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Snyman JR, Bortolotto LA, Degli Esposti L, Jayagopal PB, Konradi AO, Perrone V, Borghi C. A real-world analysis of outcomes and healthcare costs of patients on perindopril/indapamide/amlodipine single-pill vs. multiple-pill combination in Italy. J Hypertens 2024; 42:136-142. [PMID: 37728093 PMCID: PMC10712996 DOI: 10.1097/hjh.0000000000003570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 07/21/2023] [Accepted: 08/22/2023] [Indexed: 09/21/2023]
Abstract
OBJECTIVES This analysis compared adherence, cardiovascular (CV) events and all-cause mortality incidence, and healthcare costs among hypertensive patients treated with perindopril (PER)/indapamide (IND)/amlodipine (AML) in single-pill combination (SPC) vs. multiple-pill combination, in a real-world setting in Italy. METHODS In this observational retrospective analysis of Italian administrative databases, adult patients treated with PER/IND/AML between 2010 and 2020 were divided into two cohorts: single-pill vs. multiple-pill. Patient data were available for at least one year before and after index date. Propensity score matching (PSM) was applied to reduce selection bias. Adherence was defined as proportion of days covered: non-adherence, <40%; partial adherence, 40-79%, and adherence ≥80%. Mortality incidence and CV events as single, or composite, endpoints were evaluated after first year of follow-up. Healthcare cost analyses were performed from the perspective of the Italian National Health Service. RESULTS Following PSM, the single-pill cohort included 12 150 patients, and the multiple-pill cohort, 6105. The SPC cohort had a significantly higher percentage of adherent patients vs. the multiple-pill cohort (59.9% vs. 26.9%, P < 0.001). Following the first year of follow-up, incidence of all-cause mortality, and combined endpoint of all-cause mortality and CV events were lower in the SPC cohort compared with multiple-pill cohort. Average annual direct healthcare costs were lower in the single-pill cohort (€2970) vs. multiple-pill cohort (€3642); cost of all drugs and all-cause hospitalizations were major contributors. CONCLUSION The SPC of PER/IND/AML, compared with multiple-pill combination, is associated with higher adherence to medication, lower incidence of CV events and mortality, and reduced healthcare costs.
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Affiliation(s)
- Jacques R. Snyman
- Forte Research (Pty ltd) and Private Practice South Africa, Pretoria, South Africa
| | | | - Luca Degli Esposti
- CliCon S.r.l., Società Benefit-Health, Economics & Outcomes Research, Bologna, Italy
| | | | | | - Valentina Perrone
- CliCon S.r.l., Società Benefit-Health, Economics & Outcomes Research, Bologna, Italy
| | - Claudio Borghi
- University of Bologna, IRCCS Ospedale S. Orsola, Bologna, Italy
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Jayagopal PB, Shah B, Bharti BB, Vidhyadharan J, Upendra G. Applicability of the OPTA Questionnaire for Patients with Stable Ischemic Heart Disease in Indian Clinical Practice: A Cross-sectional, Real-word Evidence Study. J Assoc Physicians India 2023; 71:11-12. [PMID: 37449684 DOI: 10.59556/japi.71.0284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 07/18/2023]
Abstract
BACKGROUND Angina is the symptomatic form of stable ischemic heart disease (SIHD). The OPtimal Treatment of Angina (OPTA) questionnaire was developed and validated to overcome the lack of a standardized and accurate tool to assess patients' clinical conditions with SIHD. This study aimed to understand the applicability of OPTA in patients with SIHD in routine clinical practice in India. MATERIALS AND METHODS In this cross-sectional, single-visit study, 344 patients with SIHD were enrolled. Study endpoints were physicians' agreement on the applicability of OPTA, the usefulness of OPTA in assessing degree of impairment in daily activities of patients, and its positive predictive value (PPV). RESULTS All enrolled patients completed the study. The mean [standard deviation (SD)] age was 56.6 (10.77) years, with a majority of patients being male (69.5%) and on antianginal treatment for >1 year (80.4%). Physicians of all participating patients agreed that the OPTA questionnaire could accurately assess whether treatment received by patients was optimal (100% agreement rate). No or moderate degree of impairment of daily activities was reported by 93.9% and 73.0% of patients for one and two health-related questions, respectively. The PPV and sensitivity of the questionnaire were 88.97% [confidence interval (CI): 87.58%, 90.22%] and 39.33% (CI: 34.01%, 44.85%), respectively. CONCLUSION The OPTA questionnaire showed good agreement regarding health status between physicians and patients and could be used to periodically assess and guide clinical judgment in the management of SIHD in India. Further assessment of the impact of various treatments temporally and in the long term may be warranted.
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Affiliation(s)
- P B Jayagopal
- Senior Interventional Cardiologist, Department of Cardiology, Lakshmi Hospital, Palakkad, Kerala; Corresponding Author
| | - Bhupesh Shah
- Department of Cardiology, Harshal Cardiovascular Clinic, Ahmedabad, Gujarat
| | | | - Jayapal Vidhyadharan
- Department of Cardiology, Hridayalaya Heart Foundation, Thiruvananthapuram, Kerala
| | - Greeshma Upendra
- Established Pharmaceuticals Division, Abbott Healthcare India Pvt Ltd, Mumbai, Maharashtra, India
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Jabir A, Geevar Zachariah, Mohanan PP, Gupta MD, Ramakrishnan S, Meena CB, Sridhar L, Girish MP, Das DR, Gupta A, Praveen Nagula, Tom Devasia, Bhavesh Vajifdar, Kamlesh Thakkar, Urmil Shah, Tanuj Bhatia, Smit Srivastava, Sanjeev Sharma, Priya Kubendiran, Jayagopal PB, Sudeep Kumar, Deepthy Sadanandan, Lincy Mathew, Nitish Naik, Anup Banerji, Ashraf SM, Asokan PK, Bharti BB, Majumder B, Dhiman Kahali, Sinha DP, Sharma D, Dastidar DG, Dipankar Mukhapdhyay, Wander GS, Bali HK, Kesavamoorthy B, Agarwala MK, Khanna NN, Natesh BH, Goel PK, Chakraborty RN, Jain RK, Rakesh Yadav, Sameer Dani L, Satyavan Sharma, Satyendra Tewari, Sethi KK, Sharad Chandra, Mandal S, Bhandari S, Sikdar S, Vivek Gupta, Rath PC, Bang VH, Debabrata Roy, Das MK, Banerjee PS. COVID-19 infected ST-Elevation myocardial infarction in India (COSTA INDIA). Indian Heart J 2023; 75:243-250. [PMID: 37230465 PMCID: PMC10204278 DOI: 10.1016/j.ihj.2023.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 05/09/2023] [Accepted: 05/21/2023] [Indexed: 05/27/2023] Open
Abstract
OBJECTIVE To find out differences in the presentation, management and outcomes of COVID-19 infected STEMI patients compared to age and sex-matched non-infected STEMI patients treated during the same period. METHODS This was a retrospective multicentre observational registry in which we collected data of COVID-19 positive STEMI patients from selected tertiary care hospitals across India. For every COVID-19 positive STEMI patient, two age and sex-matched COVID-19 negative STEMI patients were enrolled as control. The primary endpoint was a composite of in-hospital mortality, re-infarction, heart failure, and stroke. RESULTS 410 COVID-19 positive STEMI cases were compared with 799 COVID-19 negative STEMI cases. The composite of death/reinfarction/stroke/heart failure was significantly higher among the COVID-19 positive STEMI patients compared with COVID-19 negative STEMI cases (27.1% vs 20.7% p value = 0.01); though mortality rate did not differ significantly (8.0% vs 5.8% p value = 0.13). Significantly lower proportion of COVID-19 positive STEMI patients received reperfusion treatment and primary PCI (60.7% vs 71.1% p value=< 0.001 and 15.4% vs 23.4% p value = 0.001 respectively). Rate of systematic early PCI (pharmaco-invasive treatment) was significantly lower in the COVID-19 positive group compared with COVID-19 negative group. There was no difference in the prevalence of high thrombus burden (14.5% and 12.0% p value = 0.55 among COVID-19 positive and negative patients respectively) CONCLUSIONS: In this large registry of STEMI patients, we did not find significant excess in in-hospital mortality among COVID-19 co-infected patients compared with non-infected patients despite lower rate of primary PCI and reperfusion treatment, though composite of in-hospital mortality, re-infarction, stroke and heart failure was higher.
