Journal of Indian College of Cardiology最新文献

{"title":"A study on clinical profile and in-hospital outcome of elderly patients receiving thrombolytic therapy for ST elevation myocardial infarction","authors":"D. Thakkar, Rangaraj Ramalingam, A. Palakshachar, S. Patil, K. Subramanyam, N. Moorthy, Meet M Thacker, B. Arun, C. Manjunath","doi":"10.4103/jicc.jicc_3_21","DOIUrl":"https://doi.org/10.4103/jicc.jicc_3_21","url":null,"abstract":"Objective: Ischemic heart disease is the leading cause of mortality in population above the age of 70 years. ST-elevation myocardial infarction (STEMI) constitutes important treatable cause of death in elderly population. However, many large, randomized trials have excluded this age group. The present study was planned to find out the benefits and complications related to thrombolytic therapy in elderly patients. Materials and Methods: The study was done between January 1, 2019, and December 31, 2019, in the Department of Cardiology, Sri Jayadeva Institute Of Cardiovascular Sciences and Research, Bengaluru, India, which included the study group comprising 106 elderly patients (age >70 years) with acute STEMI and underwent thrombolytic therapy. All patients were followed up till the index hospitalization and evaluated for in-hospital outcome. Results: Out of the 106 patients in the study group, 64 (60.38%) were male and 42 (39.62%) were female. Out of which, 88 (83%) patients were between 70 and 80 years whereas 18 (17%) patients were >80 years. Mortality was happened in 32 patients (30.2%). Coronary angiogram post thrombolysis was performed as pharmacoinvasive or rescue percutaneous coronary intervention (PCI) in 25 patients (23.6%), and cardiac arrhythmias were noted in 22 (20.6%) patients, acute kidney injury in 7 (6.6%) patients, ventricular septal rupture in 5.7%, ischemic stroke in 4.7%, free-wall rupture in 2.8%, and intracranial hemorrhage in 0.9% of patients. Conclusions: Primary PCI may offer clinical advantage over fibrinolytic therapy as manifested by the trends toward improvements in the combined endpoint of death, reinfarction, and stroke in the oldest patients. Despite the higher prevalence of comorbidities and high-risk features in elderly patients of acute STEMI, timely thrombolysis is also beneficial particularly who present early after symptom onset, absence of comorbid condition, and lower NYHA class on admission (NYHA I/II). In developing countries like India where primary PCI may not be feasible, timely thrombolysis should be given to the elderly patients also.","PeriodicalId":100789,"journal":{"name":"Journal of Indian College of Cardiology","volume":"58 1","pages":"14 - 18"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84887555","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":"Giant carotid aneurysm in takayasu arteritis","authors":"D. Acharya, Dr. Rabindra Das, Jogendra Singh, Subhash R. Pramanik","doi":"10.4103/jicc.jicc_10_21","DOIUrl":"https://doi.org/10.4103/jicc.jicc_10_21","url":null,"abstract":"Takayasu arteritis is an arteritis of unknown etiology, resulting in stenosis or dilatation of the aorta and its major branches. .We report a rare case of a giant right common carotid artery aneurysm on the one side in a 29-year-old young male with refractory hypertension with severely stenotic, diffusely diseased, corkscrew appearance of the contralateral carotid artery, which has not been described in the literature so far. Our case is a unique demonstration of nature's paradox in vascular behavior in Takayasu arteritis in the right and left carotid arteries in an index patient; one having a giant aneurysm and the other one being severely stenotic, diffusely diseased with corkscrew appearance.","PeriodicalId":100789,"journal":{"name":"Journal of Indian College of Cardiology","volume":"32 1","pages":"34 - 36"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80464374","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":"Assessment of risk factors, clinical presentation and angiographic profile of coronary slow flow phenomenon","authors":"Sara Abd-Elghaffar, R. E. El Sheikh, A. Gaafar, Yasser Elbarbary","doi":"10.4103/jicc.jicc_6_21","DOIUrl":"https://doi.org/10.4103/jicc.jicc_6_21","url":null,"abstract":"Background: Primary coronary slow flow phenomenon (PCSFP) is a clinical entity that causes attacks of mild to severe chest pain. It is characterized by delayed coronary vessel opacification in the absence of epicardial stenosis. This work aimed for the assessment of predictors, clinical presentation, and angiographic profile of PCSFP. Subjects and Methods: This cross-sectional case–control study was done between February 2019 and January 2020, including 150 patients who