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   2017| January-March  | Volume 18 | Issue 1  
    Online since May 15, 2017

 
 
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ORIGINAL ARTICLES
Outcomes of Middle Eastern patients undergoing percutaneous coronary intervention: The primary analysis of the First Jordanian PCI Registry
Imad A Alhaddad, Ramzi Tabbalat, Yousef Khader, Eyas Al-Mousa, Mahmoud Izraiq, Assem Nammas, Mohammad Jarrah, Akram Saleh, Ayman Hammoudeh, On behalf of the First Jordanian PCI Registry Investigators Group
January-March 2017, 18(1):3-7
DOI:10.4103/1995-705X.206206  PMID:28584584
Aim: This is a prospective multicenter registry designed to evaluate the incidence of adverse cardiovascular events in Middle Eastern patients undergoing percutaneous coronary interventions (PCI). The registry was also designed to determine the predictors of poor outcomes in such patients. Methods and Results: We enrolled 2426 consecutive patients who underwent PCI at 12 tertiary care centers in Jordan between January 2013 and February 2014. A case report form was used to record data prospectively at hospital admission, discharge, and 12 months of follow-up. Mean age was 56 ± 11 years, females comprised 21% of the study patients, 62% had hypertension, 53% were diabetics, and 57% were cigarette smokers. Most patients (77%) underwent PCI for acute coronary syndrome. In-hospital and 1-year mortality rates were 0.78% and 1.94%, respectively. Definite or probable stent thrombosis occurred in 9 patients (0.37%) during hospitalization and in 47 (1.94%) at 1 year. Rates of target vessel repeat PCI and coronary artery bypass graft surgery at 1 year were 3.4% and 0.6%, respectively. The multivariate analysis revealed that cardiogenic shock, congestive heart failure, ST-segment deviation, diabetes, and major bleeding were significantly associated with higher risk of 1-year mortality. Conclusions: In this first large Jordanian registry of Middle Eastern patients undergoing PCI, patients treated were relatively young age population with low in-hospital and 1-year adverse cardiovascular events. Certain clinical features were associated with worse outcomes and may warrant aggressive therapeutic strategies.
  1,299 70 -
An audit on the appropriateness of coronary computed tomography angiography referrals in a tertiary cardiac center
Ahmed Ali Alderazi, Mary Lynch
January-March 2017, 18(1):8-12
DOI:10.4103/1995-705X.206203  PMID:28584585
Background: In response to growing concerns regarding the overuse of coronary computed tomography angiography (CCTA) in the clinical setting, multiple societies, including the American College of Cardiology Foundation, have jointly published revised criteria regarding the appropriate use of this imaging modality. However, previous research indicates significant discrepancies in the rate of adherence to these guidelines. Aim: To assess the appropriateness of CCTA referrals in a tertiary cardiac center in Bahrain. Methods: This retrospective clinical audit examined the records of patients referred to CCTA between the April 1, 2015 and December 31, 2015 in Mohammed bin Khalifa Cardiac Center. Using information from medical records, each case was meticulously audited against guidelines to categorize it as appropriate, inappropriate, or uncertain. Results: Of the 234 records examined, 176 (75.2%) were appropriate, 47 (20.1%) were uncertain, and 11 (4.7%) were inappropriate. About 74.4% of all referrals were to investigate coronary artery disease (CAD). The most common indication that was deemed appropriate was the detection of CAD in the setting of suspected ischemic equivalent in patients with an intermediate pretest probability of CAD (65.9%). Most referrals deemed inappropriate were requested to detect CAD in asymptomatic patients at low or intermediate risk of CAD (63.6%). Conclusion: This audit demonstrates a relatively low rate of inappropriate CCTA referrals, indicating the appropriate and efficient use of this resource in the Mohammed bin Khalifa Cardiac Center. Agreement on and reclassification of “uncertain” cases by guideline authorities would facilitate a deeper understanding of referral appropriateness.
  1,138 54 -
CASE REPORTS
Computerized tomography use in Williams–Beuren syndrome aortopathy
Neale Nicola Kalis, Leena Khalifa Sulaibikh, Saud Rashid Al Amer, Haya Yousif Al Amer
January-March 2017, 18(1):21-25
DOI:10.4103/1995-705X.206205  PMID:28584589
Williams–Beuren syndrome is a multisystem genetic disorder caused by hemizygous deletion on chromosome 7q11.23, encompassing about 28 genes including the elastin gene, ELN. Cardiovascular abnormalities are frequent and are related to elastin insufficiency. These abnormalities include supravalvular aortic stenosis (SVAS) in 70% of case, pulmonic valve stenosis, and renal artery stenosis. Definitive therapy for supravalvar aortic stenosis consists of surgical correction of the arteriopathies. Outcomes after surgical correction of SVAS depend on the extent of the arteriopathy and the presence of other associated lesions. We present a case of a 4-year-old boy, with Williams - Beuren syndrome with an SVAS. The patient was assessed with computerized tomography angiography to determine the extent of the aortopathy before surgical intervention.
  1,132 41 -
HISTORY OF MEDICINE
Diabetes as “coronary artery disease risk equivalent”: A historical perspective
Rachel Hajar
January-March 2017, 18(1):34-37
DOI:10.4103/HEARTVIEWS.HEARTVIEWS_37_17  PMID:28584593
  1,062 109 1
CASE REPORTS
Anomalous left-sided superior vena cava with cephalad flow
Gautam V Ramani, Christopher Deible, Angel López-Candales
January-March 2017, 18(1):15-17
DOI:10.4103/1995-705X.206199  PMID:28584587
The case of a 24-year-old male with complaints of migraine headaches was referred for echocardiography. The rest of medical history was unremarkable. Agitated saline contrast bubble study showed evidence of a right to left intracardiac shunt, probably secondary to a patent foramen ovale. Results of a transesophageal echocardiogram suggested the possibility of an anomalous venous circulation and eventually identified as anomalous left-sided superior vena cava with cardiac magnetic resonance imaging.
  1,103 45 -
External compression of epicardial coronary arteries with partial calcific pericarditis
Zubair Ahmed Khan, Muhammad Rizwan Sardar, Simon K Topalian
January-March 2017, 18(1):26-29
DOI:10.4103/1995-705X.206207  PMID:28584590
Calcific pericarditis (CP) is a rare disease which results from long-standing pericardial inflammation. Pericardial calcification may completely or partially encase the ventricles, resulting in impaired diastolic filling. We present a case of a 53-year-old male who was incidentally found to have annular CP resulting in external compression of a large territory diagonal branch (D1) reaching the apex with likely chronically occluded left anterior descending artery with collateral circulation from the right coronary artery with hemodynamic compromise on coronary angiography. This was emergently treated with a drug-eluting stent with improved D1 flow and entailed the importance of percutaneous coronary intervention as a viable option in cases of CP resulting in acute hemodynamic compromise.
  1,032 40 -
CARDIOVASCULAR NEWS
Cardiovascular news

