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Arabi A, Rafie I, Arafa S, Alqahtani A, Altamimi O, Abujalala S, Hamid T, Ali M, Alkindi F, Alkhani M, Al-Hijji M, Altamimi H, Al Suwaidi J. ST Segment myocardial infarction due to totally occluded unprotected left main coronary artery (TOULM): an insight from nationwide database. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Objective
This study sought to describe the clinical profile, management and short-term outcomes of patients with ST elevation myocardial infraction (STEMI) due to totally occluded unprotected left main coronary artery (TOULM).
Methods
This is a retrospective analysis of nationwide STEMI database of patients who underwent primary percutaneous intervention (PPCI). Patients with TOULM are defined as having 100% acute thrombotic occlusion of the left main artery or subtotal occlusion with no more than TIMI 1 flow.
Results
Between January 2011 and February 2022, 7107 patients underwent Primary Percutaneous Intervention for STEMI. 35 cases (0.5%) of all STEMI were due to TOULM. The average age of patients with TOULM was 51±14 years, predominantly male (94%) and had no prior cardiac history (94%). 11 patients (31%) suffered cardiac arrest and 16 (45%) were on mechanical ventilation prior to arrival to cardiac catheterization laboratory.
The right coronary artery was the dominant vessel in 29 (89%) patients. Right to left collaterals were present in 15 (42%), absent in 8 (23%) and unknown (the right coronary artery was injected after TOULM intervention or not injected) in 12 (34%) patients. Mechanical circulatory support was used in 37% of the cases (IABP 8, ECMO 3 and ECMO plus IABP 2). Revascularization was achieved with PCI and stenting in 30 patients (86%). Five patients underwent urgent CABG after balloon angioplasty. Survival to hospital discharge was 55%.
Conclusions
STEMI due to TOULM is a rare occurrence and involved mainly male with no prior cardiac history. Despite all the patients in our series undergoing revascularization, the in-hospital mortality is almost 50%. One major limitations of our study is we had no post-mortem data of any patient who died prior to coronary angiography, which potentially will lead to higher recorded cases of TOULM related mortality.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- A Arabi
- Hamad Medical Corporation Heart Hospital, Cardiology , Doha , Qatar
| | - I Rafie
- Hamad Medical Corporation Heart Hospital, Cardiology , Doha , Qatar
| | - S Arafa
- Hamad Medical Corporation Heart Hospital, Cardiology , Doha , Qatar
| | - A Alqahtani
- Hamad Medical Corporation Heart Hospital, Cardiology , Doha , Qatar
| | - O Altamimi
- Hamad Medical Corporation Heart Hospital, Cardiology , Doha , Qatar
| | - S Abujalala
- Hamad Medical Corporation Heart Hospital, Cardiology , Doha , Qatar
| | - T Hamid
- Hamad Medical Corporation Heart Hospital, Cardiology , Doha , Qatar
| | - M Ali
- Hamad Medical Corporation Heart Hospital, Cardiology , Doha , Qatar
| | - F Alkindi
- Hamad Medical Corporation Heart Hospital, Cardiology , Doha , Qatar
| | - M Alkhani
- Hamad Medical Corporation Heart Hospital, Cardiology , Doha , Qatar
| | - M Al-Hijji
- Hamad Medical Corporation Heart Hospital, Cardiology , Doha , Qatar
| | - H Altamimi
- Hamad Medical Corporation Heart Hospital, Cardiology , Doha , Qatar
| | - J Al Suwaidi
- Hamad Medical Corporation Heart Hospital, Cardiology , Doha , Qatar
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2
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Al Khodari K, Tahtouh RA, Hamid T. Acute ST-Elevation Myocardial Infarction in Patient with Severe Uncontrolled Hyperthyroidism Complicated by Thyroid Storm. Heart Views 2022; 23:221-225. [PMID: 36605923 PMCID: PMC9809455 DOI: 10.4103/heartviews.heartviews_8_22] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 10/09/2022] [Indexed: 01/07/2023] Open
Abstract
Acute ST-elevation myocardial infarction is a life-threatening medical emergency that needs to be recognized early and treated properly to prevent deleterious complications, including death. A thyroid storm (TS) is a rare but severe manifestation of uncontrolled hyperthyroidism that might present with serious cardiovascular or neurological problems. We described a case of a 40-year-old male patient, known to have uncontrolled hyperthyroidism, who presented with acute onset of central chest pain, agitation, tachycardia, and pulmonary congestion. Fast atrial fibrillation with ST-segment elevation in anterior leads was detected on electrocardiogram. Thyroxin level (T4) was very high with undetectable thyroid stimulating hormone. Initially, the patient refused any type of coronary revascularization; therefore, he was admitted to the cardiology intensive care unit, and medical treatment was commenced for both TS and acute coronary syndrome. High-risk coronary angiography was done 2 h later because he had worsening persistent chest pain and started to develop signs of heart failure. It showed embolic occlusion of the distal left anterior descending artery that was treated medically with anti-coagulation. There were no complications. Chest pain and thyroid function tests settled down during his hospital stay with close cardiology and endocrinology follow-up.
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Affiliation(s)
| | | | - Tahir Hamid
- Department of Cardiology, Hamad Medical Corporation, Doha, Qatar
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3
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Kiranyaz S, Devecioglu OC, Ince T, Malik J, Chowdhury M, Hamid T, Mazhar R, Khandakar A, Tahir A, Rahman T, Gabbouj M. Blind ECG Restoration by Operational Cycle-GANs. IEEE Trans Biomed Eng 2022; 69:3572-3581. [PMID: 35503842 DOI: 10.1109/tbme.2022.3172125] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE ECG recordings often suffer from a set of artifacts with varying types, severities, and durations, and this makes an accurate diagnosis by machines or medical doctors difficult and unreliable. Numerous studies have proposed ECG denoising; however, they naturally fail to restore the actual ECG signal corrupted with such artifacts due to their simple and naive noise model. In this pilot study, we propose a novel approach for blind ECG restoration using cycle-consistent generative adversarial networks (Cycle-GANs) where the quality of the signal can be improved to a clinical level ECG regardless of the type and severity of the artifacts corrupting the signal. METHODS To further boost the restoration performance, we propose 1D operational Cycle-GANs with the generative neuron model. RESULTS The proposed approach has been evaluated extensively using one of the largest benchmark ECG datasets from the China Physiological Signal Challenge (CPSC-2020) with more than one million beats. Besides the quantitative and qualitative evaluations, a group of cardiologists performed medical evaluations to validate the quality and usability of the restored ECG, especially for an accurate arrhythmia diagnosis. SIGNIFICANCE As a pioneer study in ECG restoration, the corrupted ECG signals can be restored to clinical level quality. CONCLUSION By means of the proposed ECG restoration, the ECG diagnosis accuracy and performance can significantly improve.
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Fagbo S, Hamid T, Alzahrani M, Eldirdiry Y, Adam A, Asiri A. Successful Reversal of the 2020 Covid-19 Response Induced Collateral Damage on Malaria Control in Saudi Arabia. Int J Infect Dis 2022. [PMCID: PMC8884794 DOI: 10.1016/j.ijid.2021.12.288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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5
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Tahir AM, Chowdhury MEH, Khandakar A, Rahman T, Qiblawey Y, Khurshid U, Kiranyaz S, Ibtehaz N, Rahman MS, Al-Maadeed S, Mahmud S, Ezeddin M, Hameed K, Hamid T. COVID-19 infection localization and severity grading from chest X-ray images. Comput Biol Med 2021; 139:105002. [PMID: 34749094 PMCID: PMC8556687 DOI: 10.1016/j.compbiomed.2021.105002] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [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: 08/03/2021] [Revised: 10/27/2021] [Accepted: 10/27/2021] [Indexed: 12/16/2022]
Abstract
The immense spread of coronavirus disease 2019 (COVID-19) has left healthcare systems incapable to diagnose and test patients at the required rate. Given the effects of COVID-19 on pulmonary tissues, chest radiographic imaging has become a necessity for screening and monitoring the disease. Numerous studies have proposed Deep Learning approaches for the automatic diagnosis of COVID-19. Although these methods achieved outstanding performance in detection, they have used limited chest X-ray (CXR) repositories for evaluation, usually with a few hundred COVID-19 CXR images only. Thus, such data scarcity prevents reliable evaluation of Deep Learning models with the potential of overfitting. In addition, most studies showed no or limited capability in infection localization and severity grading of COVID-19 pneumonia. In this study, we address this urgent need by proposing a systematic and unified approach for lung segmentation and COVID-19 localization with infection quantification from CXR images. To accomplish this, we have constructed the largest benchmark dataset with 33,920 CXR images, including 11,956 COVID-19 samples, where the annotation of ground-truth lung segmentation masks is performed on CXRs by an elegant human-machine collaborative approach. An extensive set of experiments was performed using the state-of-the-art segmentation networks, U-Net, U-Net++, and Feature Pyramid Networks (FPN). The developed network, after an iterative process, reached a superior performance for lung region segmentation with Intersection over Union (IoU) of 96.11% and Dice Similarity Coefficient (DSC) of 97.99%. Furthermore, COVID-19 infections of various shapes and types were reliably localized with 83.05% IoU and 88.21% DSC. Finally, the proposed approach has achieved an outstanding COVID-19 detection performance with both sensitivity and specificity values above 99%.
