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Prevalence of periodontitis in chronic heart failure patients and its relationship with NT-ProBNP: A cross-sectional study.
IF 1.4
Indian heart journal Pub Date : 2025-03-07 DOI: 10.1016/j.ihj.2025.03.004
Sonika Sharma, Deepti Mathur, Sourabh Goswami, Manoj Kumar Gupta, Pankaj Bhardwaj, Pravin Kumar, Surender Deora
{"title":"Prevalence of periodontitis in chronic heart failure patients and its relationship with NT-ProBNP: A cross-sectional study.","authors":"Sonika Sharma, Deepti Mathur, Sourabh Goswami, Manoj Kumar Gupta, Pankaj Bhardwaj, Pravin Kumar, Surender Deora","doi":"10.1016/j.ihj.2025.03.004","DOIUrl":"10.1016/j.ihj.2025.03.004","url":null,"abstract":"<p><strong>Background: </strong>Periodontal disease has been associated with chronic heart failure (CHF) and may be an indicator of high risk of adverse cardiovascular outcomes. To date, only few studies have been done and none from India regarding the association of periodontal disease in heart failure patients. So, this study was done to assess the prevalence of periodontitis in CHF patients and its correlation with N-terminal pro brain natriuretic peptide (NT- ProBNP).</p><p><strong>Materials and method: </strong>In this study, 154 patients with stable CHF with left ventricular ejection fraction of less than 40 % were enrolled. All subjects underwent cardiologic and dental evaluations. NT pro-BNP level was measured in all patients. The periodontal screening index was used to quantify the degree of periodontal disease.</p><p><strong>Results: </strong>Gingivitis, moderate periodontitis, and severe periodontitis were present in 48 (31.2 %), 82 (53.2 %), and 24 (15.5 %) patients, respectively. In individuals under the age of 75 years, the study found a significant association between moderate and severe periodontitis and elevated NT-proBNP levels (p < 0.05). The comparison between gingivitis and moderate/severe periodontitis was statistically significant in post hoc analysis.</p><p><strong>Conclusion: </strong>CHF patients exhibit a high prevalence of moderate and severe periodontitis. This study highlights a significant association between periodontitis severity and elevated NT-proBNP in CHF patients, underscoring a potential cardiac impact. Further research is warranted to deepen our understanding of this relationship.</p>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585578","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}
引用次数: 0
"PERCUTANEOUS DEVICE CLOSURE FOR PARAVALVULAR LEAKS- A SINGLE CENTRE EXPERIENCE".
IF 1.4
Indian heart journal Pub Date : 2025-03-06 DOI: 10.1016/j.ihj.2025.02.008
Uday B Khanolkar, Meemansa Kashyap Buch, Satish C Govind, Barendra Kumar Raut, Bagirath Raghuraman, Kapil Kumawat, Bijay Kumar Mahala, Arjun Shenoi, Devi Prasad Shetty
{"title":"\"PERCUTANEOUS DEVICE CLOSURE FOR PARAVALVULAR LEAKS- A SINGLE CENTRE EXPERIENCE\".","authors":"Uday B Khanolkar, Meemansa Kashyap Buch, Satish C Govind, Barendra Kumar Raut, Bagirath Raghuraman, Kapil Kumawat, Bijay Kumar Mahala, Arjun Shenoi, Devi Prasad Shetty","doi":"10.1016/j.ihj.2025.02.008","DOIUrl":"https://doi.org/10.1016/j.ihj.2025.02.008","url":null,"abstract":"<p><p>The incidence of paravalvular leak (PVL) following surgical valve replacement is 5-17%. Our main aim is to determine the safety and efficacy of percutaneous device closure for significant PVLs.Transcatheter device closure was done for 45 PVLs in 42 patients. PVLs were closed percutaneously in mitral position in 23 cases, in aortic position in 20 cases, and combined mitral and aortic leaks in 2 cases. We achieved a technical success rate of 93.33% and procedural success rate of 91.11%. Transcatheter PVL closure is a safe and effective procedure for symptomatic PVLs.</p>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585576","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}
引用次数: 0
Comparison of hybrid coronary revascularization versus conventional Coronary Artery Bypass surgery in patients with multi-vessel coronary artery disease in a real-world setting: In-hospital outcomes and medium-term follow-up: COHOS study.
