Journal of cardiovascular disease research (J Cardiovasc Dis Res )

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  • ISSN
    0976-2833

Publications in this journal

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    ABSTRACT: The aim of this study was to compare the performance of nurses and medical staff in using two methods of hemodynamic monitoring in cardiac surgery patients. We designed a double-blind study in which nurses and physicians measured cardiac output and other hemodynamic variables using pulmonary artery catheter thermodilution (PACTD; the ‘gold standard’) and a comparator (continuous cardiac dynamic monitoring [CCDM]-HeartSmart®). Hemodynamic values measured using PACTD and HeartSmart® were comparable between nurses and physicians. In addition, PACTD measurements were in good agreement with those derived from CCDM-HeartSmart®. Specialized Cardiac Intensive Care Unit (CICU) nurses are as competent as any member of the medical staff in measuring hemodynamic measurements using PACTD
    Journal of cardiovascular disease research 04/2014; 2(2).
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    ABSTRACT: Case Study
    Journal of cardiovascular disease research 03/2014; 2329(2):2.
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    ABSTRACT: a b s t r a c t Background: A wide variation exists in the patterns of pharmacotherapy among patients admitted with cardiovascular diseases. Very few studies have evaluated the potential determinants of drug utilization. Our objective was to evaluate the clinical characteristics and patterns of cardiovascular drug utilization among patients in coronary care unit (CCU) and assess the determinants of cardiovascular drug use among patients with coronary artery disease (CAD). Methods: In this retrospective cohort study, the medical records of CCU patients were reviewed independently by two trained physicians over one year. Patients were analyzed as two groups e those with CAD and without CAD. Multivariate logistic regression was done to identify the determinants of cardiovascular drug utilization in the CAD group. Results: Of 574 patients, 65% were males, 57% were <60 years. The five commonly prescribed drug classes were platelet inhibitors (88.7%), statins (76.3%), ACE-inhibitors/Angiotensin receptor blockers (72%), beta-blockers (58%) and heparin (57%). Poly-pharmacy (>5 drugs) was noticed in 71% of patients. A majority of patients had diagnosis of CAD (72.6%). CAD patients received significantly higher median number of drugs and had longer duration of CCU stay (p < 0.0001). Renal dysfunction for ACE-inhibitors [0.18 (0.09e0.36)], ST-elevation myocardial infarction for calcium channel blockers [0.29 (0.09e0.93)] and brady-arrhythmias for beta-blockers [0.3 (0.2e0.7)] were identified as determinants of decreased drug use in CAD group. Conclusion: Predominance of male gender, age <60 and poly-pharmacy was observed in CCU. Antithrombotics, statins, ACE-inhibitors/Angiotensin receptor blockers and beta-blockers were the most frequently prescribed drugs. Clinical co-morbidities (renal dysfunction, arrhythmias) decreased the utilization of ACE-inhibitors, beta-blockers among CAD patients. Copyright � 2013, SciBioIMed.Org, Published by Reed Elsevier India Pvt. Ltd. All rights reserved.
    Journal of cardiovascular disease research 02/2014;
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    ABSTRACT: Background Acute myocardial infarction (AMI) concomitant with aortic dissection (AD) is rare but a devastating situation if misdiagnosed as simply AMI, followed by anticoagulant or thrombolytic therapy. In such cases, Standford type B AD was extremely infrequent. Objectives To present a case with apparent concordance with the patient's history, symptoms, cardiac enzymes that lead to diagnostic error. Case report An 85-year-old man with chronic hypertension and coronary atherosclerotic heart disease presented in our emergency department with squeezing retrosternal chest pain and dyspnea. Elevated cardiac enzymes and electrocardiography result suggested acute non-ST-segment elevation myocardial infarction. Emergency coronary angiography demonstrated a 50–90% diffuse stenosis of the proximal and mid right coronary artery also confirmed the diagnosis. Stents were deployed thereafter. However, the patient was found to be concomitant with Standford type B AD by computed tomography angiography due to unrelieved chest pain and new onset of abdominal pain after the operation. The patient refused to have endovascular operation and died of hemorrhagic shock one week later. Conclusions AD may cause AMI due to some indirect mechanisms, and it is of utmost importance to search for the existence of AD before reperfusion therapy in AMI patients. Aortic dissection detection risk score, transthoracic echocardiography and D-dimer help early identification of AD.
    Journal of cardiovascular disease research 02/2014;
  • Journal of cardiovascular disease research 01/2014;
