Cardiovascular comorbidities and complications associated with coronavirus disease 2019.

Coronavirus disease 2019 (COVID-19) has caused a devastating global pandemic and continues to overwhelm the health-care facilities and shatter the economies of countries worldwide. Although it primarily affects the lungs, it shares a strong interplay with the cardiovascular system. The presence of underlying cardiovascular disease and its risk factors (diabetes, hypertension) predispose the patients to increased severity and mortality associated with COVID-19. On the other hand, COVID-19 itself leads to various cardiovascular complications, which increase its associated morbidity and mortality in affected patients. It is, therefore, prudent to review the rapidly evolving data in this field and understand the mechanisms behind the cardiovascular involvement of this lethal disease.

Appropriate use of PCSK9 Inhibitors in India.

The burden of atherosclerotic cardiovascular (CV) disease is alarmingly high and increasing in our country. Dyslipidemia is one of the major modifiable risk factors, and INTERHEART study showed that dyslipidemia had the highest population attributable risk for myocardial infarction. In the management of dyslipidemia, low-density lipoprotein cholesterol (LDL-C) is the primary therapeutic target. In addition to therapeutic lifestyle changes, statins and ezetimibe effectively lower LDL-C and consequently improve CV outcomes. However, there are situations where these drugs fall short of achieving the target or they may not be well tolerated.

The report on the Indian coronary intervention data for the year 2011--National Interventional Council.

The National interventional council of Cardiological Society of India has conventionally been presenting the data on various forms of cardiac interventions performed in the previous year at its annual meeting. Here we are reporting the data on coronary interventions done in India during the year 2011.

The fourth-generation Calcium channel blocker: cilnidipine.

Several classes of antihypertensive agents have been in clinical use, including diuretics, α-blockers, ß-blockers, angiotensin converting enzyme (ACE) inhibitors, angiotensin II type 1 receptor blockers (ARB), and organic calcium channel blockers (CCBs). All these drugs are being currently used in the treatment of Hypertension & various disease conditions of the heart either alone or in combination. Cilnidipine is a new antihypertensive drug distinguished from other L-type Ca(2+) channel blockers or even other antihypertensives, which will be useful for selection of antihypertensive drugs according to the pathophysiological condition of a patient.

Composite risk scores for acute coronary syndromes.

There have been considerable advances in the management of acute coronary syndromes in the recent past. There are three risk scoring systems used for prognosticating these patients. An attempt is made in this article to discuss the pros and cons of the different risk scoring systems and their clinical utility.

Biomarker-guided therapy for heart failure.

Although, there have been significant advances in the management of heart failure (HF), one of the important problems faced by the clinician treating these patients is the significant recurrence of HF with consequent need for readmission. In this article, a discussion is made about the role of natriuretic peptides for monitoring long-term treatment of these patients and different trials done in this regard.

Hypoparathyroidism--a cause of reversible dilated cardiomyopathy.

Hypoparathyroidism is associated with chronic hypocalcaemia which can have a variety of manifestations including cardiovascular changes. We describe here a case of primary hypoparathyroidism associated with systolic dysfunction of left ventricle presenting as a dilated cardiomyopathy in addition to other manifestations.

A case of aneurysm of left anterior descending artery rupturing into right ventricular outflow tract presenting as acute anterior MI secondary to Behcet's syndrome.

A case of Aneurysm of Left Anterior Descending that has ruptured into Right Ventricular Outflow Tract and presenting as acute anterior MI was successfully treated with aneurysmal resection and coronary artery bypass surgery. Possible aetiology is discussed.

Angioplasty of degenerated saphenous vein grafts--role of covered stents.

To study the safety and efficacy of covered stents in angioplasty of saphenous vein grafts a retrospective study was carried out among 12 consecutive cases admitted at the cardiology unit of Nizam's Institute of Medical Sciences during last 3 years. Angioplasty of saphenous vein grafts is a challenging task due to the different nature of the disease in vein grafts compared to the native coronary arteries. The lesions in vein grafts are more often diffuse and have considerable loose atherothrombotic material that is prone for distal embolisation, resulting in slow flow/no reflow and myocardial damage. Use of covered stents for saphenous vein grafts appears to be feasible and safe.

Autologous bone marrow-derived progenitor cell myocardial delivery for recent myocardial infarction patients following early angioplasty: results from a pilot study.

PURPOSE: Cellular cardiomyoplasty is a potential therapeutic approach to preventing left ventricular remodeling after myocardial infarction and has shown encouraging results such as induction of neoangiogenesis and functional improvement of diseased hearts. We report the results of a pilot study on progenitor cells in five patients with acute myocardial infarction (AMI). MATERIALS AND METHODS: Patients with single-vessel disease who had their first episode of myocardial infarction and underwent angioplasty after 48 h (an average of 17 days following myocardial infarction) were included in the study. Mononuclear cells (MNCs) (1x10(7)) were isolated by Ficoll Hypaque method from 60 ml of bone marrow (BM) obtained from the iliac crest of 5 patients (aspiration was performed under local anesthesia). The mean CD34 count was 1-4%. After confirming the patency of the affected vessel postangioplasty, cellular concentrate was injected into the affected artery in 3-ml boluses (three to four injections), with intermittent occlusion. RESULTS: The mean age of all five male patients was 48.6+13.7 years. At 1 year, five patients were asymptomatic, and one had Class II dyspnea on exertion. The results of an echocardiogram performed at 6 months showed an improvement in ejection fraction (EF) from 35.3% to 43.13% and in fractional shortening from 24.75% to 28.33%. End-systolic volume decreased from 115.5 to 92.3 ml, end-diastolic volume decreased from 177.5 to 170 ml, and end-systolic dimensions also decreased from 4.26 to 4 mm, demonstrating positive left ventricular remodeling. Repeat echocardiogram at 1 year showed persistent improvement in EF. No adverse events were noted either before or after the procedure. CONCLUSION: The injection of autologous BM MNCs is a safe and efficacious therapy following early revascularization in AMI patients.