Journal of Clinical and Preventive Cardiology最新文献

{"title":"Reliability of a jugular venous pressure scale in cardiovascular clinical examination","authors":"Himel Mondal, Shaikat Mondal, Debasish Das, Nazmul Alam, Koushik Saha","doi":"10.4103/JCPC.JCPC_4_20","DOIUrl":"https://doi.org/10.4103/JCPC.JCPC_4_20","url":null,"abstract":"Background: Noninvasively jugular venous pressure (JVP) is measured at bedside commonly by card and ruler. New tools have been developed for the measurement of JVP with the basis of this method. However, these tools have some limitations. Aim: The aim of this study was (1) to develop a JVP scale which would be devoid of common problems faced with currently available devices and (2) to test the provisional validity and reliability of the device in the estimation of JVP. Materials and Methods: We used two common plastic rulers – one as vertical and one as horizontal. The vertical ruler was cut at the level of 5 cm mark. A piece of aluminum sheet was used to make an adapter in which the vertical ruler can slide. This adapter was attached to the horizontal ruler. Both the rulers were equipped with spirit-level capsules. This device was used by 16 raters to measure JVP on five individuals twice. Inter-rater, intra-rater, and test–retest reliability were checked by the intraclass correlation coefficient (ICC) in IBM® SPSS® Statistics Version 20 software package. Results: For average measures, inter-rater ICC was 0.998 (P < 0.001), intra-rater ICC was 0.981 (P < 0.001), and test–retest ICC was 0.829 (P = 0.001). Inter- and intra-rater reliability was “excellent,” whereas test–retest reliability was “good.” Conclusions: Developed JVP scale is low cost and easy to build at any resource-limited settings. This would be an adjunct tool for bedside cardiovascular examination of patients with good to excellent reliability. This would also be used for teaching cardiovascular physiology for medical and allied science students.","PeriodicalId":31371,"journal":{"name":"Journal of Clinical and Preventive Cardiology","volume":"9 1","pages":"61 - 66"},"PeriodicalIF":0.0,"publicationDate":"2020-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42732936","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 reproductive factors in Indian women predisposing to coronary artery disease in later life","authors":"Lalita Nemani, I. Garre, J. Maddury, Sudhanshu Garg","doi":"10.4103/JCPC.JCPC_1_20","DOIUrl":"https://doi.org/10.4103/JCPC.JCPC_1_20","url":null,"abstract":"Background: Reproductive factors in women may predispose to coronary artery disease (CAD) in later life. However, the evidence is meager and varying in response. If the appropriate factors are identified, it would enable much earlier and more aggressive risk factor modification as reproductive factors can be ascertained much earlier than traditional risk factors for CAD. The study aims to evaluate the reproductive factors in women which contribute to CAD in later life. Materials and Method: This is a retrospective study of 500 women. Reproductive factors including pregnancy details and lactation were assessed. The study population was divided into two groups depending on the presence and absence of CAD and reproductive factors compared using MINITAB version 17. Results: The CAD group was a decade older with a significant history of hypertension (P = 0.003) and diabetes (P = 0.02). Age of menarche was earlier in the CAD group (12.74 ± 1.29 years vs. 13.18 ± 1.43 years; P = 0.00) with statistically significant occurrence of early menarche, i.e., ≤12 years (46.8% vs. 33.6%; P = 0.002; risk ratio [RR] = 1.31; odds ratio [OR] = 1.74; 95% confidence interval = 1.1–1.56). Age at first pregnancy was significantly earlier in the CAD group (18.74 ± 2.94 years vs. 19.41 ± 3.36 years; P = 0.018), but early pregnancy (≤18 years) was not statistically significant (34.8% vs. 30.8%; P = 0.34). The CAD group had a higher order of parity (3.12 ± 1.49 vs. 2.67 ± 1.21; P = 0.000), but multiparity (>3 paras) was not significant. History of pregnancy complication (54% vs. 20.8%; P = 0.00; RR = 5.38, OR = 7.67) and pregnancy loss (44.4% vs. 16.4%; P = 0.00; RR = 2.71; OR = 4.07) were significantly higher in the CAD group. The average age of menopause was significantly earlier in CAD (44.25 ± 7.35 years vs. 46.16 ± 6.32 years; P = 0.006), and early menopause (≤45 years) was of borderline significance (P = 0.06; RR = 1.93; OR = 5.08). Breastfeeding did not have any impact. Conclusion: Early menarche, pregnancy complication, and pregnancy loss are associated with CAD in later life. Early menopause irrespective of whether natural or surgical also predisposed to CAD. Age of first pregnancy was earlier and order of parity was higher in the CAD group, but no definite relation between early pregnancy and multiparity with CAD could be established. Intake of hormonal therapy for menstrual irregularity, late