350 Improving outcome in coronary artery disease 1946 | BEDSIDE Short-term statin therapy for prevention of contrast induced-acute kidney injury in patients with diabetes and chronic kidney disease Minjoz, Department of Cardiology, Besancon, France; 8 University Hospital of Toulouse, Toulouse, France; 9 AP-HP - Hospital Saint Antoine, Clinical Research Unit (URC) - Est, Paris, France Y.L. Han 1 , G.Y. Zhu 2 , B. Xu 3 , R. Mehran 4 , Y. Huo 5 . 1 Shenyang Northern Hospital, Department of Cardiology, Shenyang, China, People’s Republic of; 2 Asian Heart Hospital, Wuhan, China, People’s Republic of; 3 Cardiovascular Institute & Fuwai Hospital, Beijing, China, People’s Republic of; 4 Mount Sinai Medical Center, New York, United States of America; 5 No. 1 Hospital affiliated to Beijing Medical University, Beijing, China, People’s Republic of Background and aim: Recent evidence suggests that overweight is not associated with increased risk of premature death in the general population. We assessed 5-year mortality in AMI hospital survivors according to body mass index (BMI) category and waist circumference (WC). Methods: FAST-MI is a French nationwide registry of STEMI and NSTEMI patients included at the end of 2005 in 223 institutions (60% of all institutions taking care of AMI patients). Of 3,670 patients enrolled, 3,463 were discharged alive, of whom 3102 had BMI and 1647 WC recorded. BMI was categorized into 5 groups (<22, 22-25, 25-30, 30-35 ≥35 kg/m2 ) and the upper quartile of WC was calculated within each BMI category. 5-year follow-up was available in 95%. Cox multivariate analyses included baseline characteristics, in-hospital management and complications, and discharge medications. Results: Five-year mortality was lowest (21%) in the 25-30 kg/m2 category and highest in the < 22 (35%) and ≥ 35 (27%) groups (P<0.001). Likewise, being in the upper WC quartile was associated with increased 5-year mortality (40% vs 21%). Adjusted Hazard Ratios for 5-year death, compared with the 25-30 kg/m2 category, are displayed in Figure; upper quartile of WC was also an independent correlate of 5-year death (HR 1.40; 1.14-1.73, P=0.002). Background: Contrast-induced acute kidney injury (CIAKI) is an important complication after contrast media injection. While small studies have shown positive results with statin therapy, the role of statin therapy in prevention of CIAKI remains unknown. The aim of this study was to evaluate the safety and efficacy of rosuvastatinin preventing CIAKI in patients with diabetes mellitus (DM) and chronic kidney disease (CKD). Methods and results: We randomized 2,998 patients with type 2 DM and concomitant CKD who were undergoing coronary/peripheral arterial angiography with or without percutaneous intervention to rosuvastatin 10 mg/day (n=1,498) for five days (two days before, three days post procedure) or standard-of-care (n=1,500). Renal function was assessed at baseline, 48, and 72 hours aftercontrast mediaexposure. The primary endpoint of the study was the development of CIAKI, which was defined as an increase in serum creatinine concentration ≥0.5 mg/dL (44.2μmol/L) or ≥25% above baseline at 72 hours after exposure to contrast media. Patients randomized to the rosuvastatin group had a significantly lower incidence of CIAKI compared to controls (2.3% vs 3.9%;P=0.01; OR=0.58, 95% CI 0.38, 0.89). There was no significant difference in the rate of major adverse cardiac events (MACE) except worsening heart failure, which was significantly lower in patients treated with rosuvastatin (2.6% vs 4.3%;P=0.02). Conclusion: Rosuvastatin significantly reduced the risk of CIAKI in patients with DM and CKD undergoing arterial contrast media injection. A. Gille 1 , S. Wright 2 , R. Easton 2 , C. Shear 2 . 1 CSL Limited, Parkville, VIC, Australia; 2 CSL Behring, King of Prussia, PA, United States of America Purpose: The ability of HDL to promote cholesterol efflux from atherosclerotic plaque is thought to underpin its potential for cardioprotection. CSL112 is apoA-I, the active component of HDL, purified from human plasma and reconstituted to form HDL-particles suitable for infusion. CSL112 is in development for the treatment of ACS, and this study measures the ability of CSL112 to promote cholesterol movement. Methods and results: We studied PK and biomarkers of cholesterol movement following a single infusion of 5 to 135 mg/kg CSL112 in 42 of 57 enrolled healthy subjects, all other subjects received