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186 J KARDIOL 2008; 15 (5–6)

ÖKG-Jahrestagung – Abstracts

delay mitral valve surgery, with more than one half of the patients

free of MVR 5 years after PMV. Nevertheless there is a loss of

mitral valve area over time and 15 years after PMV less than one

third of patients are free of MVR.

Gender Differences in Risk Factors Including C-reac-

tive Protein in a Large Consecutive Patient Cohort

Undergoing Elective Coronary Angiography 119

A. Suessenbacher, M. Wanitschek, S. de Waha, J. Doerler, M. Frick, O. Pachinger,

F. Weidinger*, H. F. Alber

Department of Cardiology, Innsbruck Medical University; *Department of Internal

Medicine II, Rudolfstiftung Hospital, Vienna

Background Little information is available about gender differ-

ences concerning the presence and influence of cardiovascular risk

factors including C-reactive protein (CRP) in consecutive patients

undergoing coronary angiography (CA) for the evaluation of coro-

nary artery disease (CAD).

Methods 5,641 consecutive patients (33.1 % women) undergoing

elective CA were analysed. Cardiovascular risk factors were as-

sessed by standardised questionnaire and routine blood chemistry.

CAD was graded by visual estimation of lumen diameter stenosis.

Significant stenoses were defined as lumen diameter reduction

≥ 70 % in at least one major coronary artery. Coronary angiograms

were graded as non-significant CAD, as 1-, 2- or 3-vessel disease or

as non-CAD.

Results Women were older than men (65.2 ± 11.0 vs 63.1 ± 11.0

years; p < 0.001) and had more often a positive family history for

premature CAD (30.2 vs 24.5 %; p < 0.001). The number of risk

factors was higher in men (2.4 ± 1 vs 2.3 ± 1; p = 0.01) and smoking

was more common in men (55.9 vs 35.0 %; p < 0.001). In addition,

CRP levels were higher in men (0.82 vs 0.97 mg/dl; p = 0.02). The

prevalence of hypertension (76.1 vs 77.5 %; p = 0.25), hyper-

cholesterolemia (68.5 vs 69.4 %; p = 0.47) and diabetes (17.6 vs

17.4 %; p = 0.86) was not different between gender. CAD was more

often found in men (80.0 vs 59.1 %; p < 0.001). In multinomial

logistic regression analyses including age, total cholesterol, HDL-

cholesterol, CRP, diabetes, hypertension and prior statin use in men

all variables except hypertension were independent predictors of

CAD. In women total cholesterol and hypertension were not inde-

pendently associated with CAD. According to Wald statistics, CRP

was a much stronger independent predictor of CAD in men than in

women.

Conclusion In this large consecutive patient cohort women and

men have almost similar risk factor profiles when referred for CA.

The influence of traditional risk factors on the prevalence of CAD is

similar between gender, but CRP is a stronger independent predictor

of CAD in men.

Climate Change and Acute Coronary Angiographies

in an Alpine Country 120

M. Wanitschek, A. Suessenbacher, J. Doerler, M. Frick, W. Dichtl, O. Pachinger,

H. F. Alber

Department of Cardiology, Innsbruck Medical University

Background Weather conditions are known to aggravate symp-

toms in chronic stable coronary artery disease (CAD). Whether the

ongoing climate change with rapid temperature increase year by

year may also influence the incidence and outcome of non-ST-el-

evation (NSTEMI) and ST-elevation (STEMI) myocardial infarc-

tions referred for acute coronary angiography (CA) is less clear.

Methods According to weather data from the Institute of Meteor-

ology and Geophysics, Innsbruck University, the winter 2005/2006

was very cold (CW) and the winter 2006/2007 extraordinarily warm

(WW). Patients referred for acute CA suffering an acute STEMI or

NSTEMI, their risk factors and in-hospital mortalities in these two

consecutive winters were recorded.

Results As expected, average temperature was lower (–1.6 vs

+5.9 °C; p < 0.001) and humidity was higher (82 vs 79 %; p < 0.012)

in CW compared to WW with no significant differences in other

weather conditions (rain/snowfall: 59 vs 39 days; sunshine: 3.9 ± 2.5

vs 4.3 ± 2.5 hours/day; air pressure: 713.0 ± 6.7 vs 713.8 ± 7.1 hPa).

There were no differences in the number of overall CA (987 vs 983)

in these two winters, whereas the number of acute CA (12.9 % vs

10.4 % of overall CA; p = 0.046) and the diagnosis of STEMI as

indication for acute CA (74.0 % vs 62.7 %; p = 0.046) were higher

in CW. Furthermore, patients in CW were younger (58.2 ± 12.4 vs

61.7 ± 11.7 years; p < 0.03), had higher LDL-cholesterol (134.8 ±

44.6 vs 116.7 ± 36.0 mg/dl; p < 0.003) and were less frequent

hypertensives (52.8 % vs 70.6 %; p < 0.01). In-hospital mortality

(2.4 % vs 1.0 %; p = n. s.), patients’ nationalities (Austrians: 78.0 %

vs 77.5 %), delays in STEMI treatment (3.9 ± 3.5 vs 3.8 ± 3.1 hours)

and other traditional risk factors were not different between WW

and CW.

Conclusion The dramatic average temperature increase of 7.5 °C

from the cold to the warm winter was associated with a decrease in

acute coronary angiographies and a lower incidence of STEMI

referred for primary percutaneous intervention. However, in-hospi-

tal mortality was not different between the cold and the warm win-

ter, probably due to the generally low mortality.

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