Eugene Gan 1 , Dr Cheney Wong 1 , Dr Hooi Khee Teo 2 , Dr Alex Tan 2 , Audry Lee 2

1 Singapore Health Services, Singapore, 2 National Heart Centre, Singapore

PP-GC-05 Prevalence Of Microalbuminuria And Its Relation With Risk Of Adverse Cardiac Events Among

Non-Diabetic Patients With Non-ST-Segment Elevation Myocardial Infarction

Dr Thant Syn Htoo, Dr Thant Syn Htoo 1 , Dr Swe Mar Myint Lwin 2 , Dr Nyein Thuzar Tint 3 , Prof Nwe Nwe 3 , Prof

Thin Thin Nwe 4

1 New Yangon General Hospital, Yangon, Myanmar, 2 University of Public Health, Yangon, Myanmar, 3 Yangon General

Hospital, Yangon, Myanmar, 4 University of Medicine (1), Yangon, Myanmar

PP-GC-09 Prevalence And Factors Associated With Non-Dipping Night-time Blood Pressure Determined By

Ambulatory Blood Pressure Monitoring In Virologically Suppressed HIV-infected Patients

Mr Gahn Nakornchai 1 , Assistant Professor Pairoj Chattranukulchai 1 , Associate Professor Anchalee

Avihingsanon 2 , Mrs. Sirisawat Wanthong 3

1 King Chulalongkorn Memorial Hospital, Thailand, 2 Thai Red Cross AIDs Research Center, Thailand, 3 Siriraj Hospital,

Thailand

PP-GC-10 Investigating Incidence Of Macrovascular And Microvascular Complications Of Diabetes In

Overweight/Obese Patients (MAMIDO)

Ms Shazwani Shaharuddin 1 , Ms Shobna Thuraisingam 1 , Ms Noorul Aimi Daud 2 , Ms Sarah Diyana Shafie 2

1 Monash University Malaysia, Subang Jaya, Malaysia, 2 Hospital Serdang, Kajang, Malaysia

PP-GC-11 Long Term Survival After Acute Coronary Syndrome In Thai Registry In Acute Coronary Syndrome

(TRACS)

Dr Warradit Srisuwanwattana 1 , A/Prof Suphot Srimahachota 2

1

Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital,

Bangkok, Thailand, 2 Cardiac Center and Division of Cardiovascular Disease, Department of Medicine, King Chulalongkorn

Memorial Hospital, Chulalongkorn University, Bangkok, Thailand

PP-GC-12 Left Atrial Volume Index As Assess With Handheld Echocardiogram Outperformed CHA2DS2-VASc

Score In Prediction Of POAF After Non-Cardiac Surgery

Dr Marut Thongpan 1 , A/Prof Adisai Buakhamsri 1

1

Thammasat hospital, Pathumthani, Thailand

PP-GC-14 Predicting Major Adverse Events In Post Infarction Patients Using Plasma Natriuretic Peptide

Dr Ganchimeg Ulziisaikhan 1 , Chingerel Khorloo 2 , Dr Altaisaikhan Khasag 2 , Dr Tsolmon Unurjargal 2

1 The Third State Central Hospital, National Cardiovascular Center, Ulaanbaatar, Mongolia, 2 Mongolian National

University of Medical Sciences, Ulaanbaatar, Mongolia

PP-GC-15 Validation Of GRACE Risk Score For Acute Coronary Syndrome Patients In An Asian Medical Center

Dr Lim Wei Juan 1, 2 , Dr Ow Ji Ken 1 , Dr Cheong Xian Pei 1 , Dr Lee Chuey Yan 1 , Dr Rusli bin Nordin 3

1 Hospital Sultanah Aminah, JOHOR BAHRU, Malaysia, 2 National Heart Institute, Malaysia, 3 MAHSA University, Malaysia

PP-GC-16 Peering Into The Heart Of A Mechanic: A Rare Case Of Myocarditis In Anti-Synthetase Syndrome

Dr Dillon Yeo, Dr Dillon Yeo Guo Dong 1 , Dr Louis Teo Loon Yee 1 , Dr Hawani Sasmaya Prameswari 2

1

National Heart Centre Singapore, Singapore, 2 Hasan Sadikin Hospital, Padjadjaran University, Indonesia

PP-GC-17 Predicting Factors For Ischemic Stroke In Patients With Atrial Fibrillation On Direct Oral

Anticoagulant (DOAC)

Dr Apinya Boonkerng 1

1 Sisaket Hospital, Si Sa Ket, Thailand

PP-GC-18 Effects Of Self-Reported Diaries And Checklists Compared With Usual Care In The Heart Failure

Patient: A Parallel, Single-Blind, Randomized Controlled Trial

Dr Rawipas Wonghirundecha 1 , Dr Kasem Ratanasumawong 1

1 Pgh, Bkk, Thailand

PP-HF-01 Potential Of Mineralocorticoid Receptor Antagonist Esaxerenone To Assist Cardiac Reverse

Remodeling In Patients With HFpEF

Dr Teruhiko Imamura 1 , Dr Akira Oshima 1 , Prof Koichiro Kinugawa 1

1 University Of Toyama, Toyama, Japan

PP-HF-02 In-Hospital Outcomes Of Acute Heart Failure According To Left Ventricular Ejection Fraction: A

Single-Center Retrospective Cohort Study

Dr Anchanida Han-gla 1 , Dr Kasin Viriyanukulvong 1 , Dr Sarinya Puwanant 2 , Dr Supanee Sinphurmsukskul 2 , Dr

Sarawut Siwamogsatham 2 , Dr Aekarach Ariyachaipanich 2

1 Department of Medicine Chulalongkorn University, Bangkok, Thailand, 2 Division of Cardiovascular medicine, Department

of Medicine Chulalongkorn University, Bangkok, Thailand

PP-HF-03 Rare Case Of Valvulopathy Due To Hyperthyroid Disease Acquired Hypertrophic Cardiomyopathy:

A Case Report

Mr Hendsun Hendsun 1 , Ms Eva Julita 1 , Mr Winsen Haryono 2

1 Depati Hamzah Regional Hospital, Pangkalpinang, Indonesia, 2 Cibabat Regional Hospital, Cimahi, Indonesia

PP-HF-04 Acute Myopericarditis Due To COVID-19 Infection : Case Report

Dr Fandy Santoso Budiardjo 1 , dr Agus Layanto 1 , Dr Friska Anggraini Helena Silitonga 1 , Charles Limantoro 1

1

Rsup Dr Kariadi, Semarang, Indonesia

PP-HF-05 Clinical Predictors Of CAD-Associated Acute Heart Failure Hospitalization

Dr Smith Sutharojana 1 , Dr Ing-orn Arunakul 2

1 Samutprakarn Hospital, Bangkok, Thailand, 2 Division of Cardiology, Department of Medicine, Faculty of Medicine,

Thammasat University, Pathumthani, Thailand

PP-II-01 Predictors For Sinus Rhythm After Percutaneous Mitral Commissurotomy

Mr Suchart Aroonsiriwattana 1 , Dr KId Bhummimuang 1 , A/Prof Suphot Srimahachota 2 , Dr Pisit Hutayanon 1

1 Thammasat Hospital, Thailand, 2 King Chulalongkorn Memorial Hospital, Thailand

PP-II-02 High-Dose Atorvastatin Or Trimetazidine For Reduction Of Myocardial Injury In Patient Undergoing

Elective Percutaneous Coronary Intervention

Dr Thanit Layangkool 1

1 Sunpasitthiprasong Hospital, Ubon Ratchatani, Thailand

PP-II-03 Acute Stemi Inferior With Extensive Thrombus: An Illustrative Case

Dr Fandy Santoso Budiardjo, Dr Budiardjo Fandy Santoso 1 , Charles Limantoro 1

1 RSUP dr Kariadi, Semarang, Indonesia

PP-II-04 Diagnosis And Management Of Premature Peripheral Arterial Disease : A Case Report

Dr Fandy Santoso Budiardjo 1 , Charles Limantoro 1 , Dr Friska Anggraini Helena Silitonga 1


PP-II-05 Iatrogenic Spiral Dissection Of The LMCA-LAD-LCX During Percutaneous Coronary Intervention

Resulting In Reduced LVEF In Patient With NSTE-ACS And Acute-On-CKD

Dr Katrin Sumekar 1 , Dr Eka Ginanjar 1

1

Division Cardiology of Internal Medicine, Cipto Mangunkusumo General Hospital / Faculty of Medicine University of

Indonesia, Jakarta, Indonesia

PP-II-06 Factors Associated With Getting Timely Coronary Catheterization Of Patients With Acute Ischemic

Heart Disease Of Hospitals In Thailand

Kitigon Vichairuangthum 1,2 , Dr. Pisamai Jarujittipant 2 , Dr. Kietchai Veerayannon 2

1 Kluaynamthai Hospital, Bangkok, Thailand, 2 North Bangkok University, Patumthani, Thailand

PP-II-07 Periprocedural Myocardial Infarction In Novel Low-Speed Following High-Speed Versus

Conventional High-Speed Rotational Atherectomy Technique For Heavily Calcified Coronary Artery Disease

Dr Mahesh Gurung 1 , Dr Anuruck Jeamanukoolkit 1 , Dr Wasant Soonfuang 1 , Dr Thotsaporn Morasert 2

1 Police General Hospital, Bangkok, Thailand, 2 Pulmonary and Critical care Medicine, Department of Internal Medicine,

Suratthani Hospital, Thailand

PP-II-08 Treatment Of Iatrogenic Coronary Artery Dissection In Resource Constraint In Cath-lab, (A

Retrospective Study)

Prof Khalida Soomro 1

1 7th Day Karachi Adventist Hospital, Karachi, Pakistan

PP-PR-04 Feasibility Study Of The Mobility And Activity Of Daily Living As A Predictors Of Re-Admission In

Patients with Heart Failure.

Dr Supak Kanchanaporn 1 , Dr. Kriengkri Hengrussamee 2

1 Rehabilitation center, Bangkok Heart Hospital, Bangkok, Thailand, 2 Bangkok Heart Hospital, Bangkok, Thailand

PP-PR-05 Correlation Between Levels Of Calculated Remnant Cholesterol Versus Directed LDL Cholesterol

Measurement Among Thai Patient, A Cross-Sectional Study

Mr Sathienwit Rowsathien 1

1 BAH RTAF, Bangkok, Thailand

PP-PR-08 The Innovation Of Respiratory Rehab Device For Preventing Lung Complications After Heart

Surgery: A Study Of Physical Characteristic.

Mr Daorung Sansuwandee 1 , M.D. CHAIYANUT SURAPICHPONG 2

1 Rehabilitation Center, Bangkok Hospital Headquarter, Bangkok, Thailand, 2 Bangbo Hospital, Samutprakarn, Thailand

PP-PR-09 Educating The General Public On Diabetes, Its Causes And Consequences: A Preliminary Study On

The Effectiveness Of Video-Based Interventions

Ms Shazwani Shaharuddin 1 , Mr Cheng En Tan 1 , Mr Wesley Sheng Zhi Chung 1 , Mr Zhen Yee Yeow 1 , Dr Jamuna

Appalasamy 1

1

Monash University Malaysia, Bandar Sunway, Malaysia

PP-PR-10 Characteristics Of Patients Referred For Pre-Operative Cardiovascular Assessment Of Patients

Undergoing Non-Cardiac Surgery

Dr Cheney Wong 1 , Dr Eugene Gan 1 , Dr Alex Tan 1 , Dr Hooi Khee Teo 1 , Audry Lee 1

1 National Heart Centre Singapore, Singapore,

PP-PR-11 Increased Arterial Stiffness Using CAVI (Cardio-Ankle Vascular Index) As A Predictor Of

Hypertensive Response To Exercise

Mr Chanwit Wuttichaipradit 1 , Mr Anusith Tunhasiriwet 1 , Mr Chattanong Yodwut 1 , Dr Kriengkrai

Hengrussamee 1 , Mr Pradub Sukhum 1


YIA-BS-02

Identification Of Candidate Biomarkers For Early Risk Stratification Of

STEMI And Prediction Of Post-STEMI Heart Failure Via Gene Expression

Analysis

Mr Jing Xu 1

1 Fuwai Hospital, National Center For Cardiovascular Diseases, Chinese Academy Of Medical Sciences And Peking Union

Medica, Beijing, China

Objective: Acute myocardial infarction (AMI) with the presence of ST-segment elevation (STEMI) remains a

common cardiac emergency incidence worldwide. We aimed to explore the molecular mechanism and

search for the candidate biomarkers with the predictive and prognostic potentiality that detectable in the

whole blood of STEMI patients and post-STEMI HF patients.

Materials and Methods: Microarray profiles of 46 STEMI patients and 84 healthy controls were collected to

explore differentially expressed genes (DEGs). Gene ontology and pathway enrichment were performed and

protein interaction network was constructed. LASSO logistic regression algorithm and ROC analysis were

performed to build machine learning models for predicting STEMI. Hub genes for further validated in post-

STEMI HF patients.

Results: We identified 99 DEGs convergence in these samples (|log2FC| ≥ 0.8 and adjusted p-value < 0.05).

They were mainly enriched in terms relating to cytokine secretion, pattern recognition receptors signaling

pathway, and immune cells activation. A cluster of 8 genes including MCEMP1, PLAUR, GPR97, ITGAM,

CLEC4D, SLC2A3, BST1, and MMP25 was found to be significant. A machine learning model built by GPR97,

SLC2A3, CLEC4D, PLAUR, and BST1 exerted great value for STEMI prediction. Besides, BST1 and ITGAM

might be candidate prognostic biomarkers for post-STEMI HF.

Conclusion: We re-analyzed the integrated transcriptomic signature of STEMI patients showing predictive

potentiality and revealed new insights and specific prospective biomarkers for STEMI risk stratification and

HF development, which might allow the early risk stratification of STEMI by simple RT-qPCR at the

emergency department.

YIA-EI-01

Aortic Valve Calcium Scoring In Various Etiologies Of Aortic Stenosis

Among Thai Patients

Dr Wisarut Wanchaitanawong 1 , Dr Rungsrit Kanjanavanit 1 , Asst. Prof. Tanop Srisuwan 2 , Dr Wanwarang

Wongcharoen 1 , Dr Arintaya Phrommintikul 1

1

Cardiovascular Unit, Department of Internal Medicine, Faculty of Medicine, Chiangmai University, Thailand, Muang

Chiang Mai, Thailand, 2 Department of Radiology, Faculty of Medicine, Chiangmai University, Thailand,

Background: Aortic valve calcium score (AVCS) has been used to identified severe aortic stenosis (AS). Most

of studies about AVCS in AS were based on degenerative or bicuspid AS but not rheumatic cause.

Objective: To demonstrate the diagnostic accuracy for assessing severity in AS by using AVCS and cut off

point of AVCS for discriminating severe AS in various etiologies.

Materials and Methods: Adult patients (N=116) diagnosed with mild to severe AS with echocardiogram

during January 2015-January 2021 were enrolled. AVCS were identified from MDCT scan performing within

a period of 3 months after echocardiogram.

Results: The receiver operating characteristics (ROC) curves were constructed to study diagnostic accuracy

of AVCS to identify severe AS. The ROC curve to identify severe AS, the bicuspid group had the highest area

under the ROC curve (0.914±0.07(male) and 0.908±0.07(female), compared to degenerative

group(0.896±0.06 (male) and 0.867±0.07(female), and 0.667±0.158(male) and 0.458±0.229(female) in

rheumatic group. The best cutoff AVCS values to identify severe AS were AVCS>2146.4 AU (male) and >

1316.6 AU (female) for degenerative group, AVCS>3532 AU (male) and > 1483.9 AU (female) for bicuspid

group. There were 2 young patients (19 and 25 years old) with severe bicuspid AS who had very low AVCS

(AVCS 0 and 107 AU).

Conclusion: In patients with degenerative and older bicuspid AS, AVCS is the accurate test for assessing

severity but performs poorly in rheumatic AS. We therefore recommend against using AVCS to assess AS

severity in rheumatic heart disease or younger patients with AS

YIA-EI-05

“The Effects Of Trastuzumab Therapy On The Right Ventricular Function

Of Filipino Breast Cancer Patients Tn A Tertiary Teaching Hospital”

Dr John Levi Daluz 1 , Dr. Arnold De Guzman 1 , Dr Jose Donato Magno 1 , Dr. Josephus Sibal 1

1 Angeles University Foundation Medical Center, Angeles City, Pampanga, Philippines, 2 Philippine General Hospital,

Manila, Philippines

Objective: To determine the effects of Trastuzumab on the Right ventricular function of Her2+ Filipino

Breast cancer patients.

Background: Abundant studies showed that Trastuzumab induces Left Ventricular dysfunction. However, at

present there is scarcity of data on its effect on the right ventricular function.

Materials and Methods: A total of 27 Her2 + breast cancer patients undergoing chemotherapy plus

Trastuzumab between March 2019 to July 2020 who had 2 echocardiogram done prior and during

Trastuzumab therapy were prospectively enrolled.

The following right heart parameters were evaluated based on guidelines of the American Society of

Echocardiography (ASE) : Right Ventricular Fractional Area Change (RVFAC), tricuspid annular plane systolic

excursion (TAPSE), TDI values, right atrial measurement and right ventricular diameter.

Results: Our study demonstrated that Trastuzumab has direct effect on echocardiographic measures of the

right ventricle. A decrease both in TAPSE of 5.2% (p=.0126) and FAC of 5.9% (p=.0003)) were noted but is

not correlated with Trastuzumab dose and frequency.

Meanwhile, changes in right ventricular diastolic function were also demonstrated. Changes in Tricuspid

annular systolic velocity (RV S’m), Tricuspid early annular velocity (RV e’),Tricuspid late velocity (RV a’) were

all significant (P= 0.0026, 0.0138, and 0.0023).

Trastuzumab therapy also resulted to an increase both in right ventricular diameter and right atrial size .

Conclusion: Our study concluded that Filipino women with Her2+ Breast Cancer who received Trastuzumab

therapy has a decreasing trend of echocardiographic measures of the right ventricular function regardless of

its dose and frequency.

YIA-GC-04

Clinical, Echocardiographic And Prognostic Outcomes Of Patients With

Concordant And Discordant High-Gradient Aortic Stenosis In An Asian

Cohort

Mr Yeung Jek Ho 1 , Dr Nicholas WS Chew 2 , Mr Cheng Han Ng 1 , Asst Prof William KF Kong 1,2 , Assoc Prof Kian-

Keong Poh 1,2

1 Yong Loo Lin School Of Medicine, National University of Singapore, Singapore, 2 Department of Cardiology, National

University Heart Centre, National University Hospital, Singapore

Objective: About 2.5% of patients with severe high-gradient aortic stenosis (AS) present with discordant

echocardiographic parameters (mean pressure gradient ≥40mmHg and aortic valve area ≥1.0cm2).

Prognostic outcomes of patients with HG discordant-AS (HGDIS-AS) remains understudied.

Material and Methods: From 2001–2015, patients with moderate-to-severe AS with preserved left

ventricular ejection fraction (LVEF ≥50%) were recruited and allocated into 3 groups based on index

echocardiogram – 1) HGDIS-AS, 2) HG concordant AS (HGCON-AS) and 3) moderate AS (MOD-AS). The study

endpoints were all-cause mortality, congestive heart failure (CHF) admissions and aortic valve replacement

(AVR). Multivariable Cox regression was used and Kaplan-Meier curves constructed to evaluate associations

between HGDIS-AS, HGCON-AS and MOD-AS, and the study outcomes.

Results: A total of 467 patients were included: HGDIS-AS (6.2%), HGCON-AS (13.9%) and MOD-AS (79.9%).

Univariate analysis found no differences in all-cause mortality (p=0.853) and CHF admissions (p=0.112)

between study groups. There was significantly higher AVR rates in the HGCON-AS group (58.5%), followed

by HGDIS-AS (31.0%) and MOD-AS (4.6%, p<0.001)) groups. After adjusting for important confounders,

HGCON-AS was significantly associated with all-cause mortality (HR 2.866, 95% CI 1.373-5.981, p=0.005) and

CHF admissions (HR 11.054, 95% CI 2.570-47.549 p=0.021) but not HGDIS-AS, with MOD-AS as the reference

group. Both HGDIS-AS (HR 7.512, 95% CI 2.908-19.406; p<0.001) and HGCON-AS (HR 19.874, 95% CI 10.100-

39.108, p<0.001) were independent predictors of AVR.

Conclusion: Patients with HGDIS-AS were managed similarly with AVR compared to those with HGCON-AS.

However, those with HGDIS-AS appear to have a more favorable prognostic profile compared to HGCON-AS.

YIA-II-03

Real Time U/S Guidance CFA Access Compared With Fluoroscopic

Guidance To Improve The First Pass Successful Rate

Dr Settapong Phetkua 1

1 Phramongkutklao hospital, Phayathai, Thailand

Objective: This trial aim to compare the 1st pass successful rate of CFA assessment and other clinical

outcome among patients undergoing percutaneous cardiac intervention conduct by 1st year IC fellow in

Phramongkutklao Hospital, Thailand.

Materials and Methods: 135 patients who had indication for percutaneous cardiac intervention via femoral

artery approach during August 2020 to January 2021 were randomized 1:1 into 2 study groups [Fluoroscopic

or U/S guidance]. All participants will be received CFA puncture by the 1st year IC fellow and received

manual compression for stop bleeding. Primary outcome was successful rate of CFA canulation after 1

puncture attempt [First pass successful rate].

Results: The mean age was 68-year-olds and most of patients were male. The mean BMI were 24 kg/cm2 in

both groups. Most of patients presented with chest pain and were diagnosed CCS 47%, NSTEMI 25% and

STEMI 8.8%. The mean CFA size were 6.05 cm and 6.39cm for fluoroscopic guidance and U/S guidance,

90.48% had level of CFA bifurcation lower than mid femoral bone and 92.86% had level of lowest IEA higher

than mid femoral bone. Primary outcome showed significant higher first pass successful rate in U/S

guidance compare with Fluoroscopic guidance [78.26% vs 62.12%, P=0.04]. There was high overall

successful rate in both U/S and fluoroscopic guidance groups [88.41% vs 83.33%, P = 0.39], and no

significant difference in all secondary outcomes.

Conclusion: Real time U/S guidance puncture increased fist pass successful rate of CFA canulation compare

with standard fluoroscopic guidance in a new interventional cardiology trainee.

Praxbind ® by the Numbers

Anticoagulant reversal is key to managing uncontrolled bleeding in anticoagulated patients and in those on anticoagulants

who require emergency surgery. 1

Praxbind ® offers specific, immediate, and complete reversal of Pradaxa ® , 2 which provides an additional sense of

security during an emergency when every minute counts. The proof is in the numbers!

Every

11

seconds, an

older adult is

treated for a fall 3 *

~1 in 3

patients with

AF is likely to be

hospitalised

per year 4

ONLY Praxbind® is indicated

for emergency surgery 2,5,6

NO...

• Procoagulant effects 2

• Periprocedural administration 2

• Prothrombotic effect or contraindications 2

• Interaction with heparin administration 2

• Reconstitution 2

100%

reversal within 4 hours in >98%

of patients † in the multicentre

RE-VERSE AD TM study 7

1

ready-to-use

dose for ALL

Pradaxa ® patients 2 :

Praxbind ® 5 g

bolus injection 2

2 indications

• Life-threatening or

uncontrolled bleeding 2

• Emergency surgery/

urgent procedures 2

24 hours

after administration of

Praxbind ® , Pradaxa ®

can be restarted 2

Reversal

within minutes

of administration of

idarucizumab and

independent of age,

gender, or renal function 2,7

Immediately

after administering idarucizumab,

dabigatran plasma concentrations

were reduced by >99%, resulting in

no anticoagulant activity 2,7

Available in 8300+

8

sites in 60+ countries

5 g

idarucizumab was used appropriately in >98% of dabigatran-treated patients with lifethreatening

bleeding or in need of emergency surgery in RE-VECTO, the first analysis of

idarucizumab use in a real-world setting 1

COUNT ON PRAXBIND FOR ALL YOUR PATIENTS ON PRADAXA

*In the US, CDC report

†

N=503.

References: 1. Fanikos J, Murwin D, Gruenenfelder F, et al. Global use of idarucizumab in clinical practice: outcomes of the RE-VECTO

surveillance program. Thromb Haemost. 2020;120(1):27-35. 2. Praxbind (Idarucizumab) Product Information, Singapore Aug 2018. 3. Bergen G,

Stevens MR, Burns ER. Falls and fall injuries among adults aged ≥65 years—United States, 2014. MMWR Morb Mortal Wkly Rep.

2016;65(37):993-998. 4. Steinberg BA, Kim S, Fonarow GC, et al. Drivers of hospitalization for patients with atrial fibrillation: results from the

Outcomes Registry for Better Informed Treatment of Atrial Fibrillation (ORBIT-AF). Am Heart J. 2014;167(5):735-742. 5. Ondexxya (andexanet alfa)

Summary of Product Characteristics. 2019. 6. Reed M, Tadi P, Nicolas D. Andexanet alfa. https://www.ncbi.nlm.nih.gov/books/NBK519499/.

