A randomized trial of antithrombotic therapy in patients with acute coronary syndrome and coronary ectasia.

Background: Coronary artery ectasia (CAE) of the culprit infarct artery is a rare finding in patients with acute coronary syndrome (ACS). While anticoagulants have been suggested to reduce recurrent events, the optimal anti-thrombotic therapy remains unclear.

Methods: OVER-TIME was an open label, exploratory, randomized controlled trial comparing dual antiplatelet therapy (DAPT; acetyl-salicylic-acid 100mg plus clopidogrel 75mg daily) versus single antiplatelet (SAPT, clopidogrel 75mg) plus DOAC (rivaroxaban 15mg) in patients with ACS and CAE.

Clinical Outcomes of Percutaneous Transcatheter Release of Stuck Mechanical Mitral Valve With Cerebral Embolic Protection.

Background: Surgery or fibrinolysis is the currently available evidence-based treatment for obstructive mechanical valve thrombus. We reported the feasibility and short-term outcomes of percutaneous transcatheter therapy with cerebral embolic protection. Mid- and long-term outcomes remain unknown.

Safety and feasibility of intravascular ultrasound guided zero-contrast percutaneous coronary intervention-A prospective study.

Background: There are published reports of safety and feasibility of percutaneous coronary intervention (PCI) without contrast, using intravascular ultrasound (IVUS) and coronary physiology guidance in chronic kidney disease population. We prospectively evaluated the safety and feasibility of zero-contrast PCI technique.

Methods: In this prospective study, we hypothesized that PCI is feasible without contrast, using IVUS guidance alone without mandatory coronary physiology to rule out slow-flow or no-flow at the end of PCI in a population at risk of contrast-induced acute kidney injury (CI-AKI).

Sex-Related Differences in Outcomes for Patients With ST Elevation Myocardial Infarction (STEMI): A Tamil Nadu-STEMI Program Subgroup Analysis.

Background: ST elevation myocardial infarction (STEMI) represents a large proportion of the clinical presentation of coronary artery disease in Indian people. Owing to multiple factors contributing to the sex difference, women with STEMI are thought to have a higher risk of adverse outcomes than men. The aim of this study was to evaluate sex-related differences in the clinical characteristics and prognosis of patients with STEMI within a system of care.

Radiation doses during cardiac catheterisation procedures in India: a multicentre study: Radiation dose study.

Aims: Established, evidence-based measures of radiation are required to minimise its hazards, while maintaining adequate image quality. The aim of this study is to evaluate radiation data and generate reference radiation levels for commonly performed coronary catheterisation procedures in India.

Methods And Results: In this prospective, observational study, all procedures were performed in accordance with the established standards using Innova IGS 520/2100-IQ catheterisation laboratories.

Epidermal bulla: A dermatology complication of radial artery compression band.

Patent hemostasis technique is used with the trans radial (TR) band to prevent radial artery occlusion following diagnostic coronary angiogram or percutaneous coronary intervention using radial artery access. We report epidermal bulla as a complication of TR band usage and a modified patent hemostasis technique using barbeau test to prevent this complication.

Reperfusion of myocardial infarction in India: Notions for México.

In India and México, cardiovascular diseases are the first cause of death and potential years of life lost. Close similarities exist between these two countries when facing the difficulties to establish a universal reperfusion program for ST elevation myocardial infarction (STEMI). This paper describes the situation of STEMI treatment in both countries, and examines the lessons that Mexico's health care system could adopt from the recent advances accomplished by the STEMI initiative in India.

Prevalence of parameters of suboptimal scaffold deployment following angiographic guided bioresorbable vascular scaffold implantation in real world practice - an optical coherence tomography analysis.

Aim: To assess the prevalence of suboptimal bioresorbable vascular scaffold (BVS, Abbott Vascular, Santa Clara, California) deployment in real world practice with intracoronary optical coherence tomography (OCT) imaging.

