National Institute of Cardiovascular Diseases (NICVD); Urdu نيشنل انسٹيٹيوٹ آف كارڈيو ويسكيولر ڈيزيزز in collaboration with the Government of Sindh are a chain of health care centers located in Sindh, Pakistan. It was founded in 1963 by Dr. Ali Muhammad Kasim. The National Institute of Cardiovascular Diseases (NICVD) has become the only healthcare facility in the world to have performed over 4,000 cardiac surgeries and 8,197 primary PCIs, over 12,000 procedures [and] dozens of cardiac implants, all free of charge at its main centre in Karachi and eight satellite centres spread all over Sindh.
Vascular disease (VD) is a medical condition that adversely affects the blood vessels. Peripheral Artery Disease (PAD), a significant form of VD, is a major global health concern. In developing countries such as Bangladesh, VDs often remain undiagnosed and untreated until reaching critical stages. Artificial Intelligence (AI) based methods have potential for early detection and improved treatment guidelines. This paper narratively reviews both the clinical and the AI aspects of VD, emphasizing PAD, by examining recent studies on clinical diagnostic methods, treatment strategies and clinical outcomes, highlighting AI-driven research, machine learning (ML) algorithms contributing to disease management. Existing research on VDs, addresses their epidemiology, diagnosis, treatment, prevalence and morbidity, and mortality. It shows the need for more context-sensitive treatment data, age-specific studies, better access to technology, precise treatment goals, and rigorous diagnostic methodologies. Several works have explored AI algorithms to analyze diverse data sources - such as electronic health records (EHR), radiology images, genetic data and pulse wave signals for PAD detection, achieving accuracy exceeding 94
Introduction and aim Sepsis is a complex, life-threatening condition characterized by systemic inflammation and multiorgan dysfunction. Elevated troponin levels (cTnI) have been associated with poor outcomes in sepsis; however, their role as a prognostic biomarker requires further investigation. This study aimed to (1) determine the association between elevated cardiac troponin I (>0.04 ng/mL) and 28-day mortality in patients with sepsis and organ dysfunction, and (2) evaluate the prognostic accuracy of troponin I for mortality prediction in this population. Methods We conducted a prospective cohort study involving 200 sepsis patients, measuring troponin levels at admission time and clinical and biochemical parameters, such as Sequential Organ Failure Assessment (SOFA) scores, D-dimer, and lactate. Data on organ dysfunction, coagulation abnormalities, and patient outcomes (mortality, length of ICU stay) were collected and analyzed. Results Troponin I levels were elevated in 69% of patients and were significantly associated with increased mortality (115 {83.4%} vs. 10 {16.2%}; p<0.001), longer ICU duration, and higher SOFA scores. Multivariate analysis revealed that elevated creatinine, low hemoglobin, increased CRP and alanine transaminase (ALT), neutrophilia, and reduced oxygen saturation were independent predictors of 28-day mortality. Troponin I showed high prognostic accuracy for mortality, and a cut-off value of >0.04 ng/mL demonstrated remarkable accuracy, achieving an AUC of 0.986 in receiver operating characteristic (ROC) analysis. Conclusion Troponin I serves as a readily accessible and prognostically significant biomarker that improves early risk assessment in patients experiencing sepsis with organ dysfunction.
Introduction Diabetes mellitus is a well-established risk factor for adverse cardiovascular outcomes, including non-ST-elevation myocardial infarction (NSTEMI). Percutaneous coronary intervention (PCI) is a standard treatment, but the comparative impact on health-related quality of life (HRQoL) between diabetic and nondiabetic NSTEMI patients remains underexplored. This study aimed to compare HRQoL after PCI between these two groups. Methods A prospective observational study was conducted at the Department of Cardiology, Bangladesh Medical University, Dhaka, Bangladesh, from August 1, 2023, to July 31, 2024. A total of 90 NSTEMI patients who underwent PCI (45 diabetic patients and 45 nondiabetic patients) were recruited. Sociodemographic, clinical, and laboratory data were collected via a semi-structured questionnaire. HRQoL was assessed at baseline and six months post-PCI using the World Health Organization Quality of Life-BREF (WHOQOL-BREF). Data were analyzed using Chi-square tests, Mann-Whitney U tests, t tests, and Wilcoxon signed-rank tests (p < 0.05 was considered significant). Results Diabetic patients had significantly higher rates of obesity (8, 17.8%) compared with non-diabetic patients (p = 0.006), and dyslipidemia (21, 46.7% vs. 9, 20.0%, p = 0.007). Both groups demonstrated significant improvements in HRQoL across all domains after PCI. Non-diabetic patients had higher physical domain scores at baseline (42.05 ± 10.53 vs. 30.06 ± 15.15, p = 0.001) and at six months (76.94 ± 9.40 vs. 69.30 ± 16.54, p = 0.033). Diabetic patients reported significantly higher environmental domain scores at baseline (79.68 ± 7.54 vs. 76.05 ± 7.40, p = 0.003) and at follow-up (89.98 ± 5.19 vs. 87.06 ± 7.16, p = 0.032). Psychological and social domain scores improved similarly in both groups, with no significant post-PCI differences. Symptom relief was greater among non-diabetic patients, with 42 (93.3%) achieving Class I angina, compared with 33 (73.3%) diabetic patients (p = 0.029), and dyspnea outcomes were superior, with 44 (97.8%) versus 36 (80.0%) patients in New York Heart Association (NYHA) Class I, respectively (p = 0.007). Conclusion PCIs significantly enhance HRQoL in NSTEMI patients, regardless of diabetes status. However, diabetic patients experience slower recovery in the physical domain and more persistent symptoms, suggesting the need for targeted post-PCI management to optimize functional outcomes.
OBJECTIVE:Data on the characteristics and outcomes of patients with hematologic cancers undergoing cardiovascular (CV) admissions in real-world settings are limited. METHODS:This study used data from the National Inpatient Sample (2016-2020), including all CV admissions. Patients were stratified based on the presence of hematologic cancers and their subtypes. The primary outcome was the cause of CV admission, and the secondary outcome was all-cause mortality. Descriptive statistics and multivariable logistic regression (adjusted odds ratios [aOR]) were used to compare outcomes across groups. RESULTS:Of 5,957,492 CV admissions, 78,670 (1.3%) patients were admitted with hematologic cancer. These patients were older (median age 75 vs. 70-72 years) and had a higher prevalence of comorbidities such as atrial fibrillation, thrombocytopenia, anemia, congestive heart failure, valvular disease, coagulopathy, and chronic renal failure, compared with patients with other cancer and those without cancer. Hypertension was the most common cause of CV admission (30.7% vs. 20.4-27.3% in others), followed by atrial fibrillation/flutter and heart failure/valve disorders. In-hospital mortality was higher in patients with hematologic cancer, especially for chronic ischemic heart disease (aOR 2.35, 95% CI 1.90-2.91, p < 0.001). Within hematologic cancers, acute hemorrhagic stroke had the highest mortality, particularly, in leukemia (28.7% vs. 25.3-26.5%, p < 0.001). CONCLUSION:Patients with hematologic cancers admitted with a CV cause exhibit distinct patterns of CV admission causes, with hypertension, atrial fibrillation, and heart failure being the most common, and experience higher mortality than patients without cancer during CV admissions.
