Pakistan Heart Journal最新文献

{"title":"COMPARATIVE EVALUATION OF NUTRITIONAL STATUS SCORE IN ICU-HOSPITALIZED PATIENTS INDICATES HIGHER NUTRITIONAL RISK AMONG POST CABG SUBJECTS: A CROSS-SECTIONAL STUDY IN THE NORTH OF IRAN","authors":"Motahare Haghighatkhah, Zeinab Ghorbani, Azin Vakilpour, Elahe Pouryousefi, H. A. Balou, M. Roshan","doi":"10.47144/phj.v55i4.2265","DOIUrl":"https://doi.org/10.47144/phj.v55i4.2265","url":null,"abstract":"Objectives: The current cross-sectional study intended to provide a comparative evaluation of nutritional status in the intensive care unit (ICU)-hospitalized patients according to the reasons for admission.\u0000Methodology: A total of 258 patients hospitalized for >24-hour in the ICU between February 2020- July 2021 were included. The subjects were categorized into five categories: burned injury (n=27), COVID-19 or other respiratory disorders (n=64), post coronary artery bypass graft surgery (post-CABG) (n=50), trauma (n=57), and miscellaneous causes (n=60). A modified Nutrition Risk in Critically Ill (mNUTRIC) score was applied to explore the nutritional status of the patients.\u0000Results: On average, the patients were 58± 16 years old that 46% (n=119) of them were females. The mean± SD of mNUTRIC score among patients with burned 2±1 and COVID-19 or other respiratory disorders 2±1 tended to be significantly lower than the others, including post-CABG 3±0 and patients with miscellaneous causes 3±2 (p-value=0.001). According to mNUTRIC score classifications, the majority of those who were transferred to ICU with burn or COVID-19 or other respiratory disorders were at low nutritional risk (mNUTRIC score:0-<3) (66.70%, and 67.20%, respectively); whereas relatively all post CABG subjects were at intermediate nutritional risk (mNUTRIC score:3-<5) (n= 48, 96.00%). A greater proportion of subjects in the miscellaneous category (n=12, 20.00%) were at high nutritional risk (mNUTRIC score:5-9) (p-value <0.001).\u0000Conclusion: It was revealed that approximately all post CABG and those admitted to ICU with miscellaneous causes were at a higher risk for impaired nutritional status and may require more in-depth evaluation for providing earlier nutritional support.","PeriodicalId":42273,"journal":{"name":"Pakistan Heart Journal","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48593929","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":"PREVALENCE AND CONTROL OF THE HYPERTENSION IN PATIENTS SUFFERING FROM RHEUMATOID ARTHRITIS","authors":"K. Ashiq, Sana Ashiq, N. Shehzadi, K. Hussain, M. T. Khan","doi":"10.47144/phj.v55i4.2352","DOIUrl":"https://doi.org/10.47144/phj.v55i4.2352","url":null,"abstract":"Hypertension or high blood pressure (BP) is a long-term ailment in which blood pressure in the arteries raises persistently. Blood pressure can be determined using two methods, systolic pressure which is the uppermost pressure and diastolic pressure which is the lowermost blood pressure in the arterial system. It is estimated that worldwide around 1.13 billion persons are suffering from hypertension. In addition, the World Health Organization (WHO) has reported that 13% of all deaths in the world are caused by hypertension. Furthermore, they set a target to reduce its frequency by 25% from the year 2010 to 2025.1,2\u0000Rheumatoid arthritis (RA) is a systemic autoimmune disease that leads to inflammation of the joints and pain. Approximately 1% of the global population is diagnosed with this disease. Rheumatoid arthritis can be associated with multiple comorbidities that can reduce a patient's quality of life (QoL), upturn the economic burden of the disease, and may increase the rate of mortality. Cardiovascular comorbidities are quite common in patients with rheumatoid arthritis. Cardiovascular comorbidity is estimated to be about 1.5 times more frequent in patients with rheumatoid arthritis than in healthy people. Many studies have suggested that of all cardiovascular disorders, hypertension is the most important and changeable risk factor in subjects suffering from rheumatoid arthritis. Based on a pool of 115,867 insurance claims, about 76% of rheumatoid arthritis patients in America were diagnosed with hypertension. These results are similar to studies conducted in Europe and Canada that have shown a higher incidence of hypertension in patients with