IF 1.4
Indian heart journal Pub Date : 2025-03-05 DOI: 10.1016/j.ihj.2025.03.002
Dhamodaran Kaliyamoorthy, Meeranghani Mohamed Yusuf, Vadivelu Ramalingam, Abhishek Kasha, Manickam Kathiresan, Rizwan Suliankatchi Abdulkader, Jeyashree Kathiresan, Aishwarya Mahesh Kumar, Elsa Grace, Anirban Choudhury
{"title":"Comparison of hybrid coronary revascularization versus conventional Coronary Artery Bypass surgery in patients with multi-vessel coronary artery disease in a real-world setting: In-hospital outcomes and medium-term follow-up: COHOS study.","authors":"Dhamodaran Kaliyamoorthy, Meeranghani Mohamed Yusuf, Vadivelu Ramalingam, Abhishek Kasha, Manickam Kathiresan, Rizwan Suliankatchi Abdulkader, Jeyashree Kathiresan, Aishwarya Mahesh Kumar, Elsa Grace, Anirban Choudhury","doi":"10.1016/j.ihj.2025.03.002","DOIUrl":"10.1016/j.ihj.2025.03.002","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of this observational study was to evaluate the in-hospital and medium-term outcomes of hybrid coronary revascularization (HCR) in the real-world setting compared to conventional coronary artery bypass grafting (CABG).</p><p><strong>Methods: </strong>All patients with multi-vessel coronary artery disease (MV-CAD) who underwent conventional CABG and HCR in our institution between January 2018 to January 2021 were evaluated in terms of length of intensive care unit (ICU), in-hospital stay, repeat revascularization rates, bleeding, stroke, and in-hospital mortality. Clinical outcomes (mortality and major adverse cardiac and cerebrovascular events [MACCE]) were assessed at average follow up of 3.6 years.</p><p><strong>Results: </strong>Pre-procedural characteristics were balanced between the groups after propensity score matching. There was no significant difference in MACCE [Odds ratio: 0.57; 95 % CI: 0.05 to 1.52; p = 0.66], in-hospital mortality [n = 2 (1.9 %) vs n = 0; p = 0.80], post procedure stroke [n = 2 (1.9 %) vs n = 2 (3.7 %); p = 0.86], post-procedural myocardial infarction requiring repeat revascularization [n = 2 (1.9 %) versus n = 1 (1.9 %); p = 1] during the in-hospital stay of the patients in the CABG vs HCR groups respectively. HCR was associated with significantly lower requirement for blood transfusions, bleeding risk, in-hospital stay, and intensive care unit stay. Analysis of the outcomes after 3.6 years revealed no significant difference in MACCE [Odds ratio: 1.40; 95 % CI: 0.46 to 4.30; p = 0.55], and post discharge mortality [n = 0 vs n = 0; p = 1]. Both groups had similar rates of post-procedural myocardial infarction requiring repeat revascularization [n = 0 vs n = 4 (7.4 %); p = 0.278], and rate of re-intervention [n = 0 vs n = 3 (5.6 %); p = 0.41].</p><p><strong>Conclusion: </strong>HCR may be considered as a safe and feasible alternative to conventional CABG in selected individuals with MV-CAD.</p>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585577","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}
引用次数: 0
Drug-coated balloon in patients with in-stent restenosis: A prospective observational study.
