BackgroundIn contrast with the setting of acute myocardial infarction, there are limited data reg... more BackgroundIn contrast with the setting of acute myocardial infarction, there are limited data regarding the impact of diabetes mellitus on clinical outcomes in contemporary cohorts of patients with chronic coronary syndromes. We aimed to investigate the prevalence and prognostic impact of diabetes according to geographical regions and ethnicity.Methods and resultsCLARIFY is an observational registry of patients with chronic coronary syndromes, enrolled across 45 countries in Europe, Asia, America, Middle East, Australia, and Africa in 2009–2010, and followed up yearly for 5 years. Chronic coronary syndromes were defined by ≥1 of the following criteria: prior myocardial infarction, evidence of coronary stenosis >50%, proven symptomatic myocardial ischaemia, or prior revascularization procedure.Among 32 694 patients, 9502 (29%) had diabetes, with a regional prevalence ranging from below 20% in Northern Europe to ∼60% in the Gulf countries. In a multivariable-adjusted Cox proportion...
The totally implantable venous access ports (TIVAP) is commonly indicated for oncology patients f... more The totally implantable venous access ports (TIVAP) is commonly indicated for oncology patients for administration of chemotherapy, total parenteral nutrition and long-term intravenous therapy. It is associated with some complications, which might cause significant morbidity or mortality. Spontaneous fracture and migration of the catheter is a rare but potentially serious complication. We presented a 22 year-old gentleman with diffuse large B cell lymphoma and had TIVAP done. It was complicated with the fractured and embolized catheter fragment. Endovascular retrieval was successfully performed and patient was subsequently discharged well.
The Journal of Obstetrics and Gynecology of India, 2016
A 31-year-old woman with familial hyperlipidaemia and severe coronary artery disease presented at... more A 31-year-old woman with familial hyperlipidaemia and severe coronary artery disease presented at 6 weeks of pregnancy. She had been diagnosed with familial hyperlipidaemia at the age of 7 years, after her father suffered a myocardial infarction in his early forties. She was then lost to follow-up. At the age of 24 years, she had a non-ST elevation myocardial infarction (NSTEMI). A coronary angiogram at that time showed 6 areas of plaque affecting three branches of the coronary arteries. Her medications were simvastatin 20 mg daily, perindopril 4 mg daily, aspirin 150 mg daily and metoprolol 100 mg daily. After extensive counselling, she insisted on continuing with this pregnancy. Her total cholesterol level was 16.3 mmol/L. Simvastatin and perindopril were stopped due to early pregnancy foetal concerns. She was well until at 20-week gestation, she presented to the Accidents and Emergency Department with acute chest pain and shortness of breath. Her pulse rate was 120 bpm, and her BP was 109/65. Her ECG showed ST depression in leads II, III, aVF, V4-6 (Fig. 1). Cardiac enzymes were raised (CKMB 26.6, troponin T 2.1). A diagnosis of NSTEMI was made. Acute management of myocardial infarction was instituted, except for streptokinase which is contraindicated in pregnancy. She went into ventricular fibrillation and asystole (Fig. 2), but responded to defibrillation and resuscitation.
BackgroundIn contrast with the setting of acute myocardial infarction, there are limited data reg... more BackgroundIn contrast with the setting of acute myocardial infarction, there are limited data regarding the impact of diabetes mellitus on clinical outcomes in contemporary cohorts of patients with chronic coronary syndromes. We aimed to investigate the prevalence and prognostic impact of diabetes according to geographical regions and ethnicity.Methods and resultsCLARIFY is an observational registry of patients with chronic coronary syndromes, enrolled across 45 countries in Europe, Asia, America, Middle East, Australia, and Africa in 2009–2010, and followed up yearly for 5 years. Chronic coronary syndromes were defined by ≥1 of the following criteria: prior myocardial infarction, evidence of coronary stenosis >50%, proven symptomatic myocardial ischaemia, or prior revascularization procedure.Among 32 694 patients, 9502 (29%) had diabetes, with a regional prevalence ranging from below 20% in Northern Europe to ∼60% in the Gulf countries. In a multivariable-adjusted Cox proportion...
The totally implantable venous access ports (TIVAP) is commonly indicated for oncology patients f... more The totally implantable venous access ports (TIVAP) is commonly indicated for oncology patients for administration of chemotherapy, total parenteral nutrition and long-term intravenous therapy. It is associated with some complications, which might cause significant morbidity or mortality. Spontaneous fracture and migration of the catheter is a rare but potentially serious complication. We presented a 22 year-old gentleman with diffuse large B cell lymphoma and had TIVAP done. It was complicated with the fractured and embolized catheter fragment. Endovascular retrieval was successfully performed and patient was subsequently discharged well.
The Journal of Obstetrics and Gynecology of India, 2016
A 31-year-old woman with familial hyperlipidaemia and severe coronary artery disease presented at... more A 31-year-old woman with familial hyperlipidaemia and severe coronary artery disease presented at 6 weeks of pregnancy. She had been diagnosed with familial hyperlipidaemia at the age of 7 years, after her father suffered a myocardial infarction in his early forties. She was then lost to follow-up. At the age of 24 years, she had a non-ST elevation myocardial infarction (NSTEMI). A coronary angiogram at that time showed 6 areas of plaque affecting three branches of the coronary arteries. Her medications were simvastatin 20 mg daily, perindopril 4 mg daily, aspirin 150 mg daily and metoprolol 100 mg daily. After extensive counselling, she insisted on continuing with this pregnancy. Her total cholesterol level was 16.3 mmol/L. Simvastatin and perindopril were stopped due to early pregnancy foetal concerns. She was well until at 20-week gestation, she presented to the Accidents and Emergency Department with acute chest pain and shortness of breath. Her pulse rate was 120 bpm, and her BP was 109/65. Her ECG showed ST depression in leads II, III, aVF, V4-6 (Fig. 1). Cardiac enzymes were raised (CKMB 26.6, troponin T 2.1). A diagnosis of NSTEMI was made. Acute management of myocardial infarction was instituted, except for streptokinase which is contraindicated in pregnancy. She went into ventricular fibrillation and asystole (Fig. 2), but responded to defibrillation and resuscitation.
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Papers by Anwar Ruhani