Updated February 20, 2020. Accessed May 8, 2020. 7. Pollack CV Jr, Reilly PA, van Ryn J, et al. Idarucizumab for dabigatran reversal—full cohort

analysis. N Engl J Med. 2017;377(5):431-441. 8. Data on file. Boehringer Ingelheim Pharmaceuticals, Inc. 9. Pradaxa (Dabigatran), Product

Information, Singapore, Jan 2020.

For healthcare professionals only. For Prescribing information, please refer to your country approved label.

Boehringer Ingelheim Singapore Pte. Ltd.

300 Beach Road

#37- 00 The Concourse

Singapore 199555

Phone +65 6419 8600

Fax +65 6297 5771

Document Number: PC-SSK-101358

Pradaxa ® , Praxbind ® , and PRADAXA and PRAXBIND with

associated design ® are registered trademarks of Boehringer

Ingelheim Pharma GmBH and Co. KG and used under license.

RE-VERSE AD is a trademark of Boehringer Ingelheim

International GmbH and used under license.

OP-BS-01

A Tale Of Ice And Fire: Dexmedetomidine-induced Hyperthermia After

Complex Coronary Artery Revascularization For Cardiogenic Shock



Vascular Interventions, St. Luke's Medical Center Global City, Taguig, Philippines

Objective: Dexmedetomidine, a highly-selective A2-agonist with established pharmacologic safety profile in

ICU sedation, is associated with hyperthermia in 5-7% of patients in clinical trials and small-scale cohort

studies. Drug fever (DF), although a diagnosis of exclusion, must be considered differential of fever in

patients using dexmedetomidine.

Materials/Methods: We report a case of high-grade, continuous fever whose temporal relationship strongly

implicated dexmedetomidine as cause.

Results: Patient is an 87 year-old male, known cardiogenic shock, intubated due to respiratory failure post-

IABP implantation and PCI. Due to ventilator asynchrony and restlessness, midazolam and fentanyl were

infused for 24-hours then shifted to dexmedetomidine in preparation for ventilator weaning. Three-hours

post-dexmedetomidine infusion, temperature became 38.4ºC. Septic/autoimmune work-up and thoracoabdominal

scans were unremarkable. Broad-spectrum antibiotics & antifungal were started. Over the next

24-hours, temperature averaged 39.9-40.4ºC despite antipyretics. Dexmedetomidine was maintained (0.5

µg/kg/hour) until 42-hours then discontinued due to suspected DF. He became afebrile 8-hours offdexmedetomidine

and the remainder of his stay.

Conclusions: A dexmedetomidine-induced fever pattern in a case series by Kruger demonstrating onset

post-initiation (3-24-hours), persistence while infusion (>38°C) and resolution after discontinuation (2-12-

hours) fits our patient’s case in relation to dexmedetomidine infusion. Hence, Naranjo adverse drug reaction

score of 'probable' (+5) was given. Mechanism is believed to be caused by stimulation of caudal raphe

magnus, brain area responsible for thermoregulation, by locus coeruleus which regulates arousal and the

primary site of action of dexmedetomidine. Timely recognition of drug-induced events and high index of

suspicion are needed to avoid unnecessary antibiotic exposure, costly and extensive interventions.

OP-BS-02

Bioequivalence Of Two Ticagrelor 90mg Formulations Under Fasting

Conditions In Healthy Subjects: A Randomized, Two-Period Crossover Trial

Dr Anjali Virani 1 , Mr Ravi Verma 1 , Mr Ajay Shiwalkar 1 , Mr Pradeep Labana 1

1 Torrent Research Centre, Torrent Pharmaceuticals Ltd, Ahmedabad, India

Objective: Ticagrelor is a P2Y12 platelet inhibitor. We evaluated pharmacokinetics of two (90 mg) ticagrelor

formulations (test - crystal Form II, Torrent) and reference (Brillinta from Astra Zeneca)

Materials and Methods: We conducted a randomized, open-label, two-treatment, two-period, twosequences,

single-dose, crossover design with a washout period of 7 days between the phases. Healthy

subjects (n=50) aged 18 - 43 years, BMI ranging from 18.62-26.96 kg/m2 with minimum of 50.63 kg weight

were included. Eligible subjects received a single oral dose of 90 mg tablet of ticagrelor either test or

reference formulation. Blood samples were collected until 48.00 hours post dose and analyzed using

validated LC-MS/MS method. The peak concentration (Cmax) and area under the curve AUC(0-t) were

evaluated. Safety was also assessed in each period.

Results: 47 subjects completed both study periods. The arithmetic mean (SD) of reference and test

formulations for Cmax was 769.4 (186.6) and 865.4 (194.4) ng/mL, and AUC(0-t) was 5705.3 (1537.6) and

6088.8 (1720.2) hr.ng/mL, respectively. The geometric least square mean ratio (90% CI) was 112.83%

(108.18 - 117.69) for Cmax and 106.44% (102.25 - 110.80) for (AUC(0-t), well within the acceptance range of

80.00%-125.00% which concludes that both the products are bioequivalent.

Conclusion: The test formulation is bioequivalent, well tolerated and an acceptable alternative to the

reference drug. Switching treatment to ticagrelor (Torrent) medication may reduce the cost and economic

burden of treating patients with ACS or a history of MI.

OP-BS-04

Expression Of MicroRNA 145 Across Age And Risk Factor Profiles And It’s

Correlation With Severity Of Coronary Artery Disease

Dr Arnab Banerjee 1 , Dr. Debabrata Roy 1 , Mr Hindol Majumdar 2 , Mr Rudranil Bhowmik 2 , Dr. Prof. Sanmoy

Karmakar 2 , Dr. Abhishek Roy 1 , Dr. Kaushik Manna 1 , Dr. Navanil Biswas 1

1

NH - Rabindranath Tagore International Institute Of Cardiac Sciences, Kolkata, Kolkata, India, 2 Department of

Pharmaceutical Technology, Jadavpur University, Kolkata, India

Objective: MicroRNA 145 improves homeostasis of smooth muscle cells (SMC) and are atheroprotective. We

aimed to determine expression of micro-RNA 145 across various age groups and risk factor profiles, and its

correlation with atherosclerotic cardiovascular disease.

Materials and Methods: This observational cross-sectional study was done at NH-RTIICS between February

2019 & January 2020 on 108 patients divided equally into 3 age groups: <18, 18-45 & >45years. In the first

group, risk factor profile in family was assessed; and in the latter 2 groups, presence or absence of

atherosclerosis was determined by coronary angiogram and/or carotid IMT. Micro-RNA 145 was measured

in all by RT-PCR, and the results were then compared.

Results: A negative correlation was found between Syntax score and miR 145 in the 18-45yrs (p=0.012) &

>45yrs (p=0.027). A negative but statistically insignificant association of miR145 was also found with family

history of risk factors, hypertension, diabetes, tobacco exposure and a composite of hypertension+diabetes

in 18-45yrs; and with hypertension and composite of 3 or 4 risk factors in >45yrs. In <18yrs, family history of

CVD & risk factors had a strong negative correlation with miR145(p=0.001).

Conclusion: Even in patients with significant family history, anti-atherogenic homeostasis is lost very early in

life, before 18 years of age. Above 18 years, with addition of other risk factors, this anti-atherogenic effect is

lost further, and correlated well with Syntax score and a host of risk factors. Future therapeutic targets may

aim to increase miR145 to improve SMC homeostasis, and reduce CAD.

OP-BS-05

Expression of MicroRNA 155 Across Different Age Groups With/Without

Cardiac Risk Factors and With/Without Overt Atherosclerotic

Cardiovascular Disease

Dr Arnab Banerjee 1 , Dr Debabrata Roy 1 , Mr. Hindol Mazumdar 2 , Prof. Dr. Sanmoy Karmakar 2 , Mr. Rudranil

Bhowmik 2

1 NH - Rabindranath Tagore International Institute Of Cardiac Sciences, Kolkata, India, 2 Department of Pharmaceutical

Technology, Jadavpur University, Kolkata, India

Objective: Differential expression of different micro-RNAs, which are epigenetic modulators controlling the

expression of mRNAs, have been postulated as critical factors in the causality of atherosclerosis in recent

studies. Micro-RNA 155 is believed to be pro-atherogenic and a marker of inflammation in various animal

studies. We aimed to determine expression of micro-RNA 155 across various patient profiles.

Materials and Methods: This observational cross-sectional study was done at NH-RTIICS between February

2019 & January 2020 on 108 patients. Subjects were divided into 3 age groups: <18, 18-45 & >45 years. In

the first group, we took a history of cardiac risk factors or overt atherosclerotic disease in family, and in the

latter 2 groups, presence or absence of atherosclerosis was determined by coronary angiogram and/or

carotid CIMT. Micro-RNA 155 was measured in all by RT-PCR, and then compared between patients.

Results: In 18-45 years, miR155 was positively correlated with syntax score (p=0.002); positive correlation

was also found with hypertension, diabetes, tobacco and hypertension+diabetes+dyslipidemia, but that was

statistically insignificant. In >45 yrs, miR155 correlated positively with syntax score, dyslipidemia, tobacco

exposure and a combination of 2 or 3 risk factors. In <18 years, family history of CVD or risk factors were

strongly correlated with miR155 (p=0.001).

Conclusion: Inflammation starts early in life, and is associated with increase in miR155 in people having

family history of atherosclerosis or its risk factors; the role of miR155 mitigates as we grow older, as

evidenced by significant increase in 18-45, and insignificant positive correlation after 45.

OP-CS-01

Successful Repair Of Subclavian Artery Aneurysm And Off Pump Coronary

Artery Bypass Graft Of Coronary Artery Disease With Horner’s Syndrome

Dr Frederick Gavril Leyson 1 , Dr Maidenlove Paner 1 , Dr Gay Marjorie Obrado 1 , Dr Camilo Jr. Te 1 , Jezreel

Taquiso 1

1

Manilamed Medical Center Manila-Section of Cardiology, Manila, Philippines

Objective: Aneurysm of the subclavian artery with Horner's syndrome is a rare disease combination. No

reported case in literature of subclavian artery aneurysm with Horner’s syndrome and coronary artery

disease. In addition, association of subclavian of artery aneurysm to coronary artery disease is not well

established.

Materials and Methods: A 72 year old male, diabetic, and newly diagnosed hypertensive and dyslipidemic,

came in due to two months history of nonproductive cough. This was accompanied with progressive

dysphagia, dysphonia, excessive tearing and erythema of the right eye, and nasal congestion. On physical

examination, patient was noted to have ptosis, miosis of the right eye, and bruit on the right carotid area of

the neck. Work up showed saccular aneurysm of the proximal right subclavian artery and one-vessel

coronary artery disease involving the left anterior descending artery. Patient underwent off pump coronary

artery bypass graft using left internal mammary artery to left anterior descending coronary artery, and

grafting and repair of the right subclavian artery aneurysm.

Results: Intra-operative finding showed an approximately 6 centimeter saccular aneurysm with

atherosclerotic features. Specimen culture was negative for bacterial growth and histopathology showed

degenerative changes. Post-operatively, patient had resolution of his previous symptoms and was

discharged improved after 17 hospital days.

Conclusion: No consensus yet has been established on how to manage patients with subclavian artery

aneurysm and concomitant coronary artery disease. An off-pump bypass grafting of significantly stenosed

coronary artery done alongside with open surgical repair of a subclavian artery aneurysm appears to be a

promising approach.

OP-CS-02

Predictors Of New Renal Dialysis After Off-Pump Coronary Artery Bypass

Grafting

Dr Permyos Ruengsakulrach 1 , Dr. Vitoon PITIGUAGOOL 1 , Dr. Piyapan PAMORNSING 1 , Dr. Jamorn

UDOMKUSONSRI 1 , Assistant Professor Dr. Pairote SATIRACOO 2,3

1

Bangkok Heart Hospital, Bangkok, Thailand, 2 Department of Mathematics, Faculty of Science, Mahidol University,

Bangkok, Thailand, 3 Centre of Excellence in Mathematics, CHE, Bangkok, Thailand

Objective: To determine predictors of renal dialysis after off-pump coronary artery bypass grafting (OPCAB).

Materials and Methods: All 1790 consecutive patients underwent OPCAB between January 2001 and

December 2018 were studied. The mean age was 63.0±10.4 years and 79.9% were male. Incidence of risk

factors was as follows: diabetes 48.3%, hypertension 73.6%, CVA 6.5%, PVD 2.5%, CHF 20.7%, cardiogenic

shock 5.4%, recent MI 14.2% and previous cardiac surgery 2.8%. The LVEF was 55.1±15.1%. Significant left

main disease was found in 34.2%. The preoperative serum creatinine was 1.1±0.5 mg/dl. The average

number of grafts was 4.4±1.3. Perioperative IABP was used in 16.3%. Conversion to On-Pump CABG was

1.1%. The patients who had renal failure and were on renal dialysis before OPCAB were excluded.

Results: The 30-day mortality was 3.4%. The incidence of patients who required new renal dialysis was 2.7%.

Fifteen preoperative variables considered to influence new renal dialysis were included in the initial model.

Covariates for logistic regression analysis were chosen by using stepwise selection procedure. The best-fit

model included seven significant variables, five of which were significant (P < 0.05). Age (OR: 1.07, 95% CI:

1.040-1.111), serum creatinine (OR: 1.87, 95% CI: 1.292-2.764), CVA (OR: 2.72, 95% CI: 1.164-5.856), recent

MI (OR: 2.08, 95% CI: 1.038-4.036) and LVEF (OR: 0.96, 95% CI: 0.935-0.978) were predictors of new renal

failure requiring dialysis.

Conclusion: Care should be taken in elderly or patients with CVA, recent MI or had high serum creatinine or

low LVEF to prevent new renal dialysis postoperative OPCAB.

OP-CS-03

Outcomes Of Hybrid Prothesis In Treatment Of Acute Stanford A- DeBakey

I Aortic Dissection


1 Cho Ray Hospital, Ho Chi Minh, Viet Nam

Objective: Acute aortic dissection is one of the most serious cardiovascular emergencies, especially the

Stanford A – De Bakey I one. Beside the conventional approach, hybrid surgery (modified frozen elephant

trunk technique) is considered to be an efficient solution for damages in descending aorta. However, it is

necessary to conduct a research about the efficacy of this kind of surgery.

Materials and Methods: We have reviewed retrospectively all the cases that had pre-operative diagnosis as

Stanford – De Bakey I aortic dissection and were treated by using hybrid surgery from 11/2019 to 4/2021.

Results: There are 53 patients in the study, 40 males and 13 females, whose average age is 55,9±11,6yo. The

pre-operative left ventricular ejection fraction (EF) is 63±3,9%. The average diameter of ascending aorta is

43,2±1,8 mm and the rate ascending aortic diameter/body surface is 24,14 mm/m2. The clamping time is

118±39 minutes and the time of extracoporeal circulation is 220±30 min. The number of grafts for one

patient is one, and the length is 175,7±16 mm. The mortality is 3/53 (5,66%)

Conclusion: The hybrid surgery (modified frozen elephant trunk technique) is an effective solution and

strongly-recommeneded for the cases of Acute Stanford A- DeBakey I aortic dissection. This approach can

be transferred to other cardiac centers .

OP-CS-04

Direct Oral Anticoagulation Versus Vitamin K Antagonists With Or Without

Antiplatelets In Post-Transcatheter Aortic Valve Implantation Patients

Ms Vanessa Teo, Ms Vanessa Xin Yi Teo 1 , Mr Gabriel Sheng Jie Lee 1 , Ms Hannah Si En Tay 1 , Mr Cheng Han

Ng 1 , Mr Nicholas WS Chew 2

1

National University Of Singapore, Yong Loo Lin School Of Medicine, Singapore, 2 Department of Cardiology, National

University Heart Centre, National University Health System, Singapore, Singapore

Objective: Transcatheter aortic valve implantation (TAVI) patients commonly have comorbidities requiring

anticoagulation. However, the optimal post-procedural anticoagulation regimen, with or without

concomitant anti-platelets, has not been well established. This meta-analysis investigates the safety and

efficacy outcomes associated with direct oral anticoagulants (DOACs) and Vitamin K Antagonists (VKAs),

with or without concomitant antiplatelet.

Materials and Methods: We searched the EMBASE and MEDLINE databases for studies comparing DOAC and

VKA outcomes in populations with concomitant anticoagulation indications. Primary outcomes were allcause

mortality and cardiovascular-related mortality. Secondary outcomes included bleeding, stroke,

myocardial infarction, and valve thrombosis. Subgroup analyses were performed for anticoagulant

monotherapy, and combined therapy with antiplatelet.

Results: Ten studies with 4,933 patients were included. Overall, there were no differences between DOACs

and VKA for all-cause mortality (OR: 0.691; CrI: 0.431-1.064), cardiovascular-related mortality (OR: 0.884;

CrI: 0.427-1.746), bleeding (OR: 0.897; CrI: 0.700-1.144), stroke (OR: 1.168; CrI 0.702-1.902), myocardial

infarction (OR: 1.437, CrI: 0.328-6.134) and valve thrombosis (OR: 1.058; CrI: 0.195-5.768). In the DOAC

versus VKA monotherapy sensitivity analysis, there were no differences between both anticoagulation

strategies in terms of efficacy and safety outcomes. In the sensitivity analysis of DOAC versus VKA with

concomitant antiplatelet therapy, there were decreased odds of all-cause mortality in the DOACs group

compared to VKA group (OR: 0.148; CrI: 0.050-0.442), but no difference in bleeding and stroke.

Conclusion: DOACs and VKAs have similar safety and efficacy profiles for post-TAVI patients with

anticoagulation indication. However, if concomitant antiplatelet therapy is required, DOACs are favourable

to VKAs for all-cause mortality.

OP-EI-01

Correlation Of NT-proBNP And Echocardiographic Parameters in Patients

With Heart Failure With Preserved Left Ventricular Systolic Function

Dr Shailyn Catungal 1

1 Chong Hua Hospital Heart Institute, Cebu, Philippines

Objective: Natriuretic peptides are increasingly used in clinical practice to diagnose myocardial dysfunction

in Heart Failure with Preserved Ejection Fraction (HFpEF). Recent studies indicate that plasma BNP may have

a role in the diagnosis and management of heart failure (HF). However, there is marked heterogeneity in

BNP levels among subjects with HFpEF, which is only partially explained by differences in left ventricular (LV)

dimensions or systolic function. This study aims to investigate if NT-proBNP can be a useful tool to guide

management in patients with HFpEF when echocardiography is not easily accessible.

Materials and Methods: NT-proBNP in patients admitted in Chong Hua Hospital from July 2019- July 2020

were collected from the hospital laboratory. Patients with heart failure symptoms with preserved LV systolic

function and other echocardiographic parameters were collected from the hospital records. The correlation

between the different echocardiographic parameters and NT-proBNP was determined.

Results: The NT-proBNP levels increased significantly in HFpEF as the values of LAVI ( P = 0.000), E/A ratio ( P

= 0.042 ), E/e’ ( P = 0.000) and TR velocity (P= 0.000) increases. The mean NT-proBNP level was 5, 588 pg/ml.

Highest levels were seen predominantly in diastolic dysfunction grade II.

Conclusion: Our findings indicate that NT-proBNP is positively correlated to echocardiographic parameters,

namely LAVI, E/A ratio, E/e’ and TR velocity in patients with heart failure with preserved LV systolic function.

OP-EI-03

Global Longitudinal Strain Right Ventricle And Mean Pulmonary Artery

Pressure As A Predictor For severity of Atrial Septal Defect

Nia Dyah Rahmianti 1 , dr, PhD Lucia Krisdinarti 2 , Hasanah Mumpuni 2

1 Cardiology and Vascular Medicine Department, Airlangga University, Surabaya, Indonesia, 2 Cardiology and Vascular

Medicine Department, Gadjah Mada University, Jogjakarta, Indonesia

Objective: Atrial septal defect (ASD) is one of frequent congenital heart disease, found in around 6-10% of

the population and few years later right ventricle function is an important factor for prognostic in congenital

heart disease patients. Therefore, we aimed to investigated Global Longitudinal Strain Right Ventricle (GLS

RV) and Mean Pulmonary Artery Pressure (MPAP) on Secundum Atrial Septal Defect (ASD) to predict the

severity of the disease.

Materials and Methods: This study was an analytic observational with the cross sectional approach. This

study was conducted with secundum ASD patients who underwent Right Heart Catheterisation (RHC) during

February to July 2019 at Sardjito General Teaching Hospital Yogyakarta. Demographic data were collected

and echocardiographic parameters were evaluated based on standard examination. This research has been

approved by an ethical committee.

Results: Thirty three patients were enrolled in this study. The results were artistically analysed using

correlation hypothesis test. There was strongly significant correlation between GLS RV and MPAP that found

in ASD (p=0.0001 r= 90,5%). ASD patients with mild hypertension pulmonary show better GLS RV.

Conclusion: This is the first study in Indonesia that analyzed the association between GLS RV and MPAP in

Secundum ASD patients. There was a strongly significant correlation between GLS RV and mPAP in patients

with secundum ASD after right heart catheterisation. We assume that the association influenced by

progressively and degree of disease severity.

OP-EI-04

Short-Term Prognostic Impact Of Tricuspid Annular Plane Systolic

Excursion In Acute Inferior ST-Elevation Myocardial Infarction

Dr Nadine Nurani Shabrina, Dr Nadine Shabrina 1 , Daniel Tobing 2

1 Research Associate, National Cardiovascular Center Harapan Kita, Jakarta, Indonesia, 2 National Cardiovascular Center

Harapan Kita, Jakarta, Indonesia

Objective: Dysfunction of the right ventricle (RV) may have a pivotal effect in patients with myocardial

infarction (MI). Assessment of RV function is not regularly performed in Indonesia. We aimed to evaluate

prognostic information of tricuspid annular plane systolic excursion (TAPSE) in MI patients.

Materials and Methods: Data were collected from ONE-ACS registry. Of all 899 patients who were

diagnosed with ST-segment elevated myocardial infarction (STEMI) between July 2018 to June 2019 in

National Cardiovascular Center Harapan Kita (NCCHK), 141 patients were inferior STEMI and underwent

echocardiographic examination within 24-hour of onset. The subjects were categorized into two groups:

TAPSE ≤18 mm (n=76) and TAPSE >18 mm (n=65).

Results: A total of 141 patients (131 males, mean age 53.9±10) who underwent percutaneous coronary

intervention were enrolled to this study. TAVB (14.5% vs 1.6%, p=0.001) and RV involvement (48.7% vs 20%,

p<0.001) were higher in TAPSE ≤18 mm group. In the overall cohort, TAPSE ≤18 mm was associated with

greater incidence of acute kidney injury (AKI) (p=0.037) and cardiac arrest (p=0.032), but not associated

with prolonged hospitalization (p=0.127), cardiogenic shock (p=0.340), and in-hospital mortality (p=0.297).

Logistic regression showed that TAPSE ≤18 mm was predictor for AKI (OR, 4.255, 95% CI, 1.490 to 12.048,

p=0.007) and cardiac arrest (OR, 4.773; 95% CI, 1.006 to 22.643, p=0.049).

Conclusion: The assessment of TAPSE that represents RV function may be taken into consideration as

potential prognostic factor regarding early outcomes in STEMI patients. Long-term follow-up is necessary to

obtain more comprehensive prognostic information.

OP-EP-01

Heart Rate Variability And Its Role To Predict Atrial Fibrillation In Patients

Undergoing Coronary Artery Bypass Grafting

Dr Pham Truong Son, Dr Truong Son Pham 1 , Dr Van Chien Do 2 , Dr Thanh Binh Nguyen 3



Objective: Heart rate variability (HRV) is a physiological feature indicating the influence of the autonomic

nervous system on the heart rate. However, change in HRV and its role to predict atrial fibrillation after

coronary artery bypass grafting (CABG) were still controversial. This study aimed to establish the pattern of

change in heart rate variability and to find its association with new-onset atrial fibrillation in patients

undergoing CABG.

Materials and Methods: A cross-sectional study involved 119 consecutive patients undergoing off-pump

CABG. All patients were assessed with 24-hour Holter recordings 2 days before CABG and 1 week, 3 months,

6 months postoperatively. HRV was analyzed and Atrial fibrillation was detected from its recordings.

Results: For patients undergoing CABG, all the time-domain and frequency-domain heart rate variability

parameters maximally decreased at 1 week and were mostly recovered at 3 months postoperatively. The

rate of new-onset atrial fibrillation was 13.7%; 13.8%;17.2% postoperatively at 1 week, 3 months, 6 months.

Reduced heart rate variability before surgery was significantly associated with a higher risk of developing

new-onset atrial fibrillation up to 4,3 times during the following up. The area under the receiver operating

characteristic curves for rMSSD and SDNN as a predictor of postoperative atrial fibrillation was 0.28 and

0.34, respectively.

Conclusions: After surgery, decreased heart rate variability was found in both the time-domain and

frequency-domain, which were fully recovered postoperatively at 3 months. Reduced time-domain factors

in preoperative 48-hour heart rate variability are independently associated with a higher risk of occurrence

of atrial fibrillation.

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OP-GC-01

Efficacy Of Extracorporal Shock Wave Therapy For Chronic Coronary

Artery Diseases With Refractory Angina Pectoris.