rheumatoid arthritis compared to the normal group. It is unknown why patients with rheumatoid arthritis pose such a high risk for hypertension. Reduced physical activity, obesity, systemic inflammation, and medications used to treat rheumatoid arthritis can increase the risk of high blood pressure.3 Around 0.55% of the urban population in northern Pakistan suffers from rheumatoid arthritis, while the incidence rate is close to 0.14% in southern Pakistan.4\u0000There are many reasons why people with rheumatoid arthritis have high blood pressure. Chronic inflammation in rheumatoid arthritis results in increased rigidity of arteries leading to increase systolic blood pressure. The first presumed link between low-grade systemic inflammation and hypertension has been identified in previous studies conducted on the general population. In rheumatoid arthritis, elevated levels of C-reactive protein (CRP) increase the likelihood of developing high blood pressure. Several mechanisms may be implicated in the development of hypertension with a high concentration of C-reactive protein. For example, nitric oxide synthesis may be reduced because of the increased concentration of the C-reactive protein that will cause vasoconstriction, platelet activation and thrombosis. Additionally, increased expression of the type 1 ang","PeriodicalId":42273,"journal":{"name":"Pakistan Heart Journal","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46188241","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":"VENTRICULAR TACHYCARDIA AS A FIRST PRESENTATION OF ARRHYTHMOGENIC RIGHT VENTRICULAR CARDIOMYOPATHY (ARVC) IN A PREVIOUSLY ASYMPTOMATIC SEXAGENARIAN","authors":"Muhammad Asad, Talha Bin Nazir, Qurban Hussain Khan","doi":"10.47144/phj.v55i4.2281","DOIUrl":"https://doi.org/10.47144/phj.v55i4.2281","url":null,"abstract":"Arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C) is characterised by morphological and histological changes in the ventricles. Progressive myocyte loss and fibrofatty tissue replacement, producing islands of scar, can lead to reentrant ventricular tachycardia and sudden cardiac death. It usually presents as chest pain, palpitations, heart failure, or syncope. The majority of cases are seen before the age of 40. Ventricular arrhythmia as a first presentation in the elderly is seen infrequently. We present a case of a previously asymptomatic 62-year-old gentleman who had an episode of ventricular tachycardia as the first manifestation of ARVC without having any positive family history for this disease. He was managed with amiodarone and was later planned for an implantable cardiac defibrillator (ICD).","PeriodicalId":42273,"journal":{"name":"Pakistan Heart Journal","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45554083","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":"RELATIONSHIP OF LIFESTYLE AND DIETARY HABITS OF SOUTH-EAST ASIAN (PAKISTANI) POPULATION WITH CARDIOVASCULAR DISEASES: A CASE-CONTROL STUDY","authors":"Syed Muhammad Ashraf Jahangeer, Areeba Ikram, Anmol Anmol, M. Lashari, Kainat Kataria, E. Turk, M. Rehan","doi":"10.47144/phj.v55i4.2321","DOIUrl":"https://doi.org/10.47144/phj.v55i4.2321","url":null,"abstract":"Objectives: Cardiovascular disease (CVDs) is the leading cause of deaths globally. Apart from traditional risks, multiple indigenous factors are implicated to impact disease courses. Lifestyle factors distinct to South Asians may predispose to disease or serve a protective effect. Our study objective was to determine the Relationship of lifestyle and dietary habits of South-east Asian (Pakistani) population with cardiovascular diseases.\u0000Methodology: A case-control study was conducted from April to October 2021 in a two-thousand bedded university teaching hospital in Karachi, Pakistan. Out of 400 participants, 189 were cases with a documented cardiovascular event and 211 were controls. Participants >18 years were included whereas pregnant females and patients with congenital heart defects were excluded. A structured questionnaire was designed and implemented, and anthropometrics were recorded. Chi-square test, independent sample t-test and multivariate analysis were utilized via SPSSv23. P-value <0.05 was considered significant.\u0000Results: From 400 participants, 189 cases and 211 controls were identified. 