Indian heart journal最新文献

{"title":"A groundbreaking electrocardiographic observation: “Isoelectric horizontal ST-segment with sharp ST-T angle” a novel sign for acute coronary syndrome","authors":"Maitri M. Patel ,&nbsp;Sumantkumar G. Patel ,&nbsp;Jigar K. Patel ,&nbsp;Dhruvkumar M. Patel ,&nbsp;Poojan J. Prajapati ,&nbsp;Harsh D. Patel ,&nbsp;Jayesh S. Prajapati ,&nbsp;Lalitkumar B. Patel ,&nbsp;Mukundkumar V. Patel","doi":"10.1016/j.ihj.2024.10.005","DOIUrl":"10.1016/j.ihj.2024.10.005","url":null,"abstract":"<div><div>Consecutive suspected acute coronary syndrome (ACS) cases were categorized into three groups: Group-1 (ST-depression), Group-2 (T-inversion), and Group-3 (remaining cases). Group-3 was subclassified into isoelectric horizontal ST-segment with sharp ST-T-angle (IHST) positive and IHST negative groups. They underwent serial high-sensitive Troponin-I testing. ACS incidence was 77.96 %, with 33.02 %, 15.96 %, and (15.04 %, 35.96 %) of patients in Groups 1, 2, and 3 (IHST positive, IHST negative), respectively. The presence of IHST exhibited higher sensitivity than T-inversion and greater specificity than ST-depression in detecting ACS. The presence of IHST sign additionally detected 15.04 % of ACS. The presence of IHST was significant among group-3 (p = 0.008) as well as the overall ACS cases (p = 0.048).</div></div>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":"76 5","pages":"Pages 349-351"},"PeriodicalIF":1.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142464240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term outcomes of percutaneous coronary intervention in patients with prior coronary artery bypass graft - A retrospective experience","authors":"Anil Kumar Boddu,&nbsp;Bijulal S,&nbsp;Krishnamoorthy Km,&nbsp;Ajit Kumar Vk","doi":"10.1016/j.ihj.2024.07.009","DOIUrl":"10.1016/j.ihj.2024.07.009","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the long-term clinical outcomes of percutaneous coronary intervention (PCI) in patients who had previously undergone coronary artery bypass grafting (CABG).</div></div><div><h3>Method</h3><div>A total of 219 patients who had a history of CABG and underwent PCI at tertiary care centre were retrospectively enrolled in this study. Clinical endpoints such as major adverse cardiac events (MACE; cardiac death, non-fatal myocardial infarction [MI], and target vessel revascularization), any death, cardiac death, MI, target vessel revascularization (TVR), and target lesion revascularisation (TLR) were reported at long-term follow-up.</div></div><div><h3>Results</h3><div>About 66.6 % patients were treated on the native vessel, and 24.2 % on grafts vessel. In all, 360 stents [83.3 % drug-eluting stent (DES) and 16.6 % bare metal stent (BMS)] were implanted. Diabetes mellitus (<em>p</em> = 0.03), LVEF&lt;55 % for PCI (<em>p</em> = 0.04), stent type [BMS (<em>p</em> &lt; 0.001) and DES (<em>p</em> &lt; 0.001)] and chronic kidney disease [(CKD) <em>p</em> &lt; 0.01] were appeared to be the significant predictors of mortality. Age at CABG&gt;50 years (<em>p</em> = 0.04), stent type [BMS (<em>p</em> = 0.03) and DES (<em>p</em> &lt; 0.01)] and CKD (<em>p</em> &lt; 0.01) as independent predictors for MACE. Higher event rate was reported in graft-vessel PCI group as compared to native-vessel PCI group: ISR (<em>p</em> &lt; 0.01), TLR (<em>p</em> = 0.01), mortality (<em>p</em> = 0.04), MACE (<em>p</em> &lt; 0.01) and MI (<em>p</em> = 0.05). Mortality (<em>p</em> &lt; 0.001), MACE (<em>p</em> &lt; 0.001) and MI (<em>p</em> &lt; 0.001) were significantly lower in DES vs. BMS groups.</div></div><div><h3>Conclusion</h3><div>Native-vessel PCI was associated with better clinical outcomes than graft-vessel PCI that also with the use of DES as the first choice in patients with a history of CABG.</div></div>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":"76 5","pages":"Pages 321-326"},"PeriodicalIF":1.