S. Jesmin, A. Maqbool, S. N. Sultana, F. Sohael, Majedul Islam, Y. Matsuishi, Takeru Shima, N. Shimojo, S. Kawano, A. Rahman, N. Yamaguchi, M. Moroi
Aim: Metabolic Syndrome (MetS), a significant risk factor for coronary artery disease (CAD), is now highly prevalent in South Asian countries, including Bangladesh. The diseases also affect young people. A large number of young populations with acute coronary syndrome (ACS) have MetS. The aim of this study was to determine the prevalence of MetS and the combination of components in patients with early age onset ACS (age ≤50 years). Methods: This prospective study comprised 678 consecutive patients age ≤50 years hospitalized for ACS during 2012-2013. The patients were categorized according to the criteria stated in the latest joint statement for the global definition of MetS. Results: Among 678 ACS patients, 236 (34.8%) patients have filled the criteria of MetS. The mean age was 42.4 ± 0.28 years. The prevalence of MetS was higher in females than in males (48.8% vs. 30.4%, p < 0.001). One component of MetS was found in 26.4%, two components in 29.8%, three or more components in 34.8% of young ACS study participants. Among the various components of MetS, low HDL and high TG were the crucial common components of MetS in young ACS patients in Bangladesh (low HDL: 51.9%, high TG: 44.8%). Conclusions: We conclude that the prevalence of MetSin patients with early age onset ACS (age ≤50 years) is high in Bangladesh. Since Low HDL and high TG are the most common components of MetSin our study, these biochemical parameters would be a clinical target for early treatment. Strategies are needed for the early detection and treatment of cardio-metabolic risk factors to prevent coronary artery disease progression and prognosis.
{"title":"Prevalence of Metabolic Syndrome Components among EarlyAge onset Acute Coronary Syndrome Patients in Bangladesh","authors":"S. Jesmin, A. Maqbool, S. N. Sultana, F. Sohael, Majedul Islam, Y. Matsuishi, Takeru Shima, N. Shimojo, S. Kawano, A. Rahman, N. Yamaguchi, M. Moroi","doi":"10.33425/2639-8486.1129","DOIUrl":"https://doi.org/10.33425/2639-8486.1129","url":null,"abstract":"Aim: Metabolic Syndrome (MetS), a significant risk factor for coronary artery disease (CAD), is now highly prevalent in South Asian countries, including Bangladesh. The diseases also affect young people. A large number of young populations with acute coronary syndrome (ACS) have MetS. The aim of this study was to determine the prevalence of MetS and the combination of components in patients with early age onset ACS (age ≤50 years). Methods: This prospective study comprised 678 consecutive patients age ≤50 years hospitalized for ACS during 2012-2013. The patients were categorized according to the criteria stated in the latest joint statement for the global definition of MetS. Results: Among 678 ACS patients, 236 (34.8%) patients have filled the criteria of MetS. The mean age was 42.4 ± 0.28 years. The prevalence of MetS was higher in females than in males (48.8% vs. 30.4%, p < 0.001). One component of MetS was found in 26.4%, two components in 29.8%, three or more components in 34.8% of young ACS study participants. Among the various components of MetS, low HDL and high TG were the crucial common components of MetS in young ACS patients in Bangladesh (low HDL: 51.9%, high TG: 44.8%). Conclusions: We conclude that the prevalence of MetSin patients with early age onset ACS (age ≤50 years) is high in Bangladesh. Since Low HDL and high TG are the most common components of MetSin our study, these biochemical parameters would be a clinical target for early treatment. Strategies are needed for the early detection and treatment of cardio-metabolic risk factors to prevent coronary artery disease progression and prognosis.","PeriodicalId":72522,"journal":{"name":"Cardiology & vascular research (Wilmington, Del.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45644992","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}
M. Do, E. Salcedo, R. Quaife, E. Gill, Jennifer Mercandetti, B. McNair, J. Carroll
Purpose: Mitral Regurgitation (MR) can cause left ventricular dilation (remodeling). Reverse remodeling describes improved volumes after intervention. Reverse remodeling carries favorable prognosis, but not all MitraClip patients undergo reverse remodeling. We hypothesized pre-procedural global longitudinal strain (preGLS) will predict reverse remodeling one-year post MitraClip in all-cause MR patients. Methods: Of the 189 MitraClips performed at our institution between 2007-2019, 57 patients had complete echocardiographic data,. Echocardiograms 0-120 days prior to and 6-24 months after procedure were retrospectively reviewed. Reverse remodeling was defined as reduction in end diastolic volume (EDV). Results: In 20 sample echocardiograms, intra and inter-reader GLS variability was r=0.95 and r=0.90, respectively. Our population consisted of 55.2% female, 12.3% functional , 61.4% degenerative and 26.3% mixed mitral regurgitation. A reduction in EDV was demonstrated in 38 patients (67%). EDV, ESV, LAVi, and RVSP significantly decreased post-clip (all p<0.01) but not LVEF. Regression models showed pre-EDV (p<0.01) and pre-ESV (p<0.01) had significant crude and adjusted linear associations and ?pre-GLS? had a significant crude curvilinear association (linear p=0.04, quadratic p =0.04) with EDV reductions post clip. The curvilinear association showed among lower, more abnormal ?pre-GLS? values, higher ?pre-GLS? was associated with greater reductions in EDV. When adjusted for pre-EDV and pre-ESV, GLS lost significance(linear p=0.29, quadratic p=0.29). Conclusion: Our study shows a majority of MitraClip patients demonstrate reverse remodeling and pre-GLS to be associated with reverse remodeling, though not robustly. A study with larger sample sizes is needed to better define the association.
