Indian heart journal最新文献

{"title":"A cross-sectional study on the incidence of prosthetic valve thrombosis and its outcome treated with fibrinolysis in a tertiary care hospital","authors":"Dhiviya Murugesan,&nbsp;Balasubramanian Sundaram,&nbsp;Nagasundar Gurusamy,&nbsp;Hemanath Ramamurthy,&nbsp;Nisamudeen Kaja Mohideen","doi":"10.1016/j.ihj.2025.02.003","DOIUrl":"10.1016/j.ihj.2025.02.003","url":null,"abstract":"<div><h3>Aims</h3><div>To find the incidence, risk factors of Prosthetic Valve Thrombosis (PVT)To study the efficacy, outcome and complications of fibrinolysis in PVT.</div></div><div><h3>Methods</h3><div>Data from 44 consecutive patients admitted with PVT treated with fibrinolytics were assessed, outcomes recorded. Only medically managed PVT were included in this study and Surgical management were not included due to inadequate resources.</div></div><div><h3>Results</h3><div>Out of 44 patients, 28 were female and 16 were male with mean age of 36.5 41 had underwent MVR, 3 had underwent DVR. 42 (92.4 %) had thrombus at mitral valve 2 (4.5 %) were at aortic valve. Visible clot was present in 7 (15.9 %) and absent in 37 (84 %) patients. 7 (15.9 %) had recurrent episode of PVT. At the time of thrombolysis, no patient had major bleeding manifestation. During follow up after thrombolysis, 37 (84 %) were alive and 7 (16 %) expired. The incidence of primary end point i.e successful thrombolysis (as defined as complete response without complications) was seen in 61.3 % patients. The secondary end point i.e. Therapeutic failure/death is recorded in 15.9 % study subjects. Among the vulnerable population, therapeutic Failure/death is seen with 57.1 % sub-therapeutic anticoagulant consumers and 42.8 % patients with poor drug compliance.</div></div><div><h3>Conclusion</h3><div>In conclusion this study sheds light on the complexities and challenges associated with prosthetic valve thrombosis in pregnant patients, patients with sub therapeutic anticoagulation or poor drug consumers. This study underscores the importance of close monitoring, optimal anticoagulation, patient education. This study highlights that fibrinolysis unless contraindicated can be considered as effective especially in developing countries or in centres with limited resources, where multiple factors such as surgical availability, financial cost, high operative mortality are to be weighed before treatment.</div></div>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":"77 2","pages":"Pages 63-66"},"PeriodicalIF":1.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143382323","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":"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 ,&nbsp;Meeranghani Mohamed Yusuf ,&nbsp;Vadivelu Ramalingam ,&nbsp;Abhishek Kasha ,&nbsp;Manickam Kathiresan ,&nbsp;Rizwan Suliankatchi Abdulkader ,&nbsp;Jeyashree Kathiresan ,&nbsp;Aishwarya Mahesh Kumar ,&nbsp;Elsa Grace ,&nbsp;Anirban Choudhury","doi":"10.1016/j.ihj.2025.03.002","DOIUrl":"10.1016/j.ihj.2025.03.002","url":null,"abstract":"<div><h3>Objectives</h3><div>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).</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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 <strong>in the CABG vs HCR groups respectively</strong>. 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].</div></div><div><h3>Conclusion</h3><div>HCR may be considered as a safe and feasible alternative to conventional CABG in selected individuals with MV-CAD.</div></div>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":"77 2","pages":"Pages 98-104"},"PeriodicalIF":1.4,"publicationDate":"2025-03-01","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}

{"title":"The cardiac cycle and diastolic duration in healthy adults: Verifying Golden Ratio?","authors":"Ertan Yetkin","doi":"10.1016/j.ihj.2025.03.006","DOIUrl":"10.1016/j.ihj.2025.03.006","url":null,"abstract":"","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":"77 2","pages":"Page 130"},"PeriodicalIF":1.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639557","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":"Adherence to pharmacotherapy for secondary prevention of coronary heart disease: A registry-based prospective study","authors":"Aradhai Bana ,&nbsp;Krishna Kumar Sharma ,&nbsp;Soneil Guptha ,&nbsp;Rajeev Gupta","doi":"10.1016/j.ihj.2025.02.009","DOIUrl":"10.1016/j.ihj.2025.02.009","url":null,"abstract":"<div><h3>Background and objective</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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 %) (<em>p</em> &lt; 0.05). Use of high-intensity statins declined from 92.0 % to 45.7 % (−50.3 %). At follow-up, good adherence (&gt;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.</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":"77 2","pages":"Pages 84-88"},"PeriodicalIF":1.4,"publicationDate":"2025-03-01","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}

