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2. Clinical characteristics and outcomes of Australian and Indian ST-segment elevation myocardial infarction (STEMI) patients treated with primary percutaneous coronary intervention (PCI)

Author

M.L. Savage, K. Hay, H. Sundar, R. Maharajan, D.J. Murdoch, K. Latchumanadhas, D.M. Ezhilan, U. Kalaichelvan, R. Denman, I. Ranasinghe, V. Subban, D.L. Walters, A. Mullasari, and O.C. Raffel

Subjects
STEMI (ST-Elevation myocardial infarction), Primary PCI, Population demographics, Mortality, Surgery, RD1-811, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Introduction: The incidence of STEMI and subsequent mortality has been reported to be higher in Indian populations compared to developed countries. However, there is limited data directly comparing contemporary primary percutaneous coronary intervention (pPCI) treatment strategies and clinical outcomes for STEMI patients between developed and developing countries. Materials and methods: We compared population demographics, procedural characteristics, times to reperfusion and mortality in STEMI patients treated with pPCI between two tertiary referral centers in India and Australia respectively over a 3-year period (1st Jan 2017–31st Dec 2019). Results: A total of 1293 STEMI presentations (896 Indian vs 397 Australian) were included. On average, Indian patients had lower median BMI than Australian patients (BMI 25.4 vs 27.8; p

Published
2024
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3. A randomized trial of antithrombotic therapy in patients with acute coronary syndrome and coronary ectasia

Author

Araiza-Garaygordobil, Diego, Gopar-Nieto, Rodrigo, Sierra-Lara Martínez, Jorge Daniel, Mullasari, Ajit S, Belderrain-Morales, Nallely, Nájera-Rojas, Nitzha Andrea, Diaz-Herrera, Braiana Angeles, Sarabia-Chao, Vianney, Alfaro-Ponce, Diana Laura, Briseño-De la Cruz, Jose Luis, Ruiz-Beltrán, Maximiliano, Martínez-Ríos, Marco Antonio, Piña-Reyna, Yigal, Latapi-Ruiz Esparza, Ximena, Grimaldo-Gomez, Flavio Adrian, Cortina-De la Rosa, Evelyn, Romero-Arroyo, María Oliva, Sierra-Gonzalez de Cossio, Alejandro, González-Pacheco, Héctor, and Arias-Mendoza, Alexandra

Published
2025
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4. Prevalence of atrial fibrillation on a 24-hour Holter in adult Indians

Author

M Srinivasa Rao, Ajit Mullasari, Jagdish S. Hiremath, G. Sengottuvelu, Aparna Jaiswal, Darshan Jhala, Jitendra Singh Makkar, B.C. Kalmath, Bino Benjamin, Annirudha Dharmadhikari, Mihir Tanna, Aziz Khan, Siddhant Jain, K.A. Sambasivam, A. Purnanand, N S Rama Raju, Goutam Sarkar, Hiren Prajapati, and Willem J. verberk

Subjects
Holter, Paroxysmal atrial fibrillation, India, Surgery, RD1-811, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Objective: To evaluate paroxysmal atrial fibrillation (AF) prevalence in Indian adults who completed 24-Hour Holter monitoring. Methods: A total of 23,847 patients (36.9 % women) were analyzed for AF duration using a software algorithm. Results: AF was diagnosed in 4153 (17.4 %) patients with a median AF duration of 13 min and 55 s. Conclusion: AF prevalence was high and largely untreated. The short duration of AF episodes indicates a low likelihood of detection during clinical visits, highlighting its potential underestimation in Indian healthcare.

Published
2024
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6. Safety and effectiveness of the novel Myval Octacor transcatheter heart valve in severe, symptomatic aortic valve stenosis — A real-world Indian experience (The OCTACOR India Study)

Author

Jose, John, Mandalay, Asishkumar, Cholenahally, Manjunath N., Khandenahally, Ravindranath S., Budnur, Srinivas C., Parekh, Maulik, Rao, Ravinder S., Seth, Ashok, Chandra, Praveen, Kapoor, Rajneesh, Agarwal, Praveer, Mathur, Atul, Kumar, Vijay, Kanchanahalli, Sadananda S., Mullasari, Ajith S., Subban, Vijayakumar, Khanolkar, Uday B., Mehrotra, Sanjay, Chopra, Manik, Jain, Rajendra K., Mehta, Haresh, Gupta, Rahul, Kumar, Viveka, Raghuraman, Bagirath, Shastri, Naman, Elzomor, Hesham, Soliman, Osama, and Gunasekaran, Sengottuvelu

Published
2024
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7. 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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9. Effectiveness and safety of optical coherence tomography-guided PCI in Indian patients with complex lesions: A multicenter, prospective registry

Author

Praveen Chandra, Selvamani Sethuraman, Sanjeeb Roy, Arun Mohanty, Keyur Parikh, Bahuleyan Charantharalyil Gopalan, Prasant Kumar Sahoo, Sridhar Kasturi, Vijay Trambaklal Shah, Viveka Kumar, Brian Pinto, Pratap Chandra Rath, Vijayachandra Reddy Yerramareddy, Deepak Davidson, Girish B. Navasundi, Vijayakumar Subban, Nandhini Livingston, Deva Preethi Rajaraman, Manish Narang, Nick E.J. West, and Ajit Mullasari

Subjects
Optical coherence tomography, Percutaneous coronary intervention, Complex lesions, Acute kidney injury, Minimum stent area, Clinical outcomes, Surgery, RD1-811, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Background: Optical coherence tomography (OCT) is reported to be a feasible and safe imaging modality for the guidance of percutaneous coronary intervention (PCI) of complex lesions. Methods: This multicenter, prospective registry assessed the minimum stent area (MSA) achieved under OCT guidance. A performance goal of 24% improvement in MSA over and above the recommendation set by the European Association of Percutaneous Cardiovascular Interventions Consensus 2018 (4.5 mm2 MSA for non-left main and 3.5 mm2 for small vessels). The incidence of contrast-induced nephropathy was also assessed. Core lab analysis was conducted. Results: Five hundred patients (average age: 59.4 ± 10.1 years; 83% males) with unstable angina (36.8%), NSTEMI (26.4%), and STEMI (22%) were enrolled. The primary endpoint was achieved in 93% of lesions with stent diameter ≥2.75 mm (average MSA: 6.44 mm2) and 87% of lesions with stent diameter ≤2.5 mm (average MSA: 4.56 mm2). The average MSA (with expansion ≥80% cutoff) was 6.63 mm2 and 4.74 mm2 with a stent diameter ≥2.75 mm and ≤2.5 mm, respectively. According to the core lab analysis, the average MSA achieved with a stent diameter ≥2.75 mm and ≤2.5 mm was 6.23 mm2 and 3.95 mm2, respectively (with expansion ≥80% cutoff). Clinically significant serum creatinine was noted in two patients (0.45%). Major adverse cardiac events at 1 year were noted in 1.2% (n = 6) of the patients; all were cardiac deaths. Conclusion: PCI under OCT guidance improves procedural and long-term clinical outcomes in patients with complex lesions not just in a controlled trial environment but also in routine clinical practice.

