Heart failure clinical outcomes in hyponatremic versus normonatremic patients

To compare the outcome in heart failure patients between normonatremic and hyponatremic cases in the short term. A cross-sectional study focusing on descriptive statistics at the Department of Cardiology, Lady Reading Hospital Peshawar was performed from 9th August 2011, till 29th April, 2012. Both male and female patients aged 14 years and above admitted diagnosed with heart failure were enrolled and data observed. Those having serum sodium of ?135mmol/L were defined as hyponatremic. All the patients were managed according to guidelines. All patients were followed during their hospital stay. Patients who survived were discharged on standard HF medications and followed till the end of third month for 3 month mortality and re-admissions for heart failure. Total study population was 241. Mean age was 59.2 +/- 14.9 [18- 100] years. Female patients were 51% [123]. Mean serum sodium was 136 +/- 5.1mmol/L [116-151]. Hyponatremia was present in 35.3% [85] patients. Overall three month follow up mortality was 14.7%, while it was significantly higher in hyponatremic group 22.7% compared to normonatremic patients 10.7% [P=0.02]. Being followed for a period of 3 months 25% patients were readmitted to hospital with heart failure decompensation. Hyponatremic group had readmission rate of 26.7% compared with 24% in normonatremic patients [p=0.74]. Hyponatremia in patients diagnosed with heart failure possess a significant over all risk to a higher mortality as compared to those that are normonatremic. Re-admissions for heart failure are equally common in hyponatremic and normonatremic patients

Frequancy of hyponatremia and in hospital clinical outcomes in these patients hospitalized for heart failure

To determine the frequency of hyponatremia and in-hospital clinical outcomes in hyponatremic patients hospitalized for heart failure.This was a descriptive study conducted in department of cardiology, Lady Reading Hospital, Peshawar. Both male and female patients aged 14 years and above admitted with heart failure fulfilling the inclusion criteria, were included in the study. Patients were subjected to detailed history and clinical examination. Admission Serum sodium was measured in all patients. All the patients were managed according to guidelines. All patients were followed for in hospital mortality and length of hospital stay [LOHS].The total number of patients was 241. Mean age was 59.2 +/- 14.9 [range 18-100] years. Females were 123 [51%] patients. Mean serum sodium was 136 +/- 5.1mmol/L. Hyponatremia [serum sodium

Accuracy of 12 lead ECG for diagnosis of posterior myocardial infarction

To determine the accuracy of 12 lead ECG for diagnosis of acute Posterior Myocardial Infarction [MI] after its confirmation by 15 leads ECG. This study was conducted in Cardiology Department, Lady Reading Hospital Peshawar from January to July, 2012. Patients presenting to CCU with typical chest pain, pain epigastrium, sweating, nausea or vomiting and with admitting diagnosis of acute coronary syndrome [ACS] were included. The diagnostic criteria for posterior MI on 12 leads ECG was when R:S was more than 1:1 in V2 or there was tall R wave in V1 or V2 [more than Sin the same leads] or more than 2mm ST segment depression in anterior lead. Posterior MI was confirmed on 15 leads ECG taking it as a standard when ST segment elevation of >1mm was present in C7,8,9. Out of 176 randomly selected patients, 90[51.1%] were male and86[48.9%] female; with mean age of 63 years. Out of these, 70 were in the age range of 51 to 60 years and 40 each in 41-50 and 61-70 years. Eighteen patients had changes of posterior MI on 12 leads ECG and amongst them 10patients had true posterior MI on 15 leads ECG. We had 8 false positive cases on 12 leads ECG with no false negative cases after confirmation with 15 leads. The accuracy of 12 leads ECG for detection of posterior MI was55% after confirmation with 15 leads and there was no age and gender difference in its accuracy

