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1. Impact of COVID-19 on heart failure hospitalization and outcome in India – A cardiological society of India study (CSI–HF in COVID 19 times study – 'The COVID C–HF study')

Author

Jayagopal P. B, Ramakrishnan S, Mohanan P. P, Jabir A, Venugopal K, M.K. Das, Santhosh K, Syam N, J. Ezhilan, Rajeev Agarwal, Vaidyanathan P R, Ahmed Hussain Choudhary, Meena C B, Amit Malviya, Arun Gopi, Chopra V K, Stigi Joseph, Krishna Kishore Goyal, John F. John, Sandeep Bansal, Harikrishnan S, Praveen Nagula, Johny Joseph, Ajit Bagawat, Sandeep Seth, Urmil Shah, Pravin K. Goel, P.K. Asokan, K.K. Sethi, Satyavan Sharma, (Lt.Gen)Anup Banerji, Sunandan Sikdar, ManojKumar Agarwala, Sharad Chandra, BishwaBhushan Bharti, S.M. Ashraf, Smit Srivastava, B. Kesavamoorthy, Harinder Kumar Bali, Dipak Sarma, Rajendra Kumar Jain, Sameer I. Dani, B.H. Natesh, Rabindra Nath Chakraborty, Vivek Gupta, Narendra Nath Khanna, Dipankar Mukhopadhyay, Subroto Mandal, Biswajit Majumder, Sridhar L, Meennahalli Palleda Girish, DipakRanjan Das, Tom Devasia, Bhavesh Vajifdar, Tanuj Bhatia, Zia Abdullah, Sanjeev Sharma, Sudeep Kumar, Mathew Lincy, Nitish Naik, Dhiman Kahali, Dhurjati Prasad Sinha, Dipankar Ghosh Dastidar, Gurpreet Sing Wander, Rakesh Yadav, Satyendra Tewari, Suman Bhandari, Pratap Chandra Rath, Vijay Harikisan Bang, Debabrata Roy, ParthoSarathi Banerjee, S. Shanmugasundaram, and Geevar Zachariah

Subjects
COVID-19, Acute heart failure, Acute decompensated heart failure, GDMT in heart failure, Surgery, RD1-811, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Objectives: The presentation and outcomes of acute decompensated heart failure (ADHF) during COVID times (June 2020 to Dec 2020) were compared with the historical control during the same period in 2019. Methods: Data of 4806 consecutive patients of acute HF admitted in 22 centres in the country were collected during this period. The admission patterns, aetiology, outcomes, prescription of guideline-directed medical therapy (GDMT) and interventions were analysed in this retrospective study. Results: Admissions for acute heart failure during the pandemic period in 2020 decreased by 20% compared to the corresponding six-month period in 2019, with numbers dropping from 2675 to 2131. However, no difference in the epidemiology was seen. The mean age of presentation in 2019 was 61.75 (±13.7) years, and 59.97 (±14.6) years in 2020. There was a significant decrease in the mean age of presentation (p = 0.001). Also. the proportion of male patients decreased significantly from 68.67% to 65.84% (p = 0.037). The in-hospital mortality for acute heart failure did not differ significantly between 2019 and 2020 (4.19% and 4.,97%) respectively (p = 0.19). The proportion of patients with HFrEF did not change in 2020 compared to 2019 (76.82% vs 75.74%, respectively). The average duration of hospital stay was 6.5 days. Conclusion: The outcomes of ADHF patients admitted during the Covid pandemic did not differ significantly. The length of hospital stay remained the same. The study highlighted the sub-optimal use of GDMT, though slightly improving over the last few years.

Published
2023
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2. Prevalence of hypertension among Indian adults: Results from the great India blood pressure survey

Author

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

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

Objective: Hypertension is the most important risk factor for cardiovascular morbidity and mortality. There is limited data on hypertension prevalence in India. This study was conducted to estimate the prevalence of hypertension among Indian adults. Methods: A national level survey was conducted with fixed one-day blood pressure measurement camps across 24 states and union territories of India. Hypertension was defined as systolic blood pressure (BP) ≥140 mmHg or a diastolic BP ≥90 mmHg or on treatment for hypertension. The prevalence was age- and gender-standardized according to the 2011 census population of India. Results: Blood pressure was recorded for 180,335 participants (33.2% women; mean age 40.6 ± 14.9 years). Among them, 8,898 (4.9%), 99,791 (55.3%), 35,694 (11.9%), 23,084 (12.8%), 9,989 (5.5%), and 2,878 (1.6%) participants were of the age group 18–19, 20–44, 45–54, 55–64, 65–74, and ≥ 75 years, respectively. Overall prevalence of hypertension was 30.7% (95% confidence interval [CI]: 30.5, 30.9) and the prevalence among women was 23.7% (95% CI: 23.3, 24). Prevalence adjusted for 2011 census population and the WHO reference population was 29.7% and 32.8%, respectively. Conclusion: There is a high prevalence of hypertension, with almost one in every three Indian adult affected. Keywords: Hypertension, India, Prevalence