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Affiliation(s)
| | | | | | | | | | | | - L Sridhar
- Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore, Karnataka, India.
| | | | | | | | | | - Tom Devasia
- Kasturba Medical College Manipal, Karnataka, India.
| | - Bhavesh Vajifdar
- Lilavati Hospital and Research Centre, Mumbai, Maharashtra, India
| | | | | | | | - Smit Srivastava
- Dr Bhim Rao Ambedhkar Memorial Hospital, Raipur, Chhattisgarh, India.
| | | | - Priya Kubendiran
- G Kuppuswamy Naidu Memorial Hospital, Coimbatore, Tamil Nadu, India.
| | | | - Sudeep Kumar
- Sanjay Gandhi Postgraduate of Medical Sciences, Lucknow, Uttar Pradesh, India.
| | | | | | - Nitish Naik
- All India Institute of Medical Sciences, Delhi, India.
| | - Anup Banerji
- Medica Superspeciality Hospital, Kolkata, West Bengal, India.
| | - S M Ashraf
- Government Medical College, Kannur, Kerala, India.
| | - P K Asokan
- Fathima Hospital, Kozhikode, Kerala, India.
| | | | | | - Dhiman Kahali
- B M Birla Heart Research Centre, Kolkata, West Bengal, India.
| | | | - Dipak Sharma
- Christian Medical Centre Hospital, Jorht, Assam, India.
| | | | | | | | | | - B Kesavamoorthy
- Meenakshi Multispeciality Hospital, Trichy, Tamil Nadu, India.
| | | | | | - B H Natesh
- Sri Jayadeva Institute of Cardiovascular Science and Research, Bengaluru, Karnataka, India.
| | | | | | | | | | - L Sameer Dani
- Apollo CVHF Heart Institute, Ahmedabad, Gujarat, India.
| | | | - Satyendra Tewari
- Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
| | - K K Sethi
- Delhi Heart and Lung Institute, New Delhi, India.
| | - Sharad Chandra
- King George Medical University, Lucknow, Uttar Pradesh, India.
| | - Subrato Mandal
- Ubuntu Heart and Superspeciality Hospital, Bhopal, Madhya Pradesh, India.
| | | | | | | | | | | | - Debabrata Roy
- N H Rabindranatha Tagore International Institute of Cardiac Sciences, Kolkata, West Bengal, India.
| | - Mrinal Kanti Das
- The Calcutta Medical Research Institute, Kolkata, West Bengal, India.
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Borghi C, Jayagopal PB, Konradi A, Bortolotto LA, Degli Esposti L, Perrone V, Snyman JR. Adherence to Triple Single-Pill Combination of Perindopril/Indapamide/Amlodipine: Findings from Real-World Analysis in Italy. Adv Ther 2023; 40:1765-1772. [PMID: 36829102 PMCID: PMC10070199 DOI: 10.1007/s12325-023-02451-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 02/01/2023] [Indexed: 02/26/2023]
Abstract
INTRODUCTION Single-pill combination therapy for hypertension is recognized to improve adherence to treatment. However, less is known about the benefits of triple single-pill combinations. This retrospective observational analysis aimed to assess changes in adherence when treatment was switched from perindopril (PER)/indapamide (IND) + amlodipine (AML) to PER/IND/AML single-pill combination, in Italian clinical practice. METHODS This analysis used data extracted from administrative databases of Italian healthcare entities. Adult patients receiving PER/IND/AML were selected, and the prescription date was considered as the index date. Among them, those who had a prescription for PER/IND + AML during the 12 months before the index date and a prescription of PER/IND/AML during 6 months of follow-up were included. Adherence was calculated as the proportion of days covered (PDC: PDC < 40%, non-adherent; PDC = 40-79%, partially adherent; PDC ≥ 80%, adherent). RESULTS Among the identified patients, 158 were exposed users and were included in the analysis. When patients were compared before and after switch to triple single-pill combination, the proportion of adherent patients was significantly higher with PER/IND/AML single-pill combination (75.3%) than with PER/IND + AML combination (44.3%) (P < 0.05). Conversely, the proportion of non-adherent patients was lower with the PER/IND/AML single-pill combination (14.6%) vs PER/IND + AML (17.7%) (P < 0.001). CONCLUSION This real-world analysis showed that switching to a triple single-pill combination could offer an opportunity to improve adherence to antihypertensive treatment in real-life clinical practice.
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Affiliation(s)
- Claudio Borghi
- University of Bologna, IRCCS Ospedale S. Orsola, Bologna, Italy.
| | | | - Alexandra Konradi
- Almazov National Medical Research Center, St. Petersburg, Russian Federation
| | | | - Luca Degli Esposti
- CliCon S.r.l, Società Benefit-Health, Economics and Outcomes Research, Bologna, Italy
| | - Valentina Perrone
- CliCon S.r.l, Società Benefit-Health, Economics and Outcomes Research, Bologna, Italy
| | - Jacques R Snyman
- Forte Research (Pty Ltd) and Private Practice, Pretoria, South Africa
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Chopra HK, Nair T, Ponde CK, Kaul S, Mehta Y, Vora A, Mukhopadhyay P, Jayagopal PB, Behera M, Patil R, Deshpande M, Anantharaman R. COVID-Inflicted Coagulopathy: Expert Consensus on Management with Novel Oral Anticoagulants in India. J Assoc Physicians India 2022; 69:11-12. [PMID: 35057603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Coronavirus disease 2019 (COVID-19) is a highly hypercoagulable viral infection complicated as COVID-inflicted coagulopathy (CIC), that is associated with increased risk of morbidity and mortality. International guidelines recommend low molecular weight heparin (LMWH) to treat CIC in both in-hospital and in-home settings. However, in India, using subcutaneous LMWH may not be a feasible option for a vast majority of patients under home management. Additionally, while some evidence advocates the use of novel oral anticoagulants (NOACs), in hospitalized settings, most guidelines find no role of NOACs in hospital settings. On the other hand, the resource crunch faced in recent COVID-19 pandemic in India forced physicians to treat many patients in home settings. These patients had been usually prescribed NOACs for ease of administration and adherence. Therefore, there is a need to form a consensus on the use of NOACs to manage CIC in India.