Dr Le Duy Thanh, Dr Le Duy Thanh 1 , Dr Pham The Tho 2 , Dr Bui Thi Huong Lan 3

1 108 Military Central Hospital, Hanoi, Viet Nam, 2 108 Military Central Hospital, Hanoi, Vietnam, 3 108 Military Central

Hospital, Hanoi, Vietnam

Objective: Chronic coronary artery disease (CAD) is the leading cause of death and cardiac hospitalizations.

Despite optimal therapeutic, patients still get angina. Our aims were to evaluate the effectiveness and

safety of shock wave therapy in treatment of chronic coronary artery patients with refractive angina

pectoris.

Materials and Methods: A prospective, descriptive study involved 38 CAD patients with refractory angina

who were treated at 108 Military Central Hospital, Hanoi, Vietnam. All patients undergoing the specific

therapeutic protocol for ESWT, which applied 100 shocks/spot at 0.09mJ/mm2 energy flux density for 3-

6spots each time, with three times per week at each series for three series at 1, 5, 9 weeks. Upon

completion of ESWT, patients were followed up for 3 months. Symptoms of angina, heart failure, cardiac

events, echocardiographic and nuclear cardiac perfusion parameters were recorded for each visit per

protocol.

Results: The average age was 72.8 ± 8.8 years old, male accounted for 35%. 100% passed through study

protocol with 3 months follow up. Percentage of patients treated with OTM, PCI, CABG were 68.4%, 23.7%

and 4.8%, respectively. Symptoms of angina improved significantly. Six-minute walk test improved from

340.2 ± 80.3 to 440.2 ± 79.7m. Myocardial perfusion imaging SRS score improved remarkably (from17.6 ±

10.9 to 21.2 ± 12.0), SSS score (from 11.7 ± 10.5 to 14.7 ± 12.1). No serious cardiac adverse events had been

recorded.

Conclusion: Extra-corporal shock wave therapy (ESWT) for chronic coronary artery disease patients with

refractory angina pectoris was found to be safe and effective.

OP-GC-02

A Significant Ten-Year Risk Of Fatal Cardiovascular Disease Estimation To

Predict Length Of Stay Of Hospitalized COVID19 Patients



Objective: Coronavirus disease (COVID-19) is a global pandemic that seem uncontrollable. Also, the number

of cardiovascular diseases is also worsening the patient’s outcome. Correlations between Cardiovascular

risk and COVID-19 is important. We are aiming this research to analyze the capability Ten-Year Risk of Fatal

Cardiovascular disease obtained from SCORE-Risk chart scoring to predict the length of stay (LOS) in

hospitalized COVID-19 patients.

Materials and Methods: This is a cross-sectional study including 85 moderate-severe category hospitalized

COVID-19 patients with no previous cardiovascular disease. We assessed the patient’s cardiovascular risk by

using SCORE-Risk chart. Correlation between patient’s clinical variables with the length of stay (LOS) is done

by using Mann-Whitney analysis. Variables which show p value <0.2 will then be analyzed by logistic

regression analysis.

Results: There are 27 patients (31.8%) with a high cardiovascular risk. Median LOS of low risk group is 9.5

days and high risk is 11 days. Mann-Whitney analysis of patient’s clinical variable with LOS shows heart rate,

leukocyte, NLR, CRP, blood glucose, D-dimer, and SCORE-Risk chart give p-value with value < 0.2. The logistic

regression analysis shows that SCORE-Risk chart is the strongest predictor of LOS with OR 4.046 (1.386-

11.812; p value 0.011).

Conclusions: Ten-year risk of fatal cardiovascular disease measured by SCORE-risk chart can be used as

accurate predictor of moderate-severe category COVID-19 patient’s length of stay.

OP-GC-03

A Significant Ten-Year Risk Of Fatal Cardiovascular Disease Estimation To

Predict D-Dimer Level In Hospitalized COVID-19 Patients



Objective: After the COVID-19 pandemic, the risk of thrombosis and bleeding has been an important issue. It

is reported that higher D-dimer levels are associated with poor prognosis. Cardiovascular disease risk has

also been reported to poor prognosis of COVID-19. Both cardiovascular disease risk and high D-dimer level

can be a lethal combination leading to death in COVID-19 patients. We are aiming this research to analyze

the capability ten-year risk of fatal cardiovascular disease obtained from SCORE-Risk chart to predict the D-

dimer level in hospitalized COVID-19 patients.

Materials and Methods: This is a cross-sectional study including 85 moderate-severe hospitalized COVID-19

patients without previous cardiovascular disease. We assessed the patient’s cardiovascular risk by using

SCORE-Risk chart and separate samples into two D-dimer groups. Comparison between patient’s clinical

variables and D-Dimer level is done by using Mann-Whitney analysis. Variables which show p value <0.2 will

then be analyzed by Logistic Regression.

Results: There are 27 patients (31.8%) with a high cardiovascular risk. Median D-dimer is 560 ng/ml. Mann-

Whitney analysis comparing patient’s clinical variables with D-dimer shows CRP, blood glucose, lactic acid

and SCORE-Risk chart give p-value with value < 0.2. The logistic regression analysis shows that SCORE-Risk

chart is the strongest predictor of higher D-dimer level with OR 5.647 (1.670-19.092; p value 0.005) with

88.2% specificity and 45.1% sensitivity.

Conclusions: Ten-year risk of fatal cardiovascular disease measured by SCORE-risk chart can be used as

accurate predictor of higher D-dimer level on moderate-severe COVID-19 patients.

OP-GC-04

BDMS Acute Coronary Syndrome Registry

Dr Kriengkrai Hengrussamee 1 , Damras Tresukosol 1 , Dr Rapin Kukreja 1 , Dr. Wichai Jiraroj-ungkun 1 , Dr Pradub

Sukhum 1


Objective: To analyze data collection of Bangkok Dusit Medical Service (BDMS) ACS registry and compare

between ST segment elevation acute coronary syndrome (STE-ACS) and non-ST segment elevation acute

coronary syndrome (NSTE-ACS) in terms of baseline characteristics, treatment, and in-hospital mortality

rate.

Materials and Methods: From January 2017 to December 2020, this ACS registry was conducted in Bangkok

heart hospital (BHT) and 7 hospitals under BDMS. Case record form data were done via BDMS COE webbase

and analyzed. At p< 0.001 was statistically significant.

Results: There were 2,024 ACS patients with predominant male (81%), NSTE-ACS 52.2% and the mean age of

62.2± 13 years. Diabetes (DM), hypertension (HT), dyslipidemia, and current smoking were recorded in 25.2

%,54.9%,46.6 % and 30.4 %, respectively. Reperfusion rate in STE-ACS was 93.2 % and 73.8% was primary

percutaneous coronary intervention. Emergent CABG was done in 2.5%. Intra-aortic balloon pump was

inserted in 4%. STE-ACS patients were significant younger (59±12.2 vs.65.2±13.9 yrs.), more current smokers

(39.8% vs.21.8%), more cardiogenic shock (15.3% vs.3%) and more cardiac arrest before reperfusion therapy

(9.7% vs. 1.8 %).Meanwhile, NSTE-ACS patients were significant more DM (30.6% vs. 19.4%), HT (62.4%

vs.46.7%) and dyslipidemia (53.8% vs.38.8%).In-hospital mortality rate was 2.92% and significant higher in

STE-ACS (5% vs.1%).

Conclusions: BDMS ACS registry revealed the characteristics of ACS patients in private hospitals, their

treatment and in-hospital mortality rate. High reperfusion rate has resulted in low mortality rate.

OP-GC-05

Prevalence And Associated Factors Of Abnormal Cardio-Ankle Vascular

Index In Patients With Type 2 Diabetes Mellitus In Tertiary Care Hospital

Dr Pantaree Jaigla 1 , Dr. Surapun Pongsuthana 2 , Chaicharn Deerochanawong 3

1 Department of Internal medicine, Rajavithi Hospital, Bangkok, Thailand, 2 Division of Cardiology, Department of Internal

medicine, Rajavithi hospital, College of Medicine, Rangsit university, Bangkok, Thailand, 3 Division of Endocrinology,

Department of Internal medicine, Rajavithi hospital, College of Medicine, Rangsit university, Thailand

Objectives: Peripheral arterial disease is a major complication in diabetes mellitus (DM). Previous studies

have shown the correlation between the arterial stiffness and vascular-related diseases, which may be

caused by smoking, hypertension, DM and dyslipidemia. Currently, cardio-ankle vascular index (CAVI) is the

main tool in measuring arterial stiffness and atherosclerosis. Therefore, we aimed to study the prevalence

and associated factors of abnormal CAVI in type 2 DM(T2DM) patients in Tertiary Hospital.

Materials and Methods: This cross-sectional study enrolls 280 outpatients visited Rajavithi Hospital from

January to December 2019. Patients aged 18 and above with history of T2DM were included. The exclusion

criteria were patients without arms or legs as the CAVI could not be measured. CAVI was conducted by

skilled technicians. Baseline characteristics and demographic data were collected and analyzed using SPSS

version 22.0.

Results: Among 280 patients, 70.4% were female and mean age of 57.57±12.72 years old. Most common

comorbidities were dyslipidemia 72.1%, hypertension 66.8% and ischemic heart disease 7.1% respectively.

The prevalence of abnormal CAVI was 22.8%. According to multiple logistic regression, certain age (adjusted

OR 1.13, p<0.001) and blood cholesterol (adjusted OR 1.02, p<0.001) were significantly associated with

abnormal CAVI; while history of hypertension, systolic blood pressure, and eGFR did not show statistically

significant correlation.

Conclusion: The prevalence of abnormal CAVI in patients with T2DM was considered low. Patients with

T2DM, especially in older age and higher cholesterol, are recommended for intensive cardiovascular

screening strategies.

OP-GC-06

Infected Femoral Artery Pseudoaneurysm With Klebsiella Pneumoniae

Bacteremia In Injected Drug Abuser: A Case Report

Ms Hana Khairunnisa, Ms Idzni Mardhiyah, Mr Andi Mahavira, Mr Franky Zeplin Pasaribu

Background: Injected drug abuse is a significant problem in modern societies today, with increases various

vascular complications due to repeated punctures under septic conditions. One of the severe vascular

complications is infected pseudoaneurysm. However, no study reported the involvement of Klebsiella

pneumonia in infected pseudoaneurysm.

Case Summary: A 40-year-old homeless man, an injected drug abuser, presented to the emergency

department with a severe pain lump in the right groin area since three weeks ago. The hemodynamic was

unstable, and the laboratory examination revealed severe infection. While ultrasonography was suggesting

high suspicion of lymphadenitis in the right groin area, the Doppler ultrasonography was showing a

pseudoaneurysm in the right common femoral artery. His blood cultures grew Klebsiella pneumonia ESBL.

He was planned to be referred to a vascular surgery center. Unfortunately, before he got a referral, his

condition worsened with a fall of hemoglobin suggesting rupture of pseudoaneurysm that didn’t improve

with resuscitation.

Discussion: A tender swollen groin in an injected drug abuser should prompt a suspicion for the presence of

pseudoaneurysm. Diagnosis of infected pseudoaneurysm is confirmed from the co-incidence of septic

condition. When faced with uncertain diagnosis, further investigation with appropriate imaging is

warranted. In this case, surgical management with controlled infection and resuscitation was required,

however, it remained a challenge due to the unstable condition and pseudoaneurysm itself that was prone

to rupture. In addition, Klebsiella pneumonia ESBL made bacteria resistant to cephalosporins and

monobactams.

Conclusion: Prompt diagnosis, targeted antibiotics, and surgical management are crucial in infected

pseudoaneurysm.

OP-GC-07

Baseline Characteristics of 277 Venous Thromboembolism Patients From

Taiwan And Korea Treated With Edoxaban In Routine Clinical Practice

Prof Kuan-Ming Chiu 1,2 , Dr Won-Il Choi 3 , Dr Pei-Ying Pai 4 , Dr Jung-Hyun Choi 5 , Dr Wei-Tien Chang 6 , Dr Kye-Hun

Kim 7 , Dr Paul-Egbert Reimitz 8 , Dr Martin Unverdorben 9 , Dr Alexander Cohen 10 , Dr Giancarlo Agnelli 11

1

Far Eastern Memorial Hospital, Cardiovascular Center, New Taipei City, Taiwan, 2 Yuan Ze University, Electrical

Engineering, Taoyuan City, Taiwan, 3 Hanyang University Myongji Hospital, Division of Pulmonary and Critical Care

Medicine, Goyang, Republic of Korea, 4 China Medical University Hospital, Taichung, Taiwan, 5 Pusan National University

Hospital, Division of Cardiology, Busan, Republic of Korea, 6 National Taiwan University Hospital, Taipei, Taiwan,

7 Chonnam National University Hospital, Department of Cardiovascular Medicine, Gwangju, Republic of Korea, 8 Daiichi

Sankyo Europe GmbH, Medical Affairs Europe, Munich, Germany, 9 Daiichi Sankyo, Inc., Global Medical Affairs, Basking

Ridge, United States, 10 Guy's and St Thomas' NHS Foundation Trust, King's College London, London, United Kingdom,

11 University of Perugia, Internal and Cardiovascular Medicine-Stroke Unit, Perugia, Italy

Objective: The direct oral anticoagulant edoxaban was noninferior to conventional therapy with significantly

less bleeding in patients with venous thromboembolism (VTE), including severe pulmonary embolism (PE) in

the phase III clinical trial. Effectiveness and safety from clinical practice need investigation to complement

randomized-controlled trials.

Materials and Methods: From 2017 to 2018, 277 VTE patients on edoxaban, 119 from Taiwan and 158 from

Korea, were enrolled at 20 hospitals and medical practices in the Global ETNA-VTE program. Baseline data

were analyzed using descriptive statistics.

Results: Patient mean age was 66.7 years old with 39% ≥ 75 years old and 48.0% male. The mean values

were for body weight 67.0 kg, creatinine clearance 81.6 mL/min, and the VTE-BLEED and modified HAS-

BLED scores 1.9 and 1.5, respectively. The index events were pulmonary embolism (PE) without deep vein

thrombosis (DVT) in 134 (48.4%), PE with DVT in 55 (19.9%), and DVT only in 88 (31.8%) of the patients. The

most frequent comorbidities included hypertension 142 (51.3%), diabetes mellitus 59 (21.3%), dyslipidemia

44 (15.9%), and malignancy 38 (13.7%), the majority 29/38 (76.3%) of these were active cancers. Other rare

but severe events in the patients’ histories included ischemic stroke and major or clinically relevant nonmajor

bleeding, each with 4 (1.4%), and one (0.4% intracranial hemorrhage. Edoxaban 60mg daily was

prescribed in 67.1% and 30mg in 32.9% of the patients.

Conclusion: Baseline characteristics of patients enrolled from Taiwan and Korea in the global ETNA-VTE

program were representative of typical VTE populations expected in Asian countries.

OP-GC-08

Major Bleeding, Stroke And Mortality In 3,359 Atrial Fibrillation Patients

From Korea, Taiwan, Hong Kong, And Thailand Treated With Edoxaban

Prof Songsak Kiatchoosakun 1 , Dr Bunjong Saejueng 2 , Dr Hung Fat Tse 3 , Dr Yannie Oi Yan Soo 4 , Dr Chun-Chieh

Wang 5 , Dr Chang Hoon Lee 6 , Dr Paul-Egbert Reimitz 7 , Dr Martin Unverdorben 8 , Dr Raffaele De Caterina 9 , Dr

Paulus Kirchhof 10

1 Srinagarind Hospital, Khon Kaen, Thailand, 2 Central Chest Institute of Thailand, Nonthaburi, Thailand, 3 The University of

Hong Kong, Hong Kong, Hong Kong, 4 The Chinese University of Hong Kong, Hong Kong, Hong Kong, 5 Chang Gung

Memorial Hospital-Linkou, Taoyuan, Taiwan, 6 Veterans Health Service Medical Center, Seoul, Republic of Korea, 7 Daiichi

Sankyo Europe GmbH, Munich, Germany, 8 Daiichi Sankyo, Inc., Basking Ridge, USA, 9 Pisa University Hospital - University

of Pisa, Pisa, Italy, 10 University Heart and Vascular Center Hamburg, Hamburg, Germany

Objective: Edoxaban is guidelines recommended for stroke prevention in atrial fibrillation (AF) patients

based on the phase III ENGAGE AF-TIMI 48 trial. One-year effectiveness and safety data in Asian Patients

should substantiate the above.

Materials and Methods: From 2017 to 2020, 3,359 AF patients on edoxaban were enrolled at 64 hospitals

and medical practices from Korea, Taiwan, Hong Kong, and Thailand. After 1-year, their effectiveness and

safety events were prospectively collected and analyzed.

Results: The mean age was 71.7 years old with 41.2% of the patients being ≥75 years of age. The mean (SD)

BMI was 25.0 kg/m2. The most frequent stroke risk factors and comorbidities were hypertension (72.3%),

diabetes mellitus (29.7%), history of ischemic stroke (15.1%), and heart failure (12.4%). The mean values for

CHA2DS2-VASc and HAS-BLED scores were 3.1 and 2.3. The median creatinine clearance was 60.2mL/min.

Edoxaban 60mg was prescribed in 1,670 (49.7%) and 30mg in 1,689 (50.3%) of the patients. ISTH major

bleeding occurred in 43 (1.28%) with intracranial hemorrhage in 12 (0.36%) and hemorrhagic stroke in 9

(0.27%) of the patients. Ischemic stroke occurred in 37 (1.1%) and systemic embolism in 1 (0.03%) of the

patients. After one-year, 58 (1.73%) of the patients had died overall and 22 (0.65%) from cardiovascular

causes.

Conclusion: The one-year stroke, mortality, and safety event rates were low and similar to other studies of

Asian AF patients treated with edoxaban, thus, reinforcing the effectiveness and safety of edoxaban also in

this population.

OP-GC-09

A Case Of A 60 Y/O Filipino Female With Myocardial Infarction With

Nonobstructive Coronary Artery Disease: Exercise-Induced Coronary

Artery Vasospasm



Vascular Interventions, St. Luke’s Medical Center Global City, Taguig City, Philippines

Objective: MINOCA is an increasingly recognized clinical entity more common in younger patients, women,

black, Asians and Hispanics. Initial mechanism is unclear hence ruling-out unlikely diseases & investigating

causes are important because of adverse cardiovascular outcome risks.

Materials and Methods: Patient is a 60 year-old female with unremarkable medical history with sudden

chest heaviness after lifting weights, resolving after rest. Vital signs, physical exam, blood tests and

infectious work-up were unremarkable. ECG was NSR. CXR, 2D-ECHO and CTA of thoracic aorta were

normal. HS trop-I was elevated at 486 ng/ml hence given Aspirin, Ticagrelor, Rosuvastatin and Enoxaparin.

ECG remained unchanged.

Results: Coronary angiogram (CA) showed normal coronaries. A diagnosis of probable MINOCA from stressinduced

coronary artery vasospasm was made. Cardiac MRI was not done because of claustrophobia. She

remained asymptomatic and was discharged with calcium-channel blockers, nitrates, antiplatelet and

statins.

Conclusions: The most described mechanism for MINOCA is transient epicardial coronary vasospasm,

however ECG and CA may appear normal during evaluation. We believe that weight-lifting triggered a

catecholaminergic release causing prolonged vasomotor dysfunction and c-troponin elevation. Exercise is

described to not provoke vasospasm, except for those symptomatic during the hot phase of the condition

due to catecholamines. We emphasized how focused clinical assessment of medical history and physical

exam may help narrow down etiology. Currently, there are no guidelines and RCTs regarding MINOCA,

hence given limited evidence-based reports, we must consider several aspects of management strategy -

emergency supportive care, diagnostic approach and cardioprotective, cause/risk-targeted therapies to

alleviate symptoms associated with MI.

OP-GC-10

Risk Score To Predict In-Hospital Mortality In Cardiac Care Unit Patients

Dr Ittipon Preechawettayakul 1 , Dr Sarunyou Suwanagsorn 1 , Dr Ply Chichareon 1

1

Prince Of Songkla University, Songkla, Thailand

Objective: We aimed to develop the clinical risk score to predict in-hospital all-cause mortality among

patients admitted from emergency room to cardiac care unit (CCU)

Materials and Methods: We analyzed 1,709 patients who were admitted from emergency room to cardiac

care unit of Songklanagarind hospital between July 2015 and December 2019. We fitted 16 candidate

predictors in logistic regression model using backward selection based on the Akaike Information Criterion

to derive the new risk score. Candidate predictors were selected based on preexisting knowledge of the

association of the predictors with in-hospital all-cause mortality.

Results: There was 71.91 % male and mean age was 64.3 years old. The percentage of diabetes, chronic

kidney disease and prior stroke was 22.35 %, 13.63 %, and 8.25 %, respectively. The principal diagnosis was

related to acute myocardial infarction in 63.19 %. Cardiogenic shock before or within 1 hour of CCU

admission occurred in 141 patients (8.25%). In-hospital all-cause mortality rate was 5.4%. Age, history of

chronic lung disease, Braden skin score, respiratory failure, cardiogenic shock, cardiac arrest before and

within 1 hour of admission, anion gap and red cell distribution width (RDW) were identified as independent

predictors of in-hospital all-cause mortality and included into our risk score. The logistic regression model of

the new score had c-statistic of 0.881 (95% CI 0.851-0.910). Calibration plot showed good agreement

between predicted probability derived from the regression model and actual outcomes.

Conclusions: Our risk score including 8 variables performed well in predicting in-hospital all-cause mortality

in CCU patients.

OP-GC-11

In-hospital Mortality Of Acute Coronary Syndrome (ACS) Patients After

Implementation Of National Health Insurance In Indonesia

Dr Nurul Qalby 1 , Mr Dian Sidik Arsyad 2 , Andriany Qanitha 3 , Dr Maarten J Cramer 4 , Dr Yolande Appelman 5 , Dr

Dara Rosmailina Pabittei 3 , Prof Pieter AFM Doevendans 4 , Dr Akhtar Fajar Muzakkir 6 , Dr Idar Mappangara 6

1

Department of Public Health, Faculty of Medicine, University of Hasanuddin, Makassar, Indonesia, 2 Department of

Epidemiology, Faculty of Public Health, University of Hasanuddin, Makassar, Indonesia, 3 Department of Physiology,

Faculty of Medicine, University of Hasanuddin, Makassar, Indonesia, Makassar, Indonesia, 4 Department of Cardiology,

University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands, 5 Department of Cardiology, Amsterdam

UMC- Location VU University, Amsterdam, Netherlands, 6 Department of Cardiology and Vascular Medicine, Faculty of

Medicine, University of Hasanuddin, Makassar, Indonesia

Objective: To investigate the in-hospital mortality of Acute Coronary Syndrome (ACS) patients before and

after implementation of a national health insurance named Jaminan Kesehatan Nasional (JKN) in Indonesia

in 2014.

Materials and Methods: Merged data of 364 patients who presented with an ACS in February 2013 till

December 2014 (Cohort 1) before implementation of JKN were compared with 1142 patients with an ACS

from June 2018 to January 2020 (Cohort 2) after JKN implemented. Both cohorts consisted of patients who

came to the Cardiac Center of Wahidin Sudirohusodo Hospital in Makassar, Sulawesi, Indonesia. The

difference in in-hospital mortality rates was analyzed.

Results: Comparing both cohorts, more patients had hypertension (75.5% to 87.9%; p<0.001) and increase

of active smokers (28.3% to 43.3%; p<0.001). Thrombolysis rate has tripled after JKN being implemented

and an increase of more than two-fold PCI treatment was seen (9.2% to 19.2%; p<0.001). Concerning overall

in-hospital mortality, there was 50.8% decrease comparing cohort 1 to cohort 2. Furthermore, in-hospital

mortality in NSTEMI and STEMI patient decreased significantly by 62.5% (p=0.004) and 50% (p=0.010)

respectively. In terms of sex, in-hospital mortality rates from cohort 1 and cohort 2 also decreased

significantly, for men approximately 46% (p=0.008) and 52.2% for women (p=0.014).

Conclusion: Overall in-hospital mortality rates decreased in both men and women, albeit hypertension and

smoking in the studied population raised. This study represented the benefit of universal health coverage in

improving cardiovascular health care by providing more accessible treatment, although improvement for

prevention of risk factors also imperative.

OP-GC-12

The Prevalence Of Electrocardiographic Abnormalities In The Mongolian

Population.

Dr Natsagdorj Ulziijargal, Dr Natsagdorj Ulziijargal 1 , Ms Sodgerel Batjargal 1 , Ms Yondonjamts Pilmaa 1

1 Institute Of Medical Sciences, Ulaanbaatar, Mongolia

Objective: Electrocardiography (ECG) is the leading method of assessing the prevalence of ischemic heart

disease in the general population. The prevalence of ECG disorders and their relationship with sociodemographic

parameters not previously been made in Mongolia.

Materials and Methods. We used 998 ECGs from representative samples of population (25-65 + years

old).The analysis using Minnesota code was carried out among men and women of four age groups, among

citizens and countrymen.

