Global burden of Sudden Cardiac Death and insights from India

Rao, B. Hygriv

doi:10.1016/j.ihj.2013.11.009

Cited by 22 publications

(15 citation statements)

References 31 publications

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“…These were studies conducted in response to the increase in road traffic accidents seen in Brazil and the importance of treating cardiac arrest immediately. Encouraging the adoption and implementation of these ideas in other LMICs would be beneficial to the health system as the global burden of road traffic accidents is concentrated in LMICs, and there is a growing morbidity and mortality trend due to cardiovascular diseases in LMICs 36 37. Similarly, these simulation-based initiatives can improve a country's ability to react to unforeseen threats or medical emergencies in order to deliver healthcare safely and handle outbreaks, especially after the recent Ebola crisis.…”

Section: Discussionmentioning

confidence: 99%

Enhancing quality of medical care in low income and middle income countries through simulation-based initiatives: recommendations of the Simnovate Global Health Domain Group

Puri¹,

Das²,

Pai³

et al. 2017

BMJ STEL

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BackgroundQuality of medical care in low income and middle income countries (LMICs) is variable, resulting in significant medical errors and adverse patient outcomes. Integration of simulation-based training and assessment may be considered to enhance quality of patient care in LMICs. The aim of this study was to consider the role of simulation in LMICs, to directly impact health professions education, measurement and assessment.MethodsThe Simnovate Global Health Domain Group undertook three teleconferences and a direct face-to-face meeting. A scoping review of published studies using simulation in LMICs was performed and, in addition, a detailed survey was sent to the World Directory of Medical Schools and selected known simulation centres in LMICs.ResultsStudies in LMICs employed low-tech manikins, standardised patients and procedural simulation methods. Low-technology manikins were the majority simulation method used in medical education (42%), and focused on knowledge and skills outcomes. Compared to HICs, the majority of studies evaluated baseline adherence to guidelines rather than focusing on improving medical knowledge through educational intervention. There were 46 respondents from the survey, representing 21 countries and 28 simulation centres. Within the 28 simulation centres, teachers and trainees were from across all healthcare professions.DiscussionBroad use of simulation is low in LMICs, and the full potential of simulation-based interventions for improved quality of care has yet to be realised. The use of simulation in LMICs could be a potentially untapped area that, if increased and/or improved, could positively impact patient safety and the quality of care.

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Section: Discussionmentioning

confidence: 99%

Enhancing quality of medical care in low income and middle income countries through simulation-based initiatives: recommendations of the Simnovate Global Health Domain Group

Puri¹,

Das²,

Pai³

et al. 2017

BMJ STEL

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“…The prevalence of MI is increasing with the aging global population, leading to serious disease burdens [2, 3]. Reperfusion therapy, such as immediately percutaneous coronary intervention (PCI), has been used frequently in clinical practice and has been remarkably successful in increasing the rate of revascularization and reducing the mortality of MI patients [4].…”

Section: Introductionmentioning

confidence: 99%

Effect of Wenxin Granules on Gap Junction and MiR-1 in Rats with Myocardial Infarction

Zhao

Lou

et al. 2017

BioMed Research International

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Myocardial infarction (MI) patients are at high risk of potential lethal arrhythmia. Gap junction and microRNA-1 (miR-1) are both arrhythmia generating conditions. The present study investigated whether Wenxin Granules (Wenxin-Keli, WXKL) could prevent potential lethal arrhythmia by improving gap junctions and miR-1 following MI. Male Sprague-Dawley rats were divided randomly into control, model, metoprolol, low dose WXKL, and high dose WXKL groups. The MI rat model was created by coronary artery ligation. Treatments were administrated intragastrically to the rats for 4 weeks. Conventional transmission electron microscopy was performed to observe the ultrastructure of gap junctions. Quantitative real-time PCR and western blotting were used to detect the expression of miR-1, protein kinase C (PKC), and related proteins. Additionally, a programmatic electrophysiological stimulation test was performed to detect the ventricular fibrillation threshold (VFT). WXKL protected the ultrastructure of the gap junctions and their constituent Cx43 by regulating miR-1 and PKC mediated signal transduction and increased the VFT significantly in the rat MI model. The results suggested that WXKL is an effective alternative medicine to prevent potentially lethal arrhythmia following MI.

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“… 5 , 16 And a significant proportion of those who survive suffer from severe left ventricular systolic dysfunction and continue to remain at high risk for heart failure hospitalization and sudden cardiac death. 17 There are large variations in the use of primary angioplasty for patients presenting with STEMI, ranging from 0.9% in the northern Indian state of Himachal Pradesh to 14% in government hospitals in the Southern Indian states of Kerala, and reaching up to 53.3%–60.6% in tertiary hospitals in Tamil Nadu. 7 , 16 , 18 , 19 There are single center reports, mainly from Southern India, reporting an in -hospital mortality rate of 4.2%–5.2%, among Indian STEMI patients undergoing primary PCI.…”

Section: Discussionmentioning

confidence: 99%

The design and rationale of the primary angioplasty registry of Kerala

Abdullakutty

Mathew

Viswanathan

et al. 2017

Indian Heart Journal

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BackgroundST-elevation myocardial infarction (STEMI) continues to be a major cause of cardiovascular mortality in Kerala, India. Timely primary percutaneous coronary intervention (PCI) is the recommended reperfusion strategy for STEMI. There is limited data on the safety, effectiveness, equity and efficiency of regional primary PCI services in India.Methods/DesignThe primary angioplasty registry of Kerala is a clinician-initiated prospective state-wide longitudinal hospital-based registry of patients undergoing primary PCI for STEMI. The registry aims to document the efficacy and safety of the real world use of primary PCI in Indian patients presenting with STEMI, in order to achieve regional adoption of global standard performance indicators. In addition, the registry would analyze procedural variations in the performance of primary PCI and assess its impact on relevant patient centered outcomes. We plan to enroll 6000 STEMI patients, undergoing primary PCI, across 48 hospitals. These patients would be followed up for a minimum of 1 year.ConclusionsThe primary angioplasty registry of Kerala would help analyze the quality and outcomes of primary PCI services in Kerala, thereby yielding insights that can help limit unacceptable procedural variations in the performance of primary PCI. Identifying deviations from guideline based therapies can form the basis of quality improvement programs, which in turn will enable hospitals to achieve better patient outcomes.

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Global burden of Sudden Cardiac Death and insights from India

Cited by 22 publications

References 31 publications

Enhancing quality of medical care in low income and middle income countries through simulation-based initiatives: recommendations of the Simnovate Global Health Domain Group

Enhancing quality of medical care in low income and middle income countries through simulation-based initiatives: recommendations of the Simnovate Global Health Domain Group

Effect of Wenxin Granules on Gap Junction and MiR-1 in Rats with Myocardial Infarction

The design and rationale of the primary angioplasty registry of Kerala

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