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Affiliation(s)
- H K Chopra
- Senior Consultant Cardiologist, Medanta: Moolchand Heart Institute, New Delhi
| | - Tiny Nair
- Head and Chief Consultant, Cardiology, PRS Hospital, Trivandrum, Kerala
| | - C K Ponde
- Consultant Cardiologist and Head of Department, Dept. of Cardiology, P.D. Hinduja National Hospital, Mumbai, Maharashtra
| | - Subhash Kaul
- Senior Consultant Neurologist, Krishna Institute (KIMS), Secunderabad, Telangana
| | - Yatin Mehta
- Chairman, Institute of Critical Care and Anaesthesiology, Medanta, The Medcity, Gurugram, Haryana
| | - Agam Vora
- Medical Director, Vora Clinic, Mumbai, Maharashtra; Corresponding Author
| | - Pinaki Mukhopadhyay
- Associate Professor and Head, Department of Nephrology, NRS Medical College & Hospital in Kolkata, West Bengal
| | - P B Jayagopal
- Director & Interventional Cardiologist, Lakshmi Hospital, Chittur Road, Palakkad, Kerala
| | - Mrutyunjay Behera
- Senior Consultant and Interventional Cardiologist, Kaliga Hospital and Aswini Hospital, Cuttack, Odisha
| | - Rahul Patil
- Senior Consultant Cardiologist, Ruby Hall Clinic, Pune, Maharashtra
| | - Mahesh Deshpande
- Consultant Interventional Cardiologist, Dr. Hedgewar Hospital, Aurangabad, Maharashtra
| | - R Anantharaman
- Consultant Endocrinologist & Diabetologist, Magna Centres For Obesity, Diabetes & Endocrinology, Bangalore, Karnataka
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Jadhav U, Nair T, Jayagopal PB, Pinto B, Srivastava S, Sahoo PK, Davidson D. Validation of the OPtimal Treatment of Angina (OPTA) Questionnaire in Indian Patients with Chronic Stable Angina. J Assoc Physicians India 2021; 69:11-12. [PMID: 34585888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
BACKGROUND A rising burden of coronary artery disease (CAD) in India is a major cause of concern, with angina being the leading manifestation. Hence a questionnaire to sensitize the clinicians about stable angina management and to assist in risk stratification is imperative. OBJECTIVE To evaluate the content and face validity of a modified questionnaire adapted from the 7-item Seattle Angina Questionnaire (SAQ). MATERIALS AND METHODS A panel of six experts in the field of evidence-based practice reviewed and rated the modified instrument for content clarity and relevance based on the 4-point ordinal scale. Face validity was assessed based on the trichotomous rating of "disagreed", "agree" or "neutral". Items on which ≥75% of patients "disagreed" were subjected to further review and revision. RESULTS A total of six experts and 51 patients participated in the content and face validity, respectively. As no question received a score ≤2 by two or more experts for either content clarity or relevance, no modification in the questionnaire was required post content validation. During face validation, all patients agreed that the questions correctly measured the specific area of cardiovascular health status and response options correctly captured the answers provided. Demographic and baseline data of the patients were collected. CONCLUSION The newly developed 5-item questionnaire demonstrated content and face validity, suggesting it to be a potential instrument to improve management decision and care of angina patients in India.
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Affiliation(s)
- Uday Jadhav
- Consultant In Cardiology And CV Imaging, MGM New Bombay Hospital and Hon. Professor MGM University of Health Sciences Navi Mumbai, Maharashtra; Corresponding Author
| | - Tiny Nair
- Department of Cardiology, PRS Hospital, Trivandrum, Kerala
| | - P B Jayagopal
- Department of Cardiology, Laxmi Hospital, Palakkad, Kerala
| | - Brian Pinto
- Department of Cardiology, Holy Family Hospital, Mumbai, Maharashtra
| | - Sameer Srivastava
- Department of Non Invasive Cardiology, Fortis Escort Heart Institute, New Delhi
| | - Prasant Kr Sahoo
- Department of Interventional Cardiology, Apollo Hospital, Bhubaneshwar, Odisha
| | - Deepak Davidson
- Department of Interventional Cardiology, Caritas Heart Institute, Kottayam, Kerala
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7
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Zachariah G, Ramakrishnan S, Das MK, Jabir A, Jayagopal PB, Venugopal K, Mani K, Khan AK, Malviya A, Gupta A, Goyal A, Singh BP, Mohan B, Bharti BB, Majumder B, Wilson B, Karunadas CP, Meena CB, Manjunath CN, Cibu M, Roy D, Choudhary D, Das DR, Sarma D, Girish MP, Wander GS, Wardhan H, Ezhilan J, Tummala K, Katyal VK, Goswami K, Subramanyam K, Goyal KK, Kumar K, Pathak LA, Bansal M, Mandal M, Gupta MD, Khanna NN, Hanumanthappa NB, Bardoloi N, Modi N, Naik N, Hasija PK, Kerkar P, Bhattacharyya PJ, Gadkari P, Chakraborthy RN, Patil RR, Gupta R, Yadav R, Murty RS, Nath RK, Sivakumar R, Sethi R, Baruah R, Tyagi S, Guha S, Krishnappa S, Kumar S, Routray SN, Tewari S, Ray S, Reddy SS, Chandra S, Gupta SB, Chatterjee SS, Siddiqui KKH, Sivabalan M, Yerram S, Kumar S, Nagarajan S, Devasia T, Jadhav U, Narain VS, Garg VK, Gupta VK, Prabhakaran D, Deb PK, Mohanan PP. Changing pattern of admissions for acute myocardial infarction in India during the COVID-19 pandemic. Indian Heart J 2021; 73:413-423. [PMID: 34474751 PMCID: PMC8424286 DOI: 10.1016/j.ihj.2021.06.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 06/08/2021] [Accepted: 06/09/2021] [Indexed: 02/07/2023] Open
Abstract
AIM Studies on the changes in the presentation and management of acute myocardial infarction (AMI) during the COVID-19 pandemic from low- and middle-income countries are limited. We sought to determine the changes in the number of admissions, management practices, and outcomes of AMI during the pandemic period in India. METHODS & RESULTS In this two-timepoint cross-sectional study involving 187 hospitals across India, patients admitted with AMI between 15th March to 15th June in 2020 were compared with those admitted during the corresponding period of 2019. We included 41,832 consecutive adults with AMI. Admissions during the pandemic period (n = 16414) decreased by 35·4% as compared to the corresponding period in 2019 (n = 25418). We observed significant heterogeneity in this decline across India. The weekly average decrease in AMI admissions in 2020 correlated negatively with the number of COVID cases (r = -0·48; r2 = 0·2), but strongly correlated with the stringency of lockdown index (r = 0·95; r2 = 0·90). On a multi-level logistic regression, admissions were lower in 2020 with older age categories, tier 1 cities, and centers with high patient volume. Adjusted utilization rate of coronary angiography, and percutaneous coronary intervention decreased by 11·3%, and 5·9% respectively. CONCLUSIONS The magnitude of reduction in AMI admissions across India was not uniform. The nature, time course, and the patient demographics were different compared to reports from other countries, suggesting a significant impact due to the lockdown. These findings have important implications in managing AMI during the pandemic.