Methods: Consecutive patients who underwent percutaneous coronary intervention using BVS and the final optimization assessed with OCT imaging in two tertiary care centers between December 2012 and February 2015 were evaluated for parameters of suboptimal scaffold deployment by OCT.

Results: Overall, 36 scaffolds were implanted in 27 patients during this period.

Papillary fibroelastoma of tricuspid valve presenting as pulmonary embolism.

A 65-year-old gentleman was admitted with recurrent dyspnea. Two-dimensional and transesophageal echocardiography revealed a highly mobile echogenic mass attached to the tricuspid valve. A (99m)Tc lung perfusion scan was suggestive of pulmonary embolism.

Primary percutaneous thrombus aspiration alone as definitive intervention for left main coronary artery occlusion presenting as acute anterior wall ST elevation myocardial infarction.

Primary angioplasty and stenting remains the standard of care for patients presenting with acute ST-segment elevation myocardial infarction. Recently, thrombus aspiration has been shown to improve the myocardial perfusion and outcomes in STEMI. In a subset of patients thrombus aspiration may result in optimal perfusion and minimal residual stenosis.

Apical ballooning syndrome in first degree relatives.

Apical ballooning syndrome (Takotsubo cardiomyopathy) is an unusual stress-related reversible cardiomyopathy occurring commonly in postmenopausal females. Genetic etiology of this condition is uncertain. A 68-year-old female and her daughter aged 43 got admitted to our institute simultaneously with acute chest pain following demise of one of their close relative.

Single coronary artery from the right coronary sinus with proximal origin of the left anterior descending coronary artery and left circumflex as distal continuation of the right coronary artery: a rare variant.

A single coronary artery is a rare coronary anomaly. A 68-year-old male underwent coronary angiography for recent inferior wall myocardial infarction. It revealed a common coronary trunk arising from the right sinus of Valsalva and bifurcated into the right coronary artery (RCA) and anterior descending coronary arteries.

Posterior mitral leaflet aneurysm - a rare cause of mitral regurgitation.

Posterior mitral leaflet aneurysm is a very rare complication of infective endocarditis. A 28-year-old athlete got admitted with fever, congestive heart failure and multi-organ dysfunction syndrome. The echocardiogram showed large aneurysm of the posterior mitral leaflet with severe mitral regurgitation.

Hybrid trans-apical device closure of left ventricular pseudoaneurysm under trans-oesophageal echocardiographic guidance.

Left ventricular pseudo aneurysm (LVPA) results from contained left ventricular free wall rupture following either myocardial infarction or cardiac surgery. Untreated LVPA carries approximately 30-45% risk of rupture in the first year. Conventional treatment for LVPA is surgery which carries a mortality of about 20%.

High dose statins in acute myocardial infarction.

Patients with acute myocardial infection are vulnerable in the early period for death and recurrent coronary events due to an underlying unstable coronary plaque. Stabilizing the vulnerable plaque is a key strategy in treating these high risk patients. Statins in high doses have proved their utility and safety in secondary prevention trials.

Beta blockers & left ventricular hypertrophy regression.

Left ventricular hypertrophy (LVH) particularly in hypertensive patients is a strong predictor of adverse cardiovascular events. Identifying LVH not only helps in the prognostication but also in the choice of therapeutic drugs. The prevalence of LVH is age linked and has a direct correlation to the severity of hypertension.

Early coronary aneurysm with Paclitaxel-eluting stent.

Coronary aneurysm may occur after implantation of a paclitaxel-eluting stent. However, early coronary aneurysms arevery rare. We report an early coronary aneurysm at one month in a middle-aged man who had anterior descendingartery infarct angioplasty done with two overlapped Taxus Liberte stents.

The prevalence and clinical profile of angiographic coronary ectasia.

Coronary artery ectasia, a variant of coronary atherosclerosis, is a relatively rare entity. Review of literature did not reveal an exclusive study on isolated ectasia. We decided to analyse the clinical presentation and angiographic prevalence of this subset.