Introduction: Acute kidney injury (AKI) is a common complication that can occur after invasive cardiac procedures. This condition can cause significant morbidity and mortality, especially in high-risk patients, such as those with preexisting renal dysfunction. Objectives: The main objective of the study is to find the association of radial artery access with reduced incidence of acute kidney injury. Material and methods: The study is conducted at the Department of Cardiology, Hayatabad Medical Complex, Peshawar. This is a tertiary care center that provides cardiac care services to a large population of the Khyber Pakhtunkhwa province of Pakistan. The center has state-of-the-art facilities and a team of experienced cardiologists and cardiac surgeons who perform a variety of cardiac procedures, including PCI and CABG. Results: Based on a study of 300 patients undergoing cardiac catheterization, there was a significant association between the use of radial artery access and reduced incidence of acute kidney injury (AKI). The study found that 20% of patients who underwent femoral artery access developed AKI, compared to only 10% of patients who underwent radial artery access. This indicates that radial artery access may be a safer option for cardiac catheterization procedures, as it may help reduce the risk of AKI in patients. Conclusion: In conclusion, the present study provides evidence that radial artery access is associated with a lower incidence of acute kidney injury (AKI) in patients undergoing percutaneous coronary intervention (PCI).
Background and Aim: Diabetic mellitus is an epidemic health issue causing almost twice the mortality compared to non-diabetic. Diabetes and non-diabetics with acute myocardial infarction were compared for in-hospital mortality and complications. Material and Methods: This comparative cross-sectional study was conducted on 264 successive diabetic and non-diabetic patients in the Department of Cardiology Pakistan Institute of Medical Sciences Islamabad with study duration of 6 months. All the acute myocardial infarction patients with ST-elevation were admitted and treated with thrombolytic agent such as streptokinase. Patients were categorized into two groups: 1) Diabetic patients 2). Non-diabetic patients. All the patients of either gender with age ranges from 15 years to 80 years and having chest pain for >30 minutes and <24 hours with ST-elevation were enrolled. After 60 minutes of thrombolysis, an ECG was taken to measure the baseline and the following day's ECG. SPSS version 26 was used for data analysis. Results: Out of 264 patients, there were 196 (74.2%) male and 68 (25.8%) females. Diabetic and non-diabetic group included 132 patients. Diabetic group patients had higher frequency of ST elevation in myocardial infarction than non-diabetic patients. Brady arrhythmias, post MI angina, LV failure, atrial fibrillation, and cardiogenic shock were the main complications observed in all the patients after ST Elevation MI. Diabetes patients are more likely to experience all these complications post MI angina than non-diabetics. Conclusion: The present study concluded that the prevalence of arrhythmias and left ventricular failure complications were higher in diabetic patients. Also, the mortality rate was significantly higher in diabetic patients. The non-diabetic patients had higher post MI angina than diabetic patients. It is also important to decrease the prevalence of diabetes mellitus in our population since it is a modifiable risk factor that leads to more complications following MI than non-diabetic patients. Keywords: In-hospital mortality, ST elevation, Myocardial infarction, diabetic and non-diabetic
Background and Aim: Ischemic mitral regurgitation (IMR) is the most prevalent complication following myocardial infarction (MI) and coronary artery disease. Acute or chronic MI can lead to IMR resulting from an abnormality in regional wall motion or dysfunction of papillary muscles in a territory with structurally normal mitral valve leaflets, coronary artery disease and chordae tendineae. The present study aimed to determine the incidence of ischemic mitral regurgitation in ST elevation myocardial infarction and its impact on hospital course. Material and Methods: This cross-sectional study was conducted on 164 myocardial infarction patients in the Department of Cardiology of Pakistan Institute Medical Sciences Hospital, Islamabad over a time period of 6 months. Institute research and ethical committee approved the study protocol. Patients with prior mitral surgery, heart failure, previous myocardial infarction, and mitral valve disorders were excluded. Demographic detail, echocardiographic parameters, and myocardial complications were recorded. Other parameters such as Killip class, in-hospital mortality, and MI territory with respect to electrocardiographic changes were recorded. Data analysis was carried out in SPSS version 26. Results: Of the total 164 MI patients, there were 114 (69.5%) male and 50 (30.5%) females. The overall mean age was 58.62±8.62 years. The incidence of IMR was 106 (64.6%), out of which the prevalence of mild, moderate, and severe MR were 86 (81.1%), 12 (11.3%), and 8 (7.6%) respectively. No significant association was found between the presence of IMR and other parameters such as diabetes, smoking, hypertension, gender, and BMI. There was a significant association between triglyceride and serum LDL-cholesterol levels with IMR presence. On comparing the IMR and no MR cases, left ventricular ejection fraction reduced but pulmonary arterial pressure increased in IMR groups. Conclusion: The present study found that the prevalence of IMR was 64.6% among MI patients and approximately half of the patients who suffer from IMR after having an AMI experience complications as a result of it. A proper treatment decision depends on assessing the severity of the MR in relation to AMI complications. Keywords: Ischemic mitral regurgitation, Myocardial infarction, ST elevation
Introduction: Mitral stenosis is a condition characterized by the narrowing of the mitral valve, which regulates blood flow between the left atrium and left ventricle of the heart. Objectives: The main objective of the study is to find the mid-term clinical and echocardiographic outcomes of percutaneous transvenous mitral commissurotomy in patients with rheumatic mitral stenosis. Material and Methods: The present study was a retrospective observational study conducted at Ayub Teaching Hospital, Abbottabad. The study included a total of 70 patients who underwent percutaneous transvenous mitral commissurotomy (PTMC) between 1st January 2022 and 30th June 2022. Results: A total of 70 patients who underwent PTMC at Ayub Teaching Hospital, Abbottabad, between 1st January 2022 and 30th June 2022 were included in this retrospective observational study. The mean age of the patients was 39.2 ± 12.8 years, and 52 (74.3%) were females. The mean mitral valve area (MVA) prior to PTMC was 0.9 ± 0.2 cm^2 that increased to 1.8 ± 0.3 cm^2 after the procedure, and it was statistically significant (p<0.001). The immediate success rate of PTMC was 94.3%, while the mid-term success rate was 90%. Conclusion: In conclusion, percutaneous transvenous mitral commissurotomy (PTMC) is a safe and effective treatment option for patients with rheumatic mitral stenosis. Our study showed that PTMC resulted in a significant improvement in mitral valve area, trans-mitral pressure gradient, pulmonary artery systolic pressure, and clinical symptoms of dyspnea, fatigue, and palpitations. Keywords: Mitral stenosis, PTMC, Patients, Procedures, MVA
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