Results. The survey participants covered 49.9% in urban areas, 50.1% in rural areas, and the sex ratio was 1:

1.2 (47.1% for men and 52.9% for women). In the current study, the prevalence of 2.4% (24) in of

myocardial infarctions, and in 3.0% (37) of the painless forms of ischemic heart disease, 4.0% (40) of

suspected myocardial infarction. Proven ischemic heart disease was 6.1% (61), of which 5.5% (26) were

male and 6.6% (35) were female. Suspected ischemic heart disease occurred in 3.5% (4) of the 45-54 age

group and 8.9% (10) of the 55-64 age group. The risk of suspected ischemic heart disease was 20.2% (20) in

those aged 45-54 years and 27.5% (25) in those over 55 years of age. All groups of ECG disorders are

detected more often among men than women, except for STT changes. The prevalence of most ECG

disorders does not depend on the place of residence.

Conclusion: Changes in the electrocardiogram of the heart increase with age, regardless of place of

residence. In some cases, these changes are more common in men.

OP-GC-13

Acute Coronary Syndrome After Inactivated SARS-COV-2 Vaccine: A Case

Report And Literature Review

Dr Sowitchaya Panthong 1 , Dr Thanrada Vimonsuntirungsri 1 , Dr Mananchaya Thapanasuta 2 , Dr Chaisiri

Wanlapakorn 1,2,3 , A/Prof Wasan Udayachalerm 3 , Dr Aekarach Ariyachaipanich 1,2,3

1

Department of Medicine, Chulalongkorn University, Bangkok, Thailand, 2 Division of Cardiovascular medicine,

Department of Medicine Chulalongkorn University, Bangkok, Thailand, 3 Cardiac Center, King Chulalongkorn Memorial

Hospital, Thai Red Cross Society, Bangkok, Thailand

Abstract: CoronaVac, the COVID-19 disease vaccine is an inactivated vaccines which have been developed

by inoculating SARS-CoV-2 (CN02 strain) into African green monkey kidney cells (Vero cells). This vaccine

was granted emergency authorization by the World Health Organization (WHO) and currently used in more

than 40 countries. However, there are few published reports regarding serious adverse reactions. Here, we

report two cases of worsening chest pain within 24 hours following the CoronaVac COVID-19 vaccination.

The first case was a 48-year-old man with history of diabetes mellitus type 2, hypertension and

hyperlipidemia who presented with retrosternal chest discomfort after the second dose of the CoronaVac

vaccine. The second case was a 50-year-old man with history of coronary artery disease and stable angina

who developed worsening chest pain after the first dose of the CoronaVac vaccine. Both patients had

abnormal ECGs, elevated cardiac biomarker consistent with non-ST-elevation acute coronary syndrome and

were underwent successful coronary angiogram and coronary intervention. Due to the time correlation

between these cardiac events and the vaccination, this report illustrates a potentially life-threatening

events which should be considered after the use of inactivated COVID-19 vaccine.

OP-GC-14

Prognostic Outcomes In Acute Coronary Syndrome Patients Without

Standard Modifiable Risk Factors: A Multi-Ethnic Study Of 8680 Patients

Ms Gwyneth Kong 1 , Mr Cheng Han Ng 1 , Dr Nicholas WS Chew 2 , A/Prof Mark Y Chan 2 , Poay Huan Loh 2

1 Yong Loo Lin School Of Medicine, National University Of Singapore, Singapore, 2 Department of Cardiology, National

University Heart Centre, National University Health System, Singapore

Objective: Recent evidence show that “low risk” patients without standard modifiable cardiovascular risk

factors (SMuRFs; hypertension, hypercholesterolemia, diabetes, smoking) have increased mortality in acute

coronary syndrome (ACS). This study examines the outcomes of ACS in SMuRF-less patients in a multi-ethnic

Asian population.

Materials and Methods: This is a retrospective study of consecutive ACS patients over 10 years in a tertiary

healthcare institution in Singapore. The primary outcome was cardiac-related mortality. Secondary

outcomes were all-cause mortality, 30-day readmission, cardiogenic shock, stroke, and heart failure.

Multivariable logistic regression adjusted for covariates including age, gender, race, chronic renal failure,

ACS type, cardiac arrest, and left main and/or left anterior descending disease. Kaplan-Meier curves were

constructed for 30-day survival outcomes.

Results: 8680 patients were recruited, of which 8.6% were SMuRF-less patients. SMuRF-less patients were

significantly younger and had fewer comorbidities (stroke, renal failure). However, they had higher rates of

developing ventricular arrhythmias, requiring inotropic support and intubation. Multivariable analysis

showed higher rates of cardiac mortality (SHR 1.48, 95% CI 1.09–1.86, p=0.048), cardiogenic shock (RR: 1.31,

95% CI 1.09–1.52, p=0.015) and stroke (RR: 2.51, 95% CI 1.67–3.34, p=0.030) in SMuRF-less patients. There

was no difference in 30-day readmission (RR: 1.10, 95% CI 0.87–1.39, p=0.413) and heart failure (RR: 0.82,

95% CI 0.56–1.21, p=0.326).

Conclusion: There is a subset of ACS patients without standard risk factors with poorer prognostic

outcomes. This highlights the importance of heightened focus on post-ACS care of these SMuRF-less

patients.

OP-GC-15

The Atypical Presentation And Clinical Outcomes Of Non-ST-Segment

Elevation acute coronary syndromes in chronic kidney disease patients

A/Prof Praew Kotruchin 1 , Kodchakorn Tharawadee 1 , Thanat Tangpaisarn 1 , Pariwat Phungern 1

1 Department of Emergency Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand

Objective: The atypical presentation of acute coronary syndromes (ACS) was a risk factor of unfavorable

outcomes. It is not uncommon for chronic kidney disease (CKD) patients with ACS to present atypically. We

hypothesized that the atypical presentation of non-ST-segment elevation ACS (NSTE-ACS) in CKD patients

might associate with poor clinical outcomes.

Materials and Methods: This was a retrospective cohort study in Srinagarind hospital, Thailand, from 2014

to 2017. The CKD patients with NSTE-ACS were enrolled. Clinical data including presenting symptoms,

laboratory results, treatments, and outcomes were collected from an electronic database. The atypical

presentation was defined as nausea and/or vomiting, dyspepsia, confusion, dyspnea, or no chest pain. The

outcome was a composite of all-cause mortality, the over 30-day length of stay, and recurrent ACS

underwent PCI or CABG.

Results: There were 147 patients enrolled, of those, 77 (52.3%) presented with atypical symptoms. The

atypical presentation group had a faster heart rate (HR) compared with those who presented with typical

symptoms (87 vs. 78 beats per minute, P=0.005), however, both groups had comparable age, sex, and

echocardiographic parameters. The determinant of the atypical presentation was HR (Odds ratio (OR) 1.03,

95%CI: 1.01-1.05). Atypical symptoms and diabetes mellitus were associated with the outcome, adjusted OR

2.62, 95%CI: 1.21-5.67, and adjusted OR 3.54, 95%CI: 1.56-8.03, respectively.

Conclusions: ACS should be one of the differential diagnoses in the CKD patients who presented with nausea

and/or vomiting, dyspepsia, confusion, dyspnea, or no chest pain. Considered that the atypical presentation

was associated with poorer outcomes.

OP-GC-16

Prevalence, Risk Factors And Intervention For Depression And Anxiety In

Pulmonary Hypertension: A Systematic Review And Meta-Analysis

Mr Aaron Mai 1 , Mr. Oliver Zi Hern Lim 1 , Mr Yeung Jek Ho 1 , Mr. Cheng Han Ng 1 , Dr. Nicholas WS Chew 2

1 Yong Loo Lin School of Medicine, National University Of Singapore, Singapore, 2 Deparment of Cardiology, National

University Heart Centre, Singapore

Objective: Current guidelines recommend psychological support for patients with pulmonary hypertension

(PH), but we know little about the prevalence and risk factors of depression and anxiety in patients with PH.

Hence, we aim to examine the prevalence and risk factors for depression and anxiety in PH in this review.

Materials and Methods: We searched Medline and Embase from inception to 6 May 2021. Meta-analysis of

proportions using the generalized linear mixed model was conducted to analyze the prevalence of

depression and anxiety in PH. Risk factors were evaluated using mixed-effects meta-regression for

continuous variables and a generalized linear model for binary variables.

Results: Twenty-four studies involving 2,161 PH patients were included. Overall prevalence in PH were

28.0% (95% CI: 20.5-36.8) for depression and 37.1% (95% CI: 28.7-46.4) for anxiety. Anxiety was significantly

more prevalent (p=0.0013) in Asia (61.1%) compared to Europe (40.3%) and North America (22.9%).

Congenital heart disease-related pulmonary arterial hypertension (PAH-CTD, OR: 1.68, 95% CI: 1.27-2.23,

p=0.024) and chronic thromboembolic PH (CTEPH, OR: 1.18, 95% CI: 1.10-1.26, p=0.004) were predictors of

depression, whereas PAH-CTD (OR: 1.63, 95% CI: 1.45-1.83, p=0.002), worse pulmonary vascular resistance

(β: 0.30, 95% CI: 0.09-0.52, p=0.005) and cardiac index (β: -0.96, 95% CI: -1.58 to -0.35, p=0.002) were

correlated with anxiety.

Conclusion: The prevalence of anxiety and depression in PH patients is alarmingly high, with an increased

prevalence of anxiety in Asia. Psychological support is warranted for patients with PH, particularly those

with underlying congenital heart disease, CTEPH, and severe disease.

OP-GC-17

Young (<40 years old) Coronary Artery Disease Patients In Brunei;

Differences In Clinical Characteristics And Outcomes Compared To Older

Patients

Izyan Mohammad 1 , Rajinikanth Rajagopal 2 , Dr Sofian Johar 1

1 RIPAS hospital, Bandar Seri Begawan, Brunei Darussalam, 2 Gleneagles JPMC, Jerudong, Brunei Darussalam

Objective: This study aims to compare the characteristics and outcomes of young versus older patients who

underwent percutaneous coronary intervention (PCI). Additionally, an angiographic sub-study was done in

selected patients presenting with acute coronary syndrome (ACS) from both groups.

Materials and Methods: This was a retrospective cohort study reviewing case-notes of patients who

underwent PCI from 1st January 2018 to 31st December 2018. Patients were divided into young (<40 years)

and older group (≥40 years). For the angiographic sub-study, all 21 young ACS patients were compared with

50 randomly selected older ACS patients. This research has been approved by an ethical committee.

Results: Of the 541 patients who underwent PCI in 2018, 5.2% (28 patients) were classified as young. There

was a lower incidence of hypertension (p<0.001), hyperlipidaemia (p<0.001), diabetes (p=0.017) and renal

impairment (p<0.001) in the young group. History of smoking and substance abuse was found more in the

young group (p<0.001). Young patients tend to present with ACS (p=0.019). There was no difference in the

severity of disease, major adverse cardiovascular events (MACE) and mortality (up to 1 year) between the

two groups. There was increased use of aspiration thrombectomy during PCI in young patients (p<0.001).

Conclusion: Though cardiometabolic risk factors in the young CAD patients were more prevalent than the

general adult population, this was less than the older CAD patients with the exception of smoking. Young

CAD patients had similar disease severity and similar outcomes (up to 1 year) when compared to older

patients.

OP-GC-18

Blood Glucose Reduction By Diabetic Drugs With Minimal Hypoglycemia

Risk For Cardiovascular Outcomes: Meta-regression Analysis Of

Randomized Controlled Trials

Dr Weiting Wang 1

1 Taipei Veterans General Hospital, Taipei, Taiwan

Objective: To investigate the association between antidiabetic agents with minimal hypoglycemia risk and

micro- and macrovascular outcomes in patients with type 2 diabetes (T2D).

Materials and Methods: Randomized controlled trials (RCTs) comparing the relative efficacy and safety of

antidiabetic drugs with less hypoglycemia risk were comprehensively searched in MEDLINE, Embase, and

the Cochrane Library up to April 30, 2021. Mixed-effects meta-regression analysis was conducted to explore

the relationship between haemoglobin A1c (HbA1c) reduction and the risk of major adverse cardiovascular

events (MACE), myocardial infarction, stroke, cardiovascular death, all-cause death, hospitalization for heart

failure, composite renal outcomes, and retinopathy.

Results: Seventeen RCTs comprising 150,086 participants with T2D were included and provided information

on 9773 MACE during a median follow-up of 2.6 years. The mean HbA1c concentration was 0.42% lower

(median, 0.27-0.86%) for participants given antihyperglycemic agents than those given placebo. The metaregression

analysis demonstrated that HbA1c reduction was significantly associated with a decreased risk of

MACE (β value, -0.4883, -0.720 to -0.257; P<0.0001). Lowering HbA1c by 1% conferred a significant risk

reduction of 29% (95% CI, 19-38%) for MACE.

Conclusions: The main benefits of anti-diabetic agents might be derived from lowering of blood sugar per

se, and are generally independent of the drugs being used, except that certain associated cardiovascular

conditions might favor certain classes of drugs.

OP-GC-19

Clinical Characteristics And Outcomes Of Myocardial Infarction With Non-

Obstructive Coronary Arteries In A Southeast Asian Cohort

Dr Cheney Wong 1 , Jonathan Yap 1 , Fei Gao 1 , Weiting Huang 1 , A/Prof Khung Keong Yeo 1

1 National Heart Centre Singapore, Singapore

Objective: The aim of this study was to evaluate the clinical characteristics and prognosis of myocardial

infarction with nonobstructive coronary arteries (MINOCA).

Materials and Methods: Data was obtained from the Singapore Cardiac Longitudinal Outcomes Database

(SingCLOUD). Patients with a first presentation of myocardial infarction (MI) between 2011 and 2014 were

extracted from the database. Subjects were classified as having either MINOCA or MI with obstructive

coronary artery disease (MICAD). The primary outcomes were all-cause mortality (ACM) and major adverse

cardiac events (MACE) defined as a composite of ACM, recurrent MI, heart failure hospitalization and

stroke.

Results: Of the 4124 patients who were included in this study, 159 (3.9%) were diagnosed with MINOCA and

they were more likely to be female, present with an NSTEMI, have a higher left ventricular ejection fraction

and less likely to have diabetes, previous stroke or smoking history. Over a mean follow-up duration of 4.5

years, MINOCA patients had a lower incidence of ACM (10.1% vs. 16.5%) and MACE (20.8% vs. 35.5%)

compared to patients with MICAD. On multivariable analysis, patients with MINOCA had a lower risk of ACM

(HR 0.42; 95% CI 0.21-0.82) and MACE (HR 0.42; 95% CI 0.26-0.69). Within the MINOCA group, older age,

higher creatinine, a STEMI presentation and the absence of antiplatelet use predicted ACM and MACE.

Conclusion: While patients with MINOCA had better clinical outcomes compared to MICAD patients,

MINOCA is not a benign entity with about one in five patients experiencing a major adverse cardiovascular

event in the long-term.

OP-GC-21

The Importance Of Detailed Evaluation Of Airway Obstruction By

Computed Tomography In Patients With Congenital Heart Disease

Dr Sakti Damba Dwisepto Aulia, MD Damba Dwisepto Aulia Sakti 1 , MD Budi Rahmat 2 , Oktavia Lilyasari 1


Center Harapan Kita, Jakarta, Indonesia, 2 Department of Surgery, Pediatric and Congenital Cardiothoracic and Vascular

Surgery Division, Faculty of Medicine, Universitas Indonesia, National Cardiovascular Center, Harapan Kita, Jakarta,

Indonesia

Objective: Airway obstruction in patients with Congenital Heart Disease (CHD) usually occur secondarily due

to vascular ring or extrinsic compression by enlarged cardiac and/or pulmonary vascular structures.

Comprehensive understanding of cardiovascular anatomy causing the obstruction is superiorly achieved by

computed tomography (CT) than other modalities. This study would like to show the incidence of airway

obstruction and to describe the choice of management in patients with CHD.

Materials and Methods: A search of database in patients with CHD underwent cardiac CT was done from

January 2018 until December 2020 in National Cardiovascular Centre Harapan Kita, Jakarta.

Results: Of 1871 patients, 121 had airway obstruction (66 female; 0-26 years). Twenty four (19,8%) were

tracheal, 69(57%) were left main bronchus (LMB), 16(13,2%) were right main bronchus, 8(6,6%) were both

main bronchial obstruction. The major cause of airway obstruction was extrinsic compression (due to

dilated pulmonary artery (42,9%) and other cardiac/vascular structures), only 10(8,3%) caused by vascular

ring. Airway obstruction was frequently found in double outlet ventricle, tetralogy of Fallot, pulmonary

atresia, truncus arteriosus, and aortic coarctation. Most of the cases were asymptomatic, but stridor was

found in 6 patients. One patient had prolonged use of ventilator due to severe obstruction of LMB, and

required surgical repair to release the obstruction. Three patients with vascular ring also required surgical

repair, but others were treated conservatively.

Conclusion: Detailed evaluation of airway obstruction by CT is important for the management of CHD

patients as it may help predict the need for additional interventions.

OP-HF-01

Predictors of Trastuzumab-Induced Cardiotoxicity In Breast Cancer

Patients

Dr Nichanan Osataphan 1 , Dr Wanwarang Wongcharoen 1 , Dr Arintaya Phrommintikul 1

1 Faculty of Medicine, Chiang Mai University, Chiangmai, Thailand

Objective: Adjuvant trastuzumab improves survival in women with human epidermal growth factor

receptor-2 (HER-2) positive breast cancer. The negative effect of trastuzumab on the heart is the most

concerning adverse event of this drug and may lead to overt heart failure. Therefore, identifying of the

potential risk factors for cardiac dysfunction is of value.

Materials and Methods: We retrospectively searched hospital electronic database for patients with HER-2

positive breast cancer treated with trastuzumab at Maharaj Nakorn Chiang Mai hospital from 2010 to 2020.

Patients with available data of left ventricular ejection fraction (LVEF) during trastuzumab treatment were

recruited into the study. Baseline characteristic and potential risk factors were collected. Multivariate

analysis with binary logistic regression was used to calculate odd ratio for each variable.

Results: From 225 patients treated with trastuzumab, there were 34 patients (15.1%) in which LVEF was

dropped to below 50% (LVEF <50%). Most of them (85.3%) were asymptomatic while other 14.7%

developed heart failure symptom. Among patients with LVEF < 50%, 23 (67.6%) resulted in trastuzumab

treatment interruption with 52.2% of these patients, trastuzumab was permanently stopped. Risk factors

for left ventricular systolic dysfunction were advanced age and lower baseline LVEF with OR 1.06 [95%CI

1.003-1.13, p 0.039] and OR 1.09 [95%CI 1.025-1.16, p 0.007], respectively.

Conclusion: Cardiac dysfunction is not uncommon in patients treated with trastuzumab. The potential risk

factors are advanced age and lower baseline LVEF. Close monitoring of cardiac function in order to detect

early left ventricular dysfunction in these patients may be warranted.

OP-HF-02

Correlation Between NT-proBNP Within The First 24 Hours And 30-Day In-

Hospital Survival Rate In Patients With Acute Heart Failure

Mr Kay Powpuree 1 , Dr. Surapun Pongsuthana 1

1 Rajavithi Hospital, Bangkok, Thailand

Objective: Heart failure is a crucial public health problem and it is a major cause of death in Thailand

population. Current studies about the association between prognostic biomarkers in acute heart failure and

mortality or length of hospital stay are limited. The aim of this study is to investigate the association

between NT-proBNP and mortality, as well as length of hospital stay.

Material and Methods: This is a prospective study of hospitalized patients, aged 20 to 75, who were

diagnosed with acute heart failure. The level of NT-proBNP was assessed in the first 24 hours of hospital

admission. The study recorded mortality during hospital admission and 30 days after the onset of heart

failure.

Results: Of the 65 patients included in the studies, 4 patients died during the study. The average NT-proBNP

levels in the death group and survival group are 18,529 (2,449 – 26,716) pg/ml and 8,946 (282-264,277)

pg/ml respectively. The average lengths of hospital stay in death group and survival group are 18 (4-36) days

and 8 (1-62) respectively, showing no clinical significance. A clinically significance was detected between

death group with average age of 68±2.94 years old and survival group with average age of 56±2.94 years

old.

Conclusion: NT-ProBNP level has no statistically significant association with the survival rate in acute heart

failure patients during hospital admission, 30 days after the onset of heart failure and length of hospital

stay. However, there was a clinically significant association between older age and mortality during hospital

stay.

OP-II-01

The Outcome And Importance Of Initial Hemoglobin Management During

Veno-Arterial Extracorporeal Membrane Oxygenation And Percutaneous

Ventricular Assist Device Therapy (ECPELLA)

Dr Nobuyuki Kuroiwa 1 , Dr Hikaru Ishiwaki 1 , Dr Shinichi Okino 1 , Dr Shigeru Fukuzawa 1

1 Funabashi Municipal Medical Center, Funabashi, Japan

Objective: Veno-Arterial Extracorporeal-Membrane-Oxygenation(VA-ECMO) therapy after

Cardiopulmonary-Arrest(CPA) or collapse of hemodynamics is still challenging. Our aim is to reveal the risk

factors for survival and neurological outcome under newly introduced ECPELLA(VA-ECMO+IMPELLA:

percutaneous-ventricular-assist-device) therapy.

Materials and Methods: 73 patients with STEMI and fulminant myocarditis who underwent VA-ECMO

therapy between January 2009 and July 2021 were included in this study. Age64.6±14.2, Male76.7%. 61

STEMI (25=left-main, 12=multiple-vessel-disease) and 12 were myocarditis. We compared the 30 days

survival rate and Cerebral Performance Categories(CPC) 1&2 ratio between [A] VA-ECMO without IMPELLA

group(n=54) and [B] ECPELLA group(n=19). Also investigated the risk factors for survival and neurological

outcome in ECPELLA group. In ECPELLA setting, we initially manage patient under total support. According

to our experience, using VA-ECMO and IMPELLA 2.5 or CP, maximum total circulating flow is around 5.5

litter/minute. In such artificial circumstance, we hypothesized that estimated required hemoglobincalculated-by-Fick-principle

[estHb] according to body weight and oxygen consumption is important.

Results: 30 days survival rate and ratio of CPC 1&2 between [A] and [B] group were [33.3%vs52.6%, p=0.17]

and [24.1%vs42.1%, p=0.15] respectively. ECPELLA group showed better outcome, however statistically not

significant. Looking further into ECPELLA group, better 30 days survival obtained by higher [first 24hour

average hemoglobin]/[estHb] [0.99vs0.78, p=0.04], better CPC obtained by first 24hour reduction of lactate

[2.2vs5.9 p=0.02], higher [first 24&48hour average hemoglobin]/[estHb] [1.07vs0.76, p<0.01] [1.03vs0.75,

p=0.01] and lower side effects [25%vs91%, p=0.01].

Conclusion: ECPELLA group results in better survival and neurological outcome. Management of initial

hemoglobin, lactate and side effects are crucial during ECPELLA setting.

OP-II-02

Comparison Of Bivalirudin, Heparin Plus Eptifibatide, And Unfractionated

Heparin Monotherapy For Acute Coronary Syndrome (ACS) Patients

Undergoing Percutaneous Coronary Intervention

Dr A B M Golam Mostofa 1 , Dr Tanjima Parvin 1 , Dr Rayhan Masum Mandal 1 , Dr Rawnak Afrin 2 , Professor Syed

Ali Ahsan 1

1 Bangabandhu Sheikh Mujib Medical University, Dhaka, Dhaka, Bangladesh, 2 Dhaka Medical College Hospital, Dhaka,

Dhaka, Bangladesh

Objective: To determine and compare the incidence of in-hospital and 30-day hemorrhagic complication

and major adverse cardiac events (MACEs) as evidence of safety and efficacy using three different antithrombotic

strategies like Bivalirudin, Heparin plus Eptifibatide and Unfractionated Heparin (UFH)

monotherapy in acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention.

Materials and Methods: We conducted a prospective observational study of 324 ACS patients who

underwent PCI from May 2018 to May 2019 at BSMMU were consecutively enrolled in the study and were

divided into three groups according to antithrombotic strategies. In-hospital and 30-day hemorrhagic

complications and MACEs were analyzed and compared among the study groups.

Results: In-hospital outcome: Patients treated with Bivalirudin as compared with UFH had a significantly

lower incidence of QMI lesions (0% vs.6%; p=0.038) and major bleeding (0% vs. 7%; p=0.021). The bleeding

rate was also significantly lower in Bivalirudin arm as compared with Heparin plus GPI arm (0% vs. 6%;

p=0.038). However, the incidence of cardiac death, stent thrombosis, TVR were no differences among the

three groups. 30-day outcome: There was only one NQMI in the bivalirudin group as opposed to 8% in the

heparin group (p=0.041). No other adverse effects were found significantly different among the study

groups.

Conclusion: Bivalirudin monotherapy is safer than other contemporary antithrombotic strategies. In terms

of efficacy, Bivalirudin is non inferior to Heparin plus Eptifibatide but superior to UFH monotherapy.