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    ABSTRACT: Background Cardiovascular diseases (CVDs) are the number one cause of death globally and are the leading cause of death in India also. Several surveys conducted across the country over the past few decades have shown a rising prevalence of major risk factors for CVD in Asian Indian population. The problem of increasing risk factors for CVD in India is because of lack of surveillance system and lack of proper diagnosis. This study will help to point out the need of research so that some advanced diagnosis system may be developed for proper diagnosis of CVDs and to reduce the growing burden of CVDs in the country. Methods We did a literature search for the period from 1968 to 2012 using PUBMED search to identify all relevant studies of cardiovascular diseases. Besides PUBMED searching, manual searching has also been done. This article provides a review of current understanding of the epidemiology of cardiovascular disease, particularly, coronary heart disease (CHD), stroke and related risk factors in Asian Indian population. Results Hypertension and diabetes are highly prevalent among Asian Indian population, which may explain their high rate of stroke and heart attack in India. The increasing rate of CVD may be explained by the high rates of other risk factors including adverse lipid profile. The etiology of cardiovascular diseases (CVD) is multifactorial and no single factor is an absolute cause. Conclusion The cardiovascular diseases and its risk factors are increasing with a rapid pace in Asian Indian population. Though the prevalence of CVD risk factors is found higher in urban population, yet it is increasing at an alarming rate in rural population also, which is a serious threatening to the nation. Since majority of the Indians live in rural area, CVD may lead to epidemic proportions. We need health promotion programs and reorientation of primary health care to improve CVD detection in earlier stage and its management.
    Journal of cardiovascular disease research 01/2014;
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    ABSTRACT: Many types of cardiac arrhythmias have been noted following acute myocardial infarction. Polymorphic ventricular arrhythmias (polymorphic ventricular tachycardia and ventricular fibrillation) related to an acute myocardial infarction generally strike during the hyperacute phase, are clearly related to ischaemia and are not associated with a long QT interval time. Pause-dependent Torsade de pointes has been reported following acute myocardial infarction and this arrhythmia generally occurs 3–11 days after the onset of acute myocardial infarction and none has been reported during the hyperacute phase. Torsade de pointes – a specific ventricular tachycardia with specific characteristics has been described in hypokalemia, hypomagnesaemia, during Quinidine therapy, and while using phenothiazines and tricyclic antidepressants. It is reported following liquid protein diet, brady-arrhythmias [especially III° AV Block], sick-sinus syndromes. Torsade de pointes either pause-dependent or pause-independent occurring directly as a reperfusion arrhythmia during intravenous thrombolytic therapy has not been reported in the literature to the best of the authors knowledge. Here, an episode of Torsade de pointes as a direct consequence of reperfusion following thrombolytic therapy in a patient of acute myocardial infarction is described.
    Journal of cardiovascular disease research 01/2014;
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    ABSTRACT: Background A wide variation exists in the patterns of pharmacotherapy among patients admitted with cardiovascular diseases. Very few studies have evaluated the potential determinants of drug utilization. Our objective was to evaluate the clinical characteristics and patterns of cardiovascular drug utilization among patients in coronary care unit (CCU) and assess the determinants of cardiovascular drug use among patients with coronary artery disease (CAD). Methods In this retrospective cohort study, the medical records of CCU patients were reviewed independently by two trained physicians over one year. Patients were analyzed as two groups – those with CAD and without CAD. Multivariate logistic regression was done to identify the determinants of cardiovascular drug utilization in the CAD group. Results Of 574 patients, 65% were males, 57% were <60 years. The five commonly prescribed drug classes were platelet inhibitors (88.7%), statins (76.3%), ACE-inhibitors/Angiotensin receptor blockers (72%), beta-blockers (58%) and heparin (57%). Poly-pharmacy (>5 drugs) was noticed in 71% of patients. A majority of patients had diagnosis of CAD (72.6%). CAD patients received significantly higher median number of drugs and had longer duration of CCU stay (p < 0.0001). Renal dysfunction for ACE-inhibitors [0.18 (0.09–0.36)], ST-elevation myocardial infarction for calcium channel blockers [0.29 (0.09–0.93)] and brady-arrhythmias for beta-blockers [0.3 (0.2–0.7)] were identified as determinants of decreased drug use in CAD group. Conclusion Predominance of male gender, age <60 and poly-pharmacy was observed in CCU. Antithrombotics, statins, ACE-inhibitors/Angiotensin receptor blockers and beta-blockers were the most frequently prescribed drugs. Clinical co-morbidities (renal dysfunction, arrhythmias) decreased the utilization of ACE-inhibitors, beta-blockers among CAD patients.
    Journal of cardiovascular disease research 01/2014;
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    ABSTRACT: Methadone is a drug that has found widespread utility in the management of opioid addiction and pain. Along with its popularity, methadone has also earned an infamous reputation for causing prolongation of the QT interval and an increased risk of torsades de pointes. In this article we will give a brief overview of the long QT syndromes, followed by an in-depth look at the current pathophysiologic mechanisms of methadone induced QT prolongation, a review of the existing literature and the current concepts regarding the prevention and management of methadone induced torsades de pointes. In addition, we explore the idea and implications of a genetic link between methadone induced prolongation of the QT interval and torsades de pointes.
    Journal of cardiovascular disease research 11/2013;