interventional and preventive cardiology
cardiovascular health in women
cardiovascular effects of long COVID
advanced echocardiography
6
Scopus Publications
Scopus Publications
Utility of CHA2DS2-VASc Score in Predicting Contrast-induced Nephropathy in Patients with Acute Myocardial Infarction Following Percutaneous Coronary Angiography: A Cross-sectional Study in South India Ramya R Bhat, Ashwin Kulkarni, Anupama Hegde, Aslam M Shaikh, Mohammed Suhail Journal of Association of Physicians of India, 2025 BACKGROUND: -VASc score to predict occurrence of CIN among patients undergoing PCI. MATERIALS AND METHODS: -VASc score's optimal cutoff point. RESULTS: -VASc score of >2. Additionally, a significant relationship was discovered between CIN and age, diabetes, hypertension, prior coronary artery disease (CAD), and Killip class ≥2. CONCLUSION: Patients with CHA2DS2-VASc score of >2 had higher incidence of CIN. CHA2DS2-VASc score was found to be useful in predicting contrast nephropathy among patients with acute myocardial infarction undergoing angiography.
Assessing health system preparedness from trends and time delays in the management of myocardial infarctions during the COVID-19 pandemic in India: a multicentre retrospective cohort study Jaideep C Menon, Aravind MS, Harikrishnan S, Chandrashekar Janakiram, Anju James, Aswathy Sreedevi, Geetha R Menon, Denny John, Jerin Jose Cherian, Vanajakshamma V, Rajpal K Abhaichand, Eapen P Punnoose, Arun BS, Mathew Abraham, Paul Thomas, Chakradhar Pedada, Unni Govindan, Bishav Mohan, Sunil Pisharody, Tom Devasia, Placid Sebastian, Rajesh Thachathodiyl, Vijayaraghavan G, Nitesh Arora, Anupama V Hegde, Johny Joseph, John F John, Prakash Chand Negi, Raja Ram Mantri, Amit Malviya, Ramakrishna CD, Vikrant Vijan BMJ Open, 2025 Objectives This study aimed to analyse the number of myocardial infarction (MI) admissions during the COVID-19 lockdown periods of 2020 and 2021 (March 15th to June 15th) and compare them with corresponding pre-pandemic period in 2019. The study also evaluated changes in critical treatment intervals: onset to door (O2D), door to balloon (D2B) and door to needle (D2N) and assessed 30-day clinical outcomes. This study examined MI care trends in India during the COVID-19 lockdown period, irrespective of patients’ COVID-19 infection status. Design Multicentre retrospective cohort study Setting Twenty-three public and private hospitals across multiple Indian states, all with 24/7 interventional cardiology facilities. Participants All adults (>18 years) admitted with acute myocardial infarction between March 15 and June 15 in 2019 (pre-pandemic), 2020 (first lockdown) and 2021 (second lockdown). A total of 3614 cases were analysed after excluding duplicates and incomplete data. Primary outcomes Number of MI admissions, median O2D, D2B and D2N times. Secondary outcomes 30-day outcomes including death, reinfarction and revascularisation. Results MI admissions dropped from 4470 in year 2019 to 2131 (2020) and 1483 (2021). The median O2D increased from 200 min (IQR 115–428) pre-COVID-19 to 390 min (IQR 165–796) in 2020 and 304 min (IQR 135–780) in 2021. The median D2B time reduced from 225 min (IQR 120–420) in 2019 to 100 min (IQR 53–510) in 2020 and 130 min (IQR 60–704) in 2021. Similarly, D2N time decreased from 240 min (IQR 120–840) to 35 min (IQR 25–69) and 45 min (IQR 24–75), respectively. The 30-day outcome of death, reinfarction and revascularisation was 4.25% in 2020 and 5.1% in 2021, comparable to 5.8% reported in the Acute Coronary Syndrome Quality Improvement in Kerala study. Conclusion Despite the expansion of catheterisation facilities across India, the country continues to fall short of achieving international benchmarks for optimal MI care.
His bundle pacing–is it the final frontier of physiological pacing ?–A single centre experience from the Indian sub–Continent V.S. Prakash, Anupama V. Hegde, U.M. Nagamalesh, S. Ramkumar, Y. Sai Krishna, Varsha Rakshitha Prakash, Archana Ratna Potluri Indian Heart Journal, 2020 BACKGROUND: Long term right ventricular pacing can have deleterious effects on left ventricular (LV) function. His bundle pacing (HBP), a novel procedure can probably circumvent this setback. We investigated if (1) HBP is associated with pacing induced LV dysfunction by using LV global longitudinal strain (GLS) and (2) intermediate term performance of the Select Secure (3830) lead in the His bundle location. This report is probably the first on HBP in the Indian population. METHODS: 61 patients, with normal LV ejection fraction (EF) with a guideline based indication for permanent pacing underwent a HBP pacemaker implantation using the His Select Secure 3830 lead; with lead guided mapping for locating the His bundle. The patients underwent GLS assessment; evaluation of the His lead parameters - sensing, impedance and capture thresholds immediately after implantation and at 6 months in addition to the standard follow up. RESULTS: At 6 month follow up, the average GLS did not show significant variation from baseline in patients requiring ventricular pacing more than 40% and was similar, irrespective of selective or non selective His bundle pacing. All the patients had stable pacemaker parameters - with little change in capture threshold, lead impedance or sensing of the His bundle lead - implying electrical and mechanical stability on intermediate term follow-up. CONCLUSION: HBP is a feasible procedure in the hands of an experienced operator, with stable lead performance. It does not appear to be associated with pacing mediated left ventricular dysfunction at intermediate term follow up. It should probably become the default method of permanent pacing.
