ABSTRACTS S184 Heart, Lung and Circulation Abstracts 2009;18S:S1–S286 compliance with anti failure medications. Improvement with medication was observed maximum with frusemide (84–98%) and minimum with spiranolactone (20–25%). Hospital admissions reduced considerably after CNC intervention. 61 admissions before intervention compared with 24 admissions after intervention. (Mean admission before intervention 1.47 compared with 0.55 after with Standard deviation 1.7 to 0.94.) Conclusion: There was significant reduction in recur- rent hospitalization after heart failure nurse intervention. There was improvement in medications, but it was not sta- tistically significant. Number of hospitalization reduced due to better understanding of the disease by patients after CNC intervention. doi:10.1016/j.hlc.2009.05.417 416 PATIENTS PRESENTING WITH ACUTE CORONARY SYNDROME (ACS) AND A HISTORY OF CONGESTIVE HEART FAILURE (CHF): IS THIS HIGH-RISK POPULA- TION BEING UNDER TREATED? C. Naoum 1 , I. Ranasinghe 1 , G. Devlin 2 , B. McGarity 3 , J. Lefkovits 4 , B. Aliprandi-Costa 1 , D. Brieger 1 , A.P. Sindone 1 1 Concord Hospital Sydney, Australia 2 Waikato Hospital, Hamilton NZ, Australia 3 Bathurst Base Hospital NSW, Australia 4 Royal Melbourne Hospital, Melbourne, Australia Background: The outcomes of patients with a prior his- tory of CHF who subsequently develop ACS have not been described in the Australian and New Zealand (ANZ) population. We compared the outcomes and treatments following ACS in patients with a history of CHF versus those without. Methods: Data were analysed from 5556 patients with ACS enrolled in the ANZ cohort of the Global Registry of Acute Coronary Events (GRACE), of whom 609 had a history of CHF. Comparisons in outcomes and the use of pharmacological and invasive therapies were made between patients with and without a history of CHF. Results: Both the in-hospital and 6-month mortality rates were significantly higher in those with a history of CHF (in-hospital: 8.9% vs. 2.9%, p < 0.0001; 6-months: 16.2% vs. 2.9%, p < 0.0001). With the exception of ACE- I/ARBs, the use of evidence-based medical therapies during hospital admission and at discharge was lower in the CHF group. The provision of invasive therapies was also less frequent, including coronary angiography (31.9% vs. 65.1%, p < 0.0001); percutaneous coronary intervention (9.9% vs. 33.1%, p < 0.0001); and coronary bypass surgery (6.2% vs. 11.8%, p < 0.0001). When adjustments were made for their GRACE risk scores, this significant difference persisted (Fig. 1). Conclusion: Higher mortality rates and fewer evidence- based therapies are observed in ACS patients with a history of CHF. doi:10.1016/j.hlc.2009.05.418 417 PEPTIDOMIC PROFILES OF PLASMA FROM POST- MYOCARDIAL INFARCTION RATS USING MALDI- TOF MASS SPECTROMETRY Bing H. Wang 1,2 , Simone Reisman 3 , Mustafa Ayhan 3 , Andrew Kompa 2,4 , Henry Krum 1 , Greg Rice 3 1 Centre for Clinical Research and Education in Therapeutics, Department of Epidemiology & Preventive Medicine, Monash University, Melbourne, Australia 2 Department of Medicine, Monash University, Melbourne, Australia 3 Baker IDI Heart and Diabetes Institute, Translational Pro- teomics Laboratory, Melbourne, Australia 4 Department of Medicine, University of Melbourne, St Vin- cent’s Hospital, Melbourne, Australia Objectives: Despite the advances in therapeutic devel- opment, effective cardiovascular therapies and useful cardiovascular biomarkers remain limited. In this study, we aim to leverage mass spectrometry (MS) based pep- tide profiling strategies developed in our laboratory to identify changes that occur in peptidomic profiles of blood following myocardial infarction (MI). Methods: One week after MI, rats were randomised to received either an ACE inhibitor ramipril (Ram- 1mg/kg), or vehicle (Veh) for 12 weeks. Echocardiogram and hemodynamic measurements were made before sac- rificing and plasma collection. High abundance proteins were depleted before MS profiling with affinity capture matrix assisted laser desorption ionisation time of flight (MALDI/ToF). Differentially expressed peptide ions were identified using proprietary software ClinProtTools. Results: MI increased heart/body weight (18%), lung/body weight (56%), and left ventricular (LV) end dias- tolic pressure (LVEDP, 247%); and significantly reduced percentage fractional shortening (FS, 75%) and rate pres- sure rise in the LV (dP/dt max , 20%). Ramipril treatment significantly attenuated the changes in LVEDP (61%) and FS (27%). Mass spectra from MALDI/ToF were analysis with ClinProtTools revealing that peptide ions at 1271, 1955, 2041, 2254 m/z were consistently decreased by Ram treatment compared to MI + Veh (p < 0.001) and are likely to be associated with therapeutic effects. Among the pep- tides that are significantly changed, ANF and CD24 have been identified as slightly increased at 12 weeks post-MI and significantly reduced by Ram treatment. On the other hand, the peptide at 2281 m/z was significantly higher in MI + Ram than MI + Veh suggesting it may be associated with drug-stimulated effects. Attempts have been made to obtain identities for these peptides. Conclusions: This approach allows us to screen for biomarkers using an ideal heart failure model in a window of the blood proteome that previously has been difficult