© Elsevier Masson SAS. All rights reserved.   12 Archives of Cardiovascular Diseases Supplements (2017) 9, 11-28 434 Influence of gender in ST-segment elevation myocardial infarction: insight from the first French metaregistry S. Manzo-Silberman (*) (1), F. Couturaud (2), S. Charpentier (3), V. Auf- fret (4), C. El Khoury (5), H. Le Breton (4), L. Belle (6), S. Marliere (7), M. Zeller (8), Y. Cottin (9), N. Danchin (10), T. Simon (11), F. Schiele (12), M. Gilard (2) (1) APHP-Hôpital Lariboisière, Cardiologie, Paris, France – (2) CHU Brest, Medecine interne pneumologie, Brest, France – (3) CHU Rangueil, Urgences, Toulouse, France – (4) CHU Brest, Cardiologie, Brest, France – (5) CHU Rennes, Cardiologie, Rennes, France – (6) CHU Dijon, Cardiologie, Dijon, France – (7) Hôpital Lucien Hussel, Urgences, Vienne, France – (8) CHU Annecy, Cardiologie, Annecy, France – (9) CHU Grenoble, Cardiologie, Grenoble, France – (10) Université de Bourgogne, Laboratoire de physiopathologie et pharmacologie, Dijon, France – (11) Université de Bourgogne, Inserm U866, Dijon, France – (12) CHU Dijon, Hôpital Bocage, Cardiologie, Dijon, France – (13) APHP-Hôpital Européen Georges Pompidou (HEGP), Paris, France – (14) Université Pierre et Marie Curie, Pharmacologie, Paris, France – (15) APHP-Hôpital Européen Georges Pompidou (HEGP), Cardiologie, Paris, France – (16) CHU Besançon, Cardiologie, Besançon, France *Corresponding author: stephanesilberman@hotmail.com Background Women show greater mortality after acute myocardial infarc- tion, particularly in ST-segment elevation myocardial infarction (STEMI) although the gender effect seems to diminish after control for age and comor- bidities. Purpose To investigate whether gender affects time management and impacts in-hospital mortality. Methods A patient-level pooled analysis of French MI registry data from different regions from January 2005 to December 2012. Patients presenting acute STEMI, with call delay <12 hours from symptom onset, and primary contact with an emergency department with percutaneous coronary interven- tion facility or mobile intensive care unit were included. Primary study out- comes were STEMI delays: patient delay, system delay and total ischemic time. Secondary outcome was all-cause in-hospital mortality. Results 16,733 patients were included with 4,021 females. Women less often called an emergency dispatch center. 18.3% of women and 11.6% of men (p<0.001) received no reperfusion. Patient delay was longer in women even after adjustment with adjusted mean difference of 14.4 min (p<0.001); system delay did not differ (adjusted mean: 287 vs. 281 min, p=0.25). In-hos- pital death concerned 3 times more females than males. This disadvantage per- sisted strongly adjusting for age, therapeutic strategy and even delay. Conclusions This overview of 16,733 real-life consecutive STEMI patients in prospective registries over an extensive period strongly indicates gender- related discrepancies, highlighting clinically relevant delays in seeking med- ical attention. However, higher in-hospital mortality was not totally explained by clinical characteristics or delays. Dedicated studies of specific mechanisms underlying this female disadvantage are mandatory to reduce this gender gap. The authors hereby declare no conflict of interest 458 The success of thrombectomy does not prevent angiographically visible distal embolization in STEMI patients treated by primary per- cutaneous coronary intervention and thrombectomy V. Yameogo, K. Stamboul*, C. Richard, A. Gudjoncik, J. Hamblin, P. Buffet, I. L’huillier, L. Lorgis, Y. Cottin CHU Dijon, Hôpital Bocage, Cardiologie, Dijon, France *Corresponding author: stamboulk@gmail.com Distal embolization during p-PCI and thrombectomy to treat STEMI is associ- ated with poor prognosis. The aims of our study were to determinate angiographic predictors of angiographically visible distal embolization (AVDE) during STEMI treated by p-PCI with thrombectomy and check if the success of thrombectomy prevents AVDE in STEMI. 