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Affiliation(s)
| | | | | | | | | | | | - Kalaivani Mani
- Dept. of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
| | | | - Amit Malviya
- Department of Cardiology, North Eastern Indira Gandhi Regional Institute of Health & Medical Sciences, Shillong, Meghalaya, India
| | | | | | - B P Singh
- Department of Cardiology, Indra Gandhi Institute of Medical Sciences, Patna, India
| | | | | | | | | | | | | | | | | | - Debabrata Roy
- Rabindranath Tagore International Institute of Cardiac Sciences, Kolkata, India
| | | | | | - Dipak Sarma
- Christian Medical Centre Hospital, Jorhat, India
| | | | | | - Harsh Wardhan
- Mahatma Gandhi Medical College and Hospital, Jaipur, India
| | | | | | - Virender Kumar Katyal
- Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India
| | - Kewal Goswami
- All India Institute of Medical Sciences, New Delhi, India
| | | | | | | | | | | | - Manoranjan Mandal
- Department of Cardiology, Nil Ratan Sircar Medical College, Kolkata, India
| | | | | | | | | | | | - Nitish Naik
- All India Institute of Medical Sciences, New Delhi, India
| | | | | | | | | | | | | | | | - Rakesh Yadav
- All India Institute of Medical Sciences, New Delhi, India
| | | | | | | | - Rishi Sethi
- King George Medical University, Lucknow, India
| | | | - Sanjay Tyagi
- Department of Cardiology, GB Pant Hospital, New Delhi, India
| | | | - Santhosh Krishnappa
- Cardiology Department, Sri Jayadeva Institute of Cardiovascular Science and Research, Mysore, India
| | | | - Satya Narayan Routray
- Department of Cardiology, Srirama Chandra Bhanja Medical College and Hospital, Odissa, India
| | - Satyendra Tewari
- Department of Cardiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - Saumitra Ray
- Vivekananda Institute of Medical Sciences, Kolkata, India
| | | | | | | | | | | | | | - Sreekanth Yerram
- Department of Cardiology, Nizam's Institute of Medical Science, Hyderabad, India
| | - Sudeep Kumar
- Department of Cardiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | | | | | - Uday Jadhav
- Consultant in Cardiology Department, MGM New Bombay Hospital, Mumbai, India
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Jayagopal PB, Abdullakutty J, Sridhar L, Nanjappa V, Joseph J, Vaidyanathan PR, Somasekhar G, Raghu TR, Srinivas BC, Chopra VK, Manjunath CN. Acute decompensated heart failure (ADHF) during COVID-19 pandemic-insights from South India. Indian Heart J 2021; 73:464-469. [PMID: 34474759 PMCID: PMC8256338 DOI: 10.1016/j.ihj.2021.06.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 03/18/2021] [Accepted: 06/27/2021] [Indexed: 02/07/2023] Open
Abstract
AIM This retrospective study compares admissions and outcomes due to acute decompensated heart failure (ADHF) during the COVID-19 pandemic from 25 March to 25 July 2020 with the historical patient control who were admitted during the same period in 2019. METHODS AND RESULTS Data of the participating hospitals was collected and analysed from the ICC NHFR (Indian College of Cardiology National Heart Failure Registry) for 2019 and 2020. Total number of ADHF admissions, demographics, aetiology, co-morbid conditions and in-hospital mortality was compared and analysed. A significant decrease in the number of hospital admissions due to ADHF from 2019 to 2020 (1056 vs. 526 respectively) was noted. Incidence of admissions with <40% ejection fraction (EF) reduced in 2020 (72.4% and 80.2% in2020 and 2019)and >40% (EF) increased (27.6% and 19.8% in 2019 and 2020 respectively, p = 0.0005). Ischemic heart disease (IHD) was the most common aetiology (78.59% in 2019 and 80.98% in 2020, p = 0.268). The in-hospital mortality was numerically higher in 2020 (10%) than in 2019 (8%), but not statistically significant (p = 0.161). CONCLUSION This study from the registry shows that the incidence of ADHF admissions during COVID-19 lockdown significantly reduced compared to the previous year. Demographic patterns remained similar but patients presenting with de-novo HF increased; IHD was the most common cause. The in-hospital mortality was numerically higher during the lockdown. The impact of lockdown perhaps led to fewer hospitalisations and this is to be factored in future strategies to address health care delivery during such crises.
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Affiliation(s)
| | | | - L Sridhar
- Sri Jayadeva Institute of Cardiovascular Science and Research, Bengaluru, India
| | - Veena Nanjappa
- Sri Jayadeva Institute of Cardiovascular Sciences & Research, Mysuru, Karnataka, India
| | | | - P R Vaidyanathan
- Kuppuswami Naidu Memorial Hospital, Coimbatore, Tamil Nadu, India
| | - G Somasekhar
- Aayush Hospitals, Vijayawada, Andhra Pradesh, India
| | - T R Raghu
- Rajarajeshwari Medical College, Kambipura, Mysore Road, Bangalore, India
| | - B C Srinivas
- Sri Jayadeva Institute of Cardiovascular Science and Research, Bengaluru, Karnataka, India
| | - V K Chopra
- Heart Failure Programme and Research, Max Super Specialty Hospital, Saket, New Delhi, India
| | - C N Manjunath
- Sri Jayadeva Institute of Cardiovascular Science and Research, Bengaluru, Karnataka, India
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Bahuleyan CG, Namboodiri N, Jabir A, Lip GYH, Koshy A G, Shifas BM, Viswanathan S K, Zachariah G, Venugopal K, Punnose E, Natarajan KU, Mini GK, Joseph J, Nambiar C A, Jayagopal PB, Mohanan PP, George R, Unni G, Sajeev CG, Muhammed S, Syam N, Roby A, Daniel R, Krishnakumar VV, Pillai AM, Joseph S, Jinbert Lordson A. One-year clinical outcome of patients with nonvalvular atrial fibrillation: Insights from KERALA-AF registry. Indian Heart J 2020; 73:56-62. [PMID: 33714410 PMCID: PMC7961260 DOI: 10.1016/j.ihj.2020.11.152] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 11/04/2020] [Accepted: 11/29/2020] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND We report patient characteristics, treatment pattern and one-year clinical outcome of nonvalvular atrial fibrillation (NVAF) from Kerala, India. This cohort forms part of Kerala Atrial Fibrillation (KERALA-AF) registry which is an ongoing large prospective study. METHODS KERALA-AF registry collected data of adults with previously or newly diagnosed atrial fibrillation (AF) during April 2016 to April 2017. A total of 3421 patients were recruited from 53 hospitals across Kerala state. We analysed one-year follow-up outcome of 2507 patients with NVAF. RESULTS Mean age at recruitment was 67.2 years (range 18-98) and 54.8% were males. Main co-morbidities were hypertension (61.2%), hyperlipidaemia (46.2%) and diabetes mellitus (37.2%). Major co-existing diseases were chronic kidney disease (42.1%), coronary artery disease (41.6%), and chronic heart failure (26.4%). Mean CHA2DS2-VASc score was 3.18 (SD ± 1.7) and HAS-BLED score, 1.84 (SD ± 1.3). At baseline, use of oral anticoagulants (OAC) was 38.6% and antiplatelets 32.7%. On one-month follow-up use of OAC increased to 65.8% and antiplatelets to 48.3%. One-year all-cause mortality was 16.48 and hospitalization 20.65 per 100 person years. The main causes of death were cardiovascular (75.0%), stroke (13.1%) and others (11.9%). The major causes of hospitalizations were acute coronary syndrome (35.0%), followed by arrhythmia (29.5%) and heart failure (8.4%). CONCLUSIONS Despite high risk profile of patients in this registry, use of OAC was suboptimal, whereas antiplatelets were used in nearly half of patients. A relatively high rate of annual mortality and hospitalization was observed in patients with NVAF in Kerala AF Registry.
