6.17 Re-assessing the Hispanic Paradox in women: comparison of cardiac risk factors and ischaemia by SPECT myocardial perfusion scintigraphy J Teeters, SR Yoder, S Balakrishnan, M Mackin, GP Velarde, RG Schwartz. University of Rochester Medical Center, Department Of Cardiology, Rochester, United States of America Background: The “Hispanic Paradox” associates lower risk of morbid coronary events with similar prevalence of coronary risk factors in Hispanic compared to Caucasian populations. SPECT MPS has prognostic value that is incremental to coronary risk factors, exercise induced symptoms, ECG abnormalities, and coronary arteriography, but comparisons of scintigraphic risk in Hispanic and Caucasian women are lacking. This study compares prevalence of cardiac risk factors and myocardial ischaemia with radionuclide SPECT MPS in Hispanic and Caucasian women. Methods: We reviewed consecutive SPECT MPS studies in Hispanic and Caucasian women referred from 2003 to 2006 for evaluation to the Nuclear Cardiology Laboratory of the University of Rochester Medical Center. Cardiometabolic risk factors (age, body mass index [BMI], diabetes mellitus [DM], hypertension [HTN], hypercholesterolemia, tobacco use and family history) and MPS variables of stress and rest hypoperfusion scores, percent left ventricular (LV) ischaemia, LV ejection fraction (EF), end-systolic and end-diastolic volume indices and TID ratios were tabulated. Comparisons of these variables were made between the cohorts of Hispanic and Caucasian women. A group of Caucasian women age matched to the Hispanic women cohort in this study was selected to assess age specific differences in risk factor prevalence and scintigraphic results. Variables were compared by t-test and chi square analyses. Results: A total of 1374 patient records were reviewed (54 Hispanic and 1320 Caucasian women). Hispanic women were younger (53 vs. 64 years old, p0.0001), had higher BMI (33 vs. 29, p=0.004), less hypercholesterolemia (48% vs. 66%, p=0.02), and higher prevalence ofDM (44% vs. 27%, p0.0001). No difference was noted for HTN, history of tobacco use, LVEF, LV volume indices, percent LV ischaemia or TID ratios. Hispanic women had a higher prevalence of DM (52% vs. 33%, p=0.05) and HTN (72.2% vs. 52%, p=0.03) compared to age matched Caucasian controlswith a trend of higher BMI(33 vs. 30, p=0.07). Conclusion: No difference in the scintigraphic risk profiles of Hispanic and Caucasian women was noted despite a higher prevalence of obesity and DM. The greater prevalence of cardiometabolic risk factors and similar scintigraphric risk profile in Hispanic women 10 years younger than Caucasian women suggests a greater age specific risk of subsequent coronary events in Hispanic women. Further consideration of age specific coronary event risk and referral bias appears warranted to explain the Hispanic Paradox. 6.18 Inhibition of human endothelial cell nitric oxide synthesis by advanced glycation end-products but not glucose: relevance to diabetes B Xu. Nanjing Drum Tower Hospital, Nanjing, China, People’s Republic of Endothelial dysfunction, with decreased NO (nitric oxide) biosynthesis, may play a pathophysiological role in diabetic vasculopathy. The aim of the present study was to determine the relative contributions of glucose and AGE (advanced glycation end- product) accumulation in suppressing NOS-3 (the endothelial isoform of NO synthase). Cultured HUVECs (human umbilical vein endothelial cells) were incubated with different concentrations of glucose, unmodified albumin or AGE-modified albumin for different times. NOS activity was measured from the conversion of L-[³H]arginine into L-[³H]citrulline, and the expression, serine phosphorylation and O-glycosylation of NOS-3 were determined by Western blotting. High (25 mmol/l) glucose, for up to 12 days of incubation, had no effect on the activity or expression of NOS-3, nor on its degree of serine phosphorylation or O-glycosylation, compared with physiological (5 mmol/l) glucose. By contrast, AGE-modified albumin exerted a concentration- and time-dependent suppression of NOS-3 expression in HUVECs at a range of concen- trations (0 –200 mg/l) found in diabetic plasma; this was evident after 24 h, whereas inhibition of NOS activity was seen after only 3 h incubation with AGE-modified albumin, consistent with our previous observations of rapid suppression of NOS-3 serine phosphorylation and NOS-3 activity by AGE-modified albumin. In conclusion, AGEmodified albumin suppresses NOS-3 activity in HUVECs through two mecha- nisms: one rapid, involving suppression of its serine phosphorylation, and another slower, involving a decrease in its expression. We also conclude that, in the context of the chronic hyperglycaemia in diabetes, the effects of AGEs on endothelial NO biosynthesis are considerably more important than those of glucose. 