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Chopra HK, Nair T, Wander GS, Ponde CK, Ray S, Khullar D, Nanda NC, Narula J, Kasliwal RR, Rana DS, Kirpalani A, Sawhney JPS, Chandra P, Mehta Y, Kumar V, Tewari S, Pancholia AK, Kher V, Bansal S, Mittal S, Kerkar P, Sahoo PK, Hotchandani R, Prakash S, Chauhan N, Rastogi V, Jabir A, Shanmugasundaram S, Tiwaskar M, Sinha A, Gupta V, Mishra SS, Routray SN, Omar AK, Swami OC, Jaswal A, Alam S, Passey R, Rajput R, Paul J, Kapoor A, Prabhakar D, Chandra S, Malhotra P, Singh VP, Bansal M, Shah P, Jain S, Bhargava M, Vijayalakshmi IB, Varghaese K, Jain D, Goel A, Mehmood K, Gaur N, Tandon R, Moorthy A, George S, Katyal VK, Mantri RR, Mehrotra R, Bhalla D, Mittal V, Rao S, Jagia M, Singh H, Awasthi S, Sattur A, Mishra R, Pandey A, Chawla R, Jaggi S, Sehgal B, Sehgal A, Goel N, Gupta R, Kubba S, Chhabra A, Bagga S, Shastry NR. Current Place of SGLT2i in the Management of Heart Failure: An Expert Opinion from India. J Assoc Physicians India 2024; 72:63-73. [PMID: 38736076 DOI: 10.59556/japi.71.0440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/14/2024]
Abstract
Heart failure (HF) is a global health concern that is prevalent in India as well. HF is reported at a younger age in Indian patients with comorbidity of type 2 diabetes (T2DM) in approximately 50% of patients. Sodium-glucose cotransporter-2 inhibitors (SGLT2i), originally approved for T2DM, are new guideline-recommended and approved treatment strategies for HF. Extensive evidence highlights that SGLT2i exhibits profound cardiovascular (CV) benefits beyond glycemic control. SGLT2i, in conjunction with other guideline-directed medical therapies (GMDT), has additive effects in improving heart function and reducing adverse HF outcomes. The benefits of SGLT2i are across a spectrum of patients, with and without diabetes, suggesting their potential place in broader HF populations irrespective of ejection fraction (EF). This consensus builds on the updated evidence of the efficacy and safety of SGLT2i in HF and recommends its place in therapy with a focus on Indian patients with HF.
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Affiliation(s)
- H K Chopra
- Senior Consultant, Department of Cardiology, Medanta Moolchand Heart Center, Delhi, India
| | - Tiny Nair
- Head, Department of Cardiology, PRS Hospital, Trivandrum, Kerala, India
| | - G S Wander
- Professor, Department of Cardiology, Dayanand Medical College & Hospital (DMCH); Hero DMC Heart Institute, Ludhiana, Punjab, India, Corresponding Author
| | - C K Ponde
- Consultant Cardiologist and Head, Department of Cardiology, PD Hinduja National Hospital and Medical Research Centre, Mumbai, Maharashtra, India
| | - Saumitra Ray
- Director, Department of Invasive Cardiology, AMRI Hospital, Kolkata, West Bengal, India
| | - Dinesh Khullar
- Chairman-Nephrology and Renal Transplant Medicine, Department of Nephrology and Renal Transplant Medicine, Max Super Speciality Hospital, Delhi, India
| | - Navin C Nanda
- Distinguished Professor, Department of Medicine and Cardiovascular Disease, Division of Cardiology, University of Alabama at Birmingham, Birmingham, Alabama USA
| | - Jagat Narula
- Executive Vice President & Chief Academic Officer, University of Texas, Houston K. Lance Gould, Distinguished University Chair for Coronary Pathophysiology, Distinguished Professor of Medicine & Cardiology McGovern Medical School, Houston Texas, USA
| | - Ravi R Kasliwal
- Chairman, Department of Clinical and Preventive Cardiology, Medanta-The Medicity, Gurugram, Haryana, India
| | - D S Rana
- Chairman, Department of Nephrology, Sir Ganga Ram Hospital, Delhi, India
| | - Ashok Kirpalani
- Consultant Nephrologist, Bombay Hospital, Mumbai, Maharashtra, India
| | - J P S Sawhney
- Chief of Clinical and Preventive Cardiology, Chairman, Department of Cardiology, Sir Gangaram Hospital, Delhi, India
| | - Praveen Chandra
- Chairman, Department of Interventional and Structural Heart Cardiology, Medanta-The Medicity, Gurugram, Haryana, India
| | - Yatin Mehta
- Director, Department of Critical Care Medicine, Medanta Institute of Critical Care Anaesthesiology, Medanta, The Medicity, Gurugram, Haryana, India
| | - Viveka Kumar
- Principal Director and Chief of Cath Labs (Pan Max), Department of Cardiac Sciences, Max Hospital, Delhi, India
| | - S Tewari
- Professor, Department of Cardiology at SGPGIMS, Lucknow, Uttar Pradesh, India
| | - A K Pancholia
- Head of Department, Department of Clinical and Preventive Cardiology, Arihant Hospital and Research Centre, Indore, Madhya Pradesh, India
| | - Vijay Kher
- Chairman, Department of Nephrology; Department of Kidney Transplant, Epitome Kidney Urology Institute and Lions Hospital, Delhi, India
| | - Sandeep Bansal
- Consultant in Cardiology, Professor and Head, Department of Cardiology, Vardhaman Mahavir Medical College and Safdarjung Hospital, Delhi, India
| | - Sanjay Mittal
- Senior Cardiologist, Medanta-The Medicity, Gurugram, Haryana, India
| | - Praful Kerkar
- Senior Consultant Interventional Cardiologist, Asian Heart Institute, Mumbai, Maharashtra, India
| | - P K Sahoo
- Interventional Cardiology, Department of Cardiology, Apollo Hospital, Bhubaneshwar, Odisha, India
| | - Ramesh Hotchandani
- Consultant, Head, Department of Nephrology, Moolchand Centre for Renal Care and Dialysis, Moolchand Hospital, Delhi, India
| | - Sunil Prakash
- Senior Director and Head, Department of Nephrology and Renal Transplantation, BLK-Max Super Speciality Hospital, Delhi, India
| | - Nagendra Chauhan
- Senior Cardiologist, Medanta-The Medicity, Gurugram, Haryana, India
| | - Vishal Rastogi
- Director, Department of Interventional Cardiology, Head of Advanced Heart Failure Program, Fortis Escort Heart Institute, Delhi, India
| | - A Jabir
- Senior Cardiologist and Assistant Professor, Lisie Hospital, Cochin, Kerala, India
| | | | - Mangesh Tiwaskar
- Consultant Physician and Diabetologist, Shilpa Medical Research Centre, Mumbai, Maharashtra, India
| | - Ajay Sinha
- Senior Consultant, Department of Cardiology, Medanta Heart Institute, Patna, Bihar, India
| | - Vittul Gupta
- Consulting Physician, Department of Internal Medicine, Kishori Ram Hospital and Diabetes Care Centre, Bhatinda, Punjab, India
| | - S S Mishra
- Director and Senior Consultant Cardiologist, Med N Heart Clinic, Cuttack, Odisha, India
| | - S N Routray
- Professor and Head, Department of Cardiology, SCB Medical College, Cuttack, Odisha, India
| | - A K Omar
- Director, Fortis Escorts Heart Institute, Department of Non-invasive Cardiology, Delhi, India
| | - Onkar C Swami
- Senior Vice President, Medical Services, Alembic Pharmaceuticals Ltd., Mumbai, Maharashtra, India
| | - Aparna Jaswal
- Director, Department of Cardiac Pacing and Electrophysiology, Fortis Escorts Heart Institute, Delhi, India
| | - Shamsad Alam
- Consultant Interventional Cardiologist, Jayprabha Medanta Super Speciality Hospital, Patna, Bihar, India
| | - Rajeev Passey
- Consultant Cardiologist, Sir Ganga Ram Hospital, Delhi, India
| | - Rajeeve Rajput
- Senior Consultant Cardiologist, Apollo Hospitals, Delhi, India
| | - Justin Paul
- Professor of Cardiology, Madras Medical College, Chennai, Tamil Nadu, India
| | - Aditya Kapoor
- Head, Department of Cardiology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - D Prabhakar
- Consultant Interventional Cardiologist, Ashwin Clinic, Chennai, Tamil Nadu, India
| | - Subhash Chandra
- Chairman and Head, Department of Cardiology and Structural Heart Disease, BLK Max Super Speciality Hospital, Delhi, India
| | - Poonam Malhotra
- Senior Professor, Department of Cardiac Anaesthesia, All India Institute of Medical Sciences, Delhi, India
| | - Vivudh Pratap Singh
- Senior Consultant, Interventional Cardiologist, Fortis Escort Heart Institute, Delhi, India
| | - Manish Bansal
- Senior Cardiologist, Medanta-The Medicity, Gurugram, Haryana, India
| | - Priyank Shah
- Assistant General Manager, Medical Services, Alembic Pharmaceuticals Ltd., Mumbai, Maharashtra, India
| | - Sanjay Jain
- Associate Vice President, Medical Services, Alembic Pharmaceuticals Ltd., Mumbai, Maharashtra, India
| | - Mohan Bhargava
- Director of Cardiology and Interventional Cardiologist, Max Hospital, Delhi, India
| | - I B Vijayalakshmi
- Professor Emeritus, Former Head Cardiology, Shri Jayadeva Institute of Cardiovascular Sciences and Research, Bengaluru, Karnataka, India
| | - Kiron Varghaese
- Professor and Former Head, Department of Cardiology, St. John's Medical College, Bengaluru, Karnataka, India
| | - Dharmender Jain
- Professor and Former Head, Department of Cardiology, IMS, BHU, Varanasi, Uttar Pradesh, India
| | - Anupam Goel
- Director, Interventional Cardiology, Max Super-speciality hospital, Delhi, India, India
| | - Kiran Mehmood
- Assistant Professor, Department of Medicine and Cardiology, Icahn School of Medicine at Mount Sinai; Director, Heart Failure Program, Mount Sinai Morningside Hospital, New York, USA
| | - Namrata Gaur
- CVTS, AIIMS Rishikesh, Rishikesh, Uttarakhand, India
| | - Rohit Tandon
- Consultant, Department of Cardiology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - Asha Moorthy
- Senior Consultant Cardiologist, SIMS Hospital, Chennai, Tamil Nadu, India
| | - Sheeba George
- Senior Interventional Cardiologist & Head of Cardiology, Department of Interventional Cardiology, Jubilee Memorial Hospital, Trivandrum, Kerala, India
| | - V K Katyal
- Head of Department, Department of General Medicine, Positron Hospital; Formerly Senior Professor, Department of Medicine, Pt BD Sharma Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India
| | - R R Mantri
- Director, Department of Cardiology, Sir Ganga Ram Hospital, Delhi, India
| | - Rahul Mehrotra
- Director and Head, Department of Non-invasive Cardiology, Max Super Speciality Hospital, Delhi, India
| | - Dilip Bhalla
- Senior Director, Department of Nephrology and Renal Transplant, Max Super Speciality Hospital, Delhi, India
| | - Vinod Mittal
- Senior Consultant Diabetologist and Head, Centre for Diabetes and Metabolic Diseases, Heart and Lung Institute, Delhi, India
| | - Sarita Rao
- Senior Interventional Cardiologist, Director Cath Lab, Apollo Hospital, Indore, Madhya Pradesh, India
| | - Manish Jagia
- Director, Department of Anaesthesia and Critical care, Moolchand Hospital, Delhi, India
| | - Harmeet Singh
- Consultant, Critical Care Specialist, Max Super Speciality Hospital, Ghaziabad, Uttar Pradesh, India
| | - Surabhi Awasthi
- Consultant, Critical Care Specialist, Moolchand Hospital, Delhi, India
| | - Ameet Sattur
- Director of Cath Lab HCG, Suchiraya Hospital, Hubli, Karnataka, India
| | - Rekha Mishra
- Consultant Cardiologist, Indraprastha, Apollo Hospital, Delhi, India
| | - Anand Pandey