OP-II-03

Safety And Efficacy Of Bivalirudin In Diabetic Acute Coronary Syndrome

(ACS) Patients Undergoing Percutaneous Coronary Intervention (PCI)

Dr A B M Golam Mostofa, Dr. A. B. M. Golam Mostofa 1 , Dr Tanjima Parvin 1 , Dr. Mohammad Rayhan Masum

Mandal 1 , Professor Syed Ali Ahsan 1

1

Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh

Objective: To determine and compare the incidence of in-hospital and 30-day hemorrhagic complications

and major adverse cardiac events (MACEs) as evidence of safety and efficacy using Bivalirudin versus

Heparin in diabetic acute coronary syndrome (ACS) patients undergoing percutaneous coronary

intervention (PCI).

Materials and Methods: We conducted a prospective, randomized controlled study of 218 diabetic ACS

patients who underwent PCI from May 2018 to April 2019 at BSMMU, Bangladesh were randomly assigned

to have UFH or Bivalirudin. 111 patients in UFH group received a bolus of 70-100 U/kg. 107 patients in

Bivalirudin group received loading dose of 0.75 mg/kg, followed by infusion of 1.75 mg/kg/h for up to 4

hours. Dual antiplatelet loading was given in all patients before procedure and maintenance dose was

continued for as per hospital protocol. Patients were followed telephonically up to 30 days. The outcome

measures were in-hospital and 30-day hemorrhagic complications and MACEs [death, MI, target vessel

revascularization (TVR) and stroke].

Results: Patients treated with Bivalirudin compared with Heparin had a significantly lower in-hospital

incidence of QMI (0% vs. 6%; p=0.03) and major bleeding (0% vs. 7%; p=0.02). However, the incidence of

cardiac death, stent thrombosis, TVR were no differences between two groups (p>0.05). There was only one

NQMI in the Bivalirudin group as opposed to 8% in the Heparin group in 30 days following stenting (p=0.04).

Conclusion: In diabetic ACS patients undergoing PCI, Bivalirudin is safe and effective as it reduces immediate

and short-term hemorrhagic complications as well as MACEs as compared with Heparin.

OP-II-04

Endovascular Aneurysm Repair (EVAR) With Endoanchors: For Tandem

Aortic Abdominal Aneurysm (AAA) With Hostile Neck & Proximal

Penetrating Atherosclerotic Ulcer

Dr Von Jerick Tenorio 1 , Jonald Lucero 1 , Dr Marivic Vestal 1 , Dr Edwin Tiempo 1

1 Perpetual Succour Hospital - Cebu Heart Institute, Cebu City, Philippines

Background: In patients with hostile aortic neck anatomy, the risks of proximal seal complications and stent

migration remain with EVAR despite improved endograft technology. This case report discusses how the

technical challenges of the hostile neck anatomy, proximal penetrating atherosclerotic ulcer (PAU) and

tortuous femoral access were addressed.

Case: The CT aortogram of a 63-year-old, hypertensive and diabetic man with recurring abdominal

discomfort revealed a fusiform infra-renal aneurysm measuring 8.8 cm in length and 5.7 cm in diameter.

The proximal landing zone only has a 3 mm healthy neck with conicity of > 10% and a thrombus of 4 mm

thick. Proximal to the aneurysm is a PAU with circumferential mural thrombus. The right femoral artery is

tortuous with > 90o angulation.

Discussion: A 20% oversized Endurant II endograft and Aptus Heli-FX EndoAnchors were deployed as

prophylaxis for type I endoleaks and endograft migration consequent to the conical neck and proximal

aneurysm extension consequent to the PAU. A stiff Back-up Meier guide wire facilitated deployment of the

endograft. Coil embolization of the right internal iliac artery was performed as prophylaxis for type II

endoleaks.

Conclusion: EndoAnchors can be used as adjunct to EVAR as prophylaxis for proximal seal complications and

stent migration in patients with hostile aortic aneurysm neck anatomy and concomitant proximal PAU.

OP-II-05

post-Angioplasty Myocardial Blush Grade For Long Term Prognostication

In Acute Coronary Syndrome: A Systematic Review And Meta-Data

Analysis

Dr Patrick Vera Cruz 1,2 , Dr. Nadine Bacalangco-Suerte 1 , Dr. Patricio Palmes 1

1 West Visayas State University Medical Center, Iloilo City, Philippines, 2 St. Luke's Medical Center - Heart and Vascular

Institute, Quezon City, Philippines

Objective: Several studies have reported reduced myocardial perfusion post-angioplasty detrimentally

affects long term survival. Myocardial Blush Grade (MBG) is an angiographic parameter of myocardial

perfusion. Therefore, this study aimed to determine the prognostic value of MBG for long term all-cause

mortality and major adverse cardiovascular events (MACE) among acute coronary syndrome (ACS) patients

who underwent primary angioplasty.

Materials and Methods: “Myocardial Blush Grade,” “Acute Coronary Syndrome,” and “Acute Myocardial

Infarction” were used as search terms in research databases. The PROGRESS framework and PRISMA-P were

followed. Data were encoded into RevMan 5.4 to create forest plots in a Mantel-Haenszel random effects

model.

Results: Ten studies involving a total of 11,531 ACS patients were included. MBG 0/1 with no to poor

myocardial perfusion had a negative prognostic value for mortality (OR=2.71, CI: 2.11-3.49, p <0.00001,

I2=35%) and MACE (OR = 1.28, CI: 1.03-1.58, p <0.02, I2=39%). Subgroup analysis showed MBG 0/1 had a

significant negative prognostic value for mortality among ST-elevation myocardial infarction patients(OR=

2.86, CI: 2.17-3.76, p <0.00001, I2=44%) but not for unstable angina/Non-ST-Elevation Myocardial infarction

patients (OR=1.68, CI: 0.76-3.71, p 0.20, I2=0%). Subsequently, MBG 3 with normal myocardial perfusion

was associated with a reduced risk for all-cause mortality (HR = 0.22, CI: 0.15 to 0.33, p 0.02, I2 = 39%).

Conclusion: MBG 0/1 is a strong negative prognostic marker for long term all-cause mortality and major

adverse cardiovascular events among acute coronary syndrome patients. On the other hand, MBG 3 is a

strong positive prognostic marker for long term survival.

OP-II-07

Efficacy And Safety Of Different Dual Antiplatelet Strategies In Patients

Undergoing Percutaneous Coronary Intervention: A Systematic Review

And Network Meta-Analysis

Dr Chaisiri Wanlapakorn 1

1 Chulalongkorn university, Bangkok, Thailand

Objective: Optimal strategy of dual antiplatelet therapy (DAPT) after percutaneous coronary intervention

(PCI) remains unclear. We aimed to evaluate the efficacy and safety of the different DAPT strategies in

patients undergoing PCI.

Materials and Methods: The PubMed, Embase, Cochrane Central Register of Controlled Trials, and

ClinicalTrials.gov databases were systematically searched through June 2021 to identify relevant

randomized controlled trials (RCTs). Network meta-analysis (NMA) was performed to estimate risk ratios

(RR) and 95% confidence intervals (CI) from both direct and indirect evidence.

Results: The primary efficacy endpoint was major adverse cardiac events (MACE). The primary safety

endpoint was major bleeding. A total of 14 RCTs comprised of 49,823 patients (median age, 61.6 years,

23.3% female) were included. NMA suggested that de-escalation DAPT was associated with a significantly

lower risk of MACE (RR 0.78, 95% CI 0.63-0.97), bleeding (RR 0.59, 95% CI 0.43-0.82), and net adverse

clinical events (RR 0.68, 95% CI 0.59-0.79). No significant difference in risk of major bleeding compared to

standard DAPT was found. Short-term DAPT followed by P2Y12 inhibitor monotherapy exhibited a

significantly decreased risk of major bleeding (RR 0.63, 95% CI 0.45-0.87). Clinical outcomes of de-escalation

DAPT was comparable to short-term DAPT followed by P2Y12 inhibitor monotherapy after PCI.

Conclusion De-escalation DAPT was associated with the highest probability of preventing MACE. Short DAPT

followed by P2Y12 inhibitor monotherapy was associated with the lowest probability of major bleeding for

patients undergoing PCI.

Keywords dual antiplatelet therapy, de-escalation, percutaneous coronary intervention

OP-PC-01

Pharmacology Management In Improving Exercise Capacity Of Patients

With Fontan Circulation: A Systematic Review And Meta-Analysis

Dr Brian Mendel 1 , Christianto Christianto 2 , Moira Setiawan 2 , Sisca Natalia Siagian 1 , Radityo Prakoso 1

1 National Cardiovascular Centre Harapan Kita, Jakarta, Indonesia, 2 Faculty of Medicine Universitas Indonesia, Jakarta,

Indonesia

Objective: Fontan procedure is currently the mainstay therapy for single functional ventricles. However,

with prolonged follow-up duration, various complications have been observed that seriously influence the

quality of life of patients. The aim of this meta-analysis is to compare the effectiveness of pharmacologic

agents in improving exercise capacity in patients with Fontan circulation.

Material and Methods: This meta-analysis was conducted according to the Preferred Reporting Items for

Systematic Review and Meta-Analysis (PRISMA) statement, where 11 electronic databases were searched

from date of inception to October 2020. Quality assessment of the included studies were assessed using the

Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement.

Results: Twelve studies met the predetermined inclusion criteria and were included in this meta-analysis.

This meta-analysis found that treatment using bosentan significantly improves New York Heart Association

Functional Class (NYHA FC) in Fontan patients (standard mean difference -0.59, 95% CI -0.94 – -0.25;

P=0.0008; I2 = 1%). However, the use of bosentan and sildenafil did not show a significant improvement of

maximum rate of oxygen consumption (VO2 max).

Conclusion: This meta-analysis shows that people with Fontan circulation may benefit from using bosentan

as it decreases post-exercise heart rate and improves NYHA FC and 6-minute walking test (6MWD) results.

Therefore, indirectly improving exercise capacity. Nonetheless, considerable work is required to strengthen

our knowledge regarding potential confounding determinants to improve the exercise capacity of Fontan

patients.

OP-PR-01

Reduce Cardiometabolic Risk By Reducing Sitting Time Among Overweight

And Obese Adults: A Meta-Analysis

Mr Hendsun Hendsun 1 , Mr Hendsun Hendsun 2

1 Tarakan Regional General Hospital, Tarakan, Indonesia, 2 Tarumanagara University, Jakarta, Indonesia

Objective: Obesity is a worldwide major public health concern that associates with increased

cardiometabolic risk (CMR) in adults. Rapid growth of technology and busier lifestyles cause society tends to

have longer period of sitting time which cause the obesity and worsen other CMR. Therefore, we aimed to

evaluate whether prolonged standing time may decrease CMR among overweight and obese adults.

Materials and Methods: Studies were searched from Pubmed, Cochrane, Science Direct/Clinicalkey up to

December 2019. We included studies of any design that evaluate sitting time and standing time to CMR

among overweight and obese adults. Effect sizes were expressed as mean difference (MD), 95% Confidence

interval (CI) and p-value <0.05.

Results: Five eligible studies including 220 participants (1 RCT, 2 randomized crossover trial, and 2

observational studies) were included in this study. All studies compared standing versus sitting time. We

found statistically significant difference in diastolic blood pressure (mmHg) (MD: -2.05; 95% CI -2.60 to -

1.50, 5 studies, p<0.00001), total cholesterol (mmol/L) (MD -0.38, 95% CI -0.67, -0.09, 2 studies p=0.01),

LDL-cholesterol (mmol/L) (MD -0.38, 95%CI -0.65, -0.12, 2 studies, p=0.005), and fasting glucose (mmol/L)

(MD 0.10, 95%CI 0.05, 0.16, 3 studies, p=0.0003). No statistically significant difference in systolic blood

pressure (mmHg) (MD -1.67, 95%CI -3.37, 0.02, 5 studies, p=0.05), triglycerides, HDL-cholesterol, weight,

BMI, and waist circumference.

Conclusion: Some studies shows statistically significant difference between prolonged standing and sitting

time in CMR among overweight and obese adults. Further randomized controlled trials are needed to

explore more to this issue.

OP-PR-02

Association Between Smoking Status And Outcomes In ST-Segment

Elevation And Non-ST-Segment Elevation Myocardial Infarction Patients

Undergoing Percutaneous Coronary Intervention

Dr Junsuk Ko 1 , Dr Ching-Hui Sia 2,3 , Ms. Huili Zheng 4 , Dr. Jack Wei Chieh Tan 5 , Dr. Derek J Hausenloy 3,6,7,8,9

1 Duke-nus Medical School, Singapore, 2 Department of Cardiology, National University Heart Centre Singapore, Singapore,

3 Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 4 Health Promotion Board, National

Registry of Diseases Office, Singapore, 5 Department of Cardiology, National Heart Centre Singapore, Singapore, 6 National

Heart Research Institute Singapore, National Heart Centre Singapore, Singapore, 7 Cardiovascular & Metabolic Disorders

Program, Duke-National University of Singapore Medical School, Singapore, 8 The Hatter Cardiovascular Institute,

University College London, London, United Kingdom, 9 Cardiovascular Research Center, College of Medical and Health

Sciences, Asia University, Taiwan

Objective: Cigarette Smoking is one of the risk factors for various cardiovascular diseases, including ischemic

heart disease, stroke, aortic aneurysm, and hypertension. Nonetheless, in acute myocardial infarction(AMI)

patients, smoking has been paradoxically associated with better clinical outcomes, a phenomenon called

“smoker’s paradox”. It has been proposed that the better prognosis in smokers following AMI is due to age

differences between smokers and non-smokers(smoker’s pseudoparadox). The goal of this study was to

evaluate the association between smoking and major clinical outcomes(30 day and 1 year mortality and

recurrent MI) in patients with ST-segment elevation(STEMI) and non-ST-segment elevation myocardial

infarction(NSTEMI) following percutaneous coronary intervention(PCI), using data from a national multiethnic

Asian registry.

Materials and Methods: This was a registry-based study involving AMI patients who underwent PCI from

January 2007 to June 2015. We compared clinical outcomes of smokers, including 30 day and 1-year-allcause-mortality

and recurrent MI, to non-smokers’ following the PCI treatments in different ethnicities.

Results: In unadjusted analyses, current smokers had better clinical outcomes following STEMI and NSTEMI.

However, after adjusting for age, the protective effect of smoking on outcomes disappeared, confirming the

smoker’s pseudoparadox. Interestingly, although current smokers had increased risk for recurrent MI within

1 year after PCI in both STEMI and NSTEMI patients, there was no increase in mortality at 30 days or 1 year.

Conclusion: We confirm the existence of a smoker’s pseudoparadox in a multi-ethnic Asian cohort of STEMI

and NSTEMI patients and find increased risk of recurrent MI, but not mortality in smokers versus nonsmokers.

OP-PR-03

Factors Associated With Participation In Cardiac Rehabilitation

Programme Among Coronary Heart Disease Patients

Ms Mei Sin Chong 1 , Associate Professor Dr. Janet Wing Hung Sit 2 , Dr. Kai Chow Choi 3 , Dr. Anwar Suhaimi 4 ,

Professor Dr. Sek Ying Chair 5

1

The Chinese University Of Hong Kong, Hong Kong SAR, China, 2 The Chinese University Of Hong Kong, Hong Kong SAR,

China, 3 The Chinese University Of Hong Kong, Hong Kong SAR, China, 4 Department of Rehabilitation Medicine, University

Malaya Medical Centre, Kuala Lumpur, Malaysia, 5 The Chinese University Of Hong Kong, Hong Kong SAR, China

Objective: To identify factors associated with participation in Phase II cardiac rehabilitation (CR)

programme.

Materials and Methods: This is a cross-sectional, correlational study conducted with a consecutive sample

of coronary heart disease patients from a cardiac rehabilitation clinic (n=240). Data on Coronary Artery

Disease Education Questionnaire (CADE-Q) II, Hospital Anxiety and Depression Scale (HADS),

Multidimensional Scale of Perceived Social Support (MSPSS) and Cardiac Rehabilitation Barriers Scale (CRBS)

were collected using face-to-face-interview from August 2020 to October 2020. Univariate and multivariate

logistic regressions were used to analyse associations between potential factors and Phase II CR

participation.

Results: One hundred and sixty-eight (70%) patients participated in Phase II CR. Barriers in perceived

need/healthcare factors, logistical factors and work/time conflict were significantly greater among nonparticipants

(P < 0.001). Factors like self-driving to CR venue (AOR=0.29, 95% CI: 0.13 – 0.63); perceived

need/healthcare barriers (AOR=0.18, 95% CI: 0.09 – 0.35) and logistical factors (AOR=0.22, 95% CI: 0.12 –

0.38) were associated with increased likelihood of non-participation. Patients who had greater barriers in

comorbidities/functional status, higher perceived social support from friends and anxiety were 8.21, 1.38

and 3.72 times more likely to participate. Compared to Malays, both Chinese and Indians were 0.19 and

0.49 times less likely to participate.

Conclusion: Our results provide a valuable information for understanding non-participation that serves as a

guide in future intervention development. Future studies with a tailored CR programme like a hybrid mode

with technological assisted interventions are suggested to explore options that best fit patients’ preferences

to achieve greater participation.

PP-CS-01

Early Results of Operated Giant Coronary Aneurysm Patients


1


Objective: Giant coronary aneurysms are challenges and approached individually. Surgical experience is

shared.

Materials and Methods: Case study.

Results: 4 patients (male:female=1:1), age of 34-61. Three aneurysms in RCA, one in both left and right

arteries. EF 60-65%. Operations are to resect the aneurysms and close the fistula between the aneurysms

and ventricles. No mortality.

Conclusion: Surgery is effective and safe.

PP-EI-01

Time-To-Notch RVOT Doppler: Non-Invasive Parameter To Detect

Pulmonary Vascular Disease In Adult With Secundum Atrial Septal Defect

Dr Muhamad Adrin Aefiansyah 1 , Oktavia Lilyasari 2 , Dr Amiliana Mardiani Soesanto 2 , Radityo Prakoso 2 , Dr

Arwin Saleh Mangkuanom 2 , Dr Aditya Agita Sembiring 2 , Dr Nurnajmia Curie Proklamartina 3 , Anwar Santoso 2 ,

Renan Sukmawan 2

1 Bumiayu Regional Hospital, Brebes, Indonesia, 2 Department Cardiology and Vascular Medicine, National Heart Centre

Harapan Kita, Indonesia, 3 Banten Regional Hospital, Indonesia

Objective: Gold standard for evaluating pulmonary vascular disease in adults with secundum atrial septal

defect (ASD) remains an invasive approach that has several complications. The shape of RVOT Doppler has a

good correlation to invasive measurement in general hypertension pulmonary patients. This study aimed to

evaluate time to notch (TTN) RVOT Doppler in detecting pulmonary vascular disease (PVD) in adults with

secundum ASD.

Materials and Method: Between March 2019 and June 2020, 89 adults with secundum ASD patients with

pulmonary hypertension were studied and consecutively collected. All had a clinical, laboratory,

transthoracic echocardiogram, and right heart catheterization data.

Results: Thirty-seven percent (n=24) of the patient had PVD defined as final resistance ratio of

pulmonary/systemic vascular pressure ≥0.33. A Vasoreactivity test was performed in 54 subjects using pure

oxygen. The majority of subjects were women (85%) with median age of 38 years. The area under curve

(AUC) was 0.923 for TTN to detect PVD. A cutoff point < 147.5ms has good diagnostic value (sensitivity 88%,

specificity 87%, PPV 72%, NPV 95%, LR(+) 7.11 and LR(-) 0.14 to detect PVD in adult with secundum ASD.

Conclusion: Time-to-notch has high accuracy in detecting PVD in adults with secundum ASD. However, this

method hadn’t been validated for other congenital heart diseases with shunt.

PP-EI-02

Scimitar Syndrome : A Rare Entiety Of Congenital Heart Disease

Mr Dya Andryan 1 , Rina Ariani 1 , Oktavia Lilyasari 1

1

National Cardivascular Center Harapan Kita, Bandung, Indonesia

Background: Scimitar syndrome (SS) is a rare disease consisting of anomalous pulmonary venous drainage

from the right lung to the inferior vena cava (IVC) or hepatic vein that resembles that of a curved Turkish

sword (scimitar). It is very rare anomaly, incidence of approximately 2 in 100 000 births.

Objective: We present a rare case of Scimitar syndrome in adult

Case Illustration: A 55 years-old woman came with shortness of breath and easy fatigue. From physical

examination, her vital sign was stable with 98 % oxygen saturation. From cardiac auscultation, loud

pulmonic component was heard. ECG demonstrated right axis deviation and right ventricular hypertrophy.

Chest X-Ray showed cardiomegaly and enlarged vein courses towards the diaphragm giving the

characteristic "scimitar" appearance. Echocardiography showed secundum ASD with a diameter of 39,

bidirectional shunt, dilated right atrium and right ventricle with high probability of pulmonary hypertension.

Patient then underwent invasive cardiac catheterization to evaluate pulmonary hypertension, showed ASD

Secundum low flow, high resistance, non-reactive oxygen test. Partial APVD was suspected because the

saturation of superior vena cava dan right atrium was elevated after oxygen test, and failed cannulation of

the right pulmonary vein. MSCT cardiac was advised, revealed sinus venosus defect with upper right

pulmonary vein connect with portal vein, confirm the diagnosis of Scimitar Syndrome.

Conclusion: Scimitar syndrome is a rare congenital heart disease difficult to confirm with echocardiography

alone. Advanced imaging modalities such as Cardiac MSCT provide more detailed anatomic information not

limited by narrow acoustic windows to confirm the diagnosis.

PP-EI-03

Isolated Partial Anomalous Pulmonary Vein Drainage : A Rare Cardiac

Anomaly

Mr Dya Andryan 1 , Oktavia Lilyasari 1


Center Harapan Kita, Jakarta, Indonesia, Jakarta, Indonesia

Background: Partial anomalous pulmonary venous drainage (PAPVD) is an acyanotic congenital heart defect,

which is rather difficult to diagnose. Isolated partial APVD are very rare congenital anomalies, documented

for <1% of all congenital heart diseases. We present a case of isolated partial APVD and discuss role of

cardiac magnetic resonance imaging (CMRI) to diagnose isolated partial APVD

Objective: To present a rare case about isolated partial APVD

Case Ilustration: A 16 years-old girl who came with shortness of breath, easy fatigue and recurrent

respiratory tract infection. From physical examination, her vital sign was stable with slightly desaturated

95%. Cardiac auscultation revealed wide fixed split second heart sound. Electrocardiography demonstrated

right axis deviation and right ventricular hypertrophy. Echocardiography showed dilatation of the right

atrium and ventricle, patent foramen ovale, and mild tricuspid regurgitation. Patient then underwent an

CMRI examination to look for other causes of right heart dilation. The cardiac MR showed dilation of RA, RV,

innominate vein and supracardiac partial APVD, upper left PV drainage into vertical vein into innominate

vein. Quantitative flow measurement showed flow ratio 3.69 with good LV & RV function.

Conclusion: Isolated Partial APVD is a rare disorder that often missed from the echo examination, especially

in adults. We need to suspect isolated partial APVD if we find RA, RV and PA dilatation without any

significant intracardiac defects. Advanced imaging modalities such as CMRI can be an option for further noninvasive

evaluation for diagnosing isolated partial APVD.

PP-EI-05

Correlation Between Left Ventricular Torsion Assessed By 3-Dimensional

Speckle Tracking Echocardiography And Left Ventricular Ejection Fraction

In Chronic Heart Failure

Dr Nguyen Kieu Ly, Dr Kieu Ly Nguyen Thi 1 , Dr Van Chien Do 2 , Dr Truong Son Pham 3



Objective: Torsion and strain abnormalities which have recently been emerged as new parameters to assess

heart failure patients are an important issue in the pathogenesis of heart failure. Our aim is to evaluate left

ventricular torsion, twist parameters by 3D speckle tracking in chronic heart failure patients and its

correlation with left ventricular ejection fraction.

Materials and Methods: A descriptive, cross-sectional was performed on 110 chronic heart failure patients.

Left ventricular torsion, twist parameters were measured by 3D speckle tracking, left ventricular ejection

fraction was assessed by the Simpson method on 2D echocardiography.

Results: The mean age of the group of patients with heart failure was 65.82 ± 11.77. The left ventricular

ejection fraction was 40.06 ± 14.5%. The twist and torsion on 3D echocardiography were found to be closely

correlated with EF (r=0.56 and 0.62, p<0.001). In patients with EF < 50%, the moderately correlation was

found between twist, torsion and EF (r= 0.47;r=0.51, respectively, p<0.001). In patients with EF ≥ 50%, there

was no correlation between twist, torsion and EF ( r= 0,25, r=0,3, respectively).

Conclusion: there is a close positive correlation between left ventricular twist and torsion with left

ventricular ejection fraction. No correlation between LV twist and torsion with ejection fraction in the group

with preserved ejection fraction

PP-EI-06

Acute Pulmonary Emboli With Deep Vein Thrombosis In Young Woman

Pregnancy: Case Report

Dr Rivhan Fauzan 1 , Hilfan Ade Putra Lubis 1 , Dr Teuku Bob Haykal 1 , Harris Hasan 1

1 Department of Cardiology and Vascular Medicine, University of Sumatera Utara, Medan, Indonesia, Cardiac Center

General Hospital H. Adam Malik, Medan, Indonesia, Medan, Indonesia

Background: In pregnancy, the combination of altered coagulation factors, stasis and vascular damage

heightens the thrombotic risk and venous thromboembolism is a major cause of maternal morbidity and

mortality. Despite concerns for fetal teratogenicity and oncogenicity associated with diagnostic testing, and

potential adverse effects of pharmacological treatment, an accurate diagnosis of PE and a timely

therapeutic intervention are crucial.