Published
2023
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10. Author Correction: Optical coherence tomography in coronary atherosclerosis assessment and intervention

Author

Araki, Makoto, Park, Seung-Jung, Dauerman, Harold L., Uemura, Shiro, Kim, Jung-Sun, Di Mario, Carlo, Johnson, Thomas W., Guagliumi, Giulio, Kastrati, Adnan, Joner, Michael, Holm, Niels Ramsing, Alfonso, Fernando, Wijns, William, Adriaenssens, Tom, Nef, Holger, Rioufol, Gilles, Amabile, Nicolas, Souteyrand, Geraud, Meneveau, Nicolas, Gerbaud, Edouard, Opolski, Maksymilian P., Gonzalo, Nieves, Tearney, Guillermo J., Bouma, Brett, Aguirre, Aaron D., Mintz, Gary S., Stone, Gregg W., Bourantas, Christos V., Räber, Lorenz, Gili, Sebastiano, Mizuno, Kyoichi, Kimura, Shigeki, Shinke, Toshiro, Hong, Myeong-Ki, Jang, Yangsoo, Cho, Jin Man, Yan, Bryan P., Porto, Italo, Niccoli, Giampaolo, Montone, Rocco A., Thondapu, Vikas, Papafaklis, Michail I., Michalis, Lampros K., Reynolds, Harmony, Saw, Jacqueline, Libby, Peter, Weisz, Giora, Iannaccone, Mario, Gori, Tommaso, Toutouzas, Konstantinos, Yonetsu, Taishi, Minami, Yoshiyasu, Takano, Masamichi, Raffel, O. Christopher, Kurihara, Osamu, Soeda, Tsunenari, Sugiyama, Tomoyo, Kim, Hyung Oh, Lee, Tetsumin, Higuma, Takumi, Nakajima, Akihiro, Yamamoto, Erika, Bryniarski, Krzysztof L., Di Vito, Luca, Vergallo, Rocco, Fracassi, Francesco, Russo, Michele, Seegers, Lena M., McNulty, Iris, Park, Sangjoon, Feldman, Marc, Escaned, Javier, Prati, Francesco, Arbustini, Eloisa, Pinto, Fausto J., Waksman, Ron, Garcia-Garcia, Hector M., Maehara, Akiko, Ali, Ziad, Finn, Aloke V., Virmani, Renu, Kini, Annapoorna S., Daemen, Joost, Kume, Teruyoshi, Hibi, Kiyoshi, Tanaka, Atsushi, Akasaka, Takashi, Kubo, Takashi, Yasuda, Satoshi, Croce, Kevin, Granada, Juan F., Lerman, Amir, Prasad, Abhiram, Regar, Evelyn, Saito, Yoshihiko, Sankardas, Mullasari Ajit, Subban, Vijayakumar, Weissman, Neil J., Chen, Yundai, Yu, Bo, Nicholls, Stephen J., Barlis, Peter, West, Nick E. J., Arbab-Zadeh, Armin, Ye, Jong Chul, Dijkstra, Jouke, Lee, Hang, Narula, Jagat, Crea, Filippo, Nakamura, Sunao, Kakuta, Tsunekazu, Fujimoto, James, Fuster, Valentin, and Jang, Ik-Kyung

Published
2024
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11. Position statement from the Indian Society of Gastroenterology, Cardiological Society of India, Indian Academy of Neurology and Vascular Society of India on gastrointestinal bleeding and endoscopic procedures in patients on antiplatelet and/or anticoagulant therapy

Author

Arora, Anil, Kumar, Ashish, Anand, Anil C., Kumar, Ajay, Yadav, Ajay, Bhagwat, Ajit, Mullasari, Ajit S., Satwik, Ambarish, Saraya, Anoop, Mehta, Ashwani, Roy, Debabrata, Reddy, Duvvur Nageshwar, Makharia, Govind, Murthy, Jagarapudi M. K., Roy, Jayanta, Sawhney, Jitendra P. S., Prasad, Kameshwar, Goenka, Mahesh, Philip, Mathew, Umaiorubahan, Meenakshisundaram, Sinha, Nakul, Mohanan, Padinhare P., Sylaja, Padmavathy N., Ramakrishna, Pinjala, Kerkar, Prafulla, Rai, Praveer, Kochhar, Rakesh, Yadav, Rakesh, Nijhawan, Sandeep, Sinha, Saroj K., Hastak, Shirish M., Viswanathan, Sidharth, Ghoshal, Uday C., Madathipat, Unnikrishnan, Thakore, Vijay, Dhir, Vinay, Saraswat, Vivek A., and Nabi, Zaheer

Published
2023
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13. Practical Application of Coronary Physiologic Assessment: Asia-Pacific Expert Consensus Document: Part 2

Author

Koo, Bon-Kwon, Hwang, Doyeon, Park, Sungjoon, Kuramitsu, Shoichi, Yonetsu, Taishi, Kim, Chee Hae, Zhang, Jinlong, Yang, Seokhun, Doh, Joon-Hyung, Jeong, Young-Hoon, Choi, Ki Hong, Lee, Joo Myung, Ahn, Jung-Min, Matsuo, Hitoshi, Shin, Eun-Seok, Hu, Xinyang, Low, Adrian F., Kubo, Takashi, Nam, Chang-Wook, Yong, Andy S.C., Harding, Scott A., Xu, Bo, Hur, Seung-Ho, Choo, Gim Hooi, Tan, Huay Cheem, Mullasari, Ajit, Hsieh, I-Chang, Kakuta, Tsunekazu, Akasaka, Takashi, Wang, Jian'an, Tahk, Seung-Jea, Fearon, William F., Escaned, Javier, and Park, Seung-Jung

Published
2023
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14. Ten Steps Toward Improving In-Hospital Cardiac Arrest Quality of Care and Outcomes

Author

Chan, Paul S., Greif, Robert, Anderson, Theresa, Atiq, Huba, Bittencourt Couto, Thomaz, Considine, Julie, De Caen, Allan R., Djärv, Therese, Doll, Ann, Douma, Matthew J., Edelson, Dana P., Xu, Feng, Finn, Judith C., Firestone, Grace, Girotra, Saket, Lauridsen, Kasper G., Kah-Lai Leong, Carrie, Lim, Swee Han, Morley, Peter T., Morrison, Laurie J., Moskowitz, Ari, Mullasari Sankardas, Ajit, Mustafa Mohamed, Mahmoud Tageldin, Myburgh, Michelle Christy, Nadkarni, Vinay M., Neumar, Robert W., Nolan, Jerry P., Odakha, Justine Athieno, Olasveengen, Theresa M., Orosz, Judit, Perkins, Gavin D., Previdi, Jeanette K., Vaillancourt, Christian, Montgomery, William H., Sasson, Comilla, and Nallamothu, Brahmajee K.

Published
2023
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15. Practical Application of Coronary Physiologic Assessment: Asia-Pacific Expert Consensus Document: Part 1

Author

Koo, Bon-Kwon, Lee, Joo Myung, Hwang, Doyeon, Park, Sungjoon, Shiono, Yasutsugu, Yonetsu, Taishi, Lee, Seung Hun, Kawase, Yoshiaki, Ahn, Jung-Min, Matsuo, Hitoshi, Shin, Eun-Seok, Hu, Xinyang, Ding, Daixin, Fezzi, Simone, Tu, Shengxian, Low, Adrian F., Kubo, Takashi, Nam, Chang-Wook, Yong, Andy S.C., Harding, Scott A., Xu, Bo, Hur, Seung-Ho, Choo, Gim Hooi, Tan, Huay Cheem, Mullasari, Ajit, Hsieh, I-Chang, Kakuta, Tsunekazu, Akasaka, Takashi, Wang, Jian'an, Tahk, Seung-Jea, Fearon, William F., Escaned, Javier, and Park, Seung-Jung

Published
2023
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17. Correlation of electrocardiogram changes with epicardial and myocardial perfusion in ST-elevation myocardial infarction

Author

Mahesh Kharade, Sunil Sathe, Deepak Sadashiv Phalgune, Hasmukh Gujar, and Mullasari Ajit Sankardas

Subjects
correlation, primary percutaneous coronary intervention, st-elevation myocardial infarction, thrombolysis in myocardial infarction flow grade, thrombolysis in myocardial infarction myocardial perfusion grade, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Background: The present study was aimed to find the correlation of electrocardiographic changes with epicardial thrombolysis in myocardial infarction (TIMI) flow grade and TIMI myocardial perfusion grade (TMPG) after reperfusion in ST-elevation myocardial infarction (STEMI). Methods: One hundred and fifty patients with STEMI were included. Reperfusion was done either by thrombolysis or primary percutaneous coronary intervention. The summed absolute ST-segment deviation and summed relative ST-segment deviation were calculated. TIMI and TMPG were assessed. The primary outcome measures were to study the correlation of summed absolute ST deviation and summed relative ST deviation with TIMI flow grade and TMPG after reperfusion. The secondary outcome measures were to compare TIMI flow grade and TMPG with respect to time since symptom onset to treatment and T-wave inversion after reperfusion. Results: There was a significant positive correlation between relative ST-segment deviation that occurred after reperfusion with TIMI flow grade (r = 0.475) and TMPG (r = 0.376). There was a significant negative correlation between absolute ST-segment deviation that occurred after reperfusion with TIMI flow grade (r = −0.194) and TMPG (r = −0.288). A significantly higher percentage (87.4%) of patients who got treatment within 1 h showed TMPG 2 and 3. A significantly higher percentage of patients who had T-wave inversion after reperfusion had TIMI flow Grade 3 and TMPG 2 and 3. Conclusions: There was a significant positive correlation between relative ST-segment deviation and significant negative correlation between absolute ST-segment deviation after reperfusion with TIMI flow grade and TMPG.

