{"title":"Prevalence of Metabolic Syndrome and its Clinical and Angiographic Profile in Patients with Naive Acute Coronary Syndrome","authors":"Mahmood Dhahir Al-Mendalawi","doi":"10.4103/jicc.jicc_41_22","DOIUrl":"https://doi.org/10.4103/jicc.jicc_41_22","url":null,"abstract":"Sir, Kumar et al.[1] found in their study that the metabolic syndrome (MetS) prevalence was high (46.2%) among Indian patients with naive acute coronary syndrome (ACS) and patients with MetS tended to have more complex coronary lesions. Based on the following limitation, we believe that the study findings are questionable. The revised National Cholesterol Education Program/Adult Treatment Panel III (NCEP/ATP III) guidelines[2] employed in the study to diagnose MetS include the following parameters: (1) abdominal obesity manifests as waist circumference (WC) ≥102 cm for men or ≥88 cm for women; (2) serum triglyceride (TG) level ≥150 mg/dL; (3) serum high-density lipoprotein cholesterol (HDLC) level ≤40 mg/dL for men or ≤50 mg/dL for women; (4) systolic/diastolic blood pressure (BP) ≥130/85 mmHg or receiving drug therapy; and (5) fasting plasma glucose (FBG) ≥100 mg/d. These guidelines were launched in 2005[2] and they are no more righteous. Around the world, many committees have built their MetS definition guidelines centered on various factors such as age, gender, pubertal stage, socioeconomic class, and ethnicity to accurately measure MetS prevalence.[3,4] Importantly, India released national diagnostic guidelines for MetS in 2016. These guidelines involve the following components: (1) WC ≥31” In women and ≥35” in men; (2) serum TG level ≥150 mg/dl; (3) serum HDLC level <50 mg/dl for women and <40 mg/dl for men; (4) BP ≥130/85 mmHg; and (5) FBG >100 mg/dl.[5] Since there are noticeable variations between the revised NCEP/ATP III guidelines[2] and national MetS diagnostic guidelines,[5] we believe that referring to the national guidelines could make an accurate estimate of the MetS prevalence among ACS Indian patients and assess the seriousness of coronary artery disease in those with and without MetS. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.","PeriodicalId":100789,"journal":{"name":"Journal of Indian College of Cardiology","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135649581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A Case Report of Acute Coronary Syndrome Secondary to Active Crohn’s Disease","authors":"Shishir Kumar Roul, Muni V. Reddy, Sharan Malipatil, Saurabh Ajit Deshpande","doi":"10.4103/jicc.jicc_30_21","DOIUrl":"https://doi.org/10.4103/jicc.jicc_30_21","url":null,"abstract":"Chronic inflammation is a common factor between atherosclerosis and inflammatory bowel disease (IBD). IBD (both ulcerative colitis and Crohn’s disease [CD]) has been linked with arterial atherosclerotic events such as myocardial infarction (MI) and stroke. We present the case of a young male presenting with MI which was diagnosed to be due to an underlying CD.","PeriodicalId":100789,"journal":{"name":"Journal of Indian College of Cardiology","volume":"293 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135649900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Coronary Artery Aneurysms Following Stenting","authors":"Immaneni Sathyamurthy, Kanthallu Narayanamoorthy Srinivasan, Sasikala Subramanian","doi":"10.4103/jicc.jicc_9_22","DOIUrl":"https://doi.org/10.4103/jicc.jicc_9_22","url":null,"abstract":"Coronary artery aneurysms are rare complications following stenting and were reported with drug-eluting as well as bare metal stents. They can be asymptomatic or present as acute coronary syndromes and usually detected during coronary angiography. The mechanisms responsible can be vascular trauma, hypersensitivity to drug, polymer, or metal. Rarely, it can be due to acute bacterial infections resulting in mycotic aneurysms. Management depends on symptoms, presentation, and underlying pathology and has to be tailored on a case-to-case basis.","PeriodicalId":100789,"journal":{"name":"Journal of Indian College of Cardiology","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135649887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
I. Sathyamurthy, K. Kirubakaran, Sasikala Subramanian, K. Srinivasan