Case Presentation: A 25-year-old woman at 12 weeks gestation with an acute PE with stable haemodynamic

and DVT on lef leg that highlights from TTE and doppler ultrasound in early diagnosis with McConall Sign (+)

and ECG showed sinus tachycardia, S1Q3T3 pattern and T-wave inversion V1-V4. We diagnosed her as a

case of bilateral pulmonary thromboembolism from CTPA examination with trombus at distal RPA and LPA.

She was receiving subcutaneous injections of enoxaparin 0.6 cc twice a day. She was discharged with selfinjection

enoxaparin.

Discussion: VTE is the leading cause of maternal death in developing countries. It should always be

considered in the presence of suspicious symptoms and signs and confirmed by appropriate diagnostic

tests, including VPS or CTPA. LMWH is the treatment of choice during pregnancy and safety, it should be

continued until 6 weeks after delivery with a minimum total duration of 3 months.

Conclusion: Acute PE with DVT are common in pregnancy and were associated with significant maternal

morbidity and mortality. We reported a case of a young woman in pregnancy with PE confirmed by CTPA,

and she was given anticoagulant as prophylaxis and should given until delivery.

PP-EI-07

Comparison Of Right Ventricular Systolic Function Assessment Between

Echocardiographic Method And Cardiac Magnetic Resonance Method

Mr Rapee Pongsamart 1

1 Pmk Hospital, Bangkok, Thailand

Objective: To study and examine correlation between right ventricular function parameters from

echocardiogram and RVEF from cMR.

Materials and Methods: A retrospective study, data collected from echocardiography are RV s wave, TAPSE,

RV fractional shortening (FS), RV stroke volume, RV FAC, RVEF and PAPi were compared to right ventricular

ejection fraction (RVEF) from cMR. This study attempted to examine correlation between echocardiographic

parameters and find abnormal threshold of each echocardiographic parameters to predicted abnormal

RVEF.

Results: Data were collected from two hundred ninety-nine patients who undergone both cMR and

echocardiogram in our hospital. Study found the most correlate parameter between two methods are RVEF

from echocardiogram, FAC, TAPSE, FS, Pearson correlation are 0.57, 0.544, 0.443, 0.33 respectively. The

cutoff point refer to normal right ventricular ejection fraction are TAPSE > 18 mm. [sensitivity 72.12%,

specificity 70.89%], FAC > 38% [sensitivity 78.17%, specificity 69.33%], RVEF จาก echocardiogram > 55%

[sensitivity 73.1%, specificity 69.33%], FS > 1 cm. [sensitivity 67.14%, specificity 65%], then gather up the

formula : RVEF [MRI] = 14 + 7.7 TAPSE + 3 FS + 0.42 RVEF[echo] - 0.014 FAC, To predict abnormal RVEF, if

TAPSE, FAC FS, RVEF[echocardiogram], all factors are lower than the cut point, the sensitivity will be 40.7%

and specificity 96.8%

Conclusion: Abnormal right ventricular ejection fraction can be predicted by multiple factors by

echocardiogram.

PP-EI-09

Systolic Global Longitudinal Strain : A Novel Predictor Of Myocardial

Fibrosis Extent In Patients With Hypertrophic Cardiomyopathy

Dr Punchanit Wanichsetakul 1 , A/Prof Adisai Buakhamsri 1 , Dr Ing-orn Arunakul 1

1 Division of Cardiology, Department of Internal Medicine, Faculty of Medicine, Thammasat University, Pathumthani,

Thailand

Objective: Myocardial fibrosis is a marker of adverse prognosis in hypertrophic cardiomyopathy(HCM). The

non-invasive gold-standard method for detection of myocardial fibrosis is presence of late gadolinium

enhancement(LGE) from cardiac magnetic resonance(CMR) imaging. We sought to evaluate the correlation

and predictive value of peak systolic global longitudinal strain(GLS) using 2D-speckle tracking

echocardiogram(2D-STE) and the extent of LGE by CMR.

Materials and Methods: Adult patients with diagnosis of HCM at Thammasat University Hospital during

January 2011 to December 2020 were identified if both comprehensive echocardiogram and CMR studies

were performed less than 1 year apart. We excluded those with coronary artery disease (CAD) or significant

valve disease. Echocardiographic parameters for cardiac geometry and function including GLS by 2D-STE

were retrospectively measured. %LGE by cMR ≥15% was defined as extensive LGE.

Results: Ninety-six patients with HCM were included (age= 67+14, female 54%, GLS -14.2+3.7%, extensive

LGE 37.5%). Echocardiographic GLS and maximal LV wall thickness in univariate analysis were significantly

correlated with %LGE(r=0.526 ,p=<0.001 and r=0.431, p=<0.001, respectively). In multivariate linear

regression analysis, both were independent predictors of %LGE(standard coefficient 0.418, p= 0.002 and

standard coefficient 0.309, p= 0.017, respectively). GLS was an independent predictor of extensive LGE [(OR

1.2(95%CI 1.04-1.46),p=0.013]. ROC analysis of GLS had demonstrated a best cutoff of -15% for prediction of

extensive LGE (AUC of 0.68, sensitivity 74%, specificity 53%)

Conclusion: GLS was independently correlated with extent of LGE. The use of routine 2D-STE strain analysis

provides an important role for initial risk stratification in HCM.

PP-EP-01

Ventricular Late Potentials And Its Association With Ventricular

Arrythmias In Chronic Coronary Artery Patients

Dr Nguyen Dung, Dr Dung Nguyen 1 , Dr Truong Son Pham 2 , Dr Thanh Binh Nguyen 3



Objective: The cardiac late potential has been intensively investigated as it may prevent patients from

dangerous cardiac arrhythmias. However, its role in chronic coronary artery (CAD) patients remains

controversial. Our aim is to assess the changes of cardiac late potential and its association with ventricular

arrhythmias measured by ambulatory 24-hours ECG Holter in CAD patients.

Materials and Methods: Late potentials assessed by MAC 5500 system (GE Healthcare, USA), following

parameters were recorded: HFQRS (The QRS duration based on the filtered high frequency signal)(ms), LAHF

(Duration of the high frequency, low amplitude portion at the end of QRS cycle)(ms), RMS (Root mean

square value of the high frequency signal for terminal 40ms of the ventricular activation) (µV). Positive Late

potential was defined according to ACC consensus (1995).

Results: Proportion of patients with positive cardiac late potential was of 38.36%. HFQRS and LAHF were

higher in positive late potential group (107.5± 22.31 vs 83.69 ±10.6ms and 53.39±15.53 vs 29.09±6.06 µV;

p<0,001), RMS40 was lower in positive late potential group (10,64 ± 5,00 vs 48,11 ± 28,13; p< 0,01). Positive

late potential was not associated with age, sex and severity of coronary artery stenosis, it occurs more in

female than male patients (p=0.027). CAD patients with negative late potential were free of ventricular

arrhythmias. Serious ventricular arrhythmias (high Lown grades ) were presented in 30.4% patients with

positive late potential.

Conclusion: Cardiac late potential recording is useful in prediction of ventricular arrhythmias in patients with

chronic coronary artery diseases.

PP-EP-02

Incidence Of Arrhythmic Risks After Acute ST Elevation Myocardial

Infarction In Chinese Patients In The Era Of Early Revascularization.

Dr Stephanie Quek 1 , Dr Irene Chung 1

1 National Health Group, Tan Tock Seng Hospital, Singapore

Objective: Current data on arrhythmic risks after acute myocardial infarction in the modern era of early

revascularization in the Asian population are limited. The purpose of this study was to investigate the

incidence of arrhythmic risks after acute ST elevation myocardial infarction in a contemporary cohort of

Chinese patients in the era of early revascularization.

Materials and Methods: A cohort of 394 patients admitted with ST elevation myocardial infarction

underwent emergency revascularization were studied. Mean age 59.76 ± 12.84 years old, male 88%,

diabetes mellitus 40%, hypertension 72%, hyperlipidaemia 78%, previous ischaemic heart disease or stroke

10%, smoker 65%, mean follow up of 577 ± 118 days. Pain to needle time (onset of chest pain to primary

angioplasty) 4.88 ± 4.60 hours. Mean left ventricular ejection fraction (LVEF) 41.98 ± 10.79%. 130 patients

had LVEF ≤35%.

Results: There were 12 deaths, 8 non arrhythmic cause, 1 cardiac arrest due to ventricular fibrillation and 3

deaths of unknown cause. The risk of arrhythmic death and death of unknown cause is 0.64% per year. 15

patients developed atrial fibrillation. The risk of atrial fibrillation is 2.4% per year. Mean LVEF 29.74 ± 5.95 %

improved to 39.85 ± 10.13% (p<0.001) after 6 months.

Conclusion: The arrhythmic risks after acute myocardial infarction in the modern era of early

revascularization in the Asian population is lower than previously reported. This may be due to reverse

cardiac remodeling and significant improvement in LVEF following prompt revascularization.

PP-EP-03

Electrocardiography Risk Markers Associated With Appropriate ICD

Therapy In Symptomatic Brugada Syndrome Patients Receiving ICD

Therapy

Dr Chayanis Trakulthong, A/Prof Pattarapong Makarawate

1 queen sirikit heart center khon kaen university, khon kaen, Thailand

Background : Brugada syndrome(BrS) is one of genetic arrhythmia syndromes which leading to sudden

cardiac arrest from ventricular fibrillation(VF).Implantable cardioverter defibrillator(ICD) is the

recommended treatment for secondary prevention. Previous report of recurrent appropriated ICD therapy

was about 32%. We aim to evaluate the EKG findings that associated with VF shock in Thai symptomatic

Brugada syndrome patients with ICD implants.

Methods and Results: Retrospective data of 93 BrS patients diagnosed at Khon Kaen University hospital

from year 2009 until July 2020 was collected. Clinical characteristics and EKG data was measured. There

were 67 (70%) patients aborted sudden death. Appropriate ICD therapy occurred in 52/93 patients (56%)

(mean 1.9times, total 94 events). Median time to appropriate ICD therapy was 40 ± 11.6 months with

incidence rate 13 per 100 person-year. 7 EKG parameters were measured. Multivariate analysis showed the

QRS duration in lead V2 and Tp-Tn in V2 significantly associated with appropriate ICD therapy with HR

1.012(95%CI 1.002-1.023, p 0.025) and HR1.014 (95%CI 1.003-1.025, p0.015) respectively. Patient with QRS

duration in V2 ≥ 120 millisecond had median time to first appropriate ICD shock at 29 months, while

patients with Tp-Tn in lead V2 duration ≥ 130 millisecond had median time to first appropriate ICD therapy

at 28 months, significantly earlier than others respectively.

Conclusion: In symptomatic Brugada syndrome patients, wide QRS in V2 and long Tp-Tn in lead V2 are

associated with appropriate and shorter time to ICD therapy.

PP-EP-04

One-Year Recurrence Rate And Clinical Outcomes After Catheter Ablation

In Atrial Fibrillation Patients

Dr Naruepon Yamsai 1

1 Phramongkutklao Hospital, Bangkok, Thailand

Objective: Atrial fibrillation (AF) is a common cardiac arrhythmia which contributes to higher rate of

morbidity and mortality. Catheter ablation (CA) provided higher efficacy in restoring sinus rhythm and

longer arrhythmia-free survival. We aimed to study the 1-year recurrence rate and clinical outcomes after

ablation.

Materials and Methods: This retrospective observational study enrolled patients with either paroxysmal or

persistent AF who underwent CA at Phramongkutklao Hospital from 2011 onwards.

Results: A total of 79 patients were enrolled in this study, consisting of 47 patients with paroxysmal AF

(59.5%) and 32 with persistent AF (40.5%). The overall recurrence rate of AF after CA was 46.4%. There was

no significant difference between paroxysmal and persistent AF (P=0.341). The multivariate logistic

regression analysis, the only factor which significantly affects the rate of recurrence of AF after catheter

ablation was LA roof line ablation (adjusted OR 3.74 [1.16, 12.11], P = 0.028). The rate of acute procedural

success was 87.3%. The rate of procedural-related complications was 6.3%. Almost twenty percent of the

patients could stop taking anti-arrhythmic drugs after catheter ablation. Composite endpoints of all-cause

mortality, stroke, MI and HF hospitalization at 1 year after ablation was 2.5%. Finally, the average change in

LVEF at 1 year after catheter ablation was 3.32 + 12.09 %.

Conclusion: From our study, we concluded that the overall recurrence rate at 1-year was 46.4%. LA roof line

ablation is an associated predictor for recurrence of AF after catheter ablation.

PP-GC-01

Primary Results Of The Improve Sudden Cardiac Arrest Bridge Study

A/Prof Shu Zhang 1 , Prof Wen-jone Chen 2 , Dr. Mullasari Ajit Sankardas 3 , Dr. Waqar Habib Ahmed 4 , Dr. Houng-

Bang Liew 5 , Hyeon-Cheol Gwon 6 , Dr. Fazila Tunn Nesa Malik 7 , Dr. Baopeng Tang 8 , Dr. Abdeddayem Haggui 9 ,

Dr. Il-Young Oh 10 , Tiong Kiam Ong 11 , Dr. Cheng-I Cheng 12 , Dr. Xingbin Liu 13 , Dr. Francesca Lemme 14 , Dejia

Huang 13 , Dr Amy Molan

1 Fu Wai Hospital Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China, 2 National

Taiwan University Hospital, Taipei, Taiwan, 3 Madras Medical Mission, Chennai, India, 4 King Fahad Armed Forces Hospital,

Jeddah, Saudi Arabia, 5 Clinical Research Centre, Queen Elizabeth Hospital II, Sabah, Malaysia, 6 Samsung Medical Center,

Seoul, South Korea, 7 National Heart Foundation Hospital and Research Institute, Dhaka, Bangladesh, 8 The First Affiliated

Hospital of Xinjiang Medical University, Ürümqi, China, 9 The Military Hospital of Tunis, Tunis, Tunisia, 10 Seoul National

University Bundang Hospital, Seongnam, South Korea, 11 Sarawak Heart Centre, Sarawak, Malaysia, 12 Kaohsiung Chang

Gung Memorial Hospital of CGMF, Kaohsiung, Taiwan, 13 West China Hospital, Sichuan University, Chengdu, China,

14 Medtronic Bakken Research Center, The Netherlands

Objective: To characterize the care pathway of myocardial infarction (MI) patients and understand barriers

to implantable cardioverter defibrillator (ICD) utilization to improve guideline-recommended (2017

AHA/ACC/HRS) ICD use for sudden cardiac death (SCD) prevention.

Materials and Methods: This global, prospective, non-randomized, post-market study included all patients

≥18 years old, with acute MI ≤30 days, and left ventricular ejection fraction (LVEF) <50% ≤14 days post-MI.

The primary endpoint is physician decision to refer patients for SCD risk stratification and management.

Patients were followed for 12-months in a total of 6 protocol defined regions including China, Indian

Subcontinent, Korea, Middle East, Africa, Central Asia and Turkey, Southeast Asia, and Taiwan. At any visit

during the follow-up period, patients could be referred for SCD risk stratification and management if they

had a LVEF ≤40% or met referral criteria associated with higher risk of sudden cardiac arrest. If patients

were not referred or refused referral, the reason was collected.

Results: In this study 1492 patients were consented and met all inclusion and exclusion criteria for

enrollment. Of these, 1170 subjects (78.4%) completed the 3-month follow-up visit with 329 (22.1%)

meeting referral criteria. The primary results of this study will be available for presentation at APSC 2021.

Conclusion: This is the first broad, multicenter study examining post-MI ICD guideline adherence in these

emerging countries and will provide a comprehensive understanding of the current post-MI care pathway

flow. These results may inform development of effective care pathways to improve patient outcomes and

decrease SCD risk.

PP-GC-03

The Role Of N-Terminal Pro-Brain Type Natriuretic Peptide To Predict

Cardiovascular Events In Hip Fracture Patients: A Systematic Review

Mr Jordan Budiono 1 , Mr Anthony Ekaputra 1 , Miss Karina Sylvana 1

1 Faculty of Medicine and Health Sciences Atma Jaya Catholic University of Indonesia, North Jakarta, Indonesia

Objective: The role of N-terminal Pro-brain Type Natriuretic Peptide (NT-proBNP) as independent predictors

of outcome in hip fracture surgical settings has not been elucidated. This study aims to evaluate whether

NT-proBNP is associated with cardiovascular events in hip fracture patients.

Materials and Methods: Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA)

guidelines were used for literature research. PMC, PubMed, EBSCO, Proquest search database were used,

with studies dating up to January 2021 in accordance with our eligibility criteria. To assess risk of bias

Strengthening the Reporting of Observational studies in Epidemiology (STROBE) is used.

Results: Total of 30 studies were identified, with 4 relevant studies. All studies showed significant

association between NT-proBNP and cardiovascular events. Three studies showed that pre-operative NTproBNP

levels of 285-3984 pg/mL or more is associated with 3.5-23.8 times higher risk of postoperative

cardiovascular events (OR: 3.5 [95% CI=1.3-9.5], p=0.0; OR: 23.8 [95% CI= 3.72-142.9], p=0.0008; OR: 12.9

[95% CI= 4.4-37.9], p<0.01). Another study demonstrated that elevated NT-proBNP (per 50 pmol/L) is an

independent predictor of cardiovascular events and mortality (OR: 1.04 [95% CI= 1.01-1.07], p=0.01).

Conclusion: NT-proBNP is a potential biomarker to predict cardiovascular events in hip fracture patients.

Due to limited studies available, further research with larger population and a prospective study is

necessary to elucidate more firm evidence.

PP-GC-04

Comparison Of Revised Cardiac Risk Index (RCRI) Versus Clinician Quoted

Pre-Operative Risk Assessment Of Major Adverse Cardiovascular Events

(MACE)

Dr Eugene Gan 1 , Dr Cheney Wong 1 , Dr Hooi Khee Teo 2 , Dr Alex Tan 2 , Audry Lee 2

1 Singapore Health Services, Singapore, 2 National Heart Centre, Singapore

Objective: We reviewed patients referred for cardiac risk assessment in non-cardiac surgery and analysed

discordances between computed RCRI and clinician-quoted MACE risk.

Materials and Methods: In-patients referred across 4-months were retrospectively analysed. Baseline

characteristics, cardiac evaluation, complications and clinician risk assessment were collected.

Results: 276 patients (mean age 73.1, male 52.9%, smoker 21.0%) were analysed. Majority had only primary

cardiovascular risk factors - hypertension (76.1%), hyperlipidaemia (63.5%) and diabetes (43.5%), while a

minority had ischaemic heart disease (21.7%). 69.9% were NYHA Class I. The bulk of referrals were for

intraperitoneal (28.3%) and orthopaedic (27.2%) surgeries. RCRI computed risk was 3.9-6.0% in 75.0%,

10.1% in 16.7%, and 15.0% in 8.3% of patients. Discrepancies in computed and clinician-quoted risk were

analysed in 2 groups. RCRI risk was low (3.9-6.0%) in 7 patients, however their clinicians quoted high

perioperative risks due to new myocardial infarction (3), presumptive IHD not fulfilling RCRI criteria (1), age

>90 years (2), and frailty (1). Computed RCRI risk was high - 10.1% (contributed by insulin use, elevated

creatinine) but quoted risk was low in 6 patients due to good effort tolerance (4), and negative myocardialperfusion

imaging (2). Amongst 7 patients who developed perioperative MI, 5 were quoted with low RCRI

risk. 2 had prior known impaired EF and 1 at least moderate tricuspid regurgitation, but no other known risk

factors.

Conclusion: RCRI does not encompass frailty, functional assessment, recent cardiac events and significant

valvular disease which may have greater impact on perioperative risks as evaluated by the clinician.

PP-GC-05

Prevalence Of Microalbuminuria And Its Relation With Risk Of Adverse

Cardiac Events Among Non-Diabetic Patients With Non-ST-Segment

Elevation Myocardial Infarction

Dr Thant Syn Htoo, Dr Thant Syn Htoo 1 , Dr Swe Mar Myint Lwin 2 , Dr Nyein Thuzar Tint 3 , Prof Nwe Nwe 3 , Prof

Thin Thin Nwe 4

1 New Yangon General Hospital, Yangon, Myanmar, 2 University of Public Health, Yangon, Myanmar, 3 Yangon General

Hospital, Yangon, Myanmar, 4 University of Medicine (1), Yangon, Myanmar

Objective: Microalbuminuria (MAU) is a surrogate marker for endothelial dysfunction, and has implications

on the development of coronary artery disease. The study was conducted to describe the prevalence of

microalbuminuria among non-diabetic patients with non-ST-segment elevation myocardial infarction

(NSTEMI) and to find out the association between microalbuminuria and the risk of adverse cardiac events

in non-diabetic patients with NSTEMI.

Materials and Methods: A hospital-based cross-sectional descriptive study was carried out among 43 nondiabetic

patients with non-ST-segment elevation myocardial infarction (NSTEMI) who were admitted to the

cardiac medical unit and general medical wards of Yangon General Hospital in Myanmar, from 2018 to 2019.

Bivariate analysis was conducted by using χ2 test and Fisher Exact test to detect the association between

the predictors and outcome variable. This research has been approved by an ethical committee.

Results: Of 43 patients, (30%) had microalbuminuria and (55.8%) had the thrombolysis in myocardial

infarction (TIMI) score of 3 to 4, and (25.6%) had TIMI score of 5 to 7, and (18.6%) had TIMI score of 0 to 2.

Most patients (72.1%) had hypertension, and (67.4%) were smokers in this study. No statistically-significant

association between age, sex, TIMI score, and the presence of microalbuminuria in non-diabetic patients

with NSTEMI was found out in this study (p > 0.05).

Conclusion: It was concluded that one-third of non-diabetic patients with non-ST-segment elevation

myocardial infarction had microalbuminuria, and it was not associated with the risk of adverse cardiac

events in non-diabetic patients with NSTEMI in this study.

PP-GC-09

Prevalence And Factors Associated With Non-Dipping Night-time Blood

Pressure Determined By Ambulatory Blood Pressure Monitoring In

Virologically Suppressed HIV-infected Patients

Mr Gahn Nakornchai 1 , Assistant Professor Pairoj Chattranukulchai 1 , Associate Professor Anchalee

Avihingsanon 2 , Mrs. Sirisawat Wanthong 3

1 King Chulalongkorn Memorial Hospital, Thailand, 2 Thai Red Cross AIDs Research Center, Thailand, 3 Siriraj Hospital,

Thailand

Objective: Non-dipping nocturnal blood pressure (BP) is common and associated with increased

cardiovascular (CV) events in general population. Little is known about the prevalence and associated

factors among virologically suppressed HIV-infected patients.

Materials and Methods: Well-treated HIV infected patients age ≥ 40 years with office BP < 140/90 mmHg

underwent 24-hour ambulatory blood pressure measurement (ABPM). Hypertensive patients with current

anti-hypertensive treatment were excluded. Non-dipping nocturnal BP pattern was defined as decreased

nocturnal decline in systolic BP (SBP) less than 10%.

Results: A total 54 subjects were enrolled. The median age was 54.1 years (61% female) with 61.1%

dyslipidemia and 9.2% diabetes mellitus. The median BMI was 22.2 with an average GFR of 81

ml/minute/1.73 m2. All of them were on combined anti-retroviral agents with a median duration of 22

years. The median CD4 cell count was 653 cell/mm3 and all patients had current HIV-RNA < 50 copies/ml.

An average percentage of interpretable BP values measured over 24 hours was 85.2%. Non-dipping

nocturnal BP pattern was prevalent in 46% of the subjects. There was no significant association between the

presence of non-dipping nocturnal BP and common atherosclerotic risk factors. Prevalence of masked

hypertension was 13%.

Conclusion: Non-dipping night-time BP is common among virologically suppressed HIV-infected patients.

The association with long-term adverse CV outcomes requires future prospective study.

PP-GC-10

Investigating Incidence Of Macrovascular And Microvascular

Complications Of Diabetes In Overweight/Obese Patients (MAMIDO)

Ms Shazwani Shaharuddin 1 , Ms Shobna Thuraisingam 1 , Ms Noorul Aimi Daud 2 , Ms Sarah Diyana Shafie 2

1 Monash University Malaysia, Subang Jaya, Malaysia, 2 Hospital Serdang, Kajang, Malaysia

Objective: Diabetes is one of the non-communicable diseases that attributed to more than 70% of death in

Malaysia. 1 in 5 adults in Malaysia are diabetic and 1 in 2 adults are obese. The information on the

complications of diabetes in Malaysia is scarce and some of the reports are not published. Our research

aimed to investigate the complications among uncontrolled diabetic patients seen in Diabetes Mellitus

Medication Therapy Adherence Clinic (DMTAC).

Materials and Methods: A cross-sectional study using an established clinical registry was conducted from 1

January 2019 to 31 December 2019 at Serdang Hospital. Data were collected on patients seen between

August 2008 and May 2020. The complications reported on the first point of contact with the DMTAC

pharmacist were analyzed among uncontrolled diabetic patients.

