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Background: ACS represents a global epidemic. Arrhythmia in ACS is common. Careful investigation may lead to further improvement of prognosis. Retrospectively analyzed the year- round data of our center. Study was undertaken to analyze the incidence, frequency and type of arrhythmias in ACS. This is to aid timely intervention and to modify the outcome. Identification of the type of arrhythmia is of therapeutic and prognostic importance.Methods: This cross sectional analytical study was conducted in the Department of Cardiology, Apollo Hospitals Dhaka, from January 2019 to January 2020 with ACS patients. Enrolled consecutively and data analyzed.Results: There were 500 patients enrolled considering inclusion and exclusion criteria. Sample was subdivided into 3 groups on the type of ACS. Group-I with UA, Group-II with NSTE - ACS and Group-III with STE - ACS. Different types of arrhythmia noted. Types of arrhythmia were correlated with type of ACS. 500 patients included. Mean age 55.53±12.70, 71.6% male and 28.4% female. 60.4% hypertensive, 46.2% diabetic, 20.2% positive family history of CAD, 32.2% current smoker, 56.4% dyslipidaemic and 9.6% asthmatic. 31.2% UA, 39.2% NSTE-ACS and 29.6% STE-ACS. Type of arrhythmias noted. 22% sinus tachycardia, 20.2% sinus bradycardia, 9% atrial fibrillation, 5.2% ventricular ectopic, 4.8% supra ventricular ectopic, 2.8% bundle branch block, 2.2% atrio-ventricular block, 1% broad complex tachycardia, 0.4% narrow complex tachycardia, 0.2% sinus node dysfunction and 32.2% without any arrhythmia. Significant incidences of arrhythmia detected - respectively 29.8%, 39.2% and 31%, p<0.001.Conclusions: In conclusion, arrhythmias in ACS are common. More attention should be paid to improve their treatment and prognosis.
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A nine-year-old Bangladeshi male with a body mass index 16.5 kg/m(2) presented with progressive tuberous xanthomata on both auricles, elbows, gluteal regions and legs since birth. His father, paternal and maternal grandfather had xanthelasma, however, the siblings had none. Examination of the cardiovascular system was otherwise normal. Laboratory investigations were performed on several occasions since he was 4 years of age and revealed extreme dyslipidaemia with very high total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), triglycerides (TG), apolipoprotein B (Apo-B) and lipoprotein(a), and low apolipoprotein-A (Apo-A) levels. Repeated combination of lipid lowering agents with cholestyramine, atorvastatin and ezetimibe were virtually ineffective in improving the lipid profiles. Supplementation therapy with niacin also had no effect. In view of the unavailability in Bangladesh of lipid apheresis, the cornerstone of therapy, the management of the case becomes complicated.
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Background: Aim of the study was to evaluate the primary procedural success of Multivessel Percutaneous coronary intervention in patients with acute ST-segment elevated myocardial infarction at the same sitting. Methods: Total 23 (13.4%) patients were enrolled in this very preliminary study, among the total 171 patients who had primary PCI at our center from Jan 2010 to February 2015. Among them, Male: 20 and Female: 3. Total 52 stents were deployed in 46 territories. Mean age were for both male and female were 54 yrs. Associated coronary artery disease risk factors were Dyslipidemia, High Blood pressure, Diabetes Mellitus, positive family history for coronary artery disease and Smoking. Results: Among the study group; 17(74%) were Dyslipidemic, 11(47.8%) were hypertensive; 8(34.8%) patients were Diabetic, positive family history 4(17.4%) and 9(39%) were all male smoker. Female patients were more obese (BMI: M 26: F 27). Common diagnosis at admission based on ECG evidence was; Inferior wall myocardial infarction: 12 (52.2%), Anterior wall myocardial infarction 9(39.1%) and lateral 2(8.7%). Common stented territory was left anterior descending artery 9(39.1%), right coronary artery 7(30.4%), and left circumflex artery 7(30.4%). Stent used: Bare metal stent 3 (5.7%), DES: 49 (94.2%). Among the different drug eluting stents, Everolimus 26 (52%), Sirolimus 8(15.4%) and Zotarolimus 9(17.3%), Paclitaxel 2 (3.8%), Biolimus 2 (3.8%), Genous 2 (3.8%). Conclusion: In the current prospective non randomized study, we found that the multivessel primary PCI for ST elevation myocardial infarction with non-culprit vessel are suitable for PCI at the same sitting with better in-hospital and 1 yr survival outcome.