Journal of the Saudi Heart Association最新文献

{"title":"Assessment of Coronary Collaterals Among Patients With ST-segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention and its Impact on In-hospital and 30-day Mortality: A Prospective Observational Study.","authors":"Zafar Iqbal, Muhammad N Mengal, Tariq Ashraf, Bashir A Salongi, Rajesh Kumar, Khalid I Bhatti, Bilal Ahmed, Abdul S Achakzai, Tahir Saghir","doi":"10.37616/2212-5043.1403","DOIUrl":"https://doi.org/10.37616/2212-5043.1403","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to determine the distribution of coronary collaterals (CC) as per the Rentrop Collateral Score (RCS) among patients with ST-segment elevation myocardial infarction (STEMI) and its impact on in-hospital and 30-day mortality after primary percutaneous coronary intervention (PCI).</p><p><strong>Methods: </strong>In this study, a selected sample of consecutive STEMI patients was assessed for the development of CC as per the RCS classification. An RCS grade of 2 or 3 was taken as the presence of CC with either partial or complete filling of the infarct-related artery (IRA). Patients were followed during the hospital stay and up to 30 days, and the incidence of major adverse cardiovascular events (MACE) was recorded, which included mortality, re-infarction, stroke, and hospitalization due to heart failure.</p><p><strong>Results: </strong>This study was conducted on a sample of 347 patients; 81.6% (283) were male, and the mean age was 56.2 ± 10.3 years. CC was not visible (RCS-0) in 206 (59.4%) patients, visible but without filling of the IRA (RCS-1) in 39 (11.2%) patients, and visible with partial (RCS-2) and complete (RCS-3) filling of the IRA in 72 (20.7%) and 30 (8.6%) patients, respectively. No significant differences were observed in the incidence of in-hospital mortality and short-term MACE between patients with and without CC, with an in-hospital mortality rate of 2% vs. 4.9% (p = 0.248) and a MACE rate of 7% vs. 6.4% (p = 0.850), respectively.</p><p><strong>Conclusion: </strong>Good CC with either partial or complete filling of the IRA was observed in more than one-fourth of the patients with STEMI. However, no significant benefits of good CC were observed.</p>","PeriodicalId":17319,"journal":{"name":"Journal of the Saudi Heart Association","volume":"36 4","pages":"352-359"},"PeriodicalIF":0.7,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11708903/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950663","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":"Platelet-to-White Blood Cell Ratio (PWR): A Novel Prognostic Biomarker for Spontaneous Reperfusion after Primary Percutaneous Coronary Intervention.","authors":"Gökhan Alıcı, Tayfur Erdoğdu, Arafat Yıldırım, Özge Ö Abacığglu, Ömer Genç, Ceyhun Yücel, Örsan D Urgun, Abdullah Yıldırım, Şerafettin Demir","doi":"10.37616/2212-5043.1404","DOIUrl":"10.37616/2212-5043.1404","url":null,"abstract":"<p><strong>Background: </strong>Spontaneous reperfusion (SR) occurring before primary percutaneous coronary intervention (PPCI) can offer additional clinical benefits to patients with ST-segment elevation myocardial infarction (STEMI). The Platelet-to-White Blood Cell Ratio (PWR) has been recognized as a prognostic indicator in various diseases. We aimed to explore the relationship between PWR and SR in patients with STEMI undergoing PPCI.</p><p><strong>Methods: </strong>We conducted a retrospective analysis involving 995 patients diagnosed with STEMI who underwent PPCI in a single-center setting. Demographic, clinical, laboratory, and angiographic data were extracted from the hospital database, and PWR was calculated by dividing serum platelet levels by white blood cell levels.</p><p><strong>Results: </strong>Angiographic SR was observed in 203 patients (20.4%). The SR group displayed elevated PWR values (24.4 ± 8.9 vs. 21.6 ± 7.6, p < 0.001) and a lower incidence of the no-reflow phenomenon (NRF) (13.3% vs. 22.9%, p = 0.003), along with a reduced SYNTAX (SX) score (12.7 ± 6.4 vs. 17.8 ± 7.9, p < 0.001). Furthermore, the group with a high PWR was associated with a higher rate of SR, a lower NRF rate, decreased in-hospital mortality, and reduced SX scores. Multivariable logistic regression analyses revealed that female gender, hemoglobin levels, the presence of SR, Culprit lesion, and the SX score were identified as risk factors for high PWR. High PWR, SX score, and Initial CK-MB levels were the factors associated with SR.</p><p><strong>Conclusions: </strong>Patients with high PWR at presentation may experience higher rates of SR, fewer complications, and a more favorable prognosis in the context of STEMI.