Results: A total of 495 patients with a mean HbA1c of 10.5% were included in the study. Out of 491 patients,

91% of these patients are obese/overweight. 37.8% of diabetic patients fall within the 50-59 age bracket

and 59% have been diagnosed with diabetes for less than 10 years. 29.8% has 2 comorbidities (either

diabetes with hypertension or dyslipidemia) and 63.4% has all 3 comorbidities. 18.9% had a history of

myocardial infarction, 11.1% had a history of stroke and 9% were CKD patients.

Conclusion: By understanding the current pattern of diabetes and its comorbidities, it is hoped that tailored

and targeted public education can be done so that effective intervention can be carried out to negate these

complications.

PP-GC-11

Long Term Survival After Acute Coronary Syndrome In Thai Registry In

Acute Coronary Syndrome (TRACS)

Dr Warradit Srisuwanwattana 1 , A/Prof Suphot Srimahachota 2

1 Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital,

Bangkok, Thailand, 2 Cardiac Center and Division of Cardiovascular Disease, Department of Medicine, King Chulalongkorn

Memorial Hospital, Chulalongkorn University, Bangkok, Thailand

Objective: Coronary artery disease is now the major cause of death in Thailand. The mortality rate of

patients with acute coronary syndrome (ACS) after 12 months has been demonstrated by Thai Registry of

Acute Coronary Syndrome (TRACS) study but the long-term survival was still unknown. Therefore, we aimed

to study long-term survival following ACS and to evaluate relevant prognostic factors.

Materials and Methods: We conducted a retrospective observational study of 2,030 ACS patients from

TRACS database between October 2007 and December 2008. 1,433 patients with identification were

included in this study and followed until 31st July 2020. Multivariate analysis was used to identify factors

effect on mortality.

Results: Patients with identification had nearly the same baseline characteristics as those without

identification, indicating that they could represent all ACS patients. The mortality rate of ST-elevation and

non-ST-elevation ACS patients when following up to 12 years was 46.0% and 68.2%, respectively (pvalue<0.001).

Among ST-elevation ACS patients, the risk of death increased with history of CABG, previous

unstable angina, arrhythmia, chronic renal failure and ischemic stroke, aging, female, presentation with

shock or heart failure (HF) with Killip class 4 within 48 hours. Among non-ST-elevation ACS patients, the risk

of death increased with history of chronic renal failure and HF, aging, HF during admission, presentation

with shock or HF with Killip class 4 within 48 hours.

Conclusion: Non-ST-elevation ACS patients have a higher mortality rate than ST-elevation ACS patients in

long-term follow-up. These findings alert physicians to the need of aggressive management and follow-up.

PP-GC-12

Left Atrial Volume Index As Assess With Handheld Echocardiogram

Outperformed CHA2DS2-VASc Score In Prediction Of POAF After Non-

Cardiac Surgery

Dr Marut Thongpan 1 , A/Prof Adisai Buakhamsri 1

1 Thammasat hospital, Pathumthani, Thailand

Background: Presence of postoperative atrial fibrillation (POAF) is associated with increased morbidity and

mortality. We sought to determine whether left atrial volume index (LAVI) and the widely used CHA2DS2-

VASc score was of any predictive value in risk of POAF in patient underwent non-cardiac surgery.

Materials and Methods: We prospectively enrolled adult patients and sinus rhythm who underwent noncardiac

surgery and postoperatively admitted to intensive care unit (ICU) All patients had been continuously

monitored with ECG at least 24 hours. ECG tracings were then reviewed to determine the presence of POAF

(defined as presence of atrial fibrillation within 72 hours after surgery) which was the primary outcome of

this study. Patients with severe valvular disease, unstable hemodynamic status or poor echocardiographic

window were excluded. Focused transthoracic echocardiogram was performed using Philips lumify

ultrasound (handheld ultrasound) to obtain conventional parameters including left atrial volume index

(LAVI).

Results: One hundred and thirty-nine patients developed POAF (13 of 139 patients, 9.4%). Patients with

POAF comparing to non-POAF group had significant larger LAVI [Median(IQR) 35.8(29.7-43.6) versus

20.2(15.9-24), respectively, p<0.001]. Patients with LAVI ≥ 34 ml/m2 had 27.2 times increased risk of POAF

and associated with 12.09 times the risk of developing composite outcomes of myocardial infarction,

ischemic stroke and systemic arterial thromboembolism (95% CI 1.8 – 80.51, p = 0.01). Additionally, LAVI

showed higher predictive value comparison to CHA2DS2-VASc score (AUC 0.89 versus 0.68, respectively

p=0.02).

Conclusion: LAVI is better than CHA2DS2-VASc score in prediction of POAF after non-cardiac surgery.

PP-GC-14

Predicting Major Adverse Events In Post Infarction Patients Using Plasma

Natriuretic Peptide

Dr Ganchimeg Ulziisaikhan 1 , Chingerel Khorloo 2 , Dr Altaisaikhan Khasag 2 , Dr Tsolmon Unurjargal 2

1 The Third State Central Hospital, National Cardiovascular Center, Ulaanbaatar, Mongolia, 2 Mongolian National

University of Medical Sciences, Ulaanbaatar, Mongolia

Objective: In Mongolia, ischemic heart disease is the leading cardiovascular disease and becoming one of

the major health care concern. The main goal of this study is to investigate usage of plasma NT-proBNP

concentration for predicting cardiac performance and future cardiac events after acute myocardial

infarction (AMI).

Material and Methods: We prospectively included patients with diagnosis of acute MI without heart failure

clinical signs and symptoms and followed for 6 months. According to plasma NT-proBNP level participants

were divided into two study groups and compared.

Results: The total study population was consisted of 98 participants. 80 (81.6%) were males and the mean

age of participants was 55.96 ± 9.27 years. Regarding the early prediction of follow-up GLS abnormality

(absolute value of <16%), the area under the ROC curve for discharge NT-proBNP level was significantly

higher than the baseline 0.70 (95% CI 0.55 - 0.84, p=0.016). The optimum cut-off value of discharge NT-pro-

BNP was 688.5 pg/ml, with 72.4% sensitivity and 65.4% specificity. Participants were divided into two

groups by the discharge NT-proBNP for comparison. Higher plasma NT-proBNP level was associated with

lower mean GLS and decline in left ventricular diastolic function. Kaplan-Meier curves showed that

participant of NT-proBNP <688.5 pg/ml group tended to show greater freedom from MACE than NT-proBNP

≥688.5 pg/ml group (log-rank test p = 0.02).

Conclusion: The main finding of this study is that elevated plasma concentrations of pre-discharge NTproBNP

could predict worsening left ventricular systolic function over time and future cardiac events in

asymptomatic post AMI patients.

PP-GC-15

Validation Of GRACE Risk Score For Acute Coronary Syndrome Patients In

An Asian Medical Center

Dr Lim Wei Juan 1, 2 , Dr Ow Ji Ken 1 , Dr Cheong Xian Pei 1 , Dr Lee Chuey Yan 1 , Dr Rusli bin Nordin 3

1 Hospital Sultanah Aminah, JOHOR BAHRU, Malaysia, 2 National Heart Institute, Malaysia, 3 MAHSA University, Malaysia

Objectives: Our aim is to validate GRACE score in a contemporary cohort admitted to an Asian Medical

Centre.

Materials and Methods: This study involved 428 patients aged 18 years old and above who were admitted

to Hospital Sultanah Aminah Johor Bahru between January 2018 to April 2018 for acute coronary syndrome

(ACS). 6 months after hospital discharge, the survival status was collected, calculated using GRACE risk score

and the validity of the GRACE risk score was evaluated by assessing its calibration (Hosmer-Lemeshow test)

and its discriminatory capacity (area under the receiver operating characteristic [ROC] curve).

Results: A total of 428 patients were evaluated in our study. 92 (21.5%) patients were admitted for ST

elevation myocardial infarction (STEMI), 128 (29.9%) admitted for non-ST-elevation myocardial infarction

(NSTEMI) while 208 (48.6) were admitted for unstable angina. Mortality 6 months post discharge was 15%.

Model calibration was excellent for our cohort population with validated model showing an adequate

capacity for discrimination, an area under curve-receiver operating characteristic (ROC) of 0.831 (95% CI,

0.778-0.884; P<0.001).

Conclusions: The GRACE score for predicting 6 months mortality among patients admitted for ACS in our

study population was validated and should be used routinely. It is advisable to include GRACE risk score in

medical records of patients admitted for ACS.

PP-GC-16

Peering Into The Heart Of A Mechanic: A Rare Case Of Myocarditis In Anti-

Synthetase Syndrome

Dr Dillon Yeo, Dr Dillon Yeo Guo Dong 1 , Dr Louis Teo Loon Yee 1 , Dr Hawani Sasmaya Prameswari 2

1 National Heart Centre Singapore, Singapore, 2 Hasan Sadikin Hospital, Padjadjaran University, Indonesia

Introduction: We report an unusual case of myocarditis in a South-East Asian woman of Chinese descent.

Case Report: A 67 year old lady presented acutely with severe breathlessness, chest discomfort, reduced

effort tolerance, and lower limb edema. Further history and examination revealed fluid overload, together

with proximal myopathy, Raynaud’s phenomena, periungual erythema, and Mechanic’s Hands.

Investigations: At presentation, Troponin-T (1098 ng/L) and NT-proBNP (8968 pg/mL) were markedly

elevated. Transthoracic echocardiogram showed global hypokinesia with decreased left ventricular ejection

fraction (LVEF) of 38%. Coronary angiogram was unremarkable, while cardiac magnetic resonance imaging

showed mid-wall fibrosis on late gadolinium enhancement, suggestive of myocarditis. Anti-Ro52, Anti-EJ,

and Anti-Mi2a returned positive, while spirometry revealed moderately severe restrictive disease.

Computed tomography of the thorax showed nonspecific interstitial pneumonia bilaterally. Right deltoid

muscle biopsy showed severe necrotic myopathy, type II fiber atrophy, consistent with inflammatory

myositis.

Management: Managed by a multi-disciplinary team, she was diagnosed with Anti-Synthetase Syndrome

and commenced on high dose prednisolone (1mg/kg/day) and mycophenolate mofetil (1500mg BD), with

valsartan and bisoprolol for heart failure. Repeat transthoracic echocardiogram showed improvement of

LVEF to 45% with significant reduction in troponin-T to (425 ng/L) after 3 months.

Conclusion: Myocarditis is a rare manifestation of Anti-Synthetase Syndrome that is prognostically

significant, as it can result in heart failure, arrhythmias, or sudden cardiac death. Presently, there is no

consensus regarding the medical treatment of such cases. Few case series detail varying effectiveness of

immunosuppressive therapy on myocarditis in inflammatory myositis; even less so in Anti-Synthetase

Syndrome.

PP-GC-17

Predicting Factors For Ischemic Stroke In Patients With Atrial Fibrillation

On Direct Oral Anticoagulant (DOAC)

Dr Apinya Boonkerng 1

1 Sisaket Hospital, Si Sa Ket, Thailand

Background: Atrial fibrillation (AF) is associated with five-fold risk of stroke. Direct oral anticoagulants

(DOAC) are proven effective alternative to warfarin in stroke prevention with less risk of hemorrhagic

events. However, some group of AF patients despite being on a DOAC, still have ischemic event. This study

aims to identify the risk factors for ischemic stroke while on DOAC treatment.

Materials and Methods: A retrospective, case-control study in a cohort of patients with AF on DOAC was

conducted. A case, defined as AF patient on DOAC with ischemic stroke, was matched on age with 4

controls, defined as AF patient on DOAC without stroke. Adjusted odds ratios (ORs) for the risk of ischemic

stroke were assessed by multivariate regression analysis.

Results: 14 patients with AF on DOAC with ischemic stroke and 56 matched controls were identified from

total of 722 patients diagnosed with AF, within last 5 years at Police General hospital. The mean age of the

case group and control group was 74 years (SD 11.62) and 71 years (SD 9.06), respectively. The average

duration of ischemic stroke from the date of DOAC initiation was 17.92 months. 8 patients (57.1%)

presented with large infarction. Compared to age-matched control group, there was a trend of higher

CHA2D2VASc score in the case group (4.14 Vs 3.52, p = 0.51). The adjusted odd for ischemic stroke while on

DOAC was 6.76 (95% CI = 1.19-37.97) for female gender, 7.O (95% CI = 1.58-31.01) for prior stroke or TIA

and 11.26 (95% CI = 1.32-95.86) for smoking. However, the risk of ischemic stroke while on DOAC did not

correlate with CHA2D2VASc score, type of DOACs, and inappropriate dose of DOACs received.

Conclusion: Among AF patients on DOACs, female gender, prior ischemic stroke and smoking were

associated with significantly increased risk of ischemic stroke. Understanding these risk factors will guide

clinicians to emphasize on better prevention strategies.

PP-GC-18

Effects Of Self-Reported Diaries And Checklists Compared With Usual Care

In The Heart Failure Patient: A Parallel, Single-Blind, Randomized

Controlled Trial

Dr Rawipas Wonghirundecha 1 , Dr Kasem Ratanasumawong 1

1 Pgh, Bkk, Thailand

Background: Heart failure (HF) is the major condition in cardiovascular disease. Apart from the

pharmacological treatment, there were non-pharmacological interventions including patient education,

knowledge, etc. This study aimed to identify self-reported diaries and checklists in heart failure patients

whether they have fewer emergency room (ER) visits, HF hospitalization, and all-cause mortality, and have

more knowledge and quality of life.

Materials and Methods: A parallel, single-blind, randomized controlled trial was conducted in HF clinic,

Police General Hospital between June 2020 and January 2021. The patients were randomly assigned into 2

groups, the self-reported group, and the usual care using the opaque sealed envelope technique. The

primary outcome was the composite endpoint of ER visit, HF hospitalization, and all-cause mortality. The

secondary outcome was the change in NT-proBNP level and changes in quality of life and knowledge.

Results: A total of 18 patients were enrolled while 5 were excluded, then13 patients underwent

randomization. There were 8 patients (61.5%) enrolled in the self-reported group and 5 (38.5%) in the usual

care group. There were no statistically significant differences between the two groups in baseline

characteristics. The primary composite outcome has not occurred in both groups during the follow-up time.

So, there were no statistically significant differences. The secondary outcome of the change in NT-proBNP

level and change in the quality of life and knowledge were slightly improved, however, no statistically

significant differences (P-value = 0.352, 0.274, 0.298 respectively).

Conclusion: Among the HFrEF patients who were followed up in the HF clinic, the usage of self-reported

diary compared with usual care, did not reduce the rates of the primary composite outcomes or secondary

outcomes. However, the primary composite outcome has not occurred in both groups, which may be the

consequence of the short follow-up time. Also, the pandemic COVID-19 was a major part of the limitation

result in the uncomfortable frequent hospital visit for a blood sample.

Keywords: Heart failure, Heart failure reduced EF(HFrEF), self-reported, diaries, checklists, NT-proBNP,

knowledge, quality of life

PP-HF-01

Potential Of Mineralocorticoid Receptor Antagonist Esaxerenone To Assist

Cardiac Reverse Remodeling In Patients With HFpEF

Dr Teruhiko Imamura 1 , Dr Akira Oshima 1 , Prof Koichiro Kinugawa 1

1 University Of Toyama, Toyama, Japan

Objective: The implications of mineralocorticoid receptor antagonists, including a newly-introduced

esaxerenone, on cardiac remodeling in patients with heart failure with preserved ejection fraction (HFpEF)

and hypertension remains uncertain. We investigated the impact of esaxerenone on cardiac reverse

remodeling in patients with HFpEF and hypertension.

Materials and Methods: We retrospectively included the patients with HFpEF who received esaxerenone for

resistant hypertension between Nov 2019 and Jul 2021. The trends of left ventricular mass index (LVMI)

were compared between the six-month pre-treatment period (without esaxerenone) and the six-month

treatment period (on esaxerenone).

Results: Thirty-three patients (74 [70, 81] years old, 33% men, systolic blood pressure 135 [123, 148] mmHg)

were included and completed 6-month esaxerenone therapy without any adverse events. During the pretreatment

period without esaxerenone, systolic blood pressure decreased significantly (p = 0.009) whereas

LVMI remained unchanged (p = 0.30). During the treatment period with esaxerenone, both systolic blood

pressure and LVMI decreased significantly (p = 0.003 and p = 0.001, respectively).

Conclusion: Esaxerenone may facilitate cardiac reverse remodeling in patients with HFpEF when

administered to treat hypertension. Further studies are needed to understand which patient populations

may see greater benefits.

PP-HF-02

In-Hospital Outcomes Of Acute Heart Failure According To Left Ventricular

Ejection Fraction: A Single-Center Retrospective Cohort Study

Dr Anchanida Han-gla 1 , Dr Kasin Viriyanukulvong 1 , Dr Sarinya Puwanant 2 , Dr Supanee Sinphurmsukskul 2 , Dr

Sarawut Siwamogsatham 2 , Dr Aekarach Ariyachaipanich 2

1

Department of Medicine Chulalongkorn University, Bangkok, Thailand, 2 Division of Cardiovascular medicine, Department

of Medicine Chulalongkorn University, Bangkok, Thailand

Objective: Prognosis of acute heart failure (AHF) patients categorized by left ventricular ejection fraction

(LVEF) across the regions is controversy. This study aimed to compare the outcomes of AHF patients across

LVEF categories in Thai population.

Materials and Methods: We retrospectively analyzed all consecutive AHF patients admitted during January

2018 to December 2019 who had been evaluated for LVEF during or within 12 months before

hospitalization. Baseline characteristics, management and outcomes were compared between AHF with

reduced LVEF (HFrEF), mid-ranged LVEF (HFmrEF), and preserved LVEF (HFpEF). Primary outcome was inhospital

mortality. Secondary outcomes were length of stay (LOS), 1-year all-cause mortality and 1-year

heart failure readmission rate. Statistical differences with a p-value <0.05 were considered to be significant.

Results: A total of 614 patients were enrolled (mean age 68.6 years, 52% male, 81% prior heart failure).

There were 43%, 12%, and 45% of HFpEF, HFmrEF and HFrEF, respectively. Compared to HFrEF, HFpEF

patients were older, predominately female, had more prevalence of valvular heart disease but lower

prevalence of ischemic etiologies (p<0.05). The in-hospital mortality of HFpEF and HFmrEF were not

significantly different from HFrEF (6.1% vs 4% vs 10.1%, respectively, p = 0.10). Similarly, there were no

differences in LOS, 1-year all-cause mortality and 1-year heart failure readmission rate among LVEF

subgroups (p>0.05).

Conclusion: The outcomes of HFpEF and HFmrEF were as poor as that of HFrEF. The better understanding of

phenotypes and mortality risk factors in each LVEF subgroups could help develop optimal management

strategy and improve prognosis.

PP-HF-03

Rare Case Of Valvulopathy Due To Hyperthyroid Disease Acquired

Hypertrophic Cardiomyopathy: A Case Report

Mr Hendsun Hendsun 1 , Ms Eva Julita 1 , Mr Winsen Haryono 2

1 Depati Hamzah Regional Hospital, Pangkalpinang, Indonesia, 2 Cibabat Regional Hospital, Cimahi, Indonesia

Introduction: Acquired Hypertrophic Cardiomyopathy (HCM) is a disease in which the heart muscle becomes

hypertrophied, which leads to the thickened heart muscle, so the heart will pump blood hardly.

Hyperthyroid disease is a pre-existing condition that can cause HCM, which is a very rare case.

Case Summary: A 45-year old female presented to ED with exacerbated dyspnea six hours before admission.

Due to the history taking, chest pain, palpitation, orthopnea and paroxysmal nocturnal dyspnea was

present. The patient was admitted with hyperthyroidism since two years ago on treatment of

propylthiouracil, propranolol and furosemide. Vital signs showed BP 119/92 mmHg, Temperature 36.4oC,

Pulse 160x/m, RR 26x/m, SpO2 94%. Cardiopulmonary examination revealed grade 2/4 mid-diastolic

pulmonary murmur and 4/6 systolic murmur in tricuspid and mitral. ECG showed atrial fibrillation, Right axis

deviation with poor QRS progression. CXR showed cardiomegaly with pulmonary cranialization.

Echocardiography showed severe mitral regurgitation, mild tricuspid regurgitation, pulmonary artery

systolic pressure of 24 mmHg and 47% of ejection fraction, FT4 was 1.93 ng/dL. The diagnosis was

hyperthyroid disease-acquired HCM with low ejection fraction.

Results: Guidelines for the diagnosis of HCM was typically done by physical examination, echocardiography,

electrocardiogram, and CXR. This case considered the possible effect of a three-valve malfunction.

Conclusion: We described a rare case of hyperthyroid disease-acquired HCM with low ejection fraction.

Valvulopathy considered as a combination of both secondary changes caused by dilated cardiac chambers

that cause malfunction of valve leaflets, and primary changes caused by direct damaging effects on the

valve structure.

PP-HF-04

Acute Myopericarditis Due To COVID-19 Infection : Case Report

Dr Fandy Santoso Budiardjo 1 , dr Agus Layanto 1 , Dr Friska Anggraini Helena Silitonga 1 , Charles Limantoro 1

1

Rsup Dr Kariadi, Semarang, Indonesia

Background: Acute pericarditis is the inflammatory condition that affects the sac surrounding the heart,

which is most often due to viral infections including COVID-19 that WHO declared as pandemic.

Case Summary: A 42-year-old female refferal from others hospital was admitted with severe shortness of

breath that getting worse in 10days in care, preceded by fever for 4days and pleuritic chest pain. Patient has

been checked for Ig-M COVID-19 with positive result but negative in confirmation with PCR-swab test.

Patient has no history of autoimun,tuberculosis,malignancy, and no risk factors for CAD. Patient was

somnolence,hypotension,tachycardia,neck vein distension,and muffled heart sound. ECG during chest pain

revealed wide spread ST elevation,ECG at presentation showed electric alternans,low voltage. Serial X-ray

showed cardiomegaly more prominent,bronchopneumonia,and pleural effusion. Emergency

echocardiography was performed with result of cardiac tamponade. Pericardiocentesis was performed with

serous pericardial effusion fluid. Laboratory result showed leukocytosis of 52K(89%neutrophils),high

procalcitonin,azotemia(cr4.3),increases troponin,D-dimer >20.000 with normal platelets and high

fibrinogen,normal thyroid function,negative for lupus antibody,hepatitis virus,and HIV. Pericardial effusion

fluid analysis showed acute inflammation process, no sign of malignancy, tuberculosis, and negative culture.

Patient was treated as myopericarditis e/c dd/COVID-19 with secondary infection that induced shock sepsis

and coagulophaty states. Vasopressor,inotropics,adequate antibiotic,antiviral,NSAID,

colchicine,anticoagulant,and therapy for HF was given. Clinical and hemodynamics showed improvements in

1-month hospital care. Follow-up echocardiography was performed with result improvement of LV and RV

function, no pericardial effusion.

Conclusion: This case highlights the importance of recognising COVID-19 infection with atypical clinical

presentations such as pericarditis, ECG changes, and early detection for cardiac tamponade.

PP-HF-05

Clinical Predictors Of CAD-Associated Acute Heart Failure Hospitalization

Dr Smith Sutharojana 1 , Dr Ing-orn Arunakul 2

1

Samutprakarn Hospital, Bangkok, Thailand, 2 Division of Cardiology, Department of Medicine, Faculty of Medicine,

Thammasat University, Pathumthani, Thailand

Objective: To identify clinical predictors of CAD-associated acute heart failure admissions. Secondary

outcomes are length of stay and in-hospital death for acute heart failure admissions.

Materials and Methods: The study design was retrospective cohort. All acute heart failure admissions in

Thammasat University hospital were included from January to December 2019. Medical electronic records

and discharge summary were reviewed. Admission diagnosis was validated according to 2019 Thai Heart

Failure Guideline.

Results: A total of 339 admissions, 274 patients were recruited, collecting data (patient data, underlying

diseases, vital signs, clinical signs, specific laboratory results, length of stay, in-hospital death). Documented

CAD-associated acute heart failure admission was presented in 83 admissions (24.5%). Patients in CADassociated

acute heart failure admission group had less preexisting co-morbidities, more number of

smokers, more presentations with de novo CHF& angina, higher heart rate, lower incidence of AF/EKG,

higher incidence of ST deviation/EKG, higher serum creatinine, NT-proBNP and hs-cTnT levels, less LVEF%

compared to non-CAD group significantly (P<0.05). Secondary outcomes indicated longer length of stay

[CAD 9 days vs non-CAD 7 days, p-value 0.036] and higher percentage of in-hospital death [CAD 10.8% vs

non-CAD 3.9%, p-value 0.025] in CAD-associated acute heart failure admission group.

Conclusion: Three strong & obvious predictors (more number of smokers, lower incidence of AF/EKG, higher

hs-cTnT levels) showed statistic significant in CAD group primary outcome and subgroup non-acute coronary

syndrome related of CAD group, compared to non-CAD groups.

PP-II-01

Predictors For Sinus Rhythm After Percutaneous Mitral Commissurotomy

Mr Suchart Aroonsiriwattana 1 , Dr KId Bhummimuang 1 , A/Prof Suphot Srimahachota 2 , Dr Pisit Hutayanon 1

1

Thammasat Hospital, Thailand, 2 King Chulalongkorn Memorial Hospital, Thailand

Objective: To determine the predictors of SR after PMC in patients with severe MS.

