{"title":"Cardiac Rehabilitation in Abu Dhabi: A Retrospective Investigation of Program Delivery, Participants, and Factors Associated with Program Completion Utilizing a Hospital Registry.","authors":"Aaron H Thrush","doi":"10.37616/2212-5043.1349","DOIUrl":"10.37616/2212-5043.1349","url":null,"abstract":"<p><strong>Objectives: </strong>Investigations into the provision of cardiac rehabilitation from the Arabian Gulf countries are rare, despite suffering from an unusually high prevalence of cardiovascular disease. This study reports patient and program characteristics from an exercise-based cardiac rehabilitation program in Abu Dhabi, and factors associated with program completion.</p><p><strong>Methods: </strong>Data was drawn from the institution's cardiac rehabilitation registry, populated from the electronic medical record of patients enrolled in the hospital-based cardiac rehabilitation program, from 2015 to 2022. The program was administered by physical therapist and nurse specialists and guided by individualized exercise parameters. Completion of the program was defined as attendance of ten or more sessions. Relationships between program completion and demographic characteristics, quality of life, depression, and physical function were explored statistically.</p><p><strong>Results: </strong>A total of 1774 patients attended at least one session, with a total of 15,563 sessions. The number of patients and sessions trended upward since program inception. The most common referral diagnoses of participants who completed the program were coronary artery bypass grafting, valve surgery, and percutaneous coronary intervention. Among all 1774 attendees, median age was 56, comprised of 61.6% male, and 77.1% residents of Abu Dhabi, and 73.5% Emirati nationals. 527 (29.7%) patients completed the program, and this group was significantly lower in BMI (29.4 vs 30.4 kg/m<sup>2</sup>), had lower prevalence of moderate to severe depression (9.0 vs 13.0%), were more often Abu Dhabi residents or Emirati nationals (88.2 vs 72.2%, and 76.9 and 72.0%, respectively), and more likely to have completed the 6-min walk test at the first visit (80.5 vs 72.5%). There were no differences between those who did and did not complete cardiac rehabilitation with respect to age, gender, quality of life, or first 6-min walk test distance.</p><p><strong>Conclusions: </strong>There is a growing demand for cardiac rehabilitation in Abu Dhabi, particularly among Emirati nationals and residents of Abu Dhabi. Potential risk factors for non-completion such as higher body-mass index, depression, lower physical function, non-residence in Abu Dhabi, and non-Emirati nationality warrant further exploration.</p>","PeriodicalId":17319,"journal":{"name":"Journal of the Saudi Heart Association","volume":"35 3","pages":"235-243"},"PeriodicalIF":0.8,"publicationDate":"2023-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/62/a5/sha235-243.PMC10597596.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50162004","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}
Ali A Alakhfash, Abdulrahman Almesned, Abdullah Alqwaiee, Hashem D Alqurashi, Waleed Almanea
{"title":"Congenital Complete Heart Block Complicated by Atrial Flutter Diagnosis and Management.","authors":"Ali A Alakhfash, Abdulrahman Almesned, Abdullah Alqwaiee, Hashem D Alqurashi, Waleed Almanea","doi":"10.37616/2212-5043.1347","DOIUrl":"https://doi.org/10.37616/2212-5043.1347","url":null,"abstract":"<p><p>Seventeen-month-old child was diagnosed in utero to have congenital complete heart block. The mother has Sjogren's syndrome with high Anti Ro antibodies. The baby was delivered at term with a heart rate of 55-60 beats per minute. Echocardiography revealed a structurally normal heart with a small atrial septal defect and moderate patent ductus arteriosus. At the age of 17 months, he developed atrial flutter which was aborted using electrical cardioversion in the Cath lab. No recurrence of the atrial flutter during a one-year follow-up.</p>","PeriodicalId":17319,"journal":{"name":"Journal of the Saudi Heart Association","volume":"35 3","pages":"226-231"},"PeriodicalIF":0.8,"publicationDate":"2023-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/22/80/sha226-231.PMC10544175.