{"title":"Use of Left Ventricular Global Longitudinal Strain to predict Reverse Left Ventricular Remodeling after MitraClip Repair","authors":"M. Do, E. Salcedo, R. Quaife, E. Gill, Jennifer Mercandetti, B. McNair, J. Carroll","doi":"10.33425/2639-8486.1126","DOIUrl":"https://doi.org/10.33425/2639-8486.1126","url":null,"abstract":"Purpose: Mitral Regurgitation (MR) can cause left ventricular dilation (remodeling). Reverse remodeling describes improved volumes after intervention. Reverse remodeling carries favorable prognosis, but not all MitraClip patients undergo reverse remodeling. We hypothesized pre-procedural global longitudinal strain (preGLS) will predict reverse remodeling one-year post MitraClip in all-cause MR patients. Methods: Of the 189 MitraClips performed at our institution between 2007-2019, 57 patients had complete echocardiographic data,. Echocardiograms 0-120 days prior to and 6-24 months after procedure were retrospectively reviewed. Reverse remodeling was defined as reduction in end diastolic volume (EDV). Results: In 20 sample echocardiograms, intra and inter-reader GLS variability was r=0.95 and r=0.90, respectively. Our population consisted of 55.2% female, 12.3% functional , 61.4% degenerative and 26.3% mixed mitral regurgitation. A reduction in EDV was demonstrated in 38 patients (67%). EDV, ESV, LAVi, and RVSP significantly decreased post-clip (all p<0.01) but not LVEF. Regression models showed pre-EDV (p<0.01) and pre-ESV (p<0.01) had significant crude and adjusted linear associations and ?pre-GLS? had a significant crude curvilinear association (linear p=0.04, quadratic p =0.04) with EDV reductions post clip. The curvilinear association showed among lower, more abnormal ?pre-GLS? values, higher ?pre-GLS? was associated with greater reductions in EDV. When adjusted for pre-EDV and pre-ESV, GLS lost significance(linear p=0.29, quadratic p=0.29). Conclusion: Our study shows a majority of MitraClip patients demonstrate reverse remodeling and pre-GLS to be associated with reverse remodeling, though not robustly. A study with larger sample sizes is needed to better define the association.","PeriodicalId":72522,"journal":{"name":"Cardiology & vascular research (Wilmington, Del.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48603297","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}
Sarr El Hadj Mbacké, Khaddra H, Manga Simon Joël, Seye Modou, D. Momar, B. Md, S. Lamine, Bindia Dominique, Sarr Ndeye Aramec, Tine Elisabeth Arame, Diallo Arame Diagne, Ba Kadia, Dièye Ousmane, D. Bara
The lusoria artery is a rare congenital vascular anomaly involving most of the time the right subclavian artery. It can also be associated with a serious vascular pathology such as aortic dissection although this phenomenon is not common in the literature and most often requires rather complex surgical management because of the layout of this artery. We report a discovery of a lusoria artery case revealed by aortic dissection. This is a 63-yearold patient with recently discovered hypertension as a cardiovascular risk factor. He was received for severe chest pain. Clinical examination found grade III systolo-diastolic hypertension and tachycardia. The thoracic CT angiography found an aspect of type B aortic dissection associated with an aberrant right subclavian artery of the lusoria type. In emergency, the patient had benefited from an antihypertensive treatment allowing stabilizing his high blood pressure. The development during hospitalization was favorable with a disappearance of the pain and a stabilization of his blood pressure levels. His discharge was made on D10 of hospitalization with a transfer to a cardiovascular surgery center for better treatment.
