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89 results on '"J.P.S. Sawhney"'

1. Prevalence of cardiac abnormalities and heart failure in unselected out-patients with type 2 diabetes mellitus and associated clinical factors: Real-world evidence from an Indian registry

Author

Rajesh Rajput, J.C. Mohan, J.P.S. Sawhney, Jamshed Dalal, Ajit Mullasari, Hardik Vasnawala, Amit Kumar, Bharath HS, and Shital Sarda

Subjects
2-D echocardiography, Heart failure, Left ventricular dysfunction, Type 2 diabetes mellitus, Surgery, RD1-811, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Objective: Type 2 diabetes mellitus (T2DM) is known to be associated with development of left ventricular (LV) dysfunction and heart failure (HF). The study aimed to determine the prevalence of LV dysfunction and HF in unselected out-patients with T2DM with no previous cardiac history and to correlate LV dysfunction and HF with demographic and comorbid characteristics. Methods: This cross-sectional study conducted at 27 centers in India captured demographic and clinical data through electronic case record forms. B-type natriuretic peptide of >105 pg/mL was used to diagnose HF and two-dimensional echocardiography was used to assess LV dysfunction. Results: Of the 615 patients, 54.3 % (n = 334) were males; mean age was 57.4 ± 10.48 years. More than one-third of the patients had T2DM duration of >10 years (n = 238; 38.7 %), with hypertension as the most prevalent comorbidity (n = 372, 78.6 %). Approximately 61.3 % of the patients had LV hypertrophy. The mean LV mass was 135.0 ± 56.16 g (95 % CI 130.28, 139.70). The prevalence of any type of LV dysfunction, including systolic or diastolic dysfunction and HF was 55 % (95 % CI 51.0, 59.0) and 10 % (95 % CI 7.0, 12.0), respectively. A negligible but statistically significant correlation was observed between LV dysfunction and T2DM duration (p = 0.011), alongside HF and age (p

Published
2023
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2. Exercise and lipids

Author

Kushal Madan and J.P.S. Sawhney

Subjects
Exercise, Lipids, Cholesterol, CAD, Surgery, RD1-811, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Evidence from the existing literature suggests that exercise has positive effects for prevention and treatment of cardiovascular diseases by reducing risk factors such as elevated blood lipids. Based on clinical and observational clinical trials, it is well established that increased physical activity and regular exercise has a favourable impact on blood lipids and lipoprotein profiles. Exercise training significantly decreases blood triglycerides concentration and increases high density lipoprotein cholesterol levels. Though the Indian data depicting the effect of exercise on lipids is scarce, exercise directly improves “atherogenic dyslipidaemia” which is frequently present among Indians i.e. HDL-C is increased, TG is reduced and LDL-C particle size is improved. While drug therapy is key to the treatment of dyslipidaemia, lifestyle alterations such as exercise should continue to be actively promoted and encouraged by clinicians. Exercise is a low cost, non pharmacological therapeutic lifestyle change that is of value to lipid metabolism and cardiovascular fitness.

Published
2024
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3. Familial hypercholesterolemia

Author

J.P.S. Sawhney and Kushal Madan

Subjects
Familial hypercholeterolemia, Cascade screening, DLCN, Surgery, RD1-811, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Familial hypercholesterolemia is a common genetic disorder of autosomal inheritance associated with elevated LDL-cholesterol. It is estimated to affect 1:250 individuals in general population roughly estimated to be 5 million in India. The prevalence of FH is higher in young CAD patients (

Published
2024
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4. Therapeutic adherence in hypertension: Current evidence and expert opinion from India

Author

Jamshed J. Dalal, Prafulla Kerkar, Santanu Guha, Arup Dasbiswas, J.P.S. Sawhney, Sivakadaksham Natarajan, Srinivasa Rao Maddury, A. Sreenivas Kumar, Nishith Chandra, Gulla Suryaprakash, Joy M. Thomas, N.I. Juvale, Sunil Sathe, Aziz Khan, Sandeep Bansal, Viveka Kumar, and Rajshekhar Reddi

Subjects
Hypertension, Adherence, Cardiovascular disease, Antihypertensives medications, Blood pressure, Surgery, RD1-811, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Hypertension (HTN) is a globally prevalent non-communicable disease contributing significantly to cardiovascular (CV) morbidity and mortality. In achieving control of HTN, therapeutic adherence plays a crucial role. Studies from India identify varying rates of adherence to antihypertensive medications. Multiple factors determine treatment adherence in HTN. In India, factors such as lower socioeconomic status, health literacy, asymptomatic nature of disease, forgetfulness, cost of medications, and duration of HTN determine the adherence. An excellent physician-patient relationship incorporating adequate counseling along with the use of other methods can identify poor adherence. Improving adherence necessitates incorporating a multipronged approach with strategies directed at physicians, patients, and health systems. With innovation in therapeutics, the pharmaceutical sector can contribute significantly to improve adherence. Furthermore, increasing adherence to lifestyle interventions can help achieve better HTN control and improve CV outcomes. In the Indian context, more emphasis is necessary on patient education, enhanced physician-patient relationship and communication, increased access to health care, and affordability in improving therapeutic adherence in HTN.

Published
2021
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5. Molecular studies in familial dilated cardiomyopathy – A pilot study

Author

Vyom Mori, J.P.S. Sawhney, I.C. Verma, Ashwani Mehta, Renu Saxena, Rajiv Passey, Arun Mohanty, Bhuwanesh Kandpal, B.S. Vivek, Manish Sharma, Ashish Kumar Jain, and Dipak Katare

Subjects
Familial dilated cardiomyopathy, Prevalence, Pathogenic Variants, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Aim: To study genetic variants in patients of familial dilated cardiomyopathy. Methodology: Patients with reduced ejection fraction of less than 45% and dilated left ventricle are considered to have dilated cardiomyopathy. Clinical history was taken and possible secondary causes of dilated cardiomyopathy were excluded. Family history of ≥2 affected relatives or sudden cardiac death in a relative with age less than 35 years were included. Such patients blood sample were sent for next generation sequencing and analysed for presence of genetic variants. Results: As part of pilot study 20 patients (44% were female and 66% were male) were included. There was presence of 16 different pathogenic variants in 14 patients. Two patients had more than one variants in them. Most common of which were sarcomeric mutations constituting 32%. Titin followed by Filamin, Lamin and Desmosomal where the most commonly repeated mutations. Discussion: In our patients of familial dilated cardiomyopathy, 70% were detected to have pathogenic variants in them. Most common variations were seen on Titin gene. Thus those with familial dilated cardiomyopathy should be considered for next generation sequencing. First degree relatives of those with pathogenic variants should be screened using cascade testing for earlier detection and disease monitoring in them.

Published
2022
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6. Therapeutic experience of ticagrelor in Indian patients with acute coronary syndrome: A non-interventional, prospective, and observational study

Author

J.P.S. Sawhney, J. Dalal, A. Mullasari, S. Bansal, and D. Kahali

Subjects
Surgery, RD1-811, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Objective: This observational study was designed to understand the usage pattern of ticagrelor in real-life clinical practice among a large number of acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI), coronary artery bypass graft (CABG), or medical management (MM). The study also recorded clinical events, i.e., bleeding, dyspnea, and cardiovascular (CV) events, reported by the investigator during the follow-up period. Methods: The ACS patients aged ≥18 years hospitalized for ACS and were prescribed ticagrelor upon discharge or ≤1 month and patients who underwent PCI, CABG, or MM for ACS were enrolled. The subjects were followed up for a period of up to 12 months. The data were collected on a case report form. Result: The study recruited 2997 subjects from 49 sites in India. Approximately half of the ACS subjects had ST segment elevation myocardial infarction (48.9%), and PCI was used as management in 92.4% subjects. The mean (±SD) duration of use of ticagrelor was 314 (±110.2) days over a period of 12 months. Of 136 subjects (4.5%) who experienced any clinical events, CV deaths were reported in 20 (0.7%), myocardial infraction in 19 (0.6) subjects and ischemic stroke in 23 (0.8%) subjects, and severe dyspnea was reported in 68 (2.2%) subjects. Out of 33 bleeding cases, 25 (0.8%) subjects had thrombolysis in myocardial infarction (TIMI) minimal, seven (0.2%) had TIMI minor, and one TIMI major. Platelet inhibition and patient outcomes (PLATO) major was reported in two subjects and CABG bleed in one subject. The incidence of PLATO defined major and minimal bleeding were lower in subjects undergoing fibrinolysis than overall population. Conclusion: Ticagrelor has been used across ACS types and in different management strategies in real world settings in India. The incidence of clinical events was lower as compared with data in literature. ClinicalTrials.gov Identifier: NCT02408224 Keywords: ACS, CAD, STEMI, Ticagrelor, Acute coronary syndrome, PCI

Published
2019
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7. Prevalence of familial hypercholesterolemia in premature coronary artery disease patients admitted to a tertiary care hospital in North India