{"title":"'Clopidogrel therapy in Acute Coronary Syndrome: Contemporary issues'.","authors":"Satyavir Yadav, Rakesh Yadav","doi":"10.1016/j.ihj.2025.02.002","DOIUrl":"https://doi.org/10.1016/j.ihj.2025.02.002","url":null,"abstract":"","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143373821","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 study of intracoronary thrombolytic agents in high thrombus burden lesions during primary PCI.","authors":"Venkata Rs Subrahmanya Sarma, K Gopalakrishna, K Purnachandra Rao, G Somasekahr, P S S Chowdary, P Raghuram, B Dasarath, Manohar Reddy, Ramkishore, Raji Veeramachineni, Y Sasidhar, M Prasad","doi":"10.1016/j.ihj.2025.01.008","DOIUrl":"10.1016/j.ihj.2025.01.008","url":null,"abstract":"<p><strong>Objectives: </strong>High thrombus burden during Primary Percutaneous Coronary Intervention begets poor outcomes; there are several lacunas in the management of those patients.- The purpose of this study is to analyse the long-term outcomes of patients undergoing primary percutaneous coronary intervention with high thrombus burden, treated with intracoronary thrombolysis as an adjunctive therapy.</p><p><strong>Methods: </strong>In this prospective observational study, 108 consecutive primary percutaneous coronary intervention patients with high thrombus burden were stratified into two groups basing on whether they received intracoronary thrombolytic agent before stent implantation. The primary outcome is Net Adverse Clinical Events. Secondary outcomes include Major Adverse Cardiac Events, and all other individual components of the Net Adverse Clinical Events when analysed separately.</p><p><strong>Results: </strong>The primary outcome events occurred in 21 patients (26 %) in the Primary stent group (n = 80), whereas it occurred in 2 patients (6 %) in the primary intra-coronary thrombolysis group (n = 28), this study shows that there is no difference in primary endpoints in both groups (26 % Vs 7 %, p-value - .042, Hazard ratio - 2.56; 95 % CI - .76-8.57), however Kaplan-Meier event-free survival curves show that both the curves are well separated apart even at the end of the one year of follow - up.</p><p><strong>Conclusion: </strong>There is no difference in the primary outcome events in both groups, however there was a consistent increase in events in the primary stent group over the one-year follow-up period. These findings suggest the need for a larger randomized clinical trial to confirm and further elucidate these results.</p>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074301","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":"Efficacy of Angiotensin Receptor Neprilysin Inhibitor (ARNI) in right ventricular systolic dysfunction and preserved LV ejection fraction: A randomized clinical trial","authors":"Rohit Mathur ,&nbsp;Anil Baroopal ,&nbsp;Chaina Ram Chaudhary ,&nbsp;Afjal Hakim ,&nbsp;Manoj Verma","doi":"10.1016/j.ihj.2025.01.002","DOIUrl":"10.1016/j.ihj.2025.01.002","url":null,"abstract":"<div><div>Angiotensin Receptor Neprilysin Inhibitor (ARNI) has not shown to be promising in Heart failure with preserved LVEF. Role of ARNI in Right ventricular systolic dysfunction with preserved LVEF needs to be evaluated. We took 50 patients with isolated RV systolic dysfunction and divided them into two groups of 25 patients each- Conventional treatment and ARNI in addition to conventional treatment. We found that the ARNI group showed a significant improvement in NYHA class, all the echo parameters of RV size, RV function and NT-pro BNP levels at 4 weeks and 12 weeks.</div></div>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":"77 1","pages":"Pages 42-44"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142983399","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":"ANti-Thrombotic strAtegy for the management of nonocclusive thRombus with ST-segment elevation myocardial infarCtion in young pAtients – ANTARTICA study","authors":"Pankaj Jariwala ,&nbsp;Arshad Punjani ,&nbsp;Harikishan Boorugu ,&nbsp;Dilip Gude ,&nbsp;Anusha Jariwala","doi":"10.1016/j.ihj.2024.12.003","DOIUrl":"10.1016/j.ihj.2024.12.003","url":null,"abstract":"<div><h3>Introduction</h3><div>Various cardiovascular thrombo-embolic clinical entities use combined ATS for prevention and treatment. After PCI, AF patients are typically prescribed DOAC, DAPT/SAPT, as component of ATS to minimize stroke risk and treat pulmonary embolism and venous thromboembolism. Some small observational studies have shown that a combined ATS can clear small thrombi in LV dysfunction and/or apical aneurysms. Therefore, we present a practical, cost-effective, and proof-of-concept ATS for non-occlusive significant coronary thrombus in young, clinically stable STEMI patients based on the aforementioned experiences.