{"title":"Aortic Dissection Involving a Right Retroesophagian Subclaviary Artery (LUSORIA) Associated with a Bi-Carotidian Trunk: About a Case at the National University Hospital Center of Fann (Sénégal)","authors":"Sarr El Hadj Mbacké, Khaddra H, Manga Simon Joël, Seye Modou, D. Momar, B. Md, S. Lamine, Bindia Dominique, Sarr Ndeye Aramec, Tine Elisabeth Arame, Diallo Arame Diagne, Ba Kadia, Dièye Ousmane, D. Bara","doi":"10.33425/2639-8486.1128","DOIUrl":"https://doi.org/10.33425/2639-8486.1128","url":null,"abstract":"The lusoria artery is a rare congenital vascular anomaly involving most of the time the right subclavian artery. It can also be associated with a serious vascular pathology such as aortic dissection although this phenomenon is not common in the literature and most often requires rather complex surgical management because of the layout of this artery. We report a discovery of a lusoria artery case revealed by aortic dissection. This is a 63-yearold patient with recently discovered hypertension as a cardiovascular risk factor. He was received for severe chest pain. Clinical examination found grade III systolo-diastolic hypertension and tachycardia. The thoracic CT angiography found an aspect of type B aortic dissection associated with an aberrant right subclavian artery of the lusoria type. In emergency, the patient had benefited from an antihypertensive treatment allowing stabilizing his high blood pressure. The development during hospitalization was favorable with a disappearance of the pain and a stabilization of his blood pressure levels. His discharge was made on D10 of hospitalization with a transfer to a cardiovascular surgery center for better treatment.","PeriodicalId":72522,"journal":{"name":"Cardiology & vascular research (Wilmington, Del.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47293582","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. Ibrahim, P. Olowoyo, Adewumi Oluwaserimi Ajetunmobi, A. Ayodapo, W. O. Ismail, G. Ajani
Introduction: Despite the high burden of stroke globally, there is an observed paucity of data regarding its subtypes, risk factors and treatment outcomes in rural Southwestern Nigeria. The study ascertained the subtypes, risk factors and treatment outcomes of stroke at the adult Accident and Emergency Department of a tertiary hospital in a rural Southwestern Nigeria. Materials and methods: A retrospective survey using data form and standardized questionnaire was used to review the patients admitted for stroke between January 2015 and December 2019. The data were analyzed using SPSS Version 22.0. The results were presented in descriptive and tabular formats. Results: In this study, 276 stroke patients comprised Ischemic (60.1%) vs Hemorrhagic (39.9%) strokes were studied. The mean age of the patients was 67.3±11.1 years. The majority were males and were older than 65 years. The independent predictors of stroke admissions were Informal education [(AOR = 0.288; 95% CI: (0.120-0.691), p = 0.005)], low income earners [(AOR = 0.452; 95% CI: (0.230-0.888), p = 0.021)], obesity [(AOR = 0.080; 95% CI: (0.019-0.347), p= 0.001)], heart failure [(AOR= 9.152; 95% CI: (2.325-41.266), p < 0.001)], atrial fibrillation [(AOR = 0.136; 95% CI: (0.068-0.891),p = 0.001)], tobacco smoking [(AOR = 0.350; 95% CI: (0.137-0.891), p = 0.028)], and poorly controlled blood pressure [(AOR = 0.107; 95% CI: (0.033-0.348), p <0.001)]. The mortality rate was 10.1%. Conclusion: The results of this study further support the argument on the higher prevalence of stroke admission in rural areas of Southwestern Nigeria. There may be need for public awareness on primary stroke prevention and early identification of the risk factors in order to reduce the prevalence and mortality of stroke in the rural Southwestern Nigeria.