Author

J.P.S. Sawhney, Shashi Ranjan Prasad, Manish Sharma, Kushal Madan, A. Mohanty, Rajiv Passey, Ashwani Mehta, B. Kandpal, Aman Makhija, Rajneesh Jain, R.R. Mantri, Bhola Shankar Vivek, S.C. Manchanda, and I.C. Verma

Subjects
Surgery, RD1-811, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Aims: The prevalence of premature coronary artery disease (CAD) in India is two to three times more than other ethnic groups. Untreated heterozygous familial hypercholesterolemia (FH) is one of the important causes for premature CAD. As the age advances, these patients without treatment have 100 times increased risk of cardiovascular (CV) mortality resulting from myocardial infarction (MI). Recent evidence suggests that one in 250 individuals may be affected by FH (nearly 40 million people globally). It is indicated that the true global prevalence of FH is underestimated. The true prevalence of FH in India remains unknown. Methods: A total of 635 patients with premature CAD were assessed for FH using the Dutch Lipid Clinical Network (DLCN) criteria. Based on scores, patients were diagnosed as definite, probable, possible, or no FH. Other CV risk factors known to cause CAD such as smoking, diabetes mellitus, and hypertension were also recorded. Results: Of total 635 patients, 25 (4%) were diagnosed as definite, 70 (11%) as probable, 238 (37%) as possible, and 302 (48%) without FH, suggesting the prevalence of potential (definite + probable) FH of about 15% in the North Indian population. FH is more common in younger patients, and they have lesser incidence of common CV risk factors such as diabetes, hypertension, and smoking than the younger MI patients without FH (26.32% vs.42.59%; 17.89% vs.29.44%; 22.11% vs.40.74%). Conclusion: FH prevalence is high among patients with premature CAD admitted to a cardiac unit. To detect patients with FH, routine screening with simple criteria such as family history of premature CAD combined with hypercholesterolemia, and a DLCN criteria score >5 may be effectively used. Keywords: Familial hypercholesterolemia, Premature coronary artery disease, Dutch Lipid Clinic Network Criteria, Correction factor, Arcus cornealis

Published
2019
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8. Ambulatory blood pressure monitoring in clinical practice

Author

Apaar Dadlani, Kushal Madan, and J.P.S. Sawhney

Subjects
Surgery, RD1-811, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Being one of the most widely prevalent diseases throughout the world, hypertension has emerged as one of the leading causes of global premature morbidity and mortality. Hence, blood pressure (BP) measurements are essential for physicians in the diagnosis and management of hypertension. Current American College of Cardiology/American Heart Association (ACC/AHA) guidelines recommend initiating antihypertensive medications on the basis of office BP readings. However, office BP readings provide a snapshot evaluation of the patient's BP, which might not reflect patient's true BP, with the possibility of being falsely elevated or falsely low. Recently, there is ample evidence to show that ambulatory blood pressure monitoring (ABPM) is a better predictor of major cardiovascular events than BP measurements at clinic settings. ABPM helps in reducing the number of possible false readings, along with the added benefit of understanding the dynamic variability of BP. This article will focus on the significance of ambulatory BP, its advantages and limitations compared with the standard office BP measurement and a brief outlook on its use and interpretation to diagnose and treat hypertension. Keywords: Ambulatory blood pressure, White coat hypertension, Masked hypertension, Nocturnal hypertension, Dipping

Published
2019
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9. Short- and long-term follow-up of antithrombotic management patterns in patients hospitalized with acute coronary syndrome: Indian subgroup of EPICOR Asia study

Author

J.P.S. Sawhney, Ajit Mullasari, Dhiman Kahali, Vimal Mehta, Tiny Nair, Upendra Kaul, and M.S. Hirematth

Subjects
Surgery, RD1-811, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Background: Acute coronary syndrome (ACS) is associated with emergency hospitalizations, and there are limited real-world data on clinical outcomes in post-ACS Asian patients. This article presents data on the Indian subgroup from the Long-term Follow-up of Antithrombotic Management Patterns in Acute Coronary Syndrome Patients in Asia (EPICOR-Asia) study. Methods: EPICOR included patients with ACS [ST-segment elevation myocardial infarction (STEMI), non–ST-segment elevation myocardial infarction (NSTEMI), or unstable angina (UA)]. The study had two phases: acute phase and follow-up phase. The primary objective was to describe short- and long-term antithrombotic management patterns. Results: EPICOR-India enrolled 2468 patients (STEMI-1482; NSTEMI-562; and UA-424). Cardiovascular risk factors were present in 1362 (55.2%) patients. Prehospital care was received by 879 (35.6%) patients, and the median time from the symptom onset to the first medical attention was 3 h (0.08, 100.33). The most common drug regimen prescribed during the acute phase was ≥2 antiplatelet agents + anticoagulants with no glycoprotein IIb/IIIa inhibitors and at discharge were aspirin + clopidogrel. About 78.8% of patients were discharged on dual antiplatelet therapy (DAPT) and 16%, on single antiplatelet therapy (SAPT). At 23 months after discharge, 55.6% were on DAPT, while 16.4% were on SAPT. Postdischarge outcomes at 2 years included death in 165 (6.7%) patients, composite events of death, myocardial infarction (MI), or ischemic stroke in 182 (7.4%) patients, and bleeding events in seven (0.3%) patients. Conclusion: This study showed a gap between international recommendations and implementation for managing ACS in Indian patients. Most of the patients prefer to undergo invasive management instead of non-invasive therapy. At the end of the 2-year follow-up, more than half of the population was receiving DAPT, with most patients on receiving a combination of aspirin and clopidogrel. The mortality along with composite events of death, MI, or ischemic stroke was highest for patients with NSTEMI. Keywords: EPICOR- India, ACS, Antithrombotic, DAPT, Myocardial infarction, STEMI, NSTEMI

Published
2019
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10. Risk profiles and one-year outcomes of patients with newly diagnosed atrial fibrillation in India: Insights from the GARFIELD-AF Registry