</p>","PeriodicalId":17319,"journal":{"name":"Journal of the Saudi Heart Association","volume":"36 4","pages":"360-370"},"PeriodicalIF":0.7,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11708908/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950665","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":"Reply to Author Regarding the Letter \"Postoperative Atrial Fibrillation After Cardiac Surgery\".","authors":"Yasuhiko Imashuku, Susumu Hiraoka, Motoi Inoue, Takayoshi Mizuno, Misuzu Oyagi, Hirotoshi Kitagawa","doi":"10.37616/2212-5043.1401","DOIUrl":"10.37616/2212-5043.1401","url":null,"abstract":"","PeriodicalId":17319,"journal":{"name":"Journal of the Saudi Heart Association","volume":"36 4","pages":"351"},"PeriodicalIF":0.7,"publicationDate":"2024-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11648990/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142837208","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":"Postoperative Atrial Fibrillation After Cardiac Surgery.","authors":"Mesut Engin, Abdulkerim Özkan, Abdurrahman Demirel","doi":"10.37616/2212-5043.1400","DOIUrl":"https://doi.org/10.37616/2212-5043.1400","url":null,"abstract":"","PeriodicalId":17319,"journal":{"name":"Journal of the Saudi Heart Association","volume":"36 4","pages":"349-350"},"PeriodicalIF":0.7,"publicationDate":"2024-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11708907/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950666","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":"Caffeine and Arrhythmias: A Critical Analysis of Cardiovascular Responses and Arrhythmia Susceptibility.","authors":"Adel Khalifa S Hamad","doi":"10.37616/2212-5043.1402","DOIUrl":"10.37616/2212-5043.1402","url":null,"abstract":"<p><p>Caffeine is a frequently consumed stimulant in different foods and beverages: coffee, tea, chocolate, sodas, and energy drinks. While its effects on the cardiovascular system have been extensively studied, there remains controversy surrounding its potential risks, particularly in patients with heart disease. This review provides a complete overview of caffeine's pharmacological properties, sources, and cardiovascular effects, particularly emphasizing its arrhythmogenic potential. The proarrhythmic potential of caffeine, particularly on atrial fibrillation and ventricular arrhythmias, is conducted. It explains the mechanism of action, including adenosine receptor antagonism, phosphodiesterase inhibition, calcium mobilization, and catecholamine release of caffeine. Epidemiological evidence and mechanistic insights are provided for both conditions, and caffeine consumption's incidence, triggers, and impact on premature ventricular contractions are explained. It emphasizes the need for more research to comprehend the complex relationship between caffeine consumption and cardiovascular health, specifically in high-risk populations.</p>","PeriodicalId":17319,"journal":{"name":"Journal of the Saudi Heart Association","volume":"36 4","pages":"335-348"},"PeriodicalIF":0.7,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11648991/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142837202","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":"Comparative Efficacy and Safety of Transcatheter Mitral Valve Repair Versus Mitral-valve Surgery in Elderly Patients With Mitral Regurgitation: A Systematic Review and Meta-analysis.","authors":"Saif Almuzainy, Mohamed Lemine, Rayan Aljubeh, Sami Alsalem","doi":"10.37616/2212-5043.1399","DOIUrl":"10.37616/2212-5043.1399","url":null,"abstract":"<p><strong>Objectives: </strong>Mitral valve surgery is the reference treatment for severe symptomatic mitral regurgitation (MR). Percutaneous mitral valve interventions, such as the MitraClip procedure, offer an alternative, particularly for high-risk patients. The aim of this systematic review and meta-analysis was to analyze the safety and effectiveness of transcatheter mitral valve repair (TMVR) compared to surgical mitral valve repair or replacement (SMVR) in elderly patients with mitral regurgitation.</p><p><strong>Methods: </strong>We searched PubMed, Scopus, Ovid, EBSCO, and ProQuest through July 2024. Eligible studies were randomized controlled trials and observational comparative studies of TMVR versus SMVR for patients with MR, reporting outcomes such as all-cause mortality, MR recurrence, stroke, myocardial infarction, and length of stay (LOS). Statistical analyses were performed using RevMan.</p><p><strong>Results: </strong>Our search identified 3166 records, with 2756 screened and 21 studies included after review. The studies, comprising 20 retrospective cohorts and 1 randomized controlled trial with 20,900 patients, compared TMVR to SMVR. TMVR patients were significantly older than SMVR patients (MD 3.44 years; P < 0.00001). Mortality rates were similar at 30 days (relative risk (RR) 1.08; P = 0.79) and one year (RR 1.27; P = 0.18), but SMVR showed lower mortality at three years (RR 1.82; P = 0.006). SMVR also significantly reduced MR ≥ 3+ recurrence at 30 days (RR 6.95; P < 0.00001), one year (RR 3.31; P = 0.0001), and three years (RR 4.37; P < 0.00001). TMVR was associated with higher myocardial infarction rates (RR 1.58; P = 0.02) but reduced LOS (MD -4.88 days; P < 0.00001). Sensitivity analysis showed consistent results for recurrence of MR ≥ 3+ and variable outcomes for other metrics. Evidence of publication bias was noted for mortality at 30 days and LOS.