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Objective: To assess the rate of occurrence of sub-acute Stent Thrombosis (SAT) after primary PCI in the patients presented with the acute coronary syndrome. Study Design: Retrospective cross-sectional study. Place and Duration of Study: At Tertiary Cardiac Care Center of Lahore Pakistan, from Jul 2019 to Jun 2021. Methodology: The retrospective demographical and angiographic data of the admitted patients who underwent PCI for ACS,was gathered from the Hospital Registry of a tertiary cardiac care center of Lahore. The sampling technique was nonprobability consecutive sampling, and all the data was analyzed using SPSS 20.0 and continuous data was presented as Mean±SD and frequencies & percentages for categorical variables. Chi square test (CI=95%, α=5%) was used to find the association of SAT with predisposing factors. p-value < 0.05 was taken as statistically significant. Results: Out of (n=551) patient underwent PPCI, the stent thrombosis was observed to occur in 29(5.2 %), among which 4.9 % were subacute stent thrombosis. The predisposing factors of sub-acute stent thrombosis were Diabetes Mellitus, ACS, smaller vessel size, presence of bifurcation lesion, under sizing of the stent and edge dissection and were in significant association with SAT (p < 0.05). Conclusion: Our study reveals that subacute stent thrombosis is an event with a comparatively higher frequency in patients who go through primary PCI for acute coronary syndrome, demonstrating a frequency of 4.9% and a mortality rate of 74% within 30 days of the procedure.

Background: Percutaneous Coronary intervention (PCI) is a routinely performed procedure in coronary care units. The aim of our study was to investigate the frequency of major adverse cardiac events (MACEs) after percutaneous coronary angiography in acute ST-elevation myocardial infarction (STEMI) patients in our institution. The objective of the study is to determine the frequency of MACEs after Percutaneous Coronary Intervention (PCI) in patients with acute myocardial infarction.Patients & Methods: This prospective observational study was carried out at Punjab Institute of Cardiology, Lahore from May 2017 to June 2017. A total 35 patients with STEMI who underwent Primary PCI were enrolled by consecutive sampling technique. An inclusion criterion was chest pain of 30 minutes to 12 hours duration with ECG showing ≥ 0.1mm ST-elevation in at least two contiguous leads. An exclusion criterion was thrombolysis within last 24 hours, malignancy, stroke and Left Main or equivalent disease on coronary Angiogram. Patients were followed after 2 weeks till 1 month for any MACES. (Including re-admission, need for repeat revascularization, stent thrombosis, recurrent acute MI, angina, stroke, and mortality). Frequency and percentages were calculated for MACEs by using SPSS 23.0.Results: Out of 35 cases, 34 (97.1%) were male and 1 (2.9%) were female. Mean age was 47.11±10.59 years, 14 (40%) patients had hypertension, 10 (28.6%) were diabetics and 12(34.3%) were current smokers while 4 (11.4%) were ex-smokers, 10 (28.6%) had family history of CAD, and 3 (8.6%) had hyperlipidemia. Successful revascularization with TIMI-III flow was attained in 34(97.1%) cases. 33minutes was mean door to balloon time. At one month follow-up, out of 35 patients, angina was reported only in 1 (2.9%) patient. There was no readmission, repeat revascularization, stent thrombosis, myocardial infarction, stroke and death reported in study subjects.Conclusion: Successful revascularization by Primary PCI was associated with very few early MACEs. For the treatment of coronary artery disease, PCI is an effective option. It has a few early MACEs and uses less contrast and has fewer distal complications than conventional angioplasty and invasive procedures.

Background: Contrast induced nephropathy is a well-known entity but it is less known that whether cardiac disease is a risk factor for this complication. Contrast induced nephropathy (CIN) is related with increase mortality and morbidity and the chances of this complication rises in patients who have coronary artery disease (CAD). Objective: The objective of the study is to identify the frequency of contrast induced nephropathy in patients undergoing percutaneous coronary intervention who have normal baseline renal functions. Material and methods: This cross sectional study conducted at angiography department of Punjab Institute of Cardiology, Lahore over a period of 2 years from January 2015 to January 2017. Patients regardless of gender with age of 30 - 65 years, diabetic or non-diabetics were included. Patients with renal disease or serum creatinine > 2 mg/dl at presentation or any other co-morbid medical illness, LV ejection fraction 200ml, 612 (65.3%) patients. According to the age group following patients suffered from CIN: 30-40 years, 72 (8.6%) patients, 41-55 years, 288 (11.2 %) patients and 56-65 years 576 (28.5%) patients. Out of 2988 male patients, 324 (10.8 %) patients suffered from CIN (p=0.06). Similarly, out of 2412 females 612 (25.3 %) patients had CIN (p=0.05). In 936 patients suffering from CIN, 684(73.1%) patients were diabetic and 252 (26.9%) were non-diabetic. � Conclusion: There is a high frequency of contrast induced nephropathy in elderly and diabetic patients who undergo PCI even if they have normal preexisting renal functions, so this complication can be avoided by the minimum use of contrast during the procedure