Author

Jitendra PS. Sawhney, Veerappa A. Kothiwale, Vikas Bisne, Rajashekhar Durgaprasad, Praveen Jadhav, Manoj Chopda, Velam Vanajakshamma, Ramdhan Meena, Govindan Vijayaraghavan, Kamaldeep Chawla, Jagan Allu, Karen S. Pieper, A. John Camm, Ajay K. Kakkar, Jean-Pierre Bassand, David A. Fitzmaurice, Samuel Z. Goldhaber, Shinya Goto, Sylvia Haas, Werner Hacke, Lorenzo G. Mantovani, Frank Misselwitz, Alexander G.G. Turpie, Martin van Eickels, Freek W.A. Verheugt, Gloria Kayani, Keith A.A. Fox, Bernard J. Gersh, Hector Lucas Luciardi, Harry Gibbs, Marianne Brodmann, Frank Cools, Antonio Carlos Pereira Barretto, Stuart J. Connolly, Alex Spyropoulos, John Eikelboom, Ramon Corbalan, Dayi Hu, Petr Jansky, Jørn Dalsgaard Nielsen, Hany Ragy, Pekka Raatikainen, Jean-Yves Le Heuzey, Harald Darius, Matyas Keltai, Sanjay Kakkar, Jitendra Pal Singh Sawhney, Giancarlo Agnelli, Giuseppe Ambrosio, Yukihiro Koretsune, Carlos Jerjes Sánchez Díaz, Hugo Ten Cate, Dan Atar, Janina Stepinska, Elizaveta Panchenko, Toon Wei Lim, Barry Jacobson, Seil Oh, Xavier Viñolas, Marten Rosenqvist, Jan Steffel, Pantep Angchaisuksiri, Ali Oto, Alex Parkhomenko, Wael Al Mahmeed, David Fitzmaurice, D.Y. Hu, K.N. Chen, Y.S. Zhao, H.Q. Zhang, J.Z. Chen, S.P. Cao, D.W. Wang, Y.J. Yang, W.H. Li, Y.H. Yin, G.Z. Tao, P. Yang, Y.M. Chen, S.H. He, Ying Wang, Yong Wang, G.S. Fu, X. Li, T.G. Wu, X.S. Cheng, X.W. Yan, R.P. Zhao, M.S. Chen, L.G. Xiong, P. Chen, Y. Jiao, Y. Guo, L. Xue, F.Z. Wang, H. Li, Z.M. Yang, C.L. Bai, J. Chen, J.Y. Chen, X. Chen, S. Feng, Q.H. Fu, X.J. Gao, W.N. Guo, R.H. He, X.A. He, X.S. Hu, X.F. Huang, B. Li, J. Li, L. Li, Y.H. Li, T.T. Liu, W.L. Liu, Y.Y. Liu, Z.C. Lu, X.L. Luo, T.Y. Ma, J.Q. Peng, X. Sheng, X.J. Shi, Y.H. Sun, G. Tian, K. Wang, L. Wang, R.N. Wu, Q. Xie, R.Y. Xu, J.S. Yang, L.L. Yang, Q. Yang, Y. Ye, H.Y. Yu, J.H. Yu, T. Yu, H. Zhai, Q. Zhan, G.S. Zhang, Q. Zhang, R. Zhang, Y. Zhang, W.Y. Zheng, B. Zhou, Z.H. Zhou, X.Y. Zhu, S. Kakkar, J.P.S. Sawhney, P. Jadhav, R. Durgaprasad, A.G. Ravi Shankar, R.K. Rajput, K. Bhargava, R. Sarma, A. Srinivas, D. Roy, U.M. Nagamalesh, M. Chopda, R. Kishore, G. Kulkarni, P. Chandwani, R.A. Pothiwala, M. Padinhare Purayil, S. Shah, K. Chawla, V.A. Kothiwale, B. Raghuraman, G. Vijayaraghavan, V.M. Vijan, G. Bantwal, V. Bisne, A. Khan, J.B. Gupta, S. Kumar, D. Jain, S. Abraham, D. Adak, A. Barai, H. Begum, P. Bhattacharjee, M. Dargude, D. Davies, B. Deshpande, P. Dhakrao, V. Dhyani, S. Duhan, M. Earath, A. Ganatra, S. Giradkar, V. Jain, R. Karthikeyan, L. Kasala, S. Kaur, S. Krishnappa, A. Lawande, B. Lokesh, N. Madarkar, R. Meena, P. More, D. Naik, K. Prashanth, M. Rao, N.M. Rao, N. Sadhu, D. Shah, M. Sharma, P. Shiva, S. Singhal, S. Suresh, V. Vanajakshamma, S.G. Panse, Y. Koretsune, S. Kanamori, K. Yamamoto, K. Kumagai, Y. Katsuda, K. Sadamatsu, F. Toyota, Y. Mizuno, I. Misumi, H. Noguchi, S. Ando, T. Suetsugu, M. Minamoto, Hiroshi Oda, K. Shiraishi, S. Adachi, K. Chiba, H. Norita, M. Tsuruta, T. Koyanagi, H. Ando, T. Higashi, K. Okada, S. Azakami, S. Komaki, K. Kumeda, T. Murayama, J. Matsumura, Y. Oba, R. Sonoda, K. Goto, K. Minoda, Y. Haraguchi, H. Suefuji, H. Miyagi, H. Kato, Tadashi Nakamura, Tsugihiro Nakamura, H. Nandate, R. Zaitsu, Yoshihisa Fujiura, A. Yoshimura, H. Numata, J. Ogawa, H. Tatematsu, Y. Kamogawa, K. Murakami, Y. Wakasa, M. Yamasawa, H. Maekawa, S. Abe, H. Kihara, S. Tsunoda, Katsumi Saito, Kazuyuki Saito, T. Fudo, K. Obunai, H. Tachibana, I. Oba, T. Kuwahata, S. Higa, M. Gushiken, T. Eto, H. Yoshida, D. Ikeda, Yoshitake Fujiura, M. Ishizawa, M. Nakatsuka, K. Murata, C. Ogurusu, M. Shimoyama, M. Akutsu, I. Takamura, F. Hoshino, N. Yokota, T. Iwao, K. Tsuchida, M. Takeuchi, Y. Hatori, Y. Kitami, Yoichi Nakamura, R. Oyama, M. Ageta, Hiroyuki Oda, Y. Go, K. Mishima, T. Unoki, S. Morii, Yuhei Shiga, H. Sumi, T. Nagatomo, K. Sanno, K. Fujisawa, Y. Atsuchi, T. Nagoshi, T. Seto, T. Tabuchi, M. Kameko, K. Nii, K. Oshiro, H. Takezawa, S. Nagano, N. Miyamoto, M. Iwaki, Yuichiro Nakamura, M. Fujii, M. Okawa, Masahiko Abe, Masatake Abe, Mitsunori Abe, T. Saito, T. Mito, K. Nagao, J. Minami, T. Mita, I. Sakuma, T. Taguchi, S. Marusaki, H. Doi, M. Tanaka, T. Fujito, M. Matsuta, T. Kusumoto, S. Kakinoki, K. Ashida, N. Yoshizawa, J. Agata, O. Arasaki, M. Manita, M. Ikemura, S. Fukuoka, H. Murakami, S. Matsukawa, Y. Hata, T. Taniguchi, T. Ko, H. Kubo, M. Imamaki, M. Akiyama, M. Inagaki, H. Odakura, T. Ueda, Y. Katsube, A. Nakata, H. Watanabe, M. Techigawara, M. Igarashi, K. Taga, T. Kimura, S. Tomimoto, M. Shibuya, M. Nakano, K. Ito, T. Seo, S. Hiramitsu, H. Hosokawa, M. Hoshiai, M. Hibino, K. Miyagawa, Hajime Horie, N. Sugishita, Yukio Shiga, A. Soma, K. Neya, Tetsuro Yoshida, Tomoki Yoshida, M. Mizuguchi, M. Ishiguro, T. Minagawa, M. Wada, H. Mukawa, F. Okuda, S. Nagasaka, Y. Abe, Sen Adachi, Susumu Adachi, T. Adachi, K. Akahane, T. Amano, K. Aoki, T. Aoyama, H. Arai, S. Arima, T. Arino, H. Asano, T. Asano, J. Azuma, T. Baba, T. Betsuyaku, H. Chibana, H. Date, J. Doiuchi, Y. Emura, M. Endo, Y. Fujii, R. Fujiki, A. Fujisawa, Y. Fujisawa, T. Fukuda, T. Fukui, N. Furukawa, T. Furukawa, W. Furumoto, T. Goto, M. Hamaoka, N. Hanazono, K. Hasegawa, T. Hatsuno, Y. Hayashi, K. Higuchi, K. Hirasawa, H. Hirayama, M. Hirose, S. Hirota, M. Honda, Hideki Horie, T. Ido, O. Iiji, H. Ikeda, K. Ikeda, K. Ikeoka, M. Imaizumi, H. Inaba, T. Inoue, F. Iseki, A. Ishihara, N. Ishioka, N. Ito, T. Iwase, H. Kakuda, J. Kamata, H. Kanai, H. Kanda, M. Kaneko, H. Kano, T. Kasai, T. Kato, Y. Kato, Y. Kawada, K. Kawai, K. Kawakami, S. Kawakami, T. Kawamoto, S. Kawano, J. Kim, T. Kira, H. Kitazawa, H. Kitazumi, T. Kito, T. Kobayashi, T. Koeda, J. Kojima, H. Komatsu, I. Komatsu, Y. Koshibu, T. Kotani, T. Kozuka, Y. Kumai, T. Kumazaki, I. Maeda, K. Maeda, Y. Maruyama, S. Matsui, K. Matsushita, Y. Matsuura, K. Mineoi, H. Mitsuhashi, N. Miura, S. Miyaguchi, S. Miyajima, H. Miyamoto, A. Miyashita, S. Miyata, I. Mizuguchi, A. Mizuno, T. Mori, O. Moriai, K. Morishita, O. Murai, Sho Nagai, Shunichi Nagai, E. Nagata, H. Nagata, A. Nakagomi, S. Nakahara, M. Nakamura, R. Nakamura, N. Nakanishi, T. Nakayama, R. Nakazato, T. Nanke, J. Nariyama, Y. Niijima, H. Niinuma, Y. Nishida, Y. Nishihata, K. Nishino, H. Nishioka, K. Nishizawa, I. Niwa, K. Nomura, S. Nomura, M. Nozoe, T. Ogawa, N. Ohara, M. Okada, K. Okamoto, H. Okita, M. Okuyama, H. Ono, T. Ono, Y. Onuki Pearce, S. Oriso, A. Ota, E. Otaki, Y. Saito, H. Sakai, N. Sakamoto, Y. Sakamoto, Y. Samejima, Y. Sasagawa, H. Sasaguri, A. Sasaki, T. Sasaki, Kazuki Sato, Kiyoharu Sato, M. Sawano, S. Seki, Y. Sekine, Y. Seta, K. Sezaki, N. Shibata, Y. Shiina, H. Shimono, Y. Shimoyama, T. Shindo, H. Shinohara, R. Shinohe, T. Shinozuka, T. Shirai, T. Shiraiwa, Y. Shozawa, T. Suga, C. Sugimoto, Kazuo Suzuki, Keita Suzuki, Shu Suzuki, Shunji Suzuki, Susumu Suzuki, Y. Suzuki, M. Tada, A. Taguchi, T. Takagi, Y. Takagi, K. Takahashi, S. Takahashi, H. Takai, C. Takanaka, S. Take, H. Takeda, K. Takei, K. Takenaka, T. Tana, G. Tanabe, K. Taya, H. Teragawa, S. Tohyo, S. Toru, Y. Tsuchiya, T. Tsuji, K. Tsuzaki, H. Uchiyama, O. Ueda, Y. Ueyama, N. Wakaki, T. Wakiyama, T. Washizuka, M. Watanabe, T. Yamada, T. Yamagishi, H. Yamaguchi, Kenichi Yamamoto, Kentaro Yamamoto, Kunihiko Yamamoto, T. Yamamoto, M. Yamaura, M. Yamazoe, K. Yasui, Y. Yokoyama, K. Yoshida, T.W. Lim, C.K. Ching, C.G. Foo, J.H. Chow, D.D. Chen, F.R. Jaufeerally, Y.M. Lee, G. Lim, W.T. Lim, S. Thng, S.Y. Yap, C. Yeo, S. Oh, H.N. Pak, J.-B. Kim, J.H. Kim, S.-W. Jang, D.H. Kim, D.R. Ryu, S.W. Park, D.-K. Kim, D.J. Choi, Y.S. Oh, M.-C. Cho, S.-H. Kim, H.-K. Jeon, D.-G. Shin, J.S. Park, H.K. Park, S.-J. Han, J.H. Sung, J.-G. Cho, G.-B. Nam, Y.K. On, H.E. Lim, J.J. Kwak, T.-J. Cha, T.J. Hong, S.H. Park, J.H. Yoon, N.-H. Kim, K.-S. Kim, B.C. Jung, G.-S. Hwang, C.-J. Kim, D.B. Kim, J.J. Ahn, H.J. An, H. Bae, A.L. Baek, W.J. Chi, E.A. Choi, E.H. Choi, H.K. Choi, H.S. Choi, S. Han, E.S. Heo, K.O. Her, S.W. Hwang, E.M. Jang, H.-S. Jang, S. Jang, H.-G. Jeon, S.R. Jeon, Y.R. Jeon, H.K. Jeong, I.-A. Jung, Hyeon Jeong Kim, Hyun Ju Kim, Ji Seon Kim, Jung Sook Kim, J.A. Kim, K.T. Kim, M.S. Kim, Sang Hee Kim, Sang Hyun Kim, Y.-I. Kim, C.S. Lee, E.H. Lee, G.H. Lee, H.Y. Lee, H.-Y. Lee, K.H. Lee, K.R. Lee, M.S. Lee, M.-Y. Lee, R.W. Lee, S.E. Lee, S.H. Lee, S. Lee, W.Y. Lee, I.K. Noh, A.R. Park, B.R. Park, H.N. Park, J.H. Park, M. Park, Y. Park, S.-Y. Seo, J. Shim, J.H. Sim, Y.M. Sohn, W.S. Son, Y.S. Son, H.J. Song, H.K. Wi, J.J. Woo, S. Ye, K.H. Yim, K.M. Yoo, E.J. Yoon, S.Y. Yun, P. Angchaisuksiri, S. Chawanadelert, P. Mongkolwongroj, K. Kanokphatcharakun, S. 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Nathani, M. Ibrahim, E.M. Esheiba, R. Singh, A. Naguib, M. Abu-Mahfouz, M. Al Omairi, A. Al Naeemi, R. Maruthanayagam, N. Bazargani, A. Wassef, R. Gupta, M. Khan, B. Subbaraman, A. Abdul, A. Al Mulla, S. El Bardisy, P. Haridas, S. Jadhav, K. Magdaluyo, M. Makdad, I. Maqsood, R. Mohamed, N. Sharma, R. Sharma, M. Thanzeel, S.Z. Goldhaber, R. Canosa, P. Rama, E. Blumberg, J. Garcia, P. Mullen, V. Wilson, A. Quick, K. Ferrick, W.M. Kutayli, M. Cox, M. Franco, S. Falkowski, R. Mendelson, M. Williams, S. Miller, S. Beach, A. Alfieri, T. Gutowski, I. Haque, R. Reddy, W. Ahmed, P. Delafontaine, D. Diercks, D. Theodoro, K. Remmel, M. Alberts, R. Ison, H. Noveck, P. Duffy, S. Pitta, D. Nishijima, C. Treasure, N. Asafu-Adjaye, K. Ball, M. Bartlett, M. Bentley, S. Bowers, A. Brown, A. Browne, J. Cameron-Watts, M. Canova, D. Cassidy, K. Cervellione, S. Congal, J. DePauw, A. Dickerson, M. Eley, L. Evans, S. Felpel, K. Ferdinand, D. Fielder, P. Gentry, A. Haideri, F. Hakimi, T. Harbour, E. Hartranft, B. Hawkins, M. Headlee, L. Henson, C. Herrick, T. Hicks, S. Jasinski, A. Jones, L. Jones, P. Jones, S. Karl, M. Keeling, J. Kerr, P. Knowles, J. Langdon, M. Lay, J.A. Lee, T. Lincoln, E. Malone, A. Merliss, D. Merritt, J. Minardo, B. Mooso, C. Orosco, V. Palumbo, M. Parker, T. Parrott, S. Paserchia, G. Pearl, J. Peterson, N. Pickelsimer, T. Purcell, J. Raynor, S. Raziano, C. Richard, T. Richardson, C. Robertson, A. Sage, T. Sanghera, P. Shaw, J. Shoemaker, K. Smith, B. Stephanie, A. Thatcher, H. Theobald, N. Thompson, L. Treasure, T. Tripti, C. Verdi, and V. Worthy

