No abstract

Aim The aim of this study was to evaluate the feasibility of heparinised saline as flushing media for frequency-domain optical coherence tomography (FD-OCT) image acquisition during percutaneous coronary intervention (PCI) optimisation. Methods and results Twenty-seven patients undergoing FD-OCT–guided PCI were enrolled. Heparinised saline was injected into the coronary during FD-OCT image acquisition. A total of 118 runs were analysed for image quality and diagnostic value. FD-OCT runs were categorised as follows: good runs (GRs), clinically usable runs (CURs) and clinically not usable runs (NURs); GRs and CURs were combined as clinically effective runs (ERs). Saline FD-OCT enabled visualisation of all possible coronary lesions. Of the 118 runs analysed, 61%, 27.1%, 11.9% and 88.1% were GRs, CURs, NURs and ERs, respectively. Sixty-one percent of total runs were left coronary system (LCS) and 39% were right coronary system (RCS) runs. Among LCS runs, 55.6%, 30.6%, 13.8% and 86.2% were GRs, CURs, NURs and ERs, respectively. Among RCS runs, 69.6%, 21.7%, 8.7% and 91.3% were GRs, CURs, NURs and ERs, respectively. Conclusion This is the first study to demonstrate the technical feasibility of isolated saline FD-OCT for PCI optimisation.

The systemic immune-inflammation index (SII) and systemic inflammation response index (SIRI) have previously demonstrated predictive value in coronary artery disease (CAD). We developed on an expanded, novel systemic immune-inflammation response index (SIIRI), calculated as peripheral neutrophil × monocyte × platelet ÷ lymphocyte count. We assessed 240 patients with an acute coronary syndrome that subsequently underwent percutaneous coronary intervention. CAD severity was measured using the SYNTAX score. Laboratory measurements, including cell counts, were obtained on admission. On multivariate analysis, the SIIRI was an independent predictor of severe CAD with an adjusted odds ratio (OR) of 1.666 [1.376-2.017] per 105-unit increase. The SIIRI had the highest area under the receiver operator curve of .771 [.709-.833] compared to the SII, SIRI neutrophil-lymphocyte ratio, monocyte-lymphocyte ratio, and platelet-lymphocyte ratio. The optimal cut-off for SIIRI was 4.3 × 105, with sensitivity = 69.9% and specificity = 75.8%. Increment in model performance resulting from adding SIIRI versus other inflammatory indices was assessed using discrimination, calibration, and goodness-of-fit measures. When added to a baseline model, the SIIRI resulted in a significant increase in the c-statistic and significant net reclassification index (.808, P < .0001) and integrated discrimination index (.129, P < .0001), and a decrease in Akaike and Bayesian information criteria.

Background: Hypertension and dyslipidemia are one of the most prevalent cardiovascular disorders affecting 20% of world’s population. There is emerging data that yoga therapies may be useful in managing modest elevations in BP. Yoga, specific yogic exercise (Sudarshan kriya) taught as a training protocol under Art of living course (AOL), is especially attractive as a candidate therapy in the management of elevated BP because of its combination of gentle physical activity. Hence, this study was undertaken to compare the effects of SDK on blood lipid levels.Methods: A total of 300 patients of hypertension and prehypertension were taken in the study where control group were given drugs treatment and life style modification and yoga group additionally had undergone yoga training. Lipid levels were estimated in both groups at entry, 06 months and 12 months and analyzed.Results: Lipid levels at entry were same in both while the yoga therapy group showed decrease in TG, LDL and VLDL at six months and 12 months but decrease was not significant. HDL levels showed significant increase in yoga group (P<0.05) at six months which was maintained at 12 months more so in diabetic patients.Conclusions: Yoga therapy has beneficial effect on serum lipid levels and should be included in therapy along with other measures.

We report a rare complication due to fracture of the blade of a cutting balloon in the setting of a tough nondilatable restenotic lesion. This resulted in a mural hematoma as a result of dissection of coronary artery.