Background: Pandemic caused by Corona virus infection has damaged the population throughout the universe. Cases of COVID-19 increased rapidly in whole world. COVID-19 has been associated with a number of cardiovascular co-morbidities including hypertension, ischemic heart disease, diabetes mellitus, dyslipidemia, atrial fibrillation and cardiac failure. Aims and objective: To determine the frequency of cardiovascular complications in patients with COVID-19. Material and methods: This observational cohort study was conducted in corona ward of DHQ Hospital, Gujrat from 1st January to 31st June 2021. Total 216 patients between 18-70 years of age, admitted who had COVID-19 confirmed by PCR after taking informed consent; patients already suffering from any cardiovascular, respiratory or other life threatening illness were excluded while hypertensive, diabetics and smoker were included in the study. Duration of admission was according to the severity of illness. Detailed history was taken from all patients followed by relevant examination. Investigations like ECG, echocardiographically and troponins were done to diagnose cardiovascular complications. All the patients were treated conservatively. Frequency of cardiovascular complications was noted. The patients who had clinical relief of symptoms, fever free, normal X-Ray chest and at least two consecutive negative PCR results for covid-19 were discharged. p value

Background: Depression has a significant relationship with cardiovascular diseases. But evidence is scarce regarding its impact on adverse outcome in patients of non-obstructive coronary artery disease. Aim: To assess the association of depression with adverse outcome in patients with myocardial infarction with non-obstructive coronary arteries (MINOCA). Methods: This cohort study was conducted in the Department of Cardiology, Punjab Institute of Cardiology, Lahore for 12 months i.e. July 2017 to June 2018. 260 patients; 130 in exposed group and 130 in unexposed group fulfilling selection criteria were enrolled for the study with or without depression. Patients were then evaluated for adverse outcome. SPSS v. 25 was used to analyse the data. Results: The mean age of exposed group was 42.85±9.33 years and the mean age of unexposed group was 52.52± 8.18 years. There were 49(37.7%) males and 81(62.3%) females in exposed group with the male-to-female ratio was 1: 1.7, while in unexposed group there were 55(42.3%) males and 75(57.7%) females with the male-to-female ratio was 1: 1.4. ST-segment elevation was observed in 31(23.8%) exposed patients while in 27(20.8%) unexposed patients. In exposed group, cardiovascular events were noted in 44(33.8%) patients, while in 27(20.8%) patients in unexposed group (OR=1.362, 95% CI; 1.071, 1.731, P=0.018). In exposed group, cardiovascular related mortality were noted in 38(29.2%) patients, while in 17(13.1%) patients in unexposed group (OR=1.54, 95% CI; 1.22, 1.943, P = 0.001). In exposed group, all-cause mortality were noted in 19 (14.6%) patients, while in 9 (6.9%) patients in unexposed group (OR=1.418, 95% CI; 1.063, 1.892, p=0.045). Conclusions: Our study results showed that depression in patients having MINOCA is significantly related to adverse cardiovascular sequel and leads to more severe sequel. Keywords: Depression, adverse outcome, mortality, myocardial infarction, non-obstructive coronary arteries, MINOCA

Background: Pulmonary embolism is the lethal condition that is associated with higher rate of mortality in cardia patients. The diagnosis of the acute pulmonary embolism is frequently observed in patients presenting in emergency department or during hospitalization. Level of D-dimer may be assessed by blood test to help the physicians to diagnose the thrombosis. Literature showed variable evidence regarding predictive accuracy of D-dimer for detection of pulmonary embolism. So to get local data, we conducted this study. Aim: To determine the diagnostic accuracy of D-dimer assay for detection of pulmonary embolism in patients of acute myocardial infarction presenting in emergency department taking CTPA as gold standard Methods: Cross - sectional study conducted in Cardiology Department , Punjab Institute of Cardiology, Lahore for a period of six months from 1-9-2018 to 1-3-2019. One hundred patients, fulfilled the selection criteria were enrolled from emergency. Then blood sample was taken for evaluation of D-dimer level. Reports were checked and D-dimer level was noted. Pulmonary embolism was labeled as positive on D-dimer, if D-dimer level ≥500 and was labeled as negative if D-dimer level