ABSTRACTS S216 Heart, Lung and Circulation Abstracts 2010;19S:S1–S268 512 Elevated Cardiac Troponin T (cTnT) in the Extreme Elderly Group of Patients: The Short and Long Term Prognostic Implications T. Nguyen 1,∗ , J. Gohil 1,2 , D. Leung 1 , G. Le 1 , J. French 1 , C. Juergens 1 1 Liverpool Hospital, Australia 2 Wollongong Hospital, Australia Background: There is a wide use of cardiac troponin T (cTnT) for various hospital presentations in the elderly population. The short and long term prognostic implica- tions of an elevated cTnT level, in the extreme elderly, have not been clearly defined. Methods: We analysed 229 consecutive patients ≥80 years of age (mean age 85 ± 4 years; 62% females) admit- ted to our hospital, who had cTnT measured, for both non-cardiac and cardiac presentations. The primary study endpoint was all cause mortality in hospital and long term follow up. Results: The mean follow up duration was 2 years 11 months. The provisional admission diagnosis (cTnT neg- ative/cTnT positive groups: 61% vs. 46% non-cardiac; 24% vs. 26% acute coronary syndrome; 25% vs. 28% other cardiac diagnosis). Kaplan–Meier curves showed a signifi- cantly higher all cause mortality in the cTnT positive group during hospital admission (p < 0.001) and long term follow up (p < 0.001). Higher (median and tertile) levels of cTnT elevation did not predict a poorer prognosis. However any level of cTnT elevation did confer significant mortality above those with normal levels. Baseline characteristics cTnT -ve (n = 117) cTnT +ve (n = 112) p value Age 84.1 ± 4 85.3 ± 4 NS History of IHD 54 (46%) 81 (72%) p < 0.001 Diabetes 30 (26%) 38 (34%) NS Smoking 10 (9%) 38 (34%) p < 0.001 Chronic renal failure 28 (24%) 54 (48%) p < 0.001 Conclusion: An elevated cTnT, independent of the level, in patients ≥80 years of age confers significant in-hospital and long term mortality. doi:10.1016/j.hlc.2010.06.523 513 Elevated Plasma Active Matrix Metalloproteinase 9 Level is Associated with Increased Degree of Diastolic Dysfunc- tion in Patients with Coronary Artery Disease J. Chu 1,∗ , G. Jones 2 , G. Tarr 2 , L. Philips 2 , G. Wilkins 1 , A. van Rij 2 , M. Williams 1 1 Section of Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand 2 Section of Surgery, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand Background: Circulating levels of total matrix metallo- protineases (MMP) have been associated with diastolic dysfunction and heart failure. This study aimed to investi- gate whether the endogenous active levels of MMP-1, -2, -3 and -9 or tissue inhibitor of metalloproteinases-1 (TIMP- 1) were altered in the circulation of patients with diastolic dysfunction (DD) in the setting of coronary artery disease (CAD). Methods and results: We studied 153 patients with angiographically proven coronary artery disease and clinically symptom free of angina. Demographic and angiographic characteristics were collected. Plasma sam- ples were analysed for MMPs (active forms of MMP-1, -2, -3, and -9, and the total form of MMP-9) as well as TIMP-1 using ELISA-based isoform sensitive assays. Doppler-echocardiographic assessment of diastolic fill- ing was undertaken with measurements of maximal early (E) and late (A) transmitral velocities in diastole, E/A ratio, E-wave deceleration time and isovolumic relax- ation time. Active MMP-9 level was higher in patients with more severe phases of diastolic dysfunction [normal (n = 62): median 1.41 ng/ml; mild (n = 49) 1.52 ng/ml; mild- moderate (n = 23) 2.13 ng/ml; moderate (n = 13) 2.26 ng/ml; severe (n = 6) 2.48 ng/ml; p = 0.007 for trend]. Elevated level of active MMP-9 had an adjusted odds ratios of 6.1 (95% CI: 1.7–21.2, p = 0.005) and 9.1 (95% CI: 2.2-37.2, p = 0.003) for association with mild–moderate DD and moderate and severe DD, respectively. Conclusion: Elevated active MMP-9 level is associated with increased degree of DD in patients with CAD, which may reflect abnormal extracellular matrix metabolism in myocardial ischemia. doi:10.1016/j.hlc.2010.06.524 514 Elevated Troponin T Predicts Both Short and Long-term Mortality after Pulmonary Embolism A. Ng ∗ , V. Chow, A. Yong, T. Chung, L. Kritharides Concord Hospital, The University of Sydney, Australia Background: Troponin elevation during acute pul- monary embolism (PE) predicts poor short-term outcome but its long-term significance is unknown. We investigated the long-term prognostic impact of troponin T elevation on all-cause mortality in a large patient cohort with confirmed PE. Methods and results: Clinical details of all patients pre- senting with acute PE to a tertiary hospital between 2000 and 2007 (n = 1023 patients) were retrieved from medical records. Patients with troponin T measured during index presentation (577 of 1023 patients; mean age 70 ± 15years, 47% male) were analysed. Their outcomes were tracked from local state death registry. There were 390 (68%) patients with troponin T < 0.01 g/L, 53 (9%) between 0.01 g/L and < 0.03 g/L, 91 (16%) between 0.03 g/L and <0.1 g/L, and 43 (7%) ≥0.1 g/L. Patients with tro- ponin T ≥ 0.01 g/L were significantly older, had longer admission, more underlying comorbidities including cardiovascular diseases and neurodegenerative disease, poorer renal function and lower hemoglobin. There were