H. Ali, R. Shahid, Fatima Sikandar Sikandar, A. Shahbaz, A. Shafqat
Introduction: A large number of patients with coronary artery disease (CAD) encounter surgical cardiopulmonary bypass [on-pump coronary artery bypass (ONCAB) or off-pump coronary artery bypass (OPCAB)]. Since two techniques have been commenced, the doubt of which one is more convincing and efficacious has always been discussed and is still controversial. Objective: The purpose of this study was to determine the early patency and survival rate of coronary grafts after CABG in On-Pump vs Off-pump groups. Material and methods: This retrospective cross sectional study was conducted in the Cardiac surgery department of Punjab Institute of Cardiology, Lahore in year 2020 using the data of previous surgeries done from 01-01-2009 to 01-03-2010 (14 months). Total 792 patients fulfilling inclusion criteria were included. The data consisted of two groups Group-A ONCAB (341) and Group B OPCAB (451), with total number of grafts (2333). Out of 792 patients only 315 were followed up the same year and in 2020, 135 were followed up for survival rate. The sampling technique used in this study was non probability sampling. Results: The mean age of the patients in Group A was 56.13 ±9.305 years and in Group B was 53.9 ± 9.382 years. In 315 followed up patients the number of grafts applied were 949. The mean number of grafts applied in Group A was 3.11±0.949 and in Group B was 2.95±0.959. There was no statistically significant difference seen between these groups. Out of 949 grafts 795 were patent from which 410 were applied in group A and 385 were applied in group B. 154 were blocked out of which 67 were applied in group A and 87 were applied in group B. After 10 years, only 135 were followed for survival rate, out of which 22.22% had angioplasty done, 51.85% reported events of shortness of breath, 13.33% had another attack of myocardial infarction, 30.37% had angiography done and mortality rate was 14.07%. There were 85.4% patients still alive in Group A and 86.8% in Group B. The overall survival rate is 85.9%. Conclusion: In overall comparison there is no significant difference in patency and occlusion rate. However, the survival rate is 85.9%. So we can say both groups are equally safe and no procedure is preferred over another, entailing an identical caliber of anastomosis.
{"title":"To compare the early patency and survival rate of coronary grafts in On-Pump vs Off-pump CABG","authors":"H. Ali, R. Shahid, Fatima Sikandar Sikandar, A. Shahbaz, A. Shafqat","doi":"10.55958/jcvd.v18i3.105","DOIUrl":"https://doi.org/10.55958/jcvd.v18i3.105","url":null,"abstract":"Introduction: A large number of patients with coronary artery disease (CAD) encounter surgical cardiopulmonary bypass [on-pump coronary artery bypass (ONCAB) or off-pump coronary artery bypass (OPCAB)]. Since two techniques have been commenced, the doubt of which one is more convincing and efficacious has always been discussed and is still controversial. \u0000Objective: The purpose of this study was to determine the early patency and survival rate of coronary grafts after CABG in On-Pump vs Off-pump groups. \u0000Material and methods: This retrospective cross sectional study was conducted in the Cardiac surgery department of Punjab Institute of Cardiology, Lahore in year 2020 using the data of previous surgeries done from 01-01-2009 to 01-03-2010 (14 months). Total 792 patients fulfilling inclusion criteria were included. The data consisted of two groups Group-A ONCAB (341) and Group B OPCAB (451), with total number of grafts (2333). Out of 792 patients only 315 were followed up the same year and in 2020, 135 were followed up for survival rate. The sampling technique used in this study was non probability sampling. \u0000Results: The mean age of the patients in Group A was 56.13 ±9.305 years and in Group B was 53.9 ± 9.382 years. In 315 followed up patients the number of grafts applied were 949. The mean number of grafts applied in Group A was 3.11±0.949 and in Group B was 2.95±0.959. There was no statistically significant difference seen between these groups. Out of 949 grafts 795 were patent from which 410 were applied in group A and 385 were applied in group B. 154 were blocked out of which 67 were applied in group A and 87 were applied in group B. After 10 years, only 135 were followed for survival rate, out of which 22.22% had angioplasty done, 51.85% reported events of shortness of breath, 13.33% had another attack of myocardial infarction, 30.37% had angiography done and mortality rate was 14.07%. There were 85.4% patients still alive in Group A and 86.8% in Group B. The overall survival rate is 85.9%. \u0000Conclusion: In overall comparison there is no significant difference in patency and occlusion rate. However, the survival rate is 85.9%. So we can say both groups are equally safe and no procedure is preferred over another, entailing an identical caliber of anastomosis.","PeriodicalId":227176,"journal":{"name":"The Journal of Cardiovascular Diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131621086","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}
Z. Sadiq, Muhammad Muneeb Muneeb, N. Saleem, Rizwan Ahmad Yaqoob Yaqoob, K. Ali, Muhammad Ejaz Ejaz
Background: Acute coronary syndrome is one of the most common life-threatening emergency and one of the leading causes of sudden death. If diagnosed in time, the patient can be saved. Angiography is the gold standard and helps in identifying the affected vessel. Aims and objective: To see the frequency of coronary artery dominance in cases presenting with inferior wall myocardial infarction. Material and Methods: This cross sectional observational study was done in the emergency department of Punjab Institute of Cardiology, Lahore from March to August 2017. All the patients between 18-60 years of age, both genders, diagnosed with IWMI and had been given thrombolytic therapy within 24 hours of MI were included in this study. Those patients having history of heart failure as determined by the past medical record, patients with renal failure (serum creatinine on admission 1.1 mg/dL), patients with a history of rheumatic heart disease, hypertension 5 years, uncontrolled diabetes (determined by HbA1C 7%), patients having history of previous myocardial infarction or concomitant involvement of other coronary artery areas like an anterior wall or septal wall and those were excluded from this study who did not give informed consent. Results: 227 patients enrolled in this study. Mean age of the patients was 45.07±8.17 years. Males were 51.98% (n=118) and females were 48.02% (n=109) of our study population. Mean BMI was 26.13 ± 3.29. The dominant left circumflex artery (LCX) was found in 25.55% of subjects Right Coronary Artery (RCA) was found to be dominant in 74.45% of our subjects. Conclusion: Presentation of IWMI with RCA as the dominant artery is three times more common as compared to LCx in our local population.