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Affiliation(s)
- Anas M Tahir
- Department of Electrical Engineering, Qatar University, Doha, 2713, Qatar.
| | | | - Amith Khandakar
- Department of Electrical Engineering, Qatar University, Doha, 2713, Qatar.
| | - Tawsifur Rahman
- Department of Electrical Engineering, Qatar University, Doha, 2713, Qatar.
| | - Yazan Qiblawey
- Department of Electrical Engineering, Qatar University, Doha, 2713, Qatar.
| | - Uzair Khurshid
- Department of Electrical Engineering, Qatar University, Doha, 2713, Qatar.
| | - Serkan Kiranyaz
- Department of Electrical Engineering, Qatar University, Doha, 2713, Qatar.
| | - Nabil Ibtehaz
- Department of Computer Science and Engineering, Bangladesh University of Engineering and Technology, Dhaka, 1205, Bangladesh.
| | - M Sohel Rahman
- Department of Computer Science and Engineering, Bangladesh University of Engineering and Technology, Dhaka, 1205, Bangladesh.
| | - Somaya Al-Maadeed
- Computer Science and Engineering Department, Qatar University, Doha, 2713, Qatar.
| | - Sakib Mahmud
- Department of Electrical Engineering, Qatar University, Doha, 2713, Qatar.
| | - Maymouna Ezeddin
- Department of Electrical Engineering, Qatar University, Doha, 2713, Qatar.
| | - Khaled Hameed
- Radiology Department, Reem Medical Center, Doha, Qatar.
| | - Tahir Hamid
- Hamad General Hospital and Weill Cornell Medicine - Qatar, Doha, Qatar
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6
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Mrad I, Hamila R, Al-Emadi N, Erbad A, Hamid T, Mazhar R. Machine learning screening of COVID-19 patients based on X-ray images for unbalanced classes. Journal of Emergency Medicine, Trauma and Acute Care 2021. [DOI: 10.5339/jemtac.2021.qhc.38] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Affiliation(s)
- Ilyes Mrad
- Department of Electrical Engineering, College of Engineering, Qatar University, Qatar E-mail:
| | - Ridha Hamila
- Department of Electrical Engineering, College of Engineering, Qatar University, Qatar E-mail:
| | - Nasser Al-Emadi
- Department of Electrical Engineering, College of Engineering, Qatar University, Qatar E-mail:
| | - Aiman Erbad
- Division of Information and Computing Technology, College of Science and Engineering, Hamad Bin Khalifa University, Doha, Qatar
| | - Tahir Hamid
- Department of Cardiology, The Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Rashid Mazhar
- Department of Cardiology, The Heart Hospital, Hamad Medical Corporation, Doha, Qatar
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7
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Degerli A, Ahishali M, Yamac M, Kiranyaz S, Chowdhury MEH, Hameed K, Hamid T, Mazhar R, Gabbouj M. COVID-19 infection map generation and detection from chest X-ray images. Health Inf Sci Syst 2021; 9:15. [PMID: 33824721 PMCID: PMC8015934 DOI: 10.1007/s13755-021-00146-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [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: 12/29/2020] [Accepted: 03/17/2021] [Indexed: 12/14/2022] Open
Abstract
Computer-aided diagnosis has become a necessity for accurate and immediate coronavirus disease 2019 (COVID-19) detection to aid treatment and prevent the spread of the virus. Numerous studies have proposed to use Deep Learning techniques for COVID-19 diagnosis. However, they have used very limited chest X-ray (CXR) image repositories for evaluation with a small number, a few hundreds, of COVID-19 samples. Moreover, these methods can neither localize nor grade the severity of COVID-19 infection. For this purpose, recent studies proposed to explore the activation maps of deep networks. However, they remain inaccurate for localizing the actual infestation making them unreliable for clinical use. This study proposes a novel method for the joint localization, severity grading, and detection of COVID-19 from CXR images by generating the so-called infection maps. To accomplish this, we have compiled the largest dataset with 119,316 CXR images including 2951 COVID-19 samples, where the annotation of the ground-truth segmentation masks is performed on CXRs by a novel collaborative human–machine approach. Furthermore, we publicly release the first CXR dataset with the ground-truth segmentation masks of the COVID-19 infected regions. A detailed set of experiments show that state-of-the-art segmentation networks can learn to localize COVID-19 infection with an F1-score of 83.20%, which is significantly superior to the activation maps created by the previous methods. Finally, the proposed approach achieved a COVID-19 detection performance with 94.96% sensitivity and 99.88% specificity.
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Affiliation(s)
- Aysen Degerli
- Faculty of Information Technology and Communication Sciences, Tampere University, Tampere, Finland
| | - Mete Ahishali
- Faculty of Information Technology and Communication Sciences, Tampere University, Tampere, Finland
| | - Mehmet Yamac
- Faculty of Information Technology and Communication Sciences, Tampere University, Tampere, Finland
| | - Serkan Kiranyaz
- Department of Electrical Engineering, Qatar University, Doha, Qatar
| | | | | | - Tahir Hamid
- Hamad Medical Corporation Hospital, Doha, Qatar
| | | | - Moncef Gabbouj
- Faculty of Information Technology and Communication Sciences, Tampere University, Tampere, Finland
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8
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Haleem S, Yousaf S, Hamid T, Nagappa S, Parker MJ. Characteristics and outcomes of hip fractures in lower limb amputees. Injury 2021; 52:914-917. [PMID: 33041015 DOI: 10.1016/j.injury.2020.10.017] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Revised: 08/12/2020] [Accepted: 10/04/2020] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Lower limb amputees, regardless of age are at an increased risk of developing fragility fractures of the neck of femur. The characteristics and outcomes of the fractures of the neck of femur in lower limb amputees have not been studied in detail. METHODS We undertook a retrospective review of a prospectively collected single centre and single surgeon database between March 1996 and January 2017, using a standard proforma to identify patients who required surgical intervention for fracture neck of femur and had sustained a previous lower limb amputation and compared them with a cohort of standard hip fracture patients. RESULTS Twenty-seven patients, sustaining 28 fractures of the neck of femurs were identified of which 16 were females with mean age of 78 years (50-89). Nineteen fractures were sustained on the ipsilateral side of the amputation. Results showed that seventy percent of amputees returned to their previous level of mobility and prior residence. Mortality in this group is higher as compared to a standard hip fracture patient but pain and mobility were comparable in both groups. DISCUSSION The incidence of both hip fractures and amputations in increasing worldwide but no study has compared outcomes of hip fractures in amputees and compared them to a standard hip fracture patient. Amputees exhibit reduced bone density both at the hip and stump end which increases risk for osteoporosis and fragility fractures in the hip. The management of our patients followed orthopaedic principles, well established surgical interventions and rehabilitation. CONCLUSION This study reveals that hip fractures in amputees can have comparable results to a standard hip fracture cohort if preoperative optimisation, planning and postoperative rehabilitation is carried out.
