P08 Long-Term Outcomes Have Improved After Acute Myocardial Infarction (AMI) Treated Between 1997 and 2013. A Single Centre Audit. Vinny Karunasekera 1* , Dayle Keown 2 , Rosie Lane 2 , Anna Mulholland 2 , Chris Frampton 1 , David Smyth 2 , John Elliott 1 1 University of Otago Christchurch, Christchurch, New Zealand 2 Christchurch Hospital, Christchurch, New Zealand * Corresponding author. Background: Previous audits of patients treated for AMI from 1997 to 2013 in our Department have demonstrated a trend to improved survival at one year follow-up, but little is known of longer term outcomes. Methods: We have documented long-term outcomes in consecutive AMI patients admitted to the Cardiology Dept from Oct 1 through Dec 31 in each of the years 1997 to 2002, 2006, 2010 and 2013. Trends in in-hospital investigations, revascularisation and discharge medications were recorded. Results: There were no significant trends in age and other risk factors over the study period. Pre-discharge revasculari- zation increased from 13% in 1997/98 to 70% in 2013, and beta blocker and statin use at discharge increased from 71% to 87% and 32% to 98% respectively. Five-year unadjusted survival improved from 67% in the 1997/98 group and 63% in the 1999/2000 group to 79% in those presenting in 2010 (see Figure, p = 0.0001). In those presenting with ST elevation AMI, 5-year survival improved from 70% in 1997/98 to 82% in 2001/02 and 84% in 2010 (p = 0.059). Combined endpoints including AMI, revascularisation and readmission also improved. Conclusions: Changes in our treatment of AMI between 1997 and 2013 have been associated with significant improve- ments in long-term survival and reduced repeat presentations. http://dx.doi.org/10.1016/j.hlc.2017.05.043 P09 Analysis of Acute Coronary Syndrome Patients Managed Conservatively at Hutt Hospital Alyssa Kirby 1* , Tim O’Meeghan 2 1 Capital and Coast District Health Board, Wellington, New Zealand 2 Hutt Valley District Health Board, Lower Hutt, New Zealand * Corresponding author. Aim: To review patients with acute coronary syndrome (ACS) who were managed conservatively, to determine if this was an appropriate treatment strategy given increasing evidence that a routine invasive strategy is superior for most patients. Methods: We retrospectively analysed all patients admit- ted to Hutt Hospital between 1 January and 31 December 2015 with an ACS. We identified those who were managed conservatively and reviewed their electronic and paper med- ical records to determine the rationale behind this decision. Results: There were 170 patients with ACS, 37 of whom (21.8%) were managed conservatively. Of these, 62% were male with a mean age of 83.5 years. There was a clearly documented reason for the conservative approach for 16 patients and very plausible explanation for the remainder. Two patients were dying on admission, 13 had significant co- morbidities and 11 had known severe coronary artery dis- ease. Three were frail and eight were due to age alone (mean age 94 years). In the following 6 to 18 months, 19 patients (51%) were readmitted and 12 patients (32%) died. Conclusion: While evidence-based guidelines suggest the preferred approach for high-risk ACS patients is a routine invasive strategy with coronary angiography, the decision needs to be individualised and balanced with potential risks for each patient. There appears to be valid justification for the decision to opt for conservative management in this patient cohort. However there was a high readmission rate, some of which may have been avoided if a coronary angiogram + - revascularisation had been performed. http://dx.doi.org/10.1016/j.hlc.2017.05.044 P10 Readmission Rates 30 Days Following Myocardial Infarction Alyssa Kirby 1* , Andrew Aitken 1 , Mark Simmonds 1 , Ana Holley 2 , Peter Larsen 1,2 , Scott Harding 1 1 Capital and Coast District Health Board, Wellington, New Zealand 2 University of Otago, Wellington, New Zealand * Corresponding author. Aim: To examine readmission rates within 30 days of acute MI and to determine if there were predictors of representa- tion or potentially avoidable readmissions. Method: We prospectively collected data on 1247 patients with an acute MI who were enrolled into the Wellington ACS Registry between 16 January 2012 and 1 June 2016. 30 day Abstracts S17