Effect of cholesterol level on platelet aggregability in normal individuals

The aim of present study was to find the effect of cholesterol level on platelet aggregability in normal individuals. This study was conducted in Cardiology department, Lady Reading Hospital, Peshawar in September-October 2007. Normal individuals aged 18 years or above were randomly included. Patients who were suffering from any cardiovascular or other diseases were excluded. Those who were taking ante-platelets, anti coagulants and lipid lowering drugs were also excluded. Thus a total of 101 individuals were examined, after taking informed written consent. Fasting blood samples were taken from each patient. Total cholesterol was measured in hospital laboratory, while platelet aggregation was measured with chronolog whole-blood platelet aggregometer [WBA]. A total of 101 patients were examined. Their mean age was 51.24 +/- 8.23 years. Male were 60[59.41%] and female were 41[40.59%]. Mean platelet aggregability of these individuals was 7.87 +/- 4.40 ohms. Mean cholesterol was 163.47 +/- 20.75 mg/dl. When age was correlated with aggregability, both had a weak negative correlation. Pearson correlation coefficient was -.018 [p=0.855]. When age was correlated with cholesterol, again both have a weak negative correlation. Pearson correlation coefficient was -.152 [p=0.129]. When aggregability was correlated with cholesterol, both have a significant positive correlation. Pearson correlation coefficient was +0.269 [p=0.006]. Platelet aggregability is increased in patients with high cholesterol. These patients may need higher doses of anti platelets and more aggressive treatment of lipids to avoid vascular events

In-hospital complications of acute right ventricular myocardial infarction

To determine the in-hospital complications of acute right ventricular myocardial infarction[RVMI]. This study was conducted at Cardiology Department, Lady Reading Hospital, Peshawar from May to October 2009. A total of 100 patients with acute RVMI were evaluated for in-hospital complications. Male patients were 77 [77%] and females 23 [23%]. Patient's mean age was 59.96+12.3 years with age range 28-82 years. Total in-hospital complication events were 174. In-hospital complications were present in 77% patients. Cardiogenic shock was the commonest complication with frequency of 25.8%followed by acute left ventricular failure [LVF] in 17.8% and atrioventricular blocks [AV Blocks] in 14.3% respectively. Re-infarction occurred in 5.7% [10] patients. Thirty eight patients died in our study [21.8%]. Among RVMI patients, 65% stayed in-hospital for more than 4 days. Frequency of complications is higher and cardiogenic shock is the most common complication in acute RVMI patients

Comparative analysis of type of myocardial infarction in patients with successful or unsuccessful streptokinase thrombolysis following st elevation myocardial infarction

To study the effect of thrombolytic therapy in term of success and failure on the type of ST elevation MI, using streptokinase. This was a comparative study, conducted at Department of Cardiology, Lady Reading Hospital, Peshawar, from October 2006 to October 2007. Patients with first acute myocardial infarction were divided into group A [successful thrombolysis] and group B [unsuccessful thrombolysis] using ECG criteria. Total number of patients were 200. Group A included 136 [68%] patients and group B included 64 [32%] patients. There were total 88 [44%] patients of anterior MI with 47 patients in group A and 41 patients in group B [34.6% vs 64.0%, p<0.001]. There were total 110 [55.0%] patients of inferior MI with 88 patients in group A and 22 patients in group B [64.7% vs 34.4%, p<0.001]. Lateral myocardial infarction was diagnosed in 2 [1%] patients with 1 patient each in group A and group B [0.7% vs 1.6%, p=0.583]. Anterior MI was associated with a higher rate of thromblysis failure while inferior MI and lateral wall MI was associated with a higher rate of successful thrombolysis.

