Subjects -> MEDICAL SCIENCES (Total: 8447 journals)
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CARDIOVASCULAR DISEASES (330 journals)                  1 2 | Last

Showing 1 - 200 of 330 Journals sorted alphabetically
Acta Angiologica     Open Access   (Followers: 5)
Acta Cardiologica     Hybrid Journal   (Followers: 2)
Acute Cardiac Care     Hybrid Journal   (Followers: 7)
Adipositas - Ursachen, Folgeerkrankungen, Therapie     Hybrid Journal  
AJP Heart and Circulatory Physiology     Hybrid Journal   (Followers: 12)
Aktuelle Kardiologie     Hybrid Journal   (Followers: 1)
American Heart Journal     Hybrid Journal   (Followers: 59)
American Journal of Cardiology     Hybrid Journal   (Followers: 67)
American Journal of Cardiovascular Drugs     Hybrid Journal   (Followers: 17)
American Journal of Hypertension     Hybrid Journal   (Followers: 28)
Anales de Cirugia Vascular     Full-text available via subscription   (Followers: 1)
Anatolian Journal of Cardiology     Open Access   (Followers: 6)
Angiología     Full-text available via subscription  
Angiologia e Cirurgia Vascular     Open Access   (Followers: 1)
Angiology     Hybrid Journal   (Followers: 3)
Annales de Cardiologie et d'Angéiologie     Full-text available via subscription   (Followers: 1)
Annals of Noninvasive Electrocardiology     Hybrid Journal   (Followers: 1)
Annals of Pediatric Cardiology     Open Access   (Followers: 12)
AORTA     Open Access  
Archives of Cardiovascular Diseases     Full-text available via subscription   (Followers: 5)
Archives of Cardiovascular Diseases Supplements     Full-text available via subscription   (Followers: 3)
Archives of Cardiovascular Imaging     Open Access   (Followers: 2)
Archivos de cardiología de México     Open Access   (Followers: 1)
Argentine Journal of Cardiology (English edition)     Open Access   (Followers: 2)
Arquivos Brasileiros de Cardiologia     Open Access   (Followers: 2)
Arteriosclerosis, Thrombosis and Vascular Biology     Full-text available via subscription   (Followers: 32)
Artery Research     Hybrid Journal   (Followers: 4)
ARYA Atherosclerosis     Open Access  
ASAIO Journal     Hybrid Journal   (Followers: 3)
ASEAN Heart Journal     Open Access   (Followers: 2)
Asian Cardiovascular and Thoracic Annals     Hybrid Journal   (Followers: 2)
Aswan Heart Centre Science & Practice Services     Open Access   (Followers: 1)
Atherosclerosis : X     Open Access  
Bangladesh Heart Journal     Open Access   (Followers: 3)
Basic Research in Cardiology     Hybrid Journal   (Followers: 10)
BMC Cardiovascular Disorders     Open Access   (Followers: 22)
Brain Circulation     Open Access   (Followers: 1)
British Journal of Cardiology     Full-text available via subscription   (Followers: 17)
Canadian Journal of Cardiology     Hybrid Journal   (Followers: 18)
Cardiac Cath Lab Director     Full-text available via subscription  
Cardiac Electrophysiology Review     Hybrid Journal   (Followers: 2)
Cardiocore     Full-text available via subscription   (Followers: 1)
Cardiogenetics     Open Access   (Followers: 3)
Cardiology     Full-text available via subscription   (Followers: 20)
Cardiology and Angiology: An International Journal     Open Access   (Followers: 1)
Cardiology and Therapy     Open Access   (Followers: 12)
Cardiology Clinics     Full-text available via subscription   (Followers: 14)
Cardiology in Review     Hybrid Journal   (Followers: 8)
Cardiology in the Young     Hybrid Journal   (Followers: 34)
Cardiology Journal     Open Access   (Followers: 6)
Cardiology Plus     Open Access   (Followers: 1)
Cardiology Research     Open Access   (Followers: 15)
Cardiology Research and Practice     Open Access   (Followers: 10)
Cardiopulmonary Physical Therapy Journal     Hybrid Journal   (Followers: 7)
Cardiorenal Medicine     Full-text available via subscription   (Followers: 1)
Cardiothoracic Surgeon     Open Access   (Followers: 1)
CardioVasc     Full-text available via subscription   (Followers: 1)
Cardiovascular & Haematological Disorders - Drug Targets     Hybrid Journal   (Followers: 1)
Cardiovascular & Hematological Agents in Medicinal Chemistry     Hybrid Journal   (Followers: 2)
CardioVascular and Interventional Radiology     Hybrid Journal   (Followers: 15)
Cardiovascular and Thoracic Open     Open Access  
Cardiovascular Diabetology     Open Access   (Followers: 10)
Cardiovascular Drugs and Therapy     Hybrid Journal   (Followers: 14)
Cardiovascular Endocrinology & Metabolism     Hybrid Journal   (Followers: 1)
Cardiovascular Engineering     Hybrid Journal   (Followers: 1)
Cardiovascular Engineering and Technology     Hybrid Journal   (Followers: 1)
Cardiovascular Intervention and Therapeutics     Hybrid Journal   (Followers: 5)
Cardiovascular Journal     Open Access   (Followers: 6)
Cardiovascular Journal of Africa     Full-text available via subscription   (Followers: 5)
Cardiovascular Journal of South Africa     Full-text available via subscription   (Followers: 1)
Cardiovascular Medicine in General Practice     Full-text available via subscription   (Followers: 7)
Cardiovascular Pathology     Hybrid Journal   (Followers: 4)
Cardiovascular Regenerative Medicine     Open Access  
Cardiovascular Research     Hybrid Journal   (Followers: 15)
Cardiovascular Revascularization Medicine     Hybrid Journal   (Followers: 1)
Cardiovascular System     Open Access  
Cardiovascular Therapeutics     Open Access   (Followers: 1)
Cardiovascular Toxicology     Hybrid Journal   (Followers: 6)
Cardiovascular Ultrasound     Open Access   (Followers: 5)
Case Reports in Cardiology     Open Access   (Followers: 7)
Catheterization and Cardiovascular Interventions     Hybrid Journal   (Followers: 3)
Cerebrovascular Diseases     Full-text available via subscription   (Followers: 3)
Cerebrovascular Diseases Extra     Open Access  
Chest     Full-text available via subscription   (Followers: 101)
Choroby Serca i Naczyń     Open Access   (Followers: 1)
Circulation     Hybrid Journal   (Followers: 252)
Circulation : Cardiovascular Imaging     Hybrid Journal   (Followers: 15)
Circulation : Cardiovascular Interventions     Hybrid Journal   (Followers: 17)
Circulation : Cardiovascular Quality and Outcomes     Hybrid Journal   (Followers: 11)
Circulation : Genomic and Precision Medicine     Hybrid Journal   (Followers: 15)
Circulation : Heart Failure     Hybrid Journal   (Followers: 26)
Circulation Research     Hybrid Journal   (Followers: 36)
Cirugía Cardiovascular     Open Access  
Clínica e Investigación en Arteriosclerosis     Full-text available via subscription  
Clínica e Investigación en arteriosclerosis (English Edition)     Hybrid Journal  
Clinical and Experimental Hypertension     Hybrid Journal   (Followers: 3)
Clinical Cardiology     Hybrid Journal   (Followers: 11)
Clinical Hypertension     Open Access   (Followers: 5)