placebo (NCT01129661). We previously showed that infusion of CSL112 caused an immediate and large elevation in serum cholesterol efflux capacity. Consistent with this finding, during the initial 24 h interval, HDL-cholesterol increased in a dose-dependent manner while nonHDL-cholesterol did not change. These observations demonstrate movement of tissue cholesterol to HDL. Here, we investigated the fate of that HDL cholesterol. During the first 24 h following the infusion we observed a progressive conversion of unesterified cholesterol (UC) in HDL to esterified cholesterol (EC), indicating the action of LCAT. The predominant clearance path for HDL EC involves transport to non-HDL cholesterol by CETP, an enzyme that removes HDL EC in exchange for triglyceride (TG). Two findings support the action of this pathway after infusion of CSL112. In the first 24 h we observed a transient, dose-dependent increase in TG in the HDL-fraction. Second, we observed a transient rise in CETP activity after the infusion of CSL112. Further studies showed that enhanced CETP activity did not lead to an increase in non-HDL-cholesterol indicating that there was no saturation of the hepatic LDL-receptor mediated catabolism of LDL. Conclusion: Infusion of CSL112 caused an immediate rise in apoA-I, cholesterol efflux capacity and exit of tissue cholesterol into plasma. Newly effluxed cholesterol appears to follow a normal route of clearance with passage to non-HDL lipoproteins via CETP. CSL112 may thus provide a novel option to rapidly transport cholesterol from atherosclerotic plaque to the liver and reduce early recurrent events following ACS. HR for 5-year death according to BMI Conclusion: In this real-world nationwide AMI registry, underweight (<22) and severe obesity (≥35 kg/m2 ) were independent correlates of increased 5-year mortality beyond the hospital phase. In addition, high waist circumference was also associated with increased risk. The lowest mortality was observed in the overweight category. Reducing weight, except in very obese patients, does not seem to be an important health priority in patients having sustained an AMI. 1949 | BEDSIDE Reperfusion arrhythmia bursts predict larger infarct size in STEMI patients undergoing primary percutaneous coronary intervention despite optimal epicardial and microvascular flow K. Van Der Weg 1 , W.J. Kuijt 2 , K.T. Koch 2 , J.G.P. Tijssen 2 , J.D. Haeck 2 , C.L. Green 3 , M.W. Krucoff 3 , A.P.M. Gorgels 1 , R.J. Winter 2 . 1 University Hospital Maastricht, Maastricht, Netherlands; 2 Academic Medical Center, University of Amsterdam, Department of Cardiology, Amsterdam, Netherlands; 3 Duke University Medical Center, Duke Clinical Research Institute, Durham, United States of America Background: Ventricular arrhythmia (VA) bursts are associated with larger infarct size (IS) in patients presenting with ST elevation myocardial infarction (STEMI) after achieving TIMI 3 flow with primary coronary intervention (pPCI). Inadequate microvascular reperfusion, as determined by myocardial blush grade (MBG) ≤2, has also been shown to be associated with larger IS. We hypothesized that VA burst is a marker of an unfavorable response to reperfusion resulting in larger IS in patients with optimal epicardial and optimal microvascular obstruction. Methods: 144 STEMI patients from the PREPARE study were included with 24 hour continuous, 12-lead Holter monitoring, and who achieved brisk epicardial flow restoration (TIMI 3 and MBG 3) post pPCI (figure 1). Angiographic 1948 | BEDSIDE Long-term prognostic impact of body mass index and waist circumference in hospital survivors of acute myocardial infarction. Data from the French FAST-MI 2005 registry N. Danchin 1 , E. Puymirat 1 , M. Zeller 2 , P.G. Steg 3 , J. Machecourt 4 , N. Delarche 5 , P.V. Ennezat 6 , F. Schiele 7 , J. Ferrieres 8 , T. Simon 9 on behalf of FAST-MI Investigators. 1 AP-HP - European Hospital Georges Pompidou, Paris, France; 2 University Hospital Center (CHU) Dijon, Dijon, France; 3 AP-HP - Hospital Bichat-Claude Bernard, Department of Cardiology, Paris, France; 4 CHU, Grenoble, France; 5 Hospital Francois Mitterand, Pau, France; 6 Eaux-Claires Clinic, Grenoble, France;7 University Hospital of Besancon - Hospital Jean Figure 1. Patient selection Downloaded from by guest on December 22, 2014 1947 | BEDSIDE Infusion of CSL112, a novel formulation of human apolipoprotein A-I, in healthy subjects removes tissue cholesterol and directs its clearance