Introduction Mayor bleeding is the most important complication of antithrombotic treatment in acute coronary syndrome (ACS) and is even associated with higher mortality. The CRUSADE scrore has been developed to predict mayor bleeding in ACS and is one of the most used. however, it has a moderate predictive capacity and is relatively complex to calculate at the patient's bedside. On the other hand, different bleeding risk scores have been developed for atrial fibrillation witch have also been evaluated for ACS, for example HAS-BLED. Recently, the NICE guidelines suggest using the Orbit Bleeding score (ORBIT) to assess the risk of bleeding in atrial fibrillation due to its greater predictive capacity. Its usefulness in the context of ACS has been little studied. Purpose The aim of the study is to evaluate the usefulness of the ORBIT to predict major bleeding in patients with ACS compared to the CRUSADE Methods A obserbational retrsopective study was performed. Patients with diagnostico ACS in two coronary units of Argentina were included. All of them, received antocoagulation as a antithrombitic treatment. The CRUSADE and ORBIT scores were calculated with the clinical data on admission. The primary point of major bleeding, defined as a BARC classification 3 or 5, was analyzed. Multivariate analysis was performed by logistic regression. To establish the discrimination capacity of the scores, the area under the ROC curve (AUC) was evaluated and the comparison between the curves was carried out using the chi-square area homogeneity test. Results A total of 880 patients were included (68% with non-ST elevation ACS and 32% with ST elevation), the mean of age was 68±11 years and 35% were women. As antithrombotic treatment, 100% received aspirin, 96.3% received P2Y12 receptor inhibitors, 100% received anticoagulation with enoxaparin, and 9.5% received fibrinolytics. The primary end point of major bleeding occurred in 3.4% (n=30). In univariate analysis both CRUSADE and ORBIT were predictors of mayor bleeding, but in multivariate analysis only ORBIT was independent predictor of mayor bleeding. (ORBIT OR: 2.46 (95% CI 1,61 to 3,97), P<0.001. The table shows the univariate and multivariate analysis. The AUC of CRUSADE was 0.68 (95% CI 0.57–0.80) and the ORBIT was 0.80 (95% CI 0.72–0.90). The ORBIT score presented a higher AUC than the CRUSADE (p=0.03). See Figure 1. Conclusion The Orbit score was an independent predictor of major bleeding in patients with ACS, presenting a better predictive capacity than the CRUSADE. Funding Acknowledgement Type of funding sources: None.

e16059 Background: Several biomarkers were tested in mRCC but only outcome scores showed prognostic significance. Neutrophil-to-lymphocyte ratio (NLR) has shown prognostic significance for OS in a number of cancer types but value and cutoff in mRCC is unknown. Methods: The aim of this study was to evaluate NLR as prognostic factor and find a cutoff in mRCC pts. The medical records of 103 pts with mRCC were reviewed. Analysis included adjusting for baseline disease and patient characteristics and investigating potential interaction effects between NLR status and significant BL predictors of outcome. Overal Survivall (OS) was estimated by the Kaplan-Meier method.Univariate and multivariate analysis was performed by Cox regression. Results: Total pts reviewed were 103, MSKCC risk groups (37% Good, 47% Intermediate,16% Poor).Median follow up were 50 months and median OS 29 months. Nephrectomy was performed in 81% of cases.Ninety six percent received treatment (tki – mTor inhibitors). The optimal cutoff was 4, pts with NLR ≤4 vs ≥4 have higher OS 32m vs 10m HR 3,38 (IC95%: 2,60- 4,50 p:0,0001) univariate and HR: 4,32 (IC 95%: 3,35-5,4 p:0,003) in the multivariate analysis. Conclusions: Our series show MSKCC score and RLN were prognostic factors in univariable and multivariable analisys. NRL ≥ 4 identify a group of patients with poor overall survival. The NLR provides independent prognostic information for patients with mRCC and could be useful in academic and community setting. [Table: see text]

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Background Chagas disease (ChD) has a long asymptomatic period, where there is no evidence of myocardial damage. However, incipient alterations in ventricular systo-diastolic function have been described using echocardiography with Tissue Doppler and Strain. On the other hand, the presence of elevated higth-sensitivity T troponin (HS-TnT) and N-terminal pro B-type natriuretic peptide (NT-pro BNP) has been documented in the early stages of the ChD. The association between the elevation of both markers and incipient alterations in ventricular function in patients with ChD without evidence of heart damage has been poorly studied. Purpose The aim of this study is to evaluate the prevalence of elevation of both biomarkers (HS-TnT and NT-proBNP) and their association with insipients alterations in systo-diastolic function in patients with ChD without evidence of structural heart affection. Materials and methods Outpatients with stage 0 of ChD (positive serology, with normal electrocardiogram, holter and chest teleradiography) were included prospectively. They were divided in three groups according to the dosage of HS-TnT and NT-proBNP. Group 1: patients with both markers within normal values; group 2: patients with elevation of one of the markers (HS-TnT>13 ng/L OR NT-proBNP>125 pg/ml) and group 3: patients with elevation of both markers (HS-TnT>13 ng/L AND NT-proBNP>125 pg/ml). All of them underwent Doppler echocardiography with tissue Doppler. Results Two hundred and sixty-one patients were included, with 47±9 years old of age, 44% woman, 86.6% (n=226) in group 1, 9.6% (n=25) in group 2 and 3.8% (n=10) in group 3. Table 1 shows the main results. Conclusions Elevation of both markers was found in almost 4% of patients. This elevation was associated with a higher E/e' ratio, E/A ratio, Letf Atrial Area and a lower S'-wave lateral. Funding Acknowledgement Type of funding source: None

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