Do collaterals to infarct bed in STE-ACS patients undergoing emergent percutaneous coronary revascularization matter? An assessment of a prospective pool for in-hospital course.

Background: Limited data exist on the role of coronary collaterals circulation (CCC) in patients with ST-elevation acute coronary syndrome (STE-ACS). This study aimed to assess CCC and the in-hospital course of patients with CCC undergoing primary percutaneous coronary intervention (pPCI).

Methods: The study included consecutive STE-ACS patients undergoing pPCI.

Improvement in LV end-diastolic pressure after primary PCI and its impact on patients' recovery.

In this study, we evaluated the change in left ventricular end-diastolic pressure (LVEDP) after primary percutaneous coronary intervention (PCI) and its impact on in-hospital outcomes and 30-day and three-month quality of life (SAQ-7), ejection fraction (EF), and major adverse cardiovascular events (MACE). LVEDP ≥19 mmHg was taken as elevated LVEDP. In a sample of 318 patients, 18.

Assessing in-hospital mortality and predictors in Patients with contrast-induced nephropathy Following primary percutaneous coronary Intervention.

Background: The contrast-induced nephropathy (CIN) is a common complication of primary percutaneous coronary intervention (PCI) it has been reported to be associated with an increased risk of mortality. The study reported the in-hospital mortality among patients who developed CIN after primary PCI.

Methods: This descriptive cross-sectional study was conducted on a sample of consecutive who developed CIN after primary PCI at a tertiary care cardiac hospital in Karachi, Pakistan.

Steroids and myocardial infarction: Investigating safety and short-term mortality in critical post-myocardial infarction patients.

Background: Conventionally, in the pre-percutaneous intervention era, free wall rupture is reported to be a major concern for using steroids in myocardial infarction (MI) patients. Therefore, the aim of this study was to evaluate the safety of the use of steroids in critically ill post-MI patients in terms of hospital course and short-term (up to 180-day) mortality.

Methods: We included patients admitted to CCU diagnosed with MI, undergone revascularization, critically ill, and requiring mechanical ventilator (MV) support.

Prediction of major adverse cardiac events in the emergency department using an artificial neural network with a systematic grid search.

Background: The aim of our research was to design and evaluate an Artificial Neural Network (ANN) model using a systemic grid search for the early prediction of major adverse cardiac events (MACE) among patients presenting to the triage of an emergency department.

Methods: This is a single-center, cross-sectional study using electronic health records from January 2017 to December 2020. The research population consists of adults coming to our emergency department triage at Aga Khan University Hospital.

Factors associated with poor outcomes after congenital heart surgery in low-resource setting in Pakistan: insight from the IQIC Registry - a descriptive analysis.

Objective: This study aimed to assess the International Quality Improvement Collaborative single-site data from a developing country to identify trends in outcomes and factors associated with poor outcomes.

Design: Retrospective descriptive study.

Setting: The National Institute of Cardiovascular Diseases, Karachi, Pakistan.

Clinical manifestations and outcome of patients with primary amoebic meningoencephalitis in Pakistan. A single-center experience.

Primary amoebic meningoencephalitis (PAM) is a rapidly progressing central nervous system (CNS) infection caused by Naegleria fowleri, a free-living amoeba found in warm freshwater. The disease progression is very rapid, and the outcome is nearly always fatal. We aim to describe the disease course in patients admitted with PAM in a tertiary care center in Karachi, Pakistan between the periods of 2010 to 2021.

Age and gender-based categorization of very premature, premature, and non-premature acute myocardial infarction: A comparison of clinical and angiographic profile and in-hospital outcomes.

Background: In this study, we aimed to assess and compare the distribution of demographic and clinical characteristics and composite adverse clinical outcomes after primary percutaneous coronary intervention (PCI) among "very premature", "premature", and "non-premature" patients with "ST-segment elevation acute coronary syndrome (STE-ACS)" presented at a tertiary care center.

Methods: We included consecutive patients diagnosed with STE-ACS undergoing primary PCI. The "very premature" was defined as ≤40 years for males and ≤ 45 years for females, "premature" as <55 years for males and < 65 years for females, and "non-premature" as ≥55 years for males and ≥ 65 years for females.

Increasing Incidence of ST-Elevation Acute Coronary Syndrome in Young South Asian Population, a Challenge for the World? An Assessment of Clinical and Angiographic Patterns and Hospital Course of Premature Acute Myocardial Infarction.