Published
2023
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18. Optical coherence tomography in coronary atherosclerosis assessment and intervention

Author

Araki, Makoto, Park, Seung-Jung, Dauerman, Harold L., Uemura, Shiro, Kim, Jung-Sun, Di Mario, Carlo, Johnson, Thomas W., Guagliumi, Giulio, Kastrati, Adnan, Joner, Michael, Holm, Niels Ramsing, Alfonso, Fernando, Wijns, William, Adriaenssens, Tom, Nef, Holger, Rioufol, Gilles, Amabile, Nicolas, Souteyrand, Geraud, Meneveau, Nicolas, Gerbaud, Edouard, Opolski, Maksymilian P., Gonzalo, Nieves, Tearney, Guillermo J., Bouma, Brett, Aguirre, Aaron D., Mintz, Gary S., Stone, Gregg W., Bourantas, Christos V., Räber, Lorenz, Gili, Sebastiano, Mizuno, Kyoichi, Kimura, Shigeki, Shinke, Toshiro, Hong, Myeong-Ki, Jang, Yangsoo, Cho, Jin Man, Yan, Bryan P., Porto, Italo, Niccoli, Giampaolo, Montone, Rocco A., Thondapu, Vikas, Papafaklis, Michail I., Michalis, Lampros K., Reynolds, Harmony, Saw, Jacqueline, Libby, Peter, Weisz, Giora, Iannaccone, Mario, Gori, Tommaso, Toutouzas, Konstantinos, Yonetsu, Taishi, Minami, Yoshiyasu, Takano, Masamichi, Raffel, O. Christopher, Kurihara, Osamu, Soeda, Tsunenari, Sugiyama, Tomoyo, Kim, Hyung Oh, Lee, Tetsumin, Higuma, Takumi, Nakajima, Akihiro, Yamamoto, Erika, Bryniarski, Krzysztof L., Di Vito, Luca, Vergallo, Rocco, Fracassi, Francesco, Russo, Michele, Seegers, Lena M., McNulty, Iris, Park, Sangjoon, Feldman, Marc, Escaned, Javier, Prati, Francesco, Arbustini, Eloisa, Pinto, Fausto J., Waksman, Ron, Garcia-Garcia, Hector M., Maehara, Akiko, Ali, Ziad, Finn, Aloke V., Virmani, Renu, Kini, Annapoorna S., Daemen, Joost, Kume, Teruyoshi, Hibi, Kiyoshi, Tanaka, Atsushi, Akasaka, Takashi, Kubo, Takashi, Yasuda, Satoshi, Croce, Kevin, Granada, Juan F., Lerman, Amir, Prasad, Abhiram, Regar, Evelyn, Saito, Yoshihiko, Sankardas, Mullasari Ajit, Subban, Vijayakumar, Weissman, Neil J., Chen, Yundai, Yu, Bo, Nicholls, Stephen J., Barlis, Peter, West, Nick E. J., Arbab-Zadeh, Armin, Ye, Jong Chul, Dijkstra, Jouke, Lee, Hang, Narula, Jagat, Crea, Filippo, Nakamura, Sunao, Kakuta, Tsunekazu, Fujimoto, James, Fuster, Valentin, and Jang, Ik-Kyung

Published
2022
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19. Ten Steps Toward Improving In-Hospital Cardiac Arrest Quality of Care and Outcomes

Author

Nallamothu, Brahmajee K., Greif, Robert, Anderson, Theresa, Atiq, Huba, Couto, Thomaz Bittencourt, Considine, Julie, De Caen, Allan R., Djärv, Therese, Doll, Ann, Douma, Matthew J., Edelson, Dana P., Xu, Feng, Finn, Judith C., Firestone, Grace, Girotra, Saket, Lauridsen, Kasper G., Leong, Carrie Kah-Lai, Lim, Swee Han, Morley, Peter T., Morrison, Laurie J., Moskowitz, Ari, Mullasari Sankardas, Ajit, Mohamed, Mahmoud Tageldin Mustafa, Myburgh, Michelle Christy, Nadkarni, Vinay M., Neumar, Robert W., Nolan, Jerry P., Athieno Odakha, Justine, Olasveengen, Theresa M., Orosz, Judit, Perkins, Gavin D., Previdi, Jeanette K., Vaillancourt, Christian, Montgomery, William H., Sasson, Comilla, and Chan, Paul S.

Published
2023
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20. Improve the Prevention of Sudden Cardiac Arrest in Patients With Post-Acute Myocardial Infarction

Author

Zhang, Shu, Chen, Wen-Jone, Sankardas, Mullasari Ajit, Ahmed, Waqar Habib, Liew, Houng-Bang, Gwon, Hyeon-Cheol, Nesa Malik, Fazila Tunn, Tang, Baopeng, Haggui, Abdeddayem, Oh, Il-Young, Ong, Tiong Kiam, Cheng, Cheng-I, Liu, Xingbin, Seth, Ashok, Choi, Young Jin, Qamar, Nadeem, Rungpradubvong, Voravut, Wang, Chun-Chieh, Jeon, JinKyung, Wong, Grace, Lemme, Francesca, Van Dorn, Brian, Lexcen, Dan, and Huang, Dejia

Published
2022
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22. Empagliflozin in the treatment of heart failure with reduced ejection fraction in addition to background therapies and therapeutic combinations (EMPEROR-Reduced): a post-hoc analysis of a randomised, double-blind trial