Subjects
Surgery, RD1-811, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Background: The Global Anticoagulant Registry in the FIELD–Atrial Fibrillation (GARFIELD-AF) is an ongoing prospective noninterventional registry, which is providing important information on the baseline characteristics, treatment patterns, and 1-year outcomes in patients with newly diagnosed non-valvular atrial fibrillation (NVAF). This report describes data from Indian patients recruited in this registry. Methods and results: A total of 52,014 patients with newly diagnosed AF were enrolled globally; of these, 1388 patients were recruited from 26 sites within India (2012–2016). In India, the mean age was 65.8 years at diagnosis of NVAF. Hypertension was the most prevalent risk factor for AF, present in 68.5% of patients from India and in 76.3% of patients globally (P

Published
2018
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11. Adaptation of 2016 European Society of Cardiology/European Atherosclerosis Society guideline for lipid management to Indian patients – A consensus document

Author

Saumitra Ray, J.P.S. Sawhney, M.K. Das, Jyoti Deb, Peeyush Jain, Sivakadaksham Natarajan, and K.K. Sinha

Subjects
Surgery, RD1-811, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

In the year 2016, European Society of Cardiology/European Atherosclerosis Society (ESC/EAS) guidelines provided recommendations on dyslipidemia management. The recommendation from these guidelines are restricted to European subcontinent. To adapt the updated recommendations for Indian subset of dyslipidemia, a panel of experts in management of dyslipidemia provided their expert opinions. This document provides expert consensus on adapting 2016 ESC dyslipidemia guidelines recommendations in Indian setting. The document also discussed India-specific relevant literature to support the consensus opinions provided in management of dyslipidemia. Keywords: Dyslipidemia, Hypercholesterolemia, India, Expert opinion, Guidelines

Published
2018
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12. Premature coronary artery disease in India: coronary artery disease in the young (CADY) registry

Author

S.S. Iyengar, Rajiv Gupta, Sandhya Ravi, Saral Thangam, Thomas Alexander, C.N. Manjunath, R. Keshava, C.B. Patil, Annie Sheela, and J.P.S. Sawhney

Subjects
Premature CAD, Coronary risk factors, Epidemiology, Drug therapy, Surgery, RD1-811, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Background: Coronary artery disease (CAD) occurs at younger age in India but only a limited number of studies have evaluated risk factors and management status. This is a multisite observational registry to assess risk factors and treatment patterns in young patients presenting with acute coronary syndrome (ACS) and stable ischemic heart disease (IHD). Methods: We recruited 997 young patients (men

Published
2017
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14. To study the effect of high dose Atorvastatin 40 mg versus 80 mg in patients with dyslipidemia

Author

Deepak Agrawal, S.C. Manchanda, J.P.S. Sawhney, Bhuwanesh Kandpal, Rajneesh Jain, Ashwani Mehta, Arun Mohanty, Rajiv Passey, Aman Makhija, and Manish Kr. Sharma

Subjects
Surgery, RD1-811, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Objective: Primary objective was to compare the effects of atorvastatin 40 mg vs 80 mg on LDL-C in Indian patients with atherosclerotic dyslipidemia. Secondary objectives were to compare the effects of atorvastatin 40 mg vs 80 mg on HDL-C and triglycerides and also comparing of side effects (myopathy, hepatotoxicity and new onset diabetes mellitus) of both doses. Method: This Study is A Prospective, randomized, open-label, comparative study. This study was conducted on 240 patients of dyslipidemia (as per ACC/AHA 2013 lipid guidelines) attending the OPD/wards/CCU of department of cardiology, Sir Ganga Ram Hospital. They were randomly divided into 2 groups of 120 each. Group A consisted patients who received Atorvastatin 40 mg daily and Group B Atorvastatin 80 mg daily. The follow up period was 6 months. Results: At 3 and 6 month follow up, Atorvastatin 40 mg leads to mean LDL cholesterol reduction of 47.18 ± 20.81 & 50.03 ± 18.06 respectively. While Atorvastatin 80 mg results in LDL reduction as 50.11 ± 15.85 & 52.30 ± 13.72. The comparison between two doses revealed a non-significant difference (p = .118 & p = .149 respectively).At 6 months of follow up, few patients reported myalgia (2 in group A and 7 in Group B). The difference between groups was significant (p = .045). Although none of our patient had significant elevation of CPK. Conclusion: This study concluded that both doses of atorvastatin (40 & 80 mg) are equally efficacious in improving dyslipidemia but higher dose leads to more incidence of myalgia. Keywords: Atherosclerosis, Atorvastatin, Dyslipidemia, Myalgia