{"title":"Cessation of pulmonary vasodilators in PAH related to congenital heart disease","authors":"I. Sathyamurthy, K. Kirubakaran, Sasikala Subramanian, K. Srinivasan","doi":"10.4103/jicc.jicc_23_22","DOIUrl":"https://doi.org/10.4103/jicc.jicc_23_22","url":null,"abstract":"Pulmonary arterial hypertension secondary to congenital heart diseases is a subset of patients who need pulmonary vasodilators (PVDs). We are reporting an adult female who continued to have severe pulmonary hypertension after corrective surgery for the atrial septal defect. She showed improvement in symptoms and effort tolerance assessed by 6-min walk distance, but on cessation of therapy, showed worsening of exercise tolerance which improved after reintroduction. This report stresses the importance of the need for long-term combination of PVDs without interruption.","PeriodicalId":100789,"journal":{"name":"Journal of Indian College of Cardiology","volume":"37 1","pages":"40 - 42"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80333918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Immaneni Sathyamurthy, K. Kirubakaran, Kanthallu Narayanamoorthy Srinivasan, Sasikala Subramanian
{"title":"Triple-Vessel Coronary Artery Aneurysms Following Drug-Eluting Stents","authors":"Immaneni Sathyamurthy, K. Kirubakaran, Kanthallu Narayanamoorthy Srinivasan, Sasikala Subramanian","doi":"10.4103/jicc.jicc_47_21","DOIUrl":"https://doi.org/10.4103/jicc.jicc_47_21","url":null,"abstract":"Coronary artery aneurysms (CAAs) after drug-eluting stents are rare. They can be found during routine angiograms when asymptomatic or present with acute coronary syndromes. We report a case of multiple CAAs who presented 8 years after the initial stenting. Left anterior descending artery was the culprit vessel and managed with restenting.","PeriodicalId":100789,"journal":{"name":"Journal of Indian College of Cardiology","volume":"118 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135649585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Interpreting high sensitivity troponins in various acute clinical settings – Increased significance to the present-day cardiologist","authors":"Raghuram Palaparti, Gopala Koduru, Sarada Chowdary Parvathaneni","doi":"10.4103/jicc.jicc_14_21","DOIUrl":"https://doi.org/10.4103/jicc.jicc_14_21","url":null,"abstract":"High-sensitivity cardiac troponins expedite the evaluation of patients with chest pain in the emergency department. The utility of troponins extends beyond the acute coronary syndromes to accurate the diagnosis of myocardial injury. Troponins are best friends for physicians; however, they are a double-edged sword if not interpreted appropriately. Misdiagnosis is harmful with regard to patient outcomes. The present review focuses on the recent updates in the understanding and interpretation of high-sensitivity troponins in various acute clinical settings. Common mistakes and gray zones in the interpretation of troponins, the concept of myocardial injury versus infarction, newer entities like myocardial infarction (MI) with Nonobstructive Coronary Arteries, recent controversies over the definition of periprocedural MI, complementary role of imaging in the diagnosis of myocardial injury and the role of troponins in the current COVID-19 pandemic are discussed.","PeriodicalId":100789,"journal":{"name":"Journal of Indian College of Cardiology","volume":"76 5 Pt 1 1","pages":"1 - 10"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77510889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Correlation of Left Ventricular Global Longitudinal Strain and Angiographically Derived SYNTAX Score in Patients of Stable Angina Pectoris","authors":"Suhas Hardas, Shripal Bhivaskar, Hasmukh Gujar, Deepak Sadashiv Phalgune","doi":"10.4103/jicc.jicc_31_22","DOIUrl":"https://doi.org/10.4103/jicc.jicc_31_22","url":null,"abstract":"Background: The present study aimed to assess the relationship between global longitudinal strain (GLS) by two-dimensional (2D) speckle tracking echocardiography (STE) and SYNTAX score (SS) in patients with stable angina pectoris and normal baseline left ventricular (LV) function. Methods: Fifty patients aged ≥18 years presented with stable angina pectoris with LV ejection fraction ≥60.0% posted for elective coronary angiography were included in the study. All the patients underwent 2D echocardiography, 2D STE, and coronary angiography. GLS and SSs were calculated. The primary objective was to find the correlation between GLS and SS in assessing the severity of coronary artery disease (CAD), whereas the secondary objectives were to find the sensitivity and specificity of GLS to predict critical CAD. Results: A significant negative correlation (−0.862, P = 0.001) was observed between GLS and SSs. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of GLS score 16 were 100.0%, 64.0%, 73.5%, 100.0%, and 82.0, respectively, in predicting higher SS (≥22). The mean GLS values were significantly higher in noncritical CAD (16.4 ± 1.1) as compared to critical CAD (12.4 ± 1.3). Conclusions: GLS is a useful noninvasive tool to detect the severity of CAD.","PeriodicalId":100789,"journal":{"name":"Journal of Indian College of Cardiology","volume":"52 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135600713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Elshaimaa Aly M. Elsadek Seaoud, Mohamed Salah Abdelbasit, Baher Nabil, Ahmed Shawky
{"title":"The Role of Admission Platelet Count and B-type Natriuretic Peptide in Predicting in Hospital Morbidity in ST-Elevation Myocardial Infarction Patients","authors":"Elshaimaa Aly M. Elsadek Seaoud, Mohamed Salah Abdelbasit, Baher Nabil, Ahmed Shawky","doi":"10.4103/jicc.jicc_15_21","DOIUrl":"https://doi.org/10.4103/jicc.jicc_15_21","url":null,"abstract":"Context: Platelets play a major role in the pathophysiology of acute myocardial infarction. Aim: This study aims to evaluate the potential correlation between admission platelet count (PLT) and B-type natriuretic peptide (BNP) with the development of severe heart failure during the first 24 h post primary PCI (post-PPCI) in patients admitted with ST-elevation myocardial infarction (STEMI). Settings and Design: This was cross-sectional follow-up study. Methods: One hundred and forty-six patients admitted with STEMI. At the time of admission, blood samples were drawn to measure PLT and BNP level. Twenty-four h after reperfusion, patients were assessed using Killip score, and a transthoracic echo was done to determine ejection fraction (EF) using modified Simpson’s rule. Statistical Analysis: Comparison between parametric quantitative independent groups done by t -test. The area under the receiver operating characteristic (ROC) area under the curve was calculated to determine the sensitivity and specificity of PLT in diagnosing severe heart failure (Killip III and IV) Confounding bias has been addressed through a multivariate logistic regression model. Results: we found a significant negative correlation between admission PLT and left ventricular EF measured 24 h post-PPCI and a positive correlation between PLT and both BNP and CKMB level measured at admission ( P = 0.001, 0.004 and P = 0.007, respectively). ROC curve analysis showed a platelet cut-off value of 290 × 10 3 to diagnose severe heart failure (Killip’s grades III and IV) (sensitivity of 70% and specificity of 83.1%.). Conclusion: BNP and PLT are easy, inexpensive blood tests that can be used as predictors of heart failure post-STEMI.","PeriodicalId":100789,"journal":{"name":"Journal of Indian College of Cardiology","volume":"54 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135649889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Correlation of Electrocardiogram Changes with Epicardial and Myocardial Perfusion in ST-Elevation Myocardial Infarction","authors":"Mahesh Kharade, Sunil Sathe, Deepak Sadashiv Phalgune, Hasmukh Gujar, Mullasari Ajit Sankardas","doi":"10.4103/jicc.jicc_31_23","DOIUrl":"https://doi.org/10.4103/jicc.jicc_31_23","url":null,"abstract":"Background: The present study was aimed to find the correlation of electrocardiographic changes with epicardial thrombolysis in myocardial infarction (TIMI) flow grade and TIMI myocardial perfusion grade (TMPG) after reperfusion in ST-elevation myocardial infarction (STEMI). Methods: One hundred and fifty patients with STEMI were included. Reperfusion was done either by thrombolysis or primary percutaneous coronary intervention. The summed absolute