6.19 False-positive myocardial perfusion scans. Correlation with cardiovascular risk factors and impact on event-free survival A Alessia Gimelli, 1 P Marzullo, 2 A L’abbate, 2 D Rovai. 2 1 Institute Of Clinical Physiology, Nuclear Cardiology, Pisa, Italy, 2 Pisa, Italy Background: In absence of significant coronary stenoses, stress-induced myocardial perfusion abnormalities at gated single photon emission computed tomography (G- SPECT) are usually considered as a “false-positive” result. Objectives. We sought to investigate how false-positive G-SPECT perfusion abnormalities relate to cardiovascu- lar risk factors and whether they carry any prognostic information. Methods: From 1999 to 2005 a group of 130 anginal patients with myocardial perfusion abnormalities at stress G-SPECT, with normal coronary angiography or  50% lumen reduction and with a left ventricular ejection fraction  0.45 was selected. The extent of myocardial perfusion abnormalities after stress was quantified using the summed difference score (SDS). Patients were followed-up for 36  16 months. Results: Using a logistic regression model, cardiovascular risk factors (diabetes mellitus, arterial hypertension, smoking habit, hypercholesterolemia and obesity) were closely related (r = 0.96) with the SDS. Cardiovascular risk factors were only weakly related with myocardial perfusion at rest and with variables describing systolic global and regional left ventricular function. During the follow-up, only six patients had major adverse cardiac events: non-fatal myocardial infarction in one patient, percutaneous coronary interventions in three and acute pulmonary edema in two patients. A SDS  7 (p  0.0001) and diabetes mellitus (p  0.0001) were the only independent predictors of event-free survival at Cox proportional hazard regression analysis. Conclusion: In anginal patients without significant coronary stenoses stress-induced myocardial perfusion abnormalities at G-SPECT correlate with cardiovascular risk factors and are independent predictors of the few major adverse cardiac events in the follow-up. 6.20 hs-CRP values in patients with normal myocardial perfusion V Majstorov, 1 D Pop Gjorceva, 1 J Maksimovic, 2 M Vavlukis, 2 I Peovska, 2 S Kuz- manovska. 1 1 Institute of Pathophysiol.& Nuc. Med, Nuclear Cardiology, Skopje, Macedonia, The Former Yugoslav Republic of, 2 Institute for Heart Diseases, Nuclear Cardiology, Skopje, Macedonia, The Former Yugoslav Republic of Background: High-sensitivity C-reactive protein (hs-CRP) has been recently intro- duced as a novel plasma biomarker for the assessment of cardiovascular risk. Its use is especially helpful in apparently healthy individuals for their futher risk stratification. On the other hand, since many years myocardial perfusion imaging (MPI) has been used in patients suspected of having coronary artery disease (CAD) for diagnostic purposes. It’s well known that normal myocardual perfusion places the patient in the low risk group for future cardiovascular events. The aim of our study was to examine the levels of the hs-CRP in the patients who had normal perfusion on MPI. Material & Methods: We studied 32 consecutive patients with suspected CAD who under-went two-day rest-stress gated Tc-99m sestamibi single photon emission com- puted tomo-graphy (SPECT) MPI, all of them with normal myocardial perfusion and function. None suffered from myocardial infarction or underwent revascularization. In all the subjects hs-CRP was examined. Patients with acute/chronic infection and inflamation did not enter the study. Results: The mean age of the examined subjects (14men, 18women) was 55,8 years (32-75y) 11,5. Most of the patients had hypertension (93,7%), 25% were obese, diabetes had 22% and 15,6% had hyperlipidemia. The mean value of the hs-CRP was 2,45mg/L  2. According to the levels of the hs-CRP, patients were divided into 3 groups: group 1 (low risk): 1mg/L; group 2 (moderate risk): between 1-3mg/L and group 3 (high risk): 3mg/L. The first group entered 9, second 15 and the third 8 patients. 7/8 in the group 3 were women, with mean age of 61,6 years. 3/8 (37,5%) in the later group had diabetes; the average level of hs-CRP was 5,3mg/L. Conclusions: In a considerable number of patients (25%) with normal myocardial perfusion and function we found highly elevated levels of the hs-CRP, consistent with high cardiovascular risk. Most of them were older women. Future follow-up studies are needed to clarify the prognostic role of the hs-CRP in patients with normal MPI findings. T U E S D A Y M A Y 1 T U E S D A Y M A Y 1 Journal of Nuclear Cardiology Abstracts S43 Volume 14, Number 2 Tuesday, May 1, 2007