{"title":"Coronary artery dominance in cases with IWMI","authors":"Z. Sadiq, Muhammad Muneeb Muneeb, N. Saleem, Rizwan Ahmad Yaqoob Yaqoob, K. Ali, Muhammad Ejaz Ejaz","doi":"10.55958/jcvd.v18i3.109","DOIUrl":"https://doi.org/10.55958/jcvd.v18i3.109","url":null,"abstract":"Background: Acute coronary syndrome is one of the most common life-threatening emergency and one of the leading causes of sudden death. If diagnosed in time, the patient can be saved. Angiography is the gold standard and helps in identifying the affected vessel. \u0000Aims and objective: To see the frequency of coronary artery dominance in cases presenting with inferior wall myocardial infarction. \u0000Material and Methods: This cross sectional observational study was done in the emergency department of Punjab Institute of Cardiology, Lahore from March to August 2017. All the patients between 18-60 years of age, both genders, diagnosed with IWMI and had been given thrombolytic therapy within 24 hours of MI were included in this study. Those patients having history of heart failure as determined by the past medical record, patients with renal failure (serum creatinine on admission 1.1 mg/dL), patients with a history of rheumatic heart disease, hypertension 5 years, uncontrolled diabetes (determined by HbA1C 7%), patients having history of previous myocardial infarction or concomitant involvement of other coronary artery areas like an anterior wall or septal wall and those were excluded from this study who did not give informed consent. \u0000Results: 227 patients enrolled in this study. Mean age of the patients was 45.07±8.17 years. Males were 51.98% (n=118) and females were 48.02% (n=109) of our study population. Mean BMI was 26.13 ± 3.29. The dominant left circumflex artery (LCX) was found in 25.55% of subjects Right Coronary Artery (RCA) was found to be dominant in 74.45% of our subjects. \u0000Conclusion: Presentation of IWMI with RCA as the dominant artery is three times more common as compared to LCx in our local population.","PeriodicalId":227176,"journal":{"name":"The Journal of Cardiovascular Diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130415500","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}
N. Nasrullah, Imran Abid, Aftab Ahmed Solangi, Zahirullah Zahirullah, Rizwan Ahmad Yaqoob Yaqoob, K. Ali
Background :One of the most serious side effects of percutaneous coronary intervention (PCI) for bifurcationlesions is major side branch (SB) blockage. PCI is used to treat coronary bifurcations lesions inabout 15-20% of cases. Because of the risk of SB compromise, PCI of coronary bifurcationlesions is frequently thought to be a difficult procedure.OBJECTIVE: The goal of this study was to investigate the clinical and lesional predictability ofsevere SB blockage during coronary bifurcation intervention.MATERIAL & METHODS: It was a retrospective study performed at Cardiac CatheterizationLab, Punjab Institute of Cardiology, Lahore. It was a six months study from 15th April 2022 to14th Oct, 2022. 93 patients enrolled using non-probability sampling technique. Patients betweenthe ages of 30 and 70 of either gender, with coronary bifurcation lesions undergoing PCI and atleast one significant SB were included. Data was entered in the predesigned proforma. SPSSversion 24 was used to analyze our data.RESULTS: In our study a total of 93 patients were enrolled, the mean age of the cases was53.30 ± 1.12. There were 68 (73%) male and 25 (27%) females in our study. There were 52(56%) diabetic, 50 (54%) hypertensive, 63 (68%) smokers and 42 (45%) hypercholestrolemicpatients were present in our study. In our study 36 (39%) patients were found with family historyof CAD and 6 (7%) patients found with recent MI. LAD was most frequently utilized bifurcationlesion in our study. The mean of lesion length was 28.82 ± 10.91 in this study. SB angle was 41º-50º in most of the cases 20 (22%), side branch diameter stenosis post MV stenting was 70-75%in 40 (43%) cases. Medina classification 1,1,1 was found in 43 (46%) cases. In 62 (67%) casesno side branch jailing was observed. Side branch predilatation before MV stenting was found in72 (77%) cases. Need of stenting in SB was found in 60 (65%) cases. Most frequently usedtechnique for SB provisional stenting was DK crush and mini crush in this study.Keywords: Bifurcation Lesions, SB, PCI
