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S238 Heart, Lung and CirculationAbstracts 2009;18S:S1–S286

Conclusion: Our 7 year experience of elective and emer-gent PCI at our facility, with off-site cardiac surgerybackup, demonstrates a low incidence of 30 day and 1 yearMACE following PCI. These findings continue to demon-strate excellent outcomes for these patients and validatethe safety of this practice.

doi:10.1016/j.hlc.2009.05.587

542TIME IS MYOCARDIUM: GENDER DIFFERENCEIN PATIENTS WITH ST-ELEVATION MYOCARDIALINFARCTION (STEMI) WHO UNDERGO PRIMARYPERCUTANEOUS CORONARY INTERVENTION(PPCI)

Michael Mok, James A. Black, James A. Shaw, OmarFarouque, Jeanette Dyson, Tharien Duplessis, AlexanderJ. Black, on behalf of the Melbourne Interventional Group(MIG)

Background: Gender difference is a risk factor ofincreased mortality in STEMI. Women with STEMI havehigher mortality irrespective of reperfusion strategy. Thisstudy attempts to clarify if differences in symptom-to-doortime (STDT), door-to-balloon time (DTBT) and symptom-to-balloon time (STBT) exist in the current era andexamine the effect of gender on outcomes.

Methods: We identified 1324 consecutive STEMIpatients from the multi-centre Melbourne InterventionalGroup (MIG) registry from April 2004 to October 2007.Gender difference was analysed in terms of baseline char-acteristics, 30-day and 1-year major adverse cardiac events(MACE).

Results: Women compared to men are older (72 yr vs60 yr; p < 0.001) and have more hypertension (61.5% vs44.9%; p < 0.001), but are less likely to smoke (28.5% vs38.1%; p = 0.003). The MIG data found DTBT to be longerin women and there was a trend towards longer STBT.

Mean Overall(n = 1324)

Women(n = 288, 21.8%)

Men(n = 1036, 78.2%)

p-Value

STDT (h) 2.83 2.95 2.81 N/SDTBT(h) 2.18 2.51 2.10 0.041STBT (h) 5.12 5.57 5.00 0.051

Women had higher mortality (10.8% vs 4.7%; p < 0.001),target lesion revascularisation (5.2% vs 2.7%; p = 0.039),re-infarction (3.8% vs 1.6%; p = 0.034), and MACE (17.7%vs 8.5%; p < 0.001) at 30 days. Women had higher mortal-ity (12.8% vs 6.9%; p = 0.002) and MACE (22.9% vs 16.9%;p = 0.025) at 1 year.

Conclusion: Gender difference in DTBT exists in thisobservational study and may be associated with pooreroutcome in women with STEMI.

doi:10.1016/j.hlc.2009.05.588

543TRANSRADIAL PRIMARY INFARCT ANGIO-PLASTY—CHARACTERISATION OF THE 6 FR KIMNYDEDICATED RADIAL GUIDE CATHETER

Y. Malaiapan, W. Ahmar, M. Zhang, J.D. Cameron, I.T.Meredith

Monash Cardiovascular Research Centre, MonashHEART,Southern Health & Department of Medicine (MMC), MonashUniversity, Melbourne, Australia

Background: Radial access is as safe and effective asfemoral access for primary percutaneous coronary inter-vention (PCI). However, the failure to use dedicatedtransradial guide catheters may lead to longer proceduraltimes which may impact the timely of delivery of care.

Aims: To characterize the usefulness of a dedicated 6Frdedicated transradial guide catheter and to determine theD2B in a Radial primary PCI (RPCI) group.

Methods: A cohort study was conducted in 80 pts under-going primary infarct angioplasty in our centre from July2005 to January 2009. Forty RPCI pts were matched (age,sex and infarct related artery) with 40 control transfemoralprimary PCI (FPCI) pts. Data was collected prospectivelyfor the RPCI group and retrospectively for FPCI groupfrom the procedural database and hospital records.

Results: Baseline characteristics were similar in bothgroups. Mean age: 58 ± 11 in RPCI vs. 59 ± 9 in FPCI. Punc-ture times: 2.7 ± 1.7 min vs. 2.5 ± 1 min (P = NS). D2B times:70 min (54–99) vs. 74 min (54–130), (P = NS), proceduretimes: 52 min (45–70) vs. 46 min (36–62.5), P = 0.06 and flu-oroscopy times: 16 min (12–23) vs. 11 min (8–15) (P = 0.004).B2/C lesions: 26/40 vs. 29/40; P = NS. Glycoprotein 2b3aInhibitors use: 13/40 (33%) in both groups. Proceduralsuccess was achieved in all patients. Minor groin bleed-ing complications (hematoma < 5 cm) were found in 0 vs.6,P = 0.01. Length of stay did not differ significantly (4.7 ± 1.8days vs.5.5 ± 3.7 days, P = NS).

Conclusion: The 6 Fr Kimny guide catheter is safe anddoes not prolong procedure time in PPCI, resulting inacceptable D2B time cohort.

doi:10.1016/j.hlc.2009.05.589

544TROPONIN T AND CREATINE KINASE-MB IN THEDIAGNOSIS OF EARLY RE-INFARCTION POST-PCI

Ibrahim Shugman 1,3,, Patrick Diu 1, Jayesh Gohil 2,Krishna Kishor Kadappu 1,3, Melissa Leung 1, Sid-ney Lo 1, Dominic Leung 1,3, Andrew Hopkins 1, CraigJuergens 1,3, John French 1,3

1 Liverpool Hospital, Sydney, Australia2 Wollongong Hospital, Wollongong, Australia3 The University of New South Wales, Sydney, Australia

Background: The diagnosis of peri-procedural MI inpatients with ACS and elevated troponin T (TnT) lev-els, using TnT is often problematic. Traditionally >3Xupper reference limit (URL) of CKMB levels has defined