- Senior Consultant Cardiologist, Department of Cardiology, Kailash Deepak Hospital, Delhi, India
| | - Rajeev Chawla
- Senior Consultant Diabetologist and Director of North Delhi Diabetes and Cardiac Centre, Delhi, India
| | - Shalini Jaggi
- Consultant Diabetologist and Head, Dr Mohan Diabetes Specialities Centre, Delhi, India
| | - Blessy Sehgal
- Senior Consultant, Nephrology, Shree Balaji Action Medical Institute, Delhi, India
| | - Alok Sehgal
- Head of Department and Chief Interventional Cardiologist, Yeshoda Super Speciality Hospital, Ghaziabad, Uttar Pradesh, India
| | - Naresh Goel
- Director and HOD, Department of Cardiology and HF, Fortis Shalimar Bagh Hospital, Delhi, India
| | - Ripen Gupta
- Interventional Cardiologist, Max Super Speciality Hospital, Delhi, India
| | - Samir Kubba
- Director and Unit Head, Department of Cardiology, Dharmshila Narayana Superspeciality Hospital, Delhi, India
| | | | - Saurabh Bagga
- Senior Cardiologist, Medanta-The Medicity, Gurugram, Haryana, India
| | - N R Shastry
- Consultant Cardiologist, Medanta Moolchand Heart Center, Delhi, India
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Chopra HK, Nair T, Wander GS, Ponde CK, Ray S, Khullar D, Nanda NC, Kasliwal RR, Rana DS, Kirpalani A, Sawhney JPS, Chandra P, Mehta Y, Kumar V, Tewari S, Pancholia AK, Kher V, Bansal S, Mittal S, Kerkar P, Sahoo PK, Hotchandani R, Prakash S, Chauhan N, Rastogi V, Jabir A, Shanmugasundaram S, Tiwaskar M, Sinha A, Gupta V, Mishra SS, Routray SN, Omar AK, Swami OC, Jaswal A, Alam S, Passey R, Rajput R, Paul J, Kapoor A, Prabhakar D, Chandra S, Malhotra P, Singh VP, Bansal M, Shah P, Jain S, Bhargava M, Vijayalakshmi IB, Varghaese K, Jain D, Goel A, Gaur N, Tandon R, Moorthy A, George S, Katyal VK, Mantri RR, Mehrotra R, Bhalla D, Mittal V, Rao S, Jagia M, Singh H, Awasthi S, Sattur A, Mishra R, Pandey A, Chawla R, Jaggi S, Sehgal B, Sehgal A, Goel N, Gupta R, Kubba S, Chhabra A, Bagga S, Shastry NR. Role of Bisoprolol in Heart Failure Management: A Consensus Statement from India. J Assoc Physicians India 2023; 71:77-88. [PMID: 38736057 DOI: 10.59556/japi.71.0426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/14/2024]
Abstract
In India, heart failure (HF) is an important health concern affecting younger age groups than the western population. A limited number of Indian patients receive guideline-directed medical therapy (GDMT). Selective β-1 blockers (BB) are one of the GDMTs in HF and play an important role by decreasing the sympathetic overdrive. The BB reduces heart rate (HR) reverse the adverse cardiac (both ventricular and atrial), vascular, and renovascular remodeling seen in HF. Bisoprolol, a β-1 blocker, has several advantages and can be used across a wide spectrum of HF presentations and in patients with HF and comorbid conditions such as coronary artery disease (CAD), atrial fibrillation (AF), post-myocardial infarction (MI), uncontrolled diabetes, uncontrolled hypertension, and renal impairment. Despite its advantages, bisoprolol is not optimally utilized for managing HF in India. This consensus builds on updated evidence on the efficacy and safety of bisoprolol in HF and recommends its place in therapy with a focus on Indian patients with HF.
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Affiliation(s)
- H K Chopra
- Senior Consultant, Department of Cardiology, Medanta Moolchand Heart Center, Delhi, India
| | - Tiny Nair
- Head, Department of Cardiology, PRS Hospital, Trivandrum, Kerala, India
| | - G S Wander
- Professor, Department of Cardiology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India, Corresponding Author
| | - C K Ponde
- Consultant Cardiologist and Head, Department of Cardiology, PD Hinduja National Hospital and Medical Research Centre, Mumbai, Maharashtra, India
| | - Saumitra Ray
- Director, Department of Invasive Cardiology, AMRI Hospital, Kolkata, West Bengal, India
| | - Dinesh Khullar
- Chairman, Nephrology and Renal transplant Medicine, Dept. of Nephrology and Renal transplant medicine, Max Super-speciality Hospital, Delhi, India
| | - Navin C Nanda
- Distinguished Professor of Medicine and Cardiovascular Disease, Division of Cardiology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Ravi R Kasliwal
- Chairman, Department of Clinical and Preventive Cardiology, Medanta-The Medicity, Gurgaon, Haryana, India
| | - D S Rana
- Chairman, Department of Nephrology, Sir Ganga Ram Hospital, Delhi, India
| | - Ashok Kirpalani
- Consultant Nephrologist, Bombay Hospital, Mumbai, Maharashtra, India
| | - J P S Sawhney
- Chief of Clinical and Preventive Cardiology, Chairman, Department of Cardiology, Sir Gangaram Hospital, Delhi, India
| | - Praveen Chandra
- Chairman, Department of Interventional and Structural Heart Cardiology, Medanta - The Medicity, Gurgaon, Haryana, India
| | - Yatin Mehta
- Director, Dept of Critical care medicine, Medanta Institute of Critical care Anaesthesiology, Medanta, The Medicity, Gurgaon, Haryana, India
| | - Viveka Kumar
- Principal Director and Chief of Cath Labs (Pan Max), Department of Cardiac Sciences, Max Hospital, Delhi, India
| | - S Tewari
- Professor of Cardiology at SGPGIMS, Lucknow, Uttar Pradesh, India
| | - A K Pancholia
- Head of Department, Department of Clinical and Preventive Cardiology, Arihant Hospital and Research Centre, Indore, Madhya Pradesh, India
| | - Vijay Kher
- Chairman, Department of Nephrology, Department of Kidney Transplant, Epitome Kidney Urology Institute and Lions Hospital, Delhi, India
| | - Sandeep Bansal
- Consultant in Cardiology, Professor and Head, Department of Cardiology, Vardhaman Mahavir Medical College and Safdarjung Hospital, Delhi, India
| | - Sanjay Mittal
- Senior Cardiologist, Medanta-The Medicity ,Gurgaon, Haryana, India
| | - Praful Kerkar
- Senior Consultant Interventional Cardiologist, Asian Heart Institute, Mumbai, Maharashtra, India
| | - P K Sahoo
- Interventional Cardiology, Department of Cardiology, Apollo Hospital, Bhubaneshwar, Odisha, India
| | - Ramesh Hotchandani
- Consultant, Head, Department of Nephrology, Moolchand Centre for Renal Care and Dialysis, Moolchand Hospital, Delhi, India
| | - Sunil Prakash
- Senior Director and Head, Department of Nephrology and Renal Transplantation, BLK-Max Super Speciality Hospital, Delhi, India
| | - Nagendra Chauhan
- Senior Cardiologist, Medanta-The Medicity ,Gurgaon, Haryana, India
| | - Vishal Rastogi
- Director, Department of Interventional Cardiology, Head of Advanced Heart Failure Program, Fortis Escort Heart Institute, Delhi, India
| | - A Jabir
- Senior Cardiologist and Assistant Professor, Lisie Hospital, Cochin, Kerala, India
| | | | - Mangesh Tiwaskar
- Consultant Physician and Diabetologist, Shilpa Medical Research Centre, Mumbai, Maharashtra, India
| | - Ajay Sinha
- Senior Consultant, Department of Cardiology, Medanta Heart Institute, Patna, Bihar, India
| | - Vittul Gupta
- Consulting Physician, Department of Internal Medicine, Kishori Ram Hospital and Diabetes Care Centre, Bhatinda, Punjab, India
| | - S S Mishra
- Director and Senior Consultant Cardiologist, Med N Heart Clinic, Cuttack, Odisha, India
| | - S N Routray
- Professor and Head, Department of Cardiology, SCB Medical College, Cuttack, Odisha, India
| | - A K Omar
- Director, Fortis Escorts Heart Institute, Department of Non-invasive Cardiology, Delhi, India
| | - Onkar C Swami
- Sr. Vice President, Medical Services, Alembic Pharmaceuticals Ltd, Mumbai, Maharashtra, India
| | - Aparna Jaswal
- Director, Department of Cardiac Pacing and Electrophysiology, Fortis Escorts Heart Institute, Delhi, India
| | - Shamsad Alam
- Consultant Interventional Cardiologist, Jayprabha Medanta Super Speciality Hospital, Patna, Bihar, India
| | - Rajeev Passey
- Consultant Cardiologist, Sir Ganga Ram Hospital, Delhi, India
| | - Rajeeve Rajput
- Senior Consultant Cardiologist, Apollo Hospitals, Delhi, India
| | - Justin Paul
- Professor of Cardiology, Madras Medical College, Chennai, Tamil Nadu, India
| | - Aditya Kapoor
- Head, Department of Cardiology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - D Prabhakar
- Consultant Interventional Cardiologist, Ashwin Clinic, Chennai, Tamil Nadu, India
| | - Subhash Chandra
- Chairman and Head, Dept. of Cardiology and Structural Heart Disease, BLK Max Superspeciality Hospital, Delhi, India
| | - Poonam Malhotra
- Senior Professor, Cardiac Anaesthesia, All India Institute of Medical Sciences, Delhi, India
| | - Vivudh Pratap Singh
- Sr. Consultant, Interventional Cardiologist, Fortis Escort Heart Institute, Delhi, India
| | - Manish Bansal
- Senior Cardiologist, Medanta-The Medicity ,Gurgaon, Haryana, India
| | - Priyank Shah
- Assistant General Manager, Medical Services, Alembic Pharmaceuticals Ltd., Mumbai, Maharashtra, India
| | - Sanjay Jain
- Associate Vice President, Medical Services, Alembic Pharmaceuticals Ltd., Mumbai, Maharashtra, India
| | - Mohan Bhargava
- Director of Cardiology and Interventional Cardiologist, Max Hospital, Delhi, India
| | - I B Vijayalakshmi
- Professor Emeritus, Former Head Pediatric Cardiology, Shri Jayadeva Institute of Cardiovascular sciences and Research, Bengaluru, Karnataka, India
| | - Kiron Varghaese
- Professor and Former Head, Department of Cardiology, St. John's Medical College, Bangalore, India
| | - Dharmender Jain
- Professor and Former head, Department of Cardiology, IMS, BHU, Varanasi, Uttar Pradesh, India
| | - Anupam Goel
- Director, Interventional Cardiology, Max Super-speciality hospital, Delhi, India
| | - Namrata Gaur
- CVTS, AIIMS Rishikesh, Rishikesh, Uttarakhand, India
| | - Rohit Tandon
- Consultant, Department of Cardiology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - Asha Moorthy
- Senior Consultant Cardiologist, SIMS Hospital, Chennai, Tamil Nadu, India
| | - Sheeba George
- Sree Mookambika Institute of Medical Sciences, Thiruvananthapuram, Kerala, India
| | - V K Katyal
- Head of Dept. Department of General Medicine, Positron Hospital; Formerly Senior Professor, Department of Medicine, Pt. B.D.Sharma, Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India
| | - R R Mantri
- Director, Department of Cardiology, Sir Ganga Ram Hospital, Delhi, India
| | - Rahul Mehrotra
- Director and Head, Department of Non-Invasive Cardiology, Max Super Speciality Hospital, Delhi, India
| | - Dilip Bhalla
- Senior Director, Department of Nephrology and Renal Transplant, Max Super Speciality Hospital, Delhi, India
| | - Vinod Mittal
- Senior Consultant Diabetologist and Head, Centre for Diabetes and Metabolic Diseases, Heart and Lung Institute, Delhi, India
| | - Sarita Rao
- Sr. Interventional Cardiologist, Director Cath Lab, Apollo Hospital, Indore, Madhya Pradesh, India
| | - Manish Jagia
- Director, Department of Anaesthesia and Critical care, Moolchand Hospital, Delhi, India