导论:尽管全球卒中负担沉重，但在尼日利亚西南部农村地区，关于其亚型、危险因素和治疗结果的数据缺乏。该研究确定了尼日利亚西南部农村一家三级医院成人急诊科中风的亚型、危险因素和治疗结果。材料与方法:采用资料表和标准化问卷的回顾性调查方法，对2015年1月至2019年12月住院的脑卒中患者进行回顾性调查。数据分析采用SPSS Version 22.0。结果以描述性和表格形式呈现。结果:276例脑卒中患者分为缺血性脑卒中(60.1%)和出血性脑卒中(39.9%)。患者平均年龄67.3±11.1岁。大多数是男性，年龄在65岁以上。卒中入院的独立预测因子为非正规教育[(AOR = 0.288;95% CI: (0.120-0.691)， p = 0.005)]，低收入者[(AOR = 0.452;(95%置信区间CI: 0.230 - -0.888), p = 0.021)],肥胖[(优势比= 0.080;95% CI: (0.019-0.347)， p= 0.001)]，心力衰竭[(AOR= 9.152;95% CI: (2.325 ~ 41.266)， p < 0.001)]，心房颤动[(AOR = 0.136;95% CI: (0.068-0.891)，p = 0.001)]，吸烟[(AOR = 0.350;95% CI:(0.137-0.891)， p = 0.028)]和血压控制不良[(AOR = 0.107;95% CI: (0.033-0.348)， p <0.001)。死亡率为10.1%。结论:本研究结果进一步支持了尼日利亚西南部农村地区卒中入院率较高的观点。可能需要提高公众对初级卒中预防和早期识别风险因素的认识，以降低尼日利亚西南部农村中风的患病率和死亡率。
{"title":"Stroke Subtypes, Risk Factors and Treatment Outcomes at A Tertiary Hospital Situated in Rural Southwestern Nigeria: A Five- Year Restrospective Observational Study","authors":"A. Ibrahim, P. Olowoyo, Adewumi Oluwaserimi Ajetunmobi, A. Ayodapo, W. O. Ismail, G. Ajani","doi":"10.33425/2639-8486.1127","DOIUrl":"https://doi.org/10.33425/2639-8486.1127","url":null,"abstract":"Introduction: Despite the high burden of stroke globally, there is an observed paucity of data regarding its subtypes, risk factors and treatment outcomes in rural Southwestern Nigeria. The study ascertained the subtypes, risk factors and treatment outcomes of stroke at the adult Accident and Emergency Department of a tertiary hospital in a rural Southwestern Nigeria. Materials and methods: A retrospective survey using data form and standardized questionnaire was used to review the patients admitted for stroke between January 2015 and December 2019. The data were analyzed using SPSS Version 22.0. The results were presented in descriptive and tabular formats. Results: In this study, 276 stroke patients comprised Ischemic (60.1%) vs Hemorrhagic (39.9%) strokes were studied. The mean age of the patients was 67.3±11.1 years. The majority were males and were older than 65 years. The independent predictors of stroke admissions were Informal education [(AOR = 0.288; 95% CI: (0.120-0.691), p = 0.005)], low income earners [(AOR = 0.452; 95% CI: (0.230-0.888), p = 0.021)], obesity [(AOR = 0.080; 95% CI: (0.019-0.347), p= 0.001)], heart failure [(AOR= 9.152; 95% CI: (2.325-41.266), p < 0.001)], atrial fibrillation [(AOR = 0.136; 95% CI: (0.068-0.891),p = 0.001)], tobacco smoking [(AOR = 0.350; 95% CI: (0.137-0.891), p = 0.028)], and poorly controlled blood pressure [(AOR = 0.107; 95% CI: (0.033-0.348), p <0.001)]. The mortality rate was 10.1%. Conclusion: The results of this study further support the argument on the higher prevalence of stroke admission in rural areas of Southwestern Nigeria. There may be need for public awareness on primary stroke prevention and early identification of the risk factors in order to reduce the prevalence and mortality of stroke in the rural Southwestern Nigeria.","PeriodicalId":72522,"journal":{"name":"Cardiology & vascular research (Wilmington, Del.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44940793","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}
Objective: To identify pulmonary hemorrhage incidence modification after early diagnosis-treatment of an hsPDA in ELBW infants. Study design: Data from extreme preterm infants treated by Ibuprofen were retrospectively and prospectively reviewed. X2 test and Fisher’s exact test were used for categorical analyses. t-test and Kruskl-Wallis test were used for continuous analyses. Multivariate analyses with logistic regression models were used to control for differences in observed covariates. Results: Fifty-five ELBW infants were diagnosed with PDA. Significant increase in survival in early ibuprofen group (67.7% vs 91.5%; p = .033) was seen; with a significant reduction in the pulmonary hemorrhage incidence in the 26 – 276/7 WGA in EIG (22.7% vs 0%; p = .047). To note that, proven – NEC cases occurred more frequently in the 24 – 256/7 WGA in EIG with a significant difference (44.4% vs 0%; p = .041). Conclusion: Early treatment of hemodynamically significant patent ductus arteriosus is associated with an increase in survival in ELBW infants with less pulmonary hemorrhage, especially in the 26 – 276/7 WGA. In another hand, developing proven-NEC increased if 24 – 256/7 WGA were treated earlier by Ibuprofen for their PDA. Future prospective, multi-centric, large-scale randomized trials should be conducted to determine the best strategies for PDA management, especially in ELBW infants.