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Affiliation(s)
- S Haleem
- Royal Orthopaedic Hospital, Birmingham, United Kingdom.
| | - S Yousaf
- Epsom and St. Helier University Hospitals, London, United Kingdom
| | - T Hamid
- Queen Victoria Hospital, East Grinstead, United Kingdom
| | - S Nagappa
- Royal Orthopaedic Hospital, Birmingham, United Kingdom
| | - M J Parker
- Peterborough City Hospital, Peterborough, United Kingdom
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Ahishali M, Degerli A, Yamac M, Kiranyaz S, Chowdhury MEH, Hameed K, Hamid T, Mazhar R, Gabbouj M. Advance Warning Methodologies for COVID-19 Using Chest X-Ray Images. IEEE Access 2021; 9:41052-41065. [PMID: 36789157 PMCID: PMC8768954 DOI: 10.1109/access.2021.3064927] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 03/03/2021] [Indexed: 05/23/2023]
Abstract
Coronavirus disease 2019 (COVID-19) has rapidly become a global health concern after its first known detection in December 2019. As a result, accurate and reliable advance warning system for the early diagnosis of COVID-19 has now become a priority. The detection of COVID-19 in early stages is not a straightforward task from chest X-ray images according to expert medical doctors because the traces of the infection are visible only when the disease has progressed to a moderate or severe stage. In this study, our first aim is to evaluate the ability of recent state-of-the-art Machine Learning techniques for the early detection of COVID-19 from chest X-ray images. Both compact classifiers and deep learning approaches are considered in this study. Furthermore, we propose a recent compact classifier, Convolutional Support Estimator Network (CSEN) approach for this purpose since it is well-suited for a scarce-data classification task. Finally, this study introduces a new benchmark dataset called Early-QaTa-COV19, which consists of 1065 early-stage COVID-19 pneumonia samples (very limited or no infection signs) labeled by the medical doctors and 12544 samples for control (normal) class. A detailed set of experiments shows that the CSEN achieves the top (over 97%) sensitivity with over 95.5% specificity. Moreover, DenseNet-121 network produces the leading performance among other deep networks with 95% sensitivity and 99.74% specificity.
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Affiliation(s)
- Mete Ahishali
- Faculty of Information Technology and Communication SciencesTampere University33720TampereFinland
| | - Aysen Degerli
- Faculty of Information Technology and Communication SciencesTampere University33720TampereFinland
| | - Mehmet Yamac
- Faculty of Information Technology and Communication SciencesTampere University33720TampereFinland
| | - Serkan Kiranyaz
- Department of Electrical EngineeringQatar UniversityDoha2713Qatar
| | | | | | - Tahir Hamid
- Hamad Medical Corporation HospitalDoha57621Qatar
- Weill Cornell Medicine-QatarDoha24144Qatar
| | | | - Moncef Gabbouj
- Faculty of Information Technology and Communication SciencesTampere University33720TampereFinland
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Arabi A, Alqahtani A, Arafa S, Altamimi O, Altamimi H, Jalala SA, Rafie IM, Ali MT, Hamid T, Al-Hijji M, Alkhani M, Al-Balushi S, Al Suwaidi J. The Impact of SARS-CoV-2 on ST-Elevation Myocardial Infarction Volume, Time to Presentation, and Door-to-Balloon Time: A Report from a High-Volume Statewide Primary Percutaneous Intervention Program. Heart Views 2020; 21:161-165. [PMID: 33688407 PMCID: PMC7899003 DOI: 10.4103/heartviews.heartviews_159_20] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Accepted: 08/24/2020] [Indexed: 11/04/2022] Open
Abstract
Background The novel severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) outbreak has affected ST-elevation myocardial infarction (STEMI) care worldwide. Reports from China, Europa, and North America showed a significant decline in STEMI volume with a simultaneous increase in time from symptoms to hospital presentation. Aim The aim of the study was to study the effect of the SARS-CoV-2 outbreak on primary percutaneous coronary intervention (PPCI) volume performed for STEMI, symptom onset to hospital presentation time (symptom-to-door [S2D]), and door-to-balloon time (D2B) at the main nationwide PPCI center in Qatar. Methods A retrospective evaluation of prospectively collected quality improvement cardiac catheterization data in Qatar was performed. PPCI volume and S2D and D2B time during the outbreak from March 9, 2020, to May 14, 2020, were compared with that of the same period from the prior year and the period immediately preceding the outbreak. Results Since the SARS-CoV-2 outbreak in Qatar, 137 PPCI procedures were performed. There was a 40% reduction in the volume of PPCI when compared with the period immediately preceding the outbreak and 16% reduction in volume when compared with that of the same period in 2019. The median S2D time was 115 min (interquartile range [IQR: 124]), which was not statistically different from that of the preceding period or the same period in 2019. D2B time during the outbreak increased by an average of 7 min when compared with that of the same period preceding the outbreak (median: 47 min [IQR: 28] during the outbreak vs. median: 40 min [IQR: 21] during the preceding period, P = 0.016). Conclusion In a statewide PPCI program in Qatar, we observed a mild reduction in PPCI cases during the SARS-CoV-2 outbreak (16% when compared with the same period in 2019), with a modest increase in D2B time. PPCI can be performed effectively during the SARS-CoV-2 outbreak at very high-volume centers with the adoption of strict infection control measures. With proper training and monitoring, both target D2B and hospital staff safety can be achieved.
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Affiliation(s)
- Abdulrahman Arabi
- Department of Cardiology and Cardiovascular Surgery, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Awad Alqahtani
- Department of Cardiology and Cardiovascular Surgery, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Salah Arafa
- Department of Cardiology and Cardiovascular Surgery, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Omar Altamimi
- Department of Cardiology and Cardiovascular Surgery, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Hasan Altamimi
- Department of Cardiology and Cardiovascular Surgery, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Salem Abu Jalala
- Department of Cardiology and Cardiovascular Surgery, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Ihsan Mahmoud Rafie
- Department of Cardiology and Cardiovascular Surgery, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Mohammed Thamer Ali
- Department of Cardiology and Cardiovascular Surgery, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Tahir Hamid
- Department of Cardiology and Cardiovascular Surgery, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Mohammed Al-Hijji
- Department of Cardiology and Cardiovascular Surgery, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Murad Alkhani
- Department of Cardiology and Cardiovascular Surgery, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Sara Al-Balushi
- Department of Cardiology and Cardiovascular Surgery, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Jassim Al Suwaidi
- Department of Cardiology and Cardiovascular Surgery, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
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Kamran S, Singh R, Akhtar N, George P, Salam A, Babu B, Own A, Hamid T, Perkins JD. Left Heart Factors in Embolic Stroke of Undetermined Source in a Multiethnic Asian and North African Cohort. J Am Heart Assoc 2020; 9:e016534. [PMID: 32750304 PMCID: PMC7792276 DOI: 10.1161/jaha.120.016534] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Background Cardiac features diverge in Asians; however, it is not known how these differences relate to embolic stroke of unknown source (ESUS) in Southeast Asian and Eastern Mediterranean regions. Methods and Results A retrospective analysis of prospectively collected acute ischemic stroke data from 2014 to 2018 was performed. Stroke subtypes were noncardioembolic stroke (large‐vessel and small‐vessel disease; n=1348), cardioembolic stroke (n=532), and ESUS (n=656). Subtypes were compared by demographic, clinical, and echocardiographic factors. In multivariate logistic regression, patients with ESUS in comparison with noncardioembolic stroke were twice as likely to have left ventricular diastolic dysfunction (P=0.001), 3 times the odds of global hypokinesia (P=0.001), and >7 times the odds of left ventricular wall motion abnormalities (P=0.001). In the second model comparing ESUS with cardioembolic stroke, patients with ESUS were 3 times more likely to have left ventricular wall motion abnormalities (P=0.001) and 1.5 times more likely to have left ventricular diastolic dysfunction grade I (P=0.009), and 3 times more likely to have left ventricular diastolic dysfunction grades II and III (P=0.009), whereas age (P=0.001) and left atrial volume index (P=0.004) showed an inverse relation with ESUS. ESUS in patients ≥61 years old had higher levels of traditional risk factors such as coronary artery disease, but the coronary artery disease was not significantly different in ESUS age groups (P=0.80) despite higher left ventricular wall motion abnormalities (P=0.001). Conclusions Patients with ESUS and noncardioembolic stroke were younger than patients with cardioembolic stroke. While a third of the patients with ESUS >45 years old had coronary artery disease, it was unrecognized or underreported in the older ESUS age group (≥61 years old). In patients with ESUS from Southeast Asia and Eastern Mediterranean regions, left ventricular wall motion abnormalities and left ventricular diastolic dysfunction were related to ESUS.