53.4% of the people consuming open spices had CVDs while 46.6% did not. While only 37% of people using home cooked spices had CVDs with an OR= 0.51(0.3-0.84, 95% CI, p=0.08). Our results showed an inverse or no relationship of high BMI with CVDs. No statistically significant results were observed of diabetes and hypertension with CVDs.\u0000Conclusion: Based on our results, home grounded condiments have a protective effects on CVD than open spices. With reference to CVD, poor lifestyle habits and anthropometric profiles of our controls indicate a need for urgent preventive measures at population level.","PeriodicalId":42273,"journal":{"name":"Pakistan Heart Journal","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48558877","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":"APPROACH OF WITHHOLDING P2Y12 INHIBITORS FOR URGENT CORONARY ARTERY BYPASS GRAFTING IN DIABETIC PATIENTS WITH ACUTE CORONARY SYNDROME","authors":"Ghulam Abbas Seikh, Faisal Ahmed, A. A. Shah, Syed Dilbahar Ali Shah Asad, Fareheen Ashfaq, Shabnam Shabnam, M. Lashari","doi":"10.47144/phj.v55i4.2282","DOIUrl":"https://doi.org/10.47144/phj.v55i4.2282","url":null,"abstract":"Objectives: To compare angiographic findings between diabetic and non-diabetic patients with acute coronary syndrome (ACS) along with feasibility of P2Y12 inhibitors withholding approach for urgent coronary artery bypass grafting (CABG) in diabetic (DM) patients with severe lesions.\u0000Methodology: Consecutive ACS patients were included. P2Y12 inhibitors was hold in a certain number of diabetic patients with either left main (LM) or multi-vessel disease (MVD) on baseline angiogram, at the discretion of primary physician. Angiographic diseases severity was compared between diabetic and non-diabetics. The clinical management and outcomes of diabetic patients were further compared based on the deferred P2Y12 inhibitors approach.\u0000Results: Out of 205 patients, 149 were males and 40.9% were diabetic. Involved vessel was LM in 19.8% vs. 16.6%; p=0.566, left anterior descending artery (LAD) in 62.8% vs. 39.3%; p=0.001, and right coronary artery in 27.3% vs. 45.2%; p=0.008 with MVD in 42.1% vs. 28.6%, p=0.047 of the diabetic and non-diabetic patients, respectively. P2Y12 inhibitors was hold in 59 diabetic patients who undergone urgent CABG with hospital stay of <5 days. In remaining 62 diabetic patients, 50 undergo coronary intervention and 12 undergo delayed CABG with hospital stay of >5 days due to P2Y12 administration.\u0000Conclusion: The presence of DM showed a significant association with the involvement of the LAD artery. Most participants showed presence of MVD. By holding P2Y12 inhibitors reduces the perioperative bleeding and hospital stay.","PeriodicalId":42273,"journal":{"name":"Pakistan Heart Journal","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48276924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"EFFICACY OF ACCELERATED STREPTOKINASE INFUSION IN THE TREATMENT OF ST ELEVATION MYOCARDIAL INFARCTION","authors":"Umer Shafiq, Muhammad Abdul Wahab, S. Rahman","doi":"10.47144/phj.v55isupplement1.2419","DOIUrl":"https://doi.org/10.47144/phj.v55isupplement1.2419","url":null,"abstract":"Objectives: Cardiovascular disease (CVD) is considered as one of the important priorities in the health systems of all countries. Approximately 550,000 first episodes and 200,000 recurrent episodes of acute myocardial infarction occur annually worldwide. Globally, ischemic heart disease has become the leading contributor to the burden of disease as assessed on the basis of disability-adjusted life-years. To determine the efficacy of accelerated streptokinase in patients with acute ST elevation myocardial infarction. \u0000Methodology: This Descriptive study was done in the Department of Cardiology, Hayatabad Medical Complex Peshawar from August 2020 to February 2021. Total 144 patients were observed. All patients were subjected to SK in a dose of 1.5million units over 60 minutes. All patients were under strict observation and a repeat ECG was performed to determine the efficacy of accelerated SK. \u0000Results: Our study shows that among 144 patients mean age and standard deviation was 61± 8.19. 