Association of Genetic Variants at the 4q25 Locus with Atrial Fibrillation in Indian Population.

INTRODUCTION: Atrial fibrillation (AF) is the most common cardiac arrhythmia in clinical settings known to impair cardiac function. Genome-wide association studies identified SNPs on chromosome 4q25 to be associated with AF. Till date no information is available from India related to the association of these variants with AF. MATERIALS AND METHODS: Two hundred and sixty-seven individuals comprising of 170 patients with Coronary Artery Disease (CAD), 41 patients with AF, and 56 healthy controls were genotyped for rs10033464 and rs2200733 at 4q25 locus. RESULTS: Strong association of rs10033464 with AF was observed on comparison with control groups (OR: 2.59; 95% CI: 1.08-6.21; P: 0.031) and between post-coronary artery bypass grafting (CABG) AF and control with dominant genetic model (OR: 4.73; 95% CI: 1.50-14.89; P: 0.0071). Comparison of post-CABG AF with CAD also indicated association (OR: 2.73; 95% CI: 0.9-7.56; P value: 0.05). In contrast, the rs2200733 C>T variant did not show any association with post-CABG AF, but with lone AF with the 'T' allele being associated with increased risk was seen (OR: 2.80; 95% CI: 1.08-7.24; P value: 0.042). CONCLUSION: In conclusion, the rs10033464 (T) allele is associated with the risk of post-CABG AF and the rs2200733 (T) with lone AF.

Detection of Postcoronary Stent Complication: Utility of 64-Slice Multidetector CT.

Coronary stent fracture is a known complication of coronary arterial stent placements. Multiple long-term risks are also associated with drug eluting stents. 64-slice multidetector CT (MDCT) coronary angiography has been shown to detect poststent complications such as instent stenosis, thrombosis, stent migration and stent fractures. We report a case of stent fracture in a patient who underwent RCA stenting with associated RCA perforation and almost complete thrombosis of the RCA and peristent fibrinoid collection. This is a rare case of stent fracture with perforation of the RCA. The paper highlights the role of 64-row multidetector computed tomography (MDCT) in evaluation of such poststent placement complications.

Transcatheter closure of ruptured sinus of Valsalva aneurysm using the Amplatzer duct occluder in a critically ill post-CABG patient.

Ruptured sinus of Valsalva aneurysm is a rare but well recognized clinical entity. These patients develop congestive heart failure due to biventricular increases in volume as a result of sudden aortocardiac shunting. Traditionally, surgical repair has been the mainstay of therapy. We report a case of a ruptured sinus of Valsalva aneurysm that was successfully closed percutaneously using the Amplatzer duct occluder in a critically ill patient operated on previously for coronary artery disease and presenting with acute congestive heart failure.