IF 1.4
Indian heart journal Pub Date : 2025-03-03 DOI: 10.1016/j.ihj.2025.03.003
Shuvanan Ray, Siddhartha Bandyopadhyay, Prithwiraj Bhattacharjee, Priyam Mukherjee, Suman Karmakar, Pallab Bose, Basabendra Choudhury, Deepankar Paul, Avik Karak
{"title":"Drug-coated balloon in patients with in-stent restenosis: A prospective observational study.","authors":"Shuvanan Ray, Siddhartha Bandyopadhyay, Prithwiraj Bhattacharjee, Priyam Mukherjee, Suman Karmakar, Pallab Bose, Basabendra Choudhury, Deepankar Paul, Avik Karak","doi":"10.1016/j.ihj.2025.03.003","DOIUrl":"10.1016/j.ihj.2025.03.003","url":null,"abstract":"<p><strong>Aim: </strong>The aim of this study was to compare the safety and efficacy of paclitaxel-coated balloons (PCB) and sirolimus-coated balloons (SCB) in patients with in-stent restenosis (ISR).</p><p><strong>Methods: </strong>This prospective, observational, single-centre pilot study enrolled 85 patients diagnosed with drug-eluting stent ISR. For all the eligible patients, various clinical baseline characteristics were collected, and angiography was performed to evaluate the lesion characteristics. After assessment, patients were treated with either PCB or SCB based on our center's time-based approach. Intravascular ultrasound (IVUS) imagining was used to assess the pre- and post-procedural minimal stent area (MSA). All the patients were followed up and major adverse cardiovascular events were documented for patients in both the groups.</p><p><strong>Results: </strong>Of total 85 patients with ISR, 32 underwent treatment with PCB and 53 with SCB. A significant difference was noted in the post procedural MSA in both the groups (p = 0.005) and the values were 7.01 ± 1.11 mm<sup>2</sup> and 8.01 ± 1.70 mm<sup>2</sup> for PCB and SCB group, respectively. At median follow-up of 3.8 years, no cardiac death was noted in PCB group and one death was reported in SCB group (p = 0.459). In PCB group, target lesion revascularization (TLR) was noted in one (12.5 %) patient, while in SCB group TLR was noted in four (16.5 %) patients (p = 0.920).</p><p><strong>Conclusion: </strong>Both PCB and SCB are found to be effective and safe in treating in patients with drug-eluting stents-ISR. Also, the use of DCB with imaging techniques like IVUS enhances treatment outcomes and optimizes patient care in ISR treatment.</p>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143566984","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}
引用次数: 0
Feasibility and outcomes of PCI with novel tapered coronary stent in people living with HIV: A prospective, single-center study with literature review.
IF 1.4
Indian heart journal Pub Date : 2025-03-03 DOI: 10.1016/j.ihj.2025.03.001
H S Natraj Setty, B H Natesh, M C Yeriswamy, V A Sathwik Raj, Rahul S Patil, H B Chetan Kumar, L Sridhar Shastry, B C Srinivas, Babu Reddy, Jayashree Kharge, C M Nagesh, S Manohar, C M Satwik, K H Srinivas, Santhosh Jadav, K S Subramani, Sadanand, Vijay Kumar, K S Ravindranath
{"title":"Feasibility and outcomes of PCI with novel tapered coronary stent in people living with HIV: A prospective, single-center study with literature review.","authors":"H S Natraj Setty, B H Natesh, M C Yeriswamy, V A Sathwik Raj, Rahul S Patil, H B Chetan Kumar, L Sridhar Shastry, B C Srinivas, Babu Reddy, Jayashree Kharge, C M Nagesh, S Manohar, C M Satwik, K H Srinivas, Santhosh Jadav, K S Subramani, Sadanand, Vijay Kumar, K S Ravindranath","doi":"10.1016/j.ihj.2025.03.001","DOIUrl":"10.1016/j.ihj.2025.03.001","url":null,"abstract":"<p><strong>Background and objective: </strong>Patients with chronic HIV infection face a high risk of premature coronary atherosclerosis, partly due to continuous HAART therapy and susceptibility to opportunistic infections, complicating percutaneous coronary intervention (PCI). HIV patients have unique coronary vasculature characteristics. This study aimed to assess the clinical outcomes of PCI using the novel tapered sirolimus-eluting coronary stent (SES) system in HIV patients.</p><p><strong>Methods: </strong>A prospective, single-arm, non-randomized study was conducted at a tertiary cardiac care center, including 15 HIV-positive patients with acute coronary syndromes. PCI was performed using the study device for de novo coronary lesions with significant size disparity between reference vessel segments. The cumulative incidence of major adverse cardiovascular events (MACE), defined as cardiac death, myocardial infarction, and clinically driven target-lesion revascularization (CD-TLR), was the primary endpoint.</p><p><strong>Results: </strong>Since 2018, 15 HIV-positive patients with a mean age of 50.67 years underwent PCI with the study device. Despite cardiac risk factors and complex lesions, 100 % procedural and device success was achieved by restoring myocardial flow (TIMI flow III). Over a median follow-up of 40 months, no MACE or adverse events were recorded.</p><p><strong>Conclusions: </strong>This study provides new evidence on the use of the long, tapered SES for treating HIV-positive patients, demonstrating high success rates and favorable long-term outcomes. It is the first report of such outcomes using a long, tapered SES in this population.</p>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143566985","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}
引用次数: 0
Serial electrocardiographic changes in patients with idiopathic dilated cardiomyopathy.
