Study to Evaluate Current Trends in Appropriate Usage of Tread Mill Exercise Testing.

INTRODUCTION: Non-invasive tests are used to diagnose and prognosticate Coronary Artery Disease (CAD) patients and also in pre-operative evaluation and rehabilitation. Millions of these tests are performed worldwide in these situations. However, previous studies have shown inappropriate use of these tests. AIM: The study was to evaluate the appropriate use of treadmill exercise test. MATERIALS AND METHODS: The present retrospective study was done in Rajiv Gandhi Super Speciality Hospital, Raichur and Institute of Medical sciences and RKB Super Speciality Clinic, Raichur, Karnataka, India. Tread Mill Tests (TMT) which were done between November 2013 and February 2016 were included in the study. A total of 600 tests were evaluated for appropriateness. Demographic, clinical and risk factors, indications were studied. RESULTS: Overall 298 (49.66%) tests were found to be inappro-priate. Younger age, female sex, pre-operative evaluation, evaluation in master health check up and insurance were predictors of inappropriate use (p<0.05) in this study. CONCLUSION: The treadmill exercise testing appears to be particularly vulnerable to overuse in clinical setting due to its wide availability, affordability and awareness. The inappropriate use of the method, however, may result in additional unnecessary cost to health care system.

Effect of Vitamin D on Anginal Episodes in Vitamin D Deficient Patients with Chronic Stable Angina on Medical Management.

INTRODUCTION: Vitamin D deficiency has been found to contribute to various cardiac conditions, such as hypertension, coronary artery disease, stroke, and atherosclerosis. However, the clinical cardiovascular benefits after short term supplementation have not been reported. AIM: To study the beneficial effect of Vitamin D supplementation on angina episodes in Vitamin D deficient patients with chronic stable angina on medical management. MATERIALS AND METHODS: A total of 40 patients were studied with group 1 (20 patients) with low Vitamin D levels and group 2 with normal Vitamin D levels. 60000 IU of Vitamin D supplementation was given every week for 8 weeks in group 1. Frequency of anginal episodes and use of sub-lingual nitrates were compared at base-line and after 8 weeks post supplementation. RESULTS: Significant 20% (p <0.05) reduction in anginal episodes and 17.24% (p <0.05) reduction in use of sub-lingual nitrates was noted in group1 after Vitamin D supplementation. The benefits were independent of BP, heart rate and medications, thus, attributing to supplementation. No significant change was noted in group 2. CONCLUSION: Cardiovascular patients need to be evaluated for Vitamin D deficiency. Supplementation to correct Vitamin D levels may have additional cardiovascular benefits like reduction in angina episodes.