Indian heart journal最新文献

{"title":"Indian dyslipidaemia guidelines: Need of the hour","authors":"Jitendra Pal Singh Sawhney, Rajeev Gupta","doi":"10.1016/j.ihj.2024.01.008","DOIUrl":"10.1016/j.ihj.2024.01.008","url":null,"abstract":"","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":"76 ","pages":"Pages S2-S5"},"PeriodicalIF":1.5,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0019483224000087/pdfft?md5=3ee8c7a55763e7ab7e17106d3ab8ffaf&pid=1-s2.0-S0019483224000087-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139465778","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":"Management of dyslipidemia in special groups","authors":"Jayagopal P B ,&nbsp;Prafulla G. Kerkar","doi":"10.1016/j.ihj.2024.01.018","DOIUrl":"10.1016/j.ihj.2024.01.018","url":null,"abstract":"<div><p>Dyslipidemia management in situations like pregnancy, in diseases like rheumatoid arthritis, human immunodeficiency virus (HIV) disease, chronic liver disease, and in the elderly are challenging scenarios. Pregnancy is a contraindication for many drugs. The interaction of various drugs used in HIV infection and rheumatoid arthritis makes it even more difficult to treat with conventional and approved drugs for dyslipidemia. Elderly and chronic renal failure patients often do not tolerate the drugs very well and the data of dyslipidemia management is very different. Lastly, COVID-19 is a unique scenario where clear information is yet to be provided. In this manuscript, the current understanding and available data on the treatment of dyslipidemia in these special situations are discussed.</p></div>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":"76 ","pages":"Pages S96-S100"},"PeriodicalIF":1.5,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S001948322400018X/pdfft?md5=3d881638dae320a6608efe3bca88c107&pid=1-s2.0-S001948322400018X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139712013","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":"Trends in epidemiology of dyslipidemias in India","authors":"Sonali Sharma ,&nbsp;Kiran Gaur ,&nbsp;Rajeev Gupta","doi":"10.1016/j.ihj.2023.11.266","DOIUrl":"10.1016/j.ihj.2023.11.266","url":null,"abstract":"<div><p>Dyslipidemias are the most important coronary artery disease (CAD) risk factor. High total cholesterol and its principal subtypes: low-density lipoprotein (LDL) cholesterol and non-high-density lipoprotein (NHDL) cholesterol are the most important. Epidemiological and Mendelian randomization studies have confirmed role of raised triglycerides and lipoprotein(a). INTERHEART study reported a significant association of raised ApoB/ApoA1, total-, LDL-, and NHDL-cholesterol in South Asians. Prospective Urban Rural Epidemiology (PURE) study identified raised NHDL cholesterol as the most important risk factor. Regional and multisite epidemiological studies in India have reported increasing population levels of total-, LDL-, and NHDL cholesterol and triglycerides. India Heart Watch reported higher prevalence of total and LDL cholesterol in northern and western Indian cities. ICMR-INDIAB study reported regional variations in hypercholesterolemia (≥200 mg/dl) from 4.6 % to 50.3 %, with greater prevalence in northern states, Kerala, Goa, and West Bengal. Non-Communicable Disease Risk Factor Collaboration and Global Burden of Diseases Studies have reported increasing LDL- and NHDL-cholesterol in India. Studies among emigrant Indians in UK and USA have reported higher triglycerides in compared to Caucasians. Identification of regional variations and trends in dyslipidemias need more nationwide surveys. Prospective studies are needed to assess quantum of risk with CAD incidence.</p></div>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":"76 ","pages":"Pages S20-S28"},"PeriodicalIF":1.5,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0019483223004571/pdfft?md5=bd1de3dd653c13d290bd1f8156732fd2&pid=1-s2.0-S0019483223004571-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139740952","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":"The potential influence of GSTT1 null genetic polymorphism on coronary artery disease: A pilot study in a South Indian cohort","authors":"Pranesh Rajamuthiah ,&nbsp;Sabari Krishnan B B ,&nbsp;Sharon Benita Antony ,&nbsp;Teena Koshy","doi":"10.1016/j.ihj.2024.03.002","DOIUrl":"10.1016/j.ihj.2024.03.002","url":null,"abstract":"<div><h3>Background</h3><p>Indians are known to have the highest rates of coronary artery disease (CAD), with the conventional risk factors failing to explain the increased risk. Possible candidate genes to study both the environmental and genetic risk associated with CAD is the glutathione S-transferase (GST) family, as it is involved in detoxification.