Indian heart journal
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Indian heart journal · May 2018
Observational StudyPulse wave analyzed cardiovascular parameters in young first degree relatives of type 2 diabetics- a cross-sectional study.
First degree relatives (FDR) of type 2 diabetic (T2D) are predisposed for type 2 diabetes mellitus (T2DM) which accelerates cardiovascular aging. Pulse wave analysis (PWA) gives non-invasive measurement of central hemodynamics like central blood pressure (cBP), cardiac output (CO), stroke work (SW) and vascular stiffness like pulse wave velocity (PWV) and augmentation index at heart rate 75 (AIx@75). ⋯ Young, sedentary, non-obese FDRs of T2D have adverse cardiovascular profile which is suggested to worsen before or with onset of T2DM and definitely need attention for life style modification as primary prevention.
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Indian heart journal · May 2018
EditorialPost-truth era and cardiology: After ORBITA, before CABANA.
The evidence-based medicine is rooted in the scientific truth. Oxford Dictionaries has released its 2016 word of the year: "Post-truth," which they define as "relating to or denoting circumstances in which objective facts are less influential in shaping public opinion than appeals to emotion and personal belief". In everything from climate change denial to the anti-vaccine movement, we're seeing the consequences of a failure to engage with scientific evidence. ⋯ We also see some evidence of post-truth signals in daily cardiology procedures and guidelines including both interventional cardiology and cardiac electrophysiology. Guideline recommendations made before the randomized-controlled trials (RCT) are published might result in a scenario that the interventions or procedures have been performed on millions of people, costing billions of dollars, leading to unnecessary use of health care resources and often, ending up being even accepted as routine procedures in certain clinical situations. "Justice delayed is justice denied" is a legal cliché meaning that if timely justice is not provided to the sufferer, it loses it importance and violates human rights. In medicine, "The RCT delayed is justice denied", as highlighted by ORBITA (Objective Randomised Blinded Investigation with optimal medical Therapy of Angioplasty in stable angina) trial and as may happen with CABANA (Catheter Ablation versus Anti-arrhythmic Drug Therapy for Atrial Fibrillation Trial) in the post-truth era.
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Indian heart journal · May 2018
Observational StudyIncidence and predictors of perioperative myocardial infarction in patients undergoing non-cardiac surgery in a tertiary care hospital.
The stress in the perioperative period is compounded by unpredictable and un-physiological changes in sympathetic tone, cardiovascular performance, coagulation and inflammatory responses, all of which in turn lead to alterations in plaque morphology predisposing to perioperative myocardial infarction (PMI). PMI has a considerable morbidity and mortality in patients undergoing not only high risk surgery, but also even with minor surgical interventions. ⋯ PMI is a dreaded complication associated with a very high mortality. High risk surgery, smoking and past history of ischemic heart disease were independent predictors of PMI. The RCRI is a useful tool in pre-operative risk stratification of patients.