267 Trends in Hospitalization Due to Congestive Heart Failure in Austria, 1990e2004 Ilyas Kozanli 1 , Dilek Cilesiz 1 , Rudolf Jarai 1 , Gabriele Jakl 1 , Kurt Huber 1 ; 1 3rd Med. Dept., Cardiology and Emergency Medicine, Wilhelminenhospital, Vienna, Austria Background and Aim: Chronic Heart Failure (CHF) as a clinical syndrome repre- sents a major public health problem in industrialized countries due to increasing costs and limited resources. Recurrent unplanned hospitalizations (hosps) are common and lead to premature death. Increasing life expectancy due to the improvement in man- agement of coronary artery disease, acute myocardial infarction and arterial hyper- tension thereby have contributed to an increased number of patients (pts). Nearly 160.000 people in Austria have CHF and the incidence is increasing. Methods: Data acquired from the Austrian Department for Statistics between 1990 and 2004 from pts admitted to a hospital in Austria because of acutely decompensated Heart Failure (with the appropriate ICD-9 and 10 Code) frequency and in-hospital mortality were investigated. Patients below 55 years were excluded due to low number of hosps. A total of 383,405 hospital discharges were included. Results: In 1990, a total of 22,702 hosps with the principal diagnosis of Heart Failure (HF) with an in-hospital mortality of 20% were recorded. The highest number with 31,094 hosps was regis- tered in 1999. Finally in 2004, 25,207 pts were admitted, of whom 11% died resulting in an increase of 11% hospital admissions and a 38% reduction of the in-hospital mortality during this 15 years period. Trends in age-specific rates of hospitalization per 100,000 population are given in the Figure. Conclusions: Between 1990 an 2004 hospital admissions due to CHF remains still high in Austria with a peak between 1997 an 2001. The increase of hosps especially in the elderly population (aged 75e84 years) and the reduction of the in-hospital mortality reflects the improvement in acute cardiac care. These data support the necessity for better chronic care of HF pts. The extension of outpatient units and implementation of home-care projects will be mandatory, especially for elderly HF pts resulting in a better management of these high risk/high cost individuals. 268 The Depression Treatment Gap in Patients with Heart Failure Kenneth R. Yeager 1 , Radu Saveenu 1 , Philip F. Binkley 2 ; 1 Psychiatry, The Ohio State Universtiy, Columbus, OH; 2 Medicine/Cardiovascular Medicine/Davis Heart and Lung Institute, The Ohio State University, Columbus, OH Introduction: Depression affects an estimated 30% of patient with heart failure. However, there is little data regarding the number of patients with heart failure who are clinically recognized and treated for symptoms of depression. Hypothesis: The hypothesis of this investigation was that, despite the recognized prevalence of depression in patients with heart failure, a significant number of patients are not di- agnosed or treated for depression. Methods: Deidentified hospital discharge data for the Ross Heart Hospital of the The Ohio State University Medical Center from Jan- uary 1, 2000 through December 31, 2005 were reviewed for the prescription of an- tidepressant medications. Results: Of 12,986 patients discharged with a diagnosis of any form of heart disease, 1863 (14.3%) received one or more of eight (8) major antidepressants during their hospitalization. Of 8,329 patients discharged with a diag- nosis of coronary artery disease or acute myocardial infarction, 1042 (12.5%) re- ceived antidepressants during their hospitalization. Of the 2001 patients discharged with a diagnosis of congestive heart failure or cardiomyopathy, 437 (21.8%) received antidepressants during their hospitalization. Of these 2001 patients, 1773 (88.6%) had a diagnosis of heart failure and 392 (22.1%) received antidepressants during their hospitalization. Conclusion: Studies show that depression is a risk factor for medical morbidity and mortality in patients with coronary heart disease. Despite the recog- nized significant prevalence of depression in heart failure, only 22.1% of patients dis- charged from a tertiary care heart center with heart failure were prescribed pharmacologic therapy designated for the treatment of depression during their hospi- talization. This disparity may represent lack of screening for the diagnosis and treatment of depression in this patient population and may indicate the existence of a treatment gap for depression in patients with heart failure and other forms of heart disease. 