Author

Packer, M, Anker, S, Butler, J, Filippatos, G, Pocock, S, Zannad, F, Ferreira, JP, Brueckmann, M, George, J, Jamal, W, Welty, FK, Palmer, M, Clayton, T, Parhofer, KG, Pedersen, TR, Greenberg, B, Konstam, MA, Lees, KR, Carson, P, Doehner, W, Miller, A, Haas, M, Pehrson, S, Komajda, M, Anand, I, Teerlink, J, Rabinstein, A, Steiner, T, Kamel, H, Tsivgoulis, G, Lewis, J, Freston, J, Kaplowitz, N, Mann, J, Petrie, J, Perrone, S, Nicholls, S, Janssens, S, Bocchi, E, Giannetti, N, Verma, S, Zhang, J, Spinar, J, Seronde, M-F, Boehm, M, Merkely, B, Chopra, V, Senni, M, Taddi, S, Tsutsui, H, Choi, D-J, Chuquiure, E, La Rocca, HPB, Ponikowski, P, Juanatey, JRG, Squire, I, Januzzi, J, Pina, I, Bernstein, R, Cheung, A, Green, J, Kaul, S, Lam, C, Lip, G, Marx, N, McCullough, P, Mehta, C, Rosenstock, J, Sattar, N, Scirica, B, Shah, S, Wanner, C, Aizenberg, D, Cartasegna, L, Colombo Berra, F, Colombo, H, Fernandez Moutin, M, Glenny, J, Alvarez Lorio, C, Anauch, D, Campos, R, Facta, A, Fernandez, A, Ahuad Guerrero, R, Lobo Márquez, L, Leon de la Fuente, RA, Mansilla, M, Hominal, M, Hasbani, E, Najenson, M, Moises Azize, G, Luquez, H, Guzman, L, Sessa, H, Amuchástegui, M, Salomone, O, Perna, E, Piskorz, D, Sicer, M, Perez de Arenaza, D, Zaidman, C, Nani, S, Poy, C, Resk, J, Villarreal, R, Majul, C, Smith Casabella, T, Sassone, S, Liberman, A, Carnero, G, Caccavo, A, Berli, M, Budassi, N, Bono, J, Alvarisqueta, A, Amerena, J, Kostner, K, Hamilton, A, Begg, A, Beltrame, J, Colquhoun, D, Gordon, G, Sverdlov, A, Vaddadi, G, Wong, J, Coller, J, Prior, D, Friart, A, Leone, A, Vervoort, G, Timmermans, P, Troisfontaines, P, Franssen, C, Sarens, T, Vandekerckhove, H, Van De Borne, P, Chenot, F, De Sutter, J, De Vuyst, E, Debonnaire, P, Dupont, M, Pereira Dutra, O, Canani, LH, Vieira Moreira, MdC, de Souza, W, Backes, LM, Maia, L, De Souza Paolino, B, Manenti, ER, Saporito, W, Villaça Guimarães Filho, F, Franco Hirakawa, T, Saliba, LA, Neuenschwander, FC, de Freitas Zerbini, CA, Gonçalves, G, Gonçalves Mello, Y, Ascenção de Souza, J, Beck da Silva Neto, L, Bocchi, EA, Da Silveira, J, de Moura Xavier Moraes Junior, JB, de Souza Neto, JD, Hernandes, M, Finimundi, HC, Sampaio, CR, Vasconcellos, E, Neves Mancuso, FJ, Noya Rabelo, MM, Rodrigues Bacci, M, Santos, F, Vidotti, M, Simões, MV, Gomes, FL, Vieira Nascimento, C, Precoma, D, Helfenstein Fonseca, FA, Ribas Fortes, JA, Leães, PE, Campos de Albuquerque, D, Kerr Saraiva, JF, Rassi, S, Alves da Costa, FA, Reis, G, Zieroth, S, Dion, D, Savard, D, Bourgeois, R, Constance, C, Anderson, K, Leblanc, M-H, Yung, D, Swiggum, E, Pliamm, L, Pesant, Y, Tyrrell, B, Huynh, T, Spiegelman, J, Lavoie, J-P, Hartleib, M, Bhargava, R, Straatman, L, Virani, S, Costa-Vitali, A, Hill, L, Heffernan, M, Khaykin, Y, Ricci, J, Senaratne, M, Zhai, A, Lubelsky, B, Toma, M, Yao, L, McKelvie, R, Noronha, L, Babapulle, M, Pandey, A, Curnew, G, Lavoie, A, Berlingieri, J, Kouz, S, Lonn, E, Chehayeb, R, Zheng, Y, Sun, Y, Cui, H, Fan, Z, Han, X, Jiang, X, Tang, Q, Zhou, J, Zheng, Z, Zhang, X, Zhang, N, Zhang, Y, Shen, A, Yu, J, Ye, J, Yao, Y, Yan, J, Xu, X, Wang, Z, Ma, J, Li, Y, Li, S, Lu, S, Kong, X, Song, Y, Yang, G, Yao, Z, Pan, Y, Guo, X, Sun, Z, Dong, Y, Zhu, J, Peng, D, Yuan, Z, Lin, J, Yin, Y, Jerabek, O, Burianova, H, Fiala, T, Hubac, J, Ludka, O, Monhart, Z, Vodnansky, P, Zeman, K, Foldyna, D, Krupicka, J, Podpera, I, Busak, L, Radvan, M, Vomacka, Z, Prosecky, R, Cifkova, R, Durdil, V, Vesely, J, Vaclavik, J, Cervinka, P, Linhart, A, Brabec, T, Miklik, R, Bourhaial, H, Olbrich, H-G, Genth-Zotz, S, Kemala, E, Lemke, B, Böhm, M, Schellong, S, Rieker, W, Heitzer, T, Ince, H, Faghih, M, Birkenfeld, A, Begemann, A, Ghanem, A, Ujeyl, A, von Haehling, S, Dorsel, T, Bauersachs, J, Prull, M, Weidemann, F, Darius, H, Nickenig, G, Wilke, A, Sauter, J, Rauch-Kroehnert, U, Frey, N, Schulze, CP, König, W, Maier, L, Menzel, F, Proskynitopoulos, N, Ebert, H-H, Sarnighausen, H-E, Düngen, H-D, Licka, M, Stellbrink, C, Winkelmann, B, Menck, N, López-Sendón, JL, de la Fuente Galán, L, Delgado Jiménez, JF, Manito Lorite, N, Pérez de Juan Romero, M, Galve Basilio, E, Cereto Castro, F, González Juanatey, JR, Gómez, JJ, Sanmartín Fernández, M, Garcia-Moll Marimon, X, Pascual Figal, D, Bover Freire, R, Bonnefoy Cudraz, E, Jobbe Duval, A, Tomasevic, D, Habib, G, Isnard, R, Picard, F, Khanoyan, P, Dubois-Rande, J-L, Galinier, M, Roubille, F, Alexandre, J, Babuty, D, Delarche, N, Berneau, J-B, Girerd, N, Saxena, M, Rosano, G, Yousef, Z, Clifford, C, Arden, C, Bakhai, A, Boos, C, Jenkins, G, Travill, C, Price, D, Koenyves, L, Lakatos, F, Matoltsy, A, Noori, E, Zilahi, Z, Andrassy, P, Kancz, S, Simon, G, Sydo, T, Vorobcsuk, A, Kiss, RG, Toth, K, Szakal, I, Nagy, L, Barany, T, Nagy, A, Szolnoki, E, Chopra, VK, Mandal, S, Rastogi, V, Shah, B, Mullasari, A, Shankar, J, Mehta, V, Oomman, A, Kaul, U, Komarlu, S, Kahali, D, Bhagwat, A, Vijan, V, Ghaisas, NK, Mehta, A, Kashyap, J, Kothari, Y, TaddeI, S, Scherillo, M, Zacà, V, Genovese, S, Salvioni, A, Fucili, A, Fedele, F, Cosmi, F, Volpe, M, Mazzone, C, Esposito, G, Doi, M, Yamamoto, H, Sakagami, S, Oishi, S, Yasaka, Y, Tsuboi, H, Fujino, Y, Matsuoka, S, Watanabe, Y, Himi, T, Ide, T, Ichikawa, M, Kijima, Y, Koga, T, Yuda, S, Fukui, K, Kubota, T, Manita, M, Fujinaga, H, Matsumura, T, Fukumoto, Y, Kato, R, Kawai, Y, Hiasa, G, Kazatani, Y, Mori, M, Ogimoto, A, Inoko, M, Oguri, M, Kinoshita, M, Okuhara, K, Watanabe, N, Ono, Y, Otomo, K, Sato, Y, Matsunaga, T, Takaishi, A, Miyagi, N, Uehara, H, Takaishi, H, Urata, H, Kataoka, T, Matsubara, H, Matsumoto, T, Suzuki, T, Takahashi, N, Imamaki, M, Yoshitama, T, Saito, T, Sekino, H, Furutani, Y, Koda, M, Shinozaki, T, Hirabayashi, K, Tsunoda, R, Yonezawa, K, Hori, H, Yagi, M, Arikawa, M, Hashizume, T, Ishiki, R, Koizumi, T, Nakayama, K, Taguchi, S, Nanasato, M, Yoshida, Y, Tsujiyama, S, Nakamura, T, Oku, K, Shimizu, M, Suwa, M, Momiyama, Y, Sugiyama, H, Kobayashi, K, Inoue, S, Kadokami, T, Maeno, K, Kawamitsu, K, Maruyama, Y, Nakata, A, Shibata, T, Wada, A, Cho, H-J, Na, JO, Yoo, B-S, Choi, J-O, Hong, SK, Shin, J-H, Cho, M-C, Han, SH, Jeong, J-O, Kim, J-J, Kang, SM, Kim, D-S, Kim, MH, Llamas Esperon, G, Illescas Díaz, J, Fajardo Campos, P, Almeida Alvarado, J, Bazzoni Ruiz, A, Echeverri Rico, J, Lopez Alcocer, I, Valle Molina, L, Hernandez Herrera, C, Calvo Vargas, C, Padilla Padilla, FG, Rodriguez Briones, I, Chuquiure Valenzuela, EJJR, Aguilera Real, ME, Carrillo Calvillo, J, Alpizar Salazar, M, Cervantes Escárcega, JL, Velasco Sanchez, R, Al - Windy, N, van Heerebeek, L, Bellersen, L, Brunner-La Rocca, H-P, Post, J, Linssen, GCM, van de Wetering, M, Peters, R, van Stralen, R, Groutars, R, Smits, P, Yilmaz, A, Kok, WEM, Van der Meer, P, Dijkmans, P, Troquay, R, van Alem, AP, Van de Wal, R, Handoko, L, Westendorp, ICD, van Bergen, PFMM, Rensing, BJWM, Hoogslag, P, Kietselaer, B, Kragten, JA, den Hartog, FR, Alings, A, Danilowicz-Szymanowicz, L, Raczak, G, Piesiewicz, W, Zmuda, W, Kus, W, Podolec, P, Musial, W, Drelich, G, Kania, G, Miekus, P, Mazur, S, Janik, A, Spyra, J, Peruga, J, Balsam, P, Krakowiak, B, Szachniewicz, J, Ginel, M, Grzybowski, J, Chrustowski, W, Wojewoda, P, Kalinka, A, Zurakowski, A, Koc, R, Debinski, M, Fil, W, Kujawiak, M, Forys, J, Kasprzak, M, Krol, M, Michalski, P, Mirek-Bryniarska, E, Radwan, K, Skonieczny, G, Stania, K, Skoczylas, G, Madej, A, Jurowiecki, J, Firek, B, Wozakowska-Kaplon, B, Cymerman, K, Neutel, J, Adams, K, Balfour, P, Deswal, A, Djamson, A, Duncan, P, Hong, M, Murray, C, Rinde-Hoffman, D, Woodhouse, S, MacNevin, R, Rama, B, Broome-Webster, C, Kindsvater, S, Abramov, D, Barettella, M, Pinney, S, Herre, J, Cohen, A, Vora, K, Challappa, K, West, S, Baum, S, Cox, J, Jani, S, Karim, A, Akhtar, A, Quintana, O, Paukman, L, Goldberg, R, Bhatti, Z, Budoff, M, Bush, E, Potler, A, Delgado, R, Ellis, B, Dy, J, Fialkow, J, Sangrigoli, R, Ferdinand, K, East, C, Falkowski, S, Donahoe, S, Ebrahimi, R, Kline, G, Harris, B, Khouzam, R, Jaffrani, N, Jarmukli, N, Kazemi, N, Koren, M, Friedman, K, Herzog, W, Silva Enciso, J, Cheung, D, Grover-McKay, M, Hauptman, P, Mikhalkova, D, Hegde, V, Hodsden, J, Khouri, S, McGrew, F, Littlefield, R, Bradley, P, McLaurin, B, Lupovitch, S, Labin, I, Rao, V, Leithe, M, Lesko, M, Lewis, N, Lombardo, D, Mahal, S, Malhotra, V, Dauber, I, Banerjee, A, Needell, J, Miller, G, Paladino, L, Munuswamy, K, Nanna, M, McMillan, E, Mumma, M, Napoli, M, Nelson, W, O'Brien, T, Adlakha, A, Onwuanyi, A, Serota, H, Schmedtje, J, Paraschos, A, Potu, R, Sai-Sudhakar, C, Saltzberg, M, Sauer, A, Shah, P, Skopicki, H, Bui, H, Carr, K, Stevens, G, Tahirkheli, N, Tallaj, J, Yousuf, K, Trichon, B, Welker, J, Tolerico, P, Vest, A, Vivo, R, Wang, X, Abadier, R, Dunlap, S, Weintraub, N, Malik, A, Kotha, P, Zaha, V, Kim, G, Uriel, N, Greene, T, Salacata, A, Arora, R, Gazmuri, R, Kobayashi, J, Iteld, B, Vijayakrishnan, R, Dab, R, Mirza, Z, Marques, V, Nallasivan, M, Bensimhon, D, Peart, B, Saint-Jacques, H, Barringhaus, K, Contreras, J, Gupta, A, Koneru, S, Nguyen, V, Verma, Subodh, Dhingra, Nitish K, Butler, Javed, Anker, Stefan D, Ferreira, Joao Pedro, Filippatos, Gerasimos, Januzzi, James L, Lam, Carolyn S P, Sattar, Naveed, Peil, Barbara, Nordaby, Matias, Brueckmann, Martina, Pocock, Stuart J, Zannad, Faiez, and Packer, Milton

