Background: Primary percutaneous coronary intervention (PPCI) has been performed traditionally by using femoral approach. Transradial approach has become increasingly popular as it is likely to be less complicating, more comfortable and relatively cost effective having mortality and morbidity benefits. The aim of the study was to compare the in-hospital outcomes of transradial PPCI with that of transfemoral route. Methods: A total of 80 patients with ST elevation myocardial infarction (STEMI) who underwent PPCI were enrolled in the study. Patients were divided in two groups. Group-I: transradial PPCI; and Group-II: transfemoral PPCI. All patients were followed up during the period of hospital stay and adverse outcomes were observed and compared between the groups. Results: The result showed that bleeding took place in 2.5% patient of Group-I and 15% patients of Group- II. Vascular complications occurred in 2.5% and 12.5% patients of Group-I and Group-II, respectively. In Group-II, 7.5% patients died with none in Group-I. In Group-II, 37.5% patients experienced some sort of adverse outcomes whereas only 15% of the patients of Group-I did have such experiences (p<0.05). Bleeding and vascular complications were significantly more in Group-II (p<0.05). The mean hospital stay time was significantly lower in Group-I (p<0.001). Conclusions: Transradial PPCI is safer than transfemoral approach in respect of procedural and post procedural complications including bleeding, vascular complications and mortality. So, transradial approach may be an attractive alternative to conventional transfemoral approach and can be practiced routinely for PPCI. Cardiovasc. j. 2019; 11(2): 98-104

Objective: Coronary artery disease (CAD) is rising in South Asia and is taking a more malignant proportion in South Asians than in Caucasians. Having a similar socioeconomic and cultural background, the scenario is same in Bangladesh. Obesity, especially abdominal is concerned as an important and modifiable risk factor for CAD which is now also raising both in developed and under developed countries. Waist-Hip ratio (WHR) is considered as an important tool for assessing abdominal obesity. The aim of this study is to evaluate the association between WHR and the severity of CAD of acute ST-segment elevation myocardial infarction (STEMI) patients so that primary prevention, early detection and proper management strategy can be taken to reduce the disease burden, morbidity and mortality.Methods: This cross sectional observational study was carried out among 105 patients with acute STEMI who received thrombolytic and underwent coronary angiography (CAG) at National Institute of Cardiovascular Diseases (NICVD), Dhaka from May, 2016 to November, 2016. They were divided into two groups, Group I (normal WHR) = 51 and group II (increased WHR) = 54, according to WHR level. Angiographic severity of coronary artery disease was assessed by vessel score and Genseni’s score.Results: Significant positive correlation was found between WHR and vessel score (r= 0.62, p=0.003). Moderate to severe CAD patients were significantly higher in increased WHR group than in normal WHR group (77.8% vs. 29.4%, p=<0.001). Significant positive correlation was also found between WHR and Genseni’s score (r= 0.71, p=0.001). Logistic regression analysis showed that a patient with increased WHR had 2.75 times higher risk of having significant CAD compared with those with the normal WHR.Conclusions: Increased WHR group had more significant coronary artery disease in terms of vessel score and Genseni’s score and can be considered as a predictor of the severity of the CAD disease in acute STEMI patients.Bangladesh Heart Journal 2017; 32(2) : 70-76

Abstract:Background: Obesity is an independent cardiovascular risk factor. The most common anthropometric measurement used to quantify obesity is body mass index (BMI). Percutaneous coronary intervention (PCI) is associated with various types of complications. The relationship between BMI and in-hospital complications particularly left ventricular failure (LVF) after PCI has not been thoroughly investigated, especially in Bangladesh. Methods:This cross sectional observational study was conducted at National Institute of Cardiovascular Diseases, on total 100 patients who underwent PCI with two equally divided groups on the basis of BMI of Asian ethnicity: Group I (BMI < 23 kg/m2) and Group II (BMI e" 23.0 kg/m2). In-hospital LVF after PCI were observed and recorded. Results:The mean BMI of study population was 23.9 ± 1.9 kg/m 2 . The sum of occurrence of adverse in-hospital outcomes was 14.0%. Complications were significantly (p < 0.01) higher in Group I than Group II. Among all adverse in-hospital outcomes, only acute left ventricular failure was found to be statistically significant between groups (p < 0.01). The difference of mean duration of hospital stay after PCI was higher in Group-I which was statistically significant (p < 0.01). Diabetes mellitus and dyslipidemia were found to be the independent predictors for developing adverse inhospital outcome (OR= 1.68 and 1.46; 95% CI = 1.25 -2.24 and 1.16 -1.83; p = 0.018 and 0.040, respectively). BMI was inversely associated with in-hospital outcomes after PCI (OR = 0.95; 95% CI = 0.91 -0.98; p = 0.007).Conclusion: BMI is inversely associated with in-hospital LVF after PCI. The underweight and normal weight people are at greater risk to experience in-hospital LVF than overweight and obese people following PCI.

Introduction:Cardiovascular diseases account for more than 17 million deaths globally each year. This figure is expected to grow to 23.6 million by the year 2030. Coronary artery disease alone caused 7 million deaths worldwide in 2010 and it is an increase of 35% since 1990. 1 The incidence of non-ST elevation acute coronary syndrome to ST elevation myocardial infarction is increasing, probably as a result of demographic changes in the population, including progressively increasing numbers of older persons and higher rates of diabetes mellitus. 2 NSTEMI currently accounts for about 50% of all myocardial infarctions. With the increased use of beta blockers and aspirin the incidence of NSTEMI is increasing. 3 The 6-month mortality rate in the patients with NSTEMI is about 6.2% and re-hospitalization rates over the 6 month is about 20%. This type of prognosis in patients with NSTEMI can be assessed by early risk stratification. Several risk scores are developed in predicting the outcomes in patients with acute coronary syndrome including NSTEMI. The most popular risk scores are the GRACE and TIMI risk scores. These risk scores calculate the patient's risk of mortality which depends on the severity of coronary artery disease and other comorbid conditions. But estimating the possible severity of coronary artery disease by these scores before performing coronary angiography may change the therapeutic decision and the timing or intensity of interventions.

Abstract:Background: Epicardial adipose tissue (EAT) is a visceral adipose tissue surrounding the heart and the coronary arteries. Because of its endocrine and paracrine activity, secreting pro-inflammatory and antiinflammatory cytokines and chemokines, it has been suggested to influence coronary atherosclerosis development. Objectives: To identify the relationship between echocardiographic epicardial fat thickness and the extent of coronary artery disease (CAD).