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Affiliation(s)
- Saadat Kamran
- Neuroscience Institute Hamad General Hospital Doha Qatar.,Weill Cornell Medicine Doha Qatar
| | - Rajvir Singh
- Acute Care Surgery Department Hamad General Hospital Doha Qatar
| | - Naveed Akhtar
- Neuroscience Institute Hamad General Hospital Doha Qatar.,Weill Cornell Medicine Doha Qatar
| | - Pooja George
- Neuroscience Institute Hamad General Hospital Doha Qatar
| | - Abdul Salam
- Neuroscience Institute Hamad General Hospital Doha Qatar
| | - Blessy Babu
- Neuroscience Institute Hamad General Hospital Doha Qatar
| | - Ahmed Own
- Neuroscience Institute Hamad General Hospital Doha Qatar
| | - Tahir Hamid
- Heart Hospital Hamad Medical Corporation Doha Qatar
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12
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Zsom A, Tsekhan S, Hamid T, Levin J, Truccolo W, LaFrance WC, Blum AS, Li P, Wahed LA, Shaikh MA, Sharma G, Ranieri R, Zhang L. Ictal autonomic activity recorded via wearable-sensors plus machine learning can discriminate epileptic and psychogenic nonepileptic seizures. Annu Int Conf IEEE Eng Med Biol Soc 2020; 2019:3502-3506. [PMID: 31946633 DOI: 10.1109/embc.2019.8857552] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Differentiating epileptic seizures (ES) and psychogenic nonepileptic seizures (PNES) is commonly based on electroencephalogram and concurrent video recordings (vEEG). Here, we demonstrate that these two types of seizures can be discriminated based on signals related to autonomic nervous system activity recorded via wearable sensors. We used Empatica E4 Wristband sensors worn on both arms in vEEG confirmed seizures, and machine learning methods to train classifiers, specifically, extreme gradient boosting (XGBoost). Classification performance achieved a predictive accuracy of 78 ± 1.5% on previously unseen data for whether a seizure was epileptic or psychogenic, which is 6 standard deviations above the baseline of 68% accuracy. Our dataset contained altogether 35 seizures from 18 patients out of which 8 patients had 13 convulsive seizures. Prediction of seizure type was based on simple features derived from the segments of autonomic activity measurements (electrodermal activity, body temperature, blood volume pulse, and heart rate) and forearm acceleration. Features related to heart rate and electrodermal activity were ranked as the top predictors in XGBoost classifiers. We found that patients with PNES had a higher ictal heart rate and electrodermal activity than patients with ES. In contrast to existing published studies of mainly convulsive seizures, our classifier focuses on autonomic signals to differentiate convulsive or nonconvulsive semiology ES from PNES. Our results show that autonomic activity recorded via wearable sensors provides promising signals for detection and discrimination of psychogenic and epileptic seizures, but more work is necessary to improve the predictive power of the model.
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Kamran S, Akhtar N, George P, Singh R, Imam Y, Salam A, Babu B, Burke P, Own A, Vattoth S, Perkins J, Parray A, Qadri S, Hamid T. Embolic Pattern of Stroke Associated with Cardiac Wall Motion Abnormalities; Narrowing the Embolic Stroke of Undetermined Source Category. J Stroke Cerebrovasc Dis 2020; 29:104509. [DOI: 10.1016/j.jstrokecerebrovasdis.2019.104509] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 09/29/2019] [Accepted: 10/28/2019] [Indexed: 11/26/2022] Open
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Albizreh B, Alibrahim M, Hamid T. Acute ST-Segment Elevation: Don't Rush me to the Catheter Laboratory- Please Wait. Heart Views 2020; 21:37-39. [PMID: 32082499 PMCID: PMC7006331 DOI: 10.4103/heartviews.heartviews_87_19] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Accepted: 11/06/2019] [Indexed: 12/02/2022] Open
Abstract
We report a case of a young woman with no cardiac history who presented with out-of-hospital cardiac arrest and ST-segment elevation on the electrocardiogram. The cardiac arrest initially was suspected to be secondary to coronary artery disease. Further history was taken from a relative who said that the patient had a severe headache before the cardiac arrest. It was subsequenly found on computed tomography of the head that the patient had infratentorial subarachnoid hemorrhage and diffurse brain edema. The management of course was totally different from what was contemplated initially. This case illustrates that ST-segment elevation can be caused by other conditions besides on occlusive thrombus in the coronary arteries.
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Affiliation(s)
- Bassim Albizreh
- Department of Cardiology, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Mohammad Alibrahim
- Department of Cardiology, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Tahir Hamid
- Department of Cardiology, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
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Mubasher M, Patel A, Magdi M, Hamid T. STEMI after Dobutamine Stress Echocardiography in Hyperthyroid State. Case Rep Cardiol 2019; 2019:7434071. [PMID: 31065388 PMCID: PMC6466884 DOI: 10.1155/2019/7434071] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2018] [Accepted: 03/14/2019] [Indexed: 12/26/2022] Open
Abstract
Uncontrolled hyperthyroidism has been associated with significant changes in cardiovascular hemodynamics. We report a case of a 39-year-old male who has been recently diagnosed with severe hyperthyroidism. He was undergoing dobutamine stress echocardiography (DSE) for evaluation of symptoms suggestive of stable angina. The exam was complicated by ST-segment elevation myocardial infarction- (STEMI-) required coronary angiography that showed mild coronary artery disease.
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Sharma V, Jolly SS, Hamid T, Sharma D, Chiha J, Chan W, Fuchs F, Bui S, Gao P, Kassam S, Leung RCM, Horák D, Romppanen HO, El-Omar M, Chowdhary S, Stanković G, Kedev S, Rokoss MJ, Sheth T, Džavík V, Overgaard CB. Myocardial blush and microvascular reperfusion following manual thrombectomy during percutaneous coronary intervention for ST elevation myocardial infarction: insights from the TOTAL trial. Eur Heart J 2016; 37:1891-8. [PMID: 27125948 PMCID: PMC4917747 DOI: 10.1093/eurheartj/ehw157] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Revised: 03/07/2016] [Accepted: 03/22/2016] [Indexed: 11/13/2022] Open
Abstract
AIMS Thrombectomy during primary percutaneous coronary intervention (PPCI) for ST elevation myocardial infarction (STEMI) has been thought to be an effective therapy to prevent distal embolization and improve microvascular perfusion. The TOTAL trial (N = 10 732), a randomized trial of routine manual thrombectomy vs. PCI alone in STEMI, showed no difference in the primary efficacy outcome. This angiographic sub-study was performed to determine if thrombectomy improved microvascular perfusion as measured by myocardial blush grade (MBG). METHODS AND RESULTS Of the 10 732 patients randomized, 1610 randomly selected angiograms were analysable by the angiographic core laboratory. Primary outcomes included MBG and post-PCI thrombolysis in myocardial infarction (TIMI) flow grade. Secondary outcomes included distal embolization, PPCI complications, and each component of the complications. The primary end point of final myocardial blush (221 [28%] 0/1 for thrombectomy vs. 246 {30%} 0/1 for PCI alone group, P = 0.38) and TIMI flow (712 [90%] TIMI 3 for thrombectomy vs. 733 [89.5%] TIMI 3 for PCI alone arm, P = 0.73) was similar in the two groups. Thrombectomy was associated with a significantly reduced incidence of distal embolization compared with PCI alone (56 [7.1%] vs. 87 [10.7%], P = 0.01). In multivariable analysis, distal embolization was an independent predictor of mortality (HR 3.00, 95% CI 1.19-7.58) while MBG was not (HR 2.73, 95% CI 0.94-5.3). CONCLUSIONS Routine thrombectomy during PPCI did not result in improved MBG or post-PCI TIMI flow grade but did reduce distal embolization compared with PCI alone. Distal embolization and not blush grade is independently associated with mortality.