IF 1.4
Indian heart journal Pub Date : 2025-02-26 DOI: 10.1016/j.ihj.2025.02.010
Anil Kumar Choudhary, Ajay Bahl, Yash Paul Sharma, Saurabh Mehrotra, Himanshu Gupta, Somyata Somendra
{"title":"Serial electrocardiographic changes in patients with idiopathic dilated cardiomyopathy.","authors":"Anil Kumar Choudhary, Ajay Bahl, Yash Paul Sharma, Saurabh Mehrotra, Himanshu Gupta, Somyata Somendra","doi":"10.1016/j.ihj.2025.02.010","DOIUrl":"10.1016/j.ihj.2025.02.010","url":null,"abstract":"<p><p>Broad QRS and bundle-branch blocks are associated with poor outcomes in patients with DCM, however, studies on changes in QRS duration and morphology over long-term are limited. We retrospectively analyzed changes in ventricular activation and AV conduction in serial ECGs of 165 DCM patients with a follow-up of at least 5 years from 2003 to 2022. The mean QRS duration at the last follow-up was 114.2 ± 29 vs 106.2 ± 25.3 msec at the baseline(p < 0.0001). Individuals who showed ≥10msec increase in QRS duration also had a higher prevalence of ventricular conduction defects (68%). 13.8% of patients developed broadening of QRS, with an LBBB pattern in over 50%.</p>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143531443","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}
引用次数: 0
Early experience with the "modified jailed balloon technique" for side branch protection in bifurcation lesions.
IF 1.4
Indian heart journal Pub Date : 2025-02-26 DOI: 10.1016/j.ihj.2025.02.011
Somyata Somendra, Himanshu Gupta, Yash Paul Sharma
{"title":"Early experience with the \"modified jailed balloon technique\" for side branch protection in bifurcation lesions.","authors":"Somyata Somendra, Himanshu Gupta, Yash Paul Sharma","doi":"10.1016/j.ihj.2025.02.011","DOIUrl":"10.1016/j.ihj.2025.02.011","url":null,"abstract":"<p><strong>Objective: </strong>M-JBT is a novel approach to the \"keep-it-open strategy\" for bifurcation lesions where SB anatomy is unsuitable for stenting. We intend to provide insight into a contemporary way through our experience of the M-JBT.</p><p><strong>Methods: </strong>A semi-compliant balloon sized appropriately for the SB diameter is inflated simultaneously with the MB stent balloon during stent deployment, followed by POT of the MB stent and then recrossing the SB.</p><p><strong>Results: </strong>We performed the \"M-JBT\" in 25 cases of bifurcation lesions between September 2023-24, with absolute procedural success in preventing SB occlusion during MB stenting in all 25 lesions. SB occlusion after MB stent POT was seen in one case.</p><p><strong>Conclusion: </strong>This is the first report of clinical experience with the MJBT from the Indian subcontinent. MJBT proves to be a safe and effective approach to the protection of a clinically important SB during MB stenting across it.</p>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143531441","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}
引用次数: 0
Adherence to pharmacotherapy for secondary prevention of coronary heart disease: A registry-based prospective study.
