P2-8 CHLAMYDIA INFECTION IN CARDIOVASCULAR DISEASES: SEQUEL II

Abstract of the 16th Asian Pacific Congress of Cardiology, Taipei, Taiwan, 13–16 December, 2007

Coronary artery response to acetylcholine.

with coronary artery endothelial dysfunction. This study supports the concept that SAS may play a role in the progression of coronary atherosclerosis.

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underwent fibrinolytic treatment with streptokinase ( SK) & result were assessed by fluoroscopy, transthoracic echocardiography & TEE. Contraindication for SK in our study were, large thrombi (≥ 1 cm), pregnancy and early postoperative period (1 month ) and recent cerebrovascular accident. Results: Of the 17 pts [ 9 female & 8 male, median age 43.8 years(24–68)], 14 had mechanical double-disk prostheses (8 Mitral & 6 Aortic) and 3 had singledisk prostheses (1 Aortic and 2 Mitral). The total success rate was 59%, the partial success rate was 29 % and the nonsuccess rate was12%. All pts with a double-disk prosthesis responded completely (71.3%) or partioially (28.7%) to the treatment; but non of pts with a single-disk prosthesis had complete resolution of the thrombosis; Also more effective for aortic-valve thrombosis (71.4%) completely than for mitral-valve (50% completely success rate). Mortality rate due to the use of the SK was 5.8 % and was secondry to cerebral bleeding. During SK infusion 2 (11.8%) embolic episodes occurred as follows, 1 cerebral and 1 renal. Conclusion: The use of Fibrinolytic agents was effective and relatively safe in pts with thrombosis of double-disk (especially Aortic). Keywords: Prosthetic valve thrombosis, Fibrinolytic therapy, Fluoroscopy, transthoracic echocardiography.

P2-8 P2-6 MULTI-LINK VISION AND MINIVISION STENT REGISTRY IN ASIAN PATIENTS WITH CORONARY ARTERY DISEASE: A PROSPECTIVE, MULTI-CENTER STUDY

Yawei Xu, Yidong Wei, Kai Tang, Yanqing Chen, Weiming Li, Xuejing Yu. Department of Cardiology, Shanghai Tenth People’s Hospital, Tongji University, Shanghai, China 200072 Background: Recent studies have showed that the fine mesh stents are associated with a significant reduction in both clinical and angiographic re-stenosis of the coronary arteries. To maintain a very satisfactory radio-opacity using the stents, Guidant of the USA has designed a new type of bare metal stents (BMS)-Multilink (ML) Vision/ML MiniVision stents. The clinical outcomes of Asian patients with coronary artery disease after implanting the Multi-link Vision or MiniVision stent were investigated in this study. Methods: An observational, prospective, multi-center, non-randomized post marketing registry was conducted to demonstrate the efficacy of the BMS-ML Vision/ML MiniVision stents. The primary end point of the registry was clinical target lesion revascularization (TLR) at a 6-month follow up. The major secondary end points included the rate of major adverse cardiac events (MACE) and serious adverse events (SAE) in-hospital at 6 months; and the rate of clinical TLR as a function of the type of angina. A total of 429 Asian people with 449 lesions from 14 centers were selected for this study. The average reference diameter of the lesions was (3.0±0.5) mm, and the mean length was (15.7±5.0) mm. Results: The successful rate of the procedure was 99.3%. Twenty-five percent of the lesions were treated by direct stenting without pre-dilation. Eighty-six percent of the lesions were implanted with ML Vision stent. After the 6-month follow up, the rate of clinical TLR was 1.4%. The MACE, SAE and target vessel revascularization (TVR) were 6.8%, 3.5% and 1.4% respectively. Conclusion: The current registry showed the excellent 6-month clinical outcomes of ML Vision/ML MiniVision stents in Asian patients with CAD.

CHLAMYDIA INFECTION IN CARDIOVASCULAR DISEASES: SEQUEL II

Ivan M. Petyaev, Nailya A. Zigangirova. Cambridge Theranostics Ltd., Cambridge, UK, Gamaleya Institute of Microbiology and Epidemiology, Moscow, Russian Federation It was found that that both Chlamydia pneumoniae and Chlamydia trachomatis were present in the plasma or serum of a significant number of patients with clinical complications of atherosclerosis. The fact that this was viable virulent bacteria was confirmed by an independent golden standard cell culture test in more that 80% of blood positive cases. It was also noted that about 20-40% of PCR negative samples were positive in the cell culture test which indicates that the concentration of these bacteria was below the ability of PCR proprietary sampling protocol used to recover them. Chlamydia bacteria was detected in 102 out of 189, or 54% of patients with symptomatic or silent Coronary Heart Disease, CHD, in 10 out of 19, or 53% of patients with Peripheral Occlusive Disease, POD, and in 3 out of 56, or in 5% of persons from the control group. It was noted that Chlamydia pneumoniae extracted and grown in a cell culture had a different antigen expression profile and was at least 8 times more resistant to Azithromycin than referenced respiratory strains of this bacterium. The latter finding may shed some light on reasons behind negative outcomes of numerous anti-microbial trials in the treatment of CHD. A significant level of the detection of viable Chlamydia pneumoniae and Chlamydia trachomatis in tested patients indicates that these bacteraemia may play an important role in the development of clinical complications of atherosclerosis.

POSTER SESSION 8

GENERAL CARDIOLOGY/CONGESTIVE HEART FAILURE P2-9

POSTER SESSION 7

CLINICAL CONTROVERSIES P2-7 FIBRINOLYTIC THRAPY FOR MECHANICAL PROSTHETIC VALVE THROMBOSIS

S.H. Hakim, J. Samadikhah, S. Gaffari, A. Alizadeh, R. Azarfarin. Tabriz University Of Medical Sciences, Iran Background: Thrombosis is a serious complication of prosthetic heart valves and management is often difficult. Thrombolytic therapy is a promising alternative to valve reoperation in the prosthetic valve thrombosis (PVT). Methods: In this prospective study, seventeen patients (pts) with PVT diagnosed by clinical, transesophageal echocardiography (TEE) and fluoroscopic findings,

STUDY OF ASSOCIASION BETWEEN AGE AND ECHOCARDIOGRAPHIC AND HEMODYNAMIC FINDINGS IN PATIENTS WITH RHEUMATIC MITRAL STENOSIS

Toufan Mehrnoush, Asl Azin Alizadeh, Shahsar Laleh. From The Cardiovascular Research Center of Tabriz University of Medical Sciences, Tabriz Background and Objectives: In developing countries rheumatic mitral valve disease was prevalent. The aim of the present study was to determine the influence of age in echocardiographic and Hemodynamic findings in patients with rheumatic mitral stenosis. Methods: We evaluated 167 patients with symptomatic severe rheumatic mitral stenosis programmed to undergone PTMC from April 2006 to May 2007 in Madani heart center in Tabriz (Iran). Two-dimensional and Doppler echocardiography and right and left heart catheterism were performed in all patients on the same day before PTMC. Results: There were 37 (21.7%) men and 130 (78.3%) women; aged 14 to 74