</p><p><strong>Conclusion: </strong>While TMVR with the MitraClip offers shorter hospital stays and is less invasive, SMVR provides better long-term survival and lower MR recurrence rates, emphasizing the need for a tailored approach based on patient risk profiles.</p>","PeriodicalId":17319,"journal":{"name":"Journal of the Saudi Heart Association","volume":"36 4","pages":"316-334"},"PeriodicalIF":0.7,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11590862/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142739858","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":"Mitral Valve Prolapse with Syncope: Don't Judge the Book by its Cover!","authors":"Ghadah A Alarify, Lama A Alrumaih, Sameer Qetab, Wael Alqarawi","doi":"10.37616/2212-5043.1395","DOIUrl":"10.37616/2212-5043.1395","url":null,"abstract":"<p><p>A 33-year-old female with recurrent syncope episodes showed normal ECG and Holter results, but had mitral valve prolapse (MVP) with moderate mitral regurgitation (MR) on an echocardiogram. Cardiovascular magnetic resonance (CMR) revealed mitral annulus disjunction (MAD) with fibrosis. She received an implantable loop recorder (ILR). Several months later, she experienced a syncope event, which correlated with self-terminating polymorphic ventricular tachycardia (PMVT) preceded by narrow complex tachycardia, which was proven to be atrioventricular nodal reentrant tachycardia (AVNRT) in an electrophysiology study. Post-ablation, she had no recurrences of syncope. This case highlights the importance of ILR in avoiding unnecessary ICDs in MVP patients with syncope.</p>","PeriodicalId":17319,"journal":{"name":"Journal of the Saudi Heart Association","volume":"36 3","pages":"301-304"},"PeriodicalIF":0.7,"publicationDate":"2024-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11518023/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142524076","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":"Comparison of Sternotomy Access Versus Thoracotomy Access in the Surgical Treatment of Aortic Coarctation: A Propensity Score-matched Study.","authors":"Ilya A Soynov, Ksenya A Rzayeva, Yuriy N Gorbatykh, Yuriy Y Kulyabin, Artem V Gorbatykh, Ilya A Velyukhanov, Nataliya R Nichay, Serezha N Manukian, Saihuna A Magbulova, Aleksey N Arkhipov, Aleksander V Bogachev-Prokophiev","doi":"10.37616/2212-5043.1396","DOIUrl":"10.37616/2212-5043.1396","url":null,"abstract":"<p><strong>Background: </strong>The search for the \"Holy Grail\" of surgical repair for aortic coarctation involves finding an access and correction method that successfully and consistently avoids aortic recoarctation and arterial hypertension. The controversy persists as there is still no consensus on the best surgical approach and technique to achieve these objectives.</p><p><strong>Objective: </strong>The objective of this study is to compare sternotomy and left thoracotomy as surgical techniques for treating patients with aortic coarctation and hypoplasia of the distal aortic arch.</p><p><strong>Methods: </strong>From January 2008 to December 2020, 103 surgical procedures were performed using an extended oblique anastomosis. The patients were divided into 2 groups: oblique, extended anastomosis from thoracotomy access (n-68; 66%) and oblique extended anastomosis from sternotomy access (n-35; 34%). After performing a propensity score analysis (1:1) for the entire sample, 25 patients from sternotomy access were matched with 25 patients from thoracotomy access.</p><p><strong>Results: </strong>The mortality rate in the thoracotomy group was 4%, with 1 patient, while it was 8% with 2 patients in the sternotomy group, p > 0.99. There were no significant differences in early postoperative complications between the two groups. Recurrence of aortic coarctation was observed more frequently in the thoracotomy group (20.8% vs 0%). Low weight was identified as the only risk factor for aortic re-coarctation.</p><p><strong>Conclusion: </strong>The mortality rates and early postoperative complications associated with the surgical repair of aortic coarctation were similar between the sternotomy and thoracotomy approaches. Nevertheless, sternotomy approach may be beneficial in reducing aortic recoarctation.