Frequency of aspirin resistance in patients with cardiovascular diseases

To find out the frequency of aspirin resistance, as measured by the inhibition of platelet aggregation, using Whole Blood Aggregometery, in patients with cardiovascular diseases presenting to out patient department of a tertiary care hospital. This study was conducted in the outpatient department of Cardiology, Lady Reading Hospital Peshawar, from October 2007 to January 2008. A total of 105 normal individuals not taking aspirin and 136 patients taking aspirin for cardiovascular diseases were randomly included. Blood was taken for measuring platelet aggregation using whole blood aggregometer. Result of each individual was noted on a proforma. Patients who were on any other ante-platelet like clopidogrel; or on warfarin and heparin were excluded from the study. Chi -square and independent t-test were used to find significant differences between different groups and variables. Platelet aggregability in 105 normal subjects, not taking aspirin was 9.28 +/- 3.23ohms. So cutoff for aspirin non responsiveness was taken as 9.28-3.23=6.0 ohms. Mean aggregability of 136 cardiovascular patient, taking aspirin was 5.81 +/- 5.47 ohms. Mean age was 52.66 +/- 10 years.Male were 80[58.8%]. Patients having aggregability >/= 6 ohms were 47.1%[n=64]. Mean aggregability of male patients was 5.66 +/- 5.45 ohms. Mean aggregability of female patients was 6.03 +/- 5.54 ohms[p=0.69]. When age was correlated with aggregability, both have a weak negative correlation [Pearson correlation coefficient= - .109 [p=0.205]. Mean age of patients having aggregability /= 6 was 51.46 +/- 10.36 [p=0.19]. Aspirin resistance as defined by inhibition of platelet aggregation measured with Whole Blood Aggregometry, is a common problem. Gender and age has no significant affect on platelet aggregability

Comparison of left coronary artery diameter among diabetics and non-diabetics

To compare the left coronary artery diameter between diabetic and non-diabetic patients undergoing coronary angiography. This was a hospital based cross sectional comparative study. After obtaining an informed consent, 139 patients each in diabetic and non-diabetic groups were selected by non-probability purposive sampling method. Coronary angiography was done through femoral approach using Seldeinger technique and standard views were taken. Quantitative analysis of digital angiograms was performed. Data analyzed using SPSS version 11.0. Independent t test was applied to calculate mean coronary artery size between diabetic and non-diabetic patients. A p-value of less than 0.05 was considered significant. Out of 278 patients included in the study, 139 [50%] were diabetics and 139 [50%] were non-diabetics. Males were 168 [60.4%] as compared to females 110[39.6%]. Mean age was 52.82 + 7.115, and mean body surface area was 1.8004 +.11094. There was significant difference in coronary diameters of LAD [p value 0.000], LMS [p value 0.008], and distal Cx coronary arteries [p value 0.000] between the two groups. In this study, left coronary arteries and its branches were found to be narrower in diabetic patients than in non-diabetics

How successful is secondary prevention for coronary artery disease [cad] in the real world?

To document the effects of secondary prevention on different risk factors in the real world situation. It was a cross sectional comparative study carried out at a referral cardiac clinic in Peshawar from January 2010 to December 2010. Study subjects presenting with at least 6 months follow up were included from different parts of Khyber Pukhtunkhawa. All patients with positive history or objective evidence of CAD were enrolled. Study subjects were divided in two groups based on the fact that either taking or had stopped medication for the duration of the study period. Study variables were levels of lipids, glucose, blood pressure [BP], smoking and obesity. A total of 843 patients were included in the study. Males were 70.4% [593]. Mean age was 58.74 +/- 10.6 years. Patients taking regular medicine were 69.03% while 30.97% had stopped their medicine for at least three months. Diabetics, hypertensive and positive family history for CAD were 33.4%, 50.25% and 24% respectively. When compared to patient who had stopped medicine, mean systolic BP [p= 0.014], diastolic BP [p= 0.05], mean Cholesterol [p=0.000], mean LDL [p=0.000], mean HDL [p=0.000] and HbA1c% [p=0.049], was well controlled in patients who were taking medicine regularly. Mean BMI [p=0.786], triglycerides and smoking [p=0.761] had no significant difference between the two groups. Blood pressure, serum cholesterol, LDL, HDL, as well as HbA1c% were reduced with little effect on serum TGs, BMI and smoking in those who were taking medicine regularly compared to those who had stopped

