Browsing by Author "Sawhney, Jitendra PS."

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    CSI clinical practice guidelines for dyslipidemia management: Executive summary
    (Elsevier, 2024-03) Sawhney, Jitendra PS.; Ramakrishnan, Sivasubramanian; Madan, Kushal; Ray, Saumitra; Jayagopal, P Balagopalan; Prabhakaran, Dorairaj; Nair, Tiny; Zachariah, Geevar; Jain, Peeyush; Dalal, Jamshed; Radhakrishnan, Sitaraman; Chopra, Arun; Kalra, Sanjay; Mehta, Ashwani; Pancholia, Arvind K.; Kabra, Nitin K.; Kahali, Dhiman; Ghose, Tapan; Yadav, Satyavir; Kerkar, Prafulla; Yadav, Ajay; Roy, Debabrata; Das, Mrinal Kanti; Bang, Vijay H.; Rath, Pratap Chandra; Sinha, Dhurjati Prasad; Banerjee, P.S.; Yadav, Rakesh; Gupta, Rajeev
    Dyslipidemias are the most important coronary artery disease (CAD) risk factor. Proper management of dyslipidemia is crucial to control the epidemic of premature CAD in India. Cardiological Society of India strived to develop consensus-based guidelines for better lipid management for CAD prevention and treatment. The executive summary provides a bird's eye-view of the CSI: Clinical Practice Guidelines for Dyslipidemia Management published in this issue of the Indian Heart Journal. The summary is focused onthe busy clinician and encourages evidence-based management of patients and high-risk individuals. The summary has serialized various aspects of lipid management including epidemiology and categorization of CAD risk. The focus is on management of specific dyslipidemias relevant to India-raised low density lipoprotein (LDL) cholesterol, non-high density lipoprotein cholesterol (non-HDL-C), apolipoproteins, triglycerides and lipoprotein(a). Drug therapies for lipid lowering (statins, non-statin drugs and other pharmaceutical agents) and lifestyle management (dietary interventions, physical activity and yoga) are summarized. Management of dyslipidemias in oft-neglected patient phenotypes-the elderly, young and children, and patients with comorbidities-stroke, peripheral arterial disease, kidney failure, posttrans- plant, HIV (Human immunodeficiency virus), Covid-19 and familial hypercholesterolemia is also pre- sented. This consensus statement is based on major international guidelines (mainly European) and expert opinion of lipid management leaders from India with focus on the dictum: earlier the better, lower the better, longer the better and together the better. These consensus guidelines cannot replace the indi- vidual clinician judgement who remains the sole arbiter in management of the patient.
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    Risk profiles and one-year outcomes of patients with newly diagnosed atrial fibrillation in India: Insights from the GARFIELD-AF Registry
    (Cardiological Society of India, 2018-11) Sawhney, Jitendra PS.; Kothiwale, Veerappa A.; Bisne, Vikas; Durgaprasad, Rajashekhar; Others
    Background The Global Anticoagulant Registry in the FIELD–Atrial Fibrillation (GARFIELD-AF) is an ongoing prospective noninterventional registry, which is providing important information on the baseline characteristics, treatment patterns, and 1-year outcomes in patients with newly diagnosed non-valvular atrial fibrillation (NVAF). This report describes data from Indian patients recruited in this registry. Methods and results A total of 52,014 patients with newly diagnosed AF were enrolled globally; of these, 1388 patients were recruited from 26 sites within India (2012–2016). In India, the mean age was 65.8 years at diagnosis of NVAF. Hypertension was the most prevalent risk factor for AF, present in 68.5% of patients from India and in 76.3% of patients globally (P < 0.001). Diabetes and coronary artery disease (CAD) were prevalent in 36.2% and 28.1% of patients as compared with global prevalence of 22.2% and 21.6%, respectively (P < 0.001 for both). Antiplatelet therapy was the most common antithrombotic treatment in India. With increasing stroke risk, however, patients were more likely to receive oral anticoagulant therapy [mainly vitamin K antagonist (VKA)], but average international normalized ratio (INR) was lower among Indian patients [median INR value 1.6 (interquartile range {IQR}: 1.3–2.3) versus 2.3 (IQR 1.8–2.8) (P < 0.001)]. Compared with other countries, patients from India had markedly higher rates of all-cause mortality [7.68 per 100 person-years (95% confidence interval 6.32–9.35) vs 4.34 (4.16–4.53), P < 0.0001], while rates of stroke/systemic embolism and major bleeding were lower after 1 year of follow-up. Conclusion Compared to previously published registries from India, the GARFIELD-AF registry describes clinical profiles and outcomes in Indian patients with AF of a different etiology. The registry data show that compared to the rest of the world, Indian AF patients are younger in age and have more diabetes and CAD. Patients with a higher stroke risk are more likely to receive anticoagulation therapy with VKA but are underdosed compared with the global average in the GARFIELD-AF.