ST-segment deviation and summed relative ST-segment deviation were calculated. TIMI and TMPG were assessed. The primary outcome measures were to study the correlation of summed absolute ST deviation and summed relative ST deviation with TIMI flow grade and TMPG after reperfusion. The secondary outcome measures were to compare TIMI flow grade and TMPG with respect to time since symptom onset to treatment and T-wave inversion after reperfusion. Results: There was a significant positive correlation between relative ST-segment deviation that occurred after reperfusion with TIMI flow grade ( r = 0.475) and TMPG ( r = 0.376). There was a significant negative correlation between absolute ST-segment deviation that occurred after reperfusion with TIMI flow grade ( r = −0.194) and TMPG ( r = −0.288). A significantly higher percentage (87.4%) of patients who got treatment within 1 h showed TMPG 2 and 3. A significantly higher percentage of patients who had T-wave inversion after reperfusion had TIMI flow Grade 3 and TMPG 2 and 3. Conclusions: There was a significant positive correlation between relative ST-segment deviation and significant negative correlation between absolute ST-segment deviation after reperfusion with TIMI flow grade and TMPG.","PeriodicalId":100789,"journal":{"name":"Journal of Indian College of Cardiology","volume":"275 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135649891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kavita Vilas Pande, Madhuri Rushikesh Joshi, Rushikesh Kaushik Joshi
{"title":"To Compare the Effects of Adding Handheld and Ankle Weights During Treadmill Walking on Blood Pressure and Rate of Perceived Exertion in Normal Healthy Adults: An Experimental Study","authors":"Kavita Vilas Pande, Madhuri Rushikesh Joshi, Rushikesh Kaushik Joshi","doi":"10.4103/jicc.jicc_19_23","DOIUrl":"https://doi.org/10.4103/jicc.jicc_19_23","url":null,"abstract":"Context: Walking is the most commonly reported activity which requires no special facilities and is achievable by all groups with little injury risk. Nowadays, adding weights to different locations while walking is popular in general fitness and rehabilitation programs, which again increases energy expenditure as well as oxygen consumption in a shorter quantity of time. Aims: The aim of this study was to compare the effect of adding handheld and ankle weights during treadmill walking on blood pressure and rate of perceived exertion in normal healthy adults. Settings and Design: The experimental study took place in the laboratory and was designed to be carried on for three sessions to measure the changes in blood pressure and ratings of perceived exertion (RPE) while walking with and without weight. Subjects and Methods: Thirty-three participants who satisfied the inclusion criteria were recruited to perform the exercise session with handheld and ankle and without weights and it consisted of 8 min of exercise testing with and without weights for two sessions. Statistical Analysis Used: The statistical test data were screened for normal distribution by Shapiro–Wilk test. Data were normally distributed for the systolic blood pressure (SBP), diastolic blood pressure (DBP), and RPE. Hence, parametric tests were applied for SBP, DBP, and RPE within-session and between-session analysis. Within-session analysis was done by paired t -test and between-session analysis was done by unpaired t -test. Results: Intra-session analysis by paired t -test in both sessions shows statistically significant changes in SBP and RPE ( P < 0.05). Moreover, DBP was found significant while using handheld weights compared to no weights. While inter-session analysis by unpaired t -test showed significant changes in DBP compared to that of SBP, RPE using handheld weights during treadmill walking. Conclusions: Study shows addition of handheld weights proves to be more effective in adults who cannot run, or do not like to run, or are limited in walking speed, and may benefit from the addition of hand-held weight (HHW) and ankle weight (AW).","PeriodicalId":100789,"journal":{"name":"Journal of Indian College of Cardiology","volume":"84 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135649897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}