menarche and breast feeding did not predispose to CAD.","PeriodicalId":31371,"journal":{"name":"Journal of Clinical and Preventive Cardiology","volume":"9 1","pages":"45 - 50"},"PeriodicalIF":0.0,"publicationDate":"2020-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41948003","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":"Monotherapy versus combination therapy for the initial treatment of hypertension","authors":"S. Shina","doi":"10.4103/JCPC.JCPC_27_20","DOIUrl":"https://doi.org/10.4103/JCPC.JCPC_27_20","url":null,"abstract":"Objectives: There is a significant gap among hypertensive patients who are being treated and those who actually achieve blood pressure (BP) control. The main objective of this article is to determine if there are any differences in clinical outcomes and BP control with a combination treatment as compared to monotherapy as the initial treatment of hypertension. It also focuses on to compare the efficacy and compliance of fixed-dose combination (FDC) as compared to monotherapy and conventional multi-pill combination therapy as the initial treatment of hypertension. Methods: A search of literature was done using PubMed and Google scholar to prepare a review on this topic. Results: The main evidence supporting the use of combination therapy is focused on the use of combinations of renin–angiotensin System (RAS) blocker with calcium channel blockers (CCBs) and with thiazide diuretics. Several randomized clinical trials have proven the efficacy of combination therapy to be superior to monotherapy as initial treatment for timely and adequate BP control. Conclusion: Several benefits of achieving good BP control have been proven by several studies including the Systolic Blood Pressure Intervention Trial study, but only a few guidelines internationally recommend combination antihypertensives as a routine first-line treatment in all hypertensive patients. It is reasonable to go for aggressive management of hypertension involving the use of FDC antihypertensives from two different classes of drugs to achieve the recommended goals of BP of <140/90 mmHg for most patients and <130/80 mmHg for high-risk patients. The combination treatment that can be considered is the combination of RAS blockers with CCB or RAS blockers with thiazide diuretics.","PeriodicalId":31371,"journal":{"name":"Journal of Clinical and Preventive Cardiology","volume":"9 1","pages":"78 - 83"},"PeriodicalIF":0.0,"publicationDate":"2020-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47090096","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":"Correlation between earlobe crease and coronary artery disease in Indian population- A multicentre experience","authors":"V. Mishra, D. Khanra, Kumar Himanshu, Bhavana. U. Jain, Sunil K Tripathi, P. Aggarwal, Shishir Soni, Navuluri Kumar Reddy, Rahul Singla, Meenakshi Mishra, S. Sinha","doi":"10.4103/JCPC.JCPC_10_20","DOIUrl":"https://doi.org/10.4103/JCPC.JCPC_10_20","url":null,"abstract":"Background: Earlobe crease (ELC) has been found to be associated with the presence of coronary artery disease (CAD) in many studies; however, studies from India are limited. The aim of this study was to determine the prevalence of CAD in those with ELC and to assess the correlation of ELC with severity of CAD. Materials and Methods: This was a cross-sectional, multicenter study; 1400 patients undergoing coronary angiogram were approached, but 1070 patients were analyzed after excluding patients with ear piercings and other ear diseases. Patients were classified into no ELC, mild ELC, and severe ELC according to Ishi et al. Results: Seven hundred and eighty patients had CAD proven by coronary angiography. Of these, 74% (580/780) had an ELC either mild or severe. The patients with ELC had a significantly higher incidence of hypertension, diabetes mellitus, and hypercholesterolemia. However, the prevalence of smoking and family history of premature cardiovascular death were similar in both the groups. The prevalence of CAD was found to be significantly higher (odds ratio [OR]: 4.22 [95% confidence interval (CI): 3.18–5.61], P < 0.0001) among the patients with ELC (580/698) in comparison to patients without ELC (200/372). The prevalence of multivessel disease (MVD) was found to be significantly higher among the ELC-positive patients than ELC-negative patients (OR: 5.03 [95% CI: 3.61–6.90], P < 0.0001). Moreover, MVD was significantly more prevalent in patients (OR: 6.27 [95% CI: 4.23–9.29], P < 0.0001) in the severe ELC group (150/190) in comparison to the mild ELC group (190/508). Conclusion: ELC is an important clinical sign which should be examined carefully for its presence as well as severity. Both presence and severity of crease were related to occurrence and severity of CAD, respectively, in our study. Long-term cohort studies involving multiple ethnicity populations are necessary to determine the role of ELC