| | - Harmeet Singh
- Consultant, Critical Care Specialist, Max Super-speciality hospital, Ghaziabad, Uttar Pradesh, India
| | - Surabhi Awasthi
- Consultant, Critical Care Specialist, Moolchand Hospital, Delhi, India
| | - Ameet Sattur
- Director of Cath Lab HCG, Suchiraya Hospital, Hubli, Karnataka, India
| | - Rekha Mishra
- Consultant Cardiologist, Indraprastha, Apollo Hospital, Delhi, India
| | | | - Rajeev Chawla
- Sr. Consultant Diabetologist and Director of North Delhi Diabetes and Cardiac Centre, Delhi, India
| | - Shalini Jaggi
- Consultant Diabetologist and Head at Dr. Mohans Diabetes Specialities Centre, Delhi, India
| | - Blessy Sehgal
- Sr. Consultant Nephrology, Shree Balaji Action Medical Institute, Delhi, India
| | - Alok Sehgal
- Head of Dept. and Chief Interventional Cardiologist, Yeshoda Superspeciality Hospital, Ghaziabad, Uttar Pradesh, India
| | - Naresh Goel
- Sr. cardiologist, Department of Cardiology BLK Super-speciality Hospital, Delhi, India
| | - Ripen Gupta
- Interventional Cardiologist, Max Super Speciality hospital, Delhi, India
| | - Samir Kubba
- Director and Unit Head, Cardiology Department Dharmshila Narayana Superspeciality Hospital, Delhi, India
| | | | - Saurabh Bagga
- Senior Cardiologist, Medanta-The Medicity ,Gurgaon, Haryana, India
| | - N R Shastry
- Consultant Cardiologist, Medanta Moolchand Heart Center, Delhi, India
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Chopra HK, Wander GS, Nair T, Ponde CK, Nanda NC, Narula J, Ray S, Venugopal K, Iyengar SS, Kasliwal RR, Chandra P, Prakash S, Bansal S, Rana DS, Kerkar P, Dasbiswas A, Sawhney J, Shanmungasundram S, Kumar V, Vijayalakshmi IB, Pancholia AK, Sharma V, Kapoor A, Swami OC, Isser HS, Rastogi V, Arora YK, Omar AK, Sathe S, Rajput R, Prabhakar D, Paul GJ, Jagia P, Malhotra P, Suryaprakash G, Mittal V, Jagia M, Jabir A, Mishra SS, Routray SN, Sinha AK, Bhargava M, Mahmood K, Lal S, Dabhade D, Bhatia M, Kalra P, Katyal VK, Tandon R, Grover R, Chhabra A, Shastry NR. Angiotensin Receptor-Neprilysin Inhibitor Therapy and Cardiac Remodeling in Heart Failure: Consensus Statement from India. J Assoc Physicians India 2023; 71:11-12. [PMID: 37355795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/26/2023]
Abstract
Adverse cardiac remodeling refers to progressive structural and functional modifications in the heart because of increased wall stress in the myocardium, loss of viable myocardium, and neurohormonal stimulation. The guideline-directed medical therapy for Heart failure (HF) includes Angiotensin receptor-neprilysin inhibitor (ARNI) (sacubitril/valsartan), β-blockers, sodium-glucose co-transporter 2 (SGLT2) inhibitors, and mineralocorticoid receptor antagonists (MRA). ARNI is under-prescribed in India despite its attractive safety and efficacy profile. Therefore, the consensus discusses objectives and topics related to ARNI in the management of cardiac remodeling, and experts shared their views on the early timely intervention of effective dosage of ARNI to improve the diagnosis and enhance mortality and morbidity benefits in cardiac reverse remodeling (CRR).
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Affiliation(s)
- H K Chopra
- Senior Consultant, Department of Cardiology, Medanta Moolchand Heart Center, Delhi
| | - G S Wander
- Professor and Head, Department of Cardiology, Dayanand Medical College and Hospital, Ludhiana, Punjab;Corresponding Author
| | - Tiny Nair
- Head, Department of Cardiology, PRS Hospital, Trivandrum, Kerala
| | - C K Ponde
- Consultant Cardiologist and Head, Department of Cardiology, PD Hinduja National Hospital & Medical Research Centre, Mumbai, Maharashtra, India
| | - Navin C Nanda
- Department of Cardiology Division, University of Alabama at Birmingham (UAB), Birmingham, Alabama
| | - Jagat Narula
- Associate Dean, Chief, Icahn School of Medicine at Mount Sinai (ISMMS); Division of Cardiology, Mount Sinai Hospital, New York, United States of America
| | - Saumitra Ray
- Director, Department of Invasive Cardiology, AMRI Hospital, Kolkata, West Bengal
| | - K Venugopal
- Senior Consultant Cardiologist, KVM Hospital Cherthala and SP Fort Hospital, Thiruvananthapuram, Kerala
| | - S S Iyengar
- Consultant Emeritus and Academic Head, Department of Cardiology, Manipal Hospital, Bengaluru, Karnataka
| | - R R Kasliwal
- Chairman, Department of Clinical and Preventive Cardiology, Medanta The Medicity, Gurugram, Haryana
| | - Praveen Chandra
- Chairman, Department of Interventional and Structural Heart Cardiology, Medanta The Medicity, Gurugram, Haryana
| | - Sunil Prakash
- Senior Director and Head, Department of Nephrology and Renal Transplantation, BLK-Max Super Speciality Hospital, Delhi
| | - Sandeep Bansal
- Consultant in Cardiology, Professor and Head, Department of Cardiology, Vardhaman Mahavir Medical College and Safdarjung Hospital, Delhi
| | - D S Rana
- Chairman, Department of Nephrology, Sir Ganga Ram Hospital, Delhi
| | - Prafulla Kerkar
- Senior Consultant Interventional Cardiologist, Asian Heart Institute, Mumbai, Maharashtra
| | - Arup Dasbiswas
- Ex Director ICVS, Professor and Head of Department, Department of Cardiology, ICVS; Institute of Postgraduate Medical Education & Research, Kolkata, West Bengal
| | - Jps Sawhney
- Chief of Clinical and Preventive Cardiology, Chairman, Department of Cardiology, Sir Gangaram Hospital, Delhi
| | | | - Viveka Kumar
- Principal Director and Chief of Cath Labs (Pan Max), Department of Cardiac Sciences, Max Hospital, Delhi
| | - I B Vijayalakshmi
- Professor Emeritus, Former Head Pediatric Cardiology, Shri Jayadeva Institute of Cardiovascular sciences and Research, Bengaluru, Karnataka
| | - A K Pancholia
- Head of Department, Department of Clinical and Preventive Cardiology, Arihant Hospital and Research Centre, Indore, Madhya Pradesh
| | - Vinod Sharma
- Head of Cardiology and Vice Chief Executive Officer, National Heart Institute, Delhi
| | - Aditya Kapoor
- Head, Department of Cardiology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh
| | - Onkar C Swami
- Director, Department of Medical Services, Emcure Pharmaceuticals Ltd., Pune, Maharashtra
| | - H S Isser
- Professor and Consultant, Department of Cardiology, Vardhman Mahavir Medical College and Safdarjung Hospital
| | - Vishal Rastogi
- Director, Department of Interventional Cardiology, Head of Advanced Heart Failure Program, Fortis Escort Heart Institute
| | - Y K Arora
- Consultant Cardiologist, National Heart Institute
| | - Ashok K Omar
- Director, Noninvasive Cardiology and Head Heart Command Centres, Fortis Escorts Heart Institute, Delhi
| | - Sunil Sathe
- Interventional Cardiologist, Ruby Hall Clinic, Pune, Maharashtra
| | | | - D Prabhakar
- Consultant Interventional Cardiologist, Ashwin Clinic, Chennai, Tamil Nadu
| | - G Justin Paul
- Professor of Cardiology, Madras Medical College, Chennai, Tamil Nadu
| | - Priya Jagia
- Professor and Head, Department of Cardiovascular Imaging and Endovascular Interventions, Cardiothoracic Sciences Centre, All India Institute of Medical Sciences, Delhi
| | - Poonam Malhotra
- Senior Professor, Cardiac Anaesthesia, All India Institute of Medical Sciences, Delhi
| | - G Suryaprakash
- Senior Consultant Cardiologist and Clinical Director, Care Hospitals, Hyderabad, Telangana
| | - Vinod Mittal
- Senior Consultant Diabetologist and Head, Centre for Diabetes and Metabolic Diseases, Delhi Heart and Lung Institute
| | - Manish Jagia
- Director, Department of Anaesthesia and Critical care, Moolchand Hospital, Delhi
| | - A Jabir
- Senior Cardiologist and Assistant Professor, Lisie Hospital, Cochin, Kerala
| | - S S Mishra
- Director and Senior Consultant Cardiologist, Med N Heart Clinic, Cuttack, Odisha
| | - S N Routray
- Professor and Head, Department of Cardiology, SCB Medical College, Cuttack, Odisha
| | - Ajay Kumar Sinha
- Senior Consultant, Department of Cardiology, Medanta Heart Institute, Patna, Bihar
| | - Mohan Bhargava
- Director of Cardiology and Interventional Cardiologist, Max hospital, Delhi, India
| | - Kiran Mahmood
- Assistant Professor of Medicine (Cardiology), Icahn School of Medicine at Mount Sinai (ISMMS); Director of Heart Failure Program, Mount Sinai Morningside Hospital, New York, United States of America
| | | | - Dhammdeep Dabhade
- Senior Manager, Department of Medical Services, Emcure Pharmaceuticals Ltd., Pune, Maharashtra
| | - Mona Bhatia
- Principal Director and Head, Department of Radiology and Imaging, Fortis Escorts Heart Institute, Delhi
| | - Pramila Kalra
- Professor and Head, Department of Endocrinology, Ramaiah Medical College and Hospitals, Bengaluru, Karnataka
| | - V K Katyal
- Head of Department, Department of Medicine, Positron Multispecialty and Cancer Hospital, Rohtak, Haryana
| | - Rohit Tandon
- Consultant, Department of Cardiology, Dayanand Medical College and Hospital, Ludhiana, Punjab
| | - Rahul Grover
- Associate Director, Department of Nephrology, Max Hospital, Delhi
| | - Abhinav Chhabra
- Consultant Interventional Cardiologist, Medanta Hospital, Gurugram, Haryana
| | - N R Shastry
- Consultant Cardiologist, Medanta Moolchand Heart Center, Delhi, India
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4
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Chopra HK, Wander GS, Nair T, Ponde CK, Nanda NC, Narula J, Ray S, Venugopal K, Iyengar SS, Kasliwal RR, Chandra P, Prakash S, Bansal S, Rana DS, Kerkar P, Dasbiswas A, Sawhney J, Shanmungasundram S, Kumar V, Vijayalakshmi IB, Pancholia AK, Sharma V, Kapoor A, Swami OC, Isser HS, Rastogi V, Arora YK, Omar AK, Sathe S, Rajput R, Prabhakar D, Paul GJ, Jagia P, Malhotra P, Suryaprakash G, Mittal V, Jagia M, Jabir A, Mishra SS, Routray SN, Sinha AK, Bhargava M, Mahmood K, Bhatia M, Kalra P, Katyal VK, Tandon R, Grover R, Chhabra A, Shastry NR. Role of Iron Therapy in Heart Failure: A Consensus Statement from India. J Assoc Physicians India 2023; 71:11-12. [PMID: 37354511 DOI: 10.5005/japi-11001-0214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/26/2023]
Abstract
Iron deficiency (ID) with or without anemia is frequently observed in patients with heart failure (HF). Uncorrected ID is associated with higher hospitalization and mortality in patients with acute HF (AHF) and chronic HF (CHF). Hence, in addition to chronic renal insufficiency, anemia, and diabetes, ID appears as a novel comorbidity and a treatment target of CHF. Intravenous (IV) ferric carboxymaltose (FCM) reduces the hospitalization risk due to HF worsening and improves functional capacity and quality of life (QOL) in HF patients. The current consensus document provides criteria, an expert opinion on the diagnosis of ID in HF, patient profiles for IV FCM, and correct administration and monitoring of such patients.
