PW202 Predictors of exposure to guideline-recommended secondary prevention during a hospital admission for acute coronary syndrome (ACS)

Introduction: Diabetes mellitus increases the risk of heart failure independent of coronary heart disease and hypertension. It is also associated with diabetic cardiomyopathy of which the epidemiology is not well defined. We sought to study the pattern of diastolic dysfunction in an asymptomatic diabetic population from Malaysia. Objectives: To assess prevalence of diastolic dysfunction and the predicting factors. Methods: Subjects were recruited as part of a community study on cardiovascular diseases between the years 2007 to 2011. Demographic details, cardiovascular risk factors along with echocardiogram were obtained. An exclusion criterion is abnormal left ventricular ejection fraction less than 40%. Results: A total of 1932 subjects with echocardiogram were analyzed. Mean age was 54.6 11.6. Majority of the subjects were male 98.3% (1899). Mean systolic ejection fraction (EF) was 64.5% 7.0. Prevalenve of diastolic dysfunction was 52.8% (1021). Of all the subjects with diastolic dysfunction, 29.9% (578) had impaired relaxation, 21.0% (406) pseudonormal and 1.9% (37) restrictive defect. Among subjects with diastolic dysfunction, 13.8% (266) were diabetic and 9.6% (185) were pre-diabetic (impaired fasting glucose). 60.6% (1170) had dyslipidemia of LDL level more than 3.4 mmol/L. 26.1% (505) were hypertensive and 59.1% (1142) were obese. Table below summarize the univariate analysis of the cardiovascular risk factors among the subjects with diastolic dysfunction. In multivariate analysis hypertension was the only predictor of diastolic dysfunction s1⁄4-0.65, t(505)1⁄418.6, p < 0.001. OR of hypertensive subjects to get diastolic dysfunction is 0.52 (0.39-0.70).