Ă C1-12.05 HETEROZYGOUS FAMILIAL HYPERCHOLESTEROLAEMIA IN SPECIALIST CENTRES IN SOUTH AFRICA, AUSTRALIA AND BRAZIL: IMPORTANCE OF EARLY DETECTION AND LIFESTYLE ADVICE Jing Pang 1 , A.D. Marais 2 , Dirk J. Blom 3 , Brigitte C. Brice 3 , Pamela R. Silva 4 , Cinthia E. Jannes 4 , Alexandre C. Pereira 4 , Amanda J. Hooper 5 , Kausik K. Ray 6 , Raul D. Santos 4 , Gerald F. Watts 1, 7 . 1 School of Medicine, Faculty of Health and Medical Sciences, University of Western Australia, Perth, WA, Australia; 2 Division of Chemical Pathology, University of Cape Town Health Science Faculty and National Health Laboratory Service, Cape Town, South Africa; 3 Division of Lipidology and Hatter Institute, Department of Medicine, University of Cape Town Health Science Faculty and Groote Schuur Hospital, Cape Town, South Africa; 4 Heart Institute (InCor), University of Sao Paulo Medical School Hospital, Sao Paulo, SP, Brazil; 5 Department of Clinical Biochemistry, PathWest Laboratory Medicine WA, Royal Perth Hospital and Fiona Stanley Hospital Network, Perth, WA, Australia; 6 Imperial Centre for Cardiovascular Disease Prevention, Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, United Kingdom; 7 Lipid Disorders Clinic, Cardiometabolic Services, Department of Cardiology, Royal Perth Hospital, Perth, WA, Australia Objective: Familial hypercholesterolaemia (FH) is the commonest mono- genic disorder that accelerates atherosclerotic cardiovascular disease. We aimed to compare and contrast the characteristics of patients attending three specialist centres in the southern hemisphere (South Africa, Australia and Brazil). Methods: Adult index-cases with molecularly diagnosed heterozygous FH attending specialist lipid centres in Cape Town, Perth and S~ ao Paulo were studied. Myocardial infarction, revascularisation, hypertension, diabetes, smoking and lipid-lowering treatment were recorded at the time of diagnosis and compared across the three centres. Group differences were investigated using regression analyses, with South Africa as the reference group. Univariate and multivariate logistic regression analyses were per- formed to predict the probability of coronary artery disease (CAD). Results: 875 adult index-cases with molecularly defined heterozygous FH from South Africa (n¼353), Australia (n¼266) and Brazil (n¼256) were studied. The spectrum of genetic variants causative of FH was significantly different in patients attending the centres in South Africa compared with Australia and Brazil. Hypertension and diabetes were more prevalent in Brazilian and Australian patients, than in South African patients, but the frequency of smoking was significantly greater in South Africa than the other two centres (p<0.01). Age, male sex and smoking were significant independent predictors of CAD in all three countries (p<0.05). Conclusions: Patients with FH in three specialist centres in the southern hemisphere exhibit a high prevalence of non-cholesterol cardiovascular risk factors. Older age, male sex and smoking were more common among subjects with CAD. In all three countries, there should be vigorous pro- grammes for the control of risk factors beyond good control of hypercholesterolaemia among patients with FH. Promotion of a healthy lifestyle, especially anti-smoking advice, is of paramount importance. C1-12.06 THE BUSINESS CASE FOR CASCADE SCREENING OF FAMILIAL HYPERCHOLESTEROLMIA IN THE NETHERLANDS: HIGHLY COST- EFFECTIVE AND MAJOR HEALTH BENEFITS Janneke Wittekoek , Manon Houter, Sabine Frieser. LEEFH Foundation, Amsterdam, Netherlands Background & Rationale: Patients suffering from familial hypercholester- olemia have an increased risk for cardiovascular disease. In the Netherlands The LEEFH Foundation delivers a nationwide approach to track down patients who carry this genetic disorder to prevent early death. Approximately 42% of all FH patients in the Netherlands are registered. All these 30.000 patients with FH and their families (of: The 5.000 pedigrees) are registered in a central DNA-database. A total of 14 centers within general hospitals function as IPU’s, following the LEEFH standards: multidisciplinary expertise, a uniform way of working, responsible for treatment and cascade family screening. Initiation of early medical treat- ment and nudging healthy life style, results in decreased cardiovascular risk up to normal level. Working with the nationwide database in a uni- form way is secured for the whole country. Methods: Calculations are based on current literature and Fh dbase of the Netherlands Results: Our business case shows that active cascade screening will potentially save V300 mio until 2040, while gaining 200k healthy life years. These numbers are based on active cascade screening where approximately 2000 family members of all index patients are found on a yearly basis. In the year 2029 70% of all FH patients should be registered. Our results show that active screening of family members eventually leads toward significantly lower health costs. Cost effectiveness can partly be explained by differences in employability when preventing heart disease. When put into perspective with other preventive screening programs in the Netherlands such as breast cancer screening and colon cancer screening, cascade screening of FH is extremely cost-effective (based on ICER; defined as total costs of screening divides by quality added life years (QALY’S). Conclusions: Our results show that active screening of family members eventually leads toward significantly lower health costs. Cost effectiveness can partly be explained by differences in employability when preventing heart disease. When put into perspective with other preventive screening programs in the Netherlands such as breast cancer screening and colon cancer screening, cascade screening of FH is extremely cost-effective (based on ICER; defined as total costs of screening divides by quality added life years (QALY’S). C1-13.04 SPECTRAL X-RAY IMAGING OF ATHEROSCLEROTIC PLAQUE BY MARS- SCANNING Steven P. Gieseg 1, 3 , Hannah Prebble 1 , Emily Searle 1 , Anthony Butler 1, 2, 3 . 1 University of Canterbury, Christchurch, New Zealand; 2 CERN, Geneva, Switzerland; 3 Department of Radiology, Christchurch Hospital, Christchurch, New Zealand Objective: Current non-invasive imaging modalities lack either the reso- lution or tissue differentiation to detect sub-clinical atherosclerotic pla- ques. This severely hinders clinicians’ ability to make treatment decisions based on the actual tissue pathology within the arteries. Drug develop- ment is also hindered as it is not possible to clearly identify true controls, as the level of subclinical atherosclerosis cannot be easily measured. Using the Medipix-3RX X-ray detection chip developed at CERN we have con- structed spectral X-ray cameras which can measure the energy of indi- vidual x-ray photons. The cameras form the central core of our MARS (Medipix All Resolution System) small-bore CT X-ray scanning machines. This study examined whether the MARS scanner could simultaneously identify water, lipid, calcium rich regions and contrast agents within excised human plaques at spatial resolutions higher than current medical imaging machines. Abstracts / Atherosclerosis Supplements 32 (2018) 1e162 6