Journal of Clinical and Preventive Cardiology

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Objective: The objective of this study is to assess baseline plasma C-reactive protein (CRP) levels in patients with acute coronary syndromes and their significance in prognosis. Materials and Methods: The study was carried out at the department of internal medicine in a tertiary health care center. Fifty patients diagnosed with acute coronary syndromes (ACSs) (ST-elevation acute myocardial infarction (STEMI) or unstable angina (UA)/non-STEMI) were admitted and detailed history, clinical examination, and laboratory tests were done on each patient. All routine blood investigations were carried out along with electrocardiography and echocardiography in all patients. Plasma concentrations of CRP were measured with an ultra-sensitive latex immunoassay before reperfusion, 24 h after admission, and at discharge. Results: A total of 50 patients were taken. Thirty-eight cases were found to be male and the remaining 12 were female, of which 35 were STEMI and 15 were UA/NSTEMI. The maximum prevalence of ACS was observed in the age group of 41–50 years. Among all five presenting symptoms, chest pain was the most prevalent, followed by sweating, breathlessness, vomiting, and giddiness. The major risk factors in ACS include smoking being the most common followed by diabetes and dyslipidemia. In 16 patients, left ventricular failure was recorded, which was the most common complication followed by cardiogenic shock and atrioventricular block. ventricular tachycardia/ventricular fibrillation is recorded in five patients who died, 36 patients with complications, and three patients among 40 patients without complications where CRP levels are ≥0.6 mg/dl. Four patients out of 10 patients who showed CRP levels <0.6 mg/dl are known to have complications. Conclusions: It was concluded that the measurement of plasma CRP levels at the time of admission in patients with suspected coronary artery disease may be helpful in the identification of a group of patients with a high risk of cardiac complications.

Background: Heart rate variability (HRV) is emanating as one of the most effectual techniques for probing the intricate and ever-evolving changes in the oscillations of a healthy heart, allowing us to guard against any abrupt physical threat to homeostasis, such as that which occurs when a person exercises. Aims and Objectives: To study the influence of body shape index with HRV indices in athletic population during treadmill exercise in athletic population. Materials and Methods: It was a cross-sectional study carried out on 120 healthy subjects and 30 athletes in the age range 17-35 years. Short-term HRV (5 min) was extracted from ECG recordings obtained using Power lab system, AD instruments and was analyzed by LabChart software in accordance to the standards set forth by the Task Force of the European Society of Cardiology and North American Society of Pacing and Electrophysiology. Results: Out of 30 athletes, there were a total of 17 (56%) male subjects and 13(44%) female subjects. Out of 120 controls, male subjects were 50 (41.66%) and females were 70 (58.33%). The mean age of males was 21.06±3.02 and that of females was 22.50 ± 6.25. A statistically significant positive (r=0.56) correlation between BSI and HRV on treadmill exercise was observed. Conclusion: Examining HR variations offers a window to evaluate the condition and integrity of ANS. In this study, the extent to which the ANS contributed to obesity was assessed and the relationship of measure of cardiovascular risk, a newly established and pragmatic metric Body Shape Index (ABSI) with the HRV indicators in the athletic population was explored. Background: Heart rate variability (HRV) is emanating as one of the most effectual techniques for probing the intricate and ever-evolving changes in the oscillations of a healthy heart, allowing us to guard against any abrupt physical threat to homeostasis, such as that which occurs when a person exercises. Aims and Objectives: To study the influence of body shape index with HRV indices in athletic population during treadmill exercise in athletic population. Materials and Methods: It was a cross-sectional study carried out on 120 healthy subjects and 30 athletes in the age range 17-35 years. Short-term HRV (5 min) was extracted from ECG recordings obtained using Power lab system, AD instruments and was analyzed by LabChart software in accordance to the standards set forth by the Task Force of the European Society of Cardiology and North American Society of Pacing and Electrophysiology. Results: Out of 30 athletes, there were a total of 17 (56%) male subjects and 13(44%) female subjects. Out of 120 controls, male subjects were 50 (41.66%) and females were 70 (58.33%). The mean age of males was 21.06±3.02 and that of females was 22.50 ± 6.25. A statistically significant positive (r=0.56) correlation between BSI and HRV on treadmill exercise was observed. Conclusion: Examining HR variations offers a window to evaluate the condition and integrity of ANS. In this study, the extent to which the ANS contributed to obesity was assessed and the relationship of measure of cardiovascular risk, a newly established and pragmatic metric Body Shape Index (ABSI) with the HRV indicators in the athletic population was explored.

Background: Cardiovascular diseases (CVDs) are on the rise globally. India, in spite of housing the youngest population, has now been termed the CVD capital of the world. Several independent studies have shown association between low levels of Vitamin D, insulin resistance, and low testosterone levels and coronary artery disease (CAD). However, the presence of this hormonal triad in premature CAD patients in India has not been studied. Therefore, we aimed to explore the role of this hormonal triad in CAD in young Indians. Methods: This was a prospective, case–control, study conducted at a tertiary care center in India. Premature CAD patients were enrolled as cases and healthy individuals were enrolled as controls. Demographic, behavioral, anthropometric and body composition, physiological, and biochemical parameters were recorded/assayed as per standard protocols. Results: A total of 644 individuals were enrolled in the study. Among them, 344 belonged to the case group and 300 to the control group. The mean age did not differ significantly between cases (32.1 ± 5.6 years) and controls (32.5 ± 5.0 years). Significantly lower levels of Vitamin D levels (P = 0.01) and serum insulin (P < 0.001) were observed in the case group compared to the control group. In males, no significant difference was observed between the two groups in terms of serum testosterone level (P = 0.075). Conclusion: Higher fasting insulin levels may be a reliable indicator of premature CAD. Vitamin D levels may not reliably predict premature CAD because 70%–90% of Indians are deficient of Vitamin D. Testosterone levels in females, but not in males, may be a reliable predictor for the same. However, larger studies are required to validate these findings.

Spontaneous coronary artery dissection (SCAD) presenting as stroke is indeed an extremely rare scenario. We hereby describe our experience of a case of SCAD in a 29-year-old man who presented with a massive brain stroke. Based on the neurological findings, the diagnosis of left hemiparesis, left upper motor neuron facial palsy, and acute right middle cerebral artery infarct was made. Coronary angiography displayed a large type B dissection along with heavy burden of thrombus and intimal hematoma in proximal to the mid-left anterior descending artery (LAD). SCAD of the LAD was managed with percutaneous coronary intervention using a provisional stenting approach with two overlapping drug-eluting stents. With this case, the author would like to outline vital clinical insights for clinicians managing such a challenging and perplexing patient cohort.

Online since 11^th May,2016