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142107006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Drug abuse and ACS in the very young (less than 30 years): Demographic, clinical and angiographic profile","authors":"Shibba Takkar Chhabra ,&nbsp;Gurleen Kaur ,&nbsp;Samir Kapoor ,&nbsp;Aastha Kapila ,&nbsp;Gagandeep Kaur ,&nbsp;Prannav Jain ,&nbsp;Pankaj kumar ,&nbsp;Namita Bansal ,&nbsp;Mamta Bansal ,&nbsp;Anshuman Gupta ,&nbsp;Akash Batta ,&nbsp;Gautam Singal ,&nbsp;Abhishek Goyal ,&nbsp;Rohit Tandon ,&nbsp;Naved Aslam ,&nbsp;Bishav Mohan ,&nbsp;Gurpreet Singh Wander","doi":"10.1016/j.ihj.2024.10.003","DOIUrl":"10.1016/j.ihj.2024.10.003","url":null,"abstract":"<div><h3>Aim</h3><div>To identify incidence, type of drug abuse study clinical and angiographic profile in very young population presenting with acute coronary syndrome (ACS).</div></div><div><h3>Materials and methods</h3><div>All consecutive patients less than 30 years with ACS included and segregated into Group 1 and 2 (with and without drug abuse respectively)</div></div><div><h3>Result</h3><div><em>n</em> = 153; <em>n</em> = 17 in group 1 of whom 35.29 % consumed opium, 17.64 % energy drinks, 17.64 % whey protein supplements, 17.64 % inhaled marijuana, 5.88 % heroin and spasmoproxyvon and 23.52 % multi-substance abusers. STEMI, Single vessel disease and urban domicile were predominant. Rising trends of drug abuse were identified in prospective (28.20 %) versus retrospective (5.30 %) timeframe (<em>p</em> = 0.011).</div></div><div><h3>Conclusion</h3><div>Rising trends of drug abuse, a potentially modifiable risk factor of ACS in the young are alarming. Strict regulations are needed to curb this menace.</div></div>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":"76 5","pages":"Pages 355-357"},"PeriodicalIF":1.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142464241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gender differences in the management and outcomes of acute coronary syndrome in indians: A systematic review and meta-analysis","authors":"Deep Dutta ,&nbsp;Kunal Mahajan ,&nbsp;Lokesh Verma ,&nbsp;Gunjan Gupta ,&nbsp;Meha Sharma","doi":"10.1016/j.ihj.2024.10.002","DOIUrl":"10.1016/j.ihj.2024.10.002","url":null,"abstract":"<div><h3>Background</h3><div>Gender differences in acute coronary syndrome (ACS) outcomes have been noted in global data, which however did not analyse Indian data. No prior systematic review and meta-analysis (SRM) has addressed this important aspect of gender bias in Indian women with ACS. Hence this SRM aimed to address this knowledge gap.</div></div><div><h3>Methods</h3><div>Electronic databases were searched for studies in ACS comparing cardiovascular disease presentation, treatment received and outcomes in women and men from India. Primary outcomes were to evaluate gender-differences in 30-day death and major adverse cardiovascular events (MACE). Secondary outcomes were to evaluate gender-differences in presentation, management and mortality. The SRM is registered with PROSPERO (CRD42023477286).</div></div><div><h3>Results</h3><div>From initially screened 3753 articles, data from 9 studies (61,185 patients) were analysed. Women with ACS had higher prevalence of diabetes [Odds ratio (OR) 1.65(95%CI:1.33–2.04); <em>p</em> &lt; 0.001; I² = 95 %] and hypertension [OR2.06(95%CI:1.88–2.25); <em>p</em> &lt; 0.001; I² = 42 %]. Smoking was significantly lower in women [OR 0.05(95%CI:0.03–0.07); <em>p</em> &lt; 0.001; I² = 87 %]. Non-ST elevation myocardial infarction (NSTEMI) was significantly higher in women [OR 1.92(95%CI:1.66–2.21); <em>p</em> &lt; 0.001; I² = 0 %]. Diagnostic angiography [OR 0.64(95%CI:0.56–0.74); <em>p</em> &lt; 0.001; I² = 46 %] and percutaneous coronary interventions [OR0.71(95%CI:0.55–0.92); <em>p</em> = 0.01; I² = 92 %] were significantly lower in women. Women had significantly higher 30-day mortality [Hazard ratio (HR)2.26(95%CI:2.01–2.55); <em>p</em> &lt; 0.001; I² = 6 %], 1-year mortality [HR2.41(95%CI:1.89–3.07); <em>p</em> &lt; 0.001; I² = 53 %], in-hospital death [HR1.88(95%CI:1.19–2.96); <em>p</em> = 0.007; I² = 92 %], stroke [HR 1.84 (95%CI:1.34–2.52); <em>p</em> &lt; 0.001; I² = 0 %] and MACE outcomes [OR 2.05 (95%CI:1.78–2.35); <em>p</em> &lt; 0.001]. Use of aspirin, clopidogrel, beta-blockers and nitrates were significantly lower in women.