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41134171","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 Disease in Saudi Arabia: Facts and the Way Forward.","authors":"Adel A Tash, Rasha F Al-Bawardy","doi":"10.37616/2212-5043.1336","DOIUrl":"10.37616/2212-5043.1336","url":null,"abstract":"<p><p>Cardiovascular diseases (CVDs) remain a major health concern globally. While some risk factors for CVDs are non-modifiable, other determinants like obesity, hypertension, type-2 diabetes and dyslipidemia can be mitigated by a wide plethora of measures to control CVD morbidity and mortality. Those determinants have been on the rise in Saudi Arabia, exacerbated by sedentary lifestyle. The Saudi Vision 2030 aims to reduce CVD clinical and economic burden and to scale up vitality and longevity; in a new era of comprehensive healthcare. From a health economics standpoint, CVDs entail a burden on healthcare systems directly through expenditure and indirectly through years living with the disease, low productivity, premature morbidity and mortality. This manuscript reviews current CV health and unmet needs in Saudi Arabia, discusses G20 countries' initiatives on primary prevention: public health measures, awareness programs; and proposes national registries and digital solutions to facilitate population-specific research, improve CV surveillance and alleviate CVD burden in Saudi Arabia.</p>","PeriodicalId":17319,"journal":{"name":"Journal of the Saudi Heart Association","volume":"35 2","pages":"148-162"},"PeriodicalIF":0.8,"publicationDate":"2023-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/8b/ef/sha148-162.PMC10405907.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10019405","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}
Waleed Al Habeeb, Adel Tash, Abdelfatah Elasfar, Ali Almasood, Abeer Bakhsh, Fayez Elshaer, Fakhr Al Ayoubi, Kamal Waheeb AIghalayini, Maryam Mohammed AlQaseer, Mosaad Alhussein, Osama Almogbel, Shukri Merza AlSaif, Yahia AlHebeshi
{"title":"2023 National Heart Center/Saudi Heart Association Focused Update of the 2019 Saudi Heart Association Guidelines for the Management of Heart Failure.","authors":"Waleed Al Habeeb, Adel Tash, Abdelfatah Elasfar, Ali Almasood, Abeer Bakhsh, Fayez Elshaer, Fakhr Al Ayoubi, Kamal Waheeb AIghalayini, Maryam Mohammed AlQaseer, Mosaad Alhussein, Osama Almogbel, Shukri Merza AlSaif, Yahia AlHebeshi","doi":"10.37616/2212-5043.1334","DOIUrl":"10.37616/2212-5043.1334","url":null,"abstract":"<p><strong>Background: </strong>The burden of cardiovascular diseases is undeniable in local populations, who have high mortality rates and a young age of disease onset. A systematic review of emerging evidence and update of the Saudi Heart Association (SHA) 2019 heart failure (HF) guidelines was therefore undertaken.</p><p><strong>Methodology: </strong>A panel of expert cardiologists reviewed recommendations of the 2019 guidelines following the Saudi Heart Association methodology for guideline recommendations. When needed, the panel provided updated and new recommendations endorsed by the national heart council that are appropriate for clinical practice and local resources in Saudi Arabia.</p><p><strong>Recommendations and conclusion: </strong>The focused update describes the appropriate use of clinical assessment as well as invasive and non-invasive modalities for the classification and diagnosis of HF. The prevention of HF was emphasized by expanding on both primary and secondary prevention approaches. Pharmacological treatment of HF was supplemented with recommendations on newer therapies, such as SGLT-2 inhibitors. Recommendations were also provided on the management of patients with cardiovascular and non-cardiovascular co-morbidities, with a focus on cardio-oncology and pregnancy. Updated clinical algorithms were included in support of HF management in both the acute and chronic settings. The implementation of this focused update on HF management in clinical practice is expected to lead to improved patient outcomes by providing evidence-based comprehensive guidance for practitioners in Saudi Arabia.</p>","PeriodicalId":17319,"journal":{"name":"Journal of the Saudi Heart Association","volume":"35 1","pages":"71-134"},"PeriodicalIF":0.7,"publicationDate":"2023-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/65/2b/sha71-134.PMC10263126.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9646580","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}
Syed S Habib, Thamir Al-Khlaiwi, Muhammad A Butt, Syed M Habib, Huthayfah Al-Khliwi, Khalid Al-Regaiey