Clinical Medicine Insights : Cardiology     Open Access   (Followers: 6)
Clinical Research in Cardiology     Hybrid Journal   (Followers: 6)
Clinical Research in Cardiology Supplements     Hybrid Journal  
Clinical Trials and Regulatory Science in Cardiology     Open Access   (Followers: 4)
Congenital Heart Disease     Hybrid Journal   (Followers: 6)
Congestive Heart Failure     Hybrid Journal   (Followers: 4)
Cor et Vasa     Full-text available via subscription   (Followers: 1)
Coronary Artery Disease     Hybrid Journal   (Followers: 2)
CorSalud     Open Access  
Critical Pathways in Cardiology     Hybrid Journal   (Followers: 4)
Current Cardiology Reports     Hybrid Journal   (Followers: 7)
Current Cardiology Reviews     Hybrid Journal   (Followers: 4)
Current Cardiovascular Imaging Reports     Hybrid Journal   (Followers: 1)
Current Cardiovascular Risk Reports     Hybrid Journal  
Current Heart Failure Reports     Hybrid Journal   (Followers: 5)
Current Hypertension Reports     Hybrid Journal   (Followers: 6)
Current Hypertension Reviews     Hybrid Journal   (Followers: 6)
Current Opinion in Cardiology     Hybrid Journal   (Followers: 14)
Current Problems in Cardiology     Hybrid Journal   (Followers: 3)
Current Research : Cardiology     Full-text available via subscription   (Followers: 1)
Current Treatment Options in Cardiovascular Medicine     Hybrid Journal   (Followers: 1)
Current Vascular Pharmacology     Hybrid Journal   (Followers: 5)
CVIR Endovascular     Open Access   (Followers: 1)
Der Kardiologe     Hybrid Journal   (Followers: 2)
Echo Research and Practice     Open Access   (Followers: 2)
Echocardiography     Hybrid Journal   (Followers: 4)
Egyptian Heart Journal     Open Access   (Followers: 2)
Egyptian Journal of Cardiothoracic Anesthesia     Open Access  
ESC Heart Failure     Open Access   (Followers: 4)
European Heart Journal     Hybrid Journal   (Followers: 66)
European Heart Journal - Cardiovascular Imaging     Hybrid Journal   (Followers: 10)
European Heart Journal - Cardiovascular Pharmacotherapy     Full-text available via subscription   (Followers: 2)
European Heart Journal - Quality of Care and Clinical Outcomes     Hybrid Journal  
European Heart Journal : Acute Cardiovascular Care     Hybrid Journal   (Followers: 1)
European Heart Journal : Case Reports     Open Access   (Followers: 1)
European Heart Journal Supplements     Hybrid Journal   (Followers: 8)
European Journal of Cardio-Thoracic Surgery     Hybrid Journal   (Followers: 9)
European Journal of Cardio-Thoracic Surgery Supplements     Full-text available via subscription   (Followers: 2)
European Journal of Cardiovascular Nursing     Hybrid Journal   (Followers: 5)
European Journal of Heart Failure     Hybrid Journal   (Followers: 14)
European Journal of Preventive Cardiology.     Hybrid Journal   (Followers: 6)
European Stroke Organisation     Hybrid Journal   (Followers: 3)
Experimental & Translational Stroke Medicine     Open Access   (Followers: 9)
Expert Review of Cardiovascular Therapy     Full-text available via subscription   (Followers: 3)
Folia Cardiologica     Open Access  
Forum Zaburzeń Metabolicznych     Hybrid Journal  
Frontiers in Cardiovascular Medicine     Open Access   (Followers: 1)
Future Cardiology     Hybrid Journal   (Followers: 6)
General Thoracic and Cardiovascular Surgery     Hybrid Journal   (Followers: 3)
Global Cardiology Science and Practice     Open Access   (Followers: 5)
Global Heart     Hybrid Journal   (Followers: 3)
Heart     Hybrid Journal   (Followers: 48)
Heart and Mind     Open Access  
Heart and Vessels     Hybrid Journal  
Heart Failure Clinics     Full-text available via subscription   (Followers: 2)
Heart Failure Reviews     Hybrid Journal   (Followers: 3)
Heart India     Open Access   (Followers: 2)
Heart International     Full-text available via subscription  
Heart Rhythm     Hybrid Journal   (Followers: 11)
Heart Views     Open Access   (Followers: 2)
HeartRhythm Case Reports     Open Access  
Hellenic Journal of Cardiology     Open Access   (Followers: 1)
Herz     Hybrid Journal   (Followers: 3)
High Blood Pressure & Cardiovascular Prevention     Full-text available via subscription   (Followers: 2)
Hypertension     Full-text available via subscription   (Followers: 23)
Hypertension in Pregnancy     Hybrid Journal   (Followers: 9)
Hypertension Research     Hybrid Journal   (Followers: 5)
Ibrahim Cardiac Medical Journal     Open Access  
IJC Heart & Vessels     Open Access   (Followers: 1)
IJC Heart & Vasculature     Open Access   (Followers: 1)
IJC Metabolic & Endocrine     Open Access   (Followers: 1)
Indian Heart Journal     Open Access   (Followers: 5)
Indian Journal of Cardiovascular Disease in Women WINCARS     Open Access  
Indian Journal of Thoracic and Cardiovascular Surgery     Hybrid Journal  
Indian Pacing and Electrophysiology Journal     Open Access   (Followers: 1)
Innovations : Technology and Techniques in Cardiothoracic and Vascular Surgery     Hybrid Journal   (Followers: 1)
Insuficiencia Cardíaca     Open Access  
Interactive CardioVascular and Thoracic Surgery     Hybrid Journal   (Followers: 7)
International Cardiovascular Forum Journal     Open Access  
International Journal of Angiology     Hybrid Journal   (Followers: 2)
International Journal of Cardiology     Hybrid Journal   (Followers: 18)
International Journal of Cardiology Hypertension     Open Access   (Followers: 1)
International Journal of Cardiovascular and Cerebrovascular Disease     Open Access   (Followers: 2)
International Journal of Cardiovascular Imaging     Hybrid Journal   (Followers: 2)
International Journal of Cardiovascular Research     Hybrid Journal   (Followers: 6)
International Journal of Heart Rhythm     Open Access  
International Journal of Hypertension     Open Access   (Followers: 8)
International Journal of Hyperthermia     Open Access  
International Journal of Stroke     Hybrid Journal   (Followers: 30)
International Journal of the Cardiovascular Academy     Open Access  
Interventional Cardiology Clinics     Full-text available via subscription   (Followers: 2)
Interventional Cardiology Review     Full-text available via subscription  
JACC : Basic to Translational Science     Open Access   (Followers: 5)
JACC : Cardiovascular Imaging     Hybrid Journal   (Followers: 18)
JACC : Cardiovascular Interventions     Hybrid Journal   (Followers: 17)
JACC : Heart Failure     Full-text available via subscription   (Followers: 14)
JAMA Cardiology     Hybrid Journal   (Followers: 28)
JMIR Cardio     Open Access  
Jornal Vascular Brasileiro     Open Access  
Journal of Clinical & Experimental Cardiology     Open Access   (Followers: 5)
Journal of Arrhythmia     Open Access  
Journal of Cardiac Critical Care TSS     Open Access   (Followers: 1)

