Objective: To evaluate the impact of post dilatation performed with Non- Compliant Balloon on Angiographical outcome (that is TIMI flow grade) in patients who underwent the primary percutaneous coronary intervention. Study Design: Retrospective cross-sectional study. Place and Duration of Study: At Tertiary Cardiac Care Center, Rawalpindi Pakistan from Nov 2020 to Apr 2021. Methodology: The retrospective data of the all the patients with STEMI was assessed via non-probability consecutive sampling technique and analyzed statistically. The study participants were classified into two categories based on whether they underwent post-dilatation or not, i.e., Category-I: patients who underwent post-dilatation with NC balloon and Category-II: patients who did not undergo post-dilatation. The primary study end-point was post-dilatation TIMI flow grade. Continuous study variables were expressed as Mean±S.D and categorical variables as frequencies and percentages. Chi square test was applied to find the association between study variables by keeping 95% CI and 5 % margin of error. p-value <0.05 was considered statistically significant. Results: The study included (n=410) eligible patients in total. Majority were males (n=303; 73.9%), 217 (52.9 %) patients underwent PD procedure. TIMI flow grade did not differ significantly between the two study categories (p-value > 0.05). Postprocedural success rate was 81.3% for patients with PD. Conclusion: The current study illustrates that PD does not adversely affect the final angiographic outcomes when performed after primary angioplasty.

Objective: To evaluate the long-term clinical results for a one-stent (1S) strategy compared to a two-stent (2S) strategy in distal unprotected left main coronary artery (ULMCA) bifurcation disease. Study Design: Comparative Cross-sectional study. Place and Duration of Study: Armed Forces Institute of Cardiology, Rawalpindi Pakistan, from Jan 2019 to Apr 2020. Methodology: 1-S approach was defined as stenting of the main vessel only and 2-S approach as stenting side branch and main vessel. Individual undergoing LMCA intervention were included via consecutive sampling in the study. Stent Crossover approach was used in 1-S technique; whereas, DK crush, culotte, and T-stenting approaches were employed in individuals who were treated with a 2-S approach. A composite of major adverse cardiovascular event (MACE) i.e., myocardial infarction, stroke or death and target lesion revascularization (TLR) were considered as primary end-point. Results: A sum of 110 individuals were inducted, 74 of them had stenting of left main bifurcation using a 1-S approach; and 36 patients underwent a 2-S PCI. Average age of the patients included in the study was 63.9±10.8 years. In 1 stent subset, the success rate of procedure was 99% whereas 100% success rate was seen in 2-S group. During the 2-year duration of follow up,frequency of MACE in single stent subset was (5.4%) whereas it was (13.8%, p=0.253) in the 2-S subset. Conclusion: When compared to 2-S approach of distal left main stenting, a 1-S strategy appears to demonstrate optimal clinical results and 2-year survival free of MACE. Choosing appropriate interventional strategy has proven prognostically significant; so, it demands mindful approach selection.

Objective: To determine the clinical outcome of patients admitted with acute anterior versus acute inferior wall myocardial infarction. Study Design: Comparative cross-sectional study. Place and Duration of Study: The study was conducted in emergency departments and adult cardiology wards of Armed Forces Institute of Cardiology/National Institute of Heart Diseases, from Aug 2019 to Nov 2019. Methodology: This study was conducted on 340 patients (208 patients with Anterior wall myocardial infarction and 132 patients with inferior wall MI who presented with Acute ST-Elevation MI) to emergency department of Armed Forces Institute of Cardiology/National Institute of Heart Disease during specified period. Outcome was calculated using Electrocardiogram, Two-dimensional transthoracic echocardiogram, Troponin-I, baseline investigations and coro angiography Data was entered and analyzed with SPSS-23. Results: Mean age was 59.38 ± 12.91 years in each group. In clinical symptoms chest pain was highest n=255 (71.4%) followed by diaphoresis 55 (15.4%) and breathlessness 51 (14.3%). The most common complications in patients with inferior wall MI were brady arrhythmia 8 (2.3%) whereas left ventricular failure 41 (12.1%) was more prevalent in patients with anterior wall MI after TVCAD. The results of cardiogenic shock 5 (1.5%),ventricular tachycardia 3 (0.8%) in inferior wall myocardial infarction were comparative to the results of cardiogenic shock 18 (5.3%) ventricular tachycardia 2 (0.5%) in anterior wall myocardial infarction. The number of stable patients was 91 (43.7%) in Anterior wall myocardial infarction and 51 (38.6%) in inferior wall MI. Conclusion: The study shows the comparative clinical outcome of anterior wall myocardial infarction versus inferior wall myocardial infarction.

Objective: To study the prevalence of coronary artery ectasia in the population of patients referred for coronary angiography. To describe clinical characteristics of patients with coronary artery ectasia, analyzing presentation and cardiovascular risk. To compare clinical and angiographic variables in patients with and without coronary artery ectasia. Study Design: Descriptive cross sectional study. Place and Duration of Study: Adult cardiology department in Armed Forces Institute of Cardiology/NIHD, Rawalpindi, 6 months duration after approval of synopsis i.e. Oct 2018 to May 2019. Methodology: After meeting the inclusion criteria 300 patients were enrolled. Patients admitted in AFIC/NIHD with chest pain, ST-elevation MI, Non-ST-elevation myocardial infarction and unstable angina were enrolled. Coronary angiogram was done by cardiologist. Two distinct cardiologists or resident cardiologists reported the angiograms including the coronary artery anatomy and the presence of ectatic segments or any stenotic lesions in each vessel. All the collected data was entered and analyzed on SPSS version 23. Results: The mean patients was 58.23 ± 11.73 years. The male to female ratio was 14:1. Coronary artery ectasia was detected in 53 (17.7%) patients of coronary angiography. Stenotic coronary artery disease was detected more commonly in patients having factors like diabetes, hypertension, and dyslipidemia but specifically among smokers, ectatic segments were detected higher. Conclusion: Compared to coronary artery disease, coronary ectasia occurred more in smokers and less in diabetes.