The 2017 International Joint Working Group recommendations of the Indian College of Cardiology, the Academic College of Emergency Experts, and INDUSEM on the management of low-risk chest pain in emergency departments across India Vivek Chauhan, PavitraKotini Shah, Sagar Galwankar, Maura Sammon, Prabhakar Hosad, Beeresha, TimothyB Erickson, DavidF Gaieski, Joydeep Grover, AnupamaV Hegde, TerryVanden Hoek, Bhavesh Jarwani, Himanshu Kataria, KennethA LaBresh, CholenahallyNanjappa Manjunath, AC Nagamani, Anjali Patel, Ketan Patel, D Ramesh, R Rangaraj, Narendra Shamanur, L Sridhar, KH Srinivasa, Shweta Tyagi Journal of Emergencies Trauma and Shock, 2017 There have been no published recommendations for the management of low-risk chest pain in emergency departments (EDs) across India. This is despite the fact that chest pain continues to be one of the most common presenting complaints in EDs. Risk stratification of patients utilizing an accelerated diagnostic protocol has been shown to decrease hospitalizations by approximately 40% with a low 30-day risk of major adverse cardiac events. The experts group of academic leaders from the Indian College of Cardiology and Academic College of Emergency Experts in India partnered with academic experts in emergency medicine and cardiology from leading institutions in the UK and USA collaborated to study the scientific evidence and make recommendations to guide emergency physicians working in EDs across India.
Acute pulmonary thromboembolism: Epidemiology, predictors, and long-term outcome – A single center experience U.M. Nagamalesh, V.S. Prakash, K.C. Karthik Naidu, S. Sarthak, Anupama V. Hegde, T. Abhinay Indian Heart Journal, 2017 INTRODUCTION: Acute pulmonary thromboembolism (PTE) is a life-threatening disease. Mortality in PTE still remains very high in spite of progress in diagnostic tools. Mortality rate is about 30% in patients with unrecognized acute PTE. METHODS: It is a single center observational study of 31 consecutive patients who were hospitalized in the Department of Cardiology at MS Ramaiah Memorial hospital between January 1, 2010 and June 2015. All the patients confirmed with diagnosis of acute PTE by CT scan (either HRCT or CTPA) were included in the study. Following relevant investigations chosen patients were risk stratified as per standard guidelines into massive, sub massive or low risk and treated accordingly. The included patients were followed up for a period of 1 year with 2D-echocardiogram and other relevant investigations for comparison to assess improvement. Mortality due to either acute PTE or other causes was noted in the study. RESULTS: Of the 31 patients enrolled in our study, 71% (n=22) of the patients belonged to the age range 20-50 years with those in the age group 31-40 years comprising 39% (n=12) of the total. Elderly people over 65 years of age comprised only 19% (n=6) of the total number of patients. Dyslipidemia, prolonged immobilization, deep vein thrombosis, post-operative state, malignancy and post-partum period were the commonly reported risk factors. We thrombolysed a total of 18 (58%) patients with massive and submassive PTE, of which 12 (39%) received tenecteplase and 6 patients received streptokinase (19%). Three (9%) patients required repeat thrombolysis with streptokinase due to failed thrombolytic therapy with tenecteplase. CONCLUSIONS: Our study reported higher incidence of acute PTE in the middle age group population. Prevalence of dyslipidemia was high in this cohort of patients studied although the exact association of it in APE could not be determined. Thrombolytic therapy can be considered for patients with both massive and submassive pulmonary thromboembolism. Repeat thrombolysis can be considered in case one thrombolytic agent failed to give the desirable results.
Spontaneous subdural hematoma and antiplatelet therapy: Does efficacy of Ticagrelor come with added risk? Pattanagere Manjunatha Suryanarayana Sharma, Aniruddha Tekkatte Jagannatha, Mahendra Javali, Anupama Venkatasubba Hegde, Rohan Mahale, Madhusudhan, Rangasetty Srinivasa Indian Heart Journal, 2015 Antiplatelet therapy has established clinical benefit on cardiovascular outcome and has reduced the rates of re-infarction/in stent thrombosis following percutaneous coronary intervention in acute coronary syndromes. Major bleeding episodes can occur with antiplatelet therapy and intracranial hemorrhage (ICH) is one of the most feared complications resulting in significant morbidity and mortality. Identification of high risk groups and judicious use of antiplatelet therapy reduces the bleeding risk. Ticagrelor is a newer P2Y12 receptor antagonist with established clinical benefit. However, risks of having an ICH with these newer molecules cannot be ignored. Here, we report a case of spontaneous acute subdural hematoma developing in a patient on antiplatelet therapy with aspirin and ticagrelor. Early recognition, discontinuation of the medication and appropriate management resulted in resolution of hematoma and good clinical outcome. Authors have reviewed the antithrombotic drugs and their tendencies in causing intracranial bleeds from a neurophysicians perspective.