        1 2 | Last

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Indian Heart Journal
Journal Prestige (SJR): 0.333
Citation Impact (citeScore): 1
Number of Followers: 5  

  This is an Open Access Journal Open Access journal
ISSN (Print) 0019-4832
Published by Elsevier Homepage  [3206 journals]
  • A critical analysis of the non-inferiority design of TALENT trial

    • Abstract: Publication date: Available online 14 February 2020Source: Indian Heart JournalAuthor(s): S. Saha, P. Kerkar, N.J. GogtayAbstractIn recent years, regulatory approval of stents has been based on studies that have a non-inferiority design, which has its own inherent complexities. We critically appraise in this paper, the TALENT trial which established the non-inferiority of Indian manufactured Supraflex stent (a third generation, sirolimus-eluting stent with an ultra-thin strut thickness) compared to the Xience stent – (an internationally available,everolimus-eluting stent with a thicker strut) for a device-oriented composite endpoint at the end of 12 months. Our analysis shows that ifrisk ratio rather than absolute risk difference were used to calculate the non-inferiority margin, we would obtain a value of 1.48 for the risk ratio. Supraflex would then be non-inferior to Xience by 0.92 [95% CI 0.59 to 1.47]. The upper bound of the 95% CI of 1.47 is dangerously close to 1.48 indicating that the TALENT trial would just about manage to prove non-inferiority.
       
  • Soluble Neprilysin: A Versatile Biomarker for Heart Failure,
           Cardiovascular Diseases and Diabetic complications-A systematic review

    • Abstract: Publication date: Available online 4 February 2020Source: Indian Heart JournalAuthor(s): Kumaresan Ramanathan, Giri PadmanabhanAbstractThe potential role of soluble neprilysin as a biomarker has been poorly documented. Hence, the present systematic review emphasizes to explore soluble neprilysin as an emerging biomarker for heart failure, cardiovascular diseases, diabetic kidney diseases and beyond. A systematic review was performed using an online database search in PubMed, Science Direct, Scopus and Cochrane Library. Articles reporting biomarker’s performance to diagnose various diseases in human participants were included. The results of the search outcome were 4723 articles. Based on the inclusion criteria of the systematic review finally, 12 articles fulfilled the selection criteria. In these studies, 8 cohort study, 2 cross-sectional study, 1 case-control, and 1 prospective cohort study were identified. All these studies clearly suggested that soluble neprilysin as a potential biomarker for various disease diagnosis (Heart failure, cardiovascular diseases, diabetic kidney diseases, metabolic syndrome). Soluble Neprilysin may be a potential biomarker for heart failure, cardiovascular diseases, diabetic kidney disease and beyond.
       
  • “Cardiac changes in Children Hospitalized with Severe Acute
           Malnutrition: A Prospective Study at Tertiary Care Center of Northern
           India.”

    • Abstract: Publication date: Available online 4 February 2020Source: Indian Heart JournalAuthor(s): jain Dharmendra, Sunil Kumar Rao, Dhilip Kumar, Ashok Kumar, Bhupendra Kumar SihagSevere acute malnutrition (SAM) may affect cardiac structure & function. Cardiac changes in sick SAM children have received little attention in literature. Children aged 6 to 60 months with SAM were cases, and age & sex matched children were controls. Cardiac biomarkers levels were measured by quantitative ELISA method & echocardiography was used to assess cardiac changes in all children. Study included 76 children in each group. SAM children had less left ventricular mass & increased myocardial performance index as compared to controls (p
       
  • Necessary Complexities When Standardizing Hypertension Protocols in India

    • Abstract: Publication date: Available online 13 January 2020Source: Indian Heart JournalAuthor(s): Aayush Visaria, Tina Dharamdasani
       
  • Unravelling the Utility of Modern Sulfonylureas From CVOTs and Landmark
           Trials: Expert Opinion from an International Panel

    • Abstract: Publication date: Available online 13 January 2020Source: Indian Heart JournalAuthor(s): S. Kalra, S. Ghosh, A.K. Das, T. Nair, S. Bajaj, G. Priya, R.N. Mehrotra, S. Das, P. Shah, V. Deshmukh, M. Chawla, D. Sanyal, S. Chandrasekaran, D. Khandelwal, A. Joshi, F. Eliana, H. Permana, M.D. Fariduddin, P.K. Shrestha, D. ShresthaAbstractAimThe primary objective of this review is to develop practice-based expert group opinions on the cardiovascular safety and utility of modern sulfonylureas (SUs) in cardiovascular outcome trials (CVOTs).BackgroundThe United States Food and Drug Administration (USFDA) issued new guidance to the pharmaceutical industry in 2008 regarding the development of new antihyperglycemic drugs. The guidance expanded the scope for the approval of novel antihyperglycemic drugs, by mandating cardiovascular outcome trials for safety. A few long-term cardiovascular outcome trials on dipeptidyl peptidase 4 (DPP-4) inhibitors, glucagon-like peptide 1 (GLP-1) receptor agonists, and sodium-glucose cotransporter 2 (SGLT2) inhibitors have been completed, while others are ongoing. Sulfonylureas, which constitute one of the key antihyperglycemic agents used for the management of type 2 diabetes mellitus, have been used as comparator agents in several CVOTs. However, the need for CVOTs on modern SUs remains debatable. In this context, a multinational group of endocrinologists convened for a meeting and discussed the need for CVOTs of modern SUs, to evaluate their utility in the management of patients with type 2 diabetes mellitus (T2DM). At the meeting, CVOTs of modern SUs conducted to date and the hypotheses derived from the results of these trials were discussed.Review resultsThe expert group analyzed the key trials emphasizing the CV safety of modern SUs and also reviewed the results of various CVOTs in which modern SUs were used as comparators. Based on literature evidence and individual clinical insights, the expert group opined that modern SUs are cardiosafe and that since they have been used as comparators in other CVOTs, CVOTs of SUs are not required.ConclusionModern SUs can be considered a cardiosafe option for the management of patients with diabetes mellitus and cardiovascular disease; thus CVOTs among individuals with T2DM are not required.
       
  • Clinical and Angiographic profile of very young adults presenting with
           first Acute Myocardial Infarction: Data from a tertiary care center in
           Central India

    • Abstract: Publication date: Available online 3 January 2020Source: Indian Heart JournalAuthor(s): Pradeep P. Deshmukh, Mohit M. Singh, Mukund A. Deshpande, Atul S. RajputAbstractAcute myocardial infarction (AMI) is afflicting younger individuals more frequently nowadays. The present study was planned to evaluate the clinical and angiographic profile in adults aged less than 30 years presenting with first AMI as data from central India is very scarce. This cross sectional study included 41 patients of STEMI with mean age 27 ± 2.8 years. Risk factors were male gender (95.1%), dyslipidemia (51.2%), tobacco consumption (48.8%), obesity (34.1%), and smoking (29.3%). Anterior wall myocardial infarction (AWMI) was the commonest presentation (82.9%) with obstructive CAD noted in 61% cases frequently due to LAD coronary artery involvement (46.4%).
       
