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Objectives: The objective of the current study was to determine the frequency of anxiety and depression among patients diagnosed with acute coronary syndrome (ACS) at a tertiary care cardiac center in Pakistan. Methodology: This cross-sectional study was conducted at a tertiary care cardiac center in Pakistan from May to November 2019. We included patients of either gender, between 30 and 70 years of age, diagnosed with ACS, and presented within 72 hours of onset of symptoms. After the standard treatment of the condition, the Beck Depression Inventory Scale (BDI) and Beck Anxiety Inventory (BAI) were used to assess post-AMI depression and anxiety. The BDI =17 was categorized as depression and BAI =11 was taken as anxiety. Results: In the selected sample of 122 patients, the mean age was 58.7 ± 10.2 years and 88 (72.1%) patients were male. Diabetes mellitus was detected in 76 (62.3%) patients and 64 (52.5%) patients were smokers. The mean BDI score was 28.6 ± 6.5 and mean BAI score was 19.5 ± 5.1. Anxiety and depression were observed in 36 (29.5%) and 51 (41.8%) patients, respectively. Conclusion: Depression and anxiety are a common remnants of ACS, hence, in our day to day clinical practice, appropriate consideration should be given to the psychological wellbeing of patients in addition to the management of ACS. [ABSTRACT FROM AUTHOR]

Objective: To determine whether a planned 2-stent double kissing crush technique is superior to provisional stenting patients presenting with true distal LM bifurcation lesions. Study Design: Cross-sectional comparative study. Place and Duration of Study: Armed Forces Institute of Cardiology/National Institute of Heart Diseases, Rawalpindi Pakistan, from Dec 2020 to May 2021. Methodology: A total of 70 patients enrolled in the study presented with true distal LM bifurcation lesions (Medina 1, 1, 1 or 0, 1, 1). Patients were randomized to PS or DK crush technique. The primary end-point was peri hospital and 1 month composite rate target lesion failure (TLF): target vessel myocardial infarction (TVMI), cardiac death, stent thrombosis (ST), target vessel revascularization (TVR). Routine clinical follow up done at 2 weeks and 4 weeks followed by 3 and 6 months thereafter. Results: A total of 70 patients fulfilling the inclusion criteria were enrolled in the study. The patient population was divided into two groups. Group A participants underwent DK crush technique while group B participants underwent provisional stenting. In group A [DK crush technique] 16 (45.7%) patients presented with Non-ST elevation MI followed by 14 (40%) who presented with chronic coronary syndrome (CCS) while in group B [Provisional stenting] 13 (37.1%) presented with chronic coronary syndrome followed by 9 (25.7%) who presented with non-ST elevation MI. Conclusion: LM-PCI is an acceptable procedure in patients with true distal LM bifurcation lesions who are candidates for PCI. This study also showed that DK-Crush has good periprocedural and angiographic outcomes and superior to PS in complex LMCAD lesions. PS is an acceptable option in simple distal LMCAD. [ABSTRACT FROM AUTHOR]

Objective: To determine the correlation of Global Registry for Acute Coronary Events (GRACE) and Thrombolysis in Myocardial Infarction (TIMI) scores with Synergy between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery (SYNTAX) score (SS) to predict the extent and severity of coronary artery disease (CAD) in patients presented with first onset STE levation Myocardial Infarction (STEMI) undergoing Primary Percutaneous Coronary Intervention (PPCI). Study Design: Descriptive cross-sectional study. Place and Duration of Study: Inpatient departments of Armed Forces Institute of Cardiology/ National Institute of Heart Diseases (AFIC/NIHD), Rawalpindi, from Jan 2019 to Jun 2019. Methodology: Ethical approval was taken from Institutional Ethical Review Board (IERB), AFIC/NIHD. Patients of any age and both genders who presented with chest pain and satisfied criteria for Type 1 Myocardial Infarction (MI), as stated in 4th Universal Definition of MI, were included in study by non-probability consecutive sampling technique. Patients with a previous history of ischemic heart disease, Percutaneous Coronary Intervention (PCI) or Coronary Artery Bypass Graft (CABG) surgery were excluded. Both TIMI and GRACE scores for STEMI were calculated at time of admission. The extent and severity of CAD were assessed by the SS-I. Each coronary lesion with a diameter stenosis of at least 50%, in vessels of at least 1.5 mm, were scored. Data was analyzed using the Statistical Package for Social Sciences (SPSS) version 25. Results: Out of 376 patients, 327 (86.9%) were male and 49 (13.1%) were female. Anterior wall MI was the most common presentation 164 (43.6%). Among risk factors for CAD, hypertension was the most common one 215 (57.2%). A positive correlation was found between SS and GRACE low, intermediate and high-risk groups (0.145). Conclusion: Patients having high GRACE and TIMI scores were more likely to have severe CAD. In comparison with TIMI score, GRACE score was found to have better correlation with SS, but degree of that association was not strong enough to make it a reliable and sole predictor of CAD severity. [ABSTRACT FROM AUTHOR]

Objective: To determine the frequency of diabetes mellitus in non ST segment elevation myocardial infarction. Study Design: Cross-sectional. Place and Duration of Study: The study was carried out at the Armed Forces Institute of Cardiology (AFIC) Rawalpindi, from Apr 2010 to Oct 2010. Material and Methods: In this study three hundred fifty two patients with non ST elevation myocardial infarction (NSTEMI) who fulfilled the inclusion criteria were studied while they were admitted to the hospital. They were divided into diabetic and non diabetic groups. Frequency of age, gender, rising levels of cardiac biochemical markers, plasma glucose and HbA1c were seen in both diabetic and non diabetic patients. Results were obtained by using chi-square method and independent t-test. Results: Out of 352 patients of NSTEMI 193 were diabetics. The study population was categorized in three groups according to age as; 30-45, 46-60, and 61-75 years respectively. It was found that 46-60 years group was most frequently affected with frequency of 46.1%, p<0.001 with male predominance as 67.9% and females as 32.1%. Cardiac biochemical markers were raised with mean for CK 528.51 U/L SD ± 275.82 and CK MB 79.39 U/L SD ± 32.5, p<0.001 respectively. Raised fasting plasma glucose was found in 189 patients mean 8.74 mmol/L SD ± 1.52, p<0.001 and elevated HbA1c seen in 187 patients mean 7.94% SD ± 0.83, p<0.001. Conclusion: Despite modern therapies for unstable angina (UA)/NSTEMI diabetes is an independent cardiovascular risk factor, therefore we need aggressive strategies to manage the high risk group of patients. [ABSTRACT FROM AUTHOR]