Effect of heart rate on hemodynamics in mitral stenosis

To assess the effect of heart rate [HR] on haemodynamic parameters in patients with Mitral Stenosis [MS]. The study was conducted at Cardiology department, Lady Reading Hospital, Peshawar from November 2010 to April 2011. Patients with MS, regardless of severity, were included. Patients with severe heart failure, other valvular or structural heart disease were excluded. Echocardiographic parameters were recorded at slow and fast HR. Patients with tachycardia were given beta-blockers and patients with bradycardia were given parenteral Atropine. A total of 60 patients were included, females were 57 [78%]. Mean age was 31 +/- 9 years. Mean slow and fast HR was 77 +/- 12bpm and110 +/- 13 bpm, respectively. Peak mitral valve gradient [PMVG] slow vs. fast HR was 12.8 +/- 4.80 and 14.93 +/- 7.18 mm Hg [p=0.000]. Mean mitral valve gradient [MMVG] at slow vs. fast HR was 6.62 +/- 3.29 and 8.15 +/- 4.88 mm of Hg [p=0.000]. E pulse Doppler [E] at slow vs. fast HR was 168 +/- 35 and 181 +/- 40 cm/s [p=0.013], while E tissue Doppler [E] velocity was 10.47 +/- 2.81 and 10.97 +/- 2.38 cm/s / [P=0.098], respectively. E/E ratio for slow and fast HR was 17 +/- 5.63 vs. 17 +/- 5.41 [P=0.792]. Right ventricular systolic pressure [RVSP] at slow vs. fast HR was44 +/- 16 vs.49 +/- 17.05mm of Hg [P=0.001]. The above parameters had insignificant change with the HR when there was accompanying more than mild MR. Slowing HR in patients with MS significantly decreased PMVG, MMVG and RVSP. LV function did not change significantly with HR. Rate control drugs may be used in preference to improve symptoms in moderate and severe MS

Radial artery approach for coronary intervention - early experience

To see the clinical outcome of patients undergoing Transradial Coronary Angioplasty with stable Angina. This was a single center observational study with prospective data collection of 338 patients who underwent transradial coronary angioplasty from September 2009 to August 2011, at Post Graduate Medical Institute, Lady Reading Hospital, Peshawar. Patients of both genders and all ages who had transradial coronary angioplasty for chronic stable angina were included in the study. Patients were clinically examined in out patients department on first month of hospital discharge and clinical outcome data was recorded. A total of 338 patients were included in the study. Male were 58.8% and 41.2% were female with mean age of 52 +/- 7years. All the patients had coronary intervention through right radial artery. Baseline characteristics of the patients were; 48.2% diabetic, 43.2% hypertensive, 30.5% smokers, dyslipidemia was 45.7% and mean values of serum creatinine and Hemoglobin were 1.1 +/- 0.3 and 11.5 +/- 1.5, respectively. The frequency of various complications were as follow; hematoma 1.3%, nausea and vomiting 2.2%, pain in hand 11.2%, readmission to hospital for chest pain 6.5%, need for revascularization 2.2%, hand ischemia 1.8%, minor bleeding 0.9%, no major bleeding and 1.9% mortality. The radial artery approach for coronary intervention is useful with low degree of access site vascular complications and an early mobilization

Comparison of the efficacy and safety of thrombolytic therapy for st-elevation myocardial infarction in patients with and without diabetes mellitus

