Authors : RD Sawant
Publication date : 2009
Journal : Journal of Population Therapeutics and Clinical Pharmacology
Volume : 16
Issue : 1
Description :
A case report of a ciprofloxacin and simvastatin interaction is presented. The addition of ciprofloxacin to chronic simvastatin therapy led to the development of rhabdomyolysis. As ciprofloxacin is a weak inhibitor of CYP3A4, it is very likely that other mechanisms involving the ATP-binding cassette drug efflux transporter family played a role in this drug interaction.
Total citations : Cited by 39
Authors : Rahul D Sawant, Leisa J Freeman, Katherine PS Stanley, Alistair McKelvey
Publication date : 2013/5
Journal : European journal of heart failure
Volume : 15
Issue : 5
Pages : 592-595
Description :
Left ventricular non‐compaction (LVNC) is a rare form of cardiomyopathy. This case reviews a woman with familial LVNC (EF 45%, NYHA class I, evidence of non‐sustained ventricular tachycardia pre‐pregnancy) who had significant decompensation with heart failure in the third trimester that required early delivery. Deterioration in symptoms and LV function 7 days after delivery required further hospitalization and aggressive treatment. Suppression of lactation with bromocriptine, together with standard heart failure management, has allowed recovery and return to full activities and work. Acknowledged adverse risk factors in LVNC are considered, and pre‐pregnancy risk assessment is reviewed. There is no specific treatment for LVNC in pregnancy besides the usual management of dilated cardiomyopathy. This is the ninth case report of LVNC in pregnancy reported in the literature.
Total citations : Cited by 11
Authors : Rahul Sawant, Anitha Rajamanickam, Annapoorna S Kini
Publication date : 2014
Source : Practical Manual of Interventional Cardiology
Pages : 293-297
Publisher : Springer London
Description :
Pericardiocentesis is percutaneous drainage of fluid from the pericardial space for diagnostic or therapeutic purposes and is lifesaving in cardiac tamponade. Balloon pericardiotomy is a palliative procedure for the management of recurrent pericardial effusions performed using fluoroscopy and echocardiography as an alternative to surgical pericardial window.
Total citations : Cited by 1
Authors : Anitha Rajamanickam, Christopher Varughese, Antony Innasimuthu, Mayur Lakhani, Rahul Sawant, Ravinder Rao, Jimmy Yee, Choudhury Hasan, Joseph Sweeny, Usman Baber, Robert Pyo, Pedro Moreno, Samin Sharma, Annapoorna Kini
Publication date : 2014/4/1
Journal : Journal of the American College of Cardiology
Volume : 63
Issue : 12S
Pages : A1851-A1851
Publisher : American College of Cardiology Foundation
Description : Background
CAC, a marker of future cardiovascular events, is a major challenge for achieving a successful PCI. CAC may cause stent underexpansion and increase the risk of restenosis, thrombosis, and target-lesion revascularization [TLR]. We sought to analyze long term outcomes of PCI in lesions based on degree of calcification.
Retrospective analysis of our prospectively collected database from 1/1/2010–6/12/2012 retrieved 7879 patients with 1 year completed follow up [8% with severe CAC, 8% with moderate CAC and 84% with no/mild CAC]
Cutting balloon angioplasty or rotational atherectomy were used in 100% of severe CAC and in 52% of moderate CAC. When compared to no/mild CAC, moderate and severe CAC were more likely to be chronic total occlusions, longer, bifurcation, left main or left anterior descending artery lesions while less likely to present as acute myocardial …
Authors : Rahul Sawant, Anitha Rajamanickam, Joseph Sweeny
Publication date : 2014
Source : Practical Manual of Interventional Cardiology
College of Cardiology
Pages : 187-192
Publisher : Springer London
Description : Acute coronary syndrome is a spectrum ranging from ST elevation myocardial infarction to troponin-negative unstable angina. Plaque rupture or erosion leads to thrombus formation resulting in ischemic myocardial damage. Guidelines recommend primary angioplasty for patients with STEMI and early invasive strategy [<72 h] for patients with high risk ACS.
Authors : John JV McMurray, Scott D Solomon, Silvio E Inzucchi, Lars Køber, Mikhail N Kosiborod, Felipe A Martinez, Piotr Ponikowski, Marc S Sabatine, Inder S Anand, Jan Bělohlávek, Michael Böhm, Chern-En Chiang, Vijay K Chopra, Rudolf A de Boer, Akshay S Desai, Mirta Diez, Jaroslaw Drozdz, Andrej Dukát, Junbo Ge, Jonathan G Howlett, Tzvetana Katova, Masafumi Kitakaze, Charlotta EA Ljungman, Béla Merkely, Jose C Nicolau, Eileen O’Meara, Mark C Petrie, Pham N Vinh, Morten Schou, Sergey Tereshchenko, Subodh Verma, Claes Held, David L DeMets, Kieran F Docherty, Pardeep S Jhund, Olof Bengtsson, Mikaela Sjöstrand, Anna-Maria Langkilde
Publication date : 2019/11/21
Journal : New England Journal of Medicine
Volume : 381
Issue : 21
Pages : 1995-2008
Publisher : Massachusetts Medical Society
Description : Background
In patients with type 2 diabetes, inhibitors of sodium–glucose cotransporter 2 (SGLT2) reduce the risk of a first hospitalization for heart failure, possibly through glucose-independent mechanisms. More data are needed regarding the effects of SGLT2 inhibitors in patients with established heart failure and a reduced ejection fraction, regardless of the presence or absence of type 2 diabetes.
In this phase 3, placebo-controlled trial, we randomly assigned 4744 patients with New York Heart Association class II, III, or IV heart failure and an ejection fraction of 40% or less to receive either dapagliflozin (at a dose of 10 mg once daily) or placebo, in addition to recommended therapy. The primary outcome was a composite of worsening heart failure (hospitalization or an urgent visit resulting in intravenous therapy for heart failure) or cardiovascular death.
Over a median of 18.2 months, the …
Total citations : Cited by 5633
Authors :Anuj Maheshwari, Narsingh Verma, Shipra Bhardwaj, Arun P Jose, Sandeep Bhalla, Arun More, Mansi Patil, Amit Gupta, Bal Kishen Gupta, Anant Takalkar, Priyanka Gupta, Nikki Pandey, Vishal Patil, Thomas Beaney, Anca Chis Ster, Neil R Poulter
Publication date : 2020/8/1
Journal : European Heart Journal Supplements
Volume : 22
Issue : Supplement_H
Pages : H62-H65
Publisher : Oxford University Press

