ABSTRACT
Cardiovascular disease [CVD] is a leading cause of morbidity and mortality worldwide. Although the majority of patients with CVD are treated with interventional procedures, a substantial number require medical therapy in terms of both prognosis and symptomatic relief. However, commonly used agents such as beta-blockers and calcium channel blockers reduce blood pressure in patients whose resting pressures are often already low. Ranolazine is a promising agent that does not have significant effects on blood pressure or heart rate. Use of this drug has been documented in various cardiovascular conditions, including ischaemic heart disease, heart failure and arrhythmias. This review article aimed to examine current evidence on the use of ranolazine in various cardiovascular conditions in order to determine whether it is a true pluripotent cardiovascular agent or, on the other hand, a "jack of all trades, master of none"
ABSTRACT
Objectives: Out-of-hospital cardiac arrests [OHCAs] are a leading cause of death worldwide. However, data regarding the management and outcomes of affected patients are lacking in the Middle East. The current study aimed to present the angiographic findings and outcomes of patients presenting with OHCA in Muscat, Oman
Methods: This retrospective study took place between January 2012 and December 2016 at the Sultan Qaboos University Hospital [SQUH], Muscat, Oman. All adult patients who presented following an OHCA to the Emergency Department of SQUH during the study period were included. Demographic and clinical data were collected from electronic medical records
Results: A total of 216 patients were included in the study. The majority [63.9%] presented after having collapsed, while 22.3% presented with chest pains. Asystole was the most frequent initial cardiac rhythm [62.5%], with only 10% having ventricular tachycardia/fibrillation. Very few patients [1.4%] had received cardiopulmonary resuscitation [CPR] prior to presentation. In total, 85 patients [39.4%] returned to spontaneous circulation [RSC]; of these, post RSC electrocardiography revealed an ST-segment elevation in 41.2% and normal findings in 23.5%. There were 63 patients who underwent coronary angiography, with 28 requiring stenting. Overall, 13% of patients survived and were discharged, although three survivors suffered permanent hypoxic brain damage
Conclusion: The overall survival rate of patients who had experienced an OHCA was low. Education programmes should focus on the benefits of immediate CPR for individuals experiencing an OHCA, with more opportunities for CPR training to be made available to the general public in Oman
ABSTRACT
The latest European Society of Cardiology [ESC] guidelines for the diagnosis and management of heart failure include a new patient group for those with heart failure with mildly reduced ejection fraction [HFmrEF]. By defining this group of patients as a separate entity, the ESC hope to encourage more research focusing on patients with HFmrEF. Previously, patients with this condition were caught between two classifications-heart failure with reduced ejection fraction and heart failure with preserved ejection fraction. Hopefully, the inclusion of new terminology will not increase confusion, but rather aid our understanding of heart failure, a complex clinical syndrome
ABSTRACT
Objectives: Secondary prevention of ischaemic heart disease [IHD] is very important. This study aimed to assess knowledge of necessary lifestyle changes among Omani patients diagnosed with IHD
Methods: This cross-sectional pilot study took place between October 2015 and February 2016 at the Sultan Qaboos University Hospital [SQUH], Muscat, Oman. A total of 30 random patients with IHD from the Cardiology Outpatient Clinic of SQUH were included. A 30-item survey was used to determine patients' knowledge of necessary lifestyle practices following their IHD diagnosis, with scores of <70% indicating poor knowledge
Results: Overall, 21 patients [70.0%] had low knowledge levels. Scores ranged from 38.9?94.4% [mean: 60.7% +/- 14.1%]. No demographic factors were found to predict low scores, although there were some differences in individual questions
Conclusion: Low knowledge levels regarding lifestyle changes were observed among IHD patients in Oman. More efforts should be made to educate these patients for the secondary prevention of IHD
ABSTRACT
Objectives: The aim of this study was to examine patterns of troponin testing in the emergency department of a large tertiary care hospital in Oman and to determine its effect on patient management, including length of hospital stay [LOS]
Methods: This retrospective study analysed the medical records of all adult patients undergoing troponin testing in the emergency department of the Sultan Qaboos University Hospital, Muscat, Oman, during the month of July 2015. Patients who presented with an ST-elevation myocardial infarction were excluded
Results: A total of 4,845 patients attended the emergency department during the study period; of these, troponin tests were ordered for 588 patients. The majority of the patients had negative troponin test results [81.3%]. Chest pain, palpitations and breathlessness were the most common presenting complaints for those with positive troponin results. However, 41.8% of patients did not have any cardiac symptoms. Individuals with positive troponin tests had a significantly longer LOS compared to those with negative tests [mean: three versus one day; P = 0.001]. In total, only 28.2% of those with positive troponin test results had final diagnoses associated with a cardiac condition, such as heart failure, an acute coronary syndrome [ACS], atrial fibrillation or other types of arrhythmia
Conclusion: A positive troponin test was associated with increased LOS; however, only a small proportion of these patients had a final diagnosis associated with a cardiac condition. Guidelines should be provided to ensure that troponin testing is performed only in cases where an ACS is suspected