An observational, multi-centric, prospective study to understand the usage pattern of Ticagrelor in Indian patients with acute coronary syndrome

J.P.S. Sawhney, J. Dalal, A. Mullasari, S. Bansal, D. Kahali, B. Kotak, A. Raza, A. Gandhi, K. Amit
2015 Indian Heart Journal  
place special emphasis on the detection of subclinical left ventricular (LV) systolic and diastolic dysfunction and the timely identification of risk factors for HF. Our goal was to describe the prevalence and determinants (risk factors) of LV diastolic dysfunction in asymptomatic elderly population which is expected to have higher prevalence of diastolic dysfunction. Methods: We evaluated 103 asymptomatic elderly populations at random in the LTMG Hospital, Mumbai from January 2015 to June
more » ... y 2015 to June 2015. For this we have included the patient's relatives who were beyond 60 years of age with LV ejection fraction ≥60%. Patients with organic heart disease were excluded from the study. Data on demographics, baseline characteristics, and medical therapies was collected. In a randomly recruited population sample (n = 103; 53.3% women; mean age, 67.9 years), we measured early and late diastolic peak velocities of mitral inflow (E and A), pulmonary vein flow by pulsed-wave Doppler, and the mitral annular velocities (Ea and Aa) at 4 sites by tissue Doppler imaging. Stata SE 13.1 was used to analyse data. Fishers Exact test was applied to test the relationship of categorised independent and dependent variables. Results: In the study population of 103, overall prevalence of diastolic dysfunction was 63.10% with the number of subjects in diastolic dysfunction groups 1 (impaired relaxation), 2 (elevated LV end-diastolic filling pressure), and 3 (elevated E/Ea and abnormally low E/A) were 43 (41.74%), 18 (17.47%), and 4 (3.88%), respectively (Table 1) . We used Ar-A > 30 ms to confirm possible elevation of LV filling pressures in group 2. Only 38 (36.89%) patients had normal diastolic function. Predictors of diastolic dysfunction in elderly were identified as age >70 years ( p = 0.02), type 2 DM ( p = 0.03), and smoking ( p = 0.05), though we did not find any significant difference correlating diastolic dysfunction with sex ( p = 0.09) and hypertension ( p = 0.1) ( Table 2) . Conclusions: The overall prevalence of LV diastolic dysfunction in a random sample of an elderly population is as high as 63.10% with advanced age being the best predictor of diastolic dysfunction followed by diabetes mellitus and smoking, though gender and hypertension failed to predict the presence of diastolic dysfunction. Introduction: India is now estimated to be the coronary artery disease (CAD) capital of the world. CAD among women as a group is less easily recognized worldwide and this problem is especially relevant in a developing country like India. Aims and methods: Fifty female patients of STEMI, aged less than 65 years (mean 49 years) were assessed by clinical, biochemical, and coronary angiographic study. Main parameters observed were time of presentation and angiographic severity. Results: Average duration of presentation to hospital from symptom onset was 28 h and only 30% (n = 15) patients presented within window period of 12 h. Single vessel disease (SVD) was noted in 70% (n = 35) patients. Double (DVD) and triple vessel disease (TVD) was seen in 16% (n = 8) and 14% (n = 7), respectively. Among specific coronary artery disease, LAD was involved in 78% (n = 39), LCX 26% (n = 13), and RCA 26% (n = 13). LMCA was involved in 8% (n = 4) cases. Conclusion: This study reiterates the need of establishing systems for early recognition and awareness of CAD among women in India. As SVD is more common, complete revascularization through PCI is feasible and economically viable in this segment of the Indian population.
doi:10.1016/j.ihj.2015.10.066 fatcat:hcnpjue2pvexdpef2b4auujlte