</div></div><div><h3>Conclusion</h3><div>Our study highlights worse outcomes in Indian women with ACS. Higher burden of diabetes and hypertension, decreased used of PCI and lesser aggressive pharmacotherapy may be some of the contributing factors.</div></div>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":"76 5","pages":"Pages 333-341"},"PeriodicalIF":1.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142400148","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of mitral transcatheter edge to edge repair with MitraClip™ – An Indian single center experience","authors":"Sai Satish ,&nbsp;Vijayakumar Subban ,&nbsp;Yerramareddy Vijayachandra ,&nbsp;Abraham Oomman ,&nbsp;Ganapathy Arumugam ,&nbsp;Hemalatha Senthil ,&nbsp;Hema Kethavath ,&nbsp;Kamala Devi Pulindram ,&nbsp;Saibal Kar ,&nbsp;Susheel Kodali ,&nbsp;Krishnaswamy Chandrasekaran","doi":"10.1016/j.ihj.2024.09.002","DOIUrl":"10.1016/j.ihj.2024.09.002","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the outcomes of transcatheter edge-to-edge repair (TEER) with MitraClip™ (Abbott Vascular) in symptomatic high surgical risk Indian patients with significant mitral regurgitation (MR).</div></div><div><h3>Methods</h3><div>Patients with moderately severe or severe primary or secondary MR and deemed high surgical risk were treated with MitraClip™. The data were collected retrospectively from medical records. The primary outcome was technical success, and secondary outcomes were ≤2+ MR reduction and improvement in functional capacity at 30 days.</div></div><div><h3>Results</h3><div>Between November 2018 and August 2023, 64 patients were treated with MitraClip^TM. The mean age was 70.0 ± 12.1 years and 64 % were males. The mean EuroScore II and STS score predicted mortality for mitral valve repair were 5.8 ± 4.5 % and 4.0 ± 3.8 % respectively. MR etiology was primary in 56.3 %, secondary in 40.6 % and mixed in 3.1 %. The device was implanted successfully in all but one patient with technical success rate of 98.4 %. The average number of clips per patient was 1.5 ± 0.6 and 42.2 % patients received more than one clip. The mean mitral valve gradient was 3.5 ± 1.6 mmHg. The MR severity of ≤2+ was achieved in 91.8 % of the subjects and similar proportion were in New York Heart Association Functional Class I or II at 30 days.</div></div><div><h3>Conclusion</h3><div>In high-risk Indian patients with symptomatic significant MR, TEER with MitraClip™ was achieved with a high technical success rate. It was associated with significant reduction in MR severity and improvement in functional capacity in &gt;90 % of the subjects.</div></div>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":"76 5","pages":"Pages 315-320"},"PeriodicalIF":1.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142345934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term outcome of variety of techniques used to stabilize left ventricular lead in difficult coronary sinus anatomy- A single centre experience","authors":"Parag Barwad ,&nbsp;Navjyot Kaur ,&nbsp;Bhupendra K. Sihag ,&nbsp;Sanjeev H. Naganur","doi":"10.1016/j.ihj.2024.10.001","DOIUrl":"10.1016/j.ihj.2024.10.001","url":null,"abstract":"<div><h3>Introduction</h3><div>Difficult coronary sinus (CS) anatomy may lead to difficulty in optimal left ventricular (LV) lead placement and lead displacements leading to nonresponse to cardiac resynchronization therapy (CRT).