  • Prevalence and RIsk factors for Silent Myocardial ischaemia (PRISM): a
           clinico observational study in patients of type 2 diabetes

    • Abstract: Publication date: Available online 23 December 2019Source: Indian Heart JournalAuthor(s): D.S. Prasad, Zubair Kabir, K. Revathi Devi, Pearline Suganthy Peter, B.C. DasAbstractObjectivesTo estimate the prevalence and to identify potential risk factors of silent myocardial ischaemia in a cohort of patients with asymptomatic Type 2 Diabetes (diabetes) for early detection of coronary risk by employing objective non-invasive clinical screening tools for Subclinical Atherosclerosis.MethodsThe study is a clinicbased observational study on 338 consecutive diabetes patients attending an urban health centre from Eastern India. The response rate was 96.57 % out of 350 eligible subjects, comprising 176 (52.1%) males and 162 (47.9%) females. Clinical, anthropometric, Biochemical parameters were collected in all participants. Both tools i.e. treadmill test (TMT) to identify subjects with silent myocardial ischaemia, and carotid imaging to detect subclinical atherosclerosis by evaluating carotid intima-media thickness (CIMT) were assessed. Significant determinants were predicted by multivariable logistic regression.ResultsThe study group was divided into a TMT negative (n=260), and a TMT positive group (n=78). These 78 TMT positive subjects (23.1%) were identified to have silent myocardial ischaemia. The prevalence of silent myocardial ischaemia was more common in males (28.4%) than in females (17.3%). The mean CIMT in our study group was 0.6741± 0.034 mm (males – 0.684 ± 0.034 mm and females – 0.663 ± 0.032 mm). Age ≥50 years, CIMT ≥0.70mm, hypercholesterolaemia, and hypertriglyceridaemia were significant determinants for identifying asymptomatic diabetics at risk for silent myocardial ischaemia.ConclusionSilent myocardial ischaemia is highly prevalent at about one in four asymptomatic diabetic patients. An increased CIMT can be a surrogate marker of higher coronary risk amongst these asymptomatic diabetics.
       
  • Acute myocardial infarction in pregnancy: Current diagnosis and management
           approaches.

    • Abstract: Publication date: Available online 17 December 2019Source: Indian Heart JournalAuthor(s): Mohan M. Edupuganti, Vyjayanthi GangaAbstractAcute myocardial infarction during pregnancy is a very uncommon condition, atherosclerotic coronary artery disease is by far the most common cause of an acute coronary syndrome in the general population. The causes of an acute coronary syndrome in the pregnant patient are wide and varied. This has important implications with respect to the diagnosis of the etiology and the subsequent management of the cause of the acute coronary syndrome. There are a number of diagnostic tools for the diagnosis of coronary artery disease but it is important to understand their role in pregnant patients. Spontaneous coronary artery dissection is one of the most common causes of acute coronary syndrome in pregnant patients. Understanding its pathophysiology and knowing the natural history of this condition is paramount in the management of this condition. The article also lists the various therapeutic modalities available to the clinician faced with an acute coronary syndrome in the pregnant patient. Finally, we discuss the delivery of the baby and post partum care of these complex patients.
       
  • QT prolongation in HIV-positive patients: Review article

    • Abstract: Publication date: Available online 3 December 2019Source: Indian Heart JournalAuthor(s): Jing Liu, Sumit K. Shah, Indranill Basu-Ray, Julia Garcia-Diaz, Kainat Khalid, Mohammad SaeedAbstractIntroductionAntiretrovirals have immensely increased the average life expectancy of HIV-positive patients. However, the incidence of QT interval prolongation and other arrhythmias has also increased.MethodsPubmed and Google Scholar were searched for relevant literature published between 1990 and 2019.Results and discussionHIV-positive patients with high viral load, low CD4 count, chronic inflammation, and autonomic neuropathy can develop QT interval prolongation. Another factor prolonging QT interval includes exposure to the HIV transactivator protein, which inhibits hERG K (+) channels controlling IKr K (+) currents in cardiomyocytes. Protease inhibitors inhibiting the CYP3A4 enzyme can also lead to QT interval prolongation. QT interval prolongation can potentially be exacerbated by opioids, antipsychotics, antibiotics, and antifungals, the adjunct medications often used in HIV-positive patients. Hepatic insufficiency in seropositive patients on antiretrovirals may also increase the risk of QT interval prolongation.ConclusionBaseline and follow-up EKG in the susceptible population is suggested.
       
  • Medical referrals in private practice: Need to keep the fine fabric intact

    • Abstract: Publication date: Available online 2 December 2019Source: Indian Heart JournalAuthor(s): B.Sadananda Naik
       
  • Standardizing hypertension management in a primary care setting in India
           through a protocol based model

    • Abstract: Publication date: Available online 26 November 2019Source: Indian Heart JournalAuthor(s): Priyanka Satish, Aditya Khetan, Shyamsundar Raithatha, Punam Bhende, Richard JosephsonAbstractHypertension is a leading cause of death in India. Control rates of hypertension are abysmal, even for people on treatment. There are a number of barriers to adequate control of hypertension in India, including therapeutic inertia and the lack of a systematic, simplified approach. Standardizing hypertension management through an evidence based model that sets thresholds for diagnosis, treatment goals, follow up intervals and choice of drugs can lead to improved management of hypertension in an individual hospital or health system. In this paper, we summarize the evidence for such a model, and adapt it to the Indian context, focusing on maximizing effectiveness, safety and ease of use by a non-expert. This model can be utilized by individual practitioners, hospitals, primary health centers (PHCs) and the Health and Wellness Centers (HWCs) under the Ayushman Bharat initiative.
       
  • Fragmented QRS complex is an independent predictor of plaque burden in
           patients at Intermediate Risk of Coronary Artery Disease

    • Abstract: Publication date: Available online 21 November 2019Source: Indian Heart JournalAuthor(s): Ragab A. Mahfouz, Mohamad Arab, Mohamed Abdelhamid, Ahmad ElzayatAbstractObjectiveWe aimed to evaluate the relationship between fragmented QRS complex and plaque burden in patients presented with typical chest pain and deemed to have intermediate pretest probability of CAD using coronary tomographic angiography (CCTA).MethodsWe studied electrocardiograms (ECGs) obtained from 172 subjects (47.5±9.5 years, 125 were men) presented with chest pain and had intermediate pretest probability for CAD. The presence and evaluation of CAD was performed with CCTA.ResultsSeventy four (43%) of the study cohort had CCTA documented CAD. Meanwhile the frequency of fQRS in our cohort was (57%). 70 (71.4%) patients with fQRS had CAD compared with only 4 (5.4%) patients without fQRS (p
       
  • Clinical Characteristics and Outcome in Patients with a Delayed
           Presentation after STEMI and Complicated by Cardiogenic Shock