The incidence of premature ischemic heart disease (IHD) is increasing because of urbanization, a sedentary lifestyle, and various other unexplored factors, especially in South Asia. This study aimed to assess the distribution of premature ST-elevation acute coronary syndrome (STE-ACS) with its clinical and angiographic pattern along with hospital course in a contemporary cohort of patients who underwent primary percutaneous intervention at a tertiary care center in the South Asian region. We included consecutive patients of either gender diagnosed with STE-ACS and who underwent primary percutaneous intervention.

Acute hyperglycemia, a rabble-rouser or innocent bystander? A prospective analysis of clinical implications of acute hyperglycemia in STE-ACS patients.

Background: Acute hyperglycemia is considered an independent prognosticator of both in-hospital and long-term outcomes in patients with acute coronary syndrome (ACS). This study aimed To analyze the incidence of acute hyperglycemia and its impact on the adverse in-hospital outcome in patients with STE-ACS undergoing primary percutaneous coronary intervention (PCI).

Methods: In this study, we enrolled patients presenting with STE-ACS and undergoing primary PCI at a tertiary care cardiac center.

Mechanical ventilation in acute myocardial infarction: Outcomes from a prospective audit at a cardiovascular hospital in Pakistan.

Background: This clinical audit aims to evaluate the clinical data regarding the management and outcomes of acute myocardial infarction (AMI) patients requiring mechanical ventilator (MV) support, along with identifying factors associated with prolonged MV support and 180-day mortality.

Materials And Methods: In this study, we audited clinical data regarding management, in-hospital and short-term outcomes of adult patients with AMI required MV support. Patients with prolonged MV duration (>24h) and/or 180-day mortality were compared with their counterparts, and associated factors were identified.

One-year major adverse cardiovascular events among same-day discharged patients after primary percutaneous coronary intervention at a tertiary care cardiac centre in Karachi, Pakistan: a prospective observational study.

Objective: Knowledge regarding the short-term outcomes after same-day discharge (SDD) post primary percutaneous coronary intervention (PCI) is lacking. In this study, we evaluated 1-year major adverse cardiovascular events (MACE) among SDD patients after primary PCI.

Design: 1-year follow-up analysis of a subset of patients from an existing prospective cohort study.

Safety and tolerability of Sacubitril/Valsartan in heart failure patient with reduced ejection fraction.

Background: Angiotensin receptor blocker and a neprilysin inhibitor (ARNI) has emerged as an innovative therapy for patients of heart failure with reduced ejection fraction (HFrEF). The purpose of this study was to assess the safety and tolerability of Sacubitril/Valsartan in patient with HFrEF in Pakistani population.

Methods: This proof-of-concept, open label non-randomized clinical trial was conducted at a tertiary care cardiac center of Karachi, Pakistan.

Impact of COVID-19 on cardiovascular clinics: Are we ready for telemedicine?

Objective: The need for telemedicine was felt more than ever during the COVID-19 pandemic, which impacted health care worldwide. Therefore, this study aimed to determine the difficulties faced by patients in visiting the cardiac outpatient department during COVID-19, along with assessing the awareness and acceptability of telemedicine.

Methods: In this cross-sectional study, selected patients presenting to outpatient department of a tertiary care cardiac hospital were interviewed regarding the difficulties faced by patients in visiting the outpatient department during COVID-19 and their awareness and acceptability of telemedicine using a self-designed structured questionnaire.

Comparative analysis of four established risk scores for prediction of in-hospital mortality in patients undergoing primary percutaneous coronary intervention.

Objective: This study was conducted to compare the predictive power of Shock Index (SI), TIMI Risk Index (TRI), LASH Score, and ACEF Score for the prediction of in-hospital mortality in a contemporary cohort of ST-segment elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PCI) at a tertiary care cardiac center of a developing country.

Methods: Consecutive patients diagnosed with STEMI and undergoing primary PCI were included in this study. SI, TRI, LASH, and ACEF were computed and their predictive power was assessed as the area under the curve (AUC) on the receiver operating characteristics (ROC) curve analysis for in-hospital mortality.

Predilation Ballooning in High Thrombus Laden STEMIs: An Independent Predictor of Slow Flow/No-Reflow in Patients Undergoing Emergent Percutaneous Coronary Revascularization.