presented by ST-segment myocardial infarction, non-ST segment myocardial infarction, unstable angina, chronic coronary syndrome, or atypical chest pain. The patients were divided into two groups: group 1: consisted of 100 patients who had PCSFP and Group 2: consisted of 50 patients who had normal coronary flow (NCF). Results: PCSFP was significantly more prevalent in young male patients. Among the traditional risk factors, there was significantly more prevalence of hypertension (63.0% vs. 28.0%, P = 0.001), obesity (body mass index ≥30 kg/m2 (47.0% vs. 4.0%, P = 0.001), and history of smoking (66.0% vs. 40.0%, P < 0.002) in PCSFP patients as compared to NCF patients. Triglyceride (TG), cholesterol, low-density lipoprotein, high-sensitivity C-reactive protein (hs-CRP), and hemoglobin all were higher in patients with PCSFP. Low high-density lipoprotein levels were associated with PCSFP. In multivariable analysis, PCSFP was significantly independently associated with male sex, high TG, cholesterol, and hs-CRP. TG (odds ratio [OR]: 14.427, 95% confidence interval [CI]: 3.514–59.226) and cholesterol (OR: 11.739, 95% CI, 2.439–56.513) are the strongest independent predictors for PCSFP. Conclusion: PCSFP is more common in young smoker males, is associated with hypertension, obesity, high hs-CRP, TG, and cholesterol levels. High cholesterol and TG and male sex are the strongest risk factors for PCSFP. Furthermore, inflammation plays an important factor in the pathogenesis of PCSFP due to the association of high hs-CRP level in those patients.","PeriodicalId":100789,"journal":{"name":"Journal of Indian College of Cardiology","volume":"75 1","pages":"19 - 24"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73418452","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":"Multiple systemic cardio-embolism in native aortic valve endocarditis","authors":"C. Paraschiv, L. Trasca, A. Popescu, S. Balanescu","doi":"10.4103/jicc.jicc_5_21","DOIUrl":"https://doi.org/10.4103/jicc.jicc_5_21","url":null,"abstract":"We present a challenging case of native aortic valve endocarditis with Enterococcus faecalis in a patient with a history of multiple urinary tract infections and urethral strictures treated by local dilations. The case was complicated by Clostridium difficile colitis and multiple septic embolization. Despite intensive antibacterial therapy, guided by the antibiogram, the vegetations grew in size and the infection became uncontrolled causing recurrent embolism.","PeriodicalId":100789,"journal":{"name":"Journal of Indian College of Cardiology","volume":"45 1","pages":"31 - 33"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89971335","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":"Strontium in atrioventricular conduction disorder: Is it a new target?","authors":"Subhabrata Mukherjee, D. Kumar, D. Bera, Arindam Pande, S. Patra, R. Roy, Rabin Chakraborty","doi":"10.4103/jicc.jicc_82_20","DOIUrl":"https://doi.org/10.4103/jicc.jicc_82_20","url":null,"abstract":"Introduction: Atrioventricular (AV) block is a common problem worldwide requiring permanent pacemaker implantation, which results in a huge economic burden on society. In our country, the major burden is noted in eastern India. The etiopathological correlation of degenerative conduction tissue disorder does o't explain the differential volume of disease. We speculate environmental link, particularly the influence of elevated trace metals in the pathogenesis of this condition. Purpose: The purpose of the study was to investigate and correlate the concentration of trace metals in blood of patients who have received a permanent pacemaker. Materials and Methods: The blood samples of 81 patients who had permanent pacemaker implantation in the past 3 years were collected and levels of various trace metals were evaluated. It was done using inductively coupled plasma mass spectrometry. The values were expressed in μg/l. Results: There were elevated trace metals in 21 patients and 4 among them had an overlap of more than one abnormal values. Strontium (Sr) surprisingly was elevated in a maximum of 11 patients. The most interesting observation was a trend of Sr being elevated in male sex with AV nodal disease. Conclusion: From this study we hypothesize, Sr affects ion channels in conduction tissue due to its close chemical similarity to calcium. In long run, it could have been inducing fibrosis causing AV blocks. Our observation suggests that trace metal screening may be considered in areas with a high prevalence of AV blocks requiring permanent pacemakers.","PeriodicalId":100789,"journal":{"name":"Journal of Indian College of Cardiology","volume":"14 1","pages":"25 - 