</div></div><div><h3>Methods</h3><div>In this retrospective study, we studied the CRT parameters of devices implanted by single operator during the time period from January 2014 till December 2021, where different off-label techniques were used to place/stabilize LV lead. The technique used to stabilize LV lead, CRT parameters at baseline and follow up were noted for each patient.</div></div><div><h3>Results</h3><div>Out of 133 CRTs implanted during the study period, 23 patients (17.29 %) required off-label techniques. Stylet and guidewire retaining techniques were used in 11/23 (47.82 %) and 7/23 (30.43 %) patients respectively. In two patients, LV lead was jailed using coronary stent to prevent displacement. Two patients had CS stenosis and required balloon dilation while one patient had tortuous posterolateral vein which was straightened using a coronary stent. There was technical failure of 6/23 LV leads (26.08 %) with loss of capture, at a median follow up of 44 months (Range: 06–114 months). Out of these 6 patients, stylet and guidewire retaining techniques were used in 4 and 2 patients respectively.</div></div><div><h3>Conclusion</h3><div>Despite having acceptable parameters at implantation, these techniques particularly stylet and guidewire retention, may lead to non-capture of LV lead on long term follow ups. Better LV leads like active fixation leads and conduction system pacing (His Bundle/left bundle branch pacing) should be preferred in difficult CS anatomy.</div></div>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":"76 5","pages":"Pages 327-332"},"PeriodicalIF":1.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142406377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of strain imaging to detect subtle myocardial involvement in post COVID-19 patients: An Indian perspective","authors":"Deepak Tomar ,&nbsp;Aditya Kapoor ,&nbsp;Zia Hashim ,&nbsp;Kamlesh Raut ,&nbsp;Arpita Katheria ,&nbsp;Harshit Khare ,&nbsp;Ankit Sahu ,&nbsp;Roopali Khanna ,&nbsp;Sudeep Kumar ,&nbsp;Naveen Garg ,&nbsp;Satyendra Tewari","doi":"10.1016/j.ihj.2024.09.003","DOIUrl":"10.1016/j.ihj.2024.09.003","url":null,"abstract":"<div><h3>Background</h3><div>The study assessed Global longitudinal strain imaging (GLS) to detect subtle myocardial dysfunction among patients clinically recovered from COVID-19.</div></div><div><h3>Methods</h3><div>All patients (n = 101 76 % males, mean age 55.45 ± 11.14 years), and controls (n = 30), underwent clinical assessment and echocardiography, including GLS assessment.</div></div><div><h3>Results</h3><div>The prevalence of diabetes mellitus, hypertension and dyslipidemia was comparable amongst patients and controls. The <strong><em>average GLS was significantly lesser in post COVID patients</em></strong> (−16.21 ± 1.96 vs −18.49 ± 1.64 respectively, <em>p</em> = 0.004) and <strong><em>significantly higher proportion of post COVID patients had GLS &gt; -18 %</em></strong> (43 % vs 22.58 % respectively, <em>p</em> = 0.001) as compared to controls. <strong><em>The RV free wall longitudinal strain (RVFLS) was also lower in the patient group</em></strong> (22.35 ± 4.69 vs 24.19 ± 4.11, <em>p</em> = 0.004) and <strong><em>21.7 % post COVID-19 patients had pathological RV FWLS</em></strong> (&gt; −20 %) vs controls (6.6 %).</div><div><strong><em>Average GLS was significantly lesser in severe post COVID patients</em></strong> (viz −14.25 ± 1.92 vs −16.63 ± 1.61 vs −17.63 ± 1.91, <em>p</em> &lt; 0.0001, respectively among severe, moderate and mild COVID-19 patients. On performing regression analysis, <strong><em>severity of COVID-19 (OR 7.762) was a significant predictor of impaired GLS.</em></strong></div></div><div><h3>Conclusion</h3><div>Despite normal global LVEF, post COVID-19 recovered patients had significantly lower LV GLS and RV FWLS with severe COVID-19 infection, regardless of having a clinical recovery. This study reiterates the importance of speckle tracking echocardiography as an important imaging modality for detection of subclinical myocardial dysfunction in the post COVID-19 recovered patients.