IF 1.4
Indian heart journal Pub Date : 2025-02-26 DOI: 10.1016/j.ihj.2025.02.009
Aradhai Bana, Krishna Kumar Sharma, Soneil Guptha, Rajeev Gupta
{"title":"Adherence to pharmacotherapy for secondary prevention of coronary heart disease: A registry-based prospective study.","authors":"Aradhai Bana, Krishna Kumar Sharma, Soneil Guptha, Rajeev Gupta","doi":"10.1016/j.ihj.2025.02.009","DOIUrl":"https://doi.org/10.1016/j.ihj.2025.02.009","url":null,"abstract":"<p><strong>Background and objective: </strong>There is limited data on secondary prevention medications following acute coronary syndrome (ACS) in India. We performed a registry-based study to evaluate adherence to recommended medications following ACS hospitalisation.</p><p><strong>Methods: </strong>Consecutive patients admitted with ACS were recruited. Data on demographics, baseline characteristics, in-hospital interventions, and prescribed secondary prevention therapies (antiplatelets, statins, beta-blockers, angiotensin-converting enzyme inhibitors (ACEI), angiotensin receptor blockers (ARB), and calcium channel blockers (CCB) at discharge were recorded. 6-months follow-up was conducted to evaluate adherence using validated tools.</p><p><strong>Results: </strong>716 patients were recruited; the mean age was 60.4 ± 11 years, percutaneous coronary angioplasty (PCI) was performed in 714 (99.7 %) and bypass surgery in none. At hospital discharge, the cardioprotective medications were: aspirin 97.3 %, dual antiplatelets 99.7 %, statins 99.7 %, beta-blockers 74.2 %, ACEI/ARB 38.8 % and CCB 10.9 %. Follow-up data were available for 554 patients; 15 (2.1 %) died and 147 (20.5 %) were lost to follow-up. Medication status and change at 6 months was aspirin 83.9 % (-15.9 %); dual antiplatelets 70.2 % (-29.5 %), statins 70.0 % (-29.8 %), beta-blockers 50.4 % (-32.1 %), ACEI/ARB 22.4 % (-42.3 %) and CCB (-36.7 %) (p < 0.05). Use of high-intensity statins declined from 92.0 % to 45.7 % (-50.3 %). At follow-up, good adherence (>80 %) was 42.7 %, low adherence 24.4 % and non-adherence 10.2 %. Patients with government-sponsored insurance had better adherence than privately insured and self-paying.</p><p><strong>Conclusions: </strong>Following acute coronary syndrome and PCI, the adherence to prescribed pharmacotherapy is sub-optimal at 6 months with a decline in various medications of 16-42 %. Strategies to increase adherence to secondary prevention therapies are required.</p>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143531399","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}
引用次数: 0
Factor XI and XII inhibitors-Dawn of a new era.