Published
2018
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15. Correlation of epicardial fat quantification with severity of coronary artery disease: A study in Indian population

Author

Rishabh Khurana, Anurag Yadav, T.B.S. Buxi, J.P.S. Sawhney, Kishan Singh Rawat, and Samarjit S. Ghuman

Subjects
Surgery, RD1-811, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Objective: We studied the correlation of quantified epicardial fat with severity of coronary artery disease in patients [suspected cases of coronary artery disease (CAD)] referred for computed tomography (CT) coronary angiography and established cutoffs for epicardial fat volume (EFV) for the presence of CAD and obstructive CAD. Methods: A prospective cum retrospective cross-sectional observational study was carried out on 950 Indian subjects (suspected cases of CAD) who were referred for coronary CT in the year 2013–2016. EFV was quantified using semiautomatic technique on multidetector coronary CT angiography. The presence of atherosclerotic plaques and degree of stenosis was assessed on coronary CT angiography scans. The correlation between quantified EFV and degree of stenosis was assessed. Multivariate analysis was also performed. Results: A higher quantity of epicardial fat is found in patients with increasing severity of coronary artery stenosis. The EFV cutoff for the presence of CAD and obstructive CAD are 49.75 and 67.69 mL with area under the curve, sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of 0.68, 81%, 45.9%,58.24%, 72.2%, and 62.84% and 0.709, 64.9%, 66.4%, 35.84%, 86.55%, and 66%, respectively. EFV correlates with age, weight, and body mass index (BMI). Multivariate analysis revealed EFV to be an independent risk factor for the presence of CAD. Conclusions: Higher quantities of EFV are found in patients with greater degree of coronary artery stenosis. EFV correlates with age, weight, and BMI. EFV is an independent risk factor for CAD. Keywords: Epicardial fat, Epicardial fat volume, Epicardial fat quantification, Regional thoracic fat depots

Published
2018
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16. Anemia profile in patients with congestive heart failure a hospital based observational study

Author

Himanshu Arora, J.P.S. Sawhney, Ashwani Mehta, and Arun Mohanty

Subjects
Surgery, RD1-811, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Objectives: Iron deficiency (ID) is an emerging problem in patients with congestive heart failure (CHF) and can be a potential therapeutic target. As ID is highly prevalent in the society, it is hypothesized that Indian patients with CHF have high prevalence of ID. Methods: CHF patients (n = 275) were selected and underwent laboratory evaluation including hemoglobin concentration, serum iron, transferrin, ferritin, B12 and folate level. Results: Two hundred and seventy-five patients with heart failure (mean age - 62.72, mean Hb- 10.54 g/dl, 188 males [68.36%] and 87 females [31.64%]) were enrolled in the study. 211 out of 275 (76.7%) were found to be anemic. Out of 275 patients. 148 (53.8%) were diagnosed with iron deficiency. 12.7% (n = 35) were B12 deficient and 5.1% (n = 14) were folate deficient. In the anemic group, ID was present in 130 patients (61.61%), B12 deficiency in 32 patients (15.16%) and folate deficiency in 12 patients (5.68%). In the group of patients without anemia, ID was present in 18 patients (28.12%) while B12 and folate deficiency was present in 3 (4.68%) and 2 (3.12%) patients, respectively. Conclusion: Iron deficiency is present in substantial number while B12 and folate account for a few number of cases. Substantial number of patients without anemia were found to be iron deficient. Keywords: Anemia, Iron, B 12, Folate, Heart failure

Published
2018
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25. Sleep quality and duration – Potentially modifiable risk factors for Coronary Artery Disease?

Author

Monika Sharma, J.P.S. Sawhney, and Samhita Panda

Subjects
Sleep quality, Sleep duration, Coronary Artery Disease, Surgery, RD1-811, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Purpose: Previous studies have shown that lack of sleep exerts deleterious effects on a variety of systems with detectable changes in metabolic, endocrine and immune pathways. Both short and long sleep durations are related to increased likelihood of diabetes and hypertension. However, the relation between sleep duration, sleep quality and Coronary Artery Disease (CAD) is not clear in the Indian population. We examined the hypothesis that sleep duration (compared with 5) are risk factors for CAD. Methods: A retrospective & controlled study was conducted on 352 adult (>18 yrs) subjects (176 controls and 176 cases, 60% men, age M = 51 ± 9.38). Sleep quality and duration was measured with Pittsburg Sleep Quality Index (PSQI). Poor sleep quality and short sleep duration was defined as PSQI >5 and total sleep time 5) it came out to be 16.62 (9.13–30.28). Conclusion: There was a positive association between both short sleep duration and poor sleep quality with CAD in a selected sample of Indian adults. These results suggest that poor sleep quality and short sleep duration may be important modifiable CAD risk factors in the Indian population.

Published
2014
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26. The Indian Consensus Document on cardiac biomarker

Author

I. Satyamurthy, Jamshed J. Dalal, J.P.S. Sawhney, J.C. Mohan, Shubha A. Chogle, Nagaraj Desai, Shireesh P. Sathe, and Alan S. Maisel

Subjects
Biomarkers, Heart failure, Brain natriuretic peptide, NT-proBNP, Surgery, RD1-811, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Despite recent advances, the diagnosis and management of heart failure evades the clinicians. The etiology of congestive heart failure (CHF) in the Indian scenario comprises of coronary artery disease, diabetes mellitus and hypertension. With better insights into the pathophysiology of CHF, biomarkers have evolved rapidly and received diagnostic and prognostic value. In CHF biomarkers prove as measures of the extent of pathophysiological derangement; examples include biomarkers of myocyte necrosis, myocardial remodeling, neurohormonal activation, etc. In CHF biomarkers act as indicators for the presence, degree of severity and prognosis of the disease, they may be employed in combination with the present conventional clinical assessments. These make the biomarkers feasible options against the present expensive measurements and may provide clinical benefits.

Published
2014
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27. Management standards for stable coronary artery disease in India

Author

Sundeep Mishra, Saumitra Ray, Jamshed J. Dalal, J.P.S. Sawhney, S. Ramakrishnan, Tiny Nair, S.S. Iyengar, and V.K. Bahl

Subjects
Management standards, Stable CAD, Treatment algorithms, Guidelines, Developing countries, Practice guidelines, Surgery, RD1-811, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Coronary artery disease (CAD) is one of the important causes of cardiovascular morbidity and mortality globally, giving rise to more than 7 million deaths annually. An increasing burden of CAD in India is a major cause of concern with angina being the leading manifestation. Stable coronary artery disease (SCAD) is characterised by episodes of transient central chest pain (angina pectoris), often triggered by exercise, emotion or other forms of stress, generally triggered by a reversible mismatch between myocardial oxygen demand and supply resulting in myocardial ischemia or hypoxia. A stabilised, frequently asymptomatic phase following an acute coronary syndrome (ACS) is also classified as SCAD. This definition of SCAD also encompasses vasospastic and microvascular angina under the common umbrella.

Published
2016
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30. Consensus statement on management of dyslipidemia in Indian subjects

Author

K. Sarat Chandra, Manish Bansal, Tiny Nair, S.S. Iyengar, Rajeev Gupta, Subhash C. Manchanda, P.P. Mohanan, V. Dayasagar Rao, C.N. Manjunath, J.P.S. Sawhney, Nakul Sinha, A.K. Pancholia, Sundeep Mishra, Ravi R. Kasliwal, Saumitra Kumar, Unni Krishnan, Sanjay Kalra, Anoop Misra, Usha Shrivastava, and Seema Gulati

Subjects
Surgery, RD1-811, Diseases of the circulatory (Cardiovascular) system, RC666-701
Published
2014
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31. Pulmonary Endarterectomy for CTEPH

Author

Sumir Dubey, Sujay Shad, G. Shivnani, Arun Maheshwari, R.R. Mantri, B. Khandpa, and J.P.S. Sawhney

Subjects
Surgery, RD1-811, Diseases of the circulatory (Cardiovascular) system, RC666-701
Published
2014
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33. Molecular studies in familial dilated cardiomyopathy - A pilot study

Author

Vyom Mori, J.P.S. Sawhney, I.C. Verma, Ashwani Mehta, Renu Saxena, Rajiv Passey, Arun Mohanty, Bhuwanesh Kandpal, B.S. Vivek, Manish Sharma, Ashish Kumar Jain, and Dipak Katare

Subjects
Cardiology and Cardiovascular Medicine
Abstract

To study genetic variants in patients of familial dilated cardiomyopathy.Patients with reduced ejection fraction of less than 45% and dilated left ventricle are considered to have dilated cardiomyopathy. Clinical history was taken and possible secondary causes of dilated cardiomyopathy were excluded. Family history of ≥2 affected relatives or sudden cardiac death in a relative with age less than 35 years were included. Such patients blood sample were sent for next generation sequencing and analysed for presence of genetic variants.As part of pilot study 20 patients (44% were female and 66% were male) were included. There was presence of 16 different pathogenic variants in 14 patients. Two patients had more than one variants in them. Most common of which were sarcomeric mutations constituting 32%. Titin followed by Filamin, Lamin and Desmosomal where the most commonly repeated mutations.In our patients of familial dilated cardiomyopathy, 70% were detected to have pathogenic variants in them. Most common variations were seen on Titin gene. Thus those with familial dilated cardiomyopathy should be considered for next generation sequencing. First degree relatives of those with pathogenic variants should be screened using cascade testing for earlier detection and disease monitoring in them.