in development as well as prognosis of CAD.","PeriodicalId":31371,"journal":{"name":"Journal of Clinical and Preventive Cardiology","volume":"9 1","pages":"67 - 72"},"PeriodicalIF":0.0,"publicationDate":"2020-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46489267","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":"Psychosocial impact of COVID-19 on cardiovascular health","authors":"M. Manoj, G. Vijayaraghavan","doi":"10.4103/JCPC.JCPC_30_20","DOIUrl":"https://doi.org/10.4103/JCPC.JCPC_30_20","url":null,"abstract":"","PeriodicalId":31371,"journal":{"name":"Journal of Clinical and Preventive Cardiology","volume":"9 1","pages":"84 - 89"},"PeriodicalIF":0.0,"publicationDate":"2020-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42583664","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":"Covid cardiology: A neologism for an evolving subspecialty","authors":"S. Upadhyayula, R. Kasliwal","doi":"10.4103/JCPC.JCPC_37_20","DOIUrl":"https://doi.org/10.4103/JCPC.JCPC_37_20","url":null,"abstract":"","PeriodicalId":31371,"journal":{"name":"Journal of Clinical and Preventive Cardiology","volume":"9 1","pages":"40 - 44"},"PeriodicalIF":0.0,"publicationDate":"2020-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47716018","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":"Gender differences in cardiotoxicities associated with immune checkpoint inhibitor therapy in cancer patients","authors":"Sheharyar Minhas, A. Minhas, M. Malik","doi":"10.4103/JCPC.JCPC_29_20","DOIUrl":"https://doi.org/10.4103/JCPC.JCPC_29_20","url":null,"abstract":"Background: Immune checkpoint inhibitors (ICIs) are increasingly being used for cancer therapy. Cardiotoxicity from ICIs has largely been underestimated since cardiovascular monitoring is not routinely performed after initiating immunotherapy. Cardiotoxic side effects are uncommon but are serious complications of ICIs with a high morbidity and mortality. Aims and Objectives: To determine gender differences in the risk of CVEs in cancer patients that receive immunotherapy. To determine the risk of CVEs in males and females who received different number of ICI injections. To study other possible risk factors for adverse CVEs in patients who received immunotherapy with ICIs. Materials and Methods: In this observational, retrospective, pharmacovigilance study, we used MarketScan Databases to compare cardiovascular adverse events reported in patients who received ICIs. The data used in this study was fully integrated and de-identified data. The study included 16,574 patients who had cancer and underwent ICI therapy between January 1, 2011, and December 31, 2018. ICI drugs in this study included nivolumab, pembrolizumab, atezolizumab, avelumab, durvalumab, and ipilimumab. The time to an event and the end of follow-up was counted from the time of first ICI injection. Our primary exposure variable was gender. Results: This study demonstrated that time to adverse CVE in cancer patients that receive ICI therapy is affected by the gender. The hazard time to CVEs between the male and female gender varied by age. There was no difference in CVEs between males and females at a younger age. The hazard time to CVEs increased with age above 60 years in males when compared to females. The hazard of time to CVE in males was 1.18 times the hazard in females at the mean study age of 60.5 years. Adjusted Kaplan–Meier survival curves for males and females stratified by ICI injection categories showed that those with fewer number of ICI injections had a shorter time to CVE. Conclusions: The number of ICI injections and the gender both impact adverse cardiovascular events in cancer patients. Managing and reducing cardiotoxicity is vital for safe delivery of this effective therapy. Future studies should assess whether late onset chronic cardiotoxicity can occur with ICI therapy.","PeriodicalId":31371,"journal":{"name":"Journal of Clinical and Preventive Cardiology","volume":"9 1","pages":"73 - 77"},"PeriodicalIF":0.0,"publicationDate":"2020-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46533262","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 prothrombin time and international normalized ratio values using point-of-care system with a standardized laboratory method in patients on long-term oral anticoagulation – A prospective study","authors":"Raghuram Palaparti, Gopala Koduru, Sudarshan Palaparthi, P. S. Chowdary, P. Kondru, Somasekhar Ghanta, M. Babu, Prasad Maganti, Sasidhar Yendapalli, K. N Srikanth, Rohini Medasani","doi":"10.4103/JCPC.JCPC_55_19","DOIUrl":"https://doi.org/10.4103/JCPC.JCPC_55_19","url":null,"abstract":"Background: In our country, methods of prothrombin time (PT) and international normalized ratio (INR) testing have not been standardized across various centers. Often, we find disparity in INR values from different laboratories, posing a challenge to make an appropriate clinical