{"title":"Can Early Diagnosis - Treatment of A Hemodynamically Significant Patent Ductus Arteriosus Reduce the Incidence of Pulmonary Hemorrhage in Extreme Low Birth Weight Infants?","authors":"Ghoussoub Elie, Souaid Tatiana, Daoud Patrick","doi":"10.33425/2639-8486.1125","DOIUrl":"https://doi.org/10.33425/2639-8486.1125","url":null,"abstract":"Objective: To identify pulmonary hemorrhage incidence modification after early diagnosis-treatment of an hsPDA in ELBW infants. Study design: Data from extreme preterm infants treated by Ibuprofen were retrospectively and prospectively reviewed. X2 test and Fisher’s exact test were used for categorical analyses. t-test and Kruskl-Wallis test were used for continuous analyses. Multivariate analyses with logistic regression models were used to control for differences in observed covariates. Results: Fifty-five ELBW infants were diagnosed with PDA. Significant increase in survival in early ibuprofen group (67.7% vs 91.5%; p = .033) was seen; with a significant reduction in the pulmonary hemorrhage incidence in the 26 – 276/7 WGA in EIG (22.7% vs 0%; p = .047). To note that, proven – NEC cases occurred more frequently in the 24 – 256/7 WGA in EIG with a significant difference (44.4% vs 0%; p = .041). Conclusion: Early treatment of hemodynamically significant patent ductus arteriosus is associated with an increase in survival in ELBW infants with less pulmonary hemorrhage, especially in the 26 – 276/7 WGA. In another hand, developing proven-NEC increased if 24 – 256/7 WGA were treated earlier by Ibuprofen for their PDA. Future prospective, multi-centric, large-scale randomized trials should be conducted to determine the best strategies for PDA management, especially in ELBW infants.","PeriodicalId":72522,"journal":{"name":"Cardiology & vascular research (Wilmington, Del.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48665331","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}
Therapeutic fibrinolysis has used tissue plasminogen activator (tPA) since 1987 based on a belief that tPA was responsible for biological fibrinolysis. This belief, however, was belied by clinical experience with tPA showing that it was not an effective fibrinolytic. Comparative clinical trials in almost 100,000 patients with acute myocardial infarction (AMI) failed to show that tPA was unequivocally more effective than streptokinase (SK), an indirect, inefficient, and non-specific plasminogen activator. Instead, it was found that tPA caused significantly more intracranial hemorrhage (ICH) side effects than SK. This disappointing experience led to the abandonment of fibrinolysis and its replacement by percutaneous coronary intervention (PCI) for AMI. However, PCI is a time-consuming, hospital procedure, poorly adapted to salvaging function of an ischemic myocardium, for which success is critically time dependent. Fibrinolysis remains the fastest method available for this and its abandonment is predicated on fibrinolysis and tPA being identical. This assumption, however, is contradicted by evidence that fibrinolysis requires both biological plasminogen activators, and that urokinase plasminogen activator (uPA) is the dominant of the two. This was also documented in a single clinical study in AMI, in which tPA’s fibrinolytic function was found to be analogous to that of the starter in an automobile.