January-March 2017, 18(1):1-2
DOI:10.4103/1995-705X.206208  PMID:28584583
  1,026 42 -
A PICTURE IS WORTH A THOUSAND WORDS
A case of left ventricular false tendon with ventricular tachycardia
Vijaykumar Janakaloti Ramachandra Reddy, Amjad Ali, Cholenahally Nanjappa Manjunath
January-March 2017, 18(1):30-31
DOI:10.4103/1995-705X.206202  PMID:28584591
  979 43 1
CASE REPORTS
Myocardial cleft in a patient with acute coronary syndrome assessed by multimodal imaging
Natalia Lorenzo, Ana Ma Rodriguez, Sonia Bartolomé, Rosa González
January-March 2017, 18(1):18-20
DOI:10.4103/1995-705X.206204  PMID:28584588
Myocardial clefts are rare incidental findings without clinical relevance up to now. The recognition of this imaging entity is of crucial importance to avoid misdiagnosis and even more in the context of coronary artery disease.
  951 48 -
CORRESPONDENCE
Prevalence of rheumatic heart disease
Özben Ceylan, Derya Aydın Sahin
January-March 2017, 18(1):38-38
DOI:10.4103/HEARTVIEWS.HEARTVIEWS_3_17  PMID:28584594
  835 73 -
ERRATUM
Erratum in: Rheumatic fever and rheumatic heart disease a historical perspective

January-March 2017, 18(1):39-39
DOI:10.4103/1995-705X.206209  PMID:28584595
  779 58 -
EDITORIAL
The importance of the First Jordanian Percutaneous Coronary Intervention Registry
Jassim Al-Suwaidi
January-March 2017, 18(1):13-14
DOI:10.4103/HEARTVIEWS.HEARTVIEWS_29_17  PMID:28584586
  787 40 -
ART AND MEDICINE
The power of expectation and belief
Rachel Hajar
January-March 2017, 18(1):32-33
DOI:10.4103/HEARTVIEWS.HEARTVIEWS_38_17  PMID:28584592
  748 48 -
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