346 consecutive patients admitted for STEMI who underwent p-PCI and thrombectomy were included. Clinical, angiographic and therapeutic characteristics were assessed for each patient. AVDE was defined as a distal filling defect with an abrupt “cut-off” in one of the peripheral coronary branches of the infarct related artery, distal to the angioplasty site. Patients were divided into 2 groups: presence of AVDE (AVDE+=59 patients) and absence of AVDE (AVDE-=287 patients). Comparing the 2 groups, age > 60 years was more important in AVDE+ (65.57 vs.50%; p=0.014) as was female gender (32.78 vs. 20.13%; p=0,027) and right coronary lesion (55.73 vs. 34.37%; p=0.001); while smoking was more frequent in AVDE- (62.84 vs. 44.26%; p=0.014) as was left descending coronary artery lesion (50 vs. 34.42%; p=0.004). After multivariate analysis, the infarct related right coronary artery (OR [95% CI]: 2.48 (1.36-4.52); p=0.003) and culprit coronary diameter >3mm (OR [95% CI]: 1.90 (1.01-3.56); p=0.048) were independent factors associated with AVDE during p-PCI with thrombectomy for STEMI. Success of thrombectomy and syntax score were not associated with AVDE occurrence. This study highlighted that AVDE compli- cating p-PCI with thrombectomy in STEMI is frequent (17%) and the success of thrombectomy don’t prevent AVDE. Two angiographic independent AVDE pre- dictors were identified: right coronary artery lesion and culprit coronary artery diameter >3mm. These data call into question the definition of success of throm- bectomy and the need for specific studies on the right coronary artery. The authors hereby declare no conflict of interest 256 Analysis of mortality rate in patients with ST-segment elevation myo- cardial infarction: the SCALIM registry E. Martins (2), J. Magne (*) (2), V. Pradelle (2), G. Faugeras (3), D. Caill- loce (2), D. Mohty (2), E. Fleurant (1), H. Karam (2), PB. Petitcolin (3), P. Virot (2), V. Aboyans (2) (1) CH Brive, Cardiologie, Brive, France – (2) CHU Limoges, Cardiolo- gie, Limoges, France – (3) Epsilim, Limoges, France *Corresponding author: jul.magne@yahoo.fr Background SCALIM, a registry of ST-segment elevation myocardial infarction (STEMI) managed within the first 24 hours in Limousin, reports higher mortality rate than other French registries. Aims To determine whether this difference is due to inclusion criteria and demographic characteristics, in particular as compared to the national FAST- MI 2010 registry. Methods Inclusion criteria of other registries were applied to SCALIM population in order to compare mortality rates. Risk factors for mortality were obtained by multivariate analysis in SCALIM, and these risk factors rates were compared with other registries. Results From 06/2011 to 01/2015, 1501 patients were included in SCALIM. One-month mortality rate was 8.8%. The use of FAST-MI criteria showed a lower one-month mortality rate (6.4% vs originally 8.8% in SCALIM, p=0.016). Age (OR=1.045, IC 95%=[1.025–1.065]; p<0.001) and no-reperfusion therapy within 12 hours (OR=4.395, IC 95%=[1.131–17.082], p<0.001] were independent risk factors for mortality in SCALIM. Mean age (65 vs 63.3 years, p<0.001) was higher in SCALIM than in FAST-MI and reperfusion therapy was more frequently used (84.2 vs 74.7%, p<0.001). Conclusion Higher mortality rate in SCALIM is in part due to differences of inclusion criteria. Effort should be made to harmonize these criteria and facilitate comparison between registries. Demographic data seem to explain another part of difference in mortality rate in FAST-MI 2010, especially age. The authors hereby declare no conflict of interest 366 Drift evaluation after FFR measurements C. Pouillot (1), K. Bougrini (1), R. Vi Fane (1), G. Rambaud (1), J. Glase- napp (1), C. Geyer (1), J. Adjedj (*) (2) (1) Clinique Sainte Clotilde, Sainte Clotilde, La Réunion, France – (2) APHP-Hôpital Cochin, Cardiologie, Paris, France *Corresponding author: julienadjedj@hotmail.com Aims Fractional Flow Reserve (FFR) corresponds to the coronary flow ratio in maximal hyperemia with and without coronary stenosis (Pd/Pa). FFR is an accurate test compared to other tests in cardiology with a difference