269 Gender-Related Differences in Patients Admitted with Acute Decompensated Heart Failure Humberto Villacorta 1 , Alvaro Pontes 1 , Carlos Cleverson Pereira 1 , Plinio Resende 1 , Denilson Albuquerque 1 ; 1 Cardiology, Rede D’Or de Hospitais, Rio de Janeiro, Brazil Background: Gender-related differences in patients (pts) with acute decompensated heart failure (ADHF)) have not been well described. Objectives: To report gender- related differences regarding baseline characteristics and outcomes in pts admitted with ADHF. Methods: From June 2006 through January 2007 71 pts with ADHF from 3 hospitals were included. Mean age was 73 6 12.6 years and mean LVejection fraction was 43 6 14%. We assessed gender-related differences regarding baseline characteristics and outcomes. Results: There were 47 (66%) men. Mean age did not differ between the groups (73 6 13 vs 74.5 6 12, p 5 0.72). A history of heart failure was more frequent in men (78.7% vs 50%, p 5 0.01). Women had higher prevalence of heart failure with preserved systolic function (39% vs 10.8%, p 5 0.02) and higher B-type natriuretic peptide (BNP) values (median 791 [interquartil range 491-1112] vs 486 [277-654] pg/mL, p 5 0.001). Hospital length of stay was higher in men (median 10 [6-20] vs 5 [4-10] days, p 5 0.04). There was a trend for higher mortality rate in men (8.5% vs 0%, p 5 0.29). Conclusion: In pts admitted for ADHF the presence of preserved systolic function is higher in women. Although women present with higher BNP levels than men their outcomes seem to be better, suggesting either a better response to treatment or a gender-related baseline differ- ence regarding the values of BNP which is independent of HF severity. 270 The Impact of Co-Morbid Chronic Obstructive Pulmonary Disease on Mortality in a Racially Balanced Cohort with Congestive Heart Failure Michael J. Schaefer 1 , Anna Kezerashvili 1 , Jessica Delaney 1 , Gregory Janis 1 , Ricardo Bello 1 , Daniel Spevack 1 , Sanjay Doddamani 1 , Xuan Li 1 , Evelyn Du 1 , Robert J. Ostfeld 1 ; 1 Cardiology/Internal Medicine, Montefiore Medical Center at the Albert Einstein College of Medicine, Bronx, NY Introduction: The impact of co-morbid Chronic Obstructive Pulmonary Disease (COPD) by race in subjects with Congestive Heart Failure (CHF) is not well under- stood. We investigated the impact of co-morbid COPD on all-cause mortality in sub- jects with CHF by race. Methods: A database, titled Clinical Looking Glass (CLG) was developed at the Albert Einstein College of Medicine. It includes multiple data points including ICD-9 codes, self-identified race and vital status. We queried the da- tabase for all patients aged 21-85 with the primary or secondary ICD-9 code for CHF (428.0) who were admitted from April 15, 1997 until June 1, 2005. For those subjects with multiple admissions, the first admission was the index date. The presence of COPD was defined by the ICD-9 codes (491.2, 491.20, 491.21, 491.9, 491.9). Re- sults: Sixteen thousand one hundred fifty nine subjects of known race were identified. Mean length of follow-up was 874 days. There were 5904 Caucasians (C), 5097 Af- rican Americans (AA), and 5158 Hispanics (H) with mean ages of 72.4 6 10.3 yrs, 63.8 6 13.8 yrs, and 64.5 6 12.8 yrs, respectively. The incidence of COPD for Cs was 5.1%, (n 5 303), AAs was 3.4%, (n 5 173), and Hs was 3.2%, (n 5 167). On univariate analysis by race with subjects with CHF but without COPD as the ref- erence group, the hazard ratio for mortality for co-morbid COPD for Cs was 1.45, (1.24, 1.68, p ! 0.001), AAs was 1.24, (1.03, 1.62, p 5 0.024), and Hs was 1.45, (1.15, 1.81, p 5 0.001). On multivariate analysis including age, sex, and multiple co-morbidities, the hazard ratio for mortality for co-morbid COPD for Cs was 1.43, (1.22, 1.66, p ! 0.001), AAs was 1.24 (0.99, 1.55, p 5 0.065), and Hs was 1.27, (1.01, 1.59, p 5 0.039). Conclusions: In our tertiary care population, co-morbid Chronic Obstructive Pulmonary Disease in subjects with Congestive Heart Failure was associated with increased all-cause mortality in Caucasians and Hispanics. It ap- pears that the hazard for mortality with co-morbid Chronic Obstructive Pulmonary Disease in Caucasians is larger than that in Hispanics or African Americans. Further study to explore these differences and to promote the utilization of evidence-based therapies in subjects with Chronic Obstructive Pulmonary Disease and Congestive Heart Failure is warranted. 271 HIV Patients with Acute Coronary Syndromes Have Higher Incidence of In- Hospital Heart Failure Than Non-HIV Patients Freddy Del-Carpio Munoz 1 , Carlos Cordero 1 , Vicente Corrales 1 , Alexandre Ferreira 1 , Eduardo De Marchena 1 ; 1 Internal Medicine, Division of Cardiology, University of Miami, Miami, FL Background: Recently there has been an increment in the incidence of Coronary Ar- tery Disease (CAD) and Acute Coronary Syndromes (ACS) in HIV patients. In the present study we aimed to evaluate the clinical characteristics and outcomes of HIV infected patients presenting with ACS. Methods: We studied all patients with HIV infection who were hospitalized with the diagnosis of ACS at our institution. S152 Journal of Cardiac Failure Vol. 13 No. 6 Suppl. 2007