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The prevalence of bleeding after percutaneous coronary interventions: A systematic review and meta-analysis 经皮冠状动脉介入术后出血的发生率:系统回顾和荟萃分析。
IF 1.5 Q3 Medicine Pub Date : 2024-01-01 DOI: 10.1016/j.ihj.2024.01.009
Reza Heidary Moghadam , Aida Mohammadi , Nader Salari , Arkan Ahmed , Shamarina Shohaimi , Masoud Mohammadi

Background

Bleeding is a common complication associated with percutaneous coronary intervention (PCI). The aim of this study was to determine the prevalence of bleeding after PCI through a systematic review and meta-analysis.

Methods

The systematic review and meta-analysis covered the period from 1989 to 2023. Multiple databases, including Embase, PubMed, Scopus, Web of Sciences (WoS), MagIran, Scientific Information Database (SID), and Google Scholar, were searched using validated keywords with MeSH and Emtree. The I2 index was used to check for heterogeneity among studies.

Results

The review of 8 studies, with a sample size of 397,298 participants, showed high heterogeneity (I2: 97.8 %). Therefore, the random effects method was used to analyze the results. The prevalence of bleeding after intervention in percutaneous coronary arteries was reported to be 4.4 % (95%CI: 2–9.1).

Conclusion

This meta-analysis showed a significant prevalence of bleeding after PCI, highlighting the need for health policymakers to pay more attention to the complications associated with PCI. Interventional cardiologists should consider the effective factors in these bleeding and how to treat and control them due to the importance of this complication.

背景:出血是经皮冠状动脉介入治疗(PCI)的常见并发症:出血是经皮冠状动脉介入治疗(PCI)的常见并发症。本研究旨在通过系统回顾和荟萃分析确定 PCI 术后出血的发生率:系统回顾和荟萃分析的时间跨度为 1989 年至 2022 年。使用MeSH和Emtree验证的关键词对多个数据库进行了检索,包括Embase、PubMed、Scopus、Web of Sciences(WoS)、MagIran、Scientific Information Database(SID)和Google Scholar。采用 I2 指数检查研究之间的异质性:结果:对 8 项研究(样本量为 397 298 人)的审查显示异质性很高(I2:97.8%)。因此,采用随机效应法对结果进行分析。据报道,经皮冠状动脉介入治疗后出血的发生率为4.4%(95%CI:2-9.1):这项荟萃分析表明,PCI术后出血的发生率很高,这凸显了卫生政策制定者需要更加关注PCI相关并发症。由于这种并发症的重要性,介入心脏病专家应考虑这些出血的有效因素以及如何治疗和控制这些因素。
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引用次数: 0
Study of mechanical complications in patients with acute ST-segment elevated myocardial infarction 急性 ST 段抬高型心肌梗死患者的机械并发症研究。
IF 1.5 Q3 Medicine Pub Date : 2024-01-01 DOI: 10.1016/j.ihj.2024.01.015
Rohit Mathur, Vivek Lakhawat, Viplov Kesarwani, Pawan Sarda, Anil Baroopal

This prospective observational study aimed to determine the proportion of mechanical complications in patients with acute STEMI and assess the associated outcomes. The study was conducted between June’21 and May’22, including 1307 patients. Mechanical complications were evaluated using 2D-Echo. Among the STEMI patients, 17 individuals (1.3 %) experienced mechanical complications. The most prevalent complication was FWR (n = 9), followed by VSR(n = 7) and PMR (n = 1). However, despite their low incidence, mechanical complications carry a significant mortality burden. Mortality rates were higher in older age and female patients.

这项前瞻性观察研究旨在确定急性 STEMI 患者中机械并发症的比例,并评估相关结果。研究于 21 年 6 月至 22 年 5 月进行,共纳入 1307 名患者。机械并发症采用二维回波进行评估。在 STEMI 患者中,有 17 人(1.3%)出现了机械并发症。最常见的并发症是 FWR(9 例),其次是 VSR(7 例)和 PMR(1 例)。然而,尽管机械并发症的发生率很低,但其带来的死亡率却很高。年龄较大和女性患者的死亡率较高。
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引用次数: 0
Endothelial nitric oxide synthase (eNOS) gene polymorphism (Glu298asp) and nitric oxide (NO) levels in patients with ST-segment elevation myocardial infarction (STEMI) ST 段抬高型心肌梗死(STEMI)患者的内皮一氧化氮合酶(eNOS)基因多态性(Glu298asp)和一氧化氮(NO)水平。
IF 1.5 Q3 Medicine Pub Date : 2024-01-01 DOI: 10.1016/j.ihj.2024.01.017
Mohit Dayal Gupta , Cherian Akkarappatty , Shekhar Kunal , Girish MP , Ankit Bansal , Vishal Batra , Sanjay Tyagi

Background

Genetic polymorphism in endothelial Nitric Oxide Synthase (eNOS) are associated with occurrence of multiple cardiovascular diseases (CVDs).