IF 1.4
Indian heart journal Pub Date : 2025-02-25 DOI: 10.1016/j.ihj.2025.02.007
Chhabi Satpathy, Trinath Kumar Mishra, Anshu Kumar Jha
{"title":"Factor XI and XII inhibitors-Dawn of a new era.","authors":"Chhabi Satpathy, Trinath Kumar Mishra, Anshu Kumar Jha","doi":"10.1016/j.ihj.2025.02.007","DOIUrl":"10.1016/j.ihj.2025.02.007","url":null,"abstract":"<p><p>The history of coagulation cascade dates back to 17th century. The extrinsic and intrinsic pathways were proposed in 1998. Extrinsic pathway includes the tissue factor and stable factor which activates factor X and with help of factor V, this converts prothrombin to thrombin which is stabilised by factor XIII. This helps to seal the bleeding vessel and is a physiological process as there is only \"limited\" production of thrombin which doe not expand beyond the damaged site due to absence of tissue factor. On the other hand intrinsic pathway is activated by polyanions, neutrophilic extracellular traps which are present during infection and inflammation. These activate factor XI which activates factor X with the help of factor IX and VIII and then the common pathway ensues. But newer discoveries have shown that this is a very simplified way of explaining the coagulation system. The researches propose that haemostasis is divided into initiation, amplification and propagation phase. Also, the factor VII-tissue factor complex formed activates factor IX and leads to sustained thrombin production as the amount of thrombin produced by extrinsic pathway alone is not sufficient to form a haemostatic plug. Thrombin also activates factor XI and lead to self perpetuation of intrinsic pathway. All the anticoagulants have an inherent property of bleeding. So the newer factor XI and XII inhibitors focus to inhibit the excessive thrombin production without hampering the physiological haemostasis process. This is supported by the fact that congenital factor XI and XII deficiency does not cause excessive bleeding but increased levels did make patients more vulnerable to thromboembolism. This review shall focus on the various factor XI and XII inhibitors which are in the pipeline.</p>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523313","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}
引用次数: 0
Study of fluoroscopic landmarks in IVUS guided zero contrast PCI - A single centre experience.
IF 1.4
Indian heart journal Pub Date : 2025-02-20 DOI: 10.1016/j.ihj.2025.02.006
Uday B Khanolkar, Pankaj Banotra, Bijay Kumar Mahala, Nitin Kumar Hegde, Blessvin Jino, Devi Prasad Shetty, Parin Chandrakant Sangoi
{"title":"Study of fluoroscopic landmarks in IVUS guided zero contrast PCI - A single centre experience.","authors":"Uday B Khanolkar, Pankaj Banotra, Bijay Kumar Mahala, Nitin Kumar Hegde, Blessvin Jino, Devi Prasad Shetty, Parin Chandrakant Sangoi","doi":"10.1016/j.ihj.2025.02.006","DOIUrl":"10.1016/j.ihj.2025.02.006","url":null,"abstract":"<p><strong>Introduction: </strong>Contrast induced nephropathy is third most common cause of renal insufficiency following percutaneous coronary angioplasty (PCI) and patients with preexisting renal dysfunction are even at a higher risk for poor outcomes. With the advent of intravascular imaging, safety and efficacy of angioplasty can be improved significantly in these patients.</p><p><strong>Material and methods: </strong>This observational prospective study included 72 consecutive patients with CKD(eGFR ≤45 ml/min/m<sup>2</sup>) and established CAD who underwent absolute zero contrast PCI at a single tertiary center.PCI was planned in patients with significant stenosis and indications for revascularization.All Procedures were performed under dry fluoroscopy and IVUS guidance without use of any contrast.Informed consent, clinical,procedural and follow-up data was collected and analysed.</p><p><strong>Results: </strong>Total 72 patients (90 vessels) with median age of 63 years and eGFR (34.1 ml/min/1.73 m<sup>2</sup>) underwent zero contrast PCI. Procedure was performed by Femoral (45.6 %)and radial (54.4%) route. Total 11 patients (15.3%) underwent left main stenting. Fluoroscopic landmarks such as side-branch wiring (71.1%),floating wire in aorta (22.2 %), calcifications (21.1%), bony landmarks such as ribs or vertebrae (45.5%) and Sternal wires/clips (6.6%) were used in addition to IVUS to enable more accurate placement of stent.Technical and procedural success were achieved in 91.1% and 97.2% of patients.One patient died in hospital due to non-cardiac cause and one patient required hemodialysis.Post procedure at 48 hrs, there was no deterioration of renal function.On 3 months followup, there was no significant major adverse cardiovascular events (MACE).</p><p><strong>Conclusion: </strong>Our study shows that with the help of fluoroscopy landmarks and intravascular imaging, zero contrast PCI can be performed safely with good clinical outcomes in patients at risk of nephropathy.</p>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143472470","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}
引用次数: 0
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