{"title":"Novel Adiponectin-Resistin Indices and Ratios Predict Increased Cardiovascular Risk in Patients with Type 2 Diabetes Mellitus.","authors":"Syed S Habib, Thamir Al-Khlaiwi, Muhammad A Butt, Syed M Habib, Huthayfah Al-Khliwi, Khalid Al-Regaiey","doi":"10.37616/2212-5043.1332","DOIUrl":"10.37616/2212-5043.1332","url":null,"abstract":"<p><strong>Objectives: </strong>Adiponectin and resistin are adipokines involved in insulin resistance, glucometabolic control and adiposity. There is evidence that hypoadiponectinemia and hyperresistinemia are associated with cardiovascular disease. Whether the ratio of Adiponectin-Resistin (AR) and Insulin Resistance Adiponectin-Resistin (IRAR) indices can be used as non-invasive biomarker of cardiovascular disease needs more attention. Therefore, the aim of this study was to assess the relationships of AR and IRAR indices with adiposity, glucometabolic control and cardiovascular risk incurred by high-sensitivity C-reactive protein (hsCRP) in healthy subjects and patients with Type 2 Diabetes Mellitus.</p><p><strong>Methods: </strong>This observational case control study was conducted in the Department of Physiology and Medicine, King Saud University, Riyadh. A total of 191 (control = 84 and diabetic = 107) subjects were recruited. Body composition was assessed by bioelectrical impendence analyzer (BIA). Fasting blood samples were analyzed for glucose, glycosylated hemoglobin (HbA1c), high-sensitivity C-reactive protein (hsCRP), lipid profile, adiponectin, and resistin levels. The AR and IRAR indices were determined by formulas.</p><p><strong>Results: </strong>Serum adiponectin levels were significantly lower in diabetics compared to control (95.45 ± 39.27 ng/ml vs 146.64 ± 56.36 ng/ml, <i>p</i> < .001) while serum resistin was significantly higher in diabetic when compared to control (2.94 ± 1.30 ng/ml vs 2.40 ± 1.09 ng/ml, <i>p</i> = .003). Furthermore, AR and IRAR indices were significantly increased in diabetic subjects when compared to control (.82 ± .29 vs .48 ± .35, <i>p</i> < .001) and (.30 ± .10 vs .17 ± .12, <i>p</i> < .001) respectively. ROC analysis revealed that these indices predicted increased cardiovascular risk with area under the curve (AUC) for adiponectin = .717 ( <i>p</i> = .001), resistin = .635 ( <i>p</i> = .002), AR index = .740 ( <i>p</i> < .001), and IRAR index = .737 ( <i>p</i> < .001) respectively. AR index correlated positively with Triglycerides (r = .354, <i>p</i> < .01), hsCRP (r = .264, <i>p</i> < .01), HbA1c (r = .425, <i>p</i> < .01), fat mass (r = .164, <i>p</i> < .05), Waist/Hip Ratio (WHR) (r = .248, <i>p</i> < .01), and negatively with high density lipoprotein (r=-.327, <i>p</i> < .01). Furthermore, IRAR index more strongly correlated with Triglycerides (r = .409, <i>p</i> < .01), hsCRP (r = .268, <i>p</i> < .01), HbA1c (r = .508, <i>p</i> < .01), fat mass (r = .152, <i>p</i> < .05), WHR (r = .256, <i>p</i> < .01), and negatively with high density lipoprotein (r = -.340, <i>p</i> < .01).</p><p><strong>Conclusions: </strong>AR and IRAR indices correlate significantly with adiposity, glucometabolic control and cardiovascular risk in type 2 diabetic patients and non-diabetic individuals. They may prove to be useful integrated biomarkers to predict metabolic dysregulation and cardiovascular risk.</p>","PeriodicalId":17319,"journal":{"name":"Journal of the Saudi Heart Association","volume":"35 1","pages":"59-65"},"PeriodicalIF":0.8,"publicationDate":"2023-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a6/2c/sha59-65.PMC10229130.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9620791","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}
Waleed Alhabeeb, Adel A Tash, Mostafa Alshamiri, Mohamed Arafa, Mohammed A Balghith, Ali ALmasood, Abdulla Eltayeb, Hossam Elghetany, Taher Hassan, Owayed Alshemmari
{"title":"National Heart Center/Saudi Heart Association 2023 Guidelines on the Management of Hypertension.","authors":"Waleed Alhabeeb, Adel A Tash, Mostafa Alshamiri, Mohamed Arafa, Mohammed A Balghith, Ali ALmasood, Abdulla Eltayeb, Hossam Elghetany, Taher Hassan, Owayed Alshemmari","doi":"10.37616/2212-5043.1328","DOIUrl":"10.37616/2212-5043.1328","url":null,"abstract":"<p><strong>Background: </strong>Hypertension is a highly prevalent disease in Saudi Arabia with poor control rates. Updated guidelines are needed to guide the management of hypertension and improve treatment outcomes.