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Affiliation(s)
- Vinoda Sharma
- Peter Munk Cardiac Centre, University Health Network, 6 Eaton North Room 232, Toronto, ON, Canada Toronto General Hospital, University Health Network, 200 Elizabeth Street, Toronto, ON Canada M5G 2C4
| | - Sanjit S Jolly
- The Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton General Hospital, Hamilton, ON, Canada
| | - Tahir Hamid
- Peter Munk Cardiac Centre, University Health Network, 6 Eaton North Room 232, Toronto, ON, Canada Toronto General Hospital, University Health Network, 200 Elizabeth Street, Toronto, ON Canada M5G 2C4
| | - Divyesh Sharma
- Peter Munk Cardiac Centre, University Health Network, 6 Eaton North Room 232, Toronto, ON, Canada Toronto General Hospital, University Health Network, 200 Elizabeth Street, Toronto, ON Canada M5G 2C4
| | - Joseph Chiha
- Peter Munk Cardiac Centre, University Health Network, 6 Eaton North Room 232, Toronto, ON, Canada Toronto General Hospital, University Health Network, 200 Elizabeth Street, Toronto, ON Canada M5G 2C4
| | - William Chan
- Peter Munk Cardiac Centre, University Health Network, 6 Eaton North Room 232, Toronto, ON, Canada Toronto General Hospital, University Health Network, 200 Elizabeth Street, Toronto, ON Canada M5G 2C4
| | - Felipe Fuchs
- Peter Munk Cardiac Centre, University Health Network, 6 Eaton North Room 232, Toronto, ON, Canada Toronto General Hospital, University Health Network, 200 Elizabeth Street, Toronto, ON Canada M5G 2C4
| | - Sanh Bui
- Peter Munk Cardiac Centre, University Health Network, 6 Eaton North Room 232, Toronto, ON, Canada Toronto General Hospital, University Health Network, 200 Elizabeth Street, Toronto, ON Canada M5G 2C4
| | - Peggy Gao
- The Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton General Hospital, Hamilton, ON, Canada
| | | | | | - David Horák
- KrajskáNemocnice Liberec, Liberec, Czech Republic
| | | | - Magdi El-Omar
- Central Manchester Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - Saqib Chowdhary
- Central Manchester Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - Goran Stanković
- Clinical Center of Serbia, Department of Cardiology, Medical Faculty, University of Belgrade, Belgrade, Serbia
| | - Saško Kedev
- University Clinic of Cardiology, Sts. Cyril and Methodius University, Skopje, Macedonia
| | - Michael J Rokoss
- The Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton General Hospital, Hamilton, ON, Canada
| | - Tej Sheth
- The Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton General Hospital, Hamilton, ON, Canada
| | - Vladimír Džavík
- Peter Munk Cardiac Centre, University Health Network, 6 Eaton North Room 232, Toronto, ON, Canada Toronto General Hospital, University Health Network, 200 Elizabeth Street, Toronto, ON Canada M5G 2C4
| | - Christopher B Overgaard
- Peter Munk Cardiac Centre, University Health Network, 6 Eaton North Room 232, Toronto, ON, Canada Toronto General Hospital, University Health Network, 200 Elizabeth Street, Toronto, ON Canada M5G 2C4
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Abstract
INTRODUCTION Medication error is a major source of iatrogenic illness. Error in prescription is the most common form of avoidable medication error. We present our study, performed at two, UK, National Health Services Hospitals. MATERIAL AND METHODS The prescription practice of junior doctor's working on general medical and surgical wards in National Health Service District General and University Teaching Hospitals in the UK was reviewed. Practice was assessed against standard hospital prescription charts, developed in accordance with local pharmacy guidance. RESULTS A total of 407 prescription charts were reviewed in both initial audit and re-audit one year later. In the District General Hospital, documentation of allergy, weight and capital-letter prescription was achieved in 31, 5 and 40% of charts, respectively. Forty-nine per cent of discontinued prescriptions were properly deleted and signed for. In re-audit significant improvement was noted in documentation of the patient's name 100%, gender 54%, allergy status 51% and use of generic drug name 71%. Similarly, in the University Teaching Hospital, 82, 63 and 65% compliance was achieved in documentation of age, generic drug name prescription and capital-letter prescription, respectively. Prescription practice was reassessed one year later after recommendations and changes in the prescription practice, leading to significant improvement in documentation of unit number, generic drug name prescription, insulin prescription and documentation of the patient's ward. CONCLUSION Prescription error remains an important, modifiable form of medical error, which may be rectified by introducing multidisciplinary assessment of practice, nationwide standardised prescription charts and revision of current prescribing clinical training.
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Affiliation(s)
- Tahir Hamid
- Manchester Royal Infirmary, Central Manchester University Hospitals NHS Trust, UK & Dudley Group of Hospitals, UK
| | | | - Samman Rose
- Manchester Royal Infirmary, Central Manchester University Hospitals NHS Trust, UK & Dudley Group of Hospitals, UK
| | - Sanjive Petkar
- Manchester Royal Infirmary, Central Manchester University Hospitals NHS Trust, UK & Dudley Group of Hospitals, UK
| | - Richard Fienman
- Manchester Royal Infirmary, Central Manchester University Hospitals NHS Trust, UK & Dudley Group of Hospitals, UK
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Rendon A, Hamid T, Kanaganayagam G, Karunaratne D, Mahadevan VS. Annular sizing using real-time three-dimensional intracardiac echocardiography-guided trans-catheter aortic valve replacement. Open Heart 2016; 3:e000316. [PMID: 27158522 PMCID: PMC4854149 DOI: 10.1136/openhrt-2015-000316] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Accepted: 01/25/2016] [Indexed: 01/28/2023] Open
Abstract
Objective Transcatheter aortic valve replacement (TAVR) has been established as an alternative therapy for patients with severe aortic stenosis who are unfit for the surgical aortic valve replacements. Pre and periprocedural imaging for the TAVR procedure is the key to procedural success. Currently transesophageal echocardiography (TOE), including real-time three-dimensional (RT-3D) imaging TOE, has been used for peri-interventional monitoring and guidance for TAVR. We describe our initial experience with real-time three-dimensional intracardiac echocardiography (RT-3DICE), imaging technology for the use in the TAVR procedure. Methods We used RT-3DICE using an ACUSON SC2000 2.0v (Siemens Medical Solution), and a 10F AcuNav V catheter (Siemens-Acuson, Inc, Mountain View, California, USA) in addition to preoperative multislice CT (MSCT) in total of five patients undergoing TAVR procedure. Results Aortic annulus and sinus of valsalva diameters were measured using RT-3DICE. Aortic valve measurements obtained using RT-3DICE are comparable to those obtained using MSCT with no significant difference in our patients. Conclusions This small study of five patients shows the safe use of RT-3DICE in TAVR Procedure and may help the procedures performed under local anaesthesia without the need for TOE.
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Affiliation(s)
| | - Tahir Hamid
- Manchester Royal Infirmary, University of Central Manchester NHS foundation Trust , Manchester , UK
| | | | - Devinda Karunaratne
- Manchester Royal Infirmary, University of Central Manchester NHS foundation Trust , Manchester , UK
| | - Vaikom S Mahadevan
- Manchester Royal Infirmary, University of Central Manchester NHS foundation Trust, Manchester, UK; University of California, San Francisco, USA
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Hamid T, Zaman M. Switching of Ticagrelor to Clopidogrel at 3 Months in Patients Treated for Acute Care Syndrome; Single Centre Experience. ACTA ACUST UNITED AC 2016. [DOI: 10.4172/2329-6607.1000194] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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20
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Sharma V, Hamid T. Left Ventricular Angiography Post Primary Percutaneous Intervention-does it Predict Subsequent Left Ventricular Dysfunction? Exp Clin Cardiol 2016. [DOI: 10.4172/2155-9880.1000466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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21
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Hamid T, Choudhury TR, Anderson SG, Hashmi I, Chowdhary S, Hesketh Roberts D, Fraser DG, Hasan R, Mahadevan VS, Levy R. Does the CHA2DS2-Vasc score predict procedural and short-term outcomes in patients undergoing transcatheter aortic valve implantation? Open Heart 2015; 2:e000170. [PMID: 26512326 PMCID: PMC4620233 DOI: 10.1136/openhrt-2014-000170] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2014] [Revised: 10/12/2014] [Accepted: 11/26/2014] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND Transcatheter aortic valve implantation (TAVI) is associated with periprocedural and postprocedural morbidity and mortality. Currently, there is a paucity of risk stratification models for potential TAVI candidates. We employed the CHA2DS2-Vasc score to quantify the risk of 30-day mortality and morbidity in patients undergoing TAVI. METHODS AND RESULTS A retrospective analysis of registry data for consecutive patients undergoing TAVI at 3 tertiary centres in Northwest England between 2008 and 2013. The CHA2DS2-Vasc score and its modification-the R2CHA2DS2-Vasc score, which includes pre-existing renal impairment and pre-existing conduction abnormality (right bundle branch block/left bundle branch block, RBBB/LBBB)-were calculated for all patients. A total of 313 patients with a mean age of 80 (79.1-80.8) years underwent TAVI. The implanted devices were either the CoreValve or the Edwards-SAPIEN prosthesis. The 30-day mortality was 14.3% in those with a CHA2DS2-Vasc score ≥6, whereas it was only 6.2% in those with a score <6 (p=0.04). Using the R2-CHA2DS2-Vasc score, the difference was more pronounced with a 30-day mortality of 22.6% in those patients with an R2-CHA2DS2-Vasc score ≥7 compared to 6.0% in those with a R2-CHA2DS2-Vasc score <7 (p=0.001). In multivariable Cox regression analyses, there was a significant and independent relationship between the CHA2DS2-Vasc score (hazard ratio (HR)= 2.71, (1.01 to 7.31); p<0.05) and the modified R2CHA2DS2-Vasc score (HR=4.27 (1.51 to 12.07); p=0.006) with 30-day mortality. CONCLUSIONS Our study demonstrates the potential use of the CHA2DS2-Vasc or the R2CHA2DS2-Vasc score to quantify the risk of mortality in patients undergoing TAVI. This could have significant implications in terms of clinical as well as patients' decision-making.
