ABSTRACT
Background: We aimed to compare clinical profile of premature coronary artery disease (PCAD) in urban vs. rural Indian populations.Methods: This was a prospective cross-sectional observational multi-centre study. This study is a sub-study of the ongoing PCAD registry. Between the period April 2017 and April 2018, a total of 1061 patients <40 years with PCAD were studied. Urban (n=583) and rural (n=478) populations were statistically compared.Results: Mean age of the urban and rural populations were 34.50±4.15 years and 33.99±4.46 years, respectively. All cardiovascular risk factors (smoking, diabetes, hypertension, dyslipidemia, obesity, diet and family history), except for alcoholism were more prevalent in urban subjects compared to rural subjects. However, higher prevalence of only hypertension (p=0.05) was statistically significant. Religion was significant between the two populations (p<0.001). Window period was also significant between the two populations (p<0.001). Very low density lipoprotein cholesterol (VLDL) (p=0.037) was significantly different between both populations.Conclusions: All conventional risk factors were more prevalent among urban populations than rural populations, however none of these differences except for hypertension was statistically significant.
ABSTRACT
Objective The study investigated effectiveness of transcatheter closure of post-myocardial infarction (MI) ventricular septal rupture (VSR) using atrial septal device (ASD) occluder in a cohort of patients admitted at our institute. Method This was a retrospective, observational and single center study, which included patients who were treated with transcatheter closure for post-MI VSR at our tertiary care center between May 2000 and August 2014 depending upon inclusion and exclusion criteria. Primary outcome was all-cause mortality at 30-days follow-up. The MELD-XI (Model for End Stage Liver Disease) score was used as a predictor for poor outcome in these patients. Results A total of 21 patients (mean age 66.4 ± 5.9 years) were included in the study. Study cohort predominantly included male patients (n = 15; 71.4%) and patients with single vessel disease (n = 15; 71.4%). Revascularization of the culprit lesion, before VSR closure, was attempted in 6 patients. Except one patient (treated with Cera® occluder), all patients were treated with Amplatzer® ASD occluders. Average diameter of VSR was 20.8 ± 6.9 mm. Diameter of the device used in the study ranged from 10 mm to 30 mm. Residual defect was detected in 13 patients (62%). All-cause mortality at 30-day follow-up was observed in 9 (42.9%) patients. Time to VSR closure, diameter of VSR, and serum creatinine levels were significantly related to the 30-day mortality. MELD-XI score was found to be strongly associated with increased risk of mortality. Conclusion Primary transcatheter VSR closure using ASD occluders is a feasible approach which can provide reasonable survival outcomes along with equitable mortality rates.