</div></div>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":"76 5","pages":"Pages 309-314"},"PeriodicalIF":1.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142371740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of non-HDL cholesterol with plaque burden and composition of culprit lesion in acute coronary syndrome. An intravascular ultrasound-virtual histology study","authors":"Sreenivas Reddy ,&nbsp;Raghavendra Rao K ,&nbsp;Jeet Ram Kashyap ,&nbsp;Vikas Kadiyala ,&nbsp;Suraj Kumar ,&nbsp;Debabrata Dash ,&nbsp;Lipi Uppal ,&nbsp;Jaspreet Kaur ,&nbsp;Manpreet Kaur ,&nbsp;Hithesh Reddy ,&nbsp;Imran Ibni Gani Rather ,&nbsp;Samir Malhotra","doi":"10.1016/j.ihj.2024.10.004","DOIUrl":"10.1016/j.ihj.2024.10.004","url":null,"abstract":"<div><h3>Objective</h3><div>Lipids play key role in coronary atherosclerosis. The role of non-high-density lipoprotein cholesterol (non-HDL-C) in atherosclerotic plaques using intravascular imaging remains unclear. This study aimed to assess its relationship with coronary plaque features using intravascular ultrasound (IVUS) in acute coronary syndrome (ACS).</div></div><div><h3>Methods</h3><div>A total of 601 patients divided into two groups: normal non-HDL-C≤130 mg/dl (<em>n</em> = 410) and high non-HDL cholesterol &gt;130 mg/dl (<em>n</em> = 191). IVUS performed before coronary intervention.</div></div><div><h3>Results</h3><div>Mean age 53.18 ± 12.29 years. No significant differences in hypertension, diabetes, and smoking between groups. Plaque burden was significantly higher among normal versus high non-HDL-C groups (79.59 ± 9.98 % vs. 81.61 ± 5.39 %; <em>p</em> = 0.001). At minimal luminal site, fibrofatty percentage was higher in normal non-HDL-C group (<em>p</em> = 0.027), while necrotic core greater in high non-HDL-C group (<em>p</em> = 0.033). Segmental analysis, necrotic core was significantly higher in percentage (<em>p</em> = 0.006) and volumes (<em>p</em> = 0.011) in normal versus high non-HDL-C groups. Total cholesterol (<em>r</em> = 0.099, <em>p</em> = 0.015), LDL-C (<em>r</em> = 0.081, <em>p</em> = 0.046), triglycerides (<em>r</em> = 0.083, <em>p</em> = 0.041),and non-HDL-C (<em>r</em> = 0.099, <em>p</em> = 0.015) positively correlated with plaque burden. Total cholesterol (<em>r</em> = 0.115, <em>p</em> = 0.005), LDL-C (<em>r</em> = 0.107, <em>p</em> = 0.009), and non-HDL-C (<em>r</em> = 0.105, <em>p</em> = 0.010) positively correlated with necrotic core volume. Linear regression analysis showed age and non-HDL-C as predictors of higher plaque burden. Multiple linear regression analysis; age, body mass index, and non-HDL-C were predictors of larger necrotic core volume.</div></div><div><h3>Conclusion</h3><div>Non-HDL-C levels were positively associated with plaque burden, measure of extent of atherosclerosis. It is closely associated with and is a predictor of necrotic core volume; a marker of plaque vulnerability. This IVUS study demonstrates potential role of non-HDL-C in causation of plaque in ACS.</div></div>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":"76 5","pages":"Pages 342-348"},"PeriodicalIF":1.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142400146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clopidogrel resistance and its effect on clinical outcomes in acute coronary syndrome","authors":"Heemanshu Lodhi ,&nbsp;Keshavamurthy Ganapathy Bhat ,&nbsp;Vivek Singh Guleria ,&nbsp;Ratheesh Kumar Janardhana Pillai ,&nbsp;Ribhu Goel ,&nbsp;Nitin Sharma ,&nbsp;Anuka Sharma ,&nbsp;Varun Sharma","doi":"10.1016/j.ihj.2024.07.003","DOIUrl":"10.1016/j.ihj.2024.07.003","url":null,"abstract":"<div><h3>Aim</h3><p>The genetic polymorphism of CYP2C19 influences clopidogrel metabolism and resistance. Aim was to assess the association between CYP2C19 loss of function variation, clopidogrel resistance based on platelet reactivity units and clinical outcomes.