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Affiliation(s)
- C G Bahuleyan
- Cardiovascular Centre, Ananthapuri Hospitals and Research Institute, Trivandrum, India.
| | - Narayanan Namboodiri
- Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India
| | - A Jabir
- Lisie Heart Institute, Ernakulam, India
| | - Gregory Y H Lip
- Liverpool Centre for Cardiovascular Science, University of Liverpool, United Kingdom; Liverpool Heart & Chest Hospital, Liverpool, United Kingdom; Aalborg Thrombosis Research Unit, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - George Koshy A
- Medical College Hospital, Trivandrum, India 8Global Institute of Public Health, 6. Cardiovascular Centre, Ananthapuri Hospitals and Research Institute, Trivandrum, India
| | - Babu M Shifas
- Cardiovascular Centre, Ananthapuri Hospitals and Research Institute, Trivandrum, India
| | - Kartik Viswanathan S
- Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India
| | | | - K Venugopal
- Pushpagiri Medical College, Thiruvalla, India
| | | | - K U Natarajan
- Amrita Institute of Medical Sciences, Ernakulam, India
| | - G K Mini
- Global Institute of Public Health, Trivandrum, Kerala, India
| | | | | | | | - P P Mohanan
- West Fort Hi-Tech Hospital, Ponkunam, Thrissur, India
| | - Raju George
- Government Medical College Hospital, Kottayam, India
| | | | - C G Sajeev
- Government Medical College Hospital, Calicut, India
| | | | - N Syam
- General Hospital, Kollam, India
| | - Anil Roby
- Dr Damodaran Memorial Hospital, Kollam, India
| | - Rachel Daniel
- N S Memorial Institute of Medical Sciences, Kollam, India
| | - V V Krishnakumar
- Cardiovascular Centre, Ananthapuri Hospitals and Research Institute, Trivandrum, India
| | - Anand M Pillai
- Cardiovascular Centre, Ananthapuri Hospitals and Research Institute, Trivandrum, India
| | - Stigi Joseph
- Little Flower Hospital, M C Road, Angamali, India
| | - A Jinbert Lordson
- Cardiovascular Centre, Ananthapuri Hospitals and Research Institute, Trivandrum, India; Global Institute of Public Health, Trivandrum, Kerala, India
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10
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Ramakrishnan S, Jabir A, Jayagopal PB, Mohanan PP, Nair VK, Das MK, Mandal M, Roy D, Reddy SS, Malviya A, Singh BP, Bharti BB, Majumder B, Karunadas CP, Meena CB, Girish MP, Ezhilan J, Tummala K, Katyal VK, Subramanyam K, Goyal KK, Kenchappa K, Gupta MD, Hanumanthappa NB, Bardoloi N, Modi N, Bhattacharyya PJ, Gadkari P, Patil RR, Murty RS, Baruah R, Krishnappa S, Kumar S, Routray S, Tewari S, Gupta SB, Maduramuthu S, Yerram S, Kumar S, Jadhav U, Manjunath CN, Prabhakaran D, Kerker P, Yadav R, Guha S, Deb PK, Zachariah G. Pattern of acute MI admissions in India during COVID-19 era: A Cardiological Society of India study - Rationale and design. Indian Heart J 2020; 72:541-546. [PMID: 33357642 PMCID: PMC7476577 DOI: 10.1016/j.ihj.2020.09.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 09/02/2020] [Indexed: 02/07/2023] Open
Abstract
Background COVID-19 pandemic has affected around 20million patients worldwide and 2.0 million cases from India. The lockdown was employed to delay the pandemic. However, it had an unintentional impact on acute cardiovascular care, especially acute myocardial infarction (AMI). Observational studies have shown a decrease in hospital admissions for AMI in several developed countries during the pandemic period. We aimed to evaluate the impact of COVID-19 on the AMI admissions patterns across India. Methods In this multicentric, retrospective, cross-sectional study, we included all AMI cases admitted to participating hospitals during the study period 15th March to 15th June 2020 and compared them using a historical control of all cases of AMI admitted during the corresponding period in the year 2019. Major objective of the study is to analyze the changes inthe number of hospital admissions for AMI in hospitals across India. In addition, we intend to evaluate the impact of COVID-19 on the weekly AMI admission rates, and other performance measures like rates of thrombolysis/primary percutaneous interventions (PCI), window period, door to balloon time, and door to needle time. Other objectives include evaluation of changes in the major complications and mortality rates of AMI and its predictors during COVID-19 pandemic. Conclusions This CSI-AMI study will provide scientific evidence about the impact of COVID-19 on AMI care in India. Based on this study, we may be able to suggest appropriate changes to the existing MI guidelines and to educate the public regarding emergency care for AMI during COVID-19 pandemic.
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Affiliation(s)
| | | | | | | | | | | | - Manoranjan Mandal
- Department of Cardiology, Nil Ratan Sircar Medical College, Kolkatta, West Bengal, India
| | - Debabrata Roy
- Rabindranath Tagore International Institute of Cardiac Sciences, Kolkata, West Bengal, India
| | | | - Amit Malviya
- Department of Cardiology, North Eastern Indira Gandhi Regional Institute of Health & Medical Sciences, Shillong, Meghalaya, India
| | | | | | - Biswajit Majumder
- Department of Cardiology, RG Kar Medical College, Kolkata, West Bengal, India
| | | | | | | | | | | | - Virender Kumar Katyal
- Department of Medicine Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India
| | | | | | | | | | | | | | - Nitin Modi
- Convenient Hospitals Ltd, Indore, Madhya Pradesh, India
| | | | - Pushkraj Gadkari
- Srikrishna Hrudayalaya & Critical Care Centre, Nagpur, Maharashtra, India
| | | | | | | | - Santhosh Krishnappa
- Sri Jayadeva Institute of Cardiovascular Science and Research, Mysore, Karnataka, India
| | | | - Satyanarayan Routray
- Department of Cardiology, Srirama Chandra Bhanja Medical College and Hospital, Odissa, India
| | - Satyendra Tewari
- Department of Cardiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Shashi Bhushan Gupta
- Asian Heart Institute & Ex-HOD, Medicine and Cardiology, C Rly HQ Hospital, Mumbai, Maharashtra, India
| | | | - Sreekanth Yerram
- Department of Cardiology, Nizam's Institute of Medical Science, Hyderabad, Telangana, India
| | - Sudeep Kumar
- Department of Cardiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Uday Jadhav