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Affiliation(s)
- H K Chopra
- Senior Consultant, Department of Cardiology, Medanta Moolchand Heart Institute, Delhi
| | - G S Wander
- Professor and Head, Department of Cardiology, Dayanand Medical College & Hospital (DMCH), Ludhiana, Punjab; Corresponding Author
| | - Tiny Nair
- Head, Department of Cardiology, PRS Hospital, Trivandrum, Kerala
| | - C K Ponde
- Consultant Cardiologist and Head, Department of Cardiology, P. D. Hinduja National Hospital and Medical Research Centre, Mumbai, Maharashtra
| | - Navin C Nanda
- Department of Cardiology Division, University of Alabama at Birmingham (UAB), Birmingham, Alabama
| | - Jagat Narula
- Associate Dean and Chief, Department of Cardiology, Icahn School of Medicine at Mount Sinai, Mount Sinai, New York
| | - Saumitra Ray
- Director, Department of Invasive Cardiology, AMRI Hospitals, Kolkata, West Bengal
| | - K Venugopal
- Senior Consultant Cardiologist, KVM Hospital Cherthala and SP Fort Hospital, Trivandrum, Kerala
| | - S S Iyengar
- Consultant Emeritus and Academic Head, Department of Cardiology, Manipal Hospital, Bengaluru, Karnataka
| | - R R Kasliwal
- Chairman, Department of Clinical and Preventive Cardiology, Heart Institute at Medanta, Gurgaon, Haryana
| | - Praveen Chandra
- Chairman, Department of Interventional and Structural Heart Cardiology, Medanta Moolchand Heart Institute, Gurgaon, Haryana
| | - Sunil Prakash
- Senior Director and Head, Department of Nephrology and Renal Transplantation, BLK-Max Super Speciality Hospital, Delhi
| | - Sandeep Bansal
- Consultant in Cardiology, Professor and Head, Department of Cardiology, Vardhaman Mahavir Medical College and Safdarjung Hospital, Delhi
| | - D S Rana
- Chairman, Department of Nephrology, Sir Ganga Ram Hospital, Delhi
| | - Prafulla Kerkar
- Senior Consultant Interventional Cardiologist, Asian Heart Institute, Mumbai, Maharashtra
| | - Arup Dasbiswas
- Ex Director ICVS, Professor and Head of Department, Department of Cardiology, ICVS, Institute of Postgraduate Medical Education & Research (IPGMER), Kolkata, West Bengal
| | - Jps Sawhney
- Chief Clinical and Preventive Cardiology and Chairman, Department of Cardiology, Sir Ganga Ram Hospital, Delhi
| | | | - Viveka Kumar
- Principal Director and Chief of Cath Labs (Pan Max), Department of Cardiac Sciences, Max Super Speciality Hospital, Delhi
| | - I B Vijayalakshmi
- Emeritus Professor and Former Head Pediatric Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bengaluru, Karnataka
| | - A K Pancholia
- Head of the Department and Clinical and Preventive Cardiology, Arihant Hospital & Research Centre, Indore, Madhya Pradesh
| | - Vinod Sharma
- Head of Cardiology and Vice Chief Executive Officer, National Heart Institute, Delhi
| | - Aditya Kapoor
- Head, Department of Cardiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh
| | - Onkar C Swami
- Director, Department of Medical Services, Emcure Pharmaceuticals Ltd., Pune, Maharashtra
| | - H S Isser
- Professor and Consultant, Department of Cardiology, Vardhaman Mahavir Medical College and Safdarjung Hospital, Delhi
| | - Vishal Rastogi
- Director, Head of Advanced Heart Failure Program, Department of Interventional Cardiology, Fortis Escorts Heart Institute, Delhi
| | - Y K Arora
- Consultant Cardiologist, National Heart Institute, Delhi
| | - Ashok K Omar
- Director of Noninvasive Cardiology and Head Heart Command Centers, Fortis Escorts Heart Institute, Delhi
| | - Sunil Sathe
- Interventional Cardiologist, Ruby Hall Clinic, Pune, Maharashtra
| | | | - D Prabhakar
- Consultant Interventional Cardiologist, Ashwin Clinic, Chennai, Tamil Nadu
| | - G J Paul
- Professor of Cardiology, Madras Medical College, Chennai, Tamil Nadu
| | - Priya Jagia
- Professor and Head, Department of Cardiovascular Imaging and Endovascular Interventions, Cardiothoracic Sciences Centre, All India Institute of Medical Sciences, Delhi
| | - Poonam Malhotra
- Senior Professor, Cardiac Anaesthesia, All India Institute of Medical Sciences, Delhi
| | - G Suryaprakash
- Senior Consultant Cardiologist and Clinical Director, Care Hospitals, Hyderabad, Telangana
| | - Vinod Mittal
- Senior Consultant Diabetologist and Head, Centre for Diabetes and Metabolic Diseases, Delhi Heart and Lung Institute, Delhi
| | - Manish Jagia
- Director, Department of Anaesthesia and Critical care, Moolchand Hospital, Delhi
| | - A Jabir
- Senior Cardiologist and Assistant Professor, Lisie Hospital, Kochi, Kerala
| | - S S Mishra
- Director and Senior Consultant Cardiologist, Med N Heart Clinic, Cuttack, Odisha
| | - S N Routray
- Professor and Head, Department of Cardiology, Srirama Chandra Bhanj Medical College & Hospital (S.C.B Medical College), Cuttack, Odisha
| | - Ajay K Sinha
- Senior Consultant, Department of Cardiology, Medanta Heart Institute, Patna, Bihar
| | - Mohan Bhargava
- Director Cardiology and Interventional Cardiologist, Max Super Speciality Hospital, Delhi
| | - Kiran Mahmood
- Assistant Professor of Medicine (Cardiology), Icahn School of Medicine, Mount Sinai; Director of Heart Failure Program, Mount Sinai Morningside Hospital, New York
| | - Mona Bhatia
- Principal Director and Head, Department of Radiology and Imaging, Fortis Escorts Heart Institute, Delhi
| | - Pramila Kalra
- Professor and Head, Department of Endocrinology, Ramaiah Medical College and Hospitals, Bengaluru, Karnataka
| | - V K Katyal
- Head, Department of Medicine, Positron Multispecialty and Cancer Hospital, Rohtak, Haryana
| | - Rohit Tandon
- Consultant, Department of Cardiology, Dayanand Medical College & Hospital (DMCH), Ludhiana, Punjab
| | - Rahul Grover
- Associate Director, Department of Nephrology, Max Super Speciality Hospital, Delhi
| | - Abhinav Chhabra
- Consultant Interventional Cardiologist, Medanta Moolchand Heart Institute, Gurgaon, Haryana
| | - N R Shastry
- Consultant Cardiologist, Medanta Moolchand Heart Institute, Delhi
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5
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Chopra HK, Wander GS, Ponde CK, Nanda NC, Khullar D, Venugopal K, Ray S, Nair T, Rana DS, Kher V, S Sawhney JP, Kasliwa RR, Jabir A, Chakraborty R, Chandra P, Bansal S, Kumar V, Pancholia AK, Kapoor A, Prakash S, Saxena A, Rastogi V, Sharma V, Arora YK, Dasbiswas A, Bhargava M, Jaswal A, Bhargava K, Bhatia M, Omar AK, Khanna NN, Passey R, Bhalla D, Vijayalakshmi IB, Bhalla AK, Moorthy A, Isser HS, Mishra SS, Routray SN, Tandon V, Sinha A, Bansal M, Jain P, Hotchandani R, Jain D, Katyal VK, Gulati S, Tandon R, Jaggi S, Sehgal B, Gupta V, Mehrotra R, Krishnamani NC, Pathak SN, Yadav MS, Chawla R, Pal J, Chatterjee N, Samajdar SS, Shastry NR. The Power and Promise of Angiotensin Receptor Neprilysin Inhibitor (ARNI) in Heart Failure Management: National Consensus Statement. J Assoc Physicians India 2023; 71:11-12. [PMID: 37354473 DOI: 10.5005/japi-11001-0209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/26/2023]
Abstract
;Heart failure (HF) is a huge global public health task due to morbidity, mortality, disturbed quality of life, and major economic burden. It is an area of active research and newer treatment strategies are evolving. Recently angiotensin receptor-neprilysin inhibitor (ARNI), a class of drugs (the first agent in this class, Sacubitril-Valsartan), reduces cardiovascular mortality and morbidity in chronic HF patients with reduced left ventricular ejection fraction (LVEF). Positive therapeutic effects have led to a decrease in cardiovascular mortality and HF hospitalizations (HFH), with a favorable safety profile, and have been documented in several clinical studies with an unquestionable survival benefit with ARNI, Sacubitril-Valsartan. This consensus statement of the Indian group of experts in cardiology, nephrology, and diabetes provides a comprehensive review of the power and promise of ARNI in HF management and an evidence-based appraisal of the use of ARNI as an essential treatment strategy for HF patients in clinical practice. Consensus in this review favors an early utility of Sacubitril-Valsartan in patients with HF with reduced EF (HFrEF), regardless of the previous therapy being given. A lower rate of hospitalizations for HF with Sacubitril-Valsartan in HF patients with preserved EF who are phenotypically heterogeneous suggests possible benefits of ARNI in patients having 40-50% of LVEF, frequent subtle systolic dysfunction, and higher hospitalization risk.