88(61%) patients were male and 56(39%) patients were female. More over accelerated streptokinase was effective in 92(64%) patients and was not effective in 52(36%) patients. \u0000Conclusion: The accelerated SK infusion regimen of 1.5 MU in 20 min is safe and well tolerated with significantly faster and higher clinical reperfusion rates, more preserved LV systolic function, less atrial and ventricular sustained arrhythmias, and less in-hospital and 1 year mortality rates in acute STEMI.","PeriodicalId":42273,"journal":{"name":"Pakistan Heart Journal","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2022-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46168959","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":"UNFOLDING THE REALITY OF SMOKING PARADOX IN PATIENTS PRESENTING WITH STE-ACS UNDERGOING PRIMARY PERCUTANEOUS CORONARY TREATMENT","authors":"M. Siddiqui, Rajesh Kumar, J. Sial, M. Karim","doi":"10.47144/phj.v55isupplement1.2418","DOIUrl":"https://doi.org/10.47144/phj.v55isupplement1.2418","url":null,"abstract":"Objectives: Main objective for this study to unfold this controversy in South Asian population in terms of clinical, angiographic parameters and its in-hospital outcomes. \u0000Methodology: In this study, we included 1756 consecutive patients diagnosed with STEMI undergoing primary PCI. Patients were classified into smokers and nonsmokers. Comparison was done on the basis of baseline characteristics, clinical presentation, angiographic features and in-hospital mortality between two groups. Multivariable logistic regression analysis was performed to evaluate the paradoxical role of smoking. \u0000Results: Smokers were younger (53.78±11.16 years vs. 56.43±11.17 years; p<0.001) and more frequently male (98.7% vs. 69.9%; p<0.001), and had less diabetes (19.6% vs. 44.8%; p<0.001) and hypertension (38.5% vs. 64.9%; p<0.001). Smokers presented less frequently in Killip III (5.6% vs. 8.1%; p<0.001) and Killip IV (2.5% vs. 4.8%; p<0.001) in smokers group. Smokers mostly had single vessel disease (41.7% vs. 34.4%; p=0.013) whereas non-smokers had complex disease and frequently presented with total occlusion of the culprit vessel (64.6% vs. 58.8%; p=0.040). Complication such as slow flow/no-flow (24.3% vs. 33.2%; p<0.001) and cardiogenic shock (2.3% vs. 4.6%; p<0.001) were also seen less often among smokers. Smokers has significantly lesser mortality (1.8% vs. 4.3%; p=0.009) compared to non-smokers with an odds ratio (OR) of 0.41 [95% CI: 0.21-0.82, p=0.011], however, adjusted OR on multivariable analysis was 0.67 [95% CI: 0.31-1.41, p=0.290]. Independent predictors of mortality were found to be history of CVA/stroke, pre-procedure LVEDP, multi-vessel diseases, and RBS in ER adjusted OR of 3.83 [95% CI: 1.24-11.79; p=0.019], 1.07 [95% CI: 1.03-1.12; p=0.002], 2.2 [95% CI: 1.07-4.54; p=0.033], and 1 [95% CI: 1.0-1.01; p=0.032], respectively. \u0000Conclusion: The controversial phenomenon of smoking paradox seems to be unfolded in South Asian population in post STE-ACS patients. The paradoxical protective role of smoking is confounding effect of mainly younger age, less coronary artery disease burden and complexity, lower prevalence of diabetes and hypertension and lower rate of Killip III/IV at presentation. Hence, the protective effect is insignificant in multivariable analysis and history of CVA/stroke, pre-procedure LVEDP, multi-vessel diseases, and RBS in ER were found to be independent predictors of in-hospital mortality.","PeriodicalId":42273,"journal":{"name":"Pakistan Heart Journal","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2022-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48511655","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":"PPCI OUTCOMES","authors":"Muhammad Ishaq Khan, Rafiullah Jan, Muhammad Waleed, Wali Saleem","doi":"10.47144/phj.v55isupplement1.2435","DOIUrl":"https://doi.org/10.47144/phj.v55isupplement1.2435","url":null,"abstract":"Objectives: Primary percutaneous coronary intervention (PPCI) is the standard of care for ST-elevation myocardial infarction (STEMI) worldwide. Recommended by the latest guidelines (1). In Pakistan only a handful centres offer PPCI services, many others rely on thrombolysis as the reperfusion strategy for STEMI patients which has been shown to be inferior to primary PCI (2). In our province the PPCI facility is even harder to offer where infrastructure and economic conditions of the public is lagging behind many areas in the country. Ours is a study from a public sector hospital in its infancy. We present our data of a single centre and believe that it will help shape the policy of the government in favour of expanding PPCI facilities. To share the primary PCI data of our centre. \u0000Methodology: It was a retrospective observational study. All comers who underwent PPCI for STEMI in Peshawar Institute of Cardiology from March 2022 to August 2022were enrolled. All procedures were performed by experienced interventional cardiologists or their fellows under their direct supervision. \u0000Results: A total of 337 patients were enrolled in the study. The mean age was 53 ± 16 years. 