    • Abstract: Publication date: Available online 21 November 2019Source: Indian Heart JournalAuthor(s): Yash Paul Sharma, Darshan Krishnappa, Kewal Kanabar, Ganesh Kasinadhuni, Rakesh Sharma, Kamal Kishore, Saurabh Mehrotra, Krishna Santosh, Ankur Gupta, Prashant PandaAbstractObjectiveDelayed presentation following STEMI and complicated by cardiogenic shock (CS-STEMI) is commonly encountered in developing countries and is a challenging scenario due to a delay in revascularization resulting in infarction of a large amount of myocardium. We aimed to assess the clinical characteristics, angiographic profile, and predictors of outcome in patients with a delayed presentation following CS-STEMI.MethodsA total of 147 patients with CS-STEMI with time to appropriate medical care ≥12 hours after symptom onset were prospectively recruited at a tertiary referral center.ResultsThe median time to appropriate care was 24 hours [interquartile range (IQ) 18-48 hours]. The mean age was 58.7±11.1 years. Left ventricular pump failure was the leading cause of shock (67.3%), while mechanical complications accounted for 14.9% and right ventricular infarction for 13.6% of cases. The overall in-hospital mortality was 42.9%. Acute kidney injury [Odds ratio (OR) 8.04; 95% CI 3.08-20.92], ventricular tachycardia (OR 7.04; CI 2.09-23.63), mechanical complications (OR 6.46; CI 1.80-23.13), and anterior infarction (OR 3.18; CI 1.01-9.97) were independently associated with an increased risk of mortality. Coronary angiogram (56.5%) revealed single-vessel disease (45.8%) as the most common finding. PCI was done in 53 patients (36%), at a median of 36 hours (IQ 30-72) after symptom onset.ConclusionPatients with a delayed presentation following CS-STEMI were younger and more likely to have single-vessel disease. We found a high in-hospital mortality of 42.9%. Appropriate randomized studies are required to evaluate the optimal treatment strategies in these patients.
       
  • Assessment of right ventricular systolic function in heart failure with
           preserved, reduced and mid-range ejection fraction

    • Abstract: Publication date: Available online 20 November 2019Source: Indian Heart JournalAuthor(s): Shaimaa MostafaAbstractBackgroundFew studies have evaluated right ventricle systolic function in different categories of heart failure despite its effect on outcomes.Methods and resultssingle-centre, cross-sectional study included 150 patients, 50 patients in each category of HF: group I, preserved; group II, mid-range, group III reduced ejection fraction. Left ventricular systolic function was assessed by 3D echo, and right ventricular systolic function was assessed by fraction area change (FAC), tricuspid annular plane systolic excursion (TAPSE), tissue Doppler image (TDI) and global longitudinal strain (GLS). There was no significant difference among the 3 groups regarding sex, the prevalence of risk factors, but patients in group III were significantly older (p
       
  • Leadless Pacemakers – the path to safer pacing'

    • Abstract: Publication date: Available online 19 November 2019Source: Indian Heart JournalAuthor(s): Ramesh Nadarajah, Noman Ali, Peysh A. PatelAbstractEndocardial transvenous permanent pacemakers (TVPs) are a mainstay within cardiology and used to treat a range of bradyarrhythmias. However, their use is associated with potential complications both at the time of implantation and longer-term. The concept of a leadless pacemaker, where a self-contained device is placed within the right ventricle, has obvious attractions. Two leadless systems have been developed, though only one is currently available. Results from clinical trials have been promising but a number of hurdles need to be circumvented before leadless devices can usurp TVPs. At present, use is restricted to specialist centres, for a limited indication and for patients in whom conventional implantation is contraindicated. This article provides a contemporary critique of design types, evidence base and existing limitations of this nascent technology.
       
  • Coronary Artery size in North Indian population – Intravascular
           ultrasound based study

    • Abstract: Publication date: Available online 5 November 2019Source: Indian Heart JournalAuthor(s): S. Reddy, Suraj Kumar, J.R. Kashyap, K. Raghavendra, K. Vikas, Hithesh Reddy, N. Kaur, R. Velu, J. KaurAbstractObjectiveThe coronary artery dimensions have important diagnostic and therapeutic implications in management of coronary artery disease. There is paucity of data on the coronary artery size in Indians by intravascular ultrasound.MethodsA total of 303 patients with acute coronary syndrome undergoing percutaneous intervention with intravascular ultrasound underwent analysis along with quantitative coronary angiogram (QCA). Of the 492 proximal coronary segments; 221 left main (LM), 164 left anterior descending artery (LAD), 45 left circumflex artery (LCX) and 62 right coronary artery (RCA) were considered.ResultsPatient’s age was 53.37 ± 3.5 years; men (80%); hypertension (35%); diabetes (24.8%). On IVUS mean minimal lumen diameter as compared to QCA in LM (4.60 mm vs 4.50 mm, p
       
  • 9p21.3 Coronary Artery Disease Risk Locus and Interferon Alpha 21:
           Association study in an Asian Indian population

    • Abstract: Publication date: Available online 25 October 2019Source: Indian Heart JournalAuthor(s): Bellary Kalpana, Dwarkanath K. Murthy, Nagalla BalakrishnaAbstractIntroductionType I Interferons (INFαs and INF β) are known to be proinflammatory cytokines that promote atherosclerosis. IFNA21 is a member of alpha Interferon gene cluster on short arm of chromosome 9. We analyzed the potential link between 9p21 CAD risk locus and IFNA21.Objectives: a) study of association between serum IFNA21 levels and 14 demographic/clinical variables including age, gender, diabetes, hypertension, and duration of CAD, b) study of association between high serum IFNA21 levels and 30 9p21 SNP genotypes.MethodsTo estimate serum circulating levels of IFNA21, we performed sandwich ELISA in 184 controls and 167 CAD cases. The IFNA21 levels could be classified into two broad classes: a) Low level group: ≤ 15.6 pg/ml b) High level group:> 15.6 pg/ml. We also performed SNP genotyping for 30 SNPs at 9p21 locus in all study subjects using Sequenom MassARRAY technology. Statistical software SPSS (Version 21) was used to analyze the data obtained.ResultsOur analysis indicates that there could be an association of high IFNA21 levels with variables-gender, age and duration of CAD in the study population. SNPs rs10757272 (TT), rs10757274 (GG), rs10757283 (TT), rs1333045 (CC), rs1333048 (CC), rs1333049 (CC), and rs4977574 (GG) showed significant risk association with high level IFNA21 group.ConclusionsIFNA21 may be involved in inflammatory processes in an age dependent manner and in progression of CAD. This IFNA21 mediated mechanism may be more active in females. Several 9p21 SNPs may modulate inflammatory processes mediated by IFNA21, and may therefore contribute to pathophysiology of CAD.
       