{"title":"Effect of Clinical and Lesional Characteristics On Side Branch Compromise During Provisional Bifurcation Stenting","authors":"N. Nasrullah, Imran Abid, Aftab Ahmed Solangi, Zahirullah Zahirullah, Rizwan Ahmad Yaqoob Yaqoob, K. Ali","doi":"10.55958/jcvd.v18i3.128","DOIUrl":"https://doi.org/10.55958/jcvd.v18i3.128","url":null,"abstract":"Background :One of the most serious side effects of percutaneous coronary intervention (PCI) for bifurcationlesions is major side branch (SB) blockage. PCI is used to treat coronary bifurcations lesions inabout 15-20% of cases. Because of the risk of SB compromise, PCI of coronary bifurcationlesions is frequently thought to be a difficult procedure.OBJECTIVE: The goal of this study was to investigate the clinical and lesional predictability ofsevere SB blockage during coronary bifurcation intervention.MATERIAL & METHODS: It was a retrospective study performed at Cardiac CatheterizationLab, Punjab Institute of Cardiology, Lahore. It was a six months study from 15th April 2022 to14th Oct, 2022. 93 patients enrolled using non-probability sampling technique. Patients betweenthe ages of 30 and 70 of either gender, with coronary bifurcation lesions undergoing PCI and atleast one significant SB were included. Data was entered in the predesigned proforma. SPSSversion 24 was used to analyze our data.RESULTS: In our study a total of 93 patients were enrolled, the mean age of the cases was53.30 ± 1.12. There were 68 (73%) male and 25 (27%) females in our study. There were 52(56%) diabetic, 50 (54%) hypertensive, 63 (68%) smokers and 42 (45%) hypercholestrolemicpatients were present in our study. In our study 36 (39%) patients were found with family historyof CAD and 6 (7%) patients found with recent MI. LAD was most frequently utilized bifurcationlesion in our study. The mean of lesion length was 28.82 ± 10.91 in this study. SB angle was 41º-50º in most of the cases 20 (22%), side branch diameter stenosis post MV stenting was 70-75%in 40 (43%) cases. Medina classification 1,1,1 was found in 43 (46%) cases. In 62 (67%) casesno side branch jailing was observed. Side branch predilatation before MV stenting was found in72 (77%) cases. Need of stenting in SB was found in 60 (65%) cases. Most frequently usedtechnique for SB provisional stenting was DK crush and mini crush in this study.Keywords: Bifurcation Lesions, SB, PCI","PeriodicalId":227176,"journal":{"name":"The Journal of Cardiovascular Diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133354620","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}
R. Shahid, Syed Sardar Rahim, H. Ali, A. Shahbaz, A. Shafqat
Introduction: Myocardial protection is the major component in cardiac surgery affecting the patient’s outcome (morbidity and mortality). The key components are cardiopulmonary bypass (CPB), hypothermia and the cardioplegia solution. Objective: To compare conventional vs Del Nido cardioplegias using Cardiac Troponin-I (CTnI) and CK MB release as the primary outcome variable in patients with preserved left ventricular ejection fraction undergoing coronary artery bypass surgery. Material and Methods: Retrospective comparative study conducted at Punjab Institute of Cardiology, cardiac surgery department. After informed consent, patients undergoing coronary artery bypass surgery were included in the study. Data was analyzed by comparing Del-Nido with Conventional Cardioplegia using CTnI and CKMB release as the primary outcome variable. Results: A total of 140 patients were divided in two groups 70 (50%) in Del-Nido group and 70 (50%) in conventional group. In Del Nido group the mean Cardioplegia volume given was 1271.43 ± 447.91 ml and in Conventional Cardioplegia mean volume given was 2142.86 ± 584.48 ml with p-value <0.005. The comparison of Troponin I (ug/ml) levels post-operatively after 6, 9, 12 and 24 hours and on 5th day in Del Nido and conventional Cardioplegia groups showed insignificant p-values of 0.797, 0.977, 0.956, 0.496 and 0.297 respectively, which depicted that there is no remarkable difference in Troponin I levels regarding times in both groups. The comparison of CKMB (IU/L) levels in both groups after 6 hours 24 hours and on 5th day of CABG showed significant p-value of 0.032, 0.027 and 0.001 respectively and determined the difference in both groups. Whilst the comparison of CKMB (IU/L) levels post-operatively after 9 and 12 hours of CABG in both groups showed insignificant p-values of 0.706 and 0.476 respectively which implied that there is no major difference in CKMB levels regarding times in both groups. Conclusion: The key benefits of Del Nido cardioplegia, which makes it preferable to conventional cardioplegia, are less volume needed and an uninterrupted operation. While time related troponin I and CKMB levels changes showed almost similar results in both groups. So we can say both groups are equally safe and have same outcomes.