73 % (n = 246) were males. Most commonly involved culprit artery was LAD (47%) followed by RCA (34%). 16.9% (n = 57) patients had triple vessel disease, 35 % (n = 119) double vessel disease and 47.7% (n = 161) had only one vessel disease. LMS disease was diagnosed in 18 (5.3%) patients, out of which 4 (1.1%) were stented during the index procedure. In-hospital mortality was 3% (n = 10), out of which 6 (1.8 %) patients were in cardiogenic shock and all were on inotropic support. Four patients (1.1%) needed intubation and balloon pump was used in another 4 (1.1 %) patients. Second and third generation DES were used in 86% (n = 290), POBA in 08% (n = 27), urgent surgical referral was done in 03 % (n = 10) while in 03% (n = 10) patients no stenting was done. Intravascular ultrasound was used in 4 (1.1%) cases. \u0000Conclusion: Primary PCI can be offered in public sector hospital to our population. The need of the hour is to delegate more resources to this life saving procedure.","PeriodicalId":42273,"journal":{"name":"Pakistan Heart Journal","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2022-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42596241","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 CORONARY ARTERY DISEASE SEVERITY AMONG DIABETIC AND NON DIABETIC PATIENTS ADMITTED TO KHYBER TEACHING HOSPITAL, PESHAWAR","authors":"A. Ahmad, S. Ashraf, S. Bahadar, Muhammad Irfan, A. Ashraf, M. Hafizullah","doi":"10.47144/phj.v55isupplement1.2436","DOIUrl":"https://doi.org/10.47144/phj.v55isupplement1.2436","url":null,"abstract":"Objectives: To compare the coronary artery disease severity in type-2 diabetic and non-diabetic patients suffering from coronary artery disease presenting to cardiology department of Khyber Teaching Hospital, Peshawar. \u0000Methodology: This cross sectional study was conducted at Cardiology department of Khyber Teaching Hospital, Peshawar from 29th August 2015 to 17th March 2016. Non probability convenience sampling technique was applied. All patients admitted with acute coronary syndrome or previous known coronary artery disease who were candidate for angiography and revascularization and given consent were included. Patient with type 1 diabetes mellitus, valvular heart diseases, chronic kidney disease, Connective tissue disease, previous percutaneous coronary intervention (PCI) and coronary artery bypass graft (CABG) were excluded from study. Patient’s coronary angiograms were evaluated for lesions in coronary arteries, number of vessel involved and type of lesions, by two cardiologist with more than five year post fellowship experience first separately and then results were compared for final reporting in order to eliminate bias in reporting. \u0000Results: It was noted that male diabetic patients with more were ten years duration of diabetes, smokers with 10 pack years and sedentary life style were more prone to have severe disease in coronary arteries. In diabetic patients severe disease was significantly higher in LAD (55.2% vs. 43%, p <0.01), RCA (63.3% vs. 38 %, p <0.002) and Left Circumflex (62% vs. 35%, p <0.003). Diabetic patients were found to have more extensive disease as compared to non-diabetics, so multi vessel disease was more common in diabetics as compared to non-diabetics (55.7% vs. 21.3 %, p <0.001) . It was noted that Type C lesions were more common in diabetics (33.7% vs. 13.9 %, p <0.001). Diabetic patients were having more severe, diffuse disease multivessel disease in our study population as compared to non-diabetics. \u0000Conclusion: Coronary artery disease is more severe, diffuse, aggressive with complicated lesions in diabetic patients having more than 10 years duration of diabetes along with