Published
2022
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24. Antibiotic stewardship and microbiological aspects of ventilator-associated pneumonia in patients undergoing cardiac surgery

Author

K Supraja, Thangam Menon, Mullasari Ajit Sankardas, Anusha Rohit, S Sharmila, and S M Subathra

Subjects
cardiac surgery, pneumonia, ventilator, Medicine
Abstract

Purpose: Infections are a serious threat in the postoperative period in cardiac surgical patients. Ventilator-associated pneumonia (VAP) is caused by multidrug-resistant organisms resulting in high mortality. Our aim is to study the prevalence of VAP, the organism associated with it and the appropriate management. Materials and Methods: Three thousand consecutive patients who underwent cardiac surgery were included and followed from admission till discharge. All baseline characteristics and intra- and postoperative details were collected. Data on microbiological sampling were noted. The duration of ventilation and time point at which samples were sent, microbiological growth, its sensitivity, and antibiotics used were analyzed. The reassessment of the need for antibiotics at the end of 48 h of sending culture and switching based on the sensitivity (antibiotic time-out) was also captured. Results: Forty-eight patients had VAP (12.78 per 1000 ventilator days); 38 patients had culture-proven growth. The most common organism in our setting was Klebsiella pneumoniae, Acinetobacter baumannii, and Pseudomonas aeruginosa. The resistance to β-lactams, cephalosporins, and carbapenems was high. Dual and triple antibiotic therapies were noted in 64% of patients. Failure to adhere to antibiotic time-out was associated with mortality in patients when it was adhered and not adhered (27% vs. 74%, respectively) (

Published
2022
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25. Coronary plaque and clinical characteristics of South Asian (Indian) patients with acute coronary syndromes: An optical coherence tomography study

Author

Nakajima, Akihiro, Subban, Vijaykumar, Russo, Michele, Bryniarski, Krzysztof L., Kurihara, Osamu, Araki, Makoto, Minami, Yoshiyasu, Soeda, Tsunenari, Yonetsu, Taishi, Crea, Filippo, Takano, Masamichi, Higuma, Takumi, Kakuta, Tsunekazu, Adriaenssens, Tom, Boeder, Niklas F., Nef, Holger M., Raffel, Owen C., McNulty, Iris, Lee, Hang, Nakamura, Sunao, Abdullakutty, Jabir, Mathew, Rony, Sankardas, Mullasari Ajit, and Jang, Ik-Kyung

Published
2021
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28. AngioNet: a convolutional neural network for vessel segmentation in X-ray angiography

Author

Kritika Iyer, Cyrus P. Najarian, Aya A. Fattah, Christopher J. Arthurs, S. M. Reza Soroushmehr, Vijayakumar Subban, Mullasari A. Sankardas, Raj R. Nadakuditi, Brahmajee K. Nallamothu, and C. Alberto Figueroa