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Affiliation(s)
- Tahir Hamid
- Manchester Royal Infirmary, Central Manchester University NHS Foundation Trust , Manchester , UK ; University Hospital of South Manchester NHS Foundation Trust , Wythenshawe , UK
| | - Tawfiq R Choudhury
- Manchester Royal Infirmary, Central Manchester University NHS Foundation Trust , Manchester , UK
| | - Simon G Anderson
- Manchester Royal Infirmary, Central Manchester University NHS Foundation Trust , Manchester , UK ; Institute of Cardiovascular Sciences, University of Manchester , Manchester , UK
| | - Izhar Hashmi
- Blackpool Teaching Hospitals NHS Foundation Trust , Blackpool , UK
| | - Saqib Chowdhary
- University Hospital of South Manchester NHS Foundation Trust , Wythenshawe , UK
| | | | - Douglas G Fraser
- Manchester Royal Infirmary, Central Manchester University NHS Foundation Trust , Manchester , UK
| | - Ragheb Hasan
- Manchester Royal Infirmary, Central Manchester University NHS Foundation Trust , Manchester , UK
| | - Vaikom S Mahadevan
- Manchester Royal Infirmary, Central Manchester University NHS Foundation Trust , Manchester , UK
| | - Richard Levy
- University Hospital of South Manchester NHS Foundation Trust , Wythenshawe , UK
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Hamid T, Jamallulail SI, Clarke B, Mahadevan VS. Dual Arterial Access for Stenting of Aortic Coarctation in Patients with Near-Total Descending Aortic Interruption. Cardiol Ther 2015; 4:203-7. [PMID: 26387128 PMCID: PMC4675754 DOI: 10.1007/s40119-015-0048-9] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Indexed: 11/29/2022] Open
Abstract
Endovascular stenting is a recognized treatment strategy for the treatment of coarctation of aorta (COA) in adults. The aortic coarctation is usually crossed retrogradely from the descending aorta via the femoral approach. We report three patients who had near-total descending aortic interruption and underwent successful stenting of severe COA using a combined radial/brachial and femoral approach due to difficulty in crossing the lesion retrogradely via a femoral approach. There were no procedural complications and no adverse events during 6 months of follow-up.
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Patel A, Hassan S, Ullah A, Hamid T, Kirk H. Early triaging using the Modified Early Warning Score (MEWS) and dedicated emergency teams leads to improved clinical outcomes in acute emergencies. Clin Med (Lond) 2015; 15 Suppl 3:s3. [PMID: 26026024 DOI: 10.7861/clinmedicine.15-3-s3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Amar Patel
- Wirral University Teaching Hospital, Merseyside, UK
| | - Saad Hassan
- Wirral University Teaching Hospital, Merseyside, UK
| | - Abid Ullah
- Wirral University Teaching Hospital, Merseyside, UK
| | - Tahir Hamid
- Wirral University Teaching Hospital, Merseyside, UK
| | - Hannah Kirk
- Wirral University Teaching Hospital, Merseyside, UK
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Hamid T, Malik N. Saphenous vein graft pseudoaneurysm: a case for medical management. J Coll Physicians Surg Pak 2014; 24 Suppl 3:S169-70. [PMID: 25518760 DOI: 11.2014/jcpsp.s169s170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Received: 02/18/2013] [Accepted: 10/09/2013] [Indexed: 09/29/2022]
Abstract
Saphenous vein bypass pseudoaneurysm is rare but fatal complication after coronary bypass surgery. Pseudoaneurysm is managed either with a surgical or percutaneous approach. This patient underwent quadruple coronary artery bypass grafting 10 years earlier and was referred for recurrence of angina. Coronary and graft angiography revealed a pseudoaneurysm in the saphenous vein graft supplying the intermediate coronary artery. After discussion with the cardiothoracic surgeons, the patient was managed conservatively. He was continued on Aspirin, beta-blockers, statins, nitrates and angiotensin converting enzyme inhibitors. He was followed-up regularly in outpatient clinic with a planned repeat coronary and graft angiography. The patient's symptoms remain stable and repeat angiography 24 months later did not show any significant deterioration of the graft pseudoaneurysm. He remains stable at 12 months after the repeated angiography.
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Affiliation(s)
- Tahir Hamid
- Department of Cardiology, Stepping Hill Hospital, Stockport NHS Foundation Trust, UK
| | - Nadim Malik
- Department of Cardiology, Stepping Hill Hospital, Stockport NHS Foundation Trust, UK
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Affiliation(s)
- Tahir Hamid
- Cardiology Department, Royal Albert Edward Infirmary, Wigan, UK Royal Blackburn Hospital NHS Trust, Blackburn, UK
| | | | | | - Telal Mudawi
- Royal Blackburn Hospital NHS Trust, Blackburn, UK
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Hamid T, Choudhury T, Anderson S, Hashmi I, Roberts D, Levy R. 82 Does the CHA2S2VASC or R2-CHA2DS2VASC Predict Procedural and Short-term Outcomes in Patients Undergoing Transcatheter Aortic Valve Implantation. Heart 2014. [DOI: 10.1136/heartjnl-2014-306118.82] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Hamid T, Aleem Q, Lau Y, Singh R, McDonald J, Macdonald JE, Sastry S, Arya S, Bainbridge A, Mudawi T, Balachandran K. Pre-procedural fasting for coronary interventions: is it time to change practice? Heart 2014; 100:658-61. [PMID: 24522621 DOI: 10.1136/heartjnl-2013-305289] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Traditionally, patients are kept nil-per-os/nil-by-mouth (NPO/NBM) prior to invasive cardiac procedures, yet there exists neither evidence nor clear guidance about the benefits of this practice. OBJECTIVES To demonstrate that percutaneous cardiac catheterisation does not require prior fasting. METHODS The data source is a retrospective analysis of data registry of consecutive patients who underwent percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS) and stable angina at two district general hospitals in the UK with no on-site cardiac surgery services. RESULTS A total of 1916 PCI procedures were performed over a 3-year period. None of the patients were kept NPO/NBM prior to their coronary procedures. The mean age was 67±16 years. 1349 (70%) were men; 38.5% (738/1916) had chronic stable angina, while the rest had ACS. 21% (398/1916) were diabetics while 53% (1017/1916) were hypertensive. PCI was technically successful in 95% (1821/1916) patients. 88.5% (1697/1916) had transradial approach. 77% (570/738) of elective PCI patients were discharged within 6 h postprocedure. No patients required emergency endotracheal intubation and there were no occurrences of intraprocedural or postprocedural aspiration pneumonia. CONCLUSIONS Our observational study demonstrates that patients undergoing PCI do not need to be fasted prior to their procedures.