</p></div><div><h3>Methods</h3><p>This case–control assessed the association between <em>GSTM1</em> and <em>GSTT1</em> polymorphisms in Indian patients with CAD. Fifty patients with CAD and 50 healthy volunteers were genotyped for the two polymorphisms by polymerase chain reaction. The genotype frequencies between the groups were compared, where a p-value of less than 0.05 was considered as statistically significant.</p></div><div><h3>Results</h3><p>There was a significant inverse association between <em>GSTT1</em> null polymorphism and CAD susceptibility.</p></div>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":"76 2","pages":"Pages 136-138"},"PeriodicalIF":1.5,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11143534/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140174520","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":"CSI clinical practice guidelines for dyslipidemia management: Executive summary","authors":"Jitendra PS. Sawhney ,&nbsp;Sivasubramanian Ramakrishnan ,&nbsp;Kushal Madan ,&nbsp;Saumitra Ray ,&nbsp;P Balagopalan Jayagopal ,&nbsp;Dorairaj Prabhakaran ,&nbsp;Tiny Nair ,&nbsp;Geevar Zachariah ,&nbsp;Peeyush Jain ,&nbsp;Jamshed Dalal ,&nbsp;Sitaraman Radhakrishnan ,&nbsp;Arun Chopra ,&nbsp;Sanjay Kalra ,&nbsp;Ashwani Mehta ,&nbsp;Arvind K. Pancholia ,&nbsp;Nitin K. Kabra ,&nbsp;Dhiman Kahali ,&nbsp;Tapan Ghose ,&nbsp;Satyavir Yadav ,&nbsp;Prafulla Kerkar ,&nbsp;Rajeev Gupta","doi":"10.1016/j.ihj.2023.11.271","DOIUrl":"10.1016/j.ihj.2023.11.271","url":null,"abstract":"<div><p>Dyslipidemias are the most important coronary artery disease (CAD) risk factor. Proper management of dyslipidemia is crucial to control the epidemic of premature CAD in India. <em>Cardiological Society of India</em> strived to develop consensus-based guidelines for better lipid management for CAD prevention and treatment. The executive summary provides a bird's eye-view of the ‘CSI: Clinical Practice Guidelines for Dyslipidemia Management’ published in this issue of the <em>Indian Heart Journal.</em> The summary is focused on the busy clinician and encourages evidence-based management of patients and high-risk individuals. The summary has serialized various aspects of lipid management including epidemiology and categorization of CAD risk. The focus is on management of specific dyslipidemias relevant to India-raised low density lipoprotein (LDL) cholesterol, non-high density lipoprotein cholesterol (non-HDL-C), apolipoproteins, triglycerides and lipoprotein(a). Drug therapies for lipid lowering (statins, non-statin drugs and other pharmaceutical agents) and lifestyle management (dietary interventions, physical activity and yoga) are summarized. Management of dyslipidemias in oft-neglected patient phenotypes-the elderly, young and children, and patients with comorbidities-stroke, peripheral arterial disease, kidney failure, posttransplant, HIV (Human immunodeficiency virus), Covid-19 and familial hypercholesterolemia is also presented. This consensus statement is based on major international guidelines (mainly European) and expert opinion of lipid management leaders from India with focus on the dictum: <em>earlier</em> the <em>better, lower the better, longer the better and together the better</em>. These consensus guidelines cannot replace the individual clinician judgement who remains the sole arbiter in management of the patient.</p></div>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":"76 ","pages":"Pages S6-S19"},"PeriodicalIF":1.5,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0019483223004698/pdfft?md5=f942602645d96db01a57deb888473b87&pid=1-s2.0-S0019483223004698-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138487354","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":"Cardiovascular diseases and the heart–gut cross talk","authors":"Snehali Majumder ,&nbsp;Rohan Kiritkumar Makwana ,&nbsp;Varun Shetty ,&nbsp;Suparna Mukherjee ,&nbsp;Pradeep Narayan","doi":"10.1016/j.ihj.2023.12.003","DOIUrl":"10.1016/j.ihj.2023.12.003","url":null,"abstract":"<div><p>The purpose of this narrative review is to provide a comprehensive overview of current research on heart-gut cross talk and its implications for cardiovascular disease. To uncover relevant preclinical and clinical research examining heart-gut cross talk, a thorough literature search was undertaken utilising electronic databases. The chosen publications were critically examined, and major findings were synthesised to offer a thorough perspective on the subject. We want to synthesise the most recent study findings, explain the underlying mechanisms, and provide potential treatment techniques. By exploring bidirectional connection between the heart and the gut, we shed light on novel future options for the prevention and treatment of cardiovascular diseases. The heart-gut cross talk is an exciting field of study with implications for cardiovascular disease. Understanding the complex connection between the heart and the gastrointestinal tract may lead to the development of novel therapeutic targets and therapies for the prevention and management of cardiovascular diseases. Future research should concentrate on identifying the specific processes driving this crosstalk as well as assessing the efficacy of therapies targeting the gut microbiota and the gut–brain axis in improving cardiovascular outcomes.