{"title":"Del Nido versus conventional cardioplegia comparison in term of myocardial protection using cardiac enzymes in patients undergoing coronary artery bypass surgery","authors":"R. Shahid, Syed Sardar Rahim, H. Ali, A. Shahbaz, A. Shafqat","doi":"10.55958/jcvd.v18i3.106","DOIUrl":"https://doi.org/10.55958/jcvd.v18i3.106","url":null,"abstract":"Introduction: Myocardial protection is the major component in cardiac surgery affecting the patient’s outcome (morbidity and mortality). The key components are cardiopulmonary bypass (CPB), hypothermia and the cardioplegia solution. \u0000Objective: To compare conventional vs Del Nido cardioplegias using Cardiac Troponin-I (CTnI) and CK MB release as the primary outcome variable in patients with preserved left ventricular ejection fraction undergoing coronary artery bypass surgery. \u0000Material and Methods: Retrospective comparative study conducted at Punjab Institute of Cardiology, cardiac surgery department. After informed consent, patients undergoing coronary artery bypass surgery were included in the study. Data was analyzed by comparing Del-Nido with Conventional Cardioplegia using CTnI and CKMB release as the primary outcome variable. \u0000Results: A total of 140 patients were divided in two groups 70 (50%) in Del-Nido group and 70 (50%) in conventional group. In Del Nido group the mean Cardioplegia volume given was 1271.43 ± 447.91 ml and in Conventional Cardioplegia mean volume given was 2142.86 ± 584.48 ml with p-value <0.005. The comparison of Troponin I (ug/ml) levels post-operatively after 6, 9, 12 and 24 hours and on 5th day in Del Nido and conventional Cardioplegia groups showed insignificant p-values of 0.797, 0.977, 0.956, 0.496 and 0.297 respectively, which depicted that there is no remarkable difference in Troponin I levels regarding times in both groups. The comparison of CKMB (IU/L) levels in both groups after 6 hours 24 hours and on 5th day of CABG showed significant p-value of 0.032, 0.027 and 0.001 respectively and determined the difference in both groups. Whilst the comparison of CKMB (IU/L) levels post-operatively after 9 and 12 hours of CABG in both groups showed insignificant p-values of 0.706 and 0.476 respectively which implied that there is no major difference in CKMB levels regarding times in both groups. \u0000Conclusion: The key benefits of Del Nido cardioplegia, which makes it preferable to conventional cardioplegia, are less volume needed and an uninterrupted operation. While time related troponin I and CKMB levels changes showed almost similar results in both groups. So we can say both groups are equally safe and have same outcomes.","PeriodicalId":227176,"journal":{"name":"The Journal of Cardiovascular Diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117102990","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}
Radiological examination of chest by doing X-ray chest is now considered as part of initial screening of the patients. It is a cheap, easily available and cost effective investigation which gives quite important information in the management of clinical patients. Following approach may be recommended for the interpretation of x-ray chest which may be used by trainee doctors appearing for their specialty examination. This approach may be labeled as �chest radiograph assessment using mnemonic� ABCDEFGHI �.1 A. AIRWAY: Use �PIER�. First look for the position of the patient whether supine, erect, AP/ PA/ lateral view. Look for whether it is inspiratory film or not, by counting number of ribs (one should be able to see 10-11 ribs). Then evaluate for well exposed film. Lastly, look for any rotation i.e. space between medial clavicle ends and vertebral column should be equal. Look for any tracheal deviation B. BONES AND SOFT TISSUES: Evaluate bone patency and soft tissues for any emphysema or swelling. C. CARDIAC SHADOW: Evaluate heart size. The size should be less than 50% on PA view and less than 60% on AP view. Look for cardiac shape / borders, calcification and any prosthetic valves. D. DIAPHRAGM: Look for any diaphragmatic flattening or eventration/ elevation. Also look for stomach bubble for free gas. E. EFFUSIONS: Look for blunting of costo-phrenic and cardio-phrenic angles which indicate presence of pleural effusion etc. F. FIELDS, FISSURES AND FOREIGN BODIES: Look for lung infiltrates, masses, consolidation, pneumothorax etc. Look for pulmonary vascular markings and any peripheral pruning. Look for presence of any ETT, NG tube, pacemaker leads, central lines etc. Look for sternal clips etc G. GREAT VESSELS/ GASTRIC BUBBLE: Check for Aortic knuckle and dilatation. Also look for size of pulmonary artery and central plethora. Look for gastric bubble as well. H. HILA AND MEDIASTINUM: Evaluate hila on both sides for lymph nodes, calcification or masses. Look for widening of mediastinum to rule out aortic dissection, retrosternal goiter/ thymus etc. I. IMPRESSION: After following all the above approach, a final impression should be made.2 Fig. no. 1: Anatomical landmarks on X-ray chest Fig. no. 2: X-ray chest PA view Fig.no. 3 Different common pathologies noticed on X-ray chest �
{"title":"Approach to Interpretation of Chest X-ray","authors":"Zuha Noeman","doi":"10.55958/jcvd.v18i2.116","DOIUrl":"https://doi.org/10.55958/jcvd.v18i2.116","url":null,"abstract":"Radiological examination of chest by doing X-ray chest is now considered as part of initial screening of the patients. It is a cheap, easily available and cost effective investigation which gives quite important information in the management of clinical patients. Following approach may be recommended for the interpretation of x-ray chest which may be used by trainee doctors appearing for their specialty examination. This approach may be labeled as �chest radiograph assessment using mnemonic� ABCDEFGHI �.1\u0000A. AIRWAY:\u0000Use �PIER�. First look for the position of the patient whether supine, erect, AP/ PA/ lateral view.\u0000Look for whether it is inspiratory film or not, by counting number of ribs (one should be able to see 10-11 ribs). Then evaluate for well exposed film. Lastly, look for any rotation i.e. space between medial clavicle ends and vertebral column should be equal. Look for any tracheal deviation\u0000B. BONES AND SOFT TISSUES:\u0000Evaluate bone patency and soft tissues for any emphysema or swelling.\u0000C. CARDIAC SHADOW:\u0000Evaluate heart size. The size should be less than 50% on PA view and less than 60% on AP view. Look for cardiac shape / borders, calcification and any prosthetic valves.\u0000D. DIAPHRAGM:\u0000Look for any diaphragmatic flattening or eventration/ elevation. Also look for stomach bubble for free gas.\u0000E. EFFUSIONS:\u0000Look for blunting of costo-phrenic and cardio-phrenic angles which indicate presence of pleural effusion etc.\u0000F. FIELDS, FISSURES AND FOREIGN BODIES:\u0000Look for lung infiltrates, masses, consolidation, pneumothorax etc.\u0000Look for pulmonary vascular markings and any peripheral pruning.\u0000Look for presence of any ETT, NG tube, pacemaker leads, central lines etc.\u0000Look for sternal clips etc\u0000G. GREAT VESSELS/ GASTRIC BUBBLE:\u0000Check for Aortic knuckle and dilatation. Also look for size of pulmonary artery and central plethora. Look for gastric bubble as well.\u0000H. HILA AND MEDIASTINUM:\u0000Evaluate hila on both sides for lymph nodes, calcification or masses. Look for widening of mediastinum to rule out aortic dissection, retrosternal goiter/ thymus etc.\u0000I. IMPRESSION:\u0000After following all the above approach, a final impression should be made.2\u0000Fig. no. 1: Anatomical landmarks on X-ray chest\u0000Fig. no. 2: X-ray chest PA view\u0000Fig.no. 3 Different common pathologies noticed on X-ray chest\u0000�","PeriodicalId":227176,"journal":{"name":"The Journal of Cardiovascular Diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127357605","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}
F. Umair, K. Sheikh, Fatima Qurratulain Qurratulain, Samar Arfeen Arfeen, H. Ali, M. Khalid
BACKGROUND: Acute coronary syndrome (ACS) refers to a group of conditions. It is the leading cause of death in patients with coronary artery disease (CAD). Obesity is a major risk factor for coronary artery disease (CAD) and is closely linked to increased morbidity and death. AIMS AND OBJECTIVE: To determine the association of raised BMI with MACE in patients of Percutaneous coronary intervention is used to treat the acute coronary syndrome. METHODOLOGY: A Prospective cohort study was conducted at the Punjab Institute of Cardiology, Lahore from August 2020 to February 2021. 120 patients with ACS were enrolled by Non-probability consecutive sampling after the inclusion and exclusion criteria. MACE was recorded after 3 months of clinical follow-up. RESULTS: Among the exposed, the mean age was 37.9�9.3yearsr and 39.5�8.2 years among non-exposed. Among exposed, there were 32(53.3%) males and 28(46.7%) females, while 37(61.7%) males and 23(38.3%) females among non-exposed. The risk ratio of the obese participants was high as 35%. CONCLUSION: Raised BMI individuals are at risk of in-hospital complications and 3-month MACE and mortality after PCI.
{"title":"Association of Raised BMI with MACE in patients of acute coronary syndrome undergoing percutaneous coronary intervention","authors":"F. Umair, K. Sheikh, Fatima Qurratulain Qurratulain, Samar Arfeen Arfeen, H. Ali, M. Khalid","doi":"10.55958/jcvd.v18i2.100","DOIUrl":"https://doi.org/10.55958/jcvd.v18i2.100","url":null,"abstract":"BACKGROUND: Acute coronary syndrome (ACS) refers to a group of conditions. It is the leading cause of death in patients with coronary artery disease (CAD). Obesity is a major risk factor for coronary artery disease (CAD) and is closely linked to increased morbidity and death. \u0000AIMS AND OBJECTIVE: To determine the association of raised BMI with MACE in patients of Percutaneous coronary intervention is used to treat the acute coronary syndrome. \u0000METHODOLOGY: A Prospective cohort study was conducted at the Punjab Institute of Cardiology, Lahore from August 2020 to February 2021. 120 patients with ACS were enrolled by Non-probability consecutive sampling after the inclusion and exclusion criteria. MACE was recorded after 3 months of clinical follow-up. \u0000RESULTS: Among the exposed, the mean age was 37.9�9.3yearsr and 39.5�8.2 years among non-exposed. Among exposed, there were 32(53.3%) males and 28(46.7%) females, while 37(61.7%) males and 23(38.3%) females among non-exposed. The risk ratio of the obese participants was high as 35%. \u0000CONCLUSION: Raised BMI individuals are at risk of in-hospital complications and 3-month MACE and mortality after PCI.","PeriodicalId":227176,"journal":{"name":"The Journal of Cardiovascular Diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128207174","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}
The history of smoking dates back to the ancient times and mankind has been smoking different plant materials for the leisure and addiction. One of its kind, tobacco cigarette smoking was introduced in the 19th century and its use increased exponentially by the mid of 20th century. Initially it was thought that the tobacco cigarette smoking had some medicinal properties but as the rate of tobacco smoking increased, the adverse effects started appearing and by the end of 20th century it was a well-known fact that tobacco cigarette smoking was a health hazard and a major risk factor for the fatal diseases like cancer and cardiovascular diseases1. With the emergent side effects and health hazards tobacco cigarette smoking was discouraged on a larger scale in the society and the search for the alternative to it led to the creation of E-cigarettes in the early 21st century. Since the introduction of vaping i.e., use of E-cigarettes, E-hookahs, vape pens or Electronic Nicotine Delivery Systems (ENDS), it is taken as a safe alternative of tobacco cigarettes smoking and a way to help