Bleeding in patients undergoing percutaneous coronary intervention [PCI]

To study the frequency of bleeding and associated risk factors among patients undergoing Percutaneous Coronary Intervention [PCI]. This cross-sectional study was conducted on 500 consecutive patients, who underwent PCI at Punjab Institute of Cardiology, Lahore. Bleeding was defined according to REPLACE - 2 criteria. There were 82 females [16.4%] and 418 males [83.6%]; mean age 53.4 [ +/- 9.6 years]. Bleeding complications occurred in 6.2% [n=31] of patients; major bleed 0.8% [n= 4] and minor bleed 5.6% [n= 27]. One patient with major bleed [retroperitoneal] died in hospital. The frequency of bleeding complications was 8.5% among females and 5.7% among males [P=0.24]. Radial route was used in majority [88.6%]. The risk factors found to be significantly associated with the development of post-PCI bleeding were diabetes [OR: 6.4; P < 0.0001], hypertension [OR: 13.2; P < 0.0001], smoking [OR:8.31; P<0.0001] and BMI > 40 [OR: 6.8; P < 0.002], use of streptokinase [OR: 3.1; P < 0.0005], femoral approach [OR:4.2; P < 0.02], anaemia [OR: 44.8; P < 0.0001] and ACT >/- 350 [OR: 3.73; P < 0.0005]. In our study, female gender, procedure time >/-60 minutes, use of Glycoproteins IIb/IIIa inhibitors [GPI], and patient's age >/-50 years did not show significant association with post PCI bleeding. Major bleeding complications during Percutaneous Coronary Intervention [PCI] though occur rarely, are an important cause of patient morbidity and mortality

Metabolic syndrome in patients with ischemic heart disease

To determine the frequency of metabolic syndrome in patients with Ischemic Heart Disease [IHD]. Cross-sectional, descriptive study. Cardiology Department of Punjab Institute of Cardiology, Lahore, from June 2006 to June 2007. A total of 100 subjects with ischemic heart disease, fulfilling the inclusion criteria, were enrolled in the study. Demographic data [age and gender] and the 5 component conditions of the metabolic syndrome were noted. Subjects were physically assessed for the abdominal obesity, based on waist circumference. Fasting blood samples for glucose and lipid profile in first 24 hours after acute coronary insult were drawn and tested in central laboratory. Variables were processed for descriptive statistics. In this study population, 68% were male and 32% were female with mean age of 52 +/- 13.6 years in men and 56 +/- 12.5 years in women. Frequency of metabolic syndrome was 32% in men and 28% in women. It increased with age. The highest rate of metabolic syndrome was in men diagnosed as STEMI [odds ratio: 3.39, 95% Cl=1.36-8.41]. Frequency of metabolic syndrome was high among the patients with IHD. It supports the potential for preventive efforts in persons with high-risk of IHD