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Affiliation(s)
- H K Chopra
- Senior Consultant Cardiologist, Medanta Moolchand Heart Institute, Delhi
| | - G S Wander
- Professor & Head of Cardiology, Hero DMC Heart Institute, Dayanand Medical College & Hospital (DMCH), Ludhiana, Punjab
| | - C K Ponde
- Consultant Cardiologist and Head of Department, Department of Cardiology, P. D. Hinduja Hospital & Medical Research Centre, Mumbai, Maharashtra, India
| | - Navin C Nanda
- Professor of Medicine and Cardiovascular Disease, Heersink School of Medicine, University of Alabama at Birmingham (UAB), Birmingham, United Kingdom
| | - Dinesh Khullar
- Chairman, Department of Nephrology; Department of Kidney Transplant, Max Super Speciality Hospital, Delhi
| | - K Venugopal
- Professor Emeritus, Department of Cardiology, Pushpagiri Institute of Medical Sciences and Research Centre, Thiruvalla, Kerala
| | - Saumitra Ray
- Director, Department of Invasive Cardiology, AMRI Hospitals, Kolkata, West Bengal
| | - Tiny Nair
- Head, Department of Cardiology & Interventional Cardiology, PRS Hospital, Trivandrum, Kerala
| | - D S Rana
- Emeritus Consultant Nephrologist, Department of Nephrology, Sir Ganga Ram Hospital
| | - Vijay Kher
- Chairman; Department of Nephrology; Department of Kidney Transplant, Epitome Kidney Urology Institute & Lions Hospital
| | - J P S Sawhney
- Chairman, Department of Cardiology, Sir Ganga Ram Hospital, New Delhi, Delhi
| | - R R Kasliwa
- Adjunct Professor, Department of Cardiology; Chairman, Department of Clinical and Preventive Cardiology, Medanta Moolchand Heart Institute, Gurugram, Haryana
| | - A Jabir
- Senior Consultant Cardiologist, Lisie Hospital, Kochi, Kerala
| | - Rabin Chakraborty
- Senior Vice Chairman and Head of Cardiology, Medica Superspecialty Hospital (MSH), Kolkata, West Bengal
| | - Praveen Chandra
- Chairman, Department of Interventional Cardiology, Medanta Moolchand Heart Institute
| | - Sandeep Bansal
- Professor and HOD, Department of Cardiology, Safdarjung Hospital
| | - Viveka Kumar
- Principal Director and Chief of Cath Lab, Department of Cardiac Sciences, Max Super Speciality Hospital, Delhi
| | - A K Pancholia
- HOD, Department of Medicine and Preventive Cardiology, Arihant Hospital & Research Centre, Indore, Madhya Pradesh
| | - Aditya Kapoor
- Professor and Head of the Department, Department of Cardiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences
| | - Sunil Prakash
- Director and Head, Department of Nephrology; Department of Transplant service BLK, Max Super Speciality Hospital
| | - Anil Saxena
- Executive Director, Department of Cardiac Pacing and Electrophysiology, Fortis Escorts Heart Institute
| | - Vishal Rastogi
- Director of Cardiology, Department of Cardiology, Fortis Escorts Heart Institute
| | - Vinod Sharma
- Vice CEO and Head, Department of Cardiology, National Heart Institute
| | - Y K Arora
- Cardiologist, National Heart Institute, Delhi
| | - Arup Dasbiswas
- Ex-Director, ICVS, Institute of Post Graduate Medical Education and Research (IPGME&R); Chief Cardiologist, Das Biswas Clinic, Kolkata, West Bengal
| | - Mohan Bhargava
- Director, Department of Interventional Cardiology, Max Super Speciality Hospital, Delhi, India
| | - Aparna Jaswal
- Member, Board of Directors, International Board of Heart Rhythm Examiners, Columbia, Washington, United States of America; Director, Department of Cardiac Pacing and Electrophysiology, Fortis Escorts Heart Institute
| | - K Bhargava
- Senior Director, Department of Cardiac Electrophysiology and Pacing, Medanta Moolchand Heart Institute
| | - Mona Bhatia
- Principal, Director, Head, Department of Imaging, Fortis Escorts Heart Institute
| | - A K Omar
- Director, Head, Department of Non-Invasive Cardiology, Fortis Escorts Heart Institute
| | - N N Khanna
- Advisor, Senior Consultant, Department of Cardiology, Indraprastha Apollo Hospitals
| | | | - Dilip Bhalla
- Senior Director, Department of Nephrology and Renal Transplant, Max Super Speciality Hospital, Delhi
| | - I B Vijayalakshmi
- Professor Emeritus, Former HOD, Department of Paediatric Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bengaluru, Karnataka
| | - A K Bhalla
- Chairman, Department of Nephrology, Sir Ganga Ram Hospital, Delhi
| | - Asha Moorthy
- Senior Consultant Cardiologist, SIMS Hospital, Chennai, Tamil Nadu
| | - H S Isser
- Department of Cardiology, VMMC & Safdarjung Hospital
| | | | - S N Routray
- Professor, Department of Cardiology, Srirama Chandra Bhanj Medical College & Hospital (S.C.B Medical College), Cuttack, Odisha
| | - Vivek Tandon
- Associate Director, In charge, Non-Invasive Cardiac Laboratory, Max Smart Super Speciality Hospital, Delhi
| | - Ajay Sinha
- Senior Consultant, Cardiologist, Jay Prabha Medanta Super Specialty Hospital, Patna, Bihar
| | - Manish Bansal
- Senior Director, Department Clinical and Preventive Cardiology, Medanta - The Medicity Multi-Speciality Hospital, Gurugram, Haryana
| | - Praveen Jain
- Executive Director, Chief Cardiologist, Lifeline Superspeciality Hospital and Heart Center, Jhansi, Uttar Pradesh
| | - Ramesh Hotchandani
- Consultant, Head, Department of Nephrology, Moolchand Centre for Renal Care and Dialysis, Moolchand Hospital, Delhi
| | - Dharmendra Jain
- Professor, Department of Cardiology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh
| | - V K Katyal
- HOD, Department of General Medicine, Positron Hospital; Formerly Senior Professor, HOD, Department of Medicine, Pt. B.D.Sharma, Post Graduate Institute of Medical Sciences, Rohtak, Haryana
| | - Sanjiv Gulati
- Principal Director, Department of Nephrology, Fortis Hospital, Delhi
| | - Rohit Tandon
- Senior Consultant Physician, Department of Cardiology, Hero DMC Heart Institute, Dayanand Medical College & Hospital (DMCH), Ludhiana, Punjab
| | - Shalini Jaggi
- Director, Consultant Diabetologist, Lifecare Diabetes Centre
| | - Blessy Sehgal
- Consultant Nephrologist, Department of Nephrology, Sri Balaji Action Medical Institute, Delhi
| | - Vitull Gupta
- Honorary Teaching Faculty, All India Institute of Medical Sciences; Consultant Physician, Kishori Ram Hospital, Bathinda, Punjab
| | - Rahul Mehrotra
- Director and Head, Department of Non-Invasive Cardiology, Max Super Speciality Hospital
| | | | - S N Pathak
- Senior Consultant Interventional Cardiologist, Indraprastha Apollo Hospital
| | - M S Yadav
- Senior Consultant, Department of Interventional Cardiology, Max Super Speciality Hospital
| | - Rajeev Chawla
- Senior Consultant Diabetologist, Director, North Delhi Diabetes Centre, Delhi
| | - Jyotirmoy Pal
- Professor, Department of General Medicine, R.G. Kar Medical College & Hospital
| | - Nandini Chatterjee
- Clinical Pharmacologist, Diabetes & Allergy-Asthma Therapeutics Specialty Clinic
| | - Shambo S Samajdar
- Professor, Department of Medicine, Institute of Post Graduate Medical Education and Research (IPGME&R) - SSKM Hospital
| | - N R Shastry
- Cardiologist, Department of Clinical Cardiology, Medanta-Moolchand Heart Centre, Delhi, India
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Jadhav U, Tiwaskar M, Khan A, Kalmath BC, Ponde CK, Sawhney J, Tripathy MP, Hazra PK, Sahoo PK, Routray SN, Chandra S, Alexander T, Chopra VK. Hypertension in Young Adults in India: Perspectives and Therapeutic Options amongst Clinician's in a Cross Sectional Observational Study. J Assoc Physicians India 2021; 69:11-12. [PMID: 34781615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
BACKGROUND The prevalence of hypertension in the young adult population is rising in India. Increased arterial stiffness due to RAAS activation and increased sympathetic overactivity due to stress have been implicated as primary factors for the same. This study was aimed to understand the Indian clinician's perspective on approach to management of hypertension in young adults. METHODS A cross sectional observational survey using a structured questionnaire was conducted online with 2287clinicians (cardiologists, diabetologists, consultant physicians and family physicians). RESULTS The prevalence of hypertension was 10-30% as per opinion of 64.8% clinicians. The top three risk factors for hypertension in young were perceived to be smoking, mental stress and obesity. Around 57.4% respondents opined that both increased heart rate and systolic blood pressure were markers of sympathetic overactivity. More than 60% respondents across specialities preferred ARBs to treat hypertension in young adults. Amongst the ARBs, telmisartan was the preferred ARB by >80% respondents. Metoprolol was the preferred beta blocker by almost 64% respondents. The objective of selection of beta-blocker by majority of clinicians due to sympathetic overactivity. Telmisartan and Metoprolol single pill combination achieved the BP goal in 40-60% of patients as reported by 41.3% of the physicians. The combination therapy was well tolerated in young hypertensive patients. CONCLUSIONS Initiation of an early and appropriate antihypertensive treatment in young population may lower the burden of cardiovascular disease in this population. ARBs and beta -blockers were the preferred class of anti-hypertensive drugs in the cohort of young hypertensive patients .
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Affiliation(s)
- Uday Jadhav
- MGM New Bombay Hospital, Vashi, Navi Mumbai, Maharashtra Corresponding Author
| | | | - Aziz Khan
- Crescent Hospital & Heart Centre, Nagpur, Maharashtra
| | - B C Kalmath
- Bombay Hospital & Medical Research Centre, Mumbai, Maharashtra
| | - C K Ponde
- PD Hinduja Hospital & Medical Research Centre, Mumbai, Maharashtra
| | | | | | | | - P K Sahoo
- Apollo Hospital, Bhubaneswar, Orissa
| | | | | | | | - V K Chopra
- Max Super Speciality Hospital, New Delhi
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7
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Gupta K, Ramakrishnan S, Zachariah G, Rao JS, Mohanan PP, Venugopal K, Sateesh S, Sethi R, Jain D, Bardolei N, Mani K, Kakar TS, Jain V, Gupta P, Gupta R, Bansal S, Nath RK, Tyagi S, Wander GS, Gupta S, Mandal S, Senguttuvan NB, Subramanyam G, Roy D, Datta S, Ganguly K, Routray SN, Mishra SS, Singh BP, Bharti BB, Das MK, Deb PK, Deedwania P, Seth A. Impact of the 2017 ACC/AHA guidelines on the prevalence of hypertension among Indian adults: Results from a cross-sectional survey. Int J Cardiol Hypertens 2021; 7:100055. [PMID: 33465185 PMCID: PMC7803035 DOI: 10.1016/j.ijchy.2020.100055] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 09/27/2020] [Accepted: 09/30/2020] [Indexed: 01/19/2023] Open
Abstract
Background The impact of the 2017 American College of Cardiology (ACC)/American Heart Association (AHA) guidelines for diagnosis and management of hypertension on the prevalence of hypertension in India is unknown. Methods We analyzed data from the Cardiac Prevent 2015 survey to estimate the change in the prevalence of hypertension. The JNC8 guidelines defined hypertension as a systolic blood pressure of ≥140 mmHg or diastolic blood pressure of ≥90 mmHg. The 2017 ACC/AHA guidelines define hypertension as a systolic blood pressure of ≥130 mmHg or diastolic blood pressure of ≥80 mmHg. We standardized the prevalence as per the 2011 census population of India. We also calculated the prevalence as per the World Health Organization (WHO) World Standard Population (2000–2025). Results Among 180,335 participants (33.2% women), the mean age was 40.6 ± 14.9 years (41.1 ± 15.0 and 39.7 ± 14.7 years in men and women, respectively). Among them, 8,898 (4.9%), 99,791 (55.3%), 35,694 (11.9%), 23,084 (12.8%), 9,989 (5.5%) and 2,878 (1.6%) participants belonged to age group 18–19, 20–44, 45–54, 55–64, 65–74 and ≥ 75 years respectively. The prevalence of hypertension according to the JNC8 and 2017 ACC/AHA guidelines was 29.7% and 63.8%, respectively- an increase of 115%. With the 2011 census population of India, this suggests that currently, 486 million Indian adults have hypertension according to the 2017 ACC/AHA guidelines, an addition of 260 million as compared to the JNC8 guidelines. Conclusion According to the 2017 ACC/AHA guidelines, 3 in every 5 Indian adults have hypertension.