Methods

This study included 300 young ST-segment elevation myocardial infarction (STEMI) patients and 300 healthy controls. STEMI patients were divided into two groups: premature coronary artery disease [CAD] (STEMI<40 years of age) and older STEMI (>40 years of age). Genetic polymorphisms in the eNOS gene (894G/T) was evaluated in both subjects and controls. Plasma levels of nitric oxide (NO) were estimated for both patients as well as controls.

Results

Mean age of the study population was 49.7 ± 9.2 years with premature CAD being present in 58 (19.3 %) patients. No significant difference at genotypic (P = 0.589, odds ratio (OR) = 0.9, 95 % CI = 0.6–1.6) and allelic level (P = 0.173, OR = 1.2, 95 % CI = 0.9–1.4) was observed between STEMI patients and healthy controls. Genotype 894 TT had significantly higher frequency in STEMI patients >40 years (P = 0.047, OR: 2.5; 95 % CI = 1.0–6.0). No significant difference at genotypic (P = 0.279) and allelic level (P = 0.493) was observed between premature CAD (STEMI age <40 years) and healthy controls. NO levels (131 ± 59.6 μM vs 118.11 ± 49.96 μM; P = 0.001) was significantly higher in healthy controls as compared to STEMI patients >40 years of age (P= 0.001).

Conclusion

There was significant association of eNOS gene polymorphism Glu298Asp with STEMI patients > 40 years. However, this association was not observed in premature CAD patients. Lower levels of NO in STEMI patients >40 years suggests its potential role as a marker of CVD.

背景:内皮一氧化氮合成酶(eNOS)的基因多态性与多种心血管疾病(CVDs)的发生有关:这项研究包括 300 名年轻的 ST 段抬高型心肌梗死(STEMI)患者和 300 名健康对照者。STEMI 患者被分为两组:早发冠状动脉疾病(CAD)(STEMI40 岁)和健康对照组(STEMI50 岁)。对受试者和对照组 eNOS 基因(894G/T)的遗传多态性进行了评估。对患者和对照组的血浆一氧化氮(NO)水平进行了估计:研究对象的平均年龄为(49.7 ± 9.2)岁,其中 58 例(19.3%)患者患有早发性冠状动脉综合征。STEMI患者和健康对照组之间在基因型(P = 0.589,几率比(OR)= 0.9,95 % CI = 0.6-1.6)和等位基因水平(P = 0.173,OR = 1.2,95 % CI = 0.9-1.4)上无明显差异。在年龄大于 40 岁的 STEMI 患者中,基因型 894 TT 的频率明显更高(P = 0.047,OR:2.5;95 % CI = 1.0-6.0)。早发型 CAD(STEMI 年龄为 40 岁(P = 0.001))与等位基因水平(P = 0.493)之间无明显差异:结论:eNOS 基因多态性 Glu298Asp 与年龄大于 40 岁的 STEMI 患者有明显关联。结论:eNOS 基因多态性 Glu298Asp 与年龄大于 40 岁的 STEMI 患者有明显相关性,但在早发型 CAD 患者中未观察到这种关联。年龄大于 40 岁的 STEMI 患者体内 NO 水平较低,这表明 NO 有可能成为心血管疾病的标志物。
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引用次数: 0
Transcatheter aortic valve implantation using coplanar and cuspal overlap techniques in Indian patients 在印度患者中使用共面和尖面重叠技术进行经导管主动脉瓣植入术。
IF 1.5 Q3 Medicine Pub Date : 2024-01-01 DOI: 10.1016/j.ihj.2024.01.007
Rajat Datta , Prashant Bharadwaj , G. Keshavamurthy , Vivek Singh Guleria , Ratheesh Kj , Anil Kumar Abbot

Introduction

Transcatheter Aortic Valve Implantation (TAVI) techniques gradually evolved since 2002 and have undergone various refinements. Achieving optimal implantation depth has become crucial for good long term outcome. High implantation decreases the likelihood of conduction disturbances. Conventionally TAVI valve is positioned in a tricusp coplanar (CON) fluoroscopic projection however it does not ensure a optimal implantation. In an attempt to attain higher implantation(3 mm) and decrease rate of permanent pacemaker, cuspal overlap technique (COT) view has been developed. There is scarcity of Indian literature comparing TAVI deployment using coplanar and cuspal overlap techniques.