</p><p><strong>Methodology: </strong>A panel of experts representing the National Heart Center (NHC) and the Saudi Heart Association (SHA) reviewed existing evidence and formulated guidance relevant to the local population, clinical practice and the healthcare system. The recommendations were reviewed to ensure scientific and medical accuracy.</p><p><strong>Recommendations: </strong>Hypertension was defined and a new classification was proposed as relevant to the Saudi population. Recommendations on diagnosis, clinical evaluation, cardiovascular assessment were detailed, along with guidance on measurement modalities and screening/follow-up. Non-pharmacological management is the first line of hypertension treatment. Pharmacological therapy should be used appropriately as needed. Treatment priority is to control blood pressure regardless of the drug class used. The choice of treatment should be tailored to the patient profile in order to achieve treatment targets and ensure patient compliance. Recommendations were provided on pharmacological options available in Saudi Arabia, as well as guidance on the treatment of special conditions.</p><p><strong>Conclusion: </strong>Hypertension management should be based on appropriate screening, timely diagnosis and lifestyle changes supplemented with pharmacological therapy, as needed. Clinical management should be individualized, and careful consideration should be given to special conditions and patient groups.</p>","PeriodicalId":17319,"journal":{"name":"Journal of the Saudi Heart Association","volume":"35 1","pages":"16-39"},"PeriodicalIF":0.7,"publicationDate":"2023-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e2/81/sha16-39.PMC10069676.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9250923","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}
Anwar A Alhulaibi, Abdulrahman M Alruwaili, Zahra M Albahar, Wiam T Abdelsalam, Mohamed A Elasheri, Abdullah S Alotaibi
{"title":"Case of Bilateral Atrial Myxomas in Carney Syndrome.","authors":"Anwar A Alhulaibi, Abdulrahman M Alruwaili, Zahra M Albahar, Wiam T Abdelsalam, Mohamed A Elasheri, Abdullah S Alotaibi","doi":"10.37616/2212-5043.1326","DOIUrl":"https://doi.org/10.37616/2212-5043.1326","url":null,"abstract":"<p><p>Carney complex is rare neoplastic disorder. Intracardiac myxoma presenting the most common non-cutaneous lesions in this complex. We are reporting a 31-year-old Saudi female known case of Carney complex presented with asymptomatic biatrial myxoma that was identified on routine transthoracic echocardiogram, and was successfully excised. However, these patients need a careful surveillance in order to detect any new masses and prevent their complications.</p>","PeriodicalId":17319,"journal":{"name":"Journal of the Saudi Heart Association","volume":"35 1","pages":"1-6"},"PeriodicalIF":0.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/92/4a/sha1-6.PMC10069668.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9257651","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}
Javed Jalbani, Khalid I Bhatti, Muhammad T Sallar, Ahsan M Baig, Palwasha Tariq, Faisal Ahmed, Ali Ammar, Vicky Kumar
{"title":"The Role of Neutrophil to Lymphocyte Ratio and its Common Clinical Outcomes Among Patients with Non-ST Elevation Acute Coronary Syndrome.","authors":"Javed Jalbani, Khalid I Bhatti, Muhammad T Sallar, Ahsan M Baig, Palwasha Tariq, Faisal Ahmed, Ali Ammar, Vicky Kumar","doi":"10.37616/2212-5043.1340","DOIUrl":"https://doi.org/10.37616/2212-5043.1340","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the admission neutrophil-to-lymphocyte ratio (NLR) for risk stratification for in-hospital outcomes and complications in non-ST-elevation acute coronary syndrome (non-ST-ACS) patients.</p><p><strong>Methods: </strong>We recruited consecutive patients with non-ST-ACS. The NLR was obtained and stratified as low, intermediate, and high-risk based on <3.0, 3.0-6.0, and >6.0, respectively. The new ST-T changes, arrhythmias, contrast-induced nephropathy (CIN), and mortality were recorded.</p><p><strong>Results: </strong>Median NLR was 3 [2.1-5.3] for 346 patients with 19.9% and 30.6% in high- and intermediate-risk group. New ST-T changes were observed in 3.5% (12) out of which 8, 3, and 1 patient in low, intermediate, and high-risk group (p = 0.424), respectively. Arrhythmias were observed in 5.8% (20) with 7, 5, and 8 patients in low, intermediate, and high-risk group (p = 0.067), respectively. CIN was observed in 4.9% (17) with 5, 5, and 7 in low, intermediate, and high-risk group (p = 0.064), respectively. In-hospital mortality was recorded in 1.4% (5) with 2 and 3 patients in high and low-risk group (p = 0.260), respectively.