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Affiliation(s)
- Kartik Gupta
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India.,Department of Medicine, Henry Ford Hospital, Detroit, MI, USA
| | - Sivasubramanian Ramakrishnan
- Department of Cardiology, All India Institute of Medical Sciences, New Delhi, India.,Cardiology Society of India, India
| | | | | | | | | | | | | | | | | | - Kalaivani Mani
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
| | | | - Vardhmaan Jain
- Department of Internal Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Prakash Gupta
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - P K Deb
- Cardiology Society of India, India
| | - Prakash Deedwania
- School of Medicine, University of California, San Francisco Fresno, CA, USA
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Harikrishnan S, Mohanan PP, Chopra VK, Ambuj R, Sanjay G, Bansal M, Chakraborty RN, Chandra S, Chattarjee SS, Chopra HK, Mathew C, Deb PK, Goyal A, Goswami KC, Gupta R, Guha S, Gupta V, Hasija PK, Wardhan H, Jabir A, Jayagopal PB, Kahali D, Katyal VK, Kerkar PG, Khanna NN, Majumder B, Mandal M, Meena CB, Naik N, Narain VK, Pathak LA, Ray S, Roy D, Routray SN, Sarma D, Shanmugasundaram S, Singh BP, Tyagi SK, Venugopal K, Wander GS, Yadav R, Das MK. Cardiological society of India position statement on COVID-19 and heart failure. Indian Heart J 2020; 72:75-81. [PMID: 32405088 PMCID: PMC7219407 DOI: 10.1016/j.ihj.2020.04.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 04/29/2020] [Indexed: 02/06/2023] Open
Affiliation(s)
- S Harikrishnan
- Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India.
| | | | | | | | - G Sanjay
- Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India
| | | | | | | | | | | | | | - P K Deb
- Daffodil Hospitals, Kolkata, India
| | - A Goyal
- Bani Park Hospital, D-9, Kabir Marg, Bani Park, JAIPUR, 302016, Rajasthan, India
| | | | - R Gupta
- JROP Institute of Echocardiography, New Delhi, India
| | - S Guha
- Medical College, Kolkata, India
| | - V Gupta
- Kishori Ram Hospital & Diabetes Care Centre, Bhatinda, Punjab, India
| | - P K Hasija
- MH Chennai, Armed Forces Medical Services, India
| | - Harsh Wardhan
- Mahatma Gandhi Medical College and Hospital, Jaipur, India
| | | | | | - D Kahali
- C.K.Birla Group of Hospitals (BMB), Kolkata, India
| | | | | | - N N Khanna
- Indraprastha Apollo Hospitals, Sarita Vihar, New Delhi, India
| | - B Majumder
- R.G. Kar Medical College, Kolkata, India
| | - M Mandal
- NRS Medical College, Kolkata, India
| | - C B Meena
- SMS Medical College, Jaipur, Rajasthan, India
| | | | - V K Narain
- King George's Medical University, Lucknow, India
| | - L A Pathak
- Nanavati Superspeciality Hospital, Mumbai, India
| | - S Ray
- Vivekananda Institute of Medical Sciences, Kolkata, India
| | - D Roy
- Rabindranath Tagore International Institute of Cardiac Sciences, Kolkata, India
| | | | - D Sarma
- Jorhat Christian Medical Centre Hospital, Jorhat, Assam, India
| | | | | | - S K Tyagi
- GB Pant Institute of Post Graduate Medical Education and Research, New Delhi, India
| | | | | | | | - M K Das
- C.K. Birla Group of Hospitals (BMB/CMRI), Kolkata, India
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Guha S, Harikrishnan S, Ray S, Sethi R, Ramakrishnan S, Banerjee S, Bahl VK, Goswami KC, Banerjee AK, Shanmugasundaram S, Kerkar PG, Seth S, Yadav R, Kapoor A, Mahajan AU, Mohanan PP, Mishra S, Deb PK, Narasimhan C, Pancholia AK, Sinha A, Pradhan A, Alagesan R, Roy A, Vora A, Saxena A, Dasbiswas A, Srinivas BC, Chattopadhyay BP, Singh BP, Balachandar J, Balakrishnan KR, Pinto B, Manjunath CN, Lanjewar CP, Jain D, Sarma D, Paul GJ, Zachariah GA, Chopra HK, Vijayalakshmi IB, Tharakan JA, Dalal JJ, Sawhney JPS, Saha J, Christopher J, Talwar KK, Chandra KS, Venugopal K, Ganguly K, Hiremath MS, Hot M, Das MK, Bardolui N, Deshpande NV, Yadava OP, Bhardwaj P, Vishwakarma P, Rajput RK, Gupta R, Somasundaram S, Routray SN, Iyengar SS, Sanjay G, Tewari S, Sengottuvelu G, Kumar S, Mookerjee S, Nair T, Mishra T, Samal UC, Kaul U, Chopra VK, Narain VS, Raj V, Lokhandwala Y. Corrigendum to "Cardiological Society of India position statement on management of heart failure in India" [Indian Heart J 70 (S1) (2018) S1-S72]. Indian Heart J 2018; 70:952-953. [PMID: 30580876 PMCID: PMC6306345 DOI: 10.1016/j.ihj.2018.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Affiliation(s)
- Santanu Guha
- Chairman, CSI Guidelines Committee; Medical College Kolkata, India
| | - S Harikrishnan
- Chief Coordinator, CSI HF Position Statement; Sree Chitra Tirunal Institute for Medical Sciences & Technology, Trivandrum, Kerala, India.
| | - Saumitra Ray
- Convenor, CSI Guidelines Committee; Vivekananda Institute of Medical Sciences, Kolkata, India
| | - Rishi Sethi
- Joint Coordinator, CSI HF Position Statement; KG Medical University, Lucknow, India
| | - S Ramakrishnan
- Joint Coordinator, CSI HF Position Statement; All India Institute of Medical Sciences, New Delhi, India
| | - Suvro Banerjee
- Joint Convenor, CSI Guidelines Committee; Apollo Hospitals, Kolkata, India
| | - V K Bahl
- Joint Coordinator, CSI HF Position Statement; All India Institute of Medical Sciences, New Delhi, India
| | - K C Goswami
- Joint Coordinator, CSI HF Position Statement; All India Institute of Medical Sciences, New Delhi, India
| | - Amal Kumar Banerjee
- Institute of Post Graduate Medical Education & Research, Kolkata, West Bengal, India
| | - S Shanmugasundaram
- Department of Cardiology, Tamil Nadu Medical University, Billroth Hospital, Chennai, Tamil Nadu, India
| | | | - Sandeep Seth
- Joint Coordinator, CSI HF Position Statement; All India Institute of Medical Sciences, New Delhi, India
| | - Rakesh Yadav
- Joint Coordinator, CSI HF Position Statement; All India Institute of Medical Sciences, New Delhi, India
| | - Aditya Kapoor
- Department of Cardiology, Sanjay Gandhi PGIMS, Lucknow, Uttar Pradesh, India
| | - Ajaykumar U Mahajan
- Department of Cardiology, Lokmanya Tilak Municipal Medical College and General Hospital, Mumbai, Maharashtra, India
| | - P P Mohanan
- Department of Cardiology, Westfort Hi Tech Hospital, Thrissur, Kerala, India
| | - Sundeep Mishra
- Joint Coordinator, CSI HF Position Statement; All India Institute of Medical Sciences, New Delhi, India
| | - P K Deb
- Daffodil Hospitals, Kolkata, West Bengal, India
| | - C Narasimhan
- Department of Cardiology & Chief of Electro Physiology Department, Care Hospitals, Hyderabad, Telangana, India
| | - A K Pancholia
- Clinical & Preventive Cardiology, Arihant Hospital & Research Centre, Indore, Madhya Pradesh, India
| | | | - Akshyaya Pradhan
- Department of Cardiology, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - R Alagesan
- The Tamil Nadu Dr.M.G.R. Medical University, Tamil Nadu, India
| | - Ambuj Roy
- Joint Coordinator, CSI HF Position Statement; All India Institute of Medical Sciences, New Delhi, India
| | - Amit Vora
- Arrhythmia Associates, Mumbai, Maharashtra, India
| | - Anita Saxena
- Joint Coordinator, CSI HF Position Statement; All India Institute of Medical Sciences, New Delhi, India
| | | | | | | | - B P Singh
- Department of Cardiology, IGIMS, Patna, Bihar, India
| | | | - K R Balakrishnan
- Cardiac Sciences, Fortis Malar Hospital, Adyar, Chennai, Tamil Nadu, India
| | - Brian Pinto
- Holy Family Hospitals, Mumbai, Maharashtra, India
| | - C N Manjunath
- Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore, Karnataka, India
| | | | - Dharmendra Jain
- Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Dipak Sarma
- Cardiology & Critical Care, Jorhat Christian Medical Centre Hospital, Jorhat, Assam, India
| | - G Justin Paul
- Department of Cardiology, Madras Medical College, Chennai, Tamil Nadu, India
| | | | | | - I B Vijayalakshmi
- Bengaluru Medical College and Research Institute, Bengaluru, Karnataka, India
| | - J A Tharakan
- Department of Cardiology, P.K. Das Institute of Medical Sciences, Vaniamkulam, Palakkad, Kerala, India
| | - J J Dalal
- Kokilaben Hospital, Mumbai, Maharashtra, India
| | - J P S Sawhney
- Department of Cardiology, Dharma Vira Heart Center, Sir Ganga Ram Hospital, New Delhi, India
| | - Jayanta Saha
- Chairman, CSI Guidelines Committee; Medical College Kolkata, India
| | | | - K K Talwar
- Max Healthcare, Max Super Speciality Hospital, Saket, New Delhi, India
| | - K Sarat Chandra
- Indo-US Super Speciality Hospital & Virinchi Hospital, Hyderabad, Telangana, India
| | - K Venugopal
- Pushpagiri Institute of Medical Sciences, Tiruvalla, Kerala, India
| | - Kajal Ganguly
- Department of Cardiology, N.R.S. Medical College, Kolkata, West Bengal, India
| | | | - Milind Hot
- Department of CTVS, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Mrinal Kanti Das
- B.M. Birla Heart Research Centre & CMRI, Kolkata, West Bengal, India
| | - Neil Bardolui
- Department of Cardiology, Excelcare Hospitals, Guwahati, Assam, India
| | - Niteen V Deshpande
- Cardiac Cath Lab, Spandan Heart Institute and Research Center, Nagpur, Maharashtra, India
| | - O P Yadava
- National Heart Institute, New Delhi, India
| | - Prashant Bhardwaj
- Department of Cardiology, Military Hospital (Cardio Thoracic Centre), Pune, Maharashtra, India
| | - Pravesh Vishwakarma
- Joint Coordinator, CSI HF Position Statement; KG Medical University, Lucknow, India
| | | | - Rakesh Gupta
- JROP Institute of Echocardiography, New Delhi, India
| | | | - S N Routray
- Department of Cardiology, SCB Medical College, Cuttack, Odisha, India
| | - S S Iyengar
- Manipal Hospitals, Bangalore, Karnataka, India
| | - G Sanjay
- Chief Coordinator, CSI HF Position Statement; Sree Chitra Tirunal Institute for Medical Sciences & Technology, Trivandrum, Kerala, India
| | - Satyendra Tewari
- Department of Cardiology, Sanjay Gandhi PGIMS, Lucknow, Uttar Pradesh, India
| | | | - Soumitra Kumar
- Convenor, CSI Guidelines Committee; Vivekananda Institute of Medical Sciences, Kolkata, India
| | - Soura Mookerjee
- Chairman, CSI Guidelines Committee; Medical College Kolkata, India
| | - Tiny Nair
