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Background Limited data exist on whether outcomes of patients with heart failure (HF) undergoing percutaneous coronary intervention (PCI) have improved over time. The purpose of this study was to assess temporal trends in patient characteristics, treatment and outcomes of patients with HF undergoing PCI. Methods Using data from the Melbourne Interventional Group (MIG), we evaluated temporal trends of procedure volume, major adverse cardiac events (MACE; a composite of all-cause mortality, myocardial infarction and target vessel revascularisation) and rates of cardiovascular readmission, all-cause death and cardiovascular death in consecutive patients with HF undergoing PCI. Change over time was assessed by Box-Jenkins autoregressive integrated moving average (ARIMA) models. Results Data from 1,604 patients were analysed. In our cohort, there were no significant changes in the number of procedures performed annually and patient characteristics between January 2005 and December 2014. Optimal use of HF therapy has improved over the study period. Planned clopidogrel therapy of more than 12 months increased in tandem with increasing use of drug-eluting stents (DES). Procedural success was high (≥90%). However, the rates of MACE, cardiovascular readmission, all-cause death and cardiovascular death remained unchanged throughout the study period. Conclusions Clinical outcomes in HF patients undergoing PCI have remained unchanged despite improvement in medical technology and contemporary therapeutic measures.

Background The Hospital Admission Risk Program (HARP) Cardiac Coach Program at Royal Melbourne Hospital has evolved to include a Greek and Italian service, developed in response to the diverse local community and supported by evidence that Culturally and Linguistically Diverse (CALD) groups both perceive health and respond to health care services and information, differently. This paper aims to evaluate if a phone-based cardiac coaching program can be adapted to the Greek and Italian populations using the English cohort as a comparator. Methods We retrospectively analysed cardiovascular risk profiles at recruitment into and at discharge from the program. Patients (n = 383) were recruited after an acute coronary event or intervention between June 2011 and June 2013. Recruitment was into the English (n = 301 patients (79%)) Greek (40 (10%)) or Italian (42 (11%)) model. Data was collected on demographic information and risk factor status at entry and discharge from the program: waist circumference, weight, height, lipid profile, HbA1c, smoking status and physical activity. A comparison of the proportion of patients meeting the defined targets across the English, Italian and Greek cohorts was performed, with multivariate logistic regression analysis applied to adjust for differences in baseline variables. Results There were baseline differences in age, smoking history, total cholesterol and cholesterol fractions, diastolic blood pressure, weight and physical activity between the cohorts. At discharge, the proportion of patients meeting targets within each cohort were similar. Conclusion A phone-based integrated disease management program can be adapted to CALD patients, achieving comparable outcomes as compared with an English-speaking cohort. Health services need to respond to their local needs and be flexible in program delivery in order to benefit as many patients as possible.

Table 1. Change in shock reduction programming after delivery of the first report. Programming parameter US/Canada Australia/New Zealand % on target pre-report % on target post-report % difference % on target pre-report % on target post-report % difference VF NID (PP) 18.7 33.4 14.7* 33.3 36.4 3.0 VF NID (SP) 91.2 97.0 5.9* 100.0 100.0 0.0 LTI (PP) 40.7 47.6 6.9* 40.0 45.5 5.5 LTI (SP) 27.6 30.8 3.2 30.0 27.3 −2.7 Wavelet 65.0 87.0 22.0* 53.9 82.6 28.8 PR logic 95.7 95.5 −0.1 88.5 71.9 −16.6 SVT limit 66.0 81.2 15.3* 70.0 69.1 −0.9 LIA 81.4 96.0 14.6* 85.0 96.4 11.4

B. Pang1,2,∗, S. Joshi 1,2, E. Lui 2,3, M. Tacey4, J. Alison5,6, S. Seneviratne5,6, J. Cameron5,6, H. Mond1,2 1 The Department of Cardiology, Royal Melbourne Hospital, Parkville, Australia 2 The Department of Medicine, University of Melbourne, Australia 3 The Department of Radiology, Royal Melbourne Hospital, University of Melbourne, Australia 4 Melbourne EpiCentre, University of Melbourne, Australia 5 Monash Cardiovascular Research Centre, MonashHEART, Australia 6 Southern Clinical School, Monash University, Melbourne, Australia