{"title":"Fibrinolysis with tPA Failed Because the Mechanism of Action of both was Misunderstood","authors":"V. Gurewich","doi":"10.33425/2639-8486.1123","DOIUrl":"https://doi.org/10.33425/2639-8486.1123","url":null,"abstract":"Therapeutic fibrinolysis has used tissue plasminogen activator (tPA) since 1987 based on a belief that tPA was responsible for biological fibrinolysis. This belief, however, was belied by clinical experience with tPA showing that it was not an effective fibrinolytic. Comparative clinical trials in almost 100,000 patients with acute myocardial infarction (AMI) failed to show that tPA was unequivocally more effective than streptokinase (SK), an indirect, inefficient, and non-specific plasminogen activator. Instead, it was found that tPA caused significantly more intracranial hemorrhage (ICH) side effects than SK. This disappointing experience led to the abandonment of fibrinolysis and its replacement by percutaneous coronary intervention (PCI) for AMI. However, PCI is a time-consuming, hospital procedure, poorly adapted to salvaging function of an ischemic myocardium, for which success is critically time dependent. Fibrinolysis remains the fastest method available for this and its abandonment is predicated on fibrinolysis and tPA being identical. This assumption, however, is contradicted by evidence that fibrinolysis requires both biological plasminogen activators, and that urokinase plasminogen activator (uPA) is the dominant of the two. This was also documented in a single clinical study in AMI, in which tPA’s fibrinolytic function was found to be analogous to that of the starter in an automobile.","PeriodicalId":72522,"journal":{"name":"Cardiology & vascular research (Wilmington, Del.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47407618","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. Zakaria, ,. A. A. Ali, Yaya Mahamat, Abdelkerim mahamatAboubakar, Alsser Adam Soha, Kaya Aristide, T. A. Ibrahim
Introduction: venous thrombosis is a public health problem in developing countries. Materials and Methods: This is a prospective study carried out in the cardiology department of the National Reference Teaching Hospital of N’Djamena. It spans a period of 02 years, from January 2019 to December 2020 with a 4-month follow-up for the last patients. Results: we counted a total of 49 cases of deep vein thrombosis out of 1983 patients hospitalized in the department, either a hospital prevalence of 2.47%. Our study population was dominated by the female sex (59.2%) with a sex ratio (M /W) of 0.69. The most representative age groups are those of 55-65 years old (37.0 %); 35-45 years old (26.5%) and 45-55 years old (16.0%) with an average age of 49.7 years ± 13.94 on extremes ranging from 25 to 86 years old.
{"title":"Venous Thrombosis of Lower Limbs at the National Reference Teaching Hospital of Ndjamena/Chad","authors":"A. Zakaria, ,. A. A. Ali, Yaya Mahamat, Abdelkerim mahamatAboubakar, Alsser Adam Soha, Kaya Aristide, T. A. Ibrahim","doi":"10.33425/2639-8486.1121","DOIUrl":"https://doi.org/10.33425/2639-8486.1121","url":null,"abstract":"Introduction: venous thrombosis is a public health problem in developing countries. Materials and Methods: This is a prospective study carried out in the cardiology department of the National Reference Teaching Hospital of N’Djamena. It spans a period of 02 years, from January 2019 to December 2020 with a 4-month follow-up for the last patients. Results: we counted a total of 49 cases of deep vein thrombosis out of 1983 patients hospitalized in the department, either a hospital prevalence of 2.47%. Our study population was dominated by the female sex (59.2%) with a sex ratio (M /W) of 0.69. The most representative age groups are those of 55-65 years old (37.0 %); 35-45 years old (26.5%) and 45-55 years old (16.0%) with an average age of 49.7 years ± 13.94 on extremes ranging from 25 to 86 years old.","PeriodicalId":72522,"journal":{"name":"Cardiology & vascular research (Wilmington, Del.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46826476","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}
M. Bordy, W. Kamel, Gamal Abd el hady, Ihab M. Yassin
Background: There is a lack of published research that compare stenting versus coronary artery bypass grafting (CABG) for patients with left main coronary artery (LMCA) disease. This research compared the safety and efficacy of stents versus CABG for patients with LMCA disease in the setting of acute myocardial infarction. Materials and Methods: A retrospective chart review was conducted to retrieve the records of LMCA who underwent coronary stenting or CABG. We compared both techniques in terms of major adverse cardiovascular and cerebrovascular events (MACCE) and postoperative complications. Results: Sixty patients were included (30 patients in each group). The incidence of periprocedural mortality was equal between PCI and CABG groups (6.7% versus 10%). Likewise, the overall incidence of periprocedural complications was comparable between both groups (13.3% versus 20%). The incidence of immediate post procedural complications was 20% and 30% in PCI and CABG groups, respectively (p =0.37). Likewise, the rate of immediate post procedural mortality was 3.3% and 6.7%, respectively (p =1.0). Both groups exhibited similar rates of late post procedural complications as well (p =0.25). Conclusion: In conclusion, PCI and CABG had comparable postoperative outcomes in LMCA patients in the setting of acute myocardial infarction. Further randomized controlled trials with larger sample size and longer follow-up period are required to evaluate the safety and efficacy of both techniques in such patients.
