"Correlation of red blood cell distribution width with the severity of coronary artery disease-A single center study".

OBJECTIVE: Coronary Artery Disease (CAD) is the leading cause of morbidity and mortality all around the world. We evaluated the correlation of Red blood cell Distribution Width (RDW) with the severity of lesion on coronary angiography as assessed by Modified Gensini score (MGS) in CAD patients. METHODS: A total of 576 consecutive patients admitted in Department of Cardiology over a period of one year, who underwent coronary angiography after diagnosis of CAD or presence of angina like chest pain and/or positive treadmill test were enrolled in the study (August 2014-May 2015). Patients were divided into two groups, with CAD (Group A) and without CAD (Group B). The RDW Cofficience of variance (RDW CV) and RDW standard deviatiton (RDW SD) of each patient, and their correlation with severity of CAD was assessed. RESULTS: Of the total 576 patients enrolled, 438 were in Group A and 138 were in Group B. The mean age of presentation in Group A and Group B was (53.64±10.36 vs 49.4±9.73)years (p<0.0001). The Male and Female ratio overall was 2.42:1. Patients in Group A had significantly elevated RDW CV and RDW SD levels compared with those in Group B [(14.59±1.04)% vs (13.6±0.68)%, p<0.0001], [(45.78±4.76) vs (40.77±3.01), p<0.0001 respectively]. A significant positive correlation between RDW CV, RDW SD and MGS was noted (r=0.33, p<0.0001) (r=0.43, p<0.0001) respectively. On multivariate logistic regression analysis, RDW was demonstrated to be an independent predictor for angiographic CAD (OR=4.17, 95% CI 3.05-5.69, p<0.0001). On receiver operating characteristic curve (ROC) analysis, an RDW value of 14.3% was identified as an effective cut off point in diagnosing CAD with a sensitivity of 58.9% and specificity of 84.8%. CONCLUSIONS: RDW is an independent predictor of CAD and severity of coronary stenosis, suggesting that it can be a readily available marker for prediction and severity of CAD.

Analysis of 12 Months Clinical Outcomes Associated with Implantation of Ultrathin (60 µm) Bare Metal Stent in an Unselected Real-world Population with Coronary Artery Disease.

INTRODUCTION: In the era of drug-eluting stents, Bare Metal Stent (BMS) has worked its way up to be recognized in several indications. Moreover, literature suggests that strut thickness has been directly related to the restenosis rate. AIM: We intended to evaluate the clinical performance of the ultrathin (60 µm) Flexinnium stent (Sahajanand Medical Technologies Pvt. Ltd. Surat, India) for treatment of a wide range of patients with coronary artery disease in routine clinical practice. MATERIALS AND METHODS: This was an observational, non-randomized, retrospective, single-arm study carried out in real-world patients at three clinical centres of India. A total of 419 consecutive patients' data was collected for the study, who underwent treatment for coronary lesions by implantation of Flexinnium stent, between April 2013 and December 2014. The primary endpoint of the study was Major Adverse Cardiac Events (MACE), a conglomerate of cardiac death, Myocardial Infarction (MI) (Q-wave and non-Q-wave), Target Lesion Revascularization (TLR) and Target Vessel Revascularization (TVR). Any incidence of Stent Thrombosis (ST) was also observed as safety endpoint. These endpoints were observed during in-hospital stay, at 30 days, six months and at 12 months follow up. All data were analysed using the Statistical Package for Social Sciences (SPSS; Chicago, IL, USA) program, version 15. RESULTS: A total of 491 lesions were treated in 419 patients having mean age of 54.1 years. A total of 525 Flexinnium stents were implanted. There were 243 (58.0%) patients with hypertension. At 12 months the total incidences of MACE were 14 (3.5%). These included 9 (2.3%) cardiac deaths, 1 (0.3%) MI, 3 (0.8%) TLRs and 1 (0.3%) TVR. There was one incidence of definite ST at 12 months follow up. CONCLUSION: Our results demonstrate that the Flexinnium stent is associated with a low 12 months incidence of MACE in a wide range of real-world population. Long-term follow up would further confirm its clinical performance profile.

Prolapse of all cardiac valves in Noonan syndrome.

Noonan syndrome is an autosomal dominant disorder with genetically heterogeneous inheritance. The incidence of cardiac abnormalities is higher in patients with Noonan syndrome and approximately 80% patients with Noonan syndrome are reported to have cardiac abnormalities during their lifetimes. However, polyvalvular disease in Noonan syndrome is rare. In this case-report, we describe a case of a young man whose features were strongly suggestive of Noonan syndrome and who was diagnosed with prolapse of all four cardiac valves after 22 years of uneventful survival.