Published
2019
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3. Impact of the 2017 ACC/AHA guidelines on the prevalence of hypertension among Indian adults: Results from a cross-sectional survey

Author

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

Subjects
2017 ACC/AHA blood Pressure guideline, Prevalence, Hypertension, India, Health policy, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Background: The impact of the 2017 American College of Cardiology (ACC)/American Heart Association (AHA) guidelines for diagnosis and management of hypertension on the prevalence of hypertension in India is unknown. Methods: We analyzed data from the Cardiac Prevent 2015 survey to estimate the change in the prevalence of hypertension. The JNC8 guidelines defined hypertension as a systolic blood pressure of ≥140 ​mmHg or diastolic blood pressure of ≥90 ​mmHg. The 2017 ACC/AHA guidelines define hypertension as a systolic blood pressure of ≥130 ​mmHg or diastolic blood pressure of ≥80 ​mmHg. We standardized the prevalence as per the 2011 census population of India. We also calculated the prevalence as per the World Health Organization (WHO) World Standard Population (2000–2025). Results: Among 180,335 participants (33.2% women), the mean age was 40.6 ​± ​14.9 years (41.1 ​± ​15.0 and 39.7 ​± ​14.7 years in men and women, respectively). Among them, 8,898 (4.9%), 99,791 (55.3%), 35,694 (11.9%), 23,084 (12.8%), 9,989 (5.5%) and 2,878 (1.6%) participants belonged to age group 18–19, 20–44, 45–54, 55–64, 65–74 and ​≥ ​75 years respectively. The prevalence of hypertension according to the JNC8 and 2017 ACC/AHA guidelines was 29.7% and 63.8%, respectively- an increase of 115%. With the 2011 census population of India, this suggests that currently, 486 million Indian adults have hypertension according to the 2017 ACC/AHA guidelines, an addition of 260 million as compared to the JNC8 guidelines. Conclusion: According to the 2017 ACC/AHA guidelines, 3 in every 5 Indian adults have hypertension.

Published
2020
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4. Clinical characteristics and 30-day outcomes in patients with acute decompensated heart failure: Results from Indian College of Cardiology National Heart Failure Registry (ICCNHFR)

Author

P B, Jayagopal, Sridhar L, Sastry, Veena, Nanjappa, Jabir, Abdullakutty, Johny, Joseph, P R, Vaidyanathan, Nitin, Kabra, P, Manokar, Soma Sekhar, Ghanta, Vinod, Sharma, Trinath Kumar, Mishra, Narendra, Jathappa, Vikas, Singh, S N, Routray, Subroto, Mandal, Neeraj, Bhalla, Prabhakar, Dorairaj, Nihar, Mehta, Dayanand, Kumbla, Abhijit Ramdas, Rane, Tapan Kumar, Matia, Dharmendra, Jain, Gautam, Rege, Sunil, Modi, V K, Chopra, P P, Mohanan, A, Geevar Zachariah, K S, Ravindranath, Rabin, Chakraborty, B C, Srinivas, T R, Raghu, and C N, Manjunath

Subjects
Heart Failure, Male, Creatinine, Acute Disease, Cardiology, Humans, Female, Stroke Volume, Registries, Middle Aged, Cardiology and Cardiovascular Medicine, Aged
Abstract

Acute decompensated heart failure (ADHF) is a challenging medical emergency with high mortality and its prevalence is increasing in India. There is paucity of data on ADHF in the country.Indian College of Cardiology National Heart Failure Registry (ICCNHFR) is an on-going observational registry on ADHF contributed by 22 hospitals across India; and we present the in-hospital and 30-day outcomes of ADHF patients enrolled from August 2018 to July 2019. Major objective included capturing demographics, comorbid conditions, aetiology, prescription patterns and assessing clinical outcomes.Of 5269 patients (mean age: 61.90 ± 13.85 years) enrolled in this study, males were predominant (67.09%). Mean duration of hospitalization was 5.74 ± 4.74 days. Ischemic heart disease was the most common (75.44%) aetiology. Abnormal electrocardiogram readings were found in most patients (89.86%). LVEF of ˂40% was found in 68.29% of patients. In-hospital mortality rates were 6.98%. The 30-day cumulative mortality was 12.35% and 30-day rehospitalization rate was 7.98%. At discharge, all guideline-based medical therapy (GDMT) were prescribed only to 24.99% of patients and 23.72% adhered to the prescription until 30 days. Older age, high serum creatinine levels and poor LVEF contributed to high mortality and rehospitalization.Patients with ADHF were younger and predominantly males. Usage of GDMT in ADHF patients was low (24.99%) and the in-hospital mortality was high. Older age, high serum creatinine levels, poor LVEF contributed for 30-day mortality and rehospitalization. This data on ADHF, could help in developing strategies to improve outcomes for HF patients in India.

Published
2022

6. Endophthalmitis

Author

Pradeep Venkatesh, Satpal Garg, and Subroto Mandal

Subjects
Orthodontics, Materials science, Stability (learning theory)
Published
2007

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