This study compared the efficacy and safety of streptokinase as thrombolytic agent for ST-elevation myocardial infarction [STEMI] in patients with and without diabetes mellitus. This prospective interventional study was carried out in the department of Cardiology, Postgraduate Medical Institute Govt. Lady Reading Hospital Peshawar. A total of 444 patients admitted to coronary care unit with STEMI and eligible for thrombolytic therapy [no contraindications per AHA/ACC guidelines] were studied from December 2009 to December 2010. Among these half of patients were diabetic while rests were non-diabetic. Streptokinase was administered to all patients. Resolution [reduction] of elevated ST segment was evaluated after 90 min of streptokinase administration. Comlications of streptokinase infusion including hypotension, shock and hemorrhage was noted. Failed reperfusion [<30% ST resolution] was significantly higher in diabetic as compared to non-diabetic patients [21.6% vs. 9.5%; p<0.0003] while successful reperfusion [>/= 70% ST-resolution] was significantly higher in non-diabetic than diabetic patients [66.7% vs. 49.1%; p<0.0001]. Complication rates between the two groups were statistically similar. Hypotension occurred in 45 [20.3%] and 51 [23%]; p=0.458 patients in non-diabetic and diabetic group respectively while shock occurred in 10 [4.5%] and 13 [5.9%]; p= 0.506 and hemorrhagic manifestations in 13 [5.9%] and 10 [4.5%]; p=0.294 patients respectively. The outcome of thrombolytic therapy is adversely affected by Diabetes mellitus in patients with ST-elevation myocardial infarction. Secondly the risk of hazards associated with thrombolytic therapy is same in both diabetic and non-diabetic patients

Efficacy and safety of percutaneous transvenous mitral commisurotomy [ptmc] performed through patent foramen ovale [pfo]

The aim of this study was to assess efficacy and safety of PTMC in patients with severe mitral stenosis [MS] perform through patent foramen ovale. All symptomatic patients with severe MS were included in the study from January 1998 to December 2010, at Cardiology department, Lady Reading Hospital, Peshawar. Transthoracic and trans-esophageal echocardiogram was performed to exclude left atrial appendage/left atrial clot and check the anatomy of interatrial septum. Severely calcified mitral valve and severe mitral regurgitation were excluded. Patent foramen ovale was crossed in majority of cases to reach left atrium. Stenosed mitral valve was dilated with Inoue balloon. Total number of patients was 1818. Females were 74% [p<0.05]. The mean age was 26.51 +/- 7.82 years and mean Body Mass Index [BMI] was 2 19.05 +/- 1.2kg/m[2]. The number of patients who had PTMC through PFO were 2 92.08%. Mean valve area was 0.9 +/- 0.19cm[2] on 2D Echocardiography, which 2 increased to 1.82 +/- 0.17cm[2] [p<0.05], mean mitral valve gradient decreased from 18 +/- 4.04mmHg to 7 +/- 0.25mmHg [p<0.005] and mean right ventricular systolic pressure decreased from 70 +/- 17.4mmHg to 48 +/- 13mmHg [32% drop] [p<0.05] at 24hours after PTMC. Mean time of crossing interatrial septum via PFO was 17 +/- 05minutes. Post PTMC severe MR in PFO group was 3.6% and 2.8% in inter atrial septum group [p=0.21]. Pericardial effusion was noted in 0.11% patients in PFO group and 0.27% in interatrial septum group [p>0.05]. Stroke was present in 1.5% patients. PTMC through patent foramen ovale [PFO] is a safe procedure, with few complications

Frequency of adverse outcomes of acute myocardial infarction in patients with stress hyperglycemia

To determine the frequency of in-hospital adverse outcomes of acute myocardial infarction in patients with stress hyperglycemia. This was a descriptive cross sectional study conducted from August 2010 to January 2011 in Cardiology department, Lady Reading Hospital, Peshawar. Patients of age 25-70 years, of either gender, non-diabetic with acute myocardial infarction with stress hyperglycemia were included. Random blood sugar >/= 144 mg/dl was taken as stress hyperglycemia for patients at presentation of acute myocardial infarction. Patients were monitored for electrical complications such as atrial fibrillation, ventricular tachycardia, ventricular fibrillation and complete heart block and mechanical complications such as cardiac pulmonary edema and cardiogenic shock during hospital stay. The statistical analysis was performed using the statistical package for social sciences [SPSS Ver. 15.0]. A total of 341 patients having acute myocardial infarction with stress hyperglycemia were studied. The mean age was 56.35 +/- 9.748 [95% CI 57.39 - 55.31]. Male were 58.1% [n=198]. The frequency of various major in-hospital electrical adverse outcomes of acute myocardial infarction with stress hyperglycemia were atrial fibrillation [AF] 15.8%, ventricular tachycardia [VT] 11.7%, ventricular fibrillation [VF] 10.9% and complete heart block [CHB] 6.7%, while mechanical adverse outcomes were cardiac pulmonary edema [CPE] 7.9% and cardiogenic shock [CS] 11.7%. Stress hyperglycemia has adverse impact on outcomes of patients presenting with acute myocardial infarction. Among electrical and mechanical complications of acute myocardial infarction in patients with stress hyperglycemia, the two most frequent in-hospital adverse outcomes were atrial fibrillation and cardiogenic shock, respectively

