Objective: To assess the angiographic profile and in hospital outcomes of primary percutaneous coronary intervention among young patients presenting with acute ST Elevation Myocardial Infarction and underwent primary PCI. Methods: The retrospective observational study was conducted at Shahid Gangalal National Heart Centre (SGNHC), Kathmandu, from july 2020 to June 2021, and included acute ST-Elevation Myocardial Infarction patients underwent primary percutaneous coronary intervention (PCI). Data was collected on demographic, angiographic, and in-hospital outcomes. Patients <45 years were considered young. Data was analysed using SPSS 21. Results: Total 104 patients met the inclusion criteria. Mean age of presentation was 40.16 ± 4.42 years. Over three-fourth of the patients were male 80 (76.9%). Smoking was the most prevalent risk factor with 61 (58.6%) patients followed by hypertension 35 (33.6%) and dyslipidemia 23 (22.1%). Single Vessel Disease (SVD) was the most common finding seen in 62 patients (59.6%) and Left Anterior Descending Artery (LAD) was the most commonly involved artery seen in approximately three fourth patients 80 (76.9%) followed by RCA 61 (58.6%) and LCX 15(14.4%). Left Main Coronary Artery is involved in 3 patients (2.9%). 6 (5.8%) patients suffered from cardiogenic shock either at admission or during hospital stay. Total In hospital mortality was seen in 3 (2.9%) patients. Conclusions: Among young patients (<45 years old) with STEMI who underwent PPCI in underdeveloped country majority are males and smoking is the most prevalent risk factor. Single vessel disease and LAD involvement is the most common angiographic finding and they have favorable in-hospital outcome.

Background and Aims:  Hypertension being one of the commonest non communicable diseases is major risk factor leading to premature death.1 With development of, the left ventricular strain imaging technique by echocardiography the consequences of hypertension may be identified and intervene earlier. The aim of study was to show abnormalities in cardiac function in the form of left ventricular strain imaging in hypertensive patients with preserved Ejection fraction. Methods: This  was a cross-sectional, comparative and observational study done in Shahid Gangalal National Heart Centre and National Academy of Medical Sciences, Bir Hospital Kathmandu which included hypertensive patients with baseline examination including a medical history, clinical examination and a standardized trans thoracic echocardiography and strain imaging examination and the findings were compared among age and sex frequency matched 82 healthy adults in 1 : 2 ratio. The independent paired t test was used for the comparative statistical analysis. Results: We enrolled 240 patients in this study, 158 were hypertensive (mean age 48.5 ±6.1 years with 50.6 % female) and 82 healthy control (mean age 45.62 ±6.3 years with 51.2% female). There was no significant difference in conventional echocardiographic parameters between two groups except for left ventricular mass index and relative wall thickness that was highest in hypertensive group (p value of <0.001). The hypertensive population has lower mean global longitudinal strain (GLS) value of -18.6% ± 2.06 SD compared to the healthy control population with mean of -19.5% ± 1.1 SD (p value of <0.001). Conclusion: Hypertensive patients with preserved left ventricular ejection fraction have subclinical left ventricular dysfunction revealed by GLS imaging technique.

Background and Aims: Worldwide many patients are receiving intravascular contrast media (CM) during interventional procedures. Contrast media are used to enhance visualization and guide percutaneous coronary interventions (PCI).1 However, the use of CM also carries the risk of complications and it is important to be aware of these complications. Complications with CM range from mild symptoms to life-threatening conditions like anaphylaxis, hypotension and renal dysfunction and contrast-induced nephropathy (CIN) is one of them which can have both short and long term consequences.2 This study aimed to know the incidence of CIN in our center and possible predictors associated with it. Methods: This is the single hospital based cross sectional observational study. Patients undergoing primary PCI were enrolled in the study. All the patients underwent thorough history taking and physical examination. Baseline required laboratory investigations were sent. Electrocardiogram and echocardiography screening was done before taking patient to primary PCI as per the protocol of the hospital. Results: The number of patients enrolled in the study was 83 out of which 65(78.2%) were males and mean age was 59.7±13.2. Mean Arterial Pressure (MAP) among the patients was 103.8±21.3. Almost 2/3rd of the population received intravenous fluids. Minimum contrast volume used was 50ml and maximum was 270. When absolute rise in creatinine was considered 12 (14.5%) had CIN and when percent rise was also considered total 28 (33.7%) had CIN. While evaluating the predictors of CIN, higher mean age (p=0.01), hypotension with mean MAP <60 mmhg (p=0.04)) and higher contrast volume >100ml (p=0.04) was found to be significant. Conclusion: The incidence of CIN in patients undergoing PPCI was similar to the studies done in other parts of the world. Evaluating the predictors of CIN, higher mean age, hypotension and higher contrast volume was the significant predictor.