Paramdeep Baweja

Predicting long-term bleeding after percutaneous coronary intervention

To construct a model to predict long‐term bleeding events following percutaneous coronary intervention (PCI).

Comparison of the Frequency of Acute Kidney Injury in Patients With Renal Transplant Who Underwent Percutaneous Coronary Intervention Versus Coronary Artery Bypass Graft Surgery

Percutaneous coronary intervention (PCI) and coronary artery bypass graft (CABG) are established modalities of coronary revascularization. Choosing between the two requires taking into consideration not only disease severity, patient characteristics, and expected outcomes but also adverse effects. One such adverse effect is acute kidney injury (AKI), especially when considering coronary revascularization in patients with renal transplant (RT). We searched the National Inpatient Sample from 2008 to 2014 using International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes for patients with RT (V42.0) who underwent PCI (00.66, 36.06, and 36.07) and CABG (36.1×, 36.2, and 36.3×). We further identified patients with AKI (584.5, 584.6, 584.7, 584.8, and 584.9) and those on dialysis (39.95). The propensity score model/method was used to form matched cohorts for PCI and CABG. We compared the incidence of AKI and AKI requiring dialysis in CABG and PCI groups. We identified 1,871 patients who underwent PCI and 1,878 patients who underwent CABG after propensity score matching. We found the incidence of both AKI (22% vs 38%, odds ratio 2.20, 95% confidence interval 1.91 to 2.54, p <0.0001) and AKI requiring dialysis (1% vs 3%, odds ratio 2.50, 95% confidence interval 1.49 to 4.19, p = 0.001) to be significantly higher in the CABG compared with the PCI cohort. In conclusion, the results of the study reflect the importance of accounting for the RT status before choosing between PCI and CABG for coronary revascularization.

Three-dimensional transesophageal echocardiography is an attractive alternative to cardiac multi-detector computed tomography for aortic annular sizing: Systematic review and meta-analysis

Cardiac imaging is the cornerstone of the pretranscatheter aortic valve replacement (TAVR) assessment. Multi‐detector computed tomography (MDCT) is considered the conventional imaging modality. However, there is still no definitive gold standard. Targeted cohort of inoperable high‐risk patients with underlying comorbidities, particularly renal impairment, makes apparent the need for MDCT alternative. We aimed to demonstrate the correlation extent between MDCT and three‐dimensional transesophageal echocardiography (3DTEE) aortic annular area measures and to answer the question: Is 3DTEE a good alternative to MDCT?

Takotsubo cardiomyopathy secondary to spontaneous right-sided pneumothorax

Takotsubo cardiomyopathy (TCM) is a unique type of cardiomyopathy characterised by left ventricular systolic dysfunction in association with stressful conditions. Patients with this condition usually present with chest pain and dyspnoea, and the presentation can mimic acute coronary syndrome. We present a case of a woman aged 58 years who presented with progressive dyspnoea and cough. Her initial evaluation was suggestive of acute myocardial infarction with elevated serum troponin T and ST segment elevation. Her chest radiograph showed a large right-sided pneumothorax, which was treated with chest tube insertion. Coronary angiography and echocardiogram did not show any evidence of obstructive coronary artery disease but did show a large area of akinesis consistent with TCM. The patient was managed medically with supportive care. Her pneumothorax resolved, and her follow-up echocardiogram also showed improvement. The association between pneumothorax and TCM is rare, and only four other cases have been reported so far in the English literature.