Introduction
The development of depression in cardiovascular diseases worsens the prognosis for patients. In the present study, the impact of educational technology on depressive symptoms in patients with a prior myocardial infarction was tested.
Methods
A total of 146 patients were randomly allocated to main (n=77) or control groups (n=69). It was a 2-arm, open randomized, controlled trial with 12-month follow-up comparing educational intervention plus standard cardiac rehabilitation (CR) in primary care (intervention) with standard CR in primary care alone (control). The intervention was home visits to patients by medical students who had undergone specially designed training in CR. Standard care was medicines, laboratory tests, ECG, cardiologist consultations, 10-day rehabilitation course in a hospital once a year. None of the groups were treated with psychotherapy and/or antidepressants. The outcomes were cardiovascular events and mental health. This abstract presents the results of the intervention using the Hamilton Rating Scale for Depression (HDRS). The Wilcoxon test was used to evaluate the intervention and the standardized mean difference (SMD) was calculated.
Results
At the beginning of the study, depression was diagnosed in 14.48% of patients in the intervention group and in 13.05% in the control group (p=0.665). A year later, in the intervention group, depression decreased by an average of 1 point (p=0.02), while in the control group there was no significant decrease. The difference ("before and after") in the studied outcome in the intervention group (2.7 points) was statistically significantly higher compared to the difference in the control group (1.4 points), p=0.016; SMD 0.35 (95% CI -0.48 to 1.18).
Conclusion
Intervention group improved depression compared with standard care. Study strengths include a structured intervention, randomization, and use of longer-term follow-up. Limitations include no blinding of study participants, small sample. Nonetheless, results demonstrated that educational intervention had beneficial effects on mental health symptoms.

At the conclusion of my presentation attendees will take away
1. that an outpatient cardiac rehabilitation program can reduce the need for inpatient rehabilitation
2. that good training improves the quality of care
3. that cooperation with the patient improves mental health without antidepressants and psychotherapy if there are no resources for them

Authors: Nwosu Kamarachi¹, Ariba, Adekunle², Chukwukelu Blessing¹
¹The EKO Hospitals, Lagos, Nigeria; ²Olabisi Onabanjo University Teaching Hospital (OOUTH), Sagamu, Nigeria.
Corresponding author: Nwosu KO1 email; kamara018@yahoo.com

ABSTRACT
BACKGROUND
There is growing evidence that caregiver burden (CGB) is emerging as an important predisposing factor to cardiovascular disease (CVD). Improved life expectancy has resulted in a growing number of the elderly, even in developing countries like Nigeria – and there is an attendant burgeoning of caregivers (CG) who by cultural dictates are family members. These family caregivers are vulnerable to experiencing CGB. Early identification of their CVD risk profile that may be related to CGB is imperative in ameliorating the effect of cardiovascular disease.
OBJECTIVE
To assess CVD risk and CGB using validated tools and to determine the association between both variables.
METHODOLOGY
A cross-sectional descriptive study was conducted. Informal caregivers of elderly patients (ICEPs) who met the inclusion criteria for the study were recruited via a systematic sampling method. Data was collected using a structured pre-tested interviewer-administered questionnaire adapted from the World Health Organization STEPs questionnaire, Zarit Burden Interview, and 30-year Framingham CVD risk calculator. Chi square χ2 test was used to explore the relationship between the variables.
RESULTS: 409 respondents with a 0.73:1 male-to-female ratio, exhibited a high prevalence of CVD risk and CGB. Although this study showed no statistically significant association between CGB and CVD risk, two aspects of CGB (long duration of caregiving > 1 year and not residing with the care recipient) were shown to have a statistically significant relationship with an increased CVD risk.
CONCLUSION: The demonstrated high prevalence of CGB and CVD risk underscores the need for CGB and CVD risk screening among family caregivers in primary care.