ten pack years history of smoking, with sedentary life style.","PeriodicalId":42273,"journal":{"name":"Pakistan Heart Journal","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2022-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46060120","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 QUANTIFICATION AND IMPACT OF INCOMPLETE REVASCULARIZATION USING RESIDUAL SYNTAX SCORE IN NSTEMI PATIENTS AFTER PERCUTANEOUS CORONARY INTERVENTION","authors":"Syed Waqar Ahmed, N. Rahman","doi":"10.47144/phj.v55isupplement1.2421","DOIUrl":"https://doi.org/10.47144/phj.v55isupplement1.2421","url":null,"abstract":"Objectives: The aim of this study was to assess the prognostic significance of rSS after PCI for NSTEMI in terms of all-cause mortality and MACE (Major adverse cardiac event) at 3 years of follow-up. \u0000Methodology: A retrospective analysis of 115 consecutive NSTEMI patients who underwent PCI at the Aga Khan University Hospital Karachi between January 2016 and December 2016 was performed. 7 patients were excluded from the final analysis due to missing data (n=108). The SYNTAX scores before (baseline syntax=bSS) and after PCI (rSS) were calculated. Patients were stratified as CR if rSS =0, RICR if rSS >0 and ≤8 and ICR if rSS >8. \u0000Results: Patients that achieved CR were 44 (40.7%), RICR were 40 (37.7%) and ICR were 24 (22.2%). After three-year follow-up, ICR patients had the highest incidence of both all-cause mortality [(CR) 4.5% vs. (RICR) 5% vs. (ICR) 37.5% respectively; p<0.001] and major adverse cardiovascular (MACE) defined as composite of follow up cardiac death, MI and revascularization [(CR) 5% vs. (RICR) 10% vs. (ICR) 50% respectively; p<0.001]. There was no difference in the incidence of all-cause death (4.5% vs. 5%; p=0.92) or MACE (4.5% vs 10%, p=0.332) in patients with CR and ICR respectively (Table 1). \u0000Table 1: Outcomes at two years of follow-up according to residual SYNTAX score \u0000MACE- Major Adverse cardiac event (Cardiac death,MI or Revascularisation); CR- complete revascularization; RICR- Reasonable incomplete revascularization; ICR- Incomplete revascularization \u0000 \u0000 \u0000 \u0000 \u0000  \u0000 \u0000 \u0000CR (rSS=0) \u0000N= 44 \u0000 \u0000 \u0000RICR (rSS >0 and ≤8) \u0000N= 40 \u0000 \u0000 \u0000ICR (rSS>8) \u0000N= 24 \u0000 \u0000 \u0000P value \u0000 \u0000 \u0000CR vs RICR \u0000p value \u0000 \u0000 \u0000CR vs ICR \u0000P value \u0000 \u0000 \u0000RICR vs ICR \u0000P value \u0000 \u0000 \u0000 \u0000 \u0000All cause death \u0000 \u0000 \u00002 (4.5) \u0000 \u0000 \u00002 (5) \u0000 \u0000 \u00009 (37.5) \u0000 \u0000 \u0000<0.001 \u0000 \u0000 \u00000.92 \u0000 \u0000 \u0000<0.001 \u0000 \u0000 \u00000.001 \u0000 \u0000 \u0000 \u0000 \u0000Cardiac death \u0000 \u0000 \u00001 (2.3) \u0000 \u0000 \u00002 (5) \u0000 \u0000 \u00007 (29.2) \u0000 \u0000 \u00000.001 \u0000 \u0000 \u00000.50 \u0000 \u0000 \u00000.001 \u0000 \u0000 \u00000.007 \u0000 \u0000 \u0000 \u0000 \u0000MI \u0000 \u0000 \u00001 (2.3) \u0000 \u0000 \u00001 (2.5) \u0000 \u0000 \u00008 (33.3) \u0000 \u0000 \u0000<0.001 \u0000 \u0000 \u00000.949 \u0000 \u0000 \u0000<0.001 \u0000 \u0000 \u00000.001 \u0000 \u0000 \u0000 \u0000 \u0000Revascularization \u0000 \u0000 \u00001 (2.3) \u0000 \u0000 \u00003 (7.5) \u0000 \u0000 \u00003 (12.5) \u0000 \u0000 \u00000.25 \u0000 \u0000 \u00000.261 \u0000 \u0000 \u00000.087 \u0000 \u0000 \u00000.51 \u0000 \u0000 \u0000 \u0000 \u0000MACE \u0000 \u0000 \u00002 (4.5) \u0000 \u0000 \u00004 (10) \u0000 \u0000 \u000012 (50) \u0000 \u0000 \u0000<0.001 \u0000 \u0000 \u00000.332 \u0000 \u0000 \u0000<0.001 \u0000 \u0000 \u0000<0.001 \u0000 \u0000 \u0000 \u0000 \u0000Conclusion: The residual SYNTAX score (rSS) is a useful tool in quantifying incomplete revascularization in patients undergoing PCI for NSTEMI. ICR appears to confer a higher three-year mortality and MACE, however outcomes for RICR and CR were comparable. Hence the calculation of rSS in daily practice may also be used to determine a reasonable level of revascularization in patients where complete revascularization may not be possible.","PeriodicalId":42273,"journal":{"name":"Pakistan Heart Journal","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2022-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41335813","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}