in smoking cessation2. The perception of less harmful tobacco smoking substitute, extensive marketing and a vogue of vaping have resulted in an explosive increase in the use of vaping devices among the former smokers, current smokers and even in never smoker adolescents and young adults in the past two decades. According to the National Health Interview Survey (NIHS), the number of E-cigarette users increased to 8.1 million in United States in 20183 and according to National Youth Tobacco Survey in US 19.6% of high school students and 4.7% of middle school students are regular users of E-cigarettes4. Most vaping devices are made up of four components, including: a cartridge or pod containing e-liquid, a metallic heating coil, a battery and a mouthpiece. The e-liquid contains chemicals like propylene glycol, vegetable glycerin, flavoring substance and varying amount of nicotine. Propylene glycol and vegetable glycerin act as solvent carriers. When a person puffs/inhales, it activates the heating coil that causes the e-liquid to vaporize that is inhaled by the person. The vapors or aerosols that are inhaled deliver certain chemicals into the body that are mainly: Nicotine Organic volatile compounds generated by heating of solvent carriers such as glycols, glycerin, toluene that cause irritation to the eyes, oral and laryngeal mucosa. Carbonyls such as acetaldehyde, formaldehyde, acrolein and glyoxal which are carcinogenic and cause extensive damage to the lungs. Chemical present in flavoring agents like Diacetyl, acetyl propionyl and acetoin cause severe asthma and bronchiolitis obliterans The contaminants that may be the tobacco derived alkaloids and nitrosamines Metal particles from the heating coils like chromium, cadmium, nickel, lead; and particles of copper, nickel, and silver These chemicals are responsible for the injuries to the respiratory mucosa, skin a
{"title":"Editorial: Vaping and Cardiovascular health � An opportunity or a risk?","authors":"Syed Asif Ali Ali","doi":"10.55958/jcvd.v18i2.107","DOIUrl":"https://doi.org/10.55958/jcvd.v18i2.107","url":null,"abstract":"The history of smoking dates back to the ancient times and mankind has been smoking different plant materials for the leisure and addiction. One of its kind, tobacco cigarette smoking was introduced in the 19th century and its use increased exponentially by the mid of 20th century. Initially it was thought that the tobacco cigarette smoking had some medicinal properties but as the rate of tobacco smoking increased, the adverse effects started appearing and by the end of 20th century it was a well-known fact that tobacco cigarette smoking was a health hazard and a major risk factor for the fatal diseases like cancer and cardiovascular diseases1. With the emergent side effects and health hazards tobacco cigarette smoking was discouraged on a larger scale in the society and the search for the alternative to it led to the creation of E-cigarettes in the early 21st century. \u0000Since the introduction of vaping i.e., use of E-cigarettes, E-hookahs, vape pens or Electronic Nicotine Delivery Systems (ENDS), it is taken as a safe alternative of tobacco cigarettes smoking and a way to help in smoking cessation2. The perception of less harmful tobacco smoking substitute, extensive marketing and a vogue of vaping have resulted in an explosive increase in the use of vaping devices among the former smokers, current smokers and even in never smoker adolescents and young adults in the past two decades. According to the National Health Interview Survey (NIHS), the number of E-cigarette users increased to 8.1 million in United States in 20183 and according to National Youth Tobacco Survey in US 19.6% of high school students and 4.7% of middle school students are regular users of E-cigarettes4. \u0000Most vaping devices are made up of four components, including: a cartridge or pod containing e-liquid, a metallic heating coil, a battery and a mouthpiece. The e-liquid contains chemicals like propylene glycol, vegetable glycerin, flavoring substance and varying amount of nicotine. Propylene glycol and vegetable glycerin act as solvent carriers. When a person puffs/inhales, it activates the heating coil that causes the e-liquid to vaporize that is inhaled by the person. The vapors or aerosols that are inhaled deliver certain chemicals into the body that are mainly: \u0000 \u0000Nicotine \u0000Organic volatile compounds generated by heating of solvent carriers such as glycols, glycerin, toluene that cause irritation to the eyes, oral and laryngeal mucosa. \u0000Carbonyls such as acetaldehyde, formaldehyde, acrolein and glyoxal which are carcinogenic and cause extensive damage to the lungs. \u0000Chemical present in flavoring agents like Diacetyl, acetyl propionyl and acetoin cause severe asthma and bronchiolitis obliterans \u0000The contaminants that may be the tobacco derived alkaloids and nitrosamines \u0000Metal particles from the heating coils like chromium, cadmium, nickel, lead; and particles of copper, nickel, and silver \u0000 \u0000These chemicals are responsible for the injuries to the respiratory mucosa, skin a","PeriodicalId":227176,"journal":{"name":"The Journal of Cardiovascular Diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133796675","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}
Cocaine use may lead to acute myocardial infarction. Despite being expensive, it is most commonly used illicit street drug. Cocaine-induced infarction is particularly common in younger patients. Adversely affecting the cardiovascular system, it can lead to sudden cardiac death, ventricular arrhythmias and myocardial infarction. During acute event, coronary angiography may be normal or there may be evidence of coronary artery disease. Coronary artery spasm is reversible phenomena characterized by focal or diffuse constriction of coronary segment in one or more coronaries, restricting blood flow in coronaries, causing myocardial ischemia and thrombus formation.
