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Background In the current guideline of the ESC, in patients with very high cardiovascular risk such as coronary heart disease (CHD) a treatment target for LDL-C Methods The primary objective of this prospective, multi-centre register study was the question of the guidance-based adaptation and adherence to lipid-lowering therapy during and after a cardiac rehabilitation in 1,100 patients with CHD up to 12 months after discharge from the six rehabilitation clinics involved. Patients were included from 2016 to 2018. Results The median age of the 1,100 patients was 63.4±10.4 years, the mean BMI was 28.5±4.7kg/m2, and 24.1% of patients were female. 12.2% were active smokers, 91.6% reported dyslipoproteinemia, 33.9% suffered from diabetes mellitus and 86.5% from hypertension. The majority of patients were included with the main indications NSTEMI (31.6%), STEMI (29.6%) and after CABG surgery (26.4%). The proportion of patients treated with statins was more than 94% when admitted and discharged from the rehabilitation clinic, as well as in 3- and 12-months follow-ups. Approximately 9% of patients were treated with ezetemibe at baseline. On discharge from the rehabilitation clinic 23% of patients were treated with ezetemibe, which remains stable at 3 and 12 months. PCSK9 inhibitors were used in 0.1–0.3% of patients at all times. The adjustment of LLT during three week cardiac rehabilitation resulted in median LDL-C values of 2.27mmol/l (1.80/2.84) at baseline, 1.97mmol/l (1.57/2.47) on discharge (p The proportion of patients with LDL-C Discussion In the context of cardiac rehabilitation, an effective adjustment of LLT is carried out, which resulted in a significant reduction of LDL-C. However, despite a high percentage of patients on statins and ezetemibe, the proportion of patients in the new target range Figure 1 Funding Acknowledgement Type of funding source: Private company. Main funding source(s): This study was supported by an unrestricted grant from Sanofi-Aventis Germany.

Aims In previous experiments we have demonstrated that expression of the transcription factors E2F2 and E2F4 is sufficient to induce proliferation of isolated primary cardiomyocytes from newborn rats and mice. We now wanted to analyse whether E2F2 or E2F4 are also able to promote cell cycle progression of adult cardiomyocytes in vivo , which unlike cardiomyocytes from newborn rodents lack the ability to undergo cell proliferation. Methods and results E2F2 or E2F4 was expressed in hearts of mice at different developmental stages using adenoviral vectors. Effects regarding proliferation, hypertrophy, and apoptosis were analysed on histological sections, and quantitative assessment of cell cycle regulatory genes was performed by real-time PCR (polymerase chain reaction) and western blot. We found that both E2F2 and E2F4 can stimulate hypertrophic cell growth of cardiomyocytes. However, only directed expression of E2F2 but not of E2F4 was sufficient to induce proliferation of cardiomyocytes. Expression of E2F2 in vivo did not increase the percentage of apoptotic cardiomyocytes but down-regulated the expression of the pro-apoptotic genes caspase-6 and apaf-1. Further analysis of the cell cycle regulatory machinery revealed that expression of E2F2 caused a strong induction of cyclin A and E while the expression of cyclin-dependent kinase inhibitors (CKIs) such as p21 was not affected. Conclusion We conclude that a limited induction of cardiomyocyte cell proliferation can be achieved by E2F2-mediated stimulation of cyclin A and E expression without a reduction of CKIs.

Efficient and safe anticoagulation is crucial in patients requiring percutaneous coronary intervention (PCI), where remaining rates of life-threatening complications trigger the development of new anticoagulants with improved efficacy/safety ratios. This in vitro study compared the efficacy of otamixaban, a new synthetic parenteral direct factor Xa inhibitor, with unfractionated heparin, enoxaparin and fondaparinux with/without combination with eptifibatide in the prevention of cardiac catheter thrombosis. Blood (49 ml each) from 10 healthy male volunteers pretreated with oral 500 mg aspirin was anticoagulated with unfractionated heparin (0.9 UI/ml), enoxaparin (0.6 IE/ml) or fondaparinux (0.5 μg/ml) at PCI-recommended doses, or with otamixaban at concentrations of 250 or 500 ng/ml. Each group was combined with/without 1.7 μg/ml eptifibatide (n=10 groups). The blood-anticoagulant mixtures were circulated continuously through a cardiac catheter for 60 min or until the catheter became blocked by thrombotic debris. Overall thrombus weight, global and specific coagulation parameters, and electron microscopic features such as deposits of platelets, erythrocytes and fibrin on the catheter surface were quantified as endpoints. The otamixaban regimes differed not statistically relevant from UFH and enoxaparin groups regarding the deposition of erythrocytes and demonstrated similar or even significantly reduced platelet deposition, whereas fondaparinux treatment resulted in significant increases of both values (p