Background: Distal embolization due to microthrombus fragments formed during predilation ballooning is considered one of the possible mechanisms of slow flow/no-reflow (SF/NR). Therefore, this study aimed to compare the incidence of intraprocedure SF/NR during the primary percutaneous coronary intervention (PCI) in patients with high thrombus burden (≥4 grade) with and without predilation ballooning for culprit lesion preparation. .

Timi Risk Index, A Simple Tool In Emergency Percutaneous Revascularization For The Prediction Of Contrast Induced Nephropathy.

Background: Contrast induced nephropathy (CIN) is a common complication seen after primary percutaneous coronary intervention (PCI) which can contribute to increased morbidity and mortality in patients of acute ST elevation myocardial infarction (STEMI). Aim of this study was to validate the TIMI Risk Index (TRI) for the risk stratification of CIN in patients undergone primary PCI.

Methods: Consecutive patients of STEMI undergone primary PCI at a tertiary care cardiac center were included for this study.

Predicting Post-Extubation Respiratory Failure After Myocardial Infarction Using The Rapid Shallow Breathing Index And Lung Ultrasound Score.

Background: The Rapid Shallow Breathing Index (RSBI) has been hypothesized to have discriminating power for categorizing patients at higher risk of post-extubation respiratory failure (RF). Hence aim of this study was to determine the predictive value of RSBI for post-extubation RF in patients after acute myocardial infarction (AMI).

Methods: Consecutive, intubated patients admitted post-revascularization were included.

Prospective Validation Of Heart Score For Suspected Acute Coronary Syndrome Patients.

Background: The HEART score is reported to be a useful tool for the assessment of suspected acute coronary syndrome (ACS) patients, however, data regarding its validity in our population is scarce. Therefore, aim of this study was to evaluate the prognostic utility of the HEART score to predict major adverse cardiac events (MACE) within 6 weeks in patients presenting to emergency department with chest pain.

Methods: This prospective observational study included suspected ACS patients presented with chest pain to the emergency department of a tertiary care cardiac center.

Role Of Lung Ultrasound During Weaning In Patient With Mitral Regurgitation Post Angioplasty.

Background: We hypothesize that a change in lung ultrasound score (LUS) can assist in the early diagnosis of weaning-induced respiratory failure (RF). The objective of this study was to determine the utility of LUS in weaning patients with mitral regurgitation (MR) from mechanical ventilation (MV).

Methods: This prospective observational study included patients with acute coronary syndrome (ACS) who required invasive MV after angiography/angioplasty.

The outcome of primary percutaneous coronary intervention in patients with stent thrombosis.

Background: Primary percutaneous coronary intervention (PCI) is a recommended management strategy for patients with de novo ST-segment elevation myocardial infarction (STEMI). Still, the efficacy of primary PCI in-stent thrombosis (ST) induced STEMI is unclear. The aim was to assess the clinical characteristics and the in-hospital outcomes of patients undergoing primary PCI for STEMI caused by acute, sub-acute, or late ST.

Techniques to Treat Slow-Flow/No-Reflow During Primary Percutaneous Coronary Intervention.

Objective: The aim of this study was to compare TIMI flow after administering intracoronary (IC) medications through various routes for the treatment of slow flow/no-reflow during primary PCI.

Methods: Two independent parallel cohorts of the patients who underwent primary PCI for STEMI and developed slow/no-reflow were recruited. Selection of cohort was based on the route of administration of IC medications as proximal or distal.

The Burden of Short-term Major Adverse Cardiac Events and its Determinants after Emergency Percutaneous Coronary Revascularization: A Prospective Follow-up Study.

Objectives: Primary percutaneous coronary intervention (PCI) remains recommended reperfusion therapy for patients with acute ST-elevation myocardial infarction. This study aimed to evaluate the short-term major adverse cardiac events (MACE) and their determinants among patients who underwent primary PCI at a tertiary care cardiac center of Karachi, Pakistan.

Methods: A cohort of patients who underwent primary PCI were followed for the MACE.

CHA DS -VASc score, a simple clinical tool for early prediction of no-reflow phenomenon in patients undergoing emergency percutaneous coronary revascularization.

Slow flow/no reflow (SF/NR) phenomenon during emergency percutaneous revascularization is a feared complication associated with increased risk of adverse outcomes. CHA DS -VASc score has been proposed for the risk stratification but a very limited evidences are available regarding the accuracy of this system. Therefore, we conducted this study to assess the predictive value of CHA DS -VASc score for predicting SF/NR phenomenon during primary percutaneous coronary intervention (PCI).