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ÖKG-Jahrestagung – Abstracts

J KARDIOL 2008; 15 (5–6)

171

down to 40 % by anoxia in HACM and HACF from 4 different

donors. CoCl

, which by stabilizing hypoxia inducible factor-1-

alpha mimics anoxic conditions reduced PEDF secretion dose

dependently. The data could be confirmed at RNA level.

Analysis of plasma samples of patients suffering from advanced

heart failure showed that PEDF was a predictive marker for the

combined endpoint with crude proportional hazard ratios of 1.58

(95 %-CI: 1.07–2.32; p = 0.021) and 1.94 (95 %-CI: 1.33–2.84;

p < 0.001) in the second and third tertile compared to the first.

Conclusion We could show PEDF expression in human heart

tissue and the regulation in human adult cardiac myocytes and

fibroblasts by anoxia. Our clinical analysis showed that PEDF is

independently associated with an elevated risk of death and

rehospitalization in patients with advanced heart failure. Due to our

findings we suggest a role of PEDF in the regulation of angiogenesis

in the ischemic human heart e.g. after myocardial infarction.

Body Mass Index and Waist Circumference as Pre-

dictors of the Incidence of Type 2 Diabetes Among

Angiographied Coronary Patients 031

C. H. Saely, St. Beer, P. Rein, A. Vonbank, M. Woess, St. Aczel, T. Marte, H. Drexel

VIIVIT Institute, Feldkirch

Background No data on the impact of body mass index (BMI)

and of waist circumference on the incidence of type 2 diabetes

(T2DM) among angiographied coronary patients are available.

Objective To investigate in as far BMI and waist circumference

predict incident T2DM in this clinically important patient popula-

tion.

Methods The incidence of T2DM was recorded over 6 years in

a population of 503 consecutive non-diabetic patients undergoing

coronary angiography for the evaluation of stable coronary artery

disease.

Results During follow-up, T2DM was newly diagnosed in 86

(17.1 %) of our patients. In logistic regression analysis both base-

line BMI (standardized adjusted odds ratio [OR] = 0.28 [1.01–1.63];

p = 0.041) and baseline waist circumference (OR = 1.54 [1.19–

1.99]; p = 0.001) significantly predicted the incidence of type 2 dia-

betes after multivariate adjustment when entered separately into the

regression models. When BMI and waist circumference were en-

tered simultaneously into a logistic regression model, waist circum-

ference after adjustment for BMI remained significantly predictive

of T2DM (OR = 1.66 [1.14–2.41]; p = 0.008), whereas the associa-

tion of BMI with incident T2DM after adjustment for waist circum-

ference was no longer significant (p = 0.585).

Conclusions We conclude that among angiographied coronary

patients a large waist circumference predicts the incidence of

T2DM independently from BMI, whereas BMI does not predict

T2DM independently from waist circumference.

Type 2 Diabetes Significantly Modulates the Cardio-

vascular Risk Conferred by the PAI-1 -675 5G/4G

Polymorphism in Angiographied Coronary Patients

033

C. H. Saely, A. Muendlein, A. Vonbank, G. Sonderegger, St. Aczel, P. Rein, L. Risch,

H. Drexel

VIVIT Institute, Feldkirch

Background The association of the -675 5G/4G polymorphism

of the plasminogen activator inhibitor-1- (PAI-1-) gene with cardio-

vascular disease in patients with type 2 diabetes (T2DM) is un-

known.

Objectives To investigate the association of the PAI-1 -675 5G/

4G polymorphism with angiographically determined coronary

artery disease (CAD) and its impact on future vascular events in

patients with T2DM and in non-diabetic subjects.

Methods Genotyping was performed in 672 consecutive Cauca-

sian patients undergoing coronary angiography for the evaluation of

stable CAD. Vascular events were recorded over 4 years.

