Funding Acknowledgements Type of funding sources: None. Introduction Women are less likely than men to receive guideline-recommended therapies. There is thus little real world information on possible sex-related differences regarding results of lipid lowering therapies when guidelines are correctly applied. Understanding possible sex-related differences in lipid profile’s response to treatment after an acute coronary syndrome (ACS) might provide important information in order to improve clinical outcomes. Objetives: To assess, in a real world cohort, if there are any sex-related differences regarding results of lipid-lowering therapies, implemented through telematic consultation, after an ACS. Methods A prospective cohort study that consecutively recruited all patients admitted to our centre for an ACS from January 1, 2020 to December 31, 2020, was performed. All patients were discharged with high-intensity statins and other currently recommended cardiovascular drugs. Lipid profile was evaluated 1-month after discharge. Patients were then contacted by phone and their lipid-lowering therapy adjusted according to blood test’s results. This procedure was repeated every month until LDL-c target (≤ 55 mg/dl) was achieved in accordance with current European clinical practice guidelines. Descriptive statistics of patient characteristics at baseline and end of follow up were calculated for the overall population and then compared between men and women. We determined statistical differences between women and men using chi-squared and Student's t. Results 346 patients were included, of which 32% were women. Patient characteristics are summarized in Table 1. Women were significantly older than men (72 ± 12 vs 65 ± 12 years, p<0.001) and had more past history of hypertension and dyslipidemia. There were no differences in clinical presentation at admission (predominantly non-ST elevation myocardial infarction). Mean follow-up was 17.3 months. Even though there were no statistically significant differences in treatment prescription at discharge or after follow up, women reached the goal of LDL ≤55 mg/dl in a lower proportion to men (75.5% vs 84.3%, p 0.031) and required more time (3.69 ±2.24 vs 2.92 ± 1.95 months, p < 0.001). During follow up, total mortality was similar between groups, however women presented a higher cardiovascular mortality (4.5% vs 0.4%, p 0.014). Conclusion Our findings suggest that, applying the same guideline-recommended therapies in both women and men, there might be sex-related differences regarding lipid-lowering therapies’. Results Women reach the goal of LDL ≤55 mg/dl in a lower proportion to men and require more time. These results suggest that women might therefore need more aggressive treatment at discharge. Clinical significance of these findings is yet to be determined as our cohort is limited.

Funding Acknowledgements Type of funding sources: None. Background Prosthetic valve thrombosis (DVT) is a  very serious complication, with high morbidity and mortality, a high risk of stroke during hospital admission, and which occurs especially in patients with poorly anticoagulated mechanical prostheses. Therapeutic options available for DVT are surgery, with or without prosthetic replacement, and intravenous thrombolysis. However, there is no randomized study comparing these two interventions. Therefore optional treatment is controversial. This is also reflected in the current clinical practice guidelines of international scientific societies of the year 2017, where the American College of Cardiology / American Heart Association considers surgery and thrombolysis as comparable treatments (Class I), and On the other hand, the European Society of Cardiology (ESC) opts for surgery, leaving thrombolysis only for when surgery is not available, has a very high risk or for cases of right valve thrombosis. Purpose In our center we have used a thrombolysis regimen with low doses of t-PA and in slow infusion with adequates results, proposed by Özkan et al. with 25 mg of t-PA administered over 25 hours, repeating this dose up to DVT resolution or a maximum of 8 times. Methods We reviewed eleven patients, all with mechanical valve prostheses, six treated with surgery and five with systemic thrombolysis. Of the latter, two cases were treated with a high-dose and accelerated t-PA regimen (10 mg bolus and 90 mg in 2 hours) and the other three cases with low and ultra-slow doses (25 mg in 25 hours). We consider the normalization of the mean transvalvular gradients and the resolution of regurgitation in cases of prosthetic insufficiency a successful result. The mean age was 62.6 years and the mean time from surgery to DVT of 84.9 months. Most of the patients belonged to class III and IV of the NYHA. Anticoagulation was subtherapeutic in 80% of cases. The thrombolysis success rate was 100%.  Of the three cases of ultra-slow pattern, only one of them required a second dose. No side effects or complications were observed. In the surgery group, two patients died during hospital admission as a result of shock and a state of low postoperative cardiac output. In the thrombolysis group, there was only one deceased at 8 months, although not related to DVT related to metastatic melanoma. Results We observed a full success rate in the resolution of DVT, with no complications in cases of thrombolysis compared to surgery. Bolus ultra-slow infusion of t-PA is equally effective in resolving DVT, although logically with less bleeding risk due to the dose used and the time of administration, without embolic events having been observed due to slower lysis of the thrombus or new thrombosis during a year of follow-up. Conclusion According to our results treatment with low-dose and ultra-slow t-PA regimen will be the initial therapeutic option in clinical practice guidelines given the safety, low cost, and efficacy. Abstract Figure. valvular thrombosis. Evolution.