</p></div>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":"76 2","pages":"Pages 94-100"},"PeriodicalIF":1.5,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0019483223004728/pdfft?md5=f255c2843bd801704833517681b07dcf&pid=1-s2.0-S0019483223004728-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138619548","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":"Management of triglycerides, non-high density lipoprotein cholesterol and high density lipoprotein cholesterol","authors":"Geevar Zachariah","doi":"10.1016/j.ihj.2023.11.004","DOIUrl":"10.1016/j.ihj.2023.11.004","url":null,"abstract":"<div><p>Dyslipidaemia characterised by elevated total cholesterol/LDL-C, triglyceride or both or decreased HDL-C is an important risk factor for the development of ASCVD. Atherogenic dyslipidaemia characterised by high TG, low HDL-C and elevated small dense LDL (sdLDL) is more prevalent in Asian Indians. Normal level of TG is generally considered as &lt;150 mg/dl. Hypertriglyceridemia is closely associated with obesity, metabolic syndrome and diabetes mellitus. Goals of management of hypertriglyceridemia are to lower the risk of atherosclerotic cardiovascular events and reduce the risk of pancreatitis. Lifestyle modification is important. In severe hypertriglyceridemia, TG lowering pharmacotherapy is important to prevent pancreatitis. In mild to moderate hypertriglyceridemia, pharmacotherapy is employed only if associated with ASCVD or high risk factors and not controlled with lifestyle modifications and statins.</p><p>Non-High Density Lipoprotein Cholesterol which estimates the cholesterol content of the atherogenic apoB containing lipoproteins, measured as total cholesterol minus HDL-C is equivalent to LDL-C in ASCVD risk assessment and superior to it in those with mild to moderate hypertriglyceridemia. Some international guidelines, have included measurement of non-HDL-C as primary therapeutic target for patients with ASCVD.</p><p>Low HDL cholesterol is common in Indians. Despite evidence of inverse relationship between HDL-C and cardiovascular events, HDL-C as a causative factor for development of atherosclerosis is unproven. Therapeutic strategies directed at increasing HDL-C levels have not been shown to have cardiovascular benefits and hence HDL-C is currently not a target for drug-based treatment</p></div>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":"76 ","pages":"Pages S58-S64"},"PeriodicalIF":1.5,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0019483223001773/pdfft?md5=08268fc98ab27129c2813acdc17550ca&pid=1-s2.0-S0019483223001773-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138046744","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":"Managing dyslipidemia in solid organ transplant patients","authors":"Ashwani Mehta","doi":"10.1016/j.ihj.2024.01.004","DOIUrl":"10.1016/j.ihj.2024.01.004","url":null,"abstract":"<div><p>Solid organ transplant recipients face an increased risk of dyslipidemia, which contributes to cardiovascular complications. Commonly used drugs such as ciclosporin and tacrolimus can aggravate and cause dyslipidemia. Immunosuppressive drugs particularly ciclosporin and tacrolimus are also known to worsen dyslipidemia in transplant recipients. Mammalian target of rapamycin (mTOR) inhibitors like sirolimus and everolimus also alter lipid metabolism. Lifestyle and dietary modifications should be encouraged. Careful consideration of immunosuppressant choices is also vital to control dyslipidemia. Statins are recommended as first-line agents for lipid-lowering therapy, with consideration for potential drug interactions. Other options, such as ezetimibe and nicotinic acid, may be considered as alternatives. The management of dyslipidemia in renal transplant patients mainly involves statin therapy, although the clinical effectiveness in this population is not well-documented. Lifestyle modifications, careful drug selection, and statin therapy are key components in managing dyslipidemia in solid organ transplant patients.