decision. Objective: The objective of the study was to compare and correlate the PT/INR values using a point-of-care (POC) system with standardized laboratory (SL) testing and to evaluate the efficiency of the POC system in monitoring patients. Methods: We have prospectively compared PT/INR values between a commercially available POC, CoaguChek XS System, Roche, and SL testing in 205 patients and 353 samples from July 2017 to April 2018. Results: The overall strong correlation between POC PT/INR values and simultaneous standard laboratory values was noted. The overall coefficient of correlation among the two groups was 0.919 (P = 0.001) for INR values. In INR range of 2–3.5, the values correlated well with a coefficient of correlation, 0.756 (P = 0.001). In INR range <2, the values correlated with a coefficient of 0.98. The correlation was poor when the INR values were >4. Conclusions: In this comparison study, statistical analysis yielded a good correlation between POC PT/INR values and SL values in therapeutic and subtherapeutic range. POC testing is a good alternative to SL testing. If widely available, POC testing may enable patient self-testing and self-monitoring. In our experience, POC testing had added benefits in emergency settings. However, clinicians and laboratory professionals should be aware of the occasional disagreement between POC INR and standard laboratory INR values.","PeriodicalId":31371,"journal":{"name":"Journal of Clinical and Preventive Cardiology","volume":"9 1","pages":"25 - 30"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47796194","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":"Are the urban slum population physically inactive? A descriptive study from urban Puducherry","authors":"B. Naik, K. Selvaraj, P. Daya, S. Kar","doi":"10.4103/JCPC.JCPC_47_19","DOIUrl":"https://doi.org/10.4103/JCPC.JCPC_47_19","url":null,"abstract":"Context: Physical inactivity is an important modifiable behavioral risk factor for noncommunicable diseases (NCDs). However, adequate attention has not been paid to it, especially in low- and middle-income countries like India as like other risk factors due to challenges in the administration of tools to measure physical activity. Aims: This study was conducted to assess the level of physical inactivity and contributing factors in an urban slum of Puducherry. Settings and Design: Urban community, cross-sectional study design. Materials and Methods: After obtaining consent, relevant information on sociodemographic details and physical inactivity was collected, during the house-to-house survey, using a pretested semistructured questionnaire from each household of the study areas. A total of 3300 adults (aged 30 years or above) were included in the study. Physical inactivity was defined as <150 min of leisure time moderate exercise in a week. Statistics: The results were summarized as means and proportions. Results: Nearly three-fourth of the participants were physically inactive. About 79% of the females against 70% of the males were found to be physically inactive. Physical inactivity was found to be decreasing with increase in age: 30–44 years age (77.2%), 45–59 years age (75.3%), and 60 years and above (72.2%). Individuals with chronic diseases and obesity were found to be less physically inactive. Gender, age, education, socioeconomic status, occupation, alcohol use, and obesity were found to be associated with physical inactivity. Conclusion: Physical inactivity was very high in the study population, especially among young adults and females. Health education intervention targeting these populations can decrease the level of physical inactivity and in the long-run burden of NCDs in the study population.","PeriodicalId":31371,"journal":{"name":"Journal of Clinical and Preventive Cardiology","volume":"9 1","pages":"13 - 18"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48573882","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":"Editor's Page January 2020","authors":"R. Kasliwal","doi":"10.4103/2250-3528.280823","DOIUrl":"https://doi.org/10.4103/2250-3528.280823","url":null,"abstract":"Address for correspondence: Dr. Ravi R Kasliwal, MD, DM, FIMSA, MNAMS, FASE, Chairman, Clinical and Preventive Cardiology, Medanta The Medicity, Sector 38, Gurgaon, Haryana 122 001, India. E-mail: editor@jcpconline.org cardioembolic stroke and in-hospital mortality in Eastern Nepal” conclude that “hypertension and dyslipidemia were the most prevalent conventional risk factors, while atrial fibrillation was the most common cardiac cause of cardioembolic stroke.” This only goes to show how control of conventional cardiovascular risk factors can save many lives.","PeriodicalId":31371,"journal":{"name":"Journal of Clinical and Preventive Cardiology","volume":"9 1","pages":"1 - 1"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44548269","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}