Published
2021

34. Therapeutic experience of ticagrelor in Indian patients with acute coronary syndrome: A non-interventional, prospective, and observational study

Author

Dhiman Kahali, Jamshed Dalal, A. Mullasari, J.P.S. Sawhney, and Sandeep Bansal

Subjects
Male, Acute coronary syndrome, medicine.medical_specialty, Ticagrelor, RD1-811, medicine.medical_treatment, Population, India, 030204 cardiovascular system & hematology, STEMI, 03 medical and health sciences, 0302 clinical medicine, Percutaneous Coronary Intervention, Internal medicine, medicine, Diseases of the circulatory (Cardiovascular) system, Humans, CAD, 030212 general & internal medicine, Myocardial infarction, cardiovascular diseases, Prospective Studies, Coronary Artery Bypass, education, Aged, education.field_of_study, business.industry, Percutaneous coronary intervention, PCI, Thrombolysis, medicine.disease, ACS, RC666-701, Conventional PCI, Cardiology, Surgery, Original Article, Female, Cardiology and Cardiovascular Medicine, business, TIMI, Platelet Aggregation Inhibitors, medicine.drug
Abstract

Objective: This observational study was designed to understand the usage pattern of ticagrelor in real-life clinical practice among a large number of acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI), coronary artery bypass graft (CABG), or medical management (MM). The study also recorded clinical events, i.e., bleeding, dyspnea, and cardiovascular (CV) events, reported by the investigator during the follow-up period. Methods: The ACS patients aged ≥18 years hospitalized for ACS and were prescribed ticagrelor upon discharge or ≤1 month and patients who underwent PCI, CABG, or MM for ACS were enrolled. The subjects were followed up for a period of up to 12 months. The data were collected on a case report form. Result: The study recruited 2997 subjects from 49 sites in India. Approximately half of the ACS subjects had ST segment elevation myocardial infarction (48.9%), and PCI was used as management in 92.4% subjects. The mean (±SD) duration of use of ticagrelor was 314 (±110.2) days over a period of 12 months. Of 136 subjects (4.5%) who experienced any clinical events, CV deaths were reported in 20 (0.7%), myocardial infraction in 19 (0.6) subjects and ischemic stroke in 23 (0.8%) subjects, and severe dyspnea was reported in 68 (2.2%) subjects. Out of 33 bleeding cases, 25 (0.8%) subjects had thrombolysis in myocardial infarction (TIMI) minimal, seven (0.2%) had TIMI minor, and one TIMI major. Platelet inhibition and patient outcomes (PLATO) major was reported in two subjects and CABG bleed in one subject. The incidence of PLATO defined major and minimal bleeding were lower in subjects undergoing fibrinolysis than overall population. Conclusion: Ticagrelor has been used across ACS types and in different management strategies in real world settings in India. The incidence of clinical events was lower as compared with data in literature. ClinicalTrials.gov Identifier: NCT02408224 Keywords: ACS, CAD, STEMI, Ticagrelor, Acute coronary syndrome, PCI

Published
2019

36. Family-based approach in cardiovascular risk reduction

Author

Kushal Madan and J.P.S. Sawhney

Subjects
medicine.medical_specialty, business.industry, Health Behavior, MEDLINE, General Medicine, Reduction (complexity), Cardiovascular Diseases, Heart Disease Risk Factors, Risk Factors, Humans, Medicine, Health behavior, business, Intensive care medicine, Family based, Risk Reduction Behavior
Published
2021
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37. Therapeutic adherence in hypertension: Current evidence and expert opinion from India

Author

A. Sreenivas Kumar, Jamshed Dalal, Viveka Kumar, J.P.S. Sawhney, Sandeep Bansal, N.I. Juvale, Aziz Khan, Sunil Sathe, Rajshekhar Reddi, Nishith Chandra, Arup Dasbiswas, Sivakadaksham Natarajan, Gulla Suryaprakash, Srinivasa Rao Maddury, Prafulla Kerkar, Santanu Guha, and Joy M. Thomas

Subjects
medicine.medical_specialty, RD1-811, Antihypertensives medications, India, Health literacy, Context (language use), Disease, Medication Adherence, Therapeutic Adherence, Health care, medicine, Diseases of the circulatory (Cardiovascular) system, Humans, cardiovascular diseases, Intensive care medicine, Socioeconomic status, Expert Testimony, Antihypertensive Agents, business.industry, Cardiovascular disease, Treatment Adherence and Compliance, Adherence, Expert opinion, RC666-701, Hypertension, Blood pressure, Surgery, Cardiology and Cardiovascular Medicine, business, Patient education
Abstract

Hypertension (HTN) is a globally prevalent non-communicable disease contributing significantly to cardiovascular (CV) morbidity and mortality. In achieving control of HTN, therapeutic adherence plays a crucial role. Studies from India identify varying rates of adherence to antihypertensive medications. Multiple factors determine treatment adherence in HTN. In India, factors such as lower socioeconomic status, health literacy, asymptomatic nature of disease, forgetfulness, cost of medications, and duration of HTN determine the adherence. An excellent physician-patient relationship incorporating adequate counseling along with the use of other methods can identify poor adherence. Improving adherence necessitates incorporating a multipronged approach with strategies directed at physicians, patients, and health systems. With innovation in therapeutics, the pharmaceutical sector can contribute significantly to improve adherence. Furthermore, increasing adherence to lifestyle interventions can help achieve better HTN control and improve CV outcomes. In the Indian context, more emphasis is necessary on patient education, enhanced physician-patient relationship and communication, increased access to health care, and affordability in improving therapeutic adherence in HTN.

Published
2020

38. Pathophysiology of acute coronary syndrome

Author

Simran Sawhney, Prashant Ramdas Wankhade, and J.P.S. Sawhney

Subjects
medicine.medical_specialty, Acute coronary syndrome, business.industry, Internal medicine, medicine, Cardiology, medicine.disease, business, Pathophysiology
Published
2020
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39. Heart Rate in Hypertension: Review and Expert Opinion

Author

Prafulla Kerkar, Srinivasa Rao Maddury, Immaneni Sathyamurthy, Nishith Chandra, J.P.S. Sawhney, Aziz Khan, Arup Dasbiswas, Sandeep Bansal, Sivakadaksham Natarajan, Viveka Kumar, Joy M. Thomas, Soura Mookerjee, Jamshed Dalal, Sankar Chandra Mandal, and R. Vijayakumar

Subjects
lcsh:Diseases of the circulatory (Cardiovascular) system, medicine.medical_specialty, business.industry, medicine.drug_class, Review Article, 030204 cardiovascular system & hematology, medicine.disease, Coronary artery disease, 03 medical and health sciences, 0302 clinical medicine, lcsh:RC666-701, Heart failure, Internal medicine, Expert opinion, Ambulatory, Heart rate, Internal Medicine, medicine, Aortic pressure, Cardiology, Risk factor, business, Beta blocker, 030217 neurology & neurosurgery
Abstract

Heart rate (HR) is strongly associated with both peripheral and central blood pressures. This association has implications in hypertension (HTN) prognosis and management. Elevated HR in HTN further elevates the risk of adverse outcomes. Evidence suggests that HR is an independent risk factor for cardiovascular (CV) and total mortality in patients with HTN. With objective to engage physicians and researchers in India to identify and discuss the implications related to HR management in HTN, experts in the HTN management provided consensus recommendations. The key expert recommendations included the following. (i) Heart rate (HR) has inverse relationship with the central aortic pressure, whereby reduction in HR is associated with an increase in central aortic pressure. This counter-balances the benefit of HR reduction with the harmful effects of rising central aortic pressure. (ii) Increase in the resting HR is associated with increased risk of incident HTN. A linear association between the two is observed especially in individuals with HR >80 bpm. (iii) A reduced HR variability further adds to the propensity for the development of HTN, especially in men. (iv) Each 10 beats per minute increase in the resting HR can substantially increase the risk of adverse CV and mortality outcomes. On treatment HR provides a better prognostic guide. (v) Ambulatory HR with day-time and night-time HR evaluation may also suggest different impact on outcomes. (vi) Target HR in patients with HTN remains unclear. Generally, HR symptomatic cases with elevated HR beyond 80-85 mmHg. BBs are expected to benefit by lowering HR by nearly 10 bpm. Preference should be given to newer beta-blockers which reduce HR and both peripheral and central blood pressure to derive comprehensive advantage of this dual action. (ix) It still remains unclear whether reducing HR in HTN without comorbidities alters the CV and mortality outcomes.