- Department of Cardiology, P.R.S. Hospital, Trivandrum, Kerala, India
| | - Trinath Mishra
- Department of Cardiology, M.K.C.G. Medical College, Behrampur, Odisha, India
| | | | - U Kaul
- Batra Heart Center & Batra Hospital and Medical Research Center, New Delhi, India
| | - V K Chopra
- Heart Failure Programme, Department of Cardiology, Medanta Medicity, Gurugram, Haryana, India
| | - V S Narain
- Joint Coordinator, CSI HF Position Statement; KG Medical University, Lucknow, India
| | - Vimal Raj
- Narayana Hrudayalaya Hospital, Bangalore, Karnataka, India
| | - Yash Lokhandwala
- Mumbai & Visiting Faculty, Sion Hospital, Mumbai, Maharashtra, India
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Guha S, Harikrishnan S, Ray S, Sethi R, Ramakrishnan S, Banerjee S, Bahl VK, Goswami KC, Banerjee AK, Shanmugasundaram S, Kerkar PG, Seth S, Yadav R, Kapoor A, Mahajan AU, Mohanan PP, Mishra S, Deb PK, Narasimhan C, Pancholia AK, Sinha A, Pradhan A, Alagesan R, Roy A, Vora A, Saxena A, Dasbiswas A, Srinivas BC, Chattopadhyay BP, Singh BP, Balachandar J, Balakrishnan KR, Pinto B, Manjunath CN, Lanjewar CP, Jain D, Sarma D, Paul GJ, Zachariah GA, Chopra HK, Vijayalakshmi IB, Tharakan JA, Dalal JJ, Sawhney JPS, Saha J, Christopher J, Talwar KK, Chandra KS, Venugopal K, Ganguly K, Hiremath MS, Hot M, Das MK, Bardolui N, Deshpande NV, Yadava OP, Bhardwaj P, Vishwakarma P, Rajput RK, Gupta R, Somasundaram S, Routray SN, Iyengar SS, Sanjay G, Tewari S, G S, Kumar S, Mookerjee S, Nair T, Mishra T, Samal UC, Kaul U, Chopra VK, Narain VS, Raj V, Lokhandwala Y. CSI position statement on management of heart failure in India. Indian Heart J 2018; 70 Suppl 1:S1-S72. [PMID: 30122238 PMCID: PMC6097178 DOI: 10.1016/j.ihj.2018.05.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Affiliation(s)
- Santanu Guha
- Chairman, CSI Guidelines Committee; Medical College Kolkata, India
| | - S Harikrishnan
- Chief Coordinator, CSI HF Position Statement; Sree Chitra Tirunal Institute for Medical Sciences & Technology, Trivandrum, Kerala, India.
| | - Saumitra Ray
- Convenor, CSI Guidelines Committee; Vivekananda Institute of Medical Sciences, Kolkata
| | - Rishi Sethi
- Joint Coordinator, CSI HF Position Statement; KG Medical University, Lucknow
| | - S Ramakrishnan
- Joint Coordinator, CSI HF Position Statement; All India Institute of Medical Sciences, New Delhi, India
| | - Suvro Banerjee
- Joint Convenor, CSI Guidelines Committee; Apollo Hospitals, Kolkata
| | - V K Bahl
- Joint Coordinator, CSI HF Position Statement; All India Institute of Medical Sciences, New Delhi, India
| | - K C Goswami
- Joint Coordinator, CSI HF Position Statement; All India Institute of Medical Sciences, New Delhi, India
| | - Amal Kumar Banerjee
- Institute of Post Graduate Medical Education & Research, Kolkata, West Bengal, India
| | - S Shanmugasundaram
- Department of Cardiology, Tamil Nadu Medical University, Billroth Hospital, Chennai, Tamil Nadu, India
| | | | - Sandeep Seth
- Joint Coordinator, CSI HF Position Statement; All India Institute of Medical Sciences, New Delhi, India
| | - Rakesh Yadav
- Joint Coordinator, CSI HF Position Statement; All India Institute of Medical Sciences, New Delhi, India
| | - Aditya Kapoor
- Department of Cardiology, Sanjay Gandhi PGIMS, Lucknow, Uttar Pradesh, India
| | - Ajaykumar U Mahajan
- Department of Cardiology, LokmanyaTilak Municipal Medical College and General Hospital, Mumbai, Maharashtra, India
| | - P P Mohanan
- Department of Cardiology, Westfort Hi Tech Hospital, Thrissur, Kerala, India
| | - Sundeep Mishra
- Joint Coordinator, CSI HF Position Statement; All India Institute of Medical Sciences, New Delhi, India
| | - P K Deb
- Daffodil Hospitals, Kolkata, West Bengal, India
| | - C Narasimhan
- Department of Cardiology & Chief of Electro Physiology Department, Care Hospitals, Hyderabad, Telangana, India
| | - A K Pancholia
- Clinical & Preventive Cardiology, Arihant Hospital & Research Centre, Indore, Madhya Pradesh, India
| | | | - Akshyaya Pradhan
- Department of Cardiology, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - R Alagesan
- The Tamil Nadu Dr.M.G.R. Medical University, Tamil Nadu, India
| | - Ambuj Roy
- Joint Coordinator, CSI HF Position Statement; All India Institute of Medical Sciences, New Delhi, India
| | - Amit Vora
- Arrhythmia Associates, Mumbai, Maharashtra, India
| | - Anita Saxena
- Joint Coordinator, CSI HF Position Statement; All India Institute of Medical Sciences, New Delhi, India
| | | | | | | | - B P Singh
- Department of Cardiology, IGIMS, Patna, Bihar, India
| | | | - K R Balakrishnan
- Cardiac Sciences, Fortis Malar Hospital, Adyar, Chennai, Tamil Nadu, India
| | - Brian Pinto
- Holy Family Hospitals, Mumbai, Maharashtra, India
| | - C N Manjunath
- Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore, Karnataka, India
| | | | - Dharmendra Jain
- Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Dipak Sarma
- Cardiology & Critical Care, Jorhat Christian Medical Centre Hospital, Jorhat, Assam, India
| | - G Justin Paul
- Department of Cardiology, Madras Medical College, Chennai, Tamil Nadu, India
| | | | | | - I B Vijayalakshmi
- Bengaluru Medical College and Research Institute, Bengaluru, Karnataka, India
| | - J A Tharakan
- Department of Cardiology, P.K. Das Institute of Medical Sciences, Vaniamkulam, Palakkad, Kerala, India
| | - J J Dalal
- Kokilaben Hospital, Mumbai, Maharshtra, India
| | - J P S Sawhney
- Department of Cardiology, Dharma Vira Heart Center, Sir Ganga Ram Hospital, New Delhi, India
| | - Jayanta Saha
- Chairman, CSI Guidelines Committee; Medical College Kolkata, India
| | | | - K K Talwar
- Max Healthcare, Max Super Speciality Hospital, Saket, New Delhi, India
| | - K Sarat Chandra
- Indo-US Super Speciality Hospital & Virinchi Hospital, Hyderabad, Telangana, India
| | - K Venugopal
- Pushpagiri Institute of Medical Sciences, Tiruvalla, Kerala, India
| | - Kajal Ganguly
- Department of Cardiology, N.R.S. Medical College, Kolkata, West Bengal, India
| | | | - Milind Hot
- Department of CTVS, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Mrinal Kanti Das
- B.M. Birla Heart Research Centre & CMRI, Kolkata, West Bengal, India
| | - Neil Bardolui
- Department of Cardiology, Excelcare Hospitals, Guwahati, Assam, India
| | - Niteen V Deshpande
- Cardiac Cath Lab, Spandan Heart Institute and Research Center, Nagpur, Maharashtra, India
| | - O P Yadava
- National Heart Institute, New Delhi, India
| | - Prashant Bhardwaj
- Department of Cardiology, Military Hospital (Cardio Thoracic Centre), Pune, Maharashtra, India
| | - Pravesh Vishwakarma
- Joint Coordinator, CSI HF Position Statement; KG Medical University, Lucknow
| | | | - Rakesh Gupta
- JROP Institute of Echocardiography, New Delhi, India
| | | | - S N Routray
- Department of Cardiology, SCB Medical College, Cuttack, Odisha, India
| | - S S Iyengar
- Manipal Hospitals, Bangalore, Karnataka, India
| | - G Sanjay
- Chief Coordinator, CSI HF Position Statement; Sree Chitra Tirunal Institute for Medical Sciences & Technology, Trivandrum, Kerala, India
| | - Satyendra Tewari
- Department of Cardiology, Sanjay Gandhi PGIMS, Lucknow, Uttar Pradesh, India
| | | | - Soumitra Kumar
- Convenor, CSI Guidelines Committee; Vivekananda Institute of Medical Sciences, Kolkata
| | - Soura Mookerjee
- Chairman, CSI Guidelines Committee; Medical College Kolkata, India
| | - Tiny Nair
- Department of Cardiology, P.R.S. Hospital, Trivandrum, Kerala, India
| | - Trinath Mishra
- Department of Cardiology, M.K.C.G. Medical College, Behrampur, Odisha, India
| | | | - U Kaul
- Batra Heart Center & Batra Hospital and Medical Research Center, New Delhi, India
| | - V K Chopra
- Heart Failure Programme, Department of Cardiology, Medanta Medicity, Gurugram, Haryana, India
| | - V S Narain
- Joint Coordinator, CSI HF Position Statement; KG Medical University, Lucknow
| | - Vimal Raj
- Narayana Hrudayalaya Hospital, Bangalore, Karnataka, India
| | - Yash Lokhandwala
- Mumbai & Visiting Faculty, Sion Hospital, Mumbai, Maharashtra, India
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Mishra TK, Das S, Patnaik UK, Routray SN, Behera M. Relationship of metabolic syndrome with quantum of coronary artery disease in Indian patients with chronic stable angina. Metab Syndr Relat Disord 2008; 2:187-91. [PMID: 18370685 DOI: 10.1089/met.2004.2.187] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The current study was aimed to ascertain presence and severity of coronary artery lesions in patients of Type 2 diabetic mellitus (DM) with coronary artery disease (CAD), in our population, by using scoring system analysis of the coronary angiography. METHODS 147 consecutive patients with Type 2 DM of chronic stable angina (CSA) were enrolled in the study with 147 age- and sex-matched patients of CSA who did not have diabetes to serve as control. All of them underwent coronary angiography and were evaluated by using four scores to quantify the coronary artery lesions. The scores analyzed were coronary score, extent score, severity score, and atherosclerosis score. Other major risk factors such as smoking and hypertension lipid profile were also evaluated. RESULTS Type 2 diabetics with CAD had higher coronary score (0.91 +/- 0.63 in diabetics vs. 0.43 +/- 0.39, p < 0.001), extent score (4.91 +/- 3.1 vs. 2.3 +/- 1.8, p < 0.001), severity score (1.85 +/- 0.41 vs. 1.2 +/- 0.32, p < 0.001), and atherosclerosis score (0.52 +/- 0.31 vs. 0.21 +/- 0.26, p < 0.001) as compared to non-diabetics with CAD. Left main stem involvement, 2-vessel disease, and 3-vessel disease were also more frequent in the diabetics. These diabetes also had higher incidence of obesity, hypertension, and dyslipidemia. CONCLUSIONS In our population, diabetics suffer from higher prevalence of diffuse and extensive coronary atherosclerosis. The grades of stenosis in coronary arteries are also higher in diabetic patients when compared with non-diabetics with CAD, as was the prevalence of other components of the metabolic syndrome.