</div></div><div><h3>Methods</h3><div>We retrospectively reviewed 145 stable STEMI cases with nonocclusive thrombus and thrombolysis in myocardial infarction flow 2/3 who received dabigatran and clopidogrel (<strong>ATS arm</strong>). They were compared to 147 comparable patients who received standard-of-care PCI (<strong>Control arm</strong>). At presentation and 6-months after ATS, NYHA functional class and LVEF were measured in all subjects. All the patients in the ATS arm underwent CT-CAG at 6-months. We examined significant safety outcomes like hemorrhage, reinfarction, and cardiac mortality.</div></div><div><h3>Results</h3><div>The primary angiographic outcome demonstrated complete resolution of the thrombus in all the cases of ATS arm. In the ATS arm, the clinical secondary outcome showed a greater improvement in NYHA class, from 3.53 to 1.07, compared to the control group's 3.6 to 1.49 (<em>p</em> = 0.013). Also, the secondary echocardiographic outcome demonstrated a significant improvement in LVEF from a mean of 45.1 %–49.2 % in the ATS arm vs. 44.0 %–44.9 % in the control arm (<em>p</em> &lt; 0.001). Clinical safety indicated TIMI bleeding and reinfarction reductions. There was no mortality in either arm.</div></div><div><h3>Conclusion</h3><div>Delaying PCI and treating STEMI patients with antithrombotic drugs reduced no-reflow, distal embolization, and intraprocedural thrombotic events. The medical intervention improved myocardial preservation alone.</div></div>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":"77 1","pages":"Pages 14-21"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142876849","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":"Clonal hematopoiesis of indeterminate potential and cardiovascular diseases: A review","authors":"Nagendra Boopathy Senguttuvan ,&nbsp;Vinodhini Subramanian ,&nbsp;Muralidharan TR ,&nbsp;Kavitha Sankaranarayanan ,&nbsp;Vettriselvi Venkatesan ,&nbsp;Thanikachalam Sadagopan","doi":"10.1016/j.ihj.2025.01.006","DOIUrl":"10.1016/j.ihj.2025.01.006","url":null,"abstract":"<div><div>Cardiovascular disease (CVD) is a major driver of mortality and declining health worldwide. Cardiovascular diseases (CVD) is the most common cause of morbidity and mortality globally. Although dyslipidemia, smoking, diabetes, hypertension and obesity are some well-known causes of CVD, the overlapping genetic pathways between other diseases and those affecting cardiovascular health have been overlooked.</div><div>In the past decade, mutations in <em>TET2</em>, <em>DNMT3A</em>, <em>ASXL1</em>, and <em>JAK2</em> are found to cause clonal hematopoiesis of intermediate potential (CHIP), a disease associated with age-related haematological malignancies without the presence of cytopenias or dysplasia. Coronary artery disease, heart failure, aortic stenosis, and arrhythmias have been shown to be associated with the presence of CHIP mutations. Addressing the association between CHIP could significantly reduce residual risk patients with CVD. The link between CHIP and CVD can potentially be addressed through inhibitors of inflammasomes, antagonists in the interleukin pathway, or direct antagonists of CHIP mutations.</div></div>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":"77 1","pages":"Pages 51-57"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143038256","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":"Data presentation in industry-sponsored cardiac device trials","authors":"Baskaran Chandrasekar","doi":"10.1016/j.ihj.2025.01.004","DOIUrl":"10.1016/j.ihj.2025.01.004","url":null,"abstract":"<div><div>Industry's influence on clinical trials is well known and extends to various aspects beyond funding, including industry-affiliated authors and industry-affiliated analysts. An area of potential concern is presentation of analyzed data that does not appear favorable to the desired study outcome. Such important data are at times not accorded prominence in discussion. The present article analyses such concerns in data presentation in the landmark trials of two cardiac devices the use of which has increased markedly in recent years (DanGer Shock trial and COAPT trial). It is seen that important data that did not appear favorable to the intended study outcome were relegated mostly to Supplement Section, where they are likely to receive less attention, with little discussion allocated in the text.</div></div>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":"77 1","pages":"Pages 48-50"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143046436","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}