Description : Hypertension (HTN) is the greatest attributable risk factor for cardiovascular disease in India. Recent studies have reported the crude prevalence of HTN in India to be 25.3%. In the May Measurement Month (MMM) screening campaign of 2017 conducted in India, 31.8% had HTN. In order to ratify earlier results, and further understand the awareness and control levels of HTN in India, organizations that participated in MMM 2017 decided to participate in the MMM global screening initiative of the International Society of Hypertension for a 2nd consecutive year. A total of 345 234 individuals were screened in MMM 2018. There were more than 1000 screening locations that included hospitals, clinics, workplaces, and special health camps organized across the country. After applying multiple imputation, a total of 111 462 (32.3%) individuals had HTN of whom 63 415 (55.6%) were aware of HTN and 61 646 (55 …

Total citations : Cited by 4
Authors :Hertzel C Gerstein, Naveed Sattar, Julio Rosenstock, Chinthanie Ramasundarahettige, Richard Pratley, Renato D Lopes, Carolyn SP Lam, Nardev S Khurmi, Laura Heenan, Stefano Del Prato, Leanne Dyal, Kelley Branch
Publication date : 2021/9/2
Journal : New England journal of medicine
Volume : 385
Issue : 10
Pages : 896-907
Publisher : Massachusetts Medical Society