</p></div><div><h3>Methods</h3><p>A total of 668 patients of Acute Coronary Sundrome (ACS) who underwent Percutaneous Coronary Intervention (PCI) were subjected to genetic screening and 143 patients undrewent platelet function test to study the association between drug metabolization and its effects based on platelet reactivity unit values.</p></div><div><h3>Results</h3><p>Clopidogrel resistance with CYP2C 19 loss of function variation was noted in 54.64% of patients. Clinical outcomes, such as target vessel revascularization, target lesion revascularization, in-stent restenosis, and stent thrombosis, were also studied.</p></div><div><h3>Conclusion</h3><p>CYP2C19 loss of function variation is strongly associated with clopidogrel resistance and adverse clinical outcomes.</p></div>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":"76 4","pages":"Pages 268-270"},"PeriodicalIF":1.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S001948322400155X/pdfft?md5=2de61b95e95ec8bc0b931d5592adf0a9&pid=1-s2.0-S001948322400155X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141619847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical characteristics and outcomes of Australian and Indian ST-segment elevation myocardial infarction (STEMI) patients treated with primary percutaneous coronary intervention (PCI)","authors":"M.L. Savage ,&nbsp;K. Hay ,&nbsp;H. Sundar ,&nbsp;R. Maharajan ,&nbsp;D.J. Murdoch ,&nbsp;K. Latchumanadhas ,&nbsp;D.M. Ezhilan ,&nbsp;U. Kalaichelvan ,&nbsp;R. Denman ,&nbsp;I. Ranasinghe ,&nbsp;V. Subban ,&nbsp;D.L. Walters ,&nbsp;A. Mullasari ,&nbsp;O.C. Raffel","doi":"10.1016/j.ihj.2024.08.001","DOIUrl":"10.1016/j.ihj.2024.08.001","url":null,"abstract":"<div><h3>Introduction</h3><p>The incidence of STEMI and subsequent mortality has been reported to be higher in Indian populations compared to developed countries. However, there is limited data directly comparing contemporary primary percutaneous coronary intervention (pPCI) treatment strategies and clinical outcomes for STEMI patients between developed and developing countries.</p></div><div><h3>Materials and methods</h3><p>We compared population demographics, procedural characteristics, times to reperfusion and mortality in STEMI patients treated with pPCI between two tertiary referral centers in India and Australia respectively over a 3-year period (1st Jan 2017–31st Dec 2019).</p></div><div><h3>Results</h3><p>A total of 1293 STEMI presentations (896 Indian vs 397 Australian) were included. On average, Indian patients had lower median BMI than Australian patients (BMI 25.4 vs 27.8; p &lt; 0.001), were significantly younger (mean age 56.0 vs 63.2 years; p &lt; 0.001), more likely male (84 % vs 80 %; p = 0.046) and diabetic (48 % vs 18 %); p &lt; 0.001). Radial access (50 % vs 88 %; p &lt; 0.001) and TIMI III flow post PCI was also significantly lower (85 % vs 96 %; p &lt; 0.001) with median door-to-balloon time significantly shorter in the Indian cohort (20mins vs 43mins; p &lt; 0.001); however, median symptom to balloon time was significantly longer (245mins vs 160mins; p &lt; 0.001). No significant differences in 30-day mortality (4.0 % vs 2.8 % Australian; p = 0.209) or 1-year mortality (6.5 % vs 4.3 %; p = 0.120) were observed.</p></div><div><h3>Conclusion</h3><p>Significant differences in demographics and presentation characteristics exist between Indian and Australian STEMI patients treated with pPCI. Indian patients had significantly longer pre-hospital delays and lower achievement of TIMI III flow post PCI, yet shorter in-hospital time to treatment.</p></div>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":"76 4","pages":"Pages 254-259"},"PeriodicalIF":1.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0019483224001640/pdfft?md5=9ef3411441635ad43ff583a4aad4167d&pid=1-s2.0-S0019483224001640-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142055473","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}