Methods

We included 111 patients who underwent TAVR with a self-expanding Core Valve Evolut R (Medtronic, Minneapolis, Minnesota), between January 2017 to September 2022 at our centre.Transcatheter Heart Valves (THV) were implanted using the traditional coplanar in 55 patients, while in 56 patients valves were implanted using the COT.

Results

Baseline characteristics including electrocardiographic findings were comparable in both groups. In all patients Evolut R or Evolut PRO valves were used. Procedure was done in conscious sedation in 90.9 % of patients in CON and 96.4 % in COT group. Predilatation and postdilatation was used in 38.8 % vs 33.9 % and 27 % vs 32 % in CON and COT groups respectively. 90 day PPI rate was less in COT group (7.3 % CON vs 3.5 % COP). Majority of patients who received permanent pacemaker implantation (PPI) had baseline ECG abnormality (RBBB in 50 %, LBBB in 16 %, Grade 1 AV block 16 %). Mean time of post procedure PPI was 5.6 days in COT group and 7.3 days in CON group. New onset LBBB was also less in COT group (21 % CON vs 12.5 % COT).There were 3.6 % intraprocedural deaths in CON group and 1.8 % in COT group. Depth of deployed valve was 4.8 ± 2.34 mm in COT and 6.6 ± 2.11 mm in CON group. Valve deployment time was more in COT group(10.40 CON vs 14.34 min COT). Average valve recapture rate was 2.58 in COP and 2.11 in CON. Stroke rate was more in COT group(3.6 % CON vs 7.14 % COT). Pericardial effusions were also more in COT group. All cause mortality at 3 months was 10.9 % in CON group and 5.3 % in COT.

Conclusion

In this study we achieved lower rates of PPI and new onset LBBB using COT technique in Indian patients using self-expandable prostheses. However valve deployment time, stroke rate and pericardial effusion were seen more in COT group. All cause mortality was low in cuspal overlap technique.

简介自 2002 年以来,经导管主动脉瓣植入术(TAVI)技术逐渐发展并经历了各种改进。达到最佳植入深度已成为长期良好疗效的关键。植入深度越高,发生传导障碍的可能性就越小。传统的 TAVI 瓣膜在三尖瓣共面(CON)透视投影下定位,但这并不能确保最佳植入效果。为了达到更高的植入率(3 毫米)并降低永久起搏器的使用率,人们开发了尖瓣重叠技术(COT)视图。目前,印度还缺少比较使用共面技术和尖面重叠技术进行 TAVI 部署的文献:我们纳入了2017年1月至2022年9月期间在本中心接受自扩张核心瓣膜Evolut R(美敦力公司,明尼苏达州明尼阿波利斯市)TAVR的111名患者。55名患者采用传统的共面植入经导管心脏瓣膜(THV),56名患者采用COT植入瓣膜:两组患者的基线特征(包括心电图结果)相当。所有患者均使用 Evolut R 或 Evolut PRO 瓣膜。90.9%的CON组患者和96.4%的COT组患者在有意识镇静状态下完成手术。CON组和COT组分别有38.8%对33.9%和27%对32%的患者使用了扩张前和扩张后治疗。COT 组的 90 天 PPI 率较低(CON 组 7.3% 对 COP 组 3.5%)。大多数接受永久起搏器植入术(PPI)的患者都有基线心电图异常(RBBB 占 50%,LBBB 占 16%,1 级房室传导阻滞占 16%)。COT组术后植入永久起搏器的平均时间为5.6天,CON组为7.3天。COT组新发LBBB的比例也较低(CON组21%,COT组12.5%)。COT组瓣膜展开深度为4.8 ± 2.34毫米,CON组为6.6 ± 2.11毫米。COT 组的瓣膜置入时间更长(CON 组 10.40 分钟,COT 组 14.34 分钟)。COP组的平均瓣膜再捕获率为2.58,CON组为2.11。COT 组的卒中率更高(CON 为 3.6% ,COT 为 7.14%)。COT组的心包积液率也更高。CON组3个月的全因死亡率为10.9%,COT组为5.3%:在这项研究中,我们在使用自体可扩张假体的印度患者中采用 COT 技术降低了 PPI 和新发 LBBB 的发生率。不过,COT 组的瓣膜部署时间、卒中率和心包积液发生率更高。尖瓣重叠技术的全因死亡率较低。
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引用次数: 0
Comparison of Indian clinical practice guidelines for the management of hypertension with the World Health Organization, International Society of Hypertension, American, and European guidelines 印度高血压管理临床实践指南与世界卫生组织、国际高血压学会、美国和欧洲指南的比较。
IF 1.5 Q3 Medicine Pub Date : 2024-01-01 DOI: 10.1016/j.ihj.2023.12.009
Gautam Satheesh , Rupasvi Dhurjati , Jayagopal Pathiyil Balagopalan , Padinhare P. Mohanan , Abdul Salam