Description : Background

Four glucagon-like peptide-1 (GLP-1) receptor agonists that are structurally similar to human GLP-1 have been shown to reduce the risk of adverse cardiovascular events among persons with type 2 diabetes. The effect of an exendin-based GLP-1 receptor agonist, efpeglenatide, on cardiovascular and renal outcomes in patients with type 2 diabetes who are also at high risk for adverse cardiovascular events is uncertain.
In this randomized, placebo-controlled trial conducted at 344 sites across 28 countries, we evaluated efpeglenatide in participants with type 2 diabetes and either a history of cardiovascular disease or current kidney disease (defined as an estimated glomerular filtration rate of 25.0 to 59.9 ml per minute per 1.73 m2 of body-surface area) plus at least one other cardiovascular risk factor. Participants were randomly assigned in a 1:1:1 ratio to receive weekly subcutaneous …
Total citations : Cited by 413
Authors : Madhur Jain, Rahul Sawant, Hitanshu Panchal, S Anand, Anupam Jena, Rahul Gupta, Karthik Kumar, Rajagopal Jambunathan, Sunil Modi, Ajit Mullasari, Nakul Sinha, Kimi Shetty, Pallavi Kawatra
Publication date : 2023/12/1
Journal : International Journal of Cardiology Cardiovascular Risk and Prevention
Volume : 385
Issue : 19

Pages : 200210

Publisher : Elsevier

Description : Background

Low-density lipoprotein-cholesterol (LDL-C) is an independent risk factor for atherosclerotic cardiovascular disease (ASCVD) progression. Although lipid lowering therapies remain the cornerstone of secondary ACSVD prevention, there exists residual dyslipidemia. The current study aimed to evaluate the real-world experience related to the treatment patterns and LDL-C control in Indian Acute Coronary Syndrome (ACS) patients.
This was a real-world, descriptive, retrospective, observational, and multicentric study conducted across India. The data was collected for 1 year following the ACS event. The change in the levels of LDL-C from the baseline to the follow-up visits and the control of LDL-C, the change in lipid profile, lipoprotein levels, treatment patterns for lipid-lowering, and tolerability of existing treatments were evaluated.
Overall, 575 patients were included from 11 centers across …
Total citations : Cited by 1
Authors : Rahul Sawant, Sachin Suryawanshi, Mayur Jadhav, Hanmant Barkate, Sumit Bhushan, Tanmay Rane
Publication date : 2023/6
Journal : Cardiology Research
Volume : 14
Issue : 3
Pages : 211
Publisher : Elmer Press

Description : Background

The antihypertensive agent telmisartan is an angiotensin II receptor blocker with a terminal elimination half-life of 24 h and has a high lipophilicity, thereby enhancing its bioavailability. Another antihypertensive agent, cilnidipine is a calcium antagonist and has dual mode of action on the calcium channels. This study aimed at determining effect of these drugs on ambulatory blood pressure (BP) levels.
A randomized, open-label, single-center study was conducted during 2021-2022 on newly diagnosed adult patients with stage-I hypertension, in a mega city of India. Forty eligible patients were randomized to telmisartan (40 mg) and cilnidipine (10 mg) groups, with once daily dose administered for 56 consecutive days. Ambulatory blood pressure monitoring (ABPM)(24 h) was performed pre-and post-treatment, and the ABPM-derived parameters were compared statistically.
Statistically …

Uncommon procedure, which requires great expertise and circumvents risks associated with open heart surgery, performed last week on 42-year-old patient at city hospital In a startling incident of unu

  • By PuneMirror Bureau
  • Reported By Nozia Sayyed
  • Tue, 5 Apr 2016
  • 09:00 pm

Alcohol injection saves man with heart condition


Uncommon procedure, which requires great expertise and circumvents risks associated with open heart surgery, performed last week on 42-year-old patient at city hospital

In a startling incident of unusual treatment done right, a procedure at the city’s Noble Hospital three days ago saw a patient given 100 per cent alcohol to trigger a heart attack, so as to save him from a life-threatening condition and severe morbidity. The 42-year-old patient’s condition of hypertrophic obstructive cardiomyopathy, which is mainly a genetic heart disease, is not very