27"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87481008","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":"Nonvalvular atrial fibrillation and acute coronary syndrome: Present Indian perspective and assessment","authors":"R. Modi, A. Jaswal, S. Modi","doi":"10.4103/jicc.jicc_74_20","DOIUrl":"https://doi.org/10.4103/jicc.jicc_74_20","url":null,"abstract":"Background: The number of patients undergoing percutaneous coronary intervention (PCI) who mandate additional oral anticoagulant therapy, due to presence of Atrial Fibrillation (AF), has been increasing. Dual antiplatelet therapy (DAPT) is associated with reduced ischemic events including stent thrombosis, myocardial infarction and stroke following PCI. However, the trade-off is an increased risk for bleeding while on DAPT. The addition of an anticoagulation further increases the likelihood of bleeding while on antiplatelet therapy. Thus, the overall risks and benefits for each patient undergoing PCI on anticoagulation (VKA/ NOAC) must be assessed and therapy individualized to ensure optimal therapy for each unique situation. Aims and Objectives: The aim of the study was to determine the diversity in the antiplatelet and anticoagulation treatment of patients with nonvalvular AF or flutter who develop acute coronary syndrome (ACS) or undergo PCI in India.Materials and Methods: All patients who had AF and underwent PCI were included in the study. Results: In the study 100 patients of AF with PCI were evaluated, among who 95 % were started on triple therapy (TT) and 5 % on DAPT. The patients were followed up at 1 month, 3 months, 6 months, and 1 year for adjustment of antiplatelet, anticoagulation medicines, and their dosage. Conclusion: The study reviewed the best practices for the pharmacologic management of patients requiring anticoagulation with NOAC who are treated with PCI and require antiplatelet therapy.","PeriodicalId":100789,"journal":{"name":"Journal of Indian College of Cardiology","volume":"91 1","pages":"179 - 185"},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81559335","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":"Retrograde his activation and resetting of the sinus node in parahisian pathway","authors":"D. Acharya, Debasish Das, T. Das, Subhash R. Pramanik","doi":"10.4103/jicc.jicc_27_21","DOIUrl":"https://doi.org/10.4103/jicc.jicc_27_21","url":null,"abstract":"","PeriodicalId":100789,"journal":{"name":"Journal of Indian College of Cardiology","volume":"13 1","pages":"211 - 211"},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90437580","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":"Woes of follow-up patients: A stumbling block, every cardiologist needs to intervene","authors":"B. Naik, S. Biradar","doi":"10.4103/jicc.jicc_16_21","DOIUrl":"https://doi.org/10.4103/jicc.jicc_16_21","url":null,"abstract":"","PeriodicalId":100789,"journal":{"name":"Journal of Indian College of Cardiology","volume":"33 1","pages":"210 - 210"},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87477086","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":"Newer oral anticoagulants in venous thromboembolism","authors":"S. Modi, R. Modi","doi":"10.4103/jicc.jicc_73_20","DOIUrl":"https://doi.org/10.4103/jicc.jicc_73_20","url":null,"abstract":"Venous thromboembolism (VTE) is an important medical condition for morbidity and mortality. Adequate anticoagulant treatment is necessary to reduce short- and long-term VTE related conditions. In the past low molecular weight heparin (LMWH) and Vitamin K antagonists (VKAs) have been the mainstay of anticoagulation therapy for VTE patients. The patients require frequent monitoring with INR to keep balance between effectiveness and safety in clinical practice. NOACs have been the main stay of treatment in conditions requiring effective anticoagulation. They may prove to do the same in VTE. This article analyses, the present literature on use of NOACs in VTE.","PeriodicalId":100789,"journal":{"name":"Journal of Indian College of Cardiology","volume":"55 1","pages":"172 - 178"},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85404903","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":"Retraction: The sensitivity and specificity of electrocardiogram in localizing the culprit artery with angiographic correlation in indian patients with acute st-segment elevation myocardial infarction","authors":"","doi":"10.4103/1561-8811.329184","DOIUrl":"https://doi.org/10.4103/1561-8811.329184","url":null,"abstract":"","PeriodicalId":100789,"journal":{"name":"Journal of Indian College of Cardiology","volume":"31 1","pages":"212 - 212"},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88523727","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}