Results Genotype distributions were similar in non-diabetic sub-

jects (n = 24) and in patients with T2DM (n = 148). In non-diabetic

subjects, the homozygous PAI-1 4G4G genotype was significantly

associated with significant coronary stenoses ≥ 50 % (adjusted odds

ratio [OR] 1.85 [95%-CI: 1.20–2.85]; p = 0.005); however, no such

association was observed in T2DM patients (OR 0.81 [0.33–1.93];

p = 0.627). An interaction term T2DM × 4G4G genotype was sig-

nificant (p = 0.014), indicating a significantly stronger association

of the polymorphism with CAD in non-diabetic subjects than in

patients with T2DM. Also prospectively, the 4G4G genotype con-

ferred an increased risk of vascular events in non-diabetic subjects

but not in T2DM patients, with adjusted hazard ratios of 1.76 (1.13–

2.74); p = 0.014 and 0.68 (0.30–1.54); p = 0.360, respectively.

Again, the interaction T2DM × 4G4G genotype was significant (p =

0.018).

Conclusions Presence of T2DM significantly modulates the vas-

cular risk conferred by the PAI-1 -675 5G/4G polymorphism in

angiographied coronary patients.

Cardiology Training in Europe: the EBSC Survey 2006

034

C. Schenk

, C. Carrera

, P. Mills

, R. Michels

, V. Gaute

, J. Ortoli

, P. Kearney

L. Goncalves

, H. Weber

SMZ Ost/Donauhospital, Vienna, Austria;

ESC, Sophia Antipolis, France;

Chest

Hospital London, United Kingdom;

Catharina Hospital, Eindhoven, Netherlands;

Rikshospital, Oslo, Norway;

Cork University Hospital, Cork, Ireland;

University of

Coimbra, Portugal

Background and Methods The European Board for the Speci-

ality of Cardiology (EBSC) strives to harmonize standards in cardi-

ology training in Europe. Therefore the EBSC developed European

criteria for accreditation as specialist in cardiology [EHJ 1996; 17:

996–1000], including a total training duration of 6 years, which in-

cludes a common trunk of internal medicine (at least of 2 years).

Furthermore a basic cardiology training of at least 3 years will be

recommended. Trainees must keep a personal log-book. Each train-

ing programme should be assessed at least every 5 years.

To achieve a picture as accurate as possible of cardiology training in

Europe EBSC surveyed national authorities in 49 ESC member

states containing questions regarding the training in internal medi-

cine, cardiology training and about the infrastructure of training

centers.

Results 27 (55 %) of the replying ESC countries, among them 22

EU/EFTA (71 % of all EU/EFTA) countries responded. Cardiology

as an independent mono-speciality is recognized in 15 (55 % of all

responders) countries. In further 7 (26 %) countries (NOR, PL, AT,

SE, BG, BLR, BIH) internal medicine is a prerequisite for a cardi-

ologist. 5 (19 %) countries did not answer.

The minimum of 2 years training in internal medicine (common

trunk) is usual in 22 (82 %) countries. These criteria are not fulfilled

in 4 (15 %) countries: 1 year BLR and ES; 1.5 years CZ and FR; no

reply: EE.

A minimum of 3 years in cardiology training is obligatory in 22

(82 %) countries. 5 (18 %) countries have different training

durations in cardiology: 2 years in BG, BIH, BLR, LV and PL.

A training logbook is used in all but 5 (18 %) countries: DE, FR,

ISR, SUI, TR; no reply: GB.

Most countries have an assessment procedure at the end of training

in cardiology except of 2 (7 %): AT, ES.

Evaluation of training centers (every 5 years) is mandatory in 13

(48 %) countries. There is a lack of explicit information of this

evaluation process in 14 (52 %) countries: TR, FI, PL, BE, GR, ISR,

ES, DE, FR, SK, BIH, EE, BLR, SUI.

Conclusion Within Europe tremendous differences exist in cardi-

ology training. Providing a standardised patient care and free move-

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