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Funding Acknowledgements Type of funding sources: None. Introduction and objectives   Cardiac rehabilitation programmes (CRP) are a fundamental pillar in the education, optimization of treatment and assessment of the functional class in cardiovascular pathology. The aim of this study is to analyse the levels of LDL cholesterol at discharge and after 6 months of follow-up after the CRP carried out in our centre. Material and methods   Analysis of a prospective cohort of 268 patients, included in the CRP between November 2015 and October 2018 after an acute coronary event and with a minimum follow-up of 6 months. The CRP consists of a medical and nursing consultation both for inclusion and prior to discharge. It lasts 1 month and includes 3 weekly sessions of individualised and monitored exercise which are carried out together with talks on cardiovascular risk factors, diet, treatments... In the pre-discharge consultation, an analysis is carried out to adjust the treatment, and a new control is performed after 6 months.  Results   Average age 56.2 years (SD: 8.9), 90% men, 46% hypertense, 24% diabetics, 68% dyslipemics, 70% smokers/ex-smokers and 57% sedentary. 60% of the patients had presented a STEMI, with 80% being revascularized percutaneously. 48% had 1-vessel disease. LVEF was conserved in 74% of the patients.  The mean LDL cholesterol after the event is 105.3 mg/dl (SD: 37.7) and at the discharge of the program, 61 mg/dl (SD: 21.3) being the difference statistically significant (p < 0.005). The mean LDL at 6 months was 62 mg/dl (SD: 19.9) with no statistically significant difference with respect to the previous one (p = 0.53) (table 1). At the beginning of the CRP 91% of the patients presented an LDL >55 mg/dl, after the same 55 % and at 6 months 57% (graph 1). After 6 months, 4% maintained levels >100 mg/dl. 98% of patients were receiving high-potency statins and 12% ezetimibe. At discharge, treatment with ezetimibe was started in 28 patients (13%). No treatment with iPCSK9 was initiated. This study was carried out while the 2016 European guidelines were still in effect, with an LDL target in secondary prevention of less than 70 mg/dl. Conclusions   CRPs are effective in improving control of LDL cholesterol, due to a closer monitoring and a better health education that allows greater therapeutic adherence.  However, after the programme it is necessary to continue with regular monitoring to maintain and, in some cases, reach the target figures. In our case there is a small percentage of patients who could still benefit from starting treatment with iPSCK9. Abstract Figure. Graph 1

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Funding Acknowledgements Type of funding sources: None. Introduction Erectile dysfunction (ED) is a frequent comorbidity in patients with chronic coronary syndrome; it is related to both cardiovascular risk factors (CVRF), the treatments administered and the vascular disease itself. We analyse the predictors of ED in the cardiac rehabilitation unit of a third level hospital. Material and methods Observational and prospective cohort of male patients participating in the cardiac rehabilitation programme (CRP) between 2015 and 2019. This CRP lasts 1 month, with 3 weekly sessions of monitored and supervised exercise, in addition to talks related on the cardiovascular area, diet, etc. One of these sessions is on ED, in which the patient is asked about the entity, possible interactions with drugs, etc. In addition, the degree of ED is evaluated anonymously using the IIEF5 scale, in which 5 questions are used to evaluate different conditions of the disease by scoring from 1 to 5, with values of less than 21 being considered as ED. For the statistical analysis we carried out a multiple regression model adjusted by the clinical variables collected at the beginning of the programme. Results Out of a total of 343 patients 90% were male and 265 completed the questionnaire. 63% presented ED. The mean age is 56 ± 9 years. The distribution of CVRF: 43% hypertense, 23% diabetics, 72% dyslipemia, 22% ex and 48% smokers. As for the diagnoses prior to the start of CRP, 59% suffered from STEMI, 22% from NSTEMI, 9% from unstable angina and 9% were post-operative from cardiac surgery. In the global multiple regression model the factors predisposing to ED and presenting statistically significant coefficients were age (-0.2 CI: -0.27- -0.12, p < 0.001), hypertension (-1.6; CI -2.9- -0.3, p = 0.014) and diabetes (-2.0 CI: -3.1- -0.6, p = 0.007). We performed a predictive model for the different age ranges according to the presence/absence of hypertension and diabetes (Figure 1). Conclusions ED is a prevalent entity in our series, with age-adjusted multivariate analysis predicting its development and hypertension and diabetes as potentially modifiable factors related to it. Abstract Figure. Graph 1: Predictive regression model

Introduction The leading cause of valvular heart replacement therapy is symptomatic aortic stenosis (AS). The Mitroflow (MF) bovine pericardial prosthesis is prone to early structural valve deterioration (SVD) and has been used in over 100,000 patients for the treatment of symptomatic AS. The standard of care for degenerated bioprosthesis is surgical aortic valve replacement. However, valve-in-valve transcatheter aortic valve replacement (VIV-TAVI) is an interesting therapeutic modality currently being evaluated to avoid redo surgery. Purpose The purpose of this study was to evaluate the clinical outcomes of patients with SVD MF bioprosthesis treated with VIV-TAVI. Methods Data was collected from all the patients undergoing TAVI in a single center from March 2012 to July 2019. All the cases remitted for VIV-TAVI were prospectively included and followed. All events were classified according to the VARC-2 definitions. The primary endpoints were a combination of clinical events at the end of the follow-up which included all-cause mortality, cardiovascular mortality, hospitalizations due to heart failure and stroke/transient ischemic attack. Secondary endpoints were absence of SVD and valve hemodynamics at the end of the follow-up. Results Between march 2012 and July 2019, 65 patients were derived for VIV-TAVI. The mean age was 80,4±5.93 years. 50,8% were male. The average STS score was 6.39±5,62 and Euroscore II 8.86±5.17. All the patients were diagnosed with SVD with a mixed mechanism (stenosis/regurgitation) being the most frequent form of disfunction (38,5%) followed by regurgitation (33,9%) and stenosis (27,7%). Procedural success was achieved in 98,5% of the cases, there were 2 deaths of cardiovascular origin, 1 stroke, and 2 hospitalizations due to heart failure. The mean gradient, peak gradient and valve area at discharge were 13,3mmHg, 27,2mmHg and 1,14cm2, respectively. After 28,8 months (17,4–60,9) of follow-up the combined endpoint occurred in 21 patients (32,3%). There was a total of 13 deaths (20%) and only 4 (7.3%) from cardiovascular causes. 2 patients were reported of having a stroke/TIA and there were 5 readmissions from heart failure (2 of them within the first 30 days). The mean gradient, peak gradient and valve area remained steady when comparing post-TAVI vs follow-up, 20.3mmHg vs 18.8mmHg (p=0.2), 39.6mmHg vs 35.2mmHg (p=0.01) and 1.3cm2 vs 1.3cm2 (p=0.7), respectively. The same tendency was observed in aortic regurgitation. There were no significant changes in the LVEF over time. There were only 2 patients (3.1%) presenting with valve deterioration during follow-up. Conclusions VIV-TAVI for SVD MF bioprosthesis is a safe procedure and a valid alternative to surgery in this group patients, with a high rate of success and low intraprocedural complications. At 28 months of follow-up, 68% of patients were free of late clinical events and valve hemodynamics maintain over time. Figure 1 Funding Acknowledgement Type of funding source: None