{"title":"Case Report: Cocaine induced coronary artery spasm leading to ST elevation myocardial infarction (STEMI)","authors":"K. Ali","doi":"10.55958/jcvd.v18i2.97","DOIUrl":"https://doi.org/10.55958/jcvd.v18i2.97","url":null,"abstract":"Cocaine use may lead to acute myocardial infarction. Despite being expensive, it is most commonly used illicit street drug. Cocaine-induced infarction is particularly common in younger patients. Adversely affecting the cardiovascular system, it can lead to sudden cardiac death, ventricular arrhythmias and myocardial infarction. During acute event, coronary angiography may be normal or there may be evidence of coronary artery disease. Coronary artery spasm is reversible phenomena characterized by focal or diffuse constriction of coronary segment in one or more coronaries, restricting blood flow in coronaries, causing myocardial ischemia and thrombus formation.","PeriodicalId":227176,"journal":{"name":"The Journal of Cardiovascular Diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121546329","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}
A. Ali, Khalid Iqbal, Dileep Kumar, T. Sagheer, Suresh Kumar, C. Parkash
Background: Depression is very common among individuals recovering from a chronic illness with long-term or recurrent hospitalization. Post-myocardial infarction patients are at risk of developing depression and is considered to be a risk for elevated mortality. Aims and Objective: To determine the frequency of depression among various ethnic groups of patients post primary percutaneous coronary intervention for acute myocardial infarction. Material and Methods: �A cross-sectional study was conducted at the out-patients department of NICVD, Pakistan for a duration of six months from February 2021 to July 2021. Total 256 patients aged between 18 to 85 years, were diagnosed with STEMI, and had undergone PCI were included in the study. Patients with prior diagnosis of CAD or had prior history of psychological problems were excluded from the study. Patients were interviewed for depression by using Beck's depression inventory (BDI). Patients scoring > 10 were labeled as having depression. Results: Out of 256 patients, 122 (48.8%) patients were screened positive for depressive symptoms.� Out of these, about 21.1% had mild depression, 16% had borderline clinical depression, 10.5% had moderate depression, while about 0.8% had severe depression. Age of 71 years and above, female gender, diabetes, hypertension, and sedentary lifestyle were all significantly correlated with increased risk of depression in post-MI patients with BDI scores of 17.64 � 7.9 (<0.0001), 13.54 � 7.53 (0.015), 14.47 � 7.61 (p<0.0001), 13.52 � 6.83 (p<0.0001), and 16.69 � 7.57 (p<0.0001), respectively. Conclusion: After percutaneous coronary intervention for MI, depression was found in almost half of the patients. However, as per our study, the risk for depression is independent of ethnic background.