Correlation of functional class of dyspnea with left ventricular diastolic dysfunction

To correlate functional class of dyspnea with left ventricular diastolic dysfunction assessed by echocardiography. This was a single center descriptive study, conducted in Cardiology department Lady Reading Hospital Peshawar from March 2011 to October 2011. All male and female patients of any age with clinical diagnosis of heart failure with sinus rhythm and no to minimal mitral regurgitation were included in the study, using consecutive non-probability sampling technique. Six minute walk test was performed to place the patients in proper NYHA Class of dyspnea. Detailed echocardiographic study was performed to document left ventricular diastolic dysfunction. The data was analyzed on SPSS version 16. Spearman rank correlation coefficient was used to measure the strength of association between pairs of variables. P-value

Short term effects of rosuvastatin on plasma concentration of high sensitivity c-reactive protein in patients with chronic stable angina

To determine the short term effects of rosuvastatin on elevated base line high-sensitivity C-reactive protein [hs-CRP] in patients with chronic stable angina. This Quasi-experimental comparative study was conducted in Cardiology department, Lady Reading Hospital Peshawar, between March 2010 and February, 2011. We selected 44 consecutive patients age 40 years or above, of any gender having hs-CRP levels >/= 1.2mg/l with chronic stable angina. Base line levels of hs-CRP, total cholesterol, LDL cholesterol, HDL cholesterol, triglycerides, and creatine phosphokinase [CPK] were measured in fasting status. These patients were treated with rosuvastatin 20 mg once daily at night and followed up for one month. Using SPSS version 16 data was analyzed. Mean age was 53 +/- 7.2 and 50% were females. Following treatment with rosuvastatin 20mg for one month the mean hs-CRP levels reduced from 4.08 +/- 2.56 to 2.72 +/- 2.40 [95%CI, 0.41 to 2.29, p=0.006]. Similarly mean total cholesterol levels decreased from 185.88 +/- 37.62 to 147.45 +/- 38.35, [p=0.0001]. LDL cholesterol decreased from 118.34 +/- 31.31 to 86.63 +/- 35.72 [p= 0.0001]. But mean HDL cholesterol had no significant increase from baseline levels i.e. from 32.18 +/- 9.93 to 33.95 +/- 7.65 [p=0.174]. TGs levels reduced from 240.11 +/- 123.66 to 197.43 +/- 88.24 [p=0.008]. Mean CPK levels did not differ significantly from base line at follow up, from 101.43 +/- 58.63 to 96.22 +/- 55.10 [p=0.646]. Short term treatment with rosuvastatin significantly decreases elevated hs-CRP levels in patients with chronic stable angina

Echocardiographic findings in hypertrophic obstructive cardiomyopathy [hocm]

