The aim of the study is to determine the out comes of primary percutaneous coronary intervention (PCI) in patients with acute myocardial infarction in NICVD the only government cardiac hospital of Bangladesh where resources are very limited. Total 73 (male 70, female 3) patients were enrolled in this study who were brought in to our hospital with STEMI between August 2010 to October 2013. Average age was 55.6 ±11.78. Primary PCI was performed after transferring patient from Emergency Department to cardiac catheterization laboratory. Cardiovascular risk factors among the studied population were Diabetes mellitus, Hypertension, Smoking, Dyslipidemia and Positive family history for IHD. Primary PCI either with Bare Metal Stent (BMS) or Drug Eluting Stent (DES) were performed in total 42 LAD lesions, 28 RCA lesions and 3 LCX lesions. BMS used were 87.7%, DES used were 12.3%. The procedural success was 95.8%.Four patients (5.4%) died during hospital stay. Out of four patients who died, one had cardiogenic shock. No mortality was observed in the 30 days follow up from discharge, while other complications like unstable angina and congestive heart failure were 5.7% and 4.3% respectively. Our findings suggest favorable outcomes, matching the international data which was achieved in our patients with primary PCI in the management of STEMI despite all the limitations. Primary PCI as a preferred method of reperfusion strategy needs to be practiced more often in our part of world.University Heart Journal Vol. 9, No. 2, July 2013; 83-87
Background: Hypertension is an important public-health challenge worldwide. It is important because of its high frequency and its effect on cerebrovascular, cardiovascular and kidney disease.Methods: This cross-sectional descriptive study was conducted to assess the treatment compliance of hypertensive patients and medical history of patients with hypertension in the outpatient department of Cardiology, National Institute of Cardiovascular Diseases (NICVD), Dhaka. Considering inclusion and exclusion criteria, 350 hypertensive outdoor patients were included in this study. Data was analyzed by SPSS version 20.Results: The study revealed that the mean age of the respondents was 50.49 years (SD ± 8.449). Approximately 67.2% of the respondents were suffering from hypertension from <5 years and 15.6% respondents were hospitalized three times and 12.0% respondents were hospitalized more than three times. The mean duration of taking antihypertensive medicine was 4.91 years. The study also found that 48.8% respondents were taking antihypertensive medication irregularly. The mean systolic blood pressure was 129.96 mm of Hg (SD±23.60) and diastolic blood pressure was 86.08 mm of Hg (SD ±12.76).Conclusion: The study results revealed that about half of the patients do not take drugs regularly, which is an alarming sign. Therefore, the instructions and counseling should be given to the patient to fulfill the treatment for prevention of complications related to hypertension.Cardiovasc. j. 2016; 8(2): 110-114
This study aims to describe the initial experiences and immediate outcomes of percutaneous coronary intervention (PCI) in patients with significant left main coronary artery disease with normal LV function in National Institute of Cardiovascular Diseases (NICVD), Dhaka. Left main coronary artery disease is regarded as an absolute contraindication for coronary angioplasty. Recently several reports on protected or unprotected LMCA stenting or both suggested the possibility of percutaneous intervention for this prohibited area. The study was conducted in National Institute of Cardiovascular diseases & Hospital, Dhaka, Bangladesh. Participants of the study were 100 patients with a diagnosis of critical left main coronary artery disease. Information was collected on their demographic characteristics and clinical history. Relevant physical examination and laboratory investigation were performed. Percutaneous transluminal coronary angioplasty (PTCA) with stent implantation were done in the left main coronary artery and other culprit vessel where required. They were followed up thoroughly during the hospital stay. The study subjects were from 35 to 70 years old. 70 male and 30 female were included in this study. According to the clinical history, 12 lead surface ECG reading and cardiac enzyme analysis 40% patient was diagnosed as unstable angina, 40% presented with chronic stable angina and rest of them presented with old myocardial infarction. Among the study population critically isolated LM disease were 30%, critical left main with other vessels disease were 70%. The pattern of LM disease involvement were osteal 40%, mid shaft 10%, distal bifurcation 30%, entire LM involving bifurcation 20%. Procedural success rate was 100%. No patient faced major advance cardiac events (MACE) during hospital stay. Stenting of unprotected LM coronary artery stenosis may be safe effective alternative to CABG in carefully selected patients with normal LV function. Further studies in larger population of this group are needed to assess late out comes.University Heart Journal Vol. 10, No. 1, January 2014; 7-12
Background: Coronary artery bypass grafting (CABG) continues to be the best standard in the management of severe coronary artery disease (CAD), providing good symptom management and life extension. Although CABG was first performed by reversed saphenous veins (SVGs), surgeons have increasingly adopted arterial conduits because of their longer-term patency and resistance to atherosclerosis. CABG's efficacy may potentially be affected by the extension of atherosclerosis in the native coronary arteries. Few researches have investigated the long-term angiographic disease progression of native coronary arteries after surgical revascularization, or the variables that may impact this progression. Proximal native disease progression was presented to be two to six times more common than distal disease progression, with greater rates of progression in coronaries bypassed by SVGs than arterial grafts. The goal of this research was to determine influence of CABG on the extension of native coronaries atherosclerosis. Methods: This prospective study was established on 25 patients who were diagnosed to have ischemic heart disease in cardiothoracic surgery department in Faculty of Medicine Menoufia University. Results: The study showed that according to the risk factors among the studied cases, smoking was (60%), Dyslipidemia was (32%), HTN was (32%) and Diabetes was (32). According to grafts in proximal lesions, there was progression of atherosclerosis up to total occlusion, but in Distal lesions, there was significant regression of atherosclerosis. As result, there was statistically significant difference between proximal with distal lesions. Also, study showed that there was a significant difference between left system (LAD, D, OM) in comparison with right system (PDA) regarding distal lesion. Our results showed that univariate logistic regression analysis for progression in distal lesion regarding Dyslipidemia and Diabetes. Conclusion: Progression of disease is more evident in coronary segment proximal to anastomosis, while regression of disease is more evident in coronary segment distal to anastomosis with statistically significant difference between them, also the risk of disease progression post CABG was found to be multifactorial, as certain risk factors can affect progression of the disease as Diabetes mellitus and dyslipidemia that were of statistically significance.
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