Publications by authors named "Kanwal Fatima Aamir"

5 Publications

  • Page 1 of 1

Angiographic profile and outcomes of Pakistani women with ST elevation myocardial infarction.

J Pak Med Assoc 2021 02;71(2(A)):484-488

Department of Cardiology, National Institute of Cardiovascular Diseases (NICVD), Karachi, Pakistan.

Objective: To evaluate the angiographic profile and outcome of primary percutaneous coronary intervention in female patients with acute myocardial infarction.

Methods: The cross-sectional study was conducted at the National Institute of Cardiovascular Diseases, Karachi, from July 1, 2017, to March 31, 2018, and comprised of female patients presenting with acute myocardial infarction who underwent primary percutaneous coronary intervention and got enrolled in the National Cardiovascular Data Registry. Follow-up calls were made 1 year post-intervention and outcomes were noted. Data were analysed using SPSS 21.

Results: Of the 522 female patients with a mean age of 57.41±11.14 years, 334(64%) were hypertensive, 202(38.7%) diabetic, 16(3.1%) had a family history of coronary artery disease, and 9(1.7%) were smokers. Single-vessel disease was observed in 183(35.1%) patients, and three-vessel disease in 144(27.6%). Post-procedure thrombolysis in myocardial infarction flow (0-II) was observed in 29(5.6%) patients, bleeding in 2(0.4%), and in-hospital mortality was in 22(4.2%). Telephonic follow-up was successfully conducted in 436(87.5%) of the discharged patients, and, of them 15(3.4%) had expired and recurrence was reported by 10(2.3%) patients and 8(80%) of them underwent re-intervention.

Conclusions: More than half the female patients had multi-vessel disease and bifurcation lesion was observed in more than three-fourth of the sample.
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February 2021

Clinical and procedural predictors and short-term survival of the patients with no reflow phenomenon after primary percutaneous coronary intervention.

Int J Cardiol 2019 11 23;294:27-31. Epub 2019 Jul 23.

National Institute of Cardiovascular Diseases (NICVD), Rafiqui (H.J.) Shaheed Road, Karachi 75510, Pakistan.

Objectives: In the present study, we analysed the incidence of no-reflow phenomenon, its clinical and procedural predictors, and associated in-hospital outcomes for the patients undergoing primary percutaneous coronary intervention (PCI).

Background: No-reflow phenomenon after primary PCI is a procedural complication associated with adverse post-procedure outcomes.

Methods: Data for this study were extracted from global registry, NCDR®, the site of National Institute of Cardiovascular Disease (NICVD), Karachi from July 2017 to March 2018. The demographic, clinical, and procedural characteristics, and in-hospital outcomes were analysed for the patients with and without no-reflow after primary PCI.

Results: Of total of 3255 patients, no-reflow phenomenon was found in 132 (4.1%) patients and it was associated with significantly higher in-hospitality mortality (6.8% vs. 2.9%; p = 0.01), cerebrovascular accident (1.5% vs. 0%; p < 0.001), post procedure bleeding (2.3% vs. 0.5%; p = 0.009), and cardiogenic shock (3.8% vs. 1.2%; p = 0.011). The multivariate analysis showed advanced age [odds ratio = 1.63, 95% confidence interval 1.09-2.44, p = 0.018], diabetes [1.66, 1.14-2.42, p = 0.009], prior history of CABG [8.70, 1.45-52.04, p = 0.018], low pre-procedure TIMI flow grade [2.04, 1.3-3.21, p = 0.002], longer length of target lesion [1.51, 1.06-2.16, p = 0.023], and 10 fold raised troponin I [1.55, 1.08-2.23, p = 0.018] were the independent predictors of no-reflow.

Conclusions: In this selected group of patients, the no-reflow phenomenon after primary percutaneous coronary intervention is not that uncommon. It is associated with an increased risk of adverse post-procedure hospital course including mortality. Pathophysiology of the no-reflow phenomenon is complex and opaque, however, it can be predicted based on certain clinical and procedural characteristics.
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November 2019

Measurement of interatrial septal thickness by echocardiography in patients with moderate to severe rheumatic mitral stenosis undergoing percutaneous balloon mitral valvuloplasty.

Int J Cardiol Heart Vasc 2019 Mar 9;22:35-38. Epub 2018 Dec 9.

National Institute of Cardiovascular Disease (NICVD), Karachi, Pakistan.

Background: Longstanding severe rheumatic mitral stenosis (MS) is associated with changes in the atrial chamber dimensions. It is not known whether there is an increased thickness of the inter-atrial septum (IAS) in patients with severe rheumatic mitral stenosis. The objective of this study was to evaluate pre-procedural IAS thickness by echocardiography in patients with moderate to severe rheumatic mitral stenosis undergoing percutaneous balloon mitral valvuloplasty (PBMV).

Methods: The thickness of the IAS was measured by transesophageal echocardiography (TEE) in 86 patients between 14 and 65 years of age. Patients with moderate to severe rheumatic mitral stenosis undergoing percutaneous mitral balloon valvuloplasty (PMBV) at the National Institute of Cardiovascular Diseases (NICVD), Karachi were recruited for this study. IAS thickness was measured by TEE using standard views and 3 different phases of cardiac cycles were evaluated.

Results: Out of 86 patients, almost three fourths (73.3%) were between 14 and 29 years of age and two thirds (62.8%) were females. Mean IAS thickness was 2.56 (SD 0.92) mm at anterior region (AR), 1.89 (SD 0.75) mm at fossa ovalis (FO), and 2.95 (SD 0.97) mm at posterior region (PR). None of the demographic and clinical groups showed any statistically significant difference in IAS thickness.

Conclusions: Inter-atrial septum (IAS) thickness measurement does not change in the presence of moderate to severe rheumatic mitral stenosis as compared to the reported normal values of IAS thickness in cadaveric hearts.
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March 2019

Burden Of Atherosclerosis Risk Among Different Ethinicity: A Hidden Health Challenge.

J Ayub Med Coll Abbottabad 2016 Oct-Dec;28(4):788-792

National Institute of Cardiovascular Diseases (NICVD), Karachi, College of Physicians and Surgeons Pakistan, Karachi, Pakistan.

Background: Atherosclerosis risk and incidence of developing chronic cardiovascular conditions vary greatly between ethnic groups in South Asian population. To evaluate different ethnic groups in Pakistan, population based study was conducted at Karachi, the largest metropolitan city of Pakistan; to assess ten years and lifetime estimated cardiovascular disease risks without preexisting cardiovascular disease in Pakistani subjects by using Pooled Cohort Risk equation (calculator) as per American College of Cardiology (ACC) and the American Heart Association (AHA) 2013 guidelines.

Methods: For the study, consecutive subjects (n=437) with multi-ethnic background, aged 20-79 years and having non-atherosclerotic disease were enrolled at site of National Institute of Cardio-Vascular Diseases (NICVD), Karachi, Pakistan.

Results: Within each ethnic group and overall, the risk of developing atherosclerosis was common in all ethnic groups especially Urdu speaking are mostly at the high with all the factors above the borderline values, followed by Punjabis and Pathans that may point toward associated higher risk for prevalence of cardiovascular disease. These ethnic groups showed increased prevalence of dyslipidemia, obesity, and much greater abnormalities asunique risk. Although there are differences in these altered factors but the changes in lifestyle, urbanization, genetic profile and physiological makeup are the main reasons that could be a trigger to increase cardiovascular events.

Conclusions: The present study provides the first evidence and may serve as useful guidance to calculate the estimated risk both 10 years and lifetime in the non-atherosclerotic Pakistani population with different ethnic background.
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November 2017