Subjects
Medicine, Science
Abstract

Abstract Coronary Artery Disease (CAD) is commonly diagnosed using X-ray angiography, in which images are taken as radio-opaque dye is flushed through the coronary vessels to visualize the severity of vessel narrowing, or stenosis. Cardiologists typically use visual estimation to approximate the percent diameter reduction of the stenosis, and this directs therapies like stent placement. A fully automatic method to segment the vessels would eliminate potential subjectivity and provide a quantitative and systematic measurement of diameter reduction. Here, we have designed a convolutional neural network, AngioNet, for vessel segmentation in X-ray angiography images. The main innovation in this network is the introduction of an Angiographic Processing Network (APN) which significantly improves segmentation performance on multiple network backbones, with the best performance using Deeplabv3+ (Dice score 0.864, pixel accuracy 0.983, sensitivity 0.918, specificity 0.987). The purpose of the APN is to create an end-to-end pipeline for image pre-processing and segmentation, learning the best possible pre-processing filters to improve segmentation. We have also demonstrated the interchangeability of our network in measuring vessel diameter with Quantitative Coronary Angiography. Our results indicate that AngioNet is a powerful tool for automatic angiographic vessel segmentation that could facilitate systematic anatomical assessment of coronary stenosis in the clinical workflow.

Published
2021
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29. Cyclophilin A induces macrophage apoptosis and enhances atherosclerotic lesions in high‐fat diet‐fed hyperglycemic rabbits

Author

Vinitha Anandan, Santhosh Kumar Thankayyan Retnabai, Abdul Jaleel, Thushara Thulaseedharan, Ajit Mullasari, M. Radhakrishna Pillai, Cheranellore Chandrasekharan Kartha, and Surya Ramachandran

Subjects
atherosclerosis, caspase 3, cyclophilin A, macrophage apoptosis, MPTP, Biology (General), QH301-705.5
Abstract

Abstract Macrophage apoptosis is a key contributor to the progression of atherosclerosis. Cyclophilin A, a monocyte secretory protein associated with the initiation of atherosclerosis has an inherent nuclease activity. This study reports the mechanism by which cyclophilin A causes apoptosis of macrophages and accelerates the progression of atherosclerosis. Aortic lesion formation and apoptosis were studied in New Zealand White rabbits (NZW) which were fed high‐fat diet (HFD) for 12 weeks. Using monocytes and HFD‐fed rabbits we demonstrate that cyclophilin A induces mitochondrial membrane potential loss and mitochondrial pore transition protein opening through caspase 3 activation. En face staining revealed a significant increase in the lesion area in HFD‐fed rabbits. Levels of glucose, cholesterol and proinflammatory cytokines were higher in these animals compared to rabbits fed with a normal diet. In the aorta of HFD‐fed rabbits, medial vascular smooth muscle cells were disorganized and there was a loss of integrity of the endothelium. An 8‐fold increase was seen in the number of apoptotic cells in the lesion area of HFD‐fed NZW rabbits which were associated with an elevation in plasma cyclophilin A levels. siRNA knockdown of cyclophilin A gene reduced activation of caspase 3 in macrophages. Treatment with cyclosporine A, an inhibitor of cyclophilin A, significantly attenuated apoptosis in macrophages. Our study indicates that inhibitors of proinflammatory cytokines such as cyclophilin A may arrest macrophage apoptosis and result in a regression of advanced atherosclerotic lesions.

Published
2021
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30. Impact of the 2017 ACC/AHA guidelines on the prevalence of hypertension among Indian adults: Results from a cross-sectional survey

Author

Shivkumar Rao, J., Singh, B.P., Bharti, B.B., Sinha, A.K., Gupta, Kartik, Ramakrishnan, Sivasubramanian, Bhushan, Sudha, Verma, Sunil K., Bhargava, Balram, Roy, Ambuj, Bansal, Sandeep, Sood, Sanjay, Isser, H.S., Pandit, Neeraj, Nath, Ranjit K., Tyagi, Sanjay, Trehan, Vijay, Gupta, Mohit D., Girish, M.P., Ahuja, Ramandeep, Manchanda, S.C., Mohanty, Arun, Jain, Peeyush, Shrivastava, Sameer, Kalra, I.P.S., Sarang, B.S., Ratti, H.S., Sahib, G. Bala, Gupta, Rakesh, Amit, S K Agarwal, Goswami, K.C., Bahl, V.K., Chopra, H.K., Seth, Ashok, Zachariah, Geevar, Mohanan, P.P., Venugopal, K., Koshy, George, Nair, Tiny, Shyam, N., Roby, Anil, George, Raju, Kumar, Sudhaya, Kader, Abdul, Abraham, Mathew, Viswanathan, Sunitha, Jabir, A., Menon, Jaideep, Unni, Govindan, Mathew, Cibu, Jayagopal, P.B., Sajeev, Ashokan, P.K., Asharaf, Mandal, Subroto, Pancholia, A.K., Bardolei, Neil, Gupta, A.K., Das, Rupam, Aggarwal, Dinesh, Malviya, Amit, Routray, S.N., Mishra, S.S., Ali, Syed Manzor, Barward, Parag, Singh, Navreet, Tomar, Yashbir S., Chaddha, Davinder, Dani, Sameer, Vyas, Chirayu, Bhatt, Kinjal, Doshi, Shrenik, Wander, G.S., Gupta, Satish, Meena, Chandra Bhan, Sateesh, Santosh, Senguttuvan, Nagendra Boopathy, Subramanyam, Geetha, Subramanyam, Muruganandam, Ajit Mullasari, Sethi, Rishi, Narain, Varun, Saran, R.K., Jain, Dharmendra, Jain, Praveen, Kumar, Sudeep, Goel, P.K., Roy, Debabatra, Datta, Sibananda, Ganguly, Kajal, Das, M.K., Kumar, Soumitra, Chandra, Sarat, Banerjee, Amal, Guha, Santanu, Deb, P.K., Rao, J. Shivkumar, Mani, Kalaivani, Kakar, Tanya Singh, Jain, Vardhmaan, Gupta, Prakash, Gupta, Rajeev, Das, Mrinal Kanti, and Deedwania, Prakash

Published
2020
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31. Efficacy and Safety of Ivabradine Once-Daily Prolonged-Release versus Twice-Daily Immediate-Release Formulation in Patients with Stable Chronic Heart Failure with Systolic Dysfunction: A Randomized, Double-Blind, Phase 3 Non-Inferiority (PROFICIENT) Study

Author

Ajit Mullasari and The PROFICIENT investigators

Subjects
Heart failure, Heart rate, Immediate-release, Ivabradine, Once-daily, Prolonged-release systolic dysfunction, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Abstract Introduction Dosing frequency is an important factor influencing medication compliance in patients with heart failure (HF), which in turn is imperative in achieving the desired therapeutic outcome. Here we assessed the efficacy and safety of ivabradine prolonged-release (PR) once-daily (test) vs. ivabradine immediate-release (IR) twice-daily (reference) formulations in patients with stable chronic HF with systolic dysfunction. Methods Patients with sinus rhythm and heart rate (HR) ≥ 50 bpm, left ventricular ejection fraction ≤ 40% (HF with reduced ejection fraction), on guideline-based standard care, receiving a stable dose of ivabradine IR 5/7.5 mg twice daily for ≥ 1 month were enrolled in this randomized, double-blind, phase 3 non-inferiority study. Patients were randomly assigned 1:1 to ivabradine PR (10 mg/15 mg) based on the ivabradine IR dosage or continued ivabradine IR (5 mg/7.5 mg). The primary endpoint was change in resting ECG HR from baseline to the end of 3 months, assessed by 12-lead ECG. Safety assessments and 24-h Holter HR monitoring (in a subgroup of patients) were also performed. Non-inferiority was concluded if the upper limit of the 95% CI of the difference between the test and reference was less than the margin of 6.5 bpm in the per-protocol set. Results A total of 169 out of 180 randomized patients (93.9%) completed the study (PR = 84; IR = 85). The least-square mean (standard error [SE]) for change in HR from baseline to 3 months was 0.76 (1.188; 95% CI −1.59:3.11) in ivabradine PR vs. ivabradine IR, which was within the pre-specified margin of 6.5 bpm, confirming the non-inferiority of ivabradine PR. The change from baseline to 3 months was comparable between the treatment groups for 24-h Holter ECG monitoring (p = 0.3701), mean HR awake (p = 0.3423), and mean HR asleep (p = 0.1501). Thirty-nine treatment-emergent adverse events (TEAEs) were reported; the majority in both groups were of mild or moderate severity and were subsequently resolved. Seven serious adverse events were reported (ivabradine PR = 2; ivabradine IR = 5), of which one was fatal (ivabradine IR group). The bradycardia events reported were comparable between groups. Conclusion Ivabradine PR was found to be non-inferior to ivabradine IR in the management of patients with stable CHF, with a comparable safety profile. Once-daily ivabradine PR effectively maintained the HR in patients shifted from the ivabradine IR twice-daily regimen, and thus may aid in improving treatment compliance. Trial Registration CTRI/2018/04/013464 (Trial Registered Prospectively on 24/04/2018)

