Introduction Congenital long QT syndrome (LQTS) and catecholaminergic ventricular tachycardia (CPVT) are less prevalent cardiac ion channelopathies than Brugada syndrome in Asia. The present study compared paediatric/young and adult patients with these conditions. Method This was a territory-wide retrospective cohort study of consecutive patients diagnosed with congenital LQTS and CPVT attending public hospitals in Hong Kong. The primary outcome was spontaneous ventricular tachycardia/ventricular fibrillation (VT/VF). Results A total of 142 congenital LQTS (mean onset age= 27±23 years old) and 16 CPVT (mean presentation age=11±4 years old) patients were included. For congenital LQTS, arrhythmias other than VT/VF (HR=4.67, 95% confidence interval = [1.53–14.3], p=0.007), initial VT/VF (HR=3.25 [1.29–8.16], p=0.012) and Schwartz score (HR=1.90 [1.11–3.26], p=0.020) were predictive of the primary outcome for the overall cohort, whilst arrhythmias other than VT/VF (HR=5.41 [1.36–21.4], p=0.016) and Schwartz score (HR=4.67 [1.48–14.7], p=0.009) were predictive for the adult subgroup (>25 years old; n=58). All CPVT patients presented before the age of 25 but no significant predictors of VT/VF were identified. A random survival forest model identified initial VT/VF, Schwartz score, initial QTc interval, family history of LQTS, initially asymptomatic, and arrhythmias other than VT/VF as the most important variables for risk prediction in LQTS, and initial VT/VF/sudden cardiac death, palpitations, QTc, initially symptomatic and heart rate in CPVT. Conclusion Clinical and ECG presentation vary between the pediatric/young and adult congenital LQTS population. All CPVT patients presented before the age of 25. Machine learning models achieved more accurate VT/VF prediction. Funding Acknowledgement Type of funding sources: None. Kaplan-Meier survival curve for LQTSKaplan-Meier survival curve for CPVT

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Background The effects of sodium-glucose cotransporter 2 inhibitors (SGLT2I) versus dipeptidyl peptidase-4 inhibitors (DPP4I) on the risk of new gout diagnosis have not been explored. This study aims to compare the effects of SGLT2I against DPP4I on gout risks in a Chinese population. Methods This was a retrospective population-based cohort study of patients with type-2 diabetes mellitus treated with SGLT2I or DPP4I between January 1st, 2015 and December 31st, 2020 in Hong Kong. The study outcomes are new-onset gout and all-cause mortality. Propensity score matching (1:1 ratio) between SGLT2I and DPP4I was performed. Univariable and multivariable Cox regression analysis models were conducted. Competing risks models and multiple approaches based on the propensity score were applied. Patients This study included 60996 patients (median age: 62.3 years old, 54.96% males; SGLTI group: n=21690; DPP4I group: n=39306). Results In the matched cohort, 1096 developed gout (IR: 2.52%) and 2195 died (IR: 5.05%). Univariable Cox regression showed that SGLT2I use was associated with lower risks of new diagnosis of gout (hazard ratio [HR]: 0.34; 95% confidence interval [CI]: 0.30–0.39; P-value<0.0001) and all-cause mortality (HR: 0.35; 95% CI: 0.32–0.39; P-value<0.0001) compared to DPP4I. The associated remained for both new diagnosis of gout (HR: 0.46; 95% CI: 0.37–0.57; P-value<0.0001) and all-cause mortality (HR: 0.38; 95% CI: 0.33–0.44; P-value<0.0001) after adjusting for significant demographics, past comorbidities, and non-SGLT2I/DPP4I medications. The risks of gout were lowered in each types of SGLT2I. The results were consistent on competing risk and other propensity score approaches analyses. Conclusions SGLT2I use was associated with lower risks of new gout diagnosis compared to DPP4I use. Funding Acknowledgement Type of funding sources: None.

Funding Acknowledgements Type of funding sources: None. Background Hyperlipidaemia is associated with adverse cardiovascular outcomes. However, the long-term prognostic value of visit-to-visit cholesterol variability is less certain, particularly regarding the risks of new-onset heart failure (HF). We investigated the associations between visit-to-visit cholesterol variability and adverse cardiovascular events. Methods This was a retrospective cohort study of patients attending family medicine clinics in a Chinese city during 2000-2003 with follow-up until 2019. Patients with at least three sets of blood cholesterol (low-density (LDL-C) and high-density (HDL-C) lipoprotein cholesterol, and total cholesterol) levels available at different visits were included. Patients with prior HF, myocardial infarction (MI), use of HF medications, and pregnancy were excluded. Visit-to-visit variability was calculated using standard deviation and coefficient of variation (CV). The primary outcome was new-onset HF. The secondary outcomes were cardiovascular mortality, and myocardial infarction. Multivariable Cox regression with adjustments for significant baseline predictors of outcomes were used to evaluate the association between cholesterol variability and the outcomes. Results A total of 5662 patients were included (2152 males; mean age 63.3 ± 12.4 years). The mean follow-up period was 15.3 ± 4.6 years. Lower mean HDL-C and total cholesterol predicted new-onset HF and MI, while higher mean LDL-C and total cholesterol and lower HDL-C predicted cardiovascular mortality (Table 1). Cholesterol variability was a significant predictor of the outcomes (Table 1). Higher variability of HDL-C (hazard ratio (HR) for CV: 14.202 [6.524, 30.916], p < 0.0001; Figure 1A) and total cholesterol (HR for CV: 10.340 [4.582, 23.336], p < 0.0001; Figure 1B) predicted new-onset HF. These also predicted MI (HR for CV: 40.738 [14.412, 115.150], p < 0.0001, and 34.285 [11.450, 102.660], p < 0.0001, respectively), as did higher variability of LDL-C (HR for CV: 3.798 [1.903, 7.578], p = 0.0002). Lower variability of LDL-C (HR for CV: 0.234 [0.104, 0.526], p < 0.0001) predicted cardiovascular mortality. This was probably driven by the association between cardiovascular mortality and higher mean LDL-C. Variability of HDL-C and total cholesterol did not predict cardiovascular mortality Conclusion Higher visit-to-visit cholesterol variability was associated with significantly increased long-term risks of new-onset HF and adverse cardiovascular events. Variability of different types of cholesterol had varying prognostic values, with HDL-C showing particular importance for new-onset HF. Visit-to-visit cholesterol variability may be a clinically relevant and important tool for HF and general cardiovascular risk stratification. Abstract Figure 1  Abstract Table 1

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