Published
2019
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40. Prevalence of familial hypercholesterolemia in premature coronary artery disease patients admitted to a tertiary care hospital in North India

Author

I.C. Verma, Rajneesh Jain, Bhuwanesh Kandpal, R.R. Mantri, Rajiv Passey, S.R. Prasad, Arun Mohanty, Aman Makhija, Ashwani Mehta, Kushal Madan, Bhola Shankar Vivek, J.P.S. Sawhney, Manish Sharma, and Subhash C. Manchanda

Subjects
Adult, Male, medicine.medical_specialty, Correction factor, RD1-811, Familial hypercholesterolemia, Premature coronary artery disease, India, Coronary Artery Disease, 030204 cardiovascular system & hematology, North india, Hyperlipoproteinemia Type II, Tertiary Care Centers, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Diabetes mellitus, medicine, Prevalence, Diseases of the circulatory (Cardiovascular) system, Humans, 030212 general & internal medicine, Myocardial infarction, Family history, Arcus cornealis, business.industry, Incidence (epidemiology), Dutch Lipid Clinic Network Criteria, Tertiary care hospital, Middle Aged, medicine.disease, RC666-701, Surgery, Original Article, Female, Cardiology and Cardiovascular Medicine, business
Abstract

Aims: The prevalence of premature coronary artery disease (CAD) in India is two to three times more than other ethnic groups. Untreated heterozygous familial hypercholesterolemia (FH) is one of the important causes for premature CAD. As the age advances, these patients without treatment have 100 times increased risk of cardiovascular (CV) mortality resulting from myocardial infarction (MI). Recent evidence suggests that one in 250 individuals may be affected by FH (nearly 40 million people globally). It is indicated that the true global prevalence of FH is underestimated. The true prevalence of FH in India remains unknown. Methods: A total of 635 patients with premature CAD were assessed for FH using the Dutch Lipid Clinical Network (DLCN) criteria. Based on scores, patients were diagnosed as definite, probable, possible, or no FH. Other CV risk factors known to cause CAD such as smoking, diabetes mellitus, and hypertension were also recorded. Results: Of total 635 patients, 25 (4%) were diagnosed as definite, 70 (11%) as probable, 238 (37%) as possible, and 302 (48%) without FH, suggesting the prevalence of potential (definite + probable) FH of about 15% in the North Indian population. FH is more common in younger patients, and they have lesser incidence of common CV risk factors such as diabetes, hypertension, and smoking than the younger MI patients without FH (26.32% vs.42.59%; 17.89% vs.29.44%; 22.11% vs.40.74%). Conclusion: FH prevalence is high among patients with premature CAD admitted to a cardiac unit. To detect patients with FH, routine screening with simple criteria such as family history of premature CAD combined with hypercholesterolemia, and a DLCN criteria score >5 may be effectively used. Keywords: Familial hypercholesterolemia, Premature coronary artery disease, Dutch Lipid Clinic Network Criteria, Correction factor, Arcus cornealis

Published
2019

41. Ambulatory blood pressure monitoring in clinical practice

Author

J.P.S. Sawhney, Apaar Dadlani, and Kushal Madan

Subjects
medicine.medical_specialty, Ambulatory blood pressure, RD1-811, White coat hypertension, Blood Pressure, Review Article, 030204 cardiovascular system & hematology, Masked hypertension, 03 medical and health sciences, 0302 clinical medicine, medicine, Diseases of the circulatory (Cardiovascular) system, Humans, 030212 general & internal medicine, Intensive care medicine, business.industry, Nocturnal hypertension, Blood Pressure Monitoring, Ambulatory, medicine.disease, Clinical Practice, Masked Hypertension, Dipping, Blood pressure, RC666-701, Ambulatory, Hypertension, Patient Compliance, Surgery, Cardiology and Cardiovascular Medicine, business, Algorithms
Abstract

Being one of the most widely prevalent diseases throughout the world, hypertension has emerged as one of the leading causes of global premature morbidity and mortality. Hence, blood pressure (BP) measurements are essential for physicians in the diagnosis and management of hypertension. Current American College of Cardiology/American Heart Association (ACC/AHA) guidelines recommend initiating antihypertensive medications on the basis of office BP readings. However, office BP readings provide a snapshot evaluation of the patient's BP, which might not reflect patient's true BP, with the possibility of being falsely elevated or falsely low. Recently, there is ample evidence to show that ambulatory blood pressure monitoring (ABPM) is a better predictor of major cardiovascular events than BP measurements at clinic settings. ABPM helps in reducing the number of possible false readings, along with the added benefit of understanding the dynamic variability of BP. This article will focus on the significance of ambulatory BP, its advantages and limitations compared with the standard office BP measurement and a brief outlook on its use and interpretation to diagnose and treat hypertension. Keywords: Ambulatory blood pressure, White coat hypertension, Masked hypertension, Nocturnal hypertension, Dipping

Published
2018

42. Adaptation of 2016 European Society of Cardiology/European Atherosclerosis Society guideline for lipid management to Indian patients – A consensus document

Author

Das Mk, K.K. Sinha, Sivakadaksham Natarajan, Jyoti Deb, Peeyush Jain, J.P.S. Sawhney, and Saumitra Ray

Subjects
medicine.medical_specialty, Consensus, RD1-811, Hypercholesterolemia, Cardiology, India, Review Article, Guidelines, 030204 cardiovascular system & hematology, 03 medical and health sciences, 0302 clinical medicine, Guidelines recommendations, Internal medicine, medicine, Humans, Diseases of the circulatory (Cardiovascular) system, 030212 general & internal medicine, Adaptation (computer science), Societies, Medical, Hypolipidemic Agents, Lipid management, business.industry, Expert consensus, nutritional and metabolic diseases, Guideline, Atherosclerosis, medicine.disease, Lipids, Europe, Dyslipidemia, Expert opinion, RC666-701, European atherosclerosis society, Surgery, Guideline Adherence, Morbidity, Cardiology and Cardiovascular Medicine, business
Abstract

In the year 2016, European Society of Cardiology/European Atherosclerosis Society (ESC/EAS) guidelines provided recommendations on dyslipidemia management. The recommendation from these guidelines are restricted to European subcontinent. To adapt the updated recommendations for Indian subset of dyslipidemia, a panel of experts in management of dyslipidemia provided their expert opinions. This document provides expert consensus on adapting 2016 ESC dyslipidemia guidelines recommendations in Indian setting. The document also discussed India-specific relevant literature to support the consensus opinions provided in management of dyslipidemia. Keywords: Dyslipidemia, Hypercholesterolemia, India, Expert opinion, Guidelines

Published
2018

43. Anemia profile in patients with congestive heart failure a hospital based observational study

Author

Ashwani Mehta, Arun Mohanty, Himanshu Arora, and J.P.S. Sawhney

Subjects
Male, medicine.medical_specialty, Folate, RD1-811, Anemia, Iron, India, 030204 cardiovascular system & hematology, Gastroenterology, 03 medical and health sciences, Hemoglobins, 0302 clinical medicine, Risk Factors, Internal medicine, medicine, Prevalence, Diseases of the circulatory (Cardiovascular) system, Humans, 030212 general & internal medicine, Retrospective Studies, chemistry.chemical_classification, Heart Failure, medicine.diagnostic_test, biology, business.industry, Iron deficiency, Middle Aged, medicine.disease, Ferritin, chemistry, Transferrin, RC666-701, Heart failure, Serum iron, biology.protein, B 12, Surgery, Observational study, Female, Hemoglobin, Clinical and Preventive Cardiology, Cardiology and Cardiovascular Medicine, business, Biomarkers
Abstract

Objectives: Iron deficiency (ID) is an emerging problem in patients with congestive heart failure (CHF) and can be a potential therapeutic target. As ID is highly prevalent in the society, it is hypothesized that Indian patients with CHF have high prevalence of ID. Methods: CHF patients (n = 275) were selected and underwent laboratory evaluation including hemoglobin concentration, serum iron, transferrin, ferritin, B12 and folate level. Results: Two hundred and seventy-five patients with heart failure (mean age - 62.72, mean Hb- 10.54 g/dl, 188 males [68.36%] and 87 females [31.64%]) were enrolled in the study. 211 out of 275 (76.7%) were found to be anemic. Out of 275 patients. 148 (53.8%) were diagnosed with iron deficiency. 12.7% (n = 35) were B12 deficient and 5.1% (n = 14) were folate deficient. In the anemic group, ID was present in 130 patients (61.61%), B12 deficiency in 32 patients (15.16%) and folate deficiency in 12 patients (5.68%). In the group of patients without anemia, ID was present in 18 patients (28.12%) while B12 and folate deficiency was present in 3 (4.68%) and 2 (3.12%) patients, respectively. Conclusion: Iron deficiency is present in substantial number while B12 and folate account for a few number of cases. Substantial number of patients without anemia were found to be iron deficient. Keywords: Anemia, Iron, B 12, Folate, Heart failure