At the end of my presentation, attendees will take away the following:
1. The high prevalence of caregiver burden among family caregivers of elderly patients which qualifies it as a valid concern that must be dealt with in primary care.
2. The impact of caregiving on the family caregivers resulting in taking on coping mechanisms that foster the development of cardiovascular disease.
3. A clear demonstration of the need to adopt primary, secondary, and tertiary levels of preventive measures against cardiovascular disease and caregiver burden among family caregivers of our elderly patients, especially in low-resource settings.

Background: Coronary heart disease is the leading cause of death in Australia. National guidelines have recommended regular cardiovascular disease (CVD) risk screening for adults aged 45 to 74 years without a history of CVD since 2009. Yet one in three Australians eligible for CVD risk assessment do not have up-to-date blood pressure and cholesterol measurements recorded in general practice software. No formal structured population screening programs are currently in place for CVD in Australia. The aim of this study was to test the feasibility of a general practice focused SMS recall system to invite eligible patients for a Heart Health Check.
Methods: Designed as a randomised control trial, approval by the RACGP National Research and Evaluation Ethics Committee, the pilot study recruited 231 eligible general practices, making it one of the largest targeted CVD screening trials of its kind in Australian general practice. Patients eligible for CVD risk assessment were identified using widely used clinical audit tools and a novel SMS recall feature embedded into the software. Eligible patients received a personalised SMS inviting them to see their general practitioner for a Heart Health Check and a link to supporting information and tools. De-identified baseline and 2-month data were extracted via clinical audit software. A survey was administered to 35 intervention general practices.
Results: Intervention practices showed a 14-fold increase in Heart Health Check delivery compared to control. More Heart Health Checks were associated with outer regional/remote regions, larger general practices and less disadvantaged areas. Process evaluation indicated good acceptance of the program by general practice staff.
Conclusion: This study showed that a SMS recall program for Heart Health Checks can be effective and acceptable in Australian general practices in both metropolitan and rural locations.

• Implementing systematic SMS recall systems improves the uptake of CVD risk screening in general practice
• SMS recall is acceptable and useful way to engage patients.
• Practice managers and practice nurses were very accepting of this targeting screening program and were pivotal in managing the intervention as champions.

Background/Aims:
Insulin resistance has become the most important public health issue, which is the burden of health care in numerous countries. Serum γ-glutamyltransferase (GGT) level elevates in liver disease or bile duct problems, and some research indicated GGT may represent the insulin resistance state. This study aimed to investigate the association between serum GGT and insulin resistance markers and to assess the role of GGT as a biomarker of insulin resistance in health workers of high cardiometabolic risk.

Methods:
This cross-sectional study included data collected from the medical records of Chinese adults undergoing annual health check-up examinations between 2020 and 2021 in Linkou Chang Gung Hospital. Study individuals were at high cardiometabolic risk. The following data included age, sex, body height, weight, waist circumference, blood pressure, fasting plasma glucose, triglycerides, low-density lipoprotein, high-density lipoprotein, insulin, and homeostasis model assessment-insulin resistance (HOMA-IR) index. We used Pearson’s correlation test to determine cardiometabolic risk factors and serum GGT levels. Furthermore, we conducted multiple linear regression analysis to measure the association between serum GGT and the HOMA-IR index.

Results:
We included a total of 96 health workers with high cardiometabolic risk in the analysis. Fasting plasma glucose, insulin levels, and HOMA-IR index were significantly different between high and normal serum GGT groups (p < 0.05). Pearson’s correlation analysis revealed a positive correlation between serum GGT and HOMA-IR index (r=0.3, p < 0.05). In multiple linear regression analysis with adjustment for confounding factors, serum GGT remained significantly associated with the HOMA-IR index (95% confidence interval 0.0001–0.02; p < 0.05).

Conclusion/Goals:
In our study, high serum GGT levels may lead to an increase HOMA-IR index among health workers of high cardiometabolic risk.

1. Insulin resistance is the most important public health issue.
2. Health workers with high cardiometabolic risk should be concerned.
3. Serum GGT may be an independent risk factor for insulin resistance.