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Objectives: The aim behind this study was to scientifically correlate theglycosylated hemoglobin and lipid profile with the complexity of coronary artery disease. StudyDesign: Comparative hospital based study. Setting: Cardiology Department of Isra UniversityHospital Hyderabad. Period: Six months. Patients and Methods: 112 participants between theages of 25 to 80 years both male and female and undergoing their first coronary angiographywas included. Data were entered and analyzed by using Statistical Package for the SocialSciences version 20.0. Results: The mean age of patients was 54.16 years (9.74 ± SD) and thestudy subjects consisted of 76 males (67.86%) and 36 (32.14%) females. a total of 65 patients(58.0%) were presented between the ages of 41 – 60 years (middle aged group). The meanSYNTAX Score was 15.22. Patients with increased HbA1C (≥6.5%) and triglyceride levels (≥150mg/dl) and decreased HDL-C levels (≤40 mg/dl) were tend to have high Sx score. However,we did not find any significant relationship of SX score with total cholesterol and LDL-C levels.Conclusion: It was found that the trend of complexity of CAD increased with increasing age,high HbA1C, high LDL-C, high serum triglyceride, and low HDL-C levels.

Introduction: Acute coronary syndrome(ACS) is associated with activation ofplateletsand thecoagulationsystem which could influence the incidence of early stentthrombosis(EST).Stent thrombosis is a relatively uncommon phenomenon, yet it is a serious complication which often presents as an ST-segment elevation myocardial infarction (STEMI) and/or sudden cardiac death1,2.Stent thrombosis (ST) is an uncommon but life-threatening complication after percutaneous coronary intervention (PCI), frequently manifesting as acute coronary syndrome (ACS) or even cardiac death.Platelet activation and the heightening of the coagulation system play a major role in the pathogenesis of acute coronary syndrome (ACS) and might impact the occurrence of stent thrombosis in those patients who undergo stenting during ACS. Unfortunately, stent thrombosis (ST) is more frequent after stenting for STEMI than after elective stenting with both drug-eluting stents (DES) and baremetal stents (BMS). Objective: To determine the frequency of early subacute stent thrombosis after primary percutaneous coronary intervention in patients with STsegment elevation myocardial infarction Methodology: Study Design: Descriptive Case Series Setting: This study was conducted in NICVD Hospital, Karachi Subjects and Methods: Study was approved by hospital ethical review committee. All patients who fulfilled the inclusion criteria were included in the study. Pre-operatively a written consent was taken from each patient by the primary investigator of this study. All these patients were undergone primary PCI and stent either drug-eluting stents (coated with medication) or bare-metal stent was placed. These patients were observed for 24 hours for early subacute stent thrombosis. All the collected data were entered into the proforma attached at the end. Results: Mean ± SD of age was 55.56±12.24 with C.I (53.52------57.59) years. Mean ± SD duration of surgery was 33.48±9.26 with C.I (31.90------35.05) minutes. Out of 142 patients 103 (72.53%) were male and 39 (27.4%) were female. Frequency of early subacute stent thrombosis was found to be 4(2.82%). Conclusion: It is to be concluded that frequency of early acute stent thrombosis after primary PCI was found to be 2.82%.Patients presenting with STEMI who are hemodynamically unstable and have multivessel coronary disease undergoing coronary stenting during ACS, are at increased risk of EST. Keywords: Acute myocardial Infarction, Primary PCI, Early Subacute Stent, Thrombosis, STEMI

Objective: Mitral stenosis caused by rheumatic heart disease (RHD) is the most common cause of valvular lesion in adults and prevalent in developing countries like Pakistan. Higher natriuretic peptide (BNP) levels can be observed in patients with moderate to severe untreated mitral stenosis and are associated with higher rates of morbidity and mortality. That is why this study aims to determine the association between levels of pro-BNP with severity (mild. Moderate, and severe) of mitral stenosis. Patients and Methods: This was a clinical prospective study carried out in the department of adult cardiology, national institute of cardiovascular diseases, Karachi from 8th august 2019 to 7th February 2020. Total 68 patients of either gender with age between 25-70 years had mitral stenosis of moderate to severe intensity (mitral valve area ≤1.5 cm2), diagnosed on echocardiography were included for final analysis. A simple blood sample was taken for the assessment of pro-BNP levels. Questionnaire was used for demographic & clinical data collection and analysed using SPSS version 22.0. Results: The overall mean age of study subjects was 42.21±11.50 years, ranging from 25 – 70 years. Among them, females were prevalent (n = 43, 63.2%). The overall mean serum BNP level was 1071.12±807.26 pg/ml and the mean difference of serum BNP level was not significant among groups of gender, age, and diabetes mellitus with p>0.05. Significantly raised levels of BNP were observed in patients with severe mitral stenosis as compared to moderate mitral stenosis, p<0.05 Conclusion: In conclusion, the mean BNP levels were higher in patients with severe Mitral Stenosis. Therefore, BNP may be used to complement the clinical and echocardiographic assessments in patients with Mitral Stenosis.