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Affiliation(s)
- Tahir Hamid
- Royal Blackburn Hospital NHS Trust, , Blackburn, UK
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Hamid T, Choudhury TR, Fraser D. Multi-vessel percutaneous coronary intervention in a patient with a type B aortic dissection-transradial or transfemoral? World J Cardiol 2013; 5:258-260. [PMID: 23888196 PMCID: PMC3722424 DOI: 10.4330/wjc.v5.i7.258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2013] [Revised: 06/07/2013] [Accepted: 07/05/2013] [Indexed: 02/06/2023] Open
Abstract
Patients with chronic aortic dissections are at high risk of catheter-induced complications. We report a 41-year-old patient with a type B aortic dissection (Stanford) who underwent successful three-vessel percutaneous coronary intervention via the right radial artery approach following a non-ST elevation myocardial infarction. The patient remained asymptomatic at 6 mo follow-up. Trans-radial approach for coronary interventions can be used safely in patients with Stanford type B aortic dissection without increasing the risk of procedure- related complications in this high-risk group of patients.
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Hamid T. Use of the Impella Left Ventricular Assist Device as a Bridge to Recovery in a Patient with Cardiogenic Shock Related to Takotsubo Cardiomyopathy. Exp Clin Cardiol 2013. [DOI: 10.4172/2155-9880.1000246] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Hamid T, Rajagopal R, Pius C, Clarke B, Mahadevan VS. Preclosure of large-sized venous access sites in adults undergoing transcatheter structural interventions. Catheter Cardiovasc Interv 2012; 81:586-90. [DOI: 10.1002/ccd.24358] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2011] [Accepted: 02/02/2012] [Indexed: 12/19/2022]
Affiliation(s)
- Tahir Hamid
- Manchester Royal Infirmary; University of Central Manchester and Manchester University Children's Hospital; United Kingdom
| | - Rajinikanth Rajagopal
- Manchester Royal Infirmary; University of Central Manchester and Manchester University Children's Hospital; United Kingdom
| | - Charlene Pius
- Manchester Royal Infirmary; University of Central Manchester and Manchester University Children's Hospital; United Kingdom
| | - Bernard Clarke
- Manchester Royal Infirmary; University of Central Manchester and Manchester University Children's Hospital; United Kingdom
| | - Vaikom S. Mahadevan
- Manchester Royal Infirmary; University of Central Manchester and Manchester University Children's Hospital; United Kingdom
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Hamid T, Lau YC, Aleem Q, Oozeerally I, McDonald J, John M, Singh R, Sanjay SA, Anthony B, Mudawi T, Balachandran K. TCT-323 Pre-Procedural Fasting for Diagnostic and Interventional Coronary Procedures – Is It Neccessary? J Am Coll Cardiol 2012. [DOI: 10.1016/j.jacc.2012.08.348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Hamid T, Murphy G, Mahadevan VS. Treatment of multiple residual complex coronary to right ventricular fistulae with covered stents following previous coil embolization. Exp Clin Cardiol 2012; 17:146-147. [PMID: 23620706 PMCID: PMC3628431] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Congenital coronary artery fistulae may be isolated or may be associated with complex congenital cardiac abnormalities. In patients with complex congenital heart disease, multiple fistulous or sinusoidal communications with a cardiac chamber can occur. The treatment strategy includes surgery, coil embolization and covered stent deployment. The present article describes a case involving a 20-year-old patient with complex congenital heart lesions and multiple sinusoidal coronary to right ventricle fistulous communications, which remained patent despite coil embolization in childhood. Further coil or device embolization was deemed unlikely to be successful due to the presence of multiple communications; therefore, covered stents were deployed across the previously coiled segment of the coronary artery. The patient had an excellent clinical outcome on follow-up nine months later, with significant improvement of symptoms.
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Affiliation(s)
- Tahir Hamid
- Correspondence: Dr Tahir Hamid, Manchester Heart Centre, Manchester Royal Infirmary, Oxford Road, Manchester, United Kingdom M13 9WL. Telephone 0-161-276-8098, fax 0-161-276-5138, e-mail
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33
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Petkar S, Hamid T, Iddon P, Clifford A, Rice N, Claire R, McKee D, Curtis N, Cooper PN, Fitzpatrick AP. Prolonged implantable electrocardiographic monitoring indicates a high rate of misdiagnosis of epilepsy--REVISE study. Europace 2012; 14:1653-60. [DOI: 10.1093/europace/eus185] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
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34
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Hamid T, Clarke B, Mahadevan V. Transcatheter interventions for multiple lesions in adults with congenital heart disease. Exp Clin Cardiol 2012; 17:59-62. [PMID: 22826648 PMCID: PMC3395456] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Recent advances in diagnosis, surgery and interventional management have significantly changed the quality of life of patients with congenital heart disease. Historically, congenital heart disease patients with multiple cardiac lesions have been referred for surgery; however, with the advent of newer technologies and expertise, transcatheter treatment has evolved as an alternative option. A series of patients who underwent interventional procedures for multiple congenital heart disease lesions with excellent procedural and medium-term outcomes is reported.
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Affiliation(s)
| | | | - Vaikom Mahadevan
- Correspondence: Dr VS Mahadevan, Manchester Heart Centre, Manchester Royal Infirmary, Oxford Road, Manchester, United Kingdom. Telephone 161-276-8098, fax 161-276-5138, e-mail
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Hamid T, Harper L, McDonald J. Radial artery pseudoaneurysm following coronary angiography in two octogenarians. Exp Clin Cardiol 2012; 17:260-262. [PMID: 23592950 PMCID: PMC3627289] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
The radial artery approach to coronary catheterization is considered to be superior to femoral artery access in terms of vascular complications. The authors describe two patients who developed pseudoaneurysm following radial artery access for cardiac catheterization. The patients underwent surgical exploration with good results. Although rare, radial artery pseudo-aneurysms may complicate cardiac catheterization and have serious clinical consequences.
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Affiliation(s)
- Tahir Hamid
- Correspondence: Dr Tahir Hamid, Cardiology Department, Royal Blackburn Hospital, Haslingden Road, Blackburn BB2 3HH, United Kindom. Telephone 44-079-7918-7332, fax 44-1254-293512, e-mail
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36
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Hamid T, Rose S, Horner S. Right sided single coronary artery origin: surgical interventions without clinical consequences. J Coll Physicians Surg Pak 2011; 21:700-1. [PMID: 22078352 DOI: 11.2011/jcpsp.700701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Received: 11/15/2010] [Accepted: 09/16/2011] [Indexed: 11/20/2022]
Abstract
Congenital coronary anomalies are uncommon and are usually diagnosed incidentally during coronary angiogram or autopsy. Isolated coronary artery anomalies and the anomalous origin of left main stem (LMS) from the proximal portion of the right coronary artery or from the right sinus of valsalva are extremely rare. A 68 years old woman with atypical chest pains was referred for risk assessment for the general anaesthesia. A stress exercise treadmill test and myocardial perfusion scan revealed evidence of mild myocardial ischemia. Her coronary angiography revealed her left coronary artery to have a single origin with the right coronary artery. There were no flowlimiting lesions. A CT aortography confirmed a retro-aortic course of the left coronary artery. She successfully underwent multiple surgical procedures under general anaesthesia including total abdominal hysterectomy, Burch colposuspension (twice) for stress incontinence, intravesical botox injection for urge incontinence and haemorrhoidectomy for recurrent rectal mucosal prolapse. Various anaesthetic agents including halothane, thiopentone, suxamethonium, pancuronium, enflurane, fentanyl, propofol and isoflurane were used without any adverse clinical consequences. She remained well on 48 months follow-up.
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Affiliation(s)
- Tahir Hamid
- Manchester Heart Centre, Manchester Royal Infirmary, University of Central Mancheser, UK.