Published
2020
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32. Current status and barriers in pulmonary hypertension care delivery in India: A qualitative analysis

Author

Anand Reddy Maligireddy, Supriya Shore, A. Sreenivas Kumar, S. Harikrishnan, S. Ajit Mullasari, B. K. Sastry, Sameer Gupta, Nikhil Choudhary, Auras R. Atreya, Sonali Arora, Victor M. Moles, Vallerie V. Mclaughlin, and Vikas Aggarwal

Subjects
economics, epidemiology, middle‐ and low‐income countries, social factors, Diseases of the circulatory (Cardiovascular) system, RC666-701, Diseases of the respiratory system, RC705-779
Abstract

Abstract Although pulmonary hypertension (PH) is widely prevalent in India, care delivery for this condition has unique challenges in a lower middle‐income country (LMIC). To describe care delivery for patients with PH and associated barriers in India. We interviewed physicians across eight healthcare systems in India about PH clinical care using semi‐structured enquiries to understand care delivery and associated challenges in their specific practice as well as the associated health system. Qualitative analysis was performed using content analysis methodology. Physicians reported that common causes for PH in their practice were rheumatic mitral valve disease, coronary artery disease, and congenital heart disease (CHD). No center had a dedicated PH program. Only one center had a specific protocol for PH management. Diagnostic evaluations were limited, and right heart catheterizations were recommended for patients with CHD. Pulmonary vasodilator therapy was used for severe symptoms or markers of severe disease. Agents used to treat PH were widely variable across physicians and prostacyclins are unavailable in India. Barriers included limited training in PH for physicians, lack of consensus guidelines for PH specific to LMIC, and lack of financial incentives for health care systems to organize dedicated PH programs. Other barriers included poor patient health literacy and socioeconomic barriers that limit ability to test and treat PH. PH care delivery in India is variable with widely differing clinical practices. Dedicated training in PH management and establishing guidelines specific to LMIC like India can form the first step forward.

Published
2022
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33. Cardiological Society of India: Document on acute MI care during COVID-19

Author

Kerkar, P.G., Naik, N., Alexander, T., Bahl, V.K., Chakraborty, R.N., Chatterjee, S.S., Chopra, H.K., Dani, S.I., Deb, P.K., Goswami, K.C., Guha, S., Gupta, R., Gupta, V., Hasija, P.K., Jayagopal, P.B., Justin Paul, G., Kahali, D., Katyal, V.K., Khanna, N.N., Mandal, M., Mishra, S.S., Mohanan, P.P., Mullasari, A., Mehta, S., Pancholia, A.K., Ray, S., Roy, D., Shanmugasundarm, S., Sharma, S., Singh, B.P., Tewari, S., Tyagi, S.K., Venugopal, K.N., Wander, G.S., Yadav, R., and Das, M.K.

Published
2020
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35. Registry for Acute Coronary Events in Nigeria (RACE‐Nigeria): Clinical Characterization, Management, and Outcome

Author

Simeon Isezuo, Mahmoud Umar Sani, Abdullahi Talle, Adeyemi Johnson, Abiodun‐Moshood Adeoye, Mehmet S. Ulgen, Amam Mbakwem, Okechukwu Ogah, Emmanuel Edafe, Philip Kolo, Murtala Nagabea, Rasaaq Adebayo, Eze Nwafor, Folasade Daniel, Muiyawa Zagga, Hayatu Umar, Isa Oboirien, Balarabe A. Sulaiman, Umar Abdullahi, Muhammad Sani Mijinyawa, Farouk Buba, Akinyemi Aje, Henry Okolie, Muhammad Nazir Shehu, Umar Adamu, Akinsanya Olusegun‐Joseph, Ranti Familoni, Nwuriku Chibuzor, Taiwo Olabisi Olunuga, Emmanuel Ejim, Awodun Rasheed Olaide, Dike Ojji, Bushra Sanni, Jane N. Ajuluchukwu, Michael O. Balogun, Ayodele B. Omotoso, Mullasari Ajit, and Ayodele O. Falase

Subjects
acute coronary syndrome, incidence, intervention times, reperfusion mortality, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Background Coronary artery disease was hitherto a rarity in Africa. Acute coronary syndrome (ACS) accounts for coronary artery disease–related morbidity and mortality. Reports on ACS in Africa are few. Methods and Results We enrolled 1072 indigenous Nigerian people 59.2±12.4 years old (men, 66.8%) with ACS in an observational multicentered national registry (2013–2018). Outcome measures included incidence, intervention times, reperfusion rates, and 1‐year mortality. The incidence of ACS was 59.1 people per 100 000 hospitalized adults per year, and comprised ST‐segment–elevation myocardial infarction (48.7%), non–ST‐segment–elevation myocardial infarction (24.5%), and unstable angina (26.8%). ACS frequency peaked 10 years earlier in men than women. Patients were predominantly from urban settings (87.3%). Median time from onset of symptoms to first medical contact (patients with ST‐segment–elevation myocardial infarction) was 6 hours (interquartile range, 20.1 hours), and only 11.9% presented within a 12‐hour time window. Traditional risk factors of coronary artery disease were observed. The coronary angiography rate was 42.4%. Reperfusion therapies included thrombolysis (17.1%), percutaneous coronary intervention (28.6%), and coronary artery bypass graft (11.2%). Guideline‐based pharmacotherapy was adequate. Major adverse cardiac events were 30.8%, and in‐hospital mortality was 8.1%. Mortality rates at 30 days, 3 months, 6 months, and 1 year were 8.7%, 9.9%, 10.9%, and 13.3%, respectively. Predictors of mortality included resuscitated cardiac arrest (odds ratio [OR], 50.0; 95% CI, 0.010–0.081), nonreperfusion (OR, 34.5; 95% CI, 0.004–0.221), pulmonary edema (OR, 11.1; 95% CI, 0.020–0.363), left ventricular diastolic dysfunction (OR, 4.1; 95% CI, 0.091–0.570), and left ventricular systolic dysfunction (OR, 2.1; 95% CI, 1.302–3.367). Conclusions ACS burden is rising in Nigeria, and patients are relatively young and from an urban setting. The system of care is evolving and is characterized by lack of capacity and low patient eligibility for reperfusion. We recommend preventive strategies and health care infrastructure‐appropriate management guidelines.