Published
2018

44. CSI position statement on management of heart failure in India

Author

Soura Mookerjee, U C Samal, G. Sanjay, G. Justin Paul, Johann Christopher, Ambuj Roy, Rakesh K. Gupta, Upkar A. Kaul, B.P. Chattopadhyay, K. Sarat Chandra, R Alagesan, M.S. Hiremath, B.C. Srinivas, Brian Pinto, Kewal C. Goswami, Neil Bardolui, Rishi Sethi, Arup Dasbiswas, Vijay K. Chopra, Cholenahalli Nanjappa Manjunath, Amit N. Vora, Saumitra Ray, Rakesh Yadav, Calambur Narasimhan, S. Somasundaram, Suvro Banerjee, Sundeep Mishra, K.R. Balakrishnan, J.J. Dalal, Yash Lokhandwala, K. Venugopal, Milind Hot, Anita Saxena, Sivadasanpillai Harikrishnan, Rajeeve Kumar Rajput, Trinath Kumar Mishra, Vinay K. Bahl, Varun Shankar Narain, Dharmendra Jain, Prashant Bhardwaj, Prafulla Kerkar, Akshyaya Pradhan, Ajay Kumar Sinha, Soumitra Kumar, N. V. Deshpande, J.P.S. Sawhney, G. Sengottuvelu, D. D. Sarma, S Ramakrishnan, Bhupender Singh, J. Balachandar, Satyendra Tewari, Jayanta Saha, Mrinal Kanti Das, Satyanarayan Routray, Kajal Ganguly, Om Prakash Yadava, Aditya Kapoor, H.K. Chopra, Jaganmohan Tharakan, P.K. Deb, S. Shanmugasundaram, Geevar A. Zachariah, Charan P. Lanjewar, P.P. Mohanan, Santanu Guha, Amal Kumar Banerjee, A.K. Pancholia, Sandeep Seth, A.U. Mahajan, Pravesh Vishwakarma, Vimal Raj, Kewal K. Talwar, I.B. Vijayalakshmi, Tiny Nair, and S.S. Iyengar

Subjects
Position statement, CSI Guideline, medicine.medical_specialty, business.industry, Management of heart failure, MEDLINE, 030204 cardiovascular system & hematology, 03 medical and health sciences, 0302 clinical medicine, medicine, 030212 general & internal medicine, Disease management (health), Cardiology and Cardiovascular Medicine, Intensive care medicine, business
Published
2018

45. Indian Recommendations on Antithrombotic Management for Chronic Coronary Syndrome: An Expert Consensus Delphi Study

Author

Kamal Sharma, Jay Shah, P.K. Hazra, J.S. Hiremath, V.S. Narain, Ashwani Mehta, Ajit Bhagawat, Aziz Khan, Govindan Unni, Tiny Nair, Ajay Mahajan, Ajay Naik, K. Kannan, Monotosh Panja, Prasant Sahoo, S.C. Manchanda, Sarat Chandra, B.P. Pandey, Girish Navsundi, and J.P.S. Sawhney

Subjects
Pulmonary and Respiratory Medicine, Cardiology and Cardiovascular Medicine
Published
2022
Full Text
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46. To study the effect of high dose Atorvastatin 40 mg versus 80 mg in patients with dyslipidemia

Author

J.P.S. Sawhney, Subhash C. Manchanda, Deepak Agrawal, Rajneesh Jain, Arun Mohanty, Bhuwanesh Kandpal, M.K. Sharma, Rajiv Passey, Ashwani Mehta, and Aman Makhija

Subjects
myalgia, Adult, Male, medicine.medical_specialty, Time Factors, RD1-811, Atorvastatin, 030204 cardiovascular system & hematology, Significant elevation, Group B, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Internal medicine, medicine, Diseases of the circulatory (Cardiovascular) system, Humans, In patient, 030212 general & internal medicine, Prospective Studies, Myopathy, Aged, Dyslipidemias, Aged, 80 and over, Dose-Response Relationship, Drug, business.industry, Incidence (epidemiology), Anticholesteremic Agents, nutritional and metabolic diseases, Myalgia, Cholesterol, LDL, Middle Aged, medicine.disease, Atherosclerosis, Treatment Outcome, Dyslipidemia, RC666-701, Surgery, lipids (amino acids, peptides, and proteins), Female, Clinical and Preventive Cardiology, medicine.symptom, Cardiology and Cardiovascular Medicine, business, medicine.drug, Follow-Up Studies
Abstract

Objective: Primary objective was to compare the effects of atorvastatin 40 mg vs 80 mg on LDL-C in Indian patients with atherosclerotic dyslipidemia. Secondary objectives were to compare the effects of atorvastatin 40 mg vs 80 mg on HDL-C and triglycerides and also comparing of side effects (myopathy, hepatotoxicity and new onset diabetes mellitus) of both doses. Method: This Study is A Prospective, randomized, open-label, comparative study. This study was conducted on 240 patients of dyslipidemia (as per ACC/AHA 2013 lipid guidelines) attending the OPD/wards/CCU of department of cardiology, Sir Ganga Ram Hospital. They were randomly divided into 2 groups of 120 each. Group A consisted patients who received Atorvastatin 40 mg daily and Group B Atorvastatin 80 mg daily. The follow up period was 6 months. Results: At 3 and 6 month follow up, Atorvastatin 40 mg leads to mean LDL cholesterol reduction of 47.18 ± 20.81 & 50.03 ± 18.06 respectively. While Atorvastatin 80 mg results in LDL reduction as 50.11 ± 15.85 & 52.30 ± 13.72. The comparison between two doses revealed a non-significant difference (p = .118 & p = .149 respectively).At 6 months of follow up, few patients reported myalgia (2 in group A and 7 in Group B). The difference between groups was significant (p = .045). Although none of our patient had significant elevation of CPK. Conclusion: This study concluded that both doses of atorvastatin (40 & 80 mg) are equally efficacious in improving dyslipidemia but higher dose leads to more incidence of myalgia. Keywords: Atherosclerosis, Atorvastatin, Dyslipidemia, Myalgia

Published
2018

48. Proprotein convertase subtilisin kexin 9 inhibitors: Current status and future directions

Author

Saurabh Bagga and J.P.S. Sawhney

Subjects
lcsh:Diseases of the circulatory (Cardiovascular) system, familial hypercholesterolemia, business.industry, medicine.drug_class, PCSK9, Familial hypercholesterolemia, Pharmacology, medicine.disease, Monoclonal antibody, Evolocumab, Dyslipidemia, lcsh:RC666-701, LDL receptor, medicine, lipids (amino acids, peptides, and proteins), business, Receptor, Lipoprotein, Alirocumab, statin intolerance
Abstract

The discovery of proprotein convertase subtilisin kexin 9 (PCSK9) has considerably changed the therapeutic options in the field of lipid management. PCSK9 reduces low-density lipoprotein receptor (LDLR) recycling, leading to a decrease of LDL cholesterol (LDL-C) receptors on the surface of hepatocytes and a subsequent increase of circulating LDL-C levels. Among the various approaches to PCSK9 inhibition, human data are only available for inhibition of PCSK9 binding to LDLR by monoclonal antibodies. In Phase II studies, the two most advanced monoclonal antibodies in development (alirocumab and evolocumab) decreased atherogenic lipoproteins very effectively and were well tolerated. Sixty percent to seventy percent of reduction in LDL-C was observed, especially when subcutaneous injections were performed regularly every 2 weeks. No significant side effects were observed, with the exception of injection-site reactions. Three large Phase III programs with the new anti-PCSK9 antibodies are currently underway in patients with acute coronary syndrome and LDL-C inadequately controlled by standard treatments. In this review, we will discuss the effect of PCSK9 inhibition, its current status, and future perspectives.

Published
2017

49. Management Protocols of stable coronary artery disease in India: Executive summary

Author

Saumitra Ray, S Ramakrishnan, S S Iyengar, J.P.S. Sawhney, Jamshed Dalal, Tiny Nair, Vinay K. Bahl, and Sundeep Mishra

Subjects
medicine.medical_specialty, RD1-811, MEDLINE, India, Coronary Artery Disease, 030204 cardiovascular system & hematology, Coronary artery disease, 03 medical and health sciences, 0302 clinical medicine, Clinical Protocols, Prevalence, Humans, Medicine, Diseases of the circulatory (Cardiovascular) system, 030212 general & internal medicine, Disease management (health), Intensive care medicine, Executive summary, business.industry, Disease Management, medicine.disease, RC666-701, Physical therapy, Original Article, Surgery, Cardiology and Cardiovascular Medicine, business
Published
2016

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