Hypertension is the leading risk factor for preventable cardiovascular diseases and all-cause mortality globally, with majority of the hypertension-attributed deaths occurring in low- and middle-income countries like India. Several international and national clinical practice guidelines (CPGs) provide evidence-informed recommendations to achieve optimal control. CPGs produced by the World Health Organization, International Society for Hypertension, American (AHA/ACC-2017), and European (ESC/ESH-2018) are “major” as they are widely used and are highly cited. We compared the main recommendations for the pharmacological management of hypertension among the major CPGs and the two existing Indian CPGs for similarities and shortcomings. Several deviations from the major CPGs were observed among Indian CPGs. Important shortcomings pertain to Indian CPGs’ low priority for initial combination therapy and the use of single pill combinations. Having multiple CPGs providing conflicting recommendations might discourage the adoption of evidence-based practices. There is a need for updating Indian CPGs based on up-to-date evidence.

高血压是全球可预防的心血管疾病和全因死亡的首要风险因素,而高血压导致的死亡大多发生在印度等中低收入国家。一些国际和国家临床实践指南(CPGs)提供了以证据为依据的建议,以实现最佳控制。世界卫生组织、国际高血压学会、美国(AHA/ACC-2017)和欧洲(ESC/ESH-2018)制定的临床实践指南是 "主要 "指南,因为它们被广泛使用且引用率很高。我们比较了主要 CPG 和印度现有的两份 CPG 中关于高血压药物治疗的主要建议,以找出相似之处和不足之处。我们发现印度的 CPG 与主要 CPG 有一些偏差。重要的不足之处在于,印度的 CPGs 对初始联合疗法的重视程度较低,并且使用单药联合疗法。多个 CPG 提供的建议相互矛盾,可能会阻碍循证实践的采用。有必要根据最新证据更新印度 CPG。
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引用次数: 0
Percutaneous Coronary Intervention for Ostial Restenosis of the Large Side Branch Using the "Staged Mini-Culotte" Technique 使用 "分阶段迷你库洛特 "技术对大动脉侧支梗阻性再狭窄进行经皮冠状动脉介入治疗
IF 1.5 Q3 Medicine Pub Date : 2023-12-01 DOI: 10.1016/j.ihj.2023.11.021
Pankaj Jariwala, Gururaj Pramod
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引用次数: 0
Patwardhan Modified Maze for Rheumatic atrial fibrillation - Made for India! 治疗风湿性心房颤动的 Patwardhan 改良迷宫 - 为印度制造!
IF 1.5 Q3 Medicine Pub Date : 2023-12-01 DOI: 10.1016/j.ihj.2023.11.063
Vidyadhar S. Lad, Anil M. Patwardhan
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引用次数: 0
Outcomes of Drug Eluting Balloons in a Tertiary Care Hospital in South India 印度南部一家三级医院使用药物洗脱球囊的结果
IF 1.5 Q3 Medicine Pub Date : 2023-12-01 DOI: 10.1016/j.ihj.2023.11.045
Marsha Barreto
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引用次数: 0
Early Cardiac Rupture Following Thrombolysis in the Era of Pharmaco-invasive Approach – A Retrospective Cohort Study 药物介入疗法时代溶栓后的早期心脏破裂--一项回顾性队列研究
IF 1.5 Q3 Medicine Pub Date : 2023-12-01 DOI: 10.1016/j.ihj.2023.11.046
Milind R. Kulkarni, Shrusthi Walad, Jaikrishna Mishra, Madivalswami Dhavalgimath, Sanjeev Sajjanar, Darshan M. BiradarPatil
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引用次数: 0
PREDICTIVE VALUE OF TIMI RISK INDEX FOR ANGIOGRAPHIC NO REFLOW AFTER PRIMARY PCI TIMI 风险指数对初级 PCI 后血管造影无回流的预测价值
IF 1.5 Q3 Medicine Pub Date : 2023-12-01 DOI: 10.1016/j.ihj.2023.11.091
J. Chris shiny, j. Nambirajan, j. Jegadeesh
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引用次数: 0
期刊
Indian heart journal
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