Prashanth Kulkarni ¹, Prabhu Halkati ¹, Suresh Patted ¹, Sameer Ambar ¹, Ameet Sattur ¹, S. T Yavagal ¹

Affiliations
1 Department of Cardiology, KLE University's J.N. Medical College, Belgaum-590010, Karnataka, IN

Abstract

Over the last decade, cardiovascular disease especially coronary heart disease has become the largest cause of death worldwide. This study was taken to determine the effects of parental consanguinity on the coronary artery disease (CAD) risk in the progeny. Over a period of one year from April 2010 to March 2011, 1000 patients of CAD who underwent cardiac catheterization were included in the study. Among these patients the presence of parental consanguinity and family history of CAD was noted and their impact on CAD risk was determined, controlling for diabetes mellitus, hyperlipidemia, hypertension and smoking. Parental consanguinity was present in 1.5 % (15 patients) of the total CAD patients studied. 1% (10 patients) had both parental consanguinity and family history of CAD. While consanguinity did not promote risk of CAD, but along with family history of CAD it did affect age of disease diagnosis. When both consanguinity and family history of CAD were considered as risk factors for CAD, the mean age of at CAD diagnosis was 51.2 years, compared to 62.2 years for the no-risk factor patient category. Parental consanguinity and family history of CAD is an additional risk factor and lowers the age of diagnosis for CAD. Given the extremely high prevalence of premature CAD in South Asian population, an investigation of recessive genes as predisposing factors for CAD would appear to be warranted.

Keywords

Coronary Heart Disease, Consanguinity

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Amit Joshi ¹, S. V. Patted ¹, P. C. Halkati ¹, Sameer Ambar ¹

Affiliations
1 KLES Dr. Prabhakar Kore Hospital & MRC, Department of Cardiology, Jawaharlal Nehru Medical College, Nehru Nagar, Belgaum – 590 010, Karnataka, IN

Abstract

Background and Objectives: Intra-Aortic Balloon Pump (IABP) is device developed to augment coronary blood flow and improve systemic blood pressure in patients with circulatory failure. This study was undertaken to analyze morbidity and mortality benefit of IABP counterpulsation in patients with Acute Myocardial Infarction (AMI) Methodology: This cross-sectional study done for three years in the Department of Cardiology of a tertiary care centre in North Karnataka from June 2009 to June 2012. Prior to the commencement of the study, ethical clearance was obtained from Human Ethics Committee. A total of 82 consecutive patients presenting with cardiogenic shock were included in the study. The patients satisfying selection criteria were informed in detail about the nature of the study and a written informed consent was obtained. The patients underwent electrocardiography and echocardiography. Based on the findings the indication for IABP was determined. Results: Majority of the patients were males (85.4%) and the commonest age group was 51 to 60 years (40.2%) with the mean age of 57.73 ± 9.41 years. Most common Electrocardiogram (ECG) presentation was Anterior Wall Myocardial Infarction (AWMI) (40.2%). The commonest indication for placement of an IABP was Left Ventricular (LV) dysfunction (47.6%) and mean duration of IABP was 4 ± 1 days. Diagnostic catheterization was performed in 55 (67.1%) patients. Among them, 40 (72.7%) underwent Percutaneous Transluminal Coronary Angioplasty (PTCA) and 15 (27.3%) underwent surgery. Of the 82 patients, major IABP related complications occurred in six (7.3%) patients. The in-hospital mortality rate was 43.9% and 56.1% of the patients improved. Of the 46 patients who improved, majority (78.2%) had undergone revascularization while of the 27 patients who expired, 47.2% did not had revascularization (p=0.015). The outcome in patients who had undergone either PTCA or surgery was significantly favourable resulting in improvement (p<0.050). Conclusion and Interpretation: IABP counterpulsation can be successfully employed for a wide variety of conditions in the AMI setting, providing significant haemodynamic support with rare major complications in a high-risk patient population.

Keywords

Acute Myocardial Infarction, Haemodynamic Support, Intra-aortic Balloon Pump, ST Elevation Myocardial Infarction

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