Papers by Ulhas Pandurangi
Saudi journal of kidney diseases and transplantation : an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia, 2013
We sought to determine the influence of risk factors of chronic kidney disease (CKD) on cardiac c... more We sought to determine the influence of risk factors of chronic kidney disease (CKD) on cardiac calcification. We studied the correlation between coronary artery calcium score (CACS) and the type and duration of dialysis as well as the presence of diabetes mellitus and hypertension. The relation between calcium score and mortality was also analyzed. Patients with CKD attending the outpatient department or admitted in our hospital were included. They were subjected to high-resolution computerized tomography of the thorax to determine their CACS. Serum levels of intact parathyroid hormone (iPTH), highly sensitive C-reactive protein (hCRP), homocysteine, calcium, phosphorus, and calcium × phosphorus product were measured. Out of the 50 patients studied, 39 were hypertensive (78%), 32 were diabetic (64.4%), 20 were on hemodialysis, and 13 were on continuous ambulatory peritoneal dialysis. The mean CACS was 388.6. Twenty-nine patients had high iPTH levels and 92.9% of them had calcium sc...
Journal of the American College of Cardiology, 2010
Background: Transradial access for interventions offers many advantages over the femoral access. ... more Background: Transradial access for interventions offers many advantages over the femoral access. However, this can be complicated by procedural failures, especially when encountered with radial artery anomalies. We aimed to prospectively evaluate whether the anatomic variations of radial artery can be identified accurately by ECHO-Doppler prior to the procedure. Methods: 250 consecutive patients undergoing interventions via transradial access in our institution from 01 April 2008 were enrolled into the study. All patients were screened pre procedurally by ECHO-Doppler and the presence of radial artery anomalies were documented, which were confirmed by radial arteriography. The incidence of procedural failure and need for alternative access was studied in these patients. Results: Out of 250 patients, radial artery anomalies were documented in 16% (n = 42). 15 (6%) patients had abnormal bifurcation of the brachial artery, 5 (2%) had an aberrant accessory radial artery, 11 (4.4%) had the presence of a radial loop, 4 (1.6%) had highly tortuous radial artery, atherosclerotic stenosis was present in 4 (1.6%), and 2 (0.8%) patients had hypoplasia of the radial artery. All findings were confirmed to be accurate by radial arteriography. None of the patients with normal radial anatomy needed an alternative access where as it was required in 9 (3.6%, p<0.0005) patients with radial artery anomalies. In these patients the incidence of spasm and other vascular complications were higher (5.2% Vs 15.9%, p= 0.017). Conclusions: Radial artery anomalies are relatively common. Pre procedural ECHO-Doppler screening can predict procedural complications and the need for alternative access in patients undergoing transradial interventions.
The Annals of Thoracic Surgery, 1999
Indian Heart Journal, 2021
Indian Pacing and Electrophysiology Journal, 2021
a Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India b Medanta ... more a Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India b Medanta Heart Institute, Gurgaon, India c Sri Jayadeva Institute of Cardiac Sciences and Research, Bangalore, India d Jawaharlal Institute of Postgraduate Medical Education & Research, Puducherry, India e Madras Medical Mission Hospital, Chennai, India f Apollo Hospital, New Delhi, India g Narayana Superspecialty Hospital, Gurugram, India h KEM Hospital, Mumbai, India i P.D. Hinduja National Hospital, Mumbai, India j Batra Hospital & Medical Research Centre, New Delhi, India k Lokmanya Tilak Municipal General Hospital, Mumbai, India
Cardiodiabetes Update: A Textbook of Cardiology
Journal of the American College of Cardiology
Indian Pacing and Electrophysiology Journal
Journal of Cardiovascular Electrophysiology
A 45-year old female presented with recurrent symptomatic palpitations responsive to adenosine. A... more A 45-year old female presented with recurrent symptomatic palpitations responsive to adenosine. An electrophysiology study was performed with decapolar catheter in the coronary sinus (CS) and quadripolar catheters in the His and right ventricular (RV) apex. This article is protected by copyright. All rights reserved.
Indian Pacing and Electrophysiology Journal
Not needed.
Journal of Cardiovascular Electrophysiology
Catheter ablation (CA) of ventricular tachycardia (VT) in cardiac sarcoidosis (CS) has been repor... more Catheter ablation (CA) of ventricular tachycardia (VT) in cardiac sarcoidosis (CS) has been reported with varying success. However, there is a scarcity of data on the outcomes of CA based on ongoing inflammation.