To find out various Echocardiographic findings in patients with HOCM. This was a retrospective cross-sectional study performed in Cardiology department Lady Reading Hospital, Peshawar. Data collected from the database computer section of echocardiography department from February 2009 to November 2011.The data was analyzed using SPSS version 14. Total study population was 28. Male were 14 [50%]. Mean age was 52.5_ 15.9 years. Mean left ventricular end diastolic dimension was 3.84cm; inter-ventricular septal thickness 2cm [1.1-3.1] and posterior wall thickness was 1.17cm [0.6-1.6]. Mean Left atrial [LA] diameter was 3.86cm [0.8-5.6]. Mean peak gradient across LVOT was 48.43 mmHg. Mitral regurgitation [MR] was found in 19 [67.9%] patients. MR was mild in 57.1%, moderate in 7.1% and severe in 3.6% of patients. Aortic regurgitation [AR] was found in 13 [46.4%] patients. AR was mild in 35.7%, moderate in 10.7% of patients. Left atrial size was increased in 14 [50%] patients. Mean LA diameter was 4.6cm, 5cm and 5.6cm in patients with mild, moderate, and severe MR respectively. So there was direct relation between severity of MR and LA diameter. The respective mean gradient across LVOT in patients mild, moderate and severe MR was 31mmHg, 43.5mmHg and 140mmHg. So higher the gradient across LVOT, more will be the MR and hence the LA size and the patient will be more symptomatic. HOCM is significantly associated with both MR and AR and there is direct relation between severity of MR with LA diameter and LVOT gradient

Effect of intervention on the control of risk factors in coronary artery disease patients

To assess the effect of optimal medical therapy on the control of risk factors in coronary artery disease [CAD] patients with or with-out intervention. It was a cross sectional comparative study carried out at Lady Reading Hospital, Peshawar January to December 2010. Subjects were divided into two groups based on percutaneous coronary intervention and optimal medical therapy. Study variables were smoking, physical activity, dyslipidemia, diabetes, hypertension and obesity. Informed written consent was taken from all the study participants. Data was recorded on a preformed Questionnaire and analyzed with SPSS version 16. P-value of 0.05 was taken as significant. A total of 315 patients were studied. Baseline characteristic were similar between groups. Smoking was decreased significantly in [PCI group] as compared to [OMT group] [p=0.027]. Physical activity goal >/= 150 min/ week were achieved more in [PCI group] compared to [OMT group][p=0.019]. Goals set for Serum cholesterol, HbA1c%, serum LDL, Systolic blood pressure and Diastolic blood pressure have significantly achieved in [PCI group] as compared to [OMT group] with p- valves of [0.018,0.027,0.023,0.033 and 0.017] respectively. While goals set for Triglycerides, serum HDL and BMI have no significant difference between the two groups with p-valves of [0.223, 0.089 and 0.164 respectively]. Patients who underwent intervention and remained on optimal medical therapy were more adherent to regular exercise and good compliance which lead to better risk factors control for coronary artery disease as compared to patients who remained on optimal medical therapy alone

Assessing the efficacy of danshenform compound in patients with stable angina pectoris

To assess the efficacy of danshenform compound in patient with angina pectoris already on optimal dose of anti anginal therapy assessed by exercise tolerance test. Thirty eight patients with stable angina were included in the study. Patients were exercised on treadmill according to Bruce protocol at baseline and one week later. At second week, Danshenform compound 500 mg was prescribed bid for four weeks. At the end of 4 weeks, exercise tolerance test was performed. Duration and number of anginal episodes before and at the end of 4[th] week recorded. Total exercise time, onset of chest pain during exercise, onset of ST segments depression before and after treatment with Danshenform compound was recorded. The number of anginal episodes after 4 weeks treatment with danshenform was reduced significantly from 4.2 +/- 2.4 to 1.4 +/- 1.6/ week [p=0.001]. Time of onset of chest pain improved from 4.63 +/- 2.4 to 5.4 +/- 3.7 minutes [p=0.35] on exercise tolerance test. Duration of exercise increased from 6.52 +/- 1.9 minutes to 8.32 +/- 2.3 [p=0.001]. Time of onset of ST depression increased from 5.8 +/- 1.7 to 7.7 +/- 1.6 minutes [p=0.001] on stress test. Anginal class improved significantly after 4 weeks of treatment with danshenform compound [p=0.001] with no significant effect on resting heart rate [p=0.58] and systolic blood pressure [p=0.07] respectively. Danshenform compound is useful in reducing anginal episodes, increasing exercise duration, improving functional anginal class, delaying the onset of ST depression on exercise tolerance test in patient with ischemic heart disease