Materials and Methods: We retrospectively reviewed patients who underwent successful PMC and followed

up at least 6 months at tertiary referral hospital. Patient characteristics, pre and post intervention

echocardiogram and hemodynamic data were reviewed. Multiple logistic regression was used to

determined predictors of SR after PMC.

Results: Of 109 patients, the rhythm before PMC was SR 25.6 %, paroxysmal AF 10.1%, and permanent AF

64.3%. The mean age was 52.4 + 12.6 years, mean mitral valve area (MVA) was 1.0 + 0.2 sq.cm. Mean

transmitral mean pressure gradient was 10.7 + 4.0 mmHg. At median follow up 24 months, 38 (34.8%)

patients had SR. Patients with SR at end of follow up had significantly pre procedural SR more than

paroxysmal AF or permanent AF (65.7% vs 15.7% and 18.4%, p < 0.001) and were younger (48.2 + 13.9 vs

54.6 + 11.4 years, p = 0.011). The predictors of SR after PMC were pre procedural SR (OR = 71.46, p < 0.001),

LA diameter less than 46 mm (OR = 5.48, p = 0.049) and greater MVA (OR = 64.45, p = 0.005).

Conclusion: Predictors of sinus rhythm after successful PMC were pre procedural sinus rhythm, LA diameter

less than 46 mm and greater MVA.

PP-II-02

High-Dose Atorvastatin Or Trimetazidine For Reduction Of Myocardial

Injury In Patient Undergoing Elective Percutaneous Coronary Intervention

Dr Thanit Layangkool 1

1 Sunpasitthiprasong Hospital, Ubon Ratchatani, Thailand

Objective: Myocardial damage can occur during percutaneous coronary intervention (PCI) and is associated

with worsening long-term outcome. We sought to evaluate the effect of reloading high-dose atorvastatin or

trimetazidine comparing to control therapy in preventing PCI-related myocardial injury (determined by highsensitivity

troponin T or hs-TnT level).

Materials and Methods: On-hundred ninety-seven patients with chronic coronary syndrome who

underwent elective PCI with background high-intensity statin therapy were included. Each patient was

randomly assinged to one of three treatment groups; reloading high dose atorvastatin (80 mg at 12 hours

before PCI, n=67), trimetazidine (70 mg at 12 hours before PCI, n= 64), or control group(n= 64). Primary

outcome was myocardial injury (hs-TnT level) and the secondary outcome was periprocedural myocardial

infarction.

Results: Baseline clinical characteristics were comparable in all three groups. There was no difference of

peri-procedural myocardial injury among groups (hs-TnT 0.18±0.30 ng/ml, 0.26±0.50 ng/ml, and 0.11±0.14

ng/ml, respectively, p=0.139). The mean hs-TnT changes were 0.15±0.29 ng/ml, 0.23±0.50 ng/ml and 0.09±

0.14 ng/ml, respectively(p=0.272). Incidence of peri-procedural myocardial infarction were not significantly

different (31.3%, 21.9% and 16.7%, respectively, p=0.128). No serious side effect was observed among

active treatment groups.

Conclusion: Either reloading of high-dose atorvastatin or trimetazidine in the patient who already received

high-intensity statin therapy did not further prevent myocardial damage or peri-procedural myocardial

infarction during elective PCI.

PP-II-03

Acute Stemi Inferior With Extensive Thrombus: An Illustrative Case

Dr Fandy Santoso Budiardjo, Dr Budiardjo Fandy Santoso 1 , Charles Limantoro 1

1

RSUP dr Kariadi, Semarang, Indonesia

Objective: To learn management of intracoronary thrombus (ICT) during primary percutaneus coronary

intervention (PPCI)

History and Management: An illustrative cases of 48 years old male with risk factors of type 2 diabetes,

presented 20-h history of acute chest pain after working accompanied by fainting to non-PCI capable

hospital, he was loaded aspirin 160 mg and clopidogrel 300 mg, fondaparinux 2.5 mg iv. Patient transferred

to PCI capable-hospital, at time of presentation CPO 23-h, he had only mild chest pain and was bradycardic

but hemodynamically stable. ECG showed STEMI inferior with total AV block. Patient planned for temporary

pacemaker followed by PPCI. Diagnostic coronary angiography showed a total occlusion in proximal of the

right coronary artery. Given the significant burden of ICT, a bolus dose intravenous and intracoronary of

GPIIb/IIIa inhibitor were then administered. Following this, multiple aspiration thrombectomy was

performed to aid in restoration of vessel flow and culprit lession was stented with drug eluting stent.

Results: Following PPCI the patient’s chest pain and total AV block was resolved. He had an uncomplicated

recovery in the CCU.

Conclusion: ICT during STEMI can lead to worse clinical outcomes. While there is no gold-standard therapy

to deal with ICT, there are combination of both pharmacological and mechanical therapies that can be

utilized. Aspiration thrombectomy should not be used routinely in STEMI cases but may be helpful in

selected cases. The management of ICT during PPCI remain a therapeutic challenge, but an awareness and

aggressive management of ICT can lead to improved outcomes.

PP-II-04

Diagnosis And Management Of Premature Peripheral Arterial Disease : A

Case Report

Dr Fandy Santoso Budiardjo 1 , Charles Limantoro 1 , Dr Friska Anggraini Helena Silitonga 1


Objective: Management of peripheral artery disease (PAD)

Case summary: A 25-year-old man presented with complaint cramping on right tigh after walking

approximately 100meters, relieved with rest, in the past 2month. Onset of these symptoms for 1year,

advanced insidiously, progressively limiting his exercises capacity and walking distance(WD). No history of

chest pain, edema, trauma, and radiation. No history and family history of

diabetes,hypertension,dyslipidemia, hypercoaguable-state, collagen/autoimun disorders. Active smoker for

5years. Bilateral brachial BP 95/60 mmHg. No carotid/abdominal bruits, with normal bilateral brachial and

radial pulses. Poplitea and dorsalis pedis pulses were absent on the right and normal on left side. No pedal

cyanosis. Right ankle–brachial index(ABI) was0.6 and left was1.2. His laboratory were normal

hemoglobin,platelets,renal function,hba1c,profil lipid,PT/APTT, fibrinogen, ESR,CRP. Negative result for

lupus antibody. Normal ECG and echocardiography. Duplex ultrasonography(DUS) showed partial color flow

with parvus–tardus monophasic wave on A.poplitea(POPA), and absent flow distally. Arteriography revealed

total occlusion on distal A.superficial femoralis(SFA) with bridging collateral, and partial flow to distally.

Revascularization with ballon angioplasty was successfully performed. Cilostazol, aspirin, clopidogrel, statin

was given and planned for supervised exercises therapy. Follow-up DUS after 1-month showed improved

color flow on POPA, partial flow distally. Patient’s symptom and WD was improved.

Conclusion: The patients developed PAD at an early age and didn't have any obvious modifiable risk factors.

Management includes supervised exercises program and pharmacological therapies have been shown to

slow disease progression, prevent cardiovascular events, and increase WD. Ultimately, if remain highly

limited in WD, revascularization(endovascular/surgery) of the lower extremities can be considered.

PP-II-05

Iatrogenic Spiral Dissection Of The LMCA-LAD-LCX During Percutaneous

Coronary Intervention Resulting In Reduced LVEF In Patient With NSTE-

ACS And Acute-On-CKD

Dr Katrin Sumekar 1 , Dr Eka Ginanjar 1

1 Division Cardiology of Internal Medicine, Cipto Mangunkusumo General Hospital / Faculty of Medicine University of

Indonesia, Jakarta, Indonesia

Background: Percutaneous coronary intervention involving diffuse stenosis in LAD and LCX is a complex

procedure that may lead to a disastrous consequence.

Case Summary: A 46-year-old male presented at the emergency department within 6 hours after onset of

chest and epigastric pain that lasted for 20 minutes. The patient showed an LVH and elongation of aorta on

chest x-ray, persistent ST-segment depression over anterior leads on ECG, and increased troponin level.

Coronary angiography revealed multiple segments of significant stenosis (70-90%) in the LAD, LCX, and RCA.

The patient was diagnosed with NSTE-ACS, acute-on-CKD, and hypertensive emergency with target organ

damage in the kidney. Relevant medications were administered, followed by coronary angiography and PCI,

with post-angiography supportive haemodialysis. The patient felt severe pain during the stent placement

procedure, accompanied by elevated ST segment, which was caused by an iatrogenic dissection of the LAD

on the proximal-distal segments which then expanded to the LM and LCX, leading to no-flow phenomenon

which was catastrophic. No-flow was then managed using repeated multiple balloon predilatation and

prolong ballooning, followed by stent placement on LCX and LM-LAD (T-stenting), where the patient showed

excellent outcome with post-interventional TIMI 3 flow.

Conclusion: The case demonstrated that uncontrolled hypertension and kidney failure may increase risk of

iatrogenic dissection during a complex PCI procedure. Appropriate preparation by reducing blood pressure,

supportive haemodialysis, and the use of additional devices such as intravascular ultrasound may also be

taken into consideration to avoid the risk of complication.

PP-II-06

Factors Associated With Getting Timely Coronary Catheterization Of

Patients With Acute Ischemic Heart Disease Of Hospitals In Thailand

Kitigon Vichairuangthum 1,2 , Dr. Pisamai Jarujittipant 2 , Dr. Kietchai Veerayannon 2

1 Kluaynamthai Hospital, Bangkok, Thailand, 2 North Bangkok University, Patumthani, Thailand

Objective: This study was to investigate the effectiveness of timely coronary catheterization among patients

with acute ST-segment elevation myocardial infarction (STEMI) and to study the rates of timely coronary

catheterization separated according to various hospital factors, including the study of various hospital

factors affecting the timely delivery of coronary catheterization in Thailand.

Materials and Methods: Secondary data from 1,180 hospitals in Thailand was analyzed by descriptive and

inferential statistics. Difference between variables was conducted by one-way ANOVA and the relationship

between variables was analyzed by multiple regression analysis (MRA).

Results: Thailand still has faced both shortage and improper distribution of cardiac catheterization center.

Most of the hospitals do not have catheterization facility, especially in the Northeastern area. Instead, a

high concentration of centers in Bangkok (10.42%) and often located in large hospitals (80.77%). Thailand

has not yet passed the threshold (more than 50%) because it can only achieve 49.15%. Mean rate of timely

catheterization statistically better among the hospitals larger than 120 beds, hospitals with cardiac

catheterization center, and private hospitals, and by analyzing the relationship between various factors of

hospitals to the rate of timely catheterization by MRA, various hospital factors can jointly predict trends of

the rate of timely treatment at a moderate level, 24 percent (adjusted R2 = 0. 246).

Conclusion: The rate of timely coronary catheterization is currently lagging. Thai Ministry of Public Health

budget should be allocated to provide more cardiac catheterization centers throughout the country,

especially in the northeastern provinces.

PP-II-07

Periprocedural Myocardial Infarction In Novel Low-Speed Following High-

Speed Versus Conventional High-Speed Rotational Atherectomy

Technique For Heavily Calcified Coronary Artery Disease

Dr Mahesh Gurung 1 , Dr Anuruck Jeamanukoolkit 1 , Dr Wasant Soonfuang 1 , Dr Thotsaporn Morasert 2

1 Police General Hospital, Bangkok, Thailand, 2 Pulmonary and Critical care Medicine, Department of Internal Medicine,

Suratthani Hospital, Thailand

Objectives: Background: Periprocedural myocardial infarction (PMI) or periprocedural myocardial injury

(PMJ), during rotational atherectomy (RA), is common in high-risk patients and complex coronary lesion. A

recent study suggested that using low-speed rotational atherectomy (LSRA) of 110,000 rpm following highspeed

RA (HSRA) of 190,000 rpm (HSRA+LSRA) is safe and larger lumen can be achieved, compared with

conventional HSRA. This study aimed to compare the risk of PMI or PMJ between two techniques, novel

LSRA after HSRA and conventional HSRA, in management of complex calcified coronary lesion.

Materials and Methods: A prospective observational study was conducted that included all patients with

complex calcified coronary lesions who underwent LSRA after HSRA or conventional HSRA from January

2020 to March 2021 at Police General Hospital, Bangkok, Thailand. Peri-procedural myocardial infarction or

type 4a myocardial infarction and cardiac procedural related myocardial injury was defined using the

“Fourth universal definition of myocardial infarction (2018)”. Multivariable binomial regression was used in

the final analysis.

Results: The baseline characteristics were similar in 2 groups. From 12 patients, 2 (16.7%) developed PMI

and 7 (58.3%) developed PMJ. Incidence of PMI or PMJ was similar in both arms. Compared to conventional

HSRA, HSRA+LSRA technique significantly reduced the risk of periprocedural myocardial infarction or injury

(adjusted risk difference 55%, 95% confidence interval [CI] 42% - 67%, p < 0.001), after adjusting for

potential confounders.

Conclusion: Compared to conventional high-speed rotational atherectomy technique (HSRA), the novel lowspeed

following high-speed rotational atherectomy technique (HSRA+LSRA) for heavily calcified coronary

artery disease could significantly reduce the risk of periprocedural myocardial infarction or injury.

PP-II-08

Treatment Of Iatrogenic Coronary Artery Dissection In Resource

Constraint In Cath-lab, (A Retrospective Study)

Prof Khalida Soomro 1

1 7th Day Karachi Adventist Hospital, Karachi, Pakistan

Objective: We wanted to look at these large tears resulting in severe complications to understand where

they happen most and how good we are at fixing them for our patients in limited resources of the Cath-lab

of developing countries.

Materials and Methods: We reviewed the record of 28 (3.4%) cases of large dissection found in 806 who

underwent coronary angioplasty in Cath lab of Cardiology department of DUHS Karachi. we looked for as

per (ACC/AHA) criteria lesion type, chronic total occlusion, calcific lesion intraprocedural dissection, and

vessel site, related complications and management strategies.

Results: Among the 806 patients underwent percutaneous coronary intervention during 3 years (2016-2019)

period at Cath-lab of DUHS Karachi, 28 (3.4%) patients found to have extensive dissection. Out of 10

patients who had immediate angioplasty and stenting for closure of dissection 8 patient successfully treated

and 2 (7.1) died during procedures. 8 (28.5%) needed immediate coronary artery bypass surgery. 10 (35.7%)

out of the 28 (3.4%) patients were managed by further hospitalization with medical treatment; out of them

3 patients needed angioplasty procedures. There were no late deaths.

Conclusion: Rapid recognition and attention to the angiographic appearance of the dissection is essential to

the successful management of this complication. Patients with extensive dissection who are free from the

manifestation at the end of the procedure can be managed conservatively. Attempts should be made to

stabilize extensive dissection during coronary angioplasty so that surgical intervention can be delayed or

avoided altogether if possible.

PP-PR-04

Feasibility Study Of The Mobility And Activity Of Daily Living As A

Predictors Of Re-Admission In Patients with Heart Failure.

Dr Supak Kanchanaporn 1 , Dr. Kriengkri Hengrussamee 2

1 Rehabilitation center, Bangkok Heart Hospital, Bangkok, Thailand, 2 Bangkok Heart Hospital, Bangkok, Thailand

Objective: To evaluate the sensitivity and specificity of the mobility and ADL domain on re-admission in

heart failure patients.

Materials and Methods: This study used data collection in heart failure patients admitted to cardiac

rehabilitation centers. Bangkok Heart Hospital Between July 2020 and July 2021, the mobility and ADL were

assessed on the discharge day. The Receive-Operating Characteristic (ROC) to analyze sensitivity, specificity,

and area under the curve. to return to the hospital for treatment

Results: A preliminary analysis of 59 patients showed that heart failure patients with a Mobility score ≤ 19.5

and an ADL score ≤ 22.5 were predict re-admission (Mobility; sensitivity 80.00 %, specificity 57.4% and area

under the curve 0.58; 95% CI 0.36-0.81) and (ADL; sensitivity 80.00 %, specificity 59.3% and area under the

curve 0.65; 95% CI 0.42-0.89).

Conclusion: The mobility and ADL score may be used as a tool for predicting re-admission of heart failure

patients, however, this study is only a preliminary analysis. Which requires further study.

PP-PR-05

Correlation Between Levels Of Calculated Remnant Cholesterol Versus

Directed LDL Cholesterol Measurement Among Thai Patient, A Cross-

Sectional Study

Mr Sathienwit Rowsathien 1

1 BAH RTAF, Bangkok, Thailand

Objective: To study the correlation between Remnant cholesterol and LDL cholesterol levels in the Thai

population. Including the comparison of Remnant cholesterol with the medical conditions that increase the

risk of cardiovascular disease.

Materials and Methods: A sampling of about 200 cases of Thai were tested for total cholesterol, LDL, HDL,

and TG level both in fasting and non-fasting states. The obtained values were calculated for Remnant

cholesterol levels and analyzed for a direct correlation. The AUC was used to assess the prognostic accuracy

of lipid level to diagnose the condition that poses cardiovascular risks.

Results: We found that Remnant cholesterol does correlate poorly with LDL (r = - 0.196). In the sample of

200 population, patients tested for lipid profiles in both fasting and non-fasting states. We found that

Remnant cholesterol was positively correlated both as measured in the fasting or non-fasting states (r =

0.716). Poorly correlation between Remnant cholesterol and LDL levels when compared among the fasting

conditions (r = 0.164, 0.119), as well as among the statin used(r = 0.118, 0.293). Remnant cholesterol does

well correlate positively with TG levels (r = 0.770). The predictive value of Remnant cholesterol was over LDL

levels for detecting diabetes mellitus, coronary artery disease, and overweight (AUC = 0.610, 0.588, 0.593).

Conclusion: In this study, We found that Remnant cholesterol does correlate poorly with LDL cholesterol

levels. Prediction of the incidence of diabetes mellitus, coronary heart disease, and overweight has seemed

better with Remnant cholesterol than LDL cholesterol.

PP-PR-08

The Innovation Of Respiratory Rehab Device For Preventing Lung

Complications After Heart Surgery: A Study Of Physical Characteristic.

Mr Daorung Sansuwandee 1 , M.D. CHAIYANUT SURAPICHPONG 2

1 Rehabilitation Center, Bangkok Hospital Headquarter, Bangkok, Thailand, 2 Bangbo Hospital, Samutprakarn, Thailand

Objective: To create a “Respiratory Rehab Device” for airway clearance and to study of physical

characteristics of the Respiratory Rehab Device.

Materials and Methods: The Respiratory Rehab Device (RRD) is an alternative airway clearance device for

patients with lung complications which is created by a physical characteristic of positive expiratory pressure

and oscillation frequency. The study used a physical characteristics test by BIOPAC MP 36 (Goleta,

California, USA) and artificial lung to measure positive expiratory pressure and oscillation frequency from

constant rapid rate 6 sec./inhalation with Ambu-bag 500 ml.

Results: The results showed average positive expiratory pressure 32.49 – 38.74 cmH2O and average

oscillatory frequency 11.38 – 14.15 Hz from constant rapid rate 6 sec./inhalation with Ambu-bag 500 ml.

The positive expiratory pressure and the oscillation frequency were in the sane range most effectively (13

Hz.) for secretion clearance in patients with lung complications

Conclusion: A Preliminary study of RRD with Ambu-bag 500 ml with constant rapid rate 6 sec./inhalation

had able to improve airway clearance in artificial lungs and possibly increase secretory flow and decreased

viscosity of secretion. In conclusion, the physical characteristic of RRD is suitable for patients with lung

complications after heart surgery witch further research to continue study in patients with lung

complications after heart surgery and develop to home use device.

PP-PR-09

Educating The General Public On Diabetes, Its Causes And Consequences:

A Preliminary Study On The Effectiveness Of Video-Based Interventions

Ms Shazwani Shaharuddin 1 , Mr Cheng En Tan 1 , Mr Wesley Sheng Zhi Chung 1 , Mr Zhen Yee Yeow 1 , Dr Jamuna

Appalasamy 1

1

Monash University Malaysia, Bandar Sunway, Malaysia

Objective: Diabetes Mellitus (DM) incidence is now showing an upward trend among the young adult

population. In Malaysia, the unawareness of developing diabetes has increased from 4% in 2011 to 9% in

2019. About 42% of the unknown pre-diabetes population were between 18-39 years old. This study applied

a personalized health promotional video strategy to increase the awareness of DM complications among the

young adult population.

Materials and Methods: The researchers conducted a cross-sectional study of a video engagement impact

on 80 young adults from July 2021 to August 2021. The outcome measure included participants' knowledge

before watching the video and their planned action after watching the video.

Results: About 59% of the participants were between the age of 21-25 years. 57.5% of them had a family

history of DM. Based on the knowledge measure, 80% had a good awareness of DM. Nevertheless, 58.8%

thought that DM is curable. About 88.75% of participants planned to learn more about DM. Most of them

indicated that the internet and family members are their source of information.

Conclusion: Health promotional video on DM tailored to the young adults' engagement level could trigger a

positive behavioral change. The strategic storyboard and creative editing of the video help stimulate the

young adults' curiosity to know more about DM. Audio-visual is a potential tool to help reduce the incidence

of DM among young adults in the future.

PP-PR-10

Characteristics Of Patients Referred For Pre-Operative Cardiovascular

Assessment Of Patients Undergoing Non-Cardiac Surgery

Dr Cheney Wong 1 , Dr Eugene Gan 1 , Dr Alex Tan 1 , Dr Hooi Khee Teo 1 , Audry Lee 1

1 National Heart Centre Singapore, Singapore,

Objective: The 2014 ACC/AHA guidelines provide an evidence-based approach to pre-operative cardiac risk

assessment. The aims of this study were to describe the characteristics of inpatients referred to Cardiology

for risk assessment and evaluate the appropriateness of downstream investigations ordered.

Materials and Methods: This was a retrospective study of patients admitted to a tertiary hospital who were

referred for pre-operative assessment between August and November 2019. Data including baseline clinical

characteristics, procedure type, Revised Cardiac Risk Index (RCRI) score and downstream investigations

performed were collected.

Results: A total of 276 patients were included in this study. The mean age was 73.1 and 52.9% were male.

Significant comorbidities included ischemic heart disease (21.7%), heart failure (6.5%), hypertension

(76.1%), hyperlipidemia (63.5%), diabetes mellitus (43.5%), previous stroke (15.9%) and significant renal

impairment (14.9%). Three-quarters of patients had good premorbid functional status and 207 (82.8%) were

classified as low-risk based on an RCRI score of ≤1. Patients were commonly referred for intraperitoneal

surgery (28.3%) and orthopedic surgery (27.2%). After assessment by a Cardiologist, 175 patients

underwent transthoracic echocardiography (TTE) while myocardial perfusion imaging (MPI) was performed

in 36 patients. Twenty-six patients underwent both investigations. Overall, 132, 23, and 17 low-risk patients

underwent TTE, MPI and both investigations respectively.

Conclusion: The majority of inpatients referred for pre-operative assessment were low-risk and had good

premorbid functional status. A significant number of these low-risk patients were scheduled for

downstream investigations, resulting in increased cost and delayed procedures. Further work is necessary to

investigate and standardize pre-operative approaches.

PP-PR-11

Increased Arterial Stiffness Using CAVI (Cardio-Ankle Vascular Index) As A

Predictor Of Hypertensive Response To Exercise

Mr Chanwit Wuttichaipradit 1 , Mr Anusith Tunhasiriwet 1 , Mr Chattanong Yodwut 1 , Dr Kriengkrai

Hengrussamee 1 , Mr Pradub Sukhum 1

1

Bangkok Heart Hospital, Bangkok, Thailand

Objective: CAVI (cardio-ankle vascular index) is an affirmative tool to evaluate the arterial stiffness.

Hypertensive response to exercise (HRE) always acts as a relative indication to terminate exercise during

treadmill stress test and prohibit the interpretation of inadequate result. We supposed the CAVI might be

an initial hint to anticipate hypertensive response to exercise.

Materials and Methods: Retrospective chart review in cardiology unit, patients who attended check-up

program in Bangkok heart hospital, and performed both CAVI and treadmill stress test in the same day

between June 2018 and December 2018. Independent t-test and ROC curve analysis were used to analyze

the data.

Results: 56 patients (36 females, 64%) who matched with HRE definition (SBP > 210 mmHg or DBP > 100

mmHg in male, SBP > 190 mmHg or DBP > 95 mmHg in female), mean age 55.6 ± 12.2 years, were compared

with 58 subjects with age- (mean 53.3± 6.5 years) and sex-matched (32 females, 55%) in control group. HRE

group was significantly higher arterial stiffness by CAVI result when compare with control group (8.2 ± 1 .0

in HRE vs 7.2 ± 0.8 in control, p < 0.0001). ROC curve analysis of the CAVI revealed AUC 0.722 (p < 0.001),

the sensitivity and specificity of cut-point CAVI ≥ 8 were 48% and 84% respectively.

Conclusion: This study demonstrated the significantly higher arterial stiffness by CAVI in HRE group than

non-HRE group. CAVI ≥ 8 is not the sensitive tool but quite specific to detect HRE.

APSC 2021 Abstract Book

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