  • Patent Foramen Ovale Closure Versus Medical Therapy for Cryptogenic
           Stroke: An Updated Systematic Review and Meta-Analysis

    • Abstract: Publication date: Available online 22 October 2019Source: Indian Heart JournalAuthor(s): Sunny Goel, Shanti Patel, Elina Zakin, Ravi Teja Pasam, Joseph Gotesman, Bilal Ahmad Malik, Sergey Ayzenberg, Robert Frankel, Jacob ShaniAbstractObjectivesTo compare safety and efficacy of Patent Foramen Ovale (PFO) closure compared with medical therapy in patients with cryptogenic stroke (CS)BackgroundThe role of PFO closure in preventing recurrent stroke in patients with prior CS has been controversial.MethodsWe searched PubMed, EMBASE, the Cochrane Central Register of Controlled trials, and the clinical trial registry maintained at clinicaltrials.gov for randomized control trials that compared device closure with medical management and reported on subsequent stroke and adverse events. Event rates were compared using a Forest plot of relative risk using a random-effects model assuming inter-study heterogeneity.ResultsA total of 6 studies (n= 3747) were included in the final analysis. Mean follow-up ranged from 2 to 5.9 years. Pooled analysis revealed that device closure compared to medical management was associated with a significant reduction in stroke (RR = 0.41, 95% CI = 0.20-0.83, I2 = 51%, P = 0.01).There was, however, a significant increase in atrial fibrillation with device therapy (RR = 5.29, 95% CI = 2.32-12.06, I2 = 38%, P 
       
  • Mitral valve calcium assessment: An independent predictor of balloon
           valvuloplasty results

    • Abstract: Publication date: Available online 22 October 2019Source: Indian Heart JournalAuthor(s): Ricardo A. Sarmiento, Raúl Solernó, Rodrigo Blanco, Federico Giachello, Agustin Hauqui, Martín Oscos, Federico Blanco, Gerardo Gigena, Jorge Lax, Pablo PedroniAbstractObjectivePercutaneous mitral valvuloplasty (PMV) is an effective treatment for patients with mitral valve stenosis. Echocardiographic score (ES) is a useful predictor of outcomes. However, mitral valve calcification (MVC) has been shown to predict immediate results even in patients with otherwise low ES. We sought to evaluate the usefulness of MVC assessment as a predictor of immediate and long-term outcomes after PMV.MethodsPMV was performed in 168 consecutive patients. Clinical and echocardiographic variables were analyzed. Patients were classified into 2 groups: Group 1: minimal MVC, and Group 2: moderate to severe MVC. Primary success was defined as post-PMV mitral valve area (MVA) ≥ 1.5cm2 in the absence of major complications. Restenosis was defined as a decrease in MVA>50% of initial gain or a final MVA
       
  • Correlation of urinary cotinine with cardiovascular risk factors in pan
           masala tobacco users

    • Abstract: Publication date: Available online 22 October 2019Source: Indian Heart JournalAuthor(s): Shrestha Sanjeeb, Mishra Deebya Raj, Dhakal Niraj, Bhandari Suresh, Khanal Sagar, Lamsal MadhabAbstractBackgroundTobacco consumption is considered as one of the major risk factors for Cardiovascular (CV) morbidity. However, the effect of Paan Masala Tobacco (PMT) (a type of smokeless tobacco) consumption has not been well studied in our context. Our study is aimed to find an association of CV risk factors between PMT users and nonusers and to correlate those parameters with urinary cotinine level, a degradation product of nicotine occurring in tobacco.MethodsThis comparative cross-sectional study was carried out among 200 participants. The effect of PMT use on CV risk-factors like blood pressure (BP), lipid-profileand Body Mass Index (BMI) was measured against urine-cotinine level. Statistical tests used were χ2 test for categorical variable, independent t-test, Mann-Whitney U test and Spearman’s correlation applied for numerical variable and multivariate regression analysis was performed as required. The level of significance was set at p
       
  • Evaluation Of Intra-Coronary Blood From Obstructive Vessel In Patients Of
           St-Elevation Myocardial Infarction Undergoing Primary Pci

    • Abstract: Publication date: Available online 26 September 2019Source: Indian Heart JournalAuthor(s): Suraj Kumar, Gurpreet S. Wander, Bhupinder Singh, Maninder Kansal, Bishav Mohan, Naved Aslam, Shibba T. Chabbra, Abhishek Goyal, Sumit KumarAbstractObjectiveInformation available on acid-base imbalance in ST-elevation myocardial infarction submitted to primary percutaneous intervention is limited and no data was present on intracoronary blood analysis, extracted from obstructed artery.MethodsThis was a prospective study conducted over 12 months in which STEMI patients presenting in emergency and undergoing Primary PCI were included. Blood gas analysis of intracoronary arterial blood from obstructed vessel and peripheral arterial blood was done. Patients in whom adequateintracoronary sample could not be obtained were excluded. Intracoronary and peripheral arterial blood gas measurements were correlated and relationship of Intracoronary parameters were compared clinical parameters, investigational markers and short-term outcome.ResultsThe mean age of study population was 54.8 years andaverage symptom onset to door time was 162 mins. On comparing intracoronary blood to peripheral blood arterial obtained, pH (95%CI-0.01-0.02;p=0.44), lactate (95%CI 0.03-0.1;p=0.28), bicarbonate (95%CI 0.6-1.5;p=0.64), pCO2(95%CI 1.1-2.4;p=0.79) and pO2(95%CI 3.2-47.5; p=0.06), were all found to be statistically insignificant. Intracoronary hyperlactemia was present in patients presenting with higher symptom onset to door time(p=0.025). SBP(p=0.03)was also significantly lower in patients who had high intracoronary lactate levels.ConclusionThe evaluation of intracoronary blood provides no additional information regarding the prognosis and short-term (30-days) outcome of the patients when compared to peripheral blood. However, there was significant intracoronary hyperlactemia in patients presenting late after symptom onset. SBP was also significantly less in patients with high intracoronary lactate, which signifies that predominant cause of hyperlactemia was systemic hypoperfusion rather than local increase in lactate levels.
       
  • Thrombolysis with Reteplase in Acute Pulmonary Embolism

    • Abstract: Publication date: Available online 20 September 2019Source: Indian Heart JournalAuthor(s): K.R. Nishanth, Math Ravi S, Shankar Mythri, K.S. Ravindranath, C.N. ManjunathAbstractObjectiveReteplase (recombinant plasminogen activator) is a mutant of alteplase. It has a longer half-life than its parent molecule and has shown better vessel patency rates in acute myocardial infarction. In this study, we analyzed the efficacy and safety of reteplase in acute pulmonary embolism (PE).MethodsThis observational study included patients with high and intermediate risk acute PE, presenting within 14 days of symptom onset. Patients were treated with reteplase given in two bolus doses of 10 U each, 30 minutes apart, along with intravenous heparin. Patients with hemodynamic compromise (high risk or massive PE) and normotensive patients with evidence of right ventricular (RV) dysfunction (intermediate risk or submassive PE) on echocardiography or computed tomography were included in the study. The efficacy outcomes assessed were in hospital death and improvement of RV function by echocardiography. The safety outcomes were major, minor bleeding and ischemic or hemorrhagic stroke during hospitalization.ResultsOf 40 patients included, 25% were high risk with hemodynamic compromise and 75% were intermediate risk. RV dysfunction was present in all (100%) the patients. Concomitant lower extremity deep vein thrombosis was present in 55% of the patients. The mortality rate was 5%. There was significant improvement in RV function, reduction in pulmonary artery systolic pressure and tricuspid regurgitation severity. There was no major bleeding event or stroke and 7.5% had minor extracranial bleeding.ConclusionsDouble bolus reteplase given with heparin is effective in the treatment of high, intermediate risk pulmonary embolism with minimal risk of bleeding.
       
