No abstract

Objectives: Revalidation of Killip class in our local population is mandatory. We planned this study to increase cardiologist readiness to tackle the risks associated with increased mortality in each class post ST elevation myocardial infarction (STEMI). Objectives were to determine frequency of Killip class I, II, III, IV and in-hospital mortality in each Killip class in patients with left ventricle failure secondary to STEMI.Results: This cross-sectional Study was conducted in Department of Cardiology, Jinnah Hospital. Patients with STEMI were stratified using Killip Class and validation was performed by determining the within 15 days in-hospital mortality in each Killip class. Patients with chronic disease were excluded. The frequency (percentage) of patients with STEMI in each killip class from I to IV was 395 (81.4%), 46 (9.5%), 27(5.6%) and 17(3.5%) respectively while in-hospital mortality came out to be, 39 (9.8%), 4 (8.6%), 25 (92.5%), and 17(100%), in Killip class I, II, III and IV respectively. Presence of diabetes, history of smoking and BMI more than 30kg/m2 were significant contributor to mortality along with higher Killip class and age of presentation. It is concluded that Killip class is a valid tool for risk stratification for patients after STEMI.

Objective: The study was conducted to determine the association of increased serum Uric acid level (SUA) with critical coronary artery disease (CAD) in patients subjected to coronary angiography. Methodology: 360 patients (180 cases with critical CAD and 180 controls without critical CAD) were enrolled in the study after taking informed consent. Demographic data like age, gender, diabetes mellitus, hypertension, family history of CAD, dyslipidemia, smoking and BMI was collected. Serum uric acid was advised and recorded in the questionnaire. Results: 360 patients with mean age 51.37 ± 6.5 years were included. 262 patients (72.8%) were male. 54 patients (20.8%) had hyperuricemia.  26.6% cases and 15.0% controls had hyperuricemia. Hyperuricemia was significantly associated with critical CAD (OR=2.06, CI 1.22-3.49, p=0.007). The association persisted after stratification according to age, gender, diabetes, hypertension, dyslipidemia, smoking, family history of IHD and BMI. Conclusion: There is a positive association between critical CAD and hyperuricemia. Keywords: Coronary artery disease, Hyperuricemia, IHD

Background: Hypertension, dyslipidemia, and disturbed glucose metabolism associated with central obesity are often referred to as Metabolic Syndrome (MetS) and patients of MetS have a two- to three-fold increased risk for the development of cardiovascular diseases. Objective: Objectives were to determine the frequency of MetS in patients presenting with acute coronary syndromes and to compare the frequencies of severe coronary artery disease in patients with and without MetS. Methods: This descriptive cross-sectional study included 200 patients with acute coronary syndromes over a period of six months. Frequency of MetS was calculated. The frequencies of severe coronary artery disease were compared between patients having MetS and not having MetS using chi-square chart. Results: Total 200 patients with the mean age of 54.24 ± 9.41 years were included. 131 (65.5%) patients with acute coronary syndrome had MetS. Total 112 patients (56%) had severe coronary artery disease. 63.35% with MetS and 42.03% without MetS had severe coronary artery disease (p=0.003). Conclusion: The frequency of metabolic syndrome was high (65.5%) in patients with acute coronary syndromes and severe coronary artery disease was found to be associated with the presence of metabolic syndrome in these patients.

Objectives: The purpose of our study was to determine the frequency of left main stem disease on coronary angiography in patients with non-ST segment elevation myocardial infarction (NSTEMI). By studying the exact frequency of the left main stem (LMS) disease in NSTEMI patients in our population, we will be able to better risk stratify and plan further management for this group of patients. Methodology: This cross-sectional study was conducted at the Department of Cardiology, Chaudhry Pervez Elahi Institute of Cardiology (CPEIC), Multan from 14-June-2017 to 13-Dec-2017. Total 248 patients with NSTEMI were included in the study. Coronary angiography was done in all selected patients. Diagnosis of LMS disease was made when stenosis in the LMS artery was more than half of the diameter of the left main coronary artery. Results: There were 80.6% male and 19.4% female patients with a mean age 49.39±7.23 years. In this study, 37.1% patients were found with left main stem disease. Among LMS disease patients, there was 82.6% male and 17.4% female patients. 55.4% of patients were aged 50 years and above. 40.2% were smokers and 33.7% were diabetic. No significant association of LMS was found with the age group (p=0.66), gender (p=0.54), smoking status (p=0.54) and diabetes mellitus (p=0.95). Conclusion: In this study, we found a high frequency of LMS disease in our population. This subset of patients with NSTEMI requires early re-vascularization. This also signifies a need to re-evaluate our screening programs and management protocols related to coronary artery disease.