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Affiliation(s)
- T K Mishra
- Department of Cardiology, M.K.C.G. Medical College, Berhampur, India
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Abstract
OBJECTIVE To determine the clinical and echocardiographic profiles of women with peripartum cardiomyopathy and ascertain the natural course of the disease. METHODS Fifty-six women with peripartum cardiomyopathy were followed up for a mean period of 6.1 years and their clinical and echocardiographic profiles were studied as well as their outcomes. RESULTS The mean+/-SD age at presentation was 31+/-5 years and mean parity was 2.6+/-1. Of the 56 patients, 18 (32.1%) had NYHA Class II, 24 (42.9%) had NYHA Class III, and 14 (25%) had NYHA Class IV symptoms, and 21 (37.5%) and 35 (62.5%), respectively, presented with features of heart failure during pregnancy and the postpartum. During follow-up, the left ventricular ejection fraction improved from 31%+/-7.2% to 43%+/-8% (P</=0.05). Nine patients (16.1%) became pregnant, with a mortality of 55.5% during pregnancy and 23.2% during follow-up. CONCLUSION Women with peripartum cardiomyopathy present with severe left ventricular dysfunction late in the pregnancy or early in the puerperium. A considerable number of women still die from this condition despite the use of angiotensin-converting enzyme inhibitors and beta-blockers. A subsequent pregnancy carries a very high risk of mortality.
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Affiliation(s)
- T K Mishra
- Department of Cardiology, SCB Medical College, Cuttack, Orissa, India
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Mishra TK, Routray SN, Das S, Behera M. Left ventricular dysfunction in patients with subclinical hypothyroidism and its reversibility after hormone therapy. J Assoc Physicians India 2005; 53:943-6. [PMID: 16515232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
AIM To ascertain the presence of LV dysfunction in patients of subclinical hypothyroidism and its reversibility after hormone therapy. METHODS AND METERIAL: Thirty two patients with subclinical hypothyroidism (SH) were included in the study, along with thirty two age and sex matched individuals serving as controls. The patients with SH had normal serum T3 and T4 with an elevated TSH value. All patients and the controls were subjected to detailed echocardiographic examination for assessment of LV systolic and diastolic function before and one year after hormone (thyroxine) therapy. RESULTS The systolic function of LV was normal in patients with SH. There was significant diastolic dysfunction in the SH patients as compared with controls. There was prolongation of deceleration above time (169 +/- 6.1 msec. vs. 148.1 +/- 5.4 msec in controls, p < 0.05), isovolumic relaxation time (89.1 +/- 7.3 msec vs. 79.4 +/- 5.9 msec., p<0.05), increased A wave (0.63 +/- 0.6 m/sec. vs. 0.54 +/- 0.05 m/sec) and reduced E/A ratio (0.7 +/- 0.09 vs. 1.4 +/- 0.3, p < 0.05). Echocardiography at the end of one year of hormone therapy revealed considerable improvement in diastolic function of the LV. There was significant improvement in DT (from 169 +/- 6.1 msec. to 151 +/- 5.2 msec, p < 0.05), IVRT (from 89.1 +/- 7.3 msec. to 80.2 +/- 6.5 msec, p < 0.05) and increased E/A ratio (from 0.7 +/- 0.09 to 1.3 +/- 0.1, p < 0.05). CONCLUSION Hypothyroidism, even in subclinical stage, can cause diastolic dysfunction of the LV. These abnormalities in diastolic function can be reversed by thyroxine therapy.
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Affiliation(s)
- T K Mishra
- Department of Cardiology, SCB Medical College, Cuttack, Orissa
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Routray SN, Mishra TK, Swain S, Patnaik UK, Behera M. Balloon mitral valvuloplasty during pregnancy. Int J Gynaecol Obstet 2004; 85:18-23. [PMID: 15050462 DOI: 10.1016/j.ijgo.2003.09.005] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2003] [Revised: 09/17/2003] [Accepted: 09/24/2003] [Indexed: 10/26/2022]
Abstract
OBJECTIVES Balloon mitral valvuloplasty (BMV) has been performed safely during pregnancy with good results. Reports are few on long-term effects of BMV on childhood development. METHODS BMV was performed in 40 pregnant women (age 23.4+/-4.8 years) with severe mitral stenosis at 24.2+/-4.6 weeks of gestation. RESULTS Mitral valve area increased from 0.82+/-0.34 to 1.9+/-0.4 cm(2) (P<0.001). One patient had pericardial tamponade. Mean fluoroscopy time was 5.5+/-3.8 min. There was no maternal death, no abortion, no intrauterine growth restriction and one stillbirth. All 39 babies were normal at birth. One baby died at 7 months due to pneumonia. On follow up for 36+/-15 months, all 38 babies maintained normal growth and development without any thyroid disease or malignancy. CONCLUSIONS During pregnancy BMV is feasible, safe and effective. Maternal and fetal outcomes are excellent. Growth and milestone of development are not affected.
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Affiliation(s)
- S N Routray
- Department of Cardiology, SCB Medical College, Cuttack, Orissa, India.
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Routray SN, Mishra TK, Patnaik UK, Behera M. Myocarditis as an initial manifestation of systemic lupus erythematosus. J Assoc Physicians India 2004; 52:673-4. [PMID: 15847368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
We report a case of systemic lupus erythematosus (SLE) whose initial presentation was in the form of myocarditis. The patient did not have arthritis, fever or butterfly rash. Presence of LE cell phenomenon, positive ANA, anti-DS DNA antibodies, leucopenia and high ESR with polyserositis indicated the diagnosis to be SLE. Therapy with steroid resulted in complete recovery. The patient developed atrial fibrillation during her course of acute illness which is being reported for the first time.
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Affiliation(s)
- S N Routray
- Department of Cardiology, SCB Medical Collage, Cuttack 753007, Orissa
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Routray SN, Mishra TK, Pattnaik UK, Satapathy C, Mishra CK, Behera M. Amlodipine-induced gingival hyperplasia. J Assoc Physicians India 2003; 51:818-9. [PMID: 14651149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/27/2023]
Abstract
Gingival hyperplasia can occur during use of drugs such as diphenylhydantoin, cyclosporine and nifedipine. We report, three cases of gingival hyperplasia induced by amlodipine, a second generation calcium channel blocker. Exact cause of induction of thehyperplasia is not known. Individual variation in metabolism of the drug may be a factor.
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Affiliation(s)
- S N Routray
- Department of Cardiology, SCB Medical College, Cuttack 753 001, Orissa
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Mishra TK, Routray SN, Behera M, Patnaik UK, Satapathy C. Percutaneous balloon angioplasty of membranous obstruction of the inferior vena cava. Indian Heart J 2003; 55:362-4. [PMID: 14686667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/27/2023] Open
Abstract
BACKGROUND Membranous obstruction of the inferior vena cava is common in African and Asian countries. METHODS AND RESULTS Between January 1999 and January 2002, 19 patients were prospectively studied. The mean age of the patients was 38+/-6.9 years. All of them had swelling of the abdomen and ankle edema. Five patients (26.3%) had jaundice, 9 (47.3%) had hepatomegaly, and 5 (26.3%) splenomegaly. Ultrasonography could detect the site of obstruction in 18 patients (94.7%). Vena cavography demonstrated obstruction of the inferior vena cava at the level of the diaphragm, with 2 patients (10.5%) having additional intrahepatic obstruction. The mean pressure gradient was 22+/-3.5 mmHg. Seventeen patients underwent balloon angioplasty using a Joseph balloon. The procedure was successful in 15 patients (88.2%). The post-angioplasty mean pressure gradient was 5+/-1.4 mmHg. On follow-up, 3 patients (20%) developed features of restenosis: out of them, 2 underwent successful redilatation. CONCLUSIONS Balloon angioplasty of membranous obstruction of the inferior vena cava is feasible with a high success rate, without any rupture of the inferior vena cava.
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Affiliation(s)
- T K Mishra
- Department of Cardiology, SCB Medical College, Cuttack, Orissa
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Mishra TK, Routray SN, Behera M, Pattniak UK, Satpathy C. Has the prevalence of rheumatic fever/rheumatic heart disease really changed? A hospital-based study. Indian Heart J 2003; 55:152-7. [PMID: 12921330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/04/2023] Open
Abstract
BACKGROUND Rheumatic fever and rheumatic heart disease still remain major public health problems. With a dramatic rise in the incidence of coronary artery disease cases, the focus of the physician seems to be shifting away from rheumatic fever and rheumatic heart disease. The aim of the present study was to assess the prevalence of rheumatic fever and rheumatic heart disease, and to ascertain if there was any decline in the prevalence of the disease. For the first time, data on the prevalence of rheumatic fever and rheumatic heart disease are reported from Orissa, an underdeveloped state in eastern India. METHODS AND RESULTS We scrutinized the records of cardiac patients admitted to the medicine, pediatrics and cardiology wards of the SCB Medical College and Hospital, Cuttack from 1981 to 1990 and 1991 to 2000. During the period 1981-1990, out of 11,782 cardiac patients, 5537 (46.9%) were suffering from rheumatic fever and rheumatic heart disease. During 1991-2000, out of 14,803 cardiac patients, 6670 hospitalized patients (45%) were found to have rheumatic fever and rheumatic heart disease. During the first and second periods, the number of patients with rheumatic fever admitted was 1079 (9.2%) and 1330 (8.9%), respectively. The decline in the percentage of rheumatic fever cases was statistically not significant (p>0.05). During the two periods, the number of rheumatic heart disease patients admitted was 4458 (37.8%) and 5340 (36.1%), respectively. During both the periods studied, the decline in the percentage of rheumatic heart disease cases admitted was statistically not significant (p>0.05). We also compared rheumatic fever and rheumatic heart disease cases admitted during 1981-1985 with those admitted during 1996-2000. This analysis also did not show any demonstrable decline in the prevalence of the disease (2692 [46.2%] v. 3296 [44.4%], p>0.05). CONCLUSIONS Our results show that rheumatic fever and rheumatic heart disease cases constitute a significant percentage of the admissions of total cardiac cases to our hospital. Over the past 20 years, there is no significant decline in the percentage of rheumatic fever and rheumatic heart disease cases being admitted to a major government hospital.
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Affiliation(s)
- T K Mishra
- Department of Cardiology, SCB Medical College, Cuttack
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