{"title":"Depression in Various Ethnic Groups of Pakistan after Primary Percutaneous Coronary Intervention","authors":"A. Ali, Khalid Iqbal, Dileep Kumar, T. Sagheer, Suresh Kumar, C. Parkash","doi":"10.55958/jcvd.v18i2.96","DOIUrl":"https://doi.org/10.55958/jcvd.v18i2.96","url":null,"abstract":"Background: Depression is very common among individuals recovering from a chronic illness with long-term or recurrent hospitalization. Post-myocardial infarction patients are at risk of developing depression and is considered to be a risk for elevated mortality. \u0000Aims and Objective: To determine the frequency of depression among various ethnic groups of patients post primary percutaneous coronary intervention for acute myocardial infarction. \u0000Material and Methods: �A cross-sectional study was conducted at the out-patients department of NICVD, Pakistan for a duration of six months from February 2021 to July 2021. Total 256 patients aged between 18 to 85 years, were diagnosed with STEMI, and had undergone PCI were included in the study. Patients with prior diagnosis of CAD or had prior history of psychological problems were excluded from the study. Patients were interviewed for depression by using Beck's depression inventory (BDI). Patients scoring > 10 were labeled as having depression. \u0000Results: Out of 256 patients, 122 (48.8%) patients were screened positive for depressive symptoms.� Out of these, about 21.1% had mild depression, 16% had borderline clinical depression, 10.5% had moderate depression, while about 0.8% had severe depression. Age of 71 years and above, female gender, diabetes, hypertension, and sedentary lifestyle were all significantly correlated with increased risk of depression in post-MI patients with BDI scores of 17.64 � 7.9 (<0.0001), 13.54 � 7.53 (0.015), 14.47 � 7.61 (p<0.0001), 13.52 � 6.83 (p<0.0001), and 16.69 � 7.57 (p<0.0001), respectively. \u0000Conclusion: After percutaneous coronary intervention for MI, depression was found in almost half of the patients. However, as per our study, the risk for depression is independent of ethnic background.","PeriodicalId":227176,"journal":{"name":"The Journal of Cardiovascular Diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123826487","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}
Gulshan Ahmad Ahmad, Tariq Ahmad, Samar Arfeen Arfeen, N. Saleem, S. Saleem, Naveed Iqbal Iqbal
INTRODUCTION: Hyponatremia is regarded as the most commonly occurring disorder of electrolyte observed in patients in diverse hospital settings. Hyponatremia if becomes severe, may become life-threatening leading to drastic neurological complicationsDue to it being marker for identification of underlying medical conditions, it is often associated with inadequate prognostication, even when level of sodium in serum is reduced mildly only. Development of hyponatremia begins during ST-elevation myocardial infarction�s acute phase due to neurohormonal activation. The aim of this study is to ascertain hyponatremia�s prognostic value amidst acute phase of myocardial infarction. � AIMS & OBJECTIVE: To ascertain hyponatremia�s frequency and the impact on the outcome of in-hospital patients suffering with acute ST elevated myocardial infarction. � MATERIAL AND METHODS: This was a descriptive study which was carried out at Aga Khan University Hospital, Karachi (AKUH) over a period of six months. After obtaining consent of the patients, their data was collected prospectively. Inclusion of the patients was dependent upon diagnostic criteria and 225 individuals were selected. For quantitative data we used mean�standard deviation while the categorial variables were expressed as percentages and frequency. Scarification was used to control effect modifiers to observe their effect on output variable. A chi-square test was carried out post stratification and a p-value of ?0.05 was determined as significant. � RESULTS: Overall, 225 patients admitted in department of Cardiology, Aga Khan University Hospital, Karachi were made part of this study. The mean age was 56.80�7.56 years in the present study. There were 135 (60%) male and 90 (40%) female patients. Out of 225 patients, 43 (19.1%) had hyponatremia. In-hospital mortality was 22 (100%) who had hyponatremia. CONCLUSION: Hyponatremia in patients with acute STEMI is observed as a major predictor related to cardiovascular mortality. Level of sodium in the plasma might serve to be a relatively simple marker for the identification of patients who are at risk.
{"title":"The occurrence of hyponatremia and its effect on in-hospital outcome in patient of Acute ST elevated myocardial infarction.","authors":"Gulshan Ahmad Ahmad, Tariq Ahmad, Samar Arfeen Arfeen, N. Saleem, S. Saleem, Naveed Iqbal Iqbal","doi":"10.55958/jcvd.v18i2.102","DOIUrl":"https://doi.org/10.55958/jcvd.v18i2.102","url":null,"abstract":"INTRODUCTION: Hyponatremia is regarded as the most commonly occurring disorder of electrolyte observed in patients in diverse hospital settings. Hyponatremia if becomes severe, may become life-threatening leading to drastic neurological complicationsDue to it being marker for identification of underlying medical conditions, it is often associated with inadequate prognostication, even when level of sodium in serum is reduced mildly only. Development of hyponatremia begins during ST-elevation myocardial infarction�s acute phase due to neurohormonal activation. The aim of this study is to ascertain hyponatremia�s prognostic value amidst acute phase of myocardial infarction. \u0000� \u0000AIMS & OBJECTIVE: To ascertain hyponatremia�s frequency and the impact on the outcome of in-hospital patients suffering with acute ST elevated myocardial infarction. \u0000� \u0000MATERIAL AND METHODS: This was a descriptive study which was carried out at Aga Khan University Hospital, Karachi (AKUH) over a period of six months. After obtaining consent of the patients, their data was collected prospectively. Inclusion of the patients was dependent upon diagnostic criteria and 225 individuals were selected. For quantitative data we used mean�standard deviation while the categorial variables were expressed as percentages and frequency. Scarification was used to control effect modifiers to observe their effect on output variable. A chi-square test was carried out post stratification and a p-value of ?0.05 was determined as significant. \u0000� \u0000RESULTS: Overall, 225 patients admitted in department of Cardiology, Aga Khan University Hospital, Karachi were made part of this study. The mean age was 56.80�7.56 years in the present study. There were 135 (60%) male and 90 (40%) female patients. Out of 225 patients, 43 (19.1%) had hyponatremia. In-hospital mortality was 22 (100%) who had hyponatremia. \u0000CONCLUSION: Hyponatremia in patients with acute STEMI is observed as a major predictor related to cardiovascular mortality. Level of sodium in the plasma might serve to be a relatively simple marker for the identification of patients who are at risk.","PeriodicalId":227176,"journal":{"name":"The Journal of Cardiovascular Diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130359029","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}
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