Publications by authors named "Ripen Gupta"

Article Synopsis
  • * Current guidelines recommend early combination therapy using four drug classes, especially ARNI, which significantly reduces morbidity and mortality in patients with heart failure with reduced ejection fraction (HFrEF).
  • * A national consensus by Indian cardiology experts emphasizes that ARNI should be initiated early in HFrEF patients, including those hospitalized, and can also benefit patients with preserved and mildly reduced ejection fractions.
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Chronic kidney disease (CKD) is a major contributor to morbidity and mortality in India. CKD often coexists with heart failure (HF), diabetes, and hypertension. All these comorbidities are risk factors for renal impairment.

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Article Synopsis
  • * Sodium-glucose cotransporter-2 inhibitors (SGLT2i) are new medications that not only help control blood sugar in T2DM but also provide significant cardiovascular benefits for HF patients.
  • * Evidence shows that SGLT2i can enhance heart function and improve outcomes in HF whether patients have diabetes or not, making them valuable for a wide range of HF patients, especially in India.
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Article Synopsis
  • - In India, heart failure (HF) is a significant health issue, impacting younger individuals compared to Western countries, but many patients do not receive proper medical treatment.
  • - Selective β-1 blockers, like bisoprolol, are important in treating HF because they help lower heart rate and reverse negative heart and blood vessel changes associated with the condition.
  • - Despite the benefits of bisoprolol for various HF cases and comorbid conditions, its use in India remains suboptimal, prompting a consensus on its effectiveness and recommending it for better patient care.
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Twiddler's syndrome is a rare cause of pacemaker lead dislodgement. A 61-year-old female patient was implanted with a defibrillator capable of cardiac re-synchronization therapy (CRT-D); 10 months later, she presented with uneasiness and vibratory sensations in the chest. Fluoroscopy revealed rotation of the pulse generator along its longitudinal axis and dislodgement of all three leads.

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Objective: GENAMI, an angiographic follow-up study was undertaken to evaluate the safety and efficacy of a new generation endothelial progenitor cell (EPC) capture stent, GENOUS during primary angioplasty for ST-elevation myocardial infarction (MI).

Methods: Eleven consecutive patients with acute ST-elevation MI underwent primary percutaneous coronary intervention (PCI) using a bio-engineered GENOUS EPC stent.

Results: Procedural success was 100%.

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Diffuse pulmonary arteriovenous fistulae are rare, more so when unilateral. This article describes a 12-year-old boy with diffuse right-sided pulmonary arteriovenous fistula in whom prior percutaneous transcatheter coil occlusion has been attempted without success.The patient was subjected to ligation and transection of the right pulmonary artery and he is presently doing well.

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Background: The CoStar stent is a novel cobalt chromium stent designed specifically for drug delivery. The COSTAR I trial represents the first-in-man study of the CoStar Paclitaxel-Eluting Coronary Stent System evaluating three dose release formulations of paclitaxel in a bioresorbable polymer matrix in the treatment of de novo coronary lesions.

Methods: The COSTAR I Trial was a prospective, multi-center registry enrolling 87 patients in four Indian centers for treatment of up to two de novo lesions = 25 mm in length in a reference vessel 2.

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Coronary aneurysm after stent implantation is a rare complication. Coronary aneurysms have been reported after drug-eluting stent implantation, but there has been no clear elucidation of time course, mechanism and therapeutic implications. We report two patients who developed coronary aneurysms within two weeks of the procedure and required surgical intervention to treat the complication.

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Background: Mahaim pathways are characterized by the presence of an accessory pathway potential-the 'M' potential, at the tricuspid annulus. M potential is a very useful guide during radiofrequency ablation of Mahaim pathway. During ablation, an accelerated rhythm with ORS morphology, identical to fully pre-excited QRS complex is observed, and has been labeled as Mahaim automatic rhythm.

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Of the various therapeutic modalities available to treat ectopic atrial tachycardia, radiofrequency catheter ablation has shown excellent results. It is usually possible to localize the earliest site of endocardial activation by conventional or newer three-dimensional mapping techniques. We report a case of ectopic atrial tachycardia, wherein the tachycardia was being repeatedly interrupted by mechanical trauma.

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Coronary sinus electrograms generally represent the sequence of left atrial activation, and are very helpful in localizing and differentiating left lateral accessory pathway-mediated tachycardia from other supraventricular tachycardias. The activation of the coronary sinus from the left atrium occurs through muscle bridges, which may be discrete or form an intermingled continuum. These muscle bridges, if disconnected, may dissociate the coronary sinus from the left atrium, in which case the coronary sinus electrograms do not represent left atrial activation, and do not help to understand, or may cause misinterpretation of, the mechanism of supraventricular tachycardia.

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The results of primary coronary stenting for acute myocardial infarction (AMI) have been reported to improve significantly with the concomitant administration of platelet glycoprotein IIb/IIIa inhibitor abciximab. There are, however, no data available with the use of eptifibatide, a more cost-effective, small-molecule GP IIb/IIIa blocker with a shorter half-life. In a prospective multicenter feasibility and efficacy study, we assigned 55 consecutive patients with AMI being taken up for primary stenting to receive eptifibatide just before the procedure (two boluses of 180 microg/kg 10 min apart and a 24-hr infusion of 2 microg/kg/min).

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Primary pulmonary hypertension is a rare disorder of unknown etiology with a poor prognosis. There is no cure, and drug therapy is effective in only a few patients. Calcium-channel antagonists and anticoagulants are the mainstay of therapy.

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