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S144 Abstracts Heart, Lung and Circulation2008;17S:S1–S209

340Assessment of Potential Recipients for Cardiac Resyn-chronisation Therapy (CRT): Are Current ImplantationRates too Low?

Justin Ng ∗, Brendan McQuillan, Cheryl Blanton

Sir Charles Gairdner Hospital, Perth, WA, Australia

Introduction: There is increasing evidence that CRT is auseful adjunct in heart failure (CHF) patients (NYHA classIII–IV; EF ≤35%) refractory to medical therapy. Despitethis and the rising prevalence of CHF in Australia, biven-tricular pacemaker (BiV-PM) implantations remain low.Aim: To determine whether the rate of (BiV-PM) implan-tations at our tertiary institution is due to appropriate usein a limited pool of potential candidates or a failure toidentify them.Methods: A search of inpatient morbidity coding between1/1/05 and 31/12/07 identified 522 patients admitted witha diagnosis of CHF, who were ≤80 years and independent.Results: Echocardiographic or nuclear assessment of EFwas performed on 277/522, of which 140 had an EF ≤35%.Selection criteria (NYHA class III–IV; ECG QRS duration≥120) were assessed among 110 patients with availablerecords (23 women: 87 men; mean age 64; aetiology: IHD52, non-IHD 50, mixed 8). Of 110 patients, 22 potentialcandidates for CRT were identified. Only 14 of these22 patients had been considered for/or received CRT (1

Table 1. Demographic dataCross-sectional Universe P value*

Age (year) 61.2 ± 10.7 60.6 ± 13.4 .835Males (%) 85.7 80.0 .386NYHA Class 2.4 ± 0.7 3.12 ± 0.3 .001LVEF 26.9 ± 8.7 28.9 ± 9.3 .234Duration of HF (year) 6.2 ± 5.5 5.13 ± 6.2 .0821

Results are mean ± S.D. *Based on Mann–Whitney U-test.

CoQ levels were compared to the 86 statin naıve patientsrecruited for the Universe Trial, that were randomised tostatin or placebo for 6 months.CoQ10 results Cross-

sectional,n = 56

Universebaseline,n = 69

P valuea UniverseStatingroup,n = 40

UniversePlacebogroup,n = 46

P valueb

Baseline 847± 344

1075± 398

0.0001 1149 ± 426 993 ± 352 0.101

6 months Rx 746 ± 330 1030 ± 368 0.001

a Based on Mann–Whitney U-test.b Based on ANOVA.

There was no significant correlation between plasmaCoQ10 and LVEF or NYHA class for the cross-sectionalgroup or the Universe group at baseline or 6 months post-treatment.The results confirm that statin therapy has an indepen-dent lowering of plasma CoQ10 levels. Further research isrequired to determine whether this decrease is below thethreshold required for numerous redox-dependent pro-cesses.

doi:10.1016/j.hlc.2008.05.342

342Hospital Initiated Post-Discharge Home Medication

patient refused)NYHA I NYHA II NYHA III NYHA IV

QRS <120 9 35 14 2

QRS ≥120 6 21 20 3

Discussion: The proportion of patients (277/522) who hadformal assessment of cardiac function following an admis-sion with CHF was low. This study was limited by completeinformation regarding only 110/140 patients with an EF≤35%.Conclusion: Current indications for CRT are only applica-ble to a minority of patients with CHF. Despite this, CRTappears under-utilised at our tertiary institution. ECG cri-teria for initial identification of patients may restrict accessand evolving echocardiographic techniques to improveassessment of mechanical dyssynchrony warrants atten-tion.

doi:10.1016/j.hlc.2008.05.341

341Effect of Statins on Coenzyme Q10 (CoQ10) Plasma Levelsin Patients with Chronic Heart Failure (CHF)

Emma Ashton, Henry Krum ∗

Monash University, Melbourne, Victoria, Australia

CoQ10 levels in plasma and the myocardium have beenshown to be low in patients with CHF, and particularly inthe elderly. Treatment with a statin may further decreasethese levels. 56 patients with CHF and taking a statinfor greater than 12 months were recruited and plasma

Reviews: Assessment of the Clinical Impact of an Indi-vidualised Co-Morbidity Focused Referral Process in aPredominately Chronic Heart Failure (CHF) Population

Suzanna Lovgren 1, Robyn Clark 2,∗, Desmond Colley 3,Gunner Tobin 1, Sepehr Shakib 4

1 Department of Pharmacology, Gothenburg University,Gothenburg, Sweden; 2 Faculty of Health Science University ofSouth Australia, Adelaide, Australia; 3 Flinders Medical Centre,South Australia, Adelaide, Australia; 4 Department of ClinicalPharmacology, Royal Adelaide Hospital, Adelaide, Australia

Background: Factors contributing to medication relatedproblems often occur in times of change, such as thetransition from hospital to community. To improve thequality use of medicines, the Australian Government hasfunded Home Medication Reviews (HMR), which involvesaccredited pharmacists visiting patients in their home andreporting back to patients’ general practitioners (GP). Onefactor limiting the quality of the HMRs is the variability ofthe referrals to pharmacists.Aim: The aim of this study was to utilise a standardisedreferral and reporting process to enhance the quality andclinical impact of HMR reports.