  • Permanent His-bundle pacing feasibility in routine clinical practice:
           experience from Indian centre

    • Abstract: Publication date: Available online 18 September 2019Source: Indian Heart JournalAuthor(s): Rakesh Sarkar, Daljeet Kaur, Muthiah Subramanian, Sachin Yalagudri, C. Sridevi, Soumen Devidutta, Debabrata Bera, Calambur NarasimhanAbstractThere is a paucity of experience regarding His-bundle pacing (HBP) at labs initially attempting the procedure, especially in the Indian scenario. Patient underwent HBP were either selected for pacing therapy or in lieu of CRT at a single center. Among 22 patients attempted, 19 patients underwent successful implant achieving selective HBP in 14. There was a significant improvement of LVEF(49.3±9.3 vs. 36.7 ± 9.2) in the LV dysfunction subgroup(n=6). Over a follow up of 15±6.5 months, thresholds were stable in all except one patient and there was no requirement of lead revision. In summary, we found that HBP is a feasible option for achieving physiological pacing.
       
  • Prevalence of Hypertension among Indian Adults: Results from the Great
           India Blood Pressure Survey

    • Abstract: Publication date: Available online 18 September 2019Source: Indian Heart JournalAuthor(s): Sivasubramanian Ramakrishnan, Geevar Zachariah, Kartik Gupta, J. Shivkumar Rao, P.P. Mohanan, K. Venugopal, Santosh Sateesh, Rishi Sethi, Dharmendra Jain, Neil Bardolei, Kalaivani Mani, Tanya Singh Kakar, Bharathraj Kidambi, Sudha Bhushan, Sunil K. Verma, Balram Bhargava, Ambuj Roy, Shyam S. Kothari, Rajeev Gupta, Sandeep BansalAbstractObjectiveHypertension is the most important risk factor for cardiovascular morbidity and mortality. There is limited data on hypertension prevalence in India. This study was conducted to estimate the prevalence of hypertension among Indian adults.MethodsA national level survey was conducted with fixed one-day blood pressure measurement camps across 24 states and union territories of India. Hypertension was defined as systolic blood pressure (BP) ≥140 mmHg or a diastolic BP ≥90 mmHg or on treatment. The prevalence was age and gender-standardized according to the 2011 census population of India.ResultsBlood pressure was recorded for a total of 180,335 subjects (33.2% women; mean age 40.6 ± 14.9 years). Among them 8898 (4.9%), 99791 (55.3%), 35694 (11.9%), 23084 (12.8%), 9989 (5.5%) and 2878 (1.6%) subjects were of the age group 18-19, 20-44, 45-54, 55-64, 65-74 and ≥75 years respectively. Overall prevalence of hypertension was 30.7% (95% confidence interval [CI] 30.5, 30.9) and the prevalence among women was 23.7% (95% CI 23.3, 24). Prevalence adjusted for 2011 census population and the WHO reference population was 29.7% and 32.8%, respectively.ConclusionThere is a high prevalence of hypertension, with almost one in every three Indian-adult affected.
       
  • Incidence and Predictors of Super-response to Cardiac Resynchronization
           Therapy

    • Abstract: Publication date: Available online 9 September 2019Source: Indian Heart JournalAuthor(s): ManojKumar Rohit, Darshan KrishnappaAbstractObjectivesCardiac re-synchronization therapy (CRT) has significantly improved management of patients with HFrEF. A significant number of patients have a dramatic response and have been termed ‘super-responders’. The characteristics of this subset of patients in Indian and Asian population have not been well studied. In this study we sought to assess the prevalence and clinical characteristics of this cohort of patients.MethodsThis was a retrospective study involving patients undergoing CRT. Changes in ejection fraction and LVESV at the end of one year of follow-up following device implantation were assessed and patients stratified into non-responders, responders and super-responders. Responders had a 15 – 29% decrease in LVESV while super-responders had a>30% decrease in LVESV.ResultsOf the 74 patients who had undergone CRT-P/CRT-D implantation, 16 patients did not have echocardiograms at the end of one year of follow-up and were excluded from the analysis. Thus, 58 patients were enrolled for analysis. We identified 16 patients(27.6%) to be super-responders, 26 patients(44.8%) to be responders and 16 patients(27.6%) to be non-responders. Factors associated with a super-response were, a diagnosis of dilated cardiomyopathy as against ischemic cardiomyopathy(93.7% vs 6.3%; p – 0.01), prior RV apical pacing(25% vs 2.4%; p – 0.02) and absence of a prior history of myocardial infarction(MI)(0% vs 33.3%; p – 0.02).ConclusionIn our study, 27.6% of patients were super-responders and dilated cardiomyopathy, absence of a prior history of MI and prior RV apical pacing tended to predict a super-response to CRT.
       
  • Cardiovascular manifestations of people living with HIV/AIDS: Report from
           a hot spot in eastern india

    • Abstract: Publication date: Available online 9 September 2019Source: Indian Heart JournalAuthor(s): D.R. Trinath Kumar Mishra, D.R. Sura Kishor Mishra, D.R. Subhasish SinghAbstractObjectiveTo study the profile and characteristics of cardiovascular abnormalities among patients living with HIV/AIDS at a tertiary care hospital in India. The association of cardiovascular abnormalities with the CD4 count and disease stages, according to the World Health Organization (WHO) classification, was also analyzed.MethodsA total of 200 patients with HIV/AIDS were compared with 50 healthy controls. All patients underwent blood investigations, chest X-ray, electrocardiography, and echocardiography.ResultsThe mean age of the patients was 38.66 ± 9.22 years, with a male-to-female ratio of 3.25:1. Echocardiographic abnormalities were found in 52% of the patients and 12% of the controls, with the most common abnormality being left ventricular diastolic dysfunction. Echocardiographic abnormalities were markedly more common in patients with a CD4 count of
       
  • CHA2DS2-VASc Score as a novel predictor for Contrast-Induced Nephropathy
           after Percutaneous Coronary Intervention in Acute Coronary Syndrome

    • Abstract: Publication date: Available online 9 September 2019Source: Indian Heart JournalAuthor(s): Abhay Kumar Chaudhary, Vijay Pathak, Shekhar Kunal, Shubhra Shukla, Pooja PathakAbstractObjectiveCHA2DS2-VASc score, used for atrial fibrillation to assess the risk of embolic complications, have shown to predict adverse clinical outcomes in acute coronary syndrome (ACS), irrespective of atrial fibrillation. This study envisaged to assess the predictive role of CHA2DS2-VASc score for contrast induced nephropathy (CIN) in ACS patients undergoing percutaneous coronary intervention(PCI).MethodTotal 300 consecutive patients of ACS undergoing PCI were enrolled in this study. CHA2DS2-VASc score was calculated for each patient. These patients were divided into two groups as Group 1(with CIN) and Group 2(without CIN).CIN was defined as increase in serum creatinine level ≥0.5 mg/dL or ≥25% increase from baseline within 48 hours after PCI. Post Receiver operating characteristic (ROC) curve analysis, the study population was again classified into two groups: CHA2DS2-VASc score ≤3 group (Group A) and score≥4 group (Group B).ResultsCIN was reported in 41 subjects(13.6%). Patients with CIN had a higher frequency of hypertension, diabetes mellitus and had a lower left ventricular ejection fraction and baseline estimated glomerular filtration rate. ROC curve analysis showed good predictive value of CHA2DS2-VASc score for CIN(AUC 0.81, 95% CI 0.73-0.90). Patients with a CHA2DS2-VASc score of ≥4 had a higher frequency of CIN as compared to patients with score ≤3 (56.8% vs 4.8%; P=0.0001) with multivariate analysis demonstrating CHA2DS2-VASc score of ≥4 to be an independent predictor of CIN.ConclusionIn patients with ACS undergoing PCI, CHA2DS2-VASc score can be used as a novel, simple and a sensitive diagnostic tool for the prediction of CIN.
       