</p></div>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":"76 ","pages":"Pages S93-S95"},"PeriodicalIF":1.5,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S001948322400004X/pdfft?md5=543cb591c938ee346d6e4be90f3c36bd&pid=1-s2.0-S001948322400004X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139416913","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":"Implantable cardioverter defibrillators for primary prevention in cardiomyopathies","authors":"Vineetha Kanneganti ,&nbsp;Ajay Bahl ,&nbsp;Manoj Kumar Rohit ,&nbsp;Saurabh Mehrotra","doi":"10.1016/j.ihj.2024.03.005","DOIUrl":"10.1016/j.ihj.2024.03.005","url":null,"abstract":"<div><h3>Background</h3><p>Implantable cardioverter defibrillators (ICD) are often used as primary prevention strategy for sudden cardiac death (SCD) in young individuals. This study analyzed appropriate therapies, complications and inappropriate shocks in the real-world Indian population.</p></div><div><h3>Methods</h3><p>All patients in the cardiomyopathy cohort under follow up who had ICD implanted as a primary prevention strategy were studied. The objective was to assess the incidence of appropriate ICD therapies, inappropriate therapies and complications. ICD was interrogated and stored electrograms analyzed. Underlying arrhythmia or conditions resulting in appropriate or inappropriate ICD therapy were studied. Correlation and regression studies was done to assess for the predictors of appropriate therapy.</p></div><div><h3>Results</h3><p>Fifty patients were followed up for a mean follow-up duration of 4.4 ± 3.1 years with total follow up of 220.2 patient years. Appropriate ICD therapy was delivered in 16 out of 50 (32%) patients, with 65 appropriate therapies (median 2 per patient, range: 0–20). Inappropriate therapy delivered in 7 of the 50 (14%) patients, with 44 inappropriate therapies (median 5 per patient, range: 0–20). Complications occurred in 8 of the 50 (16%) patients. Overall, the rate of appropriate therapy was 29.5 per 100 patient years, that of inappropriate therapy was 19.9 per 100 patient years and the rate of complications was 3.6 per 100 patient years.</p></div><div><h3>Conclusions</h3><p>When implanted for primary prevention in patients with cardiomyopathies over a mean period of 4.4 ± 3.1 years, appropriate ICD therapy was delivered in 32% patients. However, inappropriate therapy (14% patients) and complications (16% patients) were also common.</p></div>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":"76 2","pages":"Pages 118-122"},"PeriodicalIF":1.5,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11143500/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140193710","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":"Lipoprotein a - Lp(a)","authors":"Tapan Ghose","doi":"10.1016/j.ihj.2023.12.010","DOIUrl":"10.1016/j.ihj.2023.12.010","url":null,"abstract":"<div><p>Lp(a) is a genetically determined, heritable, independent and causal risk factor for ASCVD. About 1 in 5 people worldwide have elevated Lp(a) (&gt;50 mg/dL or &gt;125 nmol/L) whereas in Indians it is 25 %. Epidemiological, genome-wide association and mendelian randomization studies have demonstrated an association between elevated Lp(a) levels and increased incidence of myocardial infarction, aortic valve stenosis, ischemic stroke, heart failure, CV and all-cause mortality. The increased Lp(a)-mediated CV risk is mediated by pro-inflammatory, pro-thrombotic and pro-atherogenic processes, leading to progression of atherosclerosis and increased risk of thrombosis. Lp(a) level reaches peak by 5 years of age and remains stable over time. Levels are not much influenced by dietary and environmental factors but it can vary in certain clinical situations like thyroid diseases, chronic kidney disease, inflammation and sepsis. It should be measured at least once in life time. Cascade testing for high Lp(a) is recommended in the settings of FH, family history of (very) high Lp(a), and personal or family history of ASCVD. In the absence of specific Lp(a)-lowering therapies, comprehensive risk factor management is recommended as per guidelines for individuals with elevated Lp(a). PCSK9 inhibitors and Inclisiran reduce Lp(a) by 25%. Pelacarsen is an antisense oligonucleotide and is found to reduce Lp(a) by 80%. In a recent Indian study of 1,021 CAD patients, presence of elevated Lp(a) (&gt;50 mg/dL) correlated with severe angiographic disease. 37% of ACS patients exhibited elevated Lp(a) and it was higher in young CAD patients with FH (43%).</p></div>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":"76 ","pages":"Pages S117-S120"},"PeriodicalIF":1.5,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0019483223004790/pdfft?md5=a7412459343d73ab510621f7ca6f50b8&pid=1-s2.0-S0019483223004790-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139073952","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}