{"title":"Coronary Stenting versus Bypass Graft Surgery for Management of Left Main Coronary Artery Disease in the Setting of Acute Myocardial Infarction: A Retrospective Cohort Study","authors":"M. Bordy, W. Kamel, Gamal Abd el hady, Ihab M. Yassin","doi":"10.33425/2639-8486.1117","DOIUrl":"https://doi.org/10.33425/2639-8486.1117","url":null,"abstract":"Background: There is a lack of published research that compare stenting versus coronary artery bypass grafting (CABG) for patients with left main coronary artery (LMCA) disease. This research compared the safety and efficacy of stents versus CABG for patients with LMCA disease in the setting of acute myocardial infarction. Materials and Methods: A retrospective chart review was conducted to retrieve the records of LMCA who underwent coronary stenting or CABG. We compared both techniques in terms of major adverse cardiovascular and cerebrovascular events (MACCE) and postoperative complications. Results: Sixty patients were included (30 patients in each group). The incidence of periprocedural mortality was equal between PCI and CABG groups (6.7% versus 10%). Likewise, the overall incidence of periprocedural complications was comparable between both groups (13.3% versus 20%). The incidence of immediate post procedural complications was 20% and 30% in PCI and CABG groups, respectively (p =0.37). Likewise, the rate of immediate post procedural mortality was 3.3% and 6.7%, respectively (p =1.0). Both groups exhibited similar rates of late post procedural complications as well (p =0.25). Conclusion: In conclusion, PCI and CABG had comparable postoperative outcomes in LMCA patients in the setting of acute myocardial infarction. Further randomized controlled trials with larger sample size and longer follow-up period are required to evaluate the safety and efficacy of both techniques in such patients.","PeriodicalId":72522,"journal":{"name":"Cardiology & vascular research (Wilmington, Del.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49403844","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}
Background and Introduction: The chronicity of heart failure (HF) requires patients to follow complex self-care regimen. Many factors impede patients’ ability to follow the prescribed multi-component self-care regimen that include lack of knowledge attributed to inadequate health literacy. Objective: This prospective pre- and post-intervention study assessed the usability and potential efficacy of a HFeducational application (APP) in a smartphone. The HF education App included ten educational modules at a reading level of 6th grade. The study examined the association of health literacy level of participants at baseline with HF knowledge improvement after using the App for 30-days. HF related hospital readmissions was assessed at 30, 60 and 90-days. Results: A total of 31 patients with HF and (15) family member dyads were recruited for the study. Health Literacy level was measured using the Rapid Estimate of Adult Literacy in Medicine - Short Form showed a strong association with HF knowledge measured using the validated Atlanta HF Knowledge Test (t=3.629; p=0.001). Knowledge of patients with HF improved significantly after 30-days of using the HF education App (t=13.03; p=0.001); as well the knowledge of caregivers (t=9.08; p=0.001). None of the patients with HF were hospitalized during 30-days and 60-days follow-up, while one patient was hospitalized in 90-days. Conclusion: Our data suggests evaluating alternative methods of communicating health information including written material at a low literacy level verbal communication that a person with inadequate literacy may understand, and presentations using videos and Apps targeting individuals with limited literacy at 6th grade level.