Published
2022
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37. Prevalence of hypertension among Indian adults: Results from the great India blood pressure survey

Author

Shivkumar Rao, J., Singh, B.P., Bharti, B.B., Sinha, A.K., Gupta, Kartik, Ramakrishnan, Sivasubramanian, Bhushan, Sudha, Verma, Sunil K., Bhargava, Balram, Roy, Ambuj, Bansal, Sandeep, Sood, Sanjay, Isser, H.S., Pandit, Neeraj, Nath, Ranjit K., Tyagi, Sanjay, Trehan, Vijay, Gupta, Mohit D., Girish, M.P., Ahuja, Ramandeep, Manchanda, S.C., Mohanty, Arun, Jain, Peeyush, Shrivastava, Sameer, Kalra, I.P.S., Sarang, B.S., Ratti, H.S., Sahib, G. Bala, Gupta, Rakesh, Agarwal, S.K., Amit, Goswami, K.C., Bahl, V.K., Chopra, H.K., Seth, Ashok, Zachariah, Geevar, Mohanan, P.P., Venugopal, K., Koshy, George, Nair, Tiny, Shyam, N., Roby, Anil, George, Raju, Kumar, Sudhaya, Kader, Abdul, Abraham, Mathew, Viswanathan, Sunitha, Jabir, A., Menon, Jaideep, Unni, Govindan, Mathew, Cibu, Sajeev, PB Jayagopal, Ashokan, P.K., Asharaf, Mandal, Subroto, Pancholia, A.K., Bardolei, Neil, Gupta, A.K., Das, Rupam, Aggarwal, Dinesh, Malviya, Amit, Routray, S.N., Mishra, S.S., Ali, Syed Manzor, Barward, Parag, Singh, Navreet, Tomar, Yashbir S., Chaddha, Davinder, Dani, Sameer, Vyas, Chirayu, Bhatt, Kinjal, Doshi, Shrenik, Wander, G.S., Gupta, Satish, Meena, Chandra Bhan, Sateesh, Santosh, Senguttuvan, Nagendra Boopathy, Subramanyam, Geetha Subramanyam, Muruganandam, Ajit Mullasari, Sethi, Rishi, Narain, Varun, Saran, R.K., Jain, Dharmendra, Jain, Praveen, Kumar, Sudeep, Goel, P.K., Roy, Debabatra, Datta, Sibananda, Ganguly, Kajal, Das, M.K., Kumar, Soumitra, Banerjee, Sarat Chandra Amal, Guha, Santanu, Deb, P.K., Mani, Kalaivani, Kakar, Tanya Singh, Kidambi, Bharathraj, Kothari, Shyam S., Gupta, Rajeev, Subramanyam, Geetha, Das, Mrinal K., Chandra, Sarat, Banerjee, Amal, and Deedwania, Prakash

Published
2019
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39. Percutaneous coronary intervention for coronary allograft vasculopathy with drug-eluting stent in Indian subcontinent: Issues in diagnosis and management

Author

Mohammed Shakawat Alam, Arvind Sahadev Singh, Sreeja Pavithran, Vijayakumar Subban, Ajit Mullasari, and Kothandam Sivakumar

Subjects
acute coronary syndrome, coronary allograft vasculopathy, drug-eluting stent, heart transplantation, pediatric cardiology, stent angioplasty, Medicine, Pediatrics, RJ1-570, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Coronary allograft vasculopathy fails to give a warning anginal pain due to denervation and often presents with acute coronary syndrome, ventricular dysfunction, or sudden cardiac death. Early diagnosis in a pediatric patient is difficult as it involves invasive coronary angiography or advanced imaging such as intravascular ultrasound or optical coherence tomography. A 12-year-old boy developed acute coronary syndrome, elevated troponins, and right bundle branch block, 5 years after cardiac transplantation and was treated with culprit-vessel angioplasty with a drug-eluting stent. Advanced imaging showed the involvement of nonculprit vessels too. In a detailed literature search, we failed to identify a similar clinical presentation and management in the subcontinent, hence our interest in publishing this report for educational value. Issues in diagnosis, management, prognosis, and prevention are discussed.

Published
2020
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40. Design and rationale of the Management of High Bleeding Risk Patients Post Bioresorbable Polymer Coated Stent Implantation With an Abbreviated Versus Standard DAPT Regimen (MASTER DAPT) Study

Author

Frigoli, Enrico, Smits, Pieter, Vranckx, Pascal, Ozaki, Yokio, Tijssen, Jan, Jüni, Peter, Morice, Marie-Claude, Onuma, Yoshinobu, Windecker, Stephan, Frenk, Andrè, Spaulding, Christian, Chevalier, Bernard, Barbato, Emanuele, Tonino, Pim, Hildick-Smith, David, Roffi, Marco, Kornowski, Ran, Schultz, Carl, Lesiak, Maciej, Iñiguez, Andrés, Colombo, Antonio, Alasnag, Mirvat, Mullasari, Ajit, James, Stefan, Stankovic, Goran, Ong, Paul J.L, Rodriguez, Alfredo E, Mahfoud, Felix, Bartunek, Jozef, Moschovitis, Aris, Laanmets, Peep, Leonardi, Sergio, Heg, Dik, Sunnåker, Mikael, and Valgimigli, Marco

Published
2019
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44. Predictors of short-term outcomes in patients undergoing percutaneous coronary intervention in cardiogenic shock complicating STEMI—A tertiary care center experience

Author

Raja, Deep Chandh, Chopra, Aashish, Subban, Vijayakumar, Maharajan, Rashmi, Anandhan, Harini, Vasu, Nandhakumar, Farook, Jawahar, Paramasivam, Ramachandran, Narayanan, Srinivasan, Uthayakumaran, Kalaichelvan, Pakshirajan, Balaji, Victor, Suma, Solirajaram, Ramkumar, Krishnamoorthy, Jaishankar, Janakiraman, Ezhilan, Pandurangi, Ulhas M., Kalidoss, Latchumanadhas, and Mullasari, Ajit Sankaradas

Published
2018
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45. Transradial access for coronary diagnostic and interventional procedures: Consensus statement and recommendations for India: Advancing Complex CoronariES Sciences through TransRADIAL intervention in India – ACCESS RADIAL™: Clinical consensus recommendations in collaboration with Cardiological Society of India (CSI)

Author

Goel, Pravin K., Menon, Ajit, Mullasari, Ajit Sankardas, Valaparambil, Ajit Kumar, Pinto, Brian, Pahlajani, Dev, Gunasekaran, Sengottuvelu, Trehan, Vijay Kumar, Abhaichand, Rajpal K., Chugh, Sanjay Kumar, and Hiremath, M.S.

Published
2018
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47. Comparison of Reperfusion Strategies for ST‐Segment–Elevation Myocardial Infarction: A Multivariate Network Meta‐analysis

Author

Reza Fazel, Timothy I. Joseph, Mullasari A. Sankardas, Duane S. Pinto, Robert W. Yeh, Dharam J. Kumbhani, and Brahmajee K. Nallamothu

Subjects
facilitated percutaneous coronary intervention, fibrinolytic therapy, pharmacoinvasive approach, primary percutaneous coronary intervention, ST‐segment–elevation myocardial infarction, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Background We systematically reviewed trials comparing different reperfusion strategies for ST‐segment–elevation myocardial infarction and used multivariate network meta‐analysis to compare outcomes across these strategies. Methods and Results We identified 31 contemporary trials in which patients with ST‐segment–elevation myocardial infarction were randomized to ≥2 of the following strategies: fibrinolytic therapy (n=4212), primary percutaneous coronary intervention (PCI) (n=6139), or fibrinolysis followed by routine early PCI (n=5006). We categorized the last approach as “facilitated PCI” when the median time interval between fibrinolysis to PCI was

Published
2020
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48. Successful transcatheter aortic valve replacement in a kidney allograft patient on rapamycin

Author

Aashish Chopra, Vijayakumar Subban, Ravinder Singh Rao, Mullasari Ajit, and Georgi Abraham

Subjects
aortic valve stenosis, kidney transplantation, rapamycin, transcatheter aortic valve replacement, Surgery, RD1-811
Abstract

Aortic valvular stenosis producing hemodynamic compromise is a major determinant of allograft function in kidney transplant recipients. Here, we describe successful transcatheter aortic valve replacement in a 59-year-old patient who had a kidney transplantation 14 years ago on 3 drug maintenance immunosuppression, including rapamycin.

Published
2019
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