ObjectivePresent paper describes trends in prevalence and control of cardiovascular risk factors and clinical outcomes at 5-years for CLARIFY Indian cohort compared with rest of the world (ROW).MethodCLARIFY is an international, prospective-observational, longitudinal cohort study in stable coronary artery disease outpatients. The 5-year data of both cohorts were compared, and evaluated.ResultsIn Indian cohort, the angina prevalence declined significantly. There are few favorable changes in the pattern of receiving guideline-recommended therapy over 5 years, and the Indian cohort exhibited significantly lower adverse clinical outcomes than ROW.ConclusionThe 5-year trend of CLARIFY India registry indicate varying trends in prevalence and control of cardiovascular risk factors, the need for approaches to improve control of all modifiable risk factors, and increase in long-term use of essential primary and secondary prevention medications in clinical practice as emphasized in the latest Indian guidelines for management of stable CAD.

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The auscultation of second heart sound reveals presence of the disease and its pathophysiology, conduction defects, ventricular function, and hemodynamics around the aortic and pulmonary valves. To understand the splitting of the second heart sound, it is useful to understand the concepts of hangout interval and ejection time. Differential diagnosis of S2 split include opening snap, third heart sound, and pericardial knock. Variations of second heart sound may involve intensity or variations of split. Variations of split can be single heart sound, wide split, wide fixed split, or paradoxical splitting.Interpretation of second heart sound in congenital heart disease provides information about the presence and position of semilunar valves.

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