Indian Pacing and Electrophysiology Journal
The Lancet Diabetes & Endocrinology
Background After acute coronary syndrome, diabetes conveys an excess risk of ischaemic cardiovasc... more Background After acute coronary syndrome, diabetes conveys an excess risk of ischaemic cardiovascular events. A reduction in mean LDL cholesterol to 1•4-1•8 mmol/L with ezetimibe or statins reduces cardiovascular events in patients with an acute coronary syndrome and diabetes. However, the efficacy and safety of further reduction in LDL cholesterol with an inhibitor of proprotein convertase subtilisin/kexin type 9 (PCSK9) after acute coronary syndrome is unknown. We aimed to explore this issue in a prespecified analysis of the ODYSSEY OUTCOMES trial of the PCSK9 inhibitor alirocumab, assessing its effects on cardiovascular outcomes by baseline glycaemic status, while also assessing its effects on glycaemic measures including risk of new-onset diabetes. Methods ODYSSEY OUTCOMES was a randomised, double-blind, placebo-controlled trial, done at 1315 sites in 57 countries, that compared alirocumab with placebo in patients who had been admitted to hospital with an acute coronary syndrome (myocardial infarction or unstable angina) 1−12 months before randomisation and who had raised concentrations of atherogenic lipoproteins despite use of high-intensity statins. Patients were randomly assigned (1:1) to receive alirocumab or placebo every 2 weeks; randomisation was stratified by country and was done centrally with an interactive voice-response or web-response system. Alirocumab was titrated to target LDL cholesterol concentrations of 0•65-1•30 mmol/L. In this prespecified analysis, we investigated the effect of alirocumab on cardiovascular events by glycaemic status at baseline (diabetes, prediabetes, or normoglycaemia)-defined on the basis of patient history, review of medical records, or baseline HbA 1c or fasting serum glucose-and risk of new-onset diabetes among those without diabetes at baseline. The primary endpoint was a composite of death from coronary heart disease, non-fatal myocardial infarction, fatal or non-fatal ischaemic stroke, or unstable angina requiring hospital admission. ODYSSEY OUTCOMES is registered with ClinicalTrials.gov, number NCT01663402. Findings At study baseline, 5444 patients (28•8%) had diabetes, 8246 (43•6%) had prediabetes, and 5234 (27•7%) had normoglycaemia. There were no significant differences across glycaemic categories in median LDL cholesterol at baseline (2•20-2•28 mmol/L), after 4 months' treatment with alirocumab (0•80 mmol/L), or after 4 months' treatment with placebo (2•25-2•28 mmol/L). In the placebo group, the incidence of the primary endpoint over a median of 2•8 years was greater in patients with diabetes (16•4%) than in those with prediabetes (9•2%) or normoglycaemia (8•5%); hazard ratio (HR) for diabetes versus normoglycaemia 2•09 (95% CI 1•78-2•46, p<0•0001) and for diabetes versus prediabetes 1•90 (1•65-2•17, p<0•0001). Alirocumab resulted in similar relative reductions in the incidence of the primary endpoint in each glycaemic category, but a greater absolute reduction in the incidence of the primary endpoint in patients with diabetes (2•3%, 95% CI 0•4 to 4•2) than in those with prediabetes (1•2%, 0•0 to 2•4) or normoglycaemia (1•2%,-0•3 to 2•7; absolute risk reduction p interaction =0•0019). Among patients without diabetes at baseline, 676 (10•1%) developed diabetes in the placebo group, compared with 648 (9•6%) in the alirocumab group; alirocumab did not increase the risk of new-onset diabetes (HR 1•00, 95% CI 0•89-1•11). HRs were 0•97 (95% CI 0•87-1•09) for patients with prediabetes and 1•30 (95% CI 0•93-1•81) for those with normoglycaemia (p interaction =0•11). Interpretation After a recent acute coronary syndrome, alirocumab treatment targeting an LDL cholesterol concentration of 0•65-1•30 mmol/L produced about twice the absolute reduction in cardiovascular events among patients with diabetes as in those without diabetes. Alirocumab treatment did not increase the risk of new-onset diabetes. Funding Sanofi and Regeneron Pharmaceuticals.
Journal of the American College of Cardiology
Asian cardiovascular & thoracic annals, 2017
We describe a case of submitral aneurysm in a 40-year-old man, which was distinctive in its anato... more We describe a case of submitral aneurysm in a 40-year-old man, which was distinctive in its anatomy and pathophysiology. The patient had a congenital submitral aneurysm located in the anterolateral part of the mitral annulus, complicated by dissection of the left atrial wall, severe mitral regurgitation, and compression of the left circumflex artery. He was managed successfully with aid of a comprehensive preoperative evaluation with all available imaging guidance and methodical surgical techniques, resulting in exclusion of the aneurysm, mitral valve replacement, and a graft to the left circumflex artery.
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Papers by Ulhas Pandurangi