</p><p><strong>Conclusion: </strong>A significant number of non-ST-ACS patients fall in the high-risk category of NLR. Although, the association between NLR and in-hospital mortality and adverse events was not statistically significant but relatively higher rates of events were observed in high risk group.</p>","PeriodicalId":17319,"journal":{"name":"Journal of the Saudi Heart Association","volume":"35 2","pages":"177-182"},"PeriodicalIF":0.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/94/96/sha177-182.PMC10405906.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9968134","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}
Kutluhan E Hazir, Ersin Ç Şïmşek, Gizem Çabuk, Cenk Sari
{"title":"Unexpected Course of Left Ventricular Thrombus after COVID-19 Infection in a Woman with Peripartum Cardiomyopathy Single Shield Against Double Shock.","authors":"Kutluhan E Hazir, Ersin Ç Şïmşek, Gizem Çabuk, Cenk Sari","doi":"10.37616/2212-5043.1331","DOIUrl":"https://doi.org/10.37616/2212-5043.1331","url":null,"abstract":"<p><p>Peripartum cardiomyopathy (PPCMP) is defined as heart failure that develops in the last trimester of pregnancy or in the first few months after delivery without an underlying cause. Altought it is seen rarely, it can lead to thromboembolic events and can be life-threatening. Similarly, COVID-19, which is a viral pneumonia agent, is known to cause thrombogenesis. In this case report, the unexpected course of left ventricular thrombus developing in a patient with peripartum cardiomyopathy accompanied by COVID-19 infection is presented.</p>","PeriodicalId":17319,"journal":{"name":"Journal of the Saudi Heart Association","volume":"35 1","pages":"55-58"},"PeriodicalIF":0.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/0f/d2/sha55-58.PMC10069704.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9257650","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":"Culprit Lesion Morphology on Optical Coherence Tomography in ST-elevation Myocardial Infarction vs Non ST-elevation Myocardial Infarction - A Systematic Review of 7526 Patients.","authors":"Avinash Mani, Vineeta Ojha, Harikrishnan Sivadasanpillai, Bijulal Sasidharan, Sanjay Ganapathi, Ajit K Valaparambil","doi":"10.37616/2212-5043.1329","DOIUrl":"https://doi.org/10.37616/2212-5043.1329","url":null,"abstract":"<p><strong>Background: </strong>Patients with STEMI are postulated to have different culprit lesion morphology compared to NSTEMI. The use of OCT in ACS can help delineate lesion morphology. The aim of this systematic review was to analyze the available data on culprit plaque morphology in ACS patients.</p><p><strong>Methods: </strong>The available literature was systematically screened for studies on culprit lesion morphology in ACS patients. Data was extracted from the selected studies and analyzed for baseline characteristics as well as culprit lesion morphology on OCT. Lesion characteristics between STEMI and NSTEMI groups were compared.</p><p><strong>Results: </strong>A total of 32 studies were selected for the final analysis. The average age of the study population was 62.4 years. Majority of patients (66.6%) had STEMI on presentation. NSTEMI patients had a higher prevalence of diabetes compared to STEMI. Both STEMI and NSTEMI patients had similar prevalence of thin-cap fibroatheroma (44.9%). The mean fibrous cap thickness was 84.2 μm in the study. STEMI patients had higher prevalence of lipid plaques, macrophages and luminal thrombus as compared to NSTEMI patients. Plaque rupture was the predominant culprit lesion morphology in both STEMI and NSTEMI groups, with higher prevalence in STEMI patients. Plaque erosion was also more common in STEMI patients (34.4% vs 13.2%).</p><p><strong>Conclusion: </strong>Plaque rupture is the predominat culprit lesion morphology in both STEMI and NSTEMI patients, despite having differences in baseline characteristics. Use of OCT to determine plaque morphology in ACS patients can help guide management strategy in select cases. [PROSPERO CRD42021249742].</p>","PeriodicalId":17319,"journal":{"name":"Journal of the Saudi Heart Association","volume":"35 1","pages":"40-49"},"PeriodicalIF":0.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/eb/ed/sha40-49.PMC10069671.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9257653","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}