  • Prognostic Value of Frontal QRS-T Angle in Predicting Survival After
           Primary Percutaneous Coronary Revascularization/Coronary Artery Bypass
           Grafting for ST Elevation Myocardial Infarction

    • Abstract: Publication date: Available online 9 September 2019Source: Indian Heart JournalAuthor(s): Abhishek C. Sawant, Aishwarya Bhardwaj, Shantanu Srivatsa, Srilekha Sridhara, Meghana Prakash Hiriyur Prakash, Nidhi Kanwar, Janelle Rodriguez, Gary Tse, Tong Liu, Arnav Kumar, Hiroko Beck, Sanjay S. SrivatsaAbstractBackgroundFrontal QRST Angle (FQRST) has previously been correlated with mortality in patients with stable coronary artery disease, but its role as survival predictor following STEMI remains unknown.MethodsWe evaluated 267 consecutive patients with STEMI undergoing reperfusion or coronary artery bypass grafting. Data assessed included demographics, clinical presentation, electrocardiograms, medical therapy and one-year mortality.ResultsOut of 267 patients, 187 (70%) were males and the majority (49.4%) of patients were Caucasian. All-cause mortality was significantly higher among patients with the highest (101-180°) FQRST [28% vs. 15%, p = 0.02]. Patients with FQRST 1-50° had higher survival (85.6%) compared with FQRST=51-100° (72.3%) and FQRST=101-180° (67.9%), [log rank, p=0.01]. Adjusting for significant variables identified during univariate analysis, FQRST (OR = 2.04 [95% CI: 1.31-13.50]) remained an independent predictor of one-year mortality. FQRST based risk score (1-50°=0 points, 51-100°=2 points, 101-180°=5 points) had excellent discriminatory ability for one-year mortality when combined with Mayo Clinic Risk Score [MCRS] (C statistic=0.875 [95%CI: 0.813-0.937]. A high (>4 points) FQRST risk score was associated with greater mortality (32% vs. 19%, p = 0.02) and longer length of stay (6 vs. 2 days, p < 0.001).ConclusionFQRST represents a novel independent predictor of one-year mortality in STEMI patients undergoing reperfusion. A high FQRST based risk score was associated with greater mortality and longer length of stay and, after combining with MCRS, improved discriminatory ability for one-year mortality.
       
  • Therapeutic Experience of Ticagrelor in Indian Patients with Acute
           

    • Abstract: Publication date: Available online 30 August 2019Source: Indian Heart JournalAuthor(s): J.P.S. Sawhney, J. Dalal, Mullasari A, S. Bansal, D. KahaliAbstractObjectiveThis observational study was designed to understand the usage pattern of ticagrelor in real-life clinical practice among a large number of acute coronary disease (ACS) patients undergoing percutaneous coronary intervention (PCI), coronary artery bypass graft (CABG) or medical management (MM). The study also recorded clinical events, i.e., bleeding, dyspnea, and cardiovascular (CV) events reported by the investigator during the follow-up period.MethodsThe ACS patients of ≥18 years hospitalized for ACS and were prescribed ticagrelor upon discharge or ≤1 month and patients who underwent PCI, CABG or MM for ACS, were enrolled. The subjects were followed up for a period of up to 12 months. The data was collected on a case report form.ResultThe study recruited 2997 subjects from 49 sites in India. Approximately half of the ACS subjects had ST segment elevation myocardial infarction (STEMI) (48.9%), and PCI was used as management in 92.4% subjects. The mean (±SD) duration of use of ticagrelor was 314 (±110.2) days over a period of 12 months. Of 136 subjects (4.5%) who experienced any clinical events, CV deaths were reported in 20 (0.7%), myocardial infraction (MI) in 19 (0.6) subjects and ischemic stroke (IS) in 23 (0.8%) subjects, and severe dyspnea was reported in 68 (2.2%) subjects. Out of 33 bleeding cases, 25 (0.8%) subjects had thrombolysis in myocardial infarction (TIMI) minimal, seven (0.2%) had TIMI minor, and one TIMI major. Platelet inhibition and patient outcomes (PLATO) major was reported in two subjects and CABG bleed in one subject. The incidence of PLATO defined major & minimal bleeding were lower in subjects undergoing fibrinolysis than overall population.ConclusionTicagrelor has been used across ACS types and in different management strategies in real world settings in India. The incidence of clinical events was lower as compared to data in literature. ClinicalTrials.gov Identifier: NCT02408224
       
  • ASCVD risk score - Are indians underestimating the risk of cardiovascular
           disease'

    • Abstract: Publication date: Available online 30 August 2019Source: Indian Heart JournalAuthor(s): Ashish Kumar U, Mariam Shariff
       
  • A Milestone In Prediction Of The Coronary Artery Dimensions From Multiple
           Linear Regression Equation

    • Abstract: Publication date: Available online 6 August 2019Source: Indian Heart JournalAuthor(s): A. Divia Paul, S.M. Ashraf., J. Ezhilan, S. Vijayakumar, Anuj KapadiyaAbstractIntroductionCoronary artery imaging is one of the most commonly used diagnostic methods. We aimed to investigate whether there is a correlation between left main coronary artery (LMCA), left anterior descending artery (LAD) and left circumflex artery (LCx) artery dimensions in normal cases and a possibility to express the coronary dimensions by multiple linear equations.Materials and MethodsImages of coronary angiograms of 925 normal cases selected from 3855 cases made up the study population (515 men and 410 women; age range, 30–75 years). Mean age of the patients was 55.50 ± 6.49 years. Mean body mass index (BMI) was 24.79 ± 1.45 kg/m2 (range 31.30–21.26 kg/m2). The mean dimensions of LMCA, LAD, and LCx were found as 4.18 ± 0.65 mm, 3.22 ± 0.63 mm, and 3.07 ± 0.65 mm, respectively. Correlation between LMCA, LAD and LCx diameters was investigated. Multiple linear regression analysis was used to develop a model to elucidate the relationship between LMCA, LAD and LCx diameters.ResultsThere was a strong correlation between LMCA dimensions and LAD and LCx dimensions (r=0.526**, p
       
 
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