Funding Acknowledgements Type of funding sources: None. INTRODUCTION After publication of the 2019 ESC Guidelines for dyslipidemia, the LDL cholesterol target in patients with very high cardiovascular risk was reduced from 70 mg/dl to 55 mg/dl. Currently, there is more and more evidence that getting these levels is very important in prognosis, to avoid new cardiovascular events. The paradigm of this situation could be represented by young patients after STEMI, in which secondary prevention is essential to achieve a long-life expectancy. OBJECTIVE The aim of the present study is to analyze the impact the new guidelines have had on the control of LDL cholesterol in a population of young patients after STEMI, one year after their publication. METHODS A total of 101 consecutive young patients (aged ≤ 40 years) presenting with STEMI admitted at our center between 2006 and 2017 were included. There were no exclusion criteria. We collect demographic, clinical and treatment information, and laboratory values in september/2019 and again one year later.  RESULTS Out of 101 patients, 89 were male (88.1%). Mean age was 35.87 ± 4.07 years. Among the classic cardiovascular risk factors, dyslipidemia (44.5%) was the second one most prevalent in our cohort, after smoking (93.1%). In September/2019, only 66.3% of our patients had a recent LDL-cholesterol control, and only 20.9% of them had a target LDL-cholesterol lower than 55 mg/dl ("LDL-c -goal"). During the following year, a new determination of LDL cholesterol was only carried out in 18 patients out of the total sample, with these results: 15 patients had an LDL> 55 mg/dl; 2 patients maintained an "LDL-c-goal", and only a single patient achieved optimal control (from 81 mg/dl to 39 mg/dl) coinciding with the change from low to high intensity statin. Regarding lipid-lowering treatment, in September/2019 the 87.7% of our population were taking statins, 21.9% ezetimibe, and 0.0% PCSK9-inhibitors. In that moment, in 6 patients, the lipid-lowering treatment was reduced (all of them had LDL values were between 65-105 mg/dl). One year later, in September/2020, 82.2% were taking statins, 21.9% ezetimibe, and in 1 patient was started with the PCSK-9 inhibitor. Thirteen patients (12.9%) had suffered a reinfarction during follow-up, but none in the last year. CONCLUSIONS Despite of the new LDL-cholesterol target established by the ESC Guidelines, we have not improved our lipid control in a population with high cardiovascular risk -with a percentage of cardiovascular events during mean follow-up that is not negligible-, being only 1 of each 5 patients correctly treated. We must carry out a closer clinical and analytical follow-up, by increasing our efforts in secondary prevention, and perhaps the Cardiac Rehabilitation Units can play an essential role in this objective. It is possible that the Covid-19 pandemic could have influenced these results. Abstract Figure. Lipid-lowering treatment.

Funding Acknowledgements Type of funding sources: None. INTRODUCTION CRH in patients with ischemic heart disease is recommended by the different clinical practice guidelines with an IA level of evidence, with an important role in reducing cardiovascular mortality and hospital readmissions during follow-up. OBJECTIVE The goal of this study is to show the 4-year clinical results of a population of patients who participated in an CRH program after an Acute Coronary Syndrome (ACS). METHODS Between May/2014 and September/2017, 221 patients who had recently presented an ACS completed the 12 weeks of phase II of the CRH program at our center. In May/2020 we collected epidemiological, clinical and echocardiographic information at the time of the acute cardiovascular event; and we evaluate the current vital status of the patients and the incidence of readmissions for: angina, HF, new ACS, or arrhythmic events. RESULTS Of the 221 patients, 182 were men (82%). The mean age of our population was 58.3 ± 7.8 years. 58% (129 patients) suffered from ST-elevation ACS. The mean time of hospital stay was 6.20 ± 2.9 days. An echocardiogram was performed at discharge, which showed an average LVEF of 56 ± 6%. Eight patients (4%) developed early Ventricular Fibrilation (VF) during the acute phase of ACS. Among the classic CVRF, smoking (79%) was the most prevalent, followed by dyslipidemia (53%) and hypertension (47%). The mean time from hospital discharge to the start of phase II RHC was 42 ± 16 days. The overall incidence of events was 9%: 10 patients suffered reinfarction during follow-up, and 7 were readmitted for unstable angina, all of whom underwent PCI; no patient was admitted for HF; and none of the 8 patients with early VF had a new tachyarrhythmia, registering a single admission for VT during follow-up. None of the patients had sustained ventricular tachyarrhythmias during exercise-training. At the mean 4.5-year follow-up, 218 patients were still alive (98%). CONCLUSION The incidence of CV events in the follow-up of our cohort was low, which can be explained by the fact that it is a young population, with an LVEF at low limits of normality at discharge, which is one of the most important predictors in the prognosis after an ischemic event. As an improvement, we must shorten the time until the start of phase II of the program. CRH shows once again its clinical benefit after an ACS, in consonance with the existing evidence. Abstract Figure. Outcomes of a CRH program.

Funding Acknowledgements Type of funding sources: None. Introduction The transcatheter aortic valve implantation (TAVI) it´s an alternative to surgery in patients with low, moderate and high risk. The indexed systolic volume (ISV) is a parameter that has been associated with adverse events in this scenario. However, there are conflicting reports. The aim of this study was to evaluate the impact of the ISV in patients with severe aortic stenosis in which TAVI was performed. Methods Observational, retrospective and single institution study of patients in which a TAVI was performed between 2010 and 2020. The baseline characteristics of the patients were recorded and then the data were analyzed in two cohorts depending on the presence or not of an increase 3.5 ml/m2 of the ISV after TAVI in relation to the baseline (cohort A and cohort B). The cut-off point of 3.5 ml/m2 was chosen due to the fact that it was the median of the difference in the ISV before and after the TAVI. Results A total of 131 patients were included with a mean age of 84 years old (81-86). 74 patients (56.5%) presented an increase 3.5 ml/m2 of the ISV after TAVI, while there was an increment less than 3.5 ml/m2 in 57 patients (43.5%). The cohort A patients were older and had less prevalence of high blood pressure (Picture 1). Differences in survival weren´t found between the two cohorts, neither in the patients that before the TAVI had an ISV <3.5ml/m2 in relation to those with an ISV 3.5 ml/m2. Conclusions In our population, an increase of the ISV after TAVI wasn´t associated with less adverse events in the follow up. The survival was similar between the patients that before the TAVI had an ISV <3.5ml/m2 and those with an incremented ISV. Prospective studies with bigger cohorts are needed in order to prove these results. Abstract Figure. Baseline Characteristics and Events  Abstract Figure. Kaplan Meier Graphics