- MGM New Bombay Hospital, Mumbai, Maharashtra, India
| | | | - Dorairaj Prabhakaran
- Centre for Chronic Disease Control, & Vice President, Public Health Foundation of India, Gurugram, India
| | - Prafulla Kerker
- Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India
| | - Rakesh Yadav
- All India Institute of Medical Sciences, New Delhi, India
| | - Santanu Guha
- Calcutta Medical College Hospital, Kolkata, West Bengal, India
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11
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Khan MY, Pandit S, Jayagopal PB, Oomman A, Chockalingam KC, Ramakrishnan A, Mane A, Mehta S, Shah S. Effectiveness of Olmesartan on Blood Pressure Control in Hypertensive Patients in India: A Real World, Retrospective, Observational Study from Electronic Medical Records. J Assoc Physicians India 2020; 68:66-72. [PMID: 32738844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
BACKGROUND Real-world data on the effectiveness of antihypertensive drugs (AHDs) in India is limited. The present study aims to provide updated evidence regarding the effectiveness of olmesartan as monotherapy or in combination with other AHDs in Indian patients with essential hypertension. METHODS Electronic medical record data of adult patients who were diagnosed with essential hypertension (≥140/90 mmHg) and were prescribed olmesartan as mono- or add-on therapy were retrospectively analyzed. Patients were classified based on the number of AHD classes prescribed on initiation of olmesartan. Change in systolic and diastolic blood pressure (SBP and DBP) from baseline was the primary endpoint. Secondary endpoint was evaluation of proportion of patients who achieved treatment goals as per 2018 European Society of Cardiology/European Society of Hypertension guidelines. Readings were obtained before initiating olmesartan and after at least a month of therapy with olmesartan. RESULTS Among the 459 included patients, majority were on olmesartan monotherapy or olmesartan+1AHD (91.7%). Mean (95% confidence interval [CI]) change in olmesartan monotherapy group was: SBP (-13.4 [-15.7, -11.1] mmHg) and DBP (-8.3 [-9.5, -7.1] mmHg) and mean (95% CI) change in olmesartan+1AHD group was: SBP (-11.7 [-15.1, -8.3] mmHg) and DBP (-6.6 [-8.3, -4.9] mmHg) (P<0.001 for all). SBP and DBP goals were achieved by 40.4% and 50.3% of patients on olmesartan monotherapy and by 36.1% and 46.2% of patients on olmesartan+1AHD. Among patients with comorbid diabetes, mean (95% CI) change in olmesartan monotherapy group was: SBP (-15.5 [-18.6, -12.4] mmHg) and DBP (-8.7 [-10.2, -7.2] mmHg) and mean (95% CI) change in olmesartan+1AHD group was: SBP (-13.5 [-18.3, -8.7] mmHg) and DBP (-7.6 [-9.8, -5.4] mmHg) (P<0.001 for all). SBP and DBP goals were achieved by 38.5% and 49.4% of patients on olmesartan monotherapy and by 31.7% and 42.9% of patients on olmesartan+1AHD. CONCLUSION Olmesartan prescribed as mono- or add-on therapy during routine clinical practice significantly reduced blood pressure in Indian patients with essential hypertension as well as in patients with comorbid diabetes.
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Affiliation(s)
| | | | | | | | | | | | - Amey Mane
- Dr. Reddy's Laboratories Ltd, Hyderabad, Telangana
| | - Suyog Mehta
- Dr. Reddy's Laboratories Ltd, Hyderabad, Telangana
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12
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Gupta R, Das MK, Mohanan PP, Deb PK, Parashar SK, Chopra HK, Shrivastava S, Guha S, Goswami KC, Yadav R, Alagesan R, Amuthan V, Bansal M, Chakraborty RN, Chakraborti N, Chandra S, Chatterjee A, Chatterjee D, Chatterjee SS, Dutta AL, De A, Garg A, Garg VK, Goyal A, Goyal NK, Govind SC, Gupta VK, Hasija PK, Jabir A, Jain P, Jain V, Jayagopal PB, Kasliwal RR, Katyal VK, Kerkar PG, Khan AK, Khanna NN, Mandal M, Majumder B, Mishra SS, Meena CB, Naik N, Narain VS, Pancholia AK, Pathak LA, Ponde CK, Raghu K, Ray S, Roy D, Sarma D, Shanmugasundarum S, Singh BP, Tyagi S, Vijayaraghavan G, Wander GS, Wardhan H, Nanda NC. Cardiological society of India document on safety measure during echo evaluation of cardiovascular disease in the time of COVID-19. Indian Heart J 2020; 72:145-150. [PMID: 32768012 PMCID: PMC7250084 DOI: 10.1016/j.ihj.2020.05.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 05/15/2020] [Accepted: 05/19/2020] [Indexed: 01/08/2023] Open
Abstract
An echocardiographic investigation is one of the key modalities of diagnosis in cardiology. There has been a rising presence of cardiological comorbidities in patients positive for COVID-19. Hence, it is becoming extremely essential to look into the correct safety precautions, healthcare professionals must take while conducting an echo investigation. The decision matrix formulated for conducting an echocardiographic evaluation is based on presence or absence of cardiological comorbidity vis-à-vis positive, suspected or negative for COVID-19. The safety measures have been constructed keeping in mind the current safety precautions by WHO, CDC and MoHFW, India.
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Affiliation(s)
- Rakesh Gupta
- JROP Institute of Echocardiography, Ultrasound & Vascular Doppler, JROP Healthcare Pvt. Ltd., C-1/16, Ashok Vihar-II, Delhi, 110052, India; JROP Charak Heart City, MD City Hospital, Model Town Northex, Delhi, 110009, India.
| | - Mrinal Kanti Das
- C K Birla Group of Hospitals (BMB and CMRI), Kolkata, West Bengal, India
| | - P P Mohanan
- Westfort Hi-Tech Hospital, Thrissur, Kerala, India
| | | | - S K Parashar
- Metro Heart Hospital, Lajpat Nagar, New Delhi, India
| | | | | | - Santanu Guha
- Calcutta Medical College Hospital, Kolkata, West Bengal, India
| | | | - Rakesh Yadav
- All India Institute of Medical Sciences, New Delhi, India
| | | | - V Amuthan
- Jeyalakshmi Heart Center, Madurai, Tamilnadu, India
| | - M Bansal
- Medanta, The Medicity, New Delhi, India
| | - R N Chakraborty
- Medica Group of Superspeciality Hospitals, Kolkata, West Bengal, India
| | - N Chakraborti
- Medica Group of Superspeciality Hospitals, Kolkata, West Bengal, India
| | - S Chandra
- King George's Medical University, Lucknow, India
| | | | - D Chatterjee
- Rabindranath Tagore International Institute of Cardiac Sciences, Kolkata, India
| | | | | | - A De
- Apollo Gleneagles Hospital, Kolkata, India
| | - A Garg
- Jaipur Heart Institute, Jaipur, India
| | - V K Garg
- R D Gardi Medical College, Ujjain, India
| | - A Goyal
- Bani Park Hospital, Jaipur, India
| | - N K Goyal
- BLK Superspeciality Hospital, New Delhi, India
| | | | - V K Gupta
- Kishori Ram Hospital & Diabetes Care Centre, Bhatinda, India
| | | | - A Jabir
- Lisie Hospital Kochi, Kerala, India
| | - P Jain
- Lifeline Superspeciality Hospital, Jhansi, India
| | - V Jain
- Choithram Hospital &R.C., Indore, India
| | | | | | | | | | | | | | - M Mandal
- NRS Medical College, Kolkata, India
| | - B Majumder
- R.G. Kar Medical College & Hospital, Kolkata, India
| | - S S Mishra
- Hi-Tech Medical College and Hospital, Bhubaneshwar, India
| | - C B Meena
- SMS Medical College, Jaipur, Rajasthan
| | | | - V S Narain
- King George's Medical University, Lucknow, India
| | | | - L A Pathak
- Nanavati Heart Institute, Nanavati Superspeciality Hospital, Mumbai, India
| | - C K Ponde
- PD Hinduja National Hospital & RC, Mumbai, India
| | - K Raghu
- Care Hospital, Hyderabad, India
| | - S Ray
- Vivekananda Institute of Medical Sciences, Kolkata, India
| | - D Roy
- Rabindranath Tagore International Institute of Cardiac Sciences, Kolkata, India
| | - D Sarma
- Jorhat Christian Medical Centre Hospital, Jorhat, Assam, India
| | | | | | - S Tyagi
- GB Pant Institute of Post Graduate Medical Education and Research, New Delhi, India
| | | | - G S Wander
- Hero DMC Heart Institute, Ludhiana, India
| | - Harsh Wardhan
- Mahatma Gandhi Medical College and Hospital, Jaipur, India
| | - N C Nanda
- University of Alabama at Birmingham, Birmingham, AL, USA
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13
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Kerkar PG, Naik N, Alexander T, Bahl VK, Chakraborty RN, Chatterjee SS, Chopra HK, Dani SI, Deb PK, Goswami KC, Guha S, Gupta R, Gupta V, Hasija PK, Jayagopal PB, Justin Paul G, Kahali D, Katyal VK, Khanna NN, Mandal M, Mishra SS, Mohanan PP, Mullasari A, Mehta S, Pancholia AK, Ray S, Roy D, Shanmugasundarm S, Sharma S, Singh BP, Tewari S, Tyagi SK, Venugopal KN, Wander GS, Yadav R, Das MK. Cardiological Society of India: Document on acute MI care during COVID-19. Indian Heart J 2020; 72:70-74. [PMID: 32534693 PMCID: PMC7201231 DOI: 10.1016/j.ihj.2020.04.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 04/29/2020] [Indexed: 12/20/2022] Open
Abstract
The unprecedented and rapidly spreading Coronavirus Disease-19 (COVID-19) pandemic has challenged public health care systems globally. Based on worldwide experience, India has initiated a nationwide lockdown to prevent the exponential surge of cases. During COVID-19, management of cardiovascular emergencies like acute Myocardial Infarction (MI) may be compromised. Cardiological Society of India (CSI) has ventured in this moment of crisis to evolve a consensus document for care of acute MI. However, this care should be individualized, based on local expertise and governmental advisories.
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Affiliation(s)
- P G Kerkar
- Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India
| | - N Naik
- All India Institute of Medical Sciences, New Delhi, India
| | - T Alexander
- Kovai Medical Center and Hospital, Coimbatore, Tamil Nadu, India
| | - V K Bahl
- All India Institute of Medical Sciences, New Delhi, India
| | - R N Chakraborty
- Medica Group of Superspeciality Hospitals, Kolkata, West Bengal, India
| | - S S Chatterjee
- Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India
| | | | - S I Dani
- Apollo Hospital, Ahmedabad, Gujarat, India
| | - P K Deb
- Daffodil Hospital, Kolkata, West Bengal, India
| | - K C Goswami
- All India Institute of Medical Sciences, New Delhi, India
| | - S Guha
- Calcutta Medical College Hospital, Kolkata, West Bengal, India
| | - R Gupta
- JROP Healthcare, New Delhi, India
| | - V Gupta
- Kishori Ram Hospital & Diabetes Care Centre, India
| | - P K Hasija
- Armed Forces Medical College, Pune, Maharashtra, India
| | | | | | - D Kahali
- BM Birla Heart Research Center, Kolkata, West Bengal, India
| | - V K Katyal
- Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India
| | - N N Khanna
- Indraprastha Apollo Hospital, New Delhi, India
| | - M Mandal
- NRS Medical College and Hospital, Kolkata, West Bengal, India
| | - S S Mishra
- Hi-Tech Medical College and Hospital, Bhubaneshwar, Odisha, India
| | - P P Mohanan
- Westfort Hi-Tech Hospital, Thrissur, Kerala, India
| | - A Mullasari
- Madras Medical Mission Hospital, Chennai, Tamil Nadu, India
| | - S Mehta
- University of Miami, Florida, USA
| | | | - S Ray
- Vivekanand Institute of Medical Sciences, Kolkata, West Bengal, India
| | - D Roy
- Rabindranath Tagore International Institute of Medical Sciences, Kolkata, West Bengal, India
| | | | | | - B P Singh
- Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India
| | - S Tewari
- Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | | | - K N Venugopal
- Pushpagiri Institute of Medical Sciences, Tiruvalla, Kerala, India
| | - G S Wander
- Dayanand Medical College, Ludhiana, Punjab, India
| | - R Yadav
- All India Institute of Medical Sciences, New Delhi, India
| | - M K Das
- C K Birla Group of Hospitals (BMB and CMRI), Kolkata, West Bengal, India.
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14
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Harikrishnan S, Mohanan PP, Chopra VK, Ambuj R, Sanjay G, Bansal M, Chakraborty RN, Chandra S, Chattarjee SS, Chopra HK, Mathew C, Deb PK, Goyal A, Goswami KC, Gupta R, Guha S, Gupta V, Hasija PK, Wardhan H, Jabir A, Jayagopal PB, Kahali D, Katyal VK, Kerkar PG, Khanna NN, Majumder B, Mandal M, Meena CB, Naik N, Narain VK, Pathak LA, Ray S, Roy D, Routray SN, Sarma D, Shanmugasundaram S, Singh BP, Tyagi SK, Venugopal K, Wander GS, Yadav R, Das MK. Cardiological society of India position statement on COVID-19 and heart failure. Indian Heart J 2020; 72:75-81. [PMID: 32405088 PMCID: PMC7219407 DOI: 10.1016/j.ihj.2020.04.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 04/29/2020] [Indexed: 02/06/2023] Open
Affiliation(s)
- S Harikrishnan
- Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India.
| | | | | | | | - G Sanjay
- Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India
| | | | | | | | | | | | | | - P K Deb
- Daffodil Hospitals, Kolkata, India
| | - A Goyal
- Bani Park Hospital, D-9, Kabir Marg, Bani Park, JAIPUR, 302016, Rajasthan, India
| | | | - R Gupta
- JROP Institute of Echocardiography, New Delhi, India
| | - S Guha
- Medical College, Kolkata, India
| | - V Gupta
- Kishori Ram Hospital & Diabetes Care Centre, Bhatinda, Punjab, India
| | - P K Hasija
- MH Chennai, Armed Forces Medical Services, India
| | - Harsh Wardhan
- Mahatma Gandhi Medical College and Hospital, Jaipur, India
| | | | | | - D Kahali
- C.K.Birla Group of Hospitals (BMB), Kolkata, India
| | | | | | - N N Khanna
- Indraprastha Apollo Hospitals, Sarita Vihar, New Delhi, India
| | - B Majumder
- R.G. Kar Medical College, Kolkata, India
| | - M Mandal
- NRS Medical College, Kolkata, India
| | - C B Meena
- SMS Medical College, Jaipur, Rajasthan, India
| | | | - V K Narain
- King George's Medical University, Lucknow, India
| | - L A Pathak
- Nanavati Superspeciality Hospital, Mumbai, India
| | - S Ray
- Vivekananda Institute of Medical Sciences, Kolkata, India
| | - D Roy
- Rabindranath Tagore International Institute of Cardiac Sciences, Kolkata, India
| | | | - D Sarma
- Jorhat Christian Medical Centre Hospital, Jorhat, Assam, India
| | | | | | - S K Tyagi
- GB Pant Institute of Post Graduate Medical Education and Research, New Delhi, India
| | | | | | | | - M K Das
- C.K. Birla Group of Hospitals (BMB/CMRI), Kolkata, India
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15
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Jadhav U, Pinto B, Jayagopal PB, Nair T, Kumar P, Sahoo PK, Ganguly A, Srivastava S, Kapoor S, Davidson D, Ahuja RC, Dharamadhikari A, Singh A. Indian Consensus on OPtimal Treatment of Angina (OPTA ). J Assoc Physicians India 2018; 66:95-103. [PMID: 31315340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Affiliation(s)
- Uday Jadhav
- Cardiologist at MGM Hospital, Mumbai, Maharashtra
| | - Brian Pinto
- Chief of Cardiology, Holy Family Hospital, Mumbai, Maharashtra
| | - P B Jayagopal
- Interventional Cardiologist, Laxmi Hospital, Palakkad, Kerala
| | - Tiny Nair
- Interventional Cardiologist, PRS Hospital, Trivandrum, Kerala
| | - Prabhat Kumar
- Interventional Cardiologist, Medica Hospital, Patna, Bihar
| | - Prasant Kr Sahoo
- Interventional Cardiologist, Apollo Hospital, Bhubaneshwar, Orissa
| | | | | | - Sunil Kapoor
- Interventional Cardiologist, Apollo Hospital, Hyderabad, Telangana
| | - Deepak Davidson
- Interventional Cardiologist, Paritham Hospital, Kottyam, Kerala
| | - R C Ahuja
- Interventional Cardiologist, Krishna Medical Centre, Lucknow, Uttar Pradesh
| | | | - Ashutosh Singh
- Cardiologist at Old MLA Quarters, Bhopal, Madhya Pradesh
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Jayagopal PB, Sarjun Basha KM. Intracoronary tenecteplase in STEMI with massive thrombus. Indian Heart J 2018; 70:446-449. [PMID: 29961467 PMCID: PMC6034014 DOI: 10.1016/j.ihj.2017.08.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Revised: 08/18/2017] [Accepted: 08/22/2017] [Indexed: 11/24/2022] Open
Abstract
Primary percutaneous coronary intervention is the current standard of care in ST elevation myocardial infarction (STEMI). However, large thrombus is an independent predictor for stent thrombosis and major adverse cardiac events in patients undergoing primary angioplasty for STEMI. Here we report a series of STEMI patients with large thrombus burden treated successfully with low dose intracoronary thrombolysis. There was prompt and early ST resolution. There was improvement in thrombolysis in myocardial infarction (TIMI) flow and myocardial blush grade postlysis in all patients. Majority had recanalised infarct related coronary artery thus obviating the need for stenting. There was no inhospital or 1 month mortality or bleeding events. Hence intracoronary thrombolysis is an option in patients with large thrombus burden.
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Guha S, Sethi R, Ray S, Bahl VK, Shanmugasundaram S, Kerkar P, Ramakrishnan S, Yadav R, Chaudhary G, Kapoor A, Mahajan A, Sinha AK, Mullasari A, Pradhan A, Banerjee AK, Singh BP, Balachander J, Pinto B, Manjunath CN, Makhale C, Roy D, Kahali D, Zachariah G, Wander GS, Kalita HC, Chopra HK, Jabir A, Tharakan J, Paul J, Venogopal K, Baksi KB, Ganguly K, Goswami KC, Somasundaram M, Chhetri MK, Hiremath MS, Ravi MS, Das MK, Khanna NN, Jayagopal PB, Asokan PK, Deb PK, Mohanan PP, Chandra P, Girish CR, Rabindra Nath O, Gupta R, Raghu C, Dani S, Bansal S, Tyagi S, Routray S, Tewari S, Chandra S, Mishra SS, Datta S, Chaterjee SS, Kumar S, Mookerjee S, Victor SM, Mishra S, Alexander T, Samal UC, Trehan V. Cardiological Society of India: Position statement for the management of ST elevation myocardial infarction in India. Indian Heart J 2017; 69 Suppl 1:S63-S97. [PMID: 28400042 PMCID: PMC5388060 DOI: 10.1016/j.ihj.2017.03.006] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Affiliation(s)
| | - Rishi Sethi
- King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Saumitra Ray
- Vivekananda Institute of Medical Sciences, Kolkata, West Bengal, India
| | - Vinay K Bahl
- All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | | | - Prafula Kerkar
- Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India
| | | | - Rakesh Yadav
- All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | | | - Aditya Kapoor
- Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Ajay Mahajan
- Lokmanya Tilak Municipal Medical College & General Hospital, Mumbai, Maharashtra, India
| | | | | | | | - Amal Kumar Banerjee
- Institute of Post Graduate Medical Education & Research and Memorial Hospital, Kolkata, West Bengal, India
| | - B P Singh
- Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India
| | - J Balachander
- Jawaharlal Institute of Postgraduate Medical Education & Research (JIPMER), Puducherry, India
| | - Brian Pinto
- Holy family Hospital, Mumbai, Maharashtra, India
| | - C N Manjunath
- Sri Jaydeva Institute of Cardiovascular Sciences & Research, Bangaluru, Karnataka, India
| | | | | | - Dhiman Kahali
- BM Birla Heart Research Center, Kolkata, West Bengal, India
| | | | - G S Wander
- Hero DMC Heart Institute, Ludhiana, Punjab, India
| | - H C Kalita
- Assam Medical College, Dibrugarh, Assam, India
| | | | - A Jabir
- Lisie Hospital, Kochi, Kerala, India
| | - JagMohan Tharakan
- Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India
| | - Justin Paul
- Madras Medical College, Chennai, Tamil Nadu, India
| | - K Venogopal
- Pushpagiri Institute of Medical Sciences, Tiruvalla, Kerala, India
| | - K B Baksi
- Belle Vue Clinic, Kolkata, West Bengal, India
| | | | - Kewal C Goswami
- All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | | | - M K Chhetri
- IPGMER & SSKM Hospital, Kolkata, West Bengal, India
| | | | - M S Ravi
- Madras Medical College, Chennai, Tamil Nadu, India
| | | | | | | | - P K Asokan
- The Fatima Hospital, Calicut, Kerala, India
| | - P K Deb
- ESI Hospital, Manicktala, Kolkata, West Bengal, India
| | - P P Mohanan
- Westfort Hi-Tech Hospital, Thrissur, Kerala, India
| | | | - Col R Girish
- Command Hospital, Central Command, Lucknow, India
| | - O Rabindra Nath
- Apollo Gleneagles Heart Institute, Kolkata, West Bengal, India
| | | | - C Raghu
- Prime Hospitals, Hyderabad, India
| | | | | | - Sanjay Tyagi
- GB Pant Institute of Post Graduate Medical Education & Research, New Delhi, India
| | | | - Satyendra Tewari
- Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | | | | | | | - S S Chaterjee
- Indra Gandhi Institute of Cardiology, Patna, Bihar, India
| | - Soumitra Kumar
- Vivekananda Institute of Medical Sciences, Kolkata, West Bengal, India
| | | | | | - Sundeep Mishra
- All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | | | | | - Vijay Trehan
- Indo-US Super Speciality Hospital, Hyderabad, India
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