{"title":"Health Literacy Impacts Knowledge and the Use of Education App in Heart Failure: A Pilot Study","authors":"Laureen Mack, P. Athilingam, Jorge Adorno-Nieves","doi":"10.33425/2639-8486.1124","DOIUrl":"https://doi.org/10.33425/2639-8486.1124","url":null,"abstract":"Background and Introduction: The chronicity of heart failure (HF) requires patients to follow complex self-care regimen. Many factors impede patients’ ability to follow the prescribed multi-component self-care regimen that include lack of knowledge attributed to inadequate health literacy. Objective: This prospective pre- and post-intervention study assessed the usability and potential efficacy of a HFeducational application (APP) in a smartphone. The HF education App included ten educational modules at a reading level of 6th grade. The study examined the association of health literacy level of participants at baseline with HF knowledge improvement after using the App for 30-days. HF related hospital readmissions was assessed at 30, 60 and 90-days. Results: A total of 31 patients with HF and (15) family member dyads were recruited for the study. Health Literacy level was measured using the Rapid Estimate of Adult Literacy in Medicine - Short Form showed a strong association with HF knowledge measured using the validated Atlanta HF Knowledge Test (t=3.629; p=0.001). Knowledge of patients with HF improved significantly after 30-days of using the HF education App (t=13.03; p=0.001); as well the knowledge of caregivers (t=9.08; p=0.001). None of the patients with HF were hospitalized during 30-days and 60-days follow-up, while one patient was hospitalized in 90-days. Conclusion: Our data suggests evaluating alternative methods of communicating health information including written material at a low literacy level verbal communication that a person with inadequate literacy may understand, and presentations using videos and Apps targeting individuals with limited literacy at 6th grade level.","PeriodicalId":72522,"journal":{"name":"Cardiology & vascular research (Wilmington, Del.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46936812","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}
Rohanlal Vishwanath, S. Gorgis, Varinder P. Singh, James Iordanou, H. Papukhyan, A. Hana, Cori E. Russell, K. Ananthasubramaniam
Coronary artery calcification (CAC) is an independent predictor of cardiovascular events and can be reliably detected on non-Electrocardiogram (ECG) gated computed tomography (CT) scans. The increased use of CT has made CAC a common incidental finding, although the frequency remains variable in published literature. We aimed to identify the incidence of CAC found on routine non-ECG gated CT scans, risk factors associated with these findings, and management outcomes that resulted from discovery of CAC. A systematic review was conducted through literature search using predetermined search criteria. Applicable studies were screened by 3 investigators for eligibility. Data regarding indication for CT imaging, presence of CAC, cardiovascular risk factors, and management outcomes was collected. A total of 3585 study subjects were included for review. CAC was found in 31.2% (n = 1118) patients. Indications for CT imaging were 33.0% lung cancer screening, 16.0% for intrapulmonary pathology, and 50.0% for other reasons. In patients with CAC, the average age was 61.5 + 8.8 years old, 77.2% were male, 41.4% were smokers, 32.2% had hypertension, 31.5% had hyperlipidemia, and 11.2% had diabetes. Patients with CAC were older (p < 0.001), more likely to be smokers (p = 0.002), and more likely to have hyperlipidemia (p < 0.001). The presence of CAC in reports did not significantly alter management plans. In conclusion, traditional cardiovascular risk factors are associated with incidental CAC. Not reporting incidental CAC is a missed opportunity for identification of patient at increased risk of cardiovascular events in the community.
{"title":"Incidence, Risk Factors, and Patient Management of Incidental Coronary Artery Calcification on Non-ECG Gated Computed Chest Tomography: A Systematic Review","authors":"Rohanlal Vishwanath, S. Gorgis, Varinder P. Singh, James Iordanou, H. Papukhyan, A. Hana, Cori E. Russell, K. Ananthasubramaniam","doi":"10.33425/2639-8486.1119","DOIUrl":"https://doi.org/10.33425/2639-8486.1119","url":null,"abstract":"Coronary artery calcification (CAC) is an independent predictor of cardiovascular events and can be reliably detected on non-Electrocardiogram (ECG) gated computed tomography (CT) scans. The increased use of CT has made CAC a common incidental finding, although the frequency remains variable in published literature. We aimed to identify the incidence of CAC found on routine non-ECG gated CT scans, risk factors associated with these findings, and management outcomes that resulted from discovery of CAC. A systematic review was conducted through literature search using predetermined search criteria. Applicable studies were screened by 3 investigators for eligibility. Data regarding indication for CT imaging, presence of CAC, cardiovascular risk factors, and management outcomes was collected. A total of 3585 study subjects were included for review. CAC was found in 31.2% (n = 1118) patients. Indications for CT imaging were 33.0% lung cancer screening, 16.0% for intrapulmonary pathology, and 50.0% for other reasons. In patients with CAC, the average age was 61.5 + 8.8 years old, 77.2% were male, 41.4% were smokers, 32.2% had hypertension, 31.5% had hyperlipidemia, and 11.2% had diabetes. Patients with CAC were older (p < 0.001), more likely to be smokers (p = 0.002), and more likely to have hyperlipidemia (p < 0.001). The presence of CAC in reports did not significantly alter management plans. In conclusion, traditional cardiovascular risk factors are associated with incidental CAC. Not reporting incidental CAC is a missed opportunity for identification of patient at increased risk of cardiovascular events in the community.","PeriodicalId":72522,"journal":{"name":"Cardiology & vascular research (Wilmington, Del.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42570751","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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