</p>","PeriodicalId":17319,"journal":{"name":"Journal of the Saudi Heart Association","volume":"36 3","pages":"305-315"},"PeriodicalIF":0.7,"publicationDate":"2024-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11534338/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142574996","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":"A Saudi Heart Association Position Statement on Obesity and Cardiovascular Disease.","authors":"Waleed Alhabeeb, Abdulhalim J Kinsara, Abeer Bakhsh, Adel Tash, Afaf Alshammary, Ali Almasood, Kamal Alghalayini, Mohammed Arafah, Osama Hamdy, Saud Alsifri, Suleiman M Kharabsheh, Wail Alkattan","doi":"10.37616/2212-5043.1391","DOIUrl":"10.37616/2212-5043.1391","url":null,"abstract":"<p><strong>Objectives: </strong>The obesity pandemic is a major public health concern in Saudi Arabia, with significant impact on cardiovascular disease (CVD). This position statement aims to provide an overview of available evidence as well as the recommendations of the Saudi Heart Association on the management of obesity associated with CVD.</p><p><strong>Methods: </strong>Under the auspices of the Saudi Heart Association, a multidisciplinary expert panel comprised of cardiologists and endocrinologists discussed available evidence and provided recommendations on the management of obesity in CVD. The expert panel discussions occurred between September of 2023 and May of 2024 and also took into consideration local expertise in addition to published data in the management of obesity and CVD in the Kingdom of Saudi Arabia.</p><p><strong>Results and conclusions: </strong>The expert panel explored studies on obesity and its implication on CVD assessment modalities, while also examining the efficacy and cardiovascular safety of available interventions for weight reduction. The association between obesity and CVD is undeniable. The treatment of obesity, be it through lifestyle changes, pharmacological therapy or surgery, is an effective strategy for both weight loss as well as the primary and secondary prevention of CVD. The Saudi Heart Association position statement thus provides guidance and recommendations for the management of obesity/overweight and CVD in Saudi Arabia. This position statement is expected to contribute towards obesity and CVD prevention efforts in Saudi Arabia by promoting adequate and time-appropriate treatment of these conditions.</p>","PeriodicalId":17319,"journal":{"name":"Journal of the Saudi Heart Association","volume":"36 3","pages":"263-300"},"PeriodicalIF":0.7,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11518015/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142522234","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":"Barriers to Cardiac Rehabilitation Enrollment and Secondary Prevention Adherence in Patients with Coronary Heart Disease Following Percutaneous Coronary Intervention: A Cross-sectional Survey.","authors":"Ahmed M Almoghairi, Jane O'Brien, Anna Doubrovsky, Jed Duff","doi":"10.37616/2212-5043.1392","DOIUrl":"10.37616/2212-5043.1392","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to evaluate adherence to secondary prevention measures and to identify barriers to cardiac rehabilitation enrolment among patients with coronary heart disease after percutaneous coronary intervention.</p><p><strong>Methods: </strong>An observational cross-sectional survey was conducted through computer-assisted telephone interviews to assess recently treated percutaneous coronary intervention patients at the Prince Sultan Cardiac Center in Saudi Arabia.</p><p><strong>Results: </strong>Out of 104 surveyed patients with coronary heart disease, 85 (82%) were male, with an average age of 59.5 years. The obesity rate was 28% (<i>n</i> = 29), with a high prevalence of comorbidities: 82 (79%), 63 (61%), and 62 (60%) patients had hyperlipidemia, diabetes, and hypertension, respectively. Despite high medication compliance (97%), adherence to secondary prevention measures was low (21%). Adherence to physical exercise and weight monitoring for fluid body build-up was notably poor at 35% and 9%, respectively. Only 11 (10.6%) patients were referred for cardiac rehabilitation, of whom only four (36.4%) attended. Significant barriers such as a lack of staff contact, insufficient physician support, and distance to cardiac rehabilitation facilities were particularly noted by 69% of rural patients.</p><p><strong>Conclusions: </strong>This study underscores the significant cardiac risk factors and low adherence to secondary prevention measures among post revascularization patients with coronary heart disease in Saudi Arabia. Low referral and other organizational barriers, as well as the travel distance to hospital-based cardiac rehabilitation, hinder program enrolment. To improve cardiac rehabilitation accessibility, it is crucial to revise the discharge plans, implement automated referral systems, expand the services across all regions, and utilize alternative delivery models.</p>","PeriodicalId":17319,"journal":{"name":"Journal of the Saudi Heart Association","volume":"36 3","pages":"252-262"},"PeriodicalIF":0.7,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11517995/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142522235","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}