Indian heart journal
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Indian heart journal · Jan 2012
ReviewPlatelet adenosine diphosphate receptor antagonists: ticlopidine to ticagrelor-a long continuing journey.
Platelet aggregation plays a central role in the pathogenesis of atherothrombosis. Platelet adenosine diphosphate (ADP) receptor antagonists (ticlopidine, clopidogrel, prasugrel, and ticagrelor) are a major advance in the treatment of atherothrombotic diseases, especially acute coronary syndromes (ACS). Ticlopidine was the first thienopyridine introduced into clinical practice, but its potentially serious haematological side-effects limited its use and it was quickly eclipsed by clopidogrel. ⋯ The data so far suggests that ticagrelor has a wider applicability in usage in patients with ACS as compared to prasugrel. Prasugrel however seems to be better tolerated. Search is on for newer more potent but safer anti-platelet agents.
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Indian heart journal · Jan 2012
Correlation between peripheral arterial disease and coronary artery disease using ankle brachial index-a study in Indian population.
To study the prevalence of peripheral arterial disease (PAD) of the lower limbs in a high-risk population and its correlation with coronary artery disease (CAD), using the ankle brachial index (ABI). ⋯ There is a definite and strong correlation between PAD and CAD. Correct diagnosis and supervision of patients with PAD is important for preventing the local progression of the disease and effective secondary prevention of future coronary and cerebrovascular events.
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Indian heart journal · Jan 2012
ReviewPulmonary hypertension-"state of the art" management in 2012.
Pulmonary artery hypertension (PAH) is a pathological condition of small pulmonary arteries, characterised by vascular proliferation and remodelling. The pulmonary artery pressure and pulmonary vascular resistance progressively rise, leading to right heart failure and death. Pulmonary artery hypertension may be secondary to various conditions, or it may be idiopathic where no underlying cause is identifiable. ⋯ However, over the years, improvement in understanding the pathogenesis has resulted in the development of targeted approaches to the treatment of PAH. Survival advantage has also been shown with some of the pharmacologic agents. This review article discusses the current management strategy for PAH with special emphasis on an idiopathic variety, in an Indian context.
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Indian heart journal · Jan 2012
Outcomes of in-hospital, out of intensive care and operation theatre cardiac arrests in a tertiary referral hospital.
Cardiac arrest in the hospital wards may not receive as much attention as it does in the operation theatre and intensive care unit (ICU). The experience and the qualifications of personnel in the ward may not be comparable to those in the other vital areas of the hospital. The outcome of cardiac arrest from the ward areas is a reasonable surrogate of training of the ward nurses and technicians in cardiopulmonary resuscitation. We conducted an audit to assess the issues surrounding the resuscitation of cardiac arrest in areas other than operation theatre and ICU in a tertiary referral hospital. AIMS OF THE AUDIT: To assess the outcomes of cardiac arrest in a tertiary referral hospital. Areas such as wards, dialysis room and emergency room were considered for the audit. ⋯ A overall survival to discharge rate of 30% was noted in this audit. Higher survival rates might be attributable to high rate and degree of training at the time of their employment, which was repeated at yearly interval.
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Indian heart journal · Sep 2011
Comparative StudyCoronary artery bypass grafting in women--is OPCAB mandatory?
There has been an explosive increase in our understanding of the natural history and progression of CAD in women. Women have a poorer prognosis and a more severe outcome than men after myocardial infarction, Percutaneous transluminal coronary angioplasty (PTCA) and coronary artery bypass grafting (CABG). The purpose of the present study was to evaluate the differences in the results of CABG in women as compared with men using Pump and Off Pump operating techniques. ⋯ Women coming for coronary artery bypass surgery are a special risk group. The operative and early mortality of bypass surgery in women is higher than in men for conventional CABG. However, off pump techniques has negated this to a large extent. Our findings lead us to conclude that use of OPCAB promises to be gratifying enough to mitigate the early concerns in this group of patients.