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Khattar RS, Nair SB, Hamid T, Chacko S, Mamas M, Turkie W, Arumugam P. Prognostic value of demographic factors, pre-test probability scoring, exercise test diagnosis, and inability to exercise in patients with recent onset suspected cardiac chest pain. Eur J Prev Cardiol 2011; 19:419-27. [DOI: 10.1177/1741826711404505] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Aims: To assess the prognostic value of an inconclusive exercise test or inability to exercise in patients with recent onset suspected cardiac chest pain and to determine the independent predictors of events in these patients. Methods: This was an observational follow-up study of patients presenting to a rapid access chest pain clinic with a history of recent-onset suspected cardiac chest pain as referred by the family practitioner. The main outcome measure was a composite endpoint of death and acute coronary syndrome hospital admission. Results: The study cohort consisted of 1851 patients in whom a total of 147 events were recorded during a mean follow-up period of 4.1 ± 1.1 years. Those with events were significantly older (65.1 ± 12.5 years versus 56.4 ± 13.2 years, p < 0.001), had higher mean pre-test probability of coronary artery disease (CAD), and had higher prevalence of diabetes (18.4% vs. 13.6%, p < 0.001), hypertension (55.8% vs. 38.7%, p < 0.001), and smoking (36.7% vs. 25.4%, p = 0.03) than those without events. These patients were also more likely to have a positive exercise electrocardiogram (ECG) (15.6% vs. 8.6%, p < 0.001) or not have a diagnostic exercise test because of an inconclusive result or inability to exercise (60.5% vs. 28.6%, p < 0.001). Cox multivariate regression analysis showed that age (hazard ratio, HR 1.03, p < 0.001), pre-test probability of CAD (HR 1.08, p = 0.04), positive exercise ECG (HR 2.94, p < 0.001), and an inconclusive test or inability to exercise (HR 3.45, p < 0.001) were independent predictors of events. Conclusions: In patients with recent onset suspected cardiac chest pain, not having a diagnostic exercise ECG because of an inconclusive test or inability to exercise is an independent predictor of events and has similar prognostic implications to a positive exercise ECG. In addition, pre-test probability estimation at baseline is a robust indicator of clinical outcome. Future models of care need to incorporate early and increased access to non-exercise cardiac imaging techniques in order to meet the needs of this high-risk subgroup of patients.
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Affiliation(s)
- Rajdeep S Khattar
- Manchester Heart Centre, Manchester Royal Infirmary and The University of Manchester, Manchester, UK
| | - Satheesh B Nair
- Manchester Heart Centre, Manchester Royal Infirmary and The University of Manchester, Manchester, UK
| | - Tahir Hamid
- Manchester Heart Centre, Manchester Royal Infirmary and The University of Manchester, Manchester, UK
| | - Sanoj Chacko
- Manchester Heart Centre, Manchester Royal Infirmary and The University of Manchester, Manchester, UK
| | - Mamas Mamas
- Manchester Academic Health Science Centre, University of Manchester, Manchester, UK
| | - Wajdi Turkie
- Manchester Heart Centre, Manchester Royal Infirmary and The University of Manchester, Manchester, UK
| | - Parthiban Arumugam
- Department of Nuclear Medicine, Manchester Royal Infirmary, Manchester, UK
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Hamid T, Rose S, Harris R, Malik N. ECG changes in a patient with essential tremors. J Coll Physicians Surg Pak 2010; 20:633. [PMID: 20810064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2010] [Accepted: 09/01/2010] [Indexed: 05/29/2023]
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Hamid T, Lazz-Onyenobi G, Griffiths L, Clarke B, Mahadevan SV. 096 Endovascular stenting for native coarctation of the aorta using the CP Numed covered stent: Abstract 096 Table 1. Heart 2010. [DOI: 10.1136/hrt.2010.196071.18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Hamid T, Foskett L, Rose S, Malik N. Interferences or real ECG changes? J Coll Physicians Surg Pak 2010; 20:424. [PMID: 20642981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2010] [Accepted: 06/01/2010] [Indexed: 05/29/2023]
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Nair SB, Chacko SM, Hamid T, Turkie W, Rezai R, Khattar RS. 112 Inability to exercise or a non-diagnostic exercise test identify a higher risk sub-set of patients in those with an intermediate pretest probability of coronary artery disease:. Heart 2010. [DOI: 10.1136/hrt.2010.196089.7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Hamid T, Rose S, Clifford A, Homa S, Garratt C, Clarke B, Cooper P, Fitzpatrick A, Petkar S, McHugh C. FP35-WE-01 Value of long term cardiac rhythm monitoring by an implantable ECG loop recorder (ILR) in patients presenting to the neurologist with transient loss of consciousness (T-LOC). J Neurol Sci 2009. [DOI: 10.1016/s0022-510x(09)70450-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Chacko S, Mamas M, Nair S, Luckie M, Hamid T, Mahadevan V. EMERGENCY PERCUTANEOUS AORTIC BALLOON VALVULOPLASTY IN A NONAGENARIAN. J Am Geriatr Soc 2009; 57:185-6. [DOI: 10.1111/j.1532-5415.2009.02066.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Petkar S, Hamid T, Pendegrast B, Garratt C, Arumugam P. Disappearing hot spot on an indium 111 white cell scan: a case report. J Nucl Cardiol 2008; 15:e1-5. [PMID: 18242469 DOI: 10.1016/j.nuclcard.2007.11.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Sanjiv Petkar
- Manchester Hear Centre, Manchester Royal Infirmary, Manchester, England
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Kakar S, Hamid T. 236 PTTG/securin induces and modulates p53 expression and function. EJC Suppl 2004. [DOI: 10.1016/s1359-6349(04)80244-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Abstract
Pituitary tumor transforming gene (pttg) is a recently isolated oncogene that is expressed in most of the tumors. Overexpression of pttg results in an increase in cell proliferation, induces cell transformation in vitro, and promotes tumor formation in nude mice. The gene encodes a protein of 202 amino acids with no significant homology with other known proteins. The protein is a multi domain consisting of a transactivation domain, domain required for ubiquitin-mediated proteolysis and a DNA binding domain. pttg protein is bestowed with a multitude of functions and seems to be involved in most of the important mechanisms of cell proliferation, differentiation and signaling. Given the number of processes that are involved in the manifestation of cancer, it thus becomes mandatory to study the role of this potent oncogene in relation to the processes of cell survival, death and functioning.
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Affiliation(s)
- T Hamid
- Department of Medicine, James Brown Cancer Center, University of Louisville, Louisville, Kentucky 40202, USA
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Ahmad I, Hamid T, Fatima M, Chand HS, Jain SK, Athar M, Raisuddin S. Induction of hepatic antioxidants in freshwater catfish (Channa punctatus Bloch) is a biomarker of paper mill effluent exposure. Biochim Biophys Acta 2000; 1523:37-48. [PMID: 11099856 DOI: 10.1016/s0304-4165(00)00098-2] [Citation(s) in RCA: 268] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Enzymatic and non-enzymatic antioxidants serve as an important biological defense against environmental oxidative stress. Information on antioxidant defense in fish is meager despite that fish are constantly exposed to a myriad of environmental stress including the oxidants. This study, therefore, assesses the activities of antioxidant enzymes viz., glutathione peroxidase, catalase and glutathione S-transferase and the non-enzymatic antioxidants viz., glutathione and metallothionein in various tissues of freshwater fish Channa punctatus (Bloch), in response to short-term and long-term exposures to paper mill effluent. The fish were exposed to the effluent at a concentration of 1.0% (v/v) for 15, 30, 60 and 90 days. The exposure caused a time-dependent increase in glutathione level (P < 0.001), activities of glutathione peroxidase (P < 0.05 to P < 0.001), glutathione S-transferase (P < 0.001) and a marginal initial decrease in catalase activity in the liver (P < 0.01 to P < 0.001). Metallothionein was induced in liver after 60 days of exposure. Two isoforms of metallothionein were detected. Catalase activity also increased 60 days afterwards. Antioxidant pattern was different in gill and kidney showing that liver was more resistant to oxidative damage as compared to gills and kidney. Our results demonstrate a pollutant-induced adaptive response in fish. In addition, levels of enzymatic and non-enzymatic tissue antioxidants may serve as surrogate markers of exposure to oxidant pollutants in fish.
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Affiliation(s)
- I Ahmad
- Department of Medical Elementology and Toxicology, Jamia Hamdard, Hamdard University, New Delhi, India
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Sayeed I, Ahmad I, Fatima M, Hamid T, Islam F, Raisuddin S. Inhibition of brain Na(+),K(+)-ATPase activity in freshwater catfish (Channa punctatus bloch) exposed to paper mill effluent. Bull Environ Contam Toxicol 2000; 65:161-167. [PMID: 10885992 DOI: 10.1007/s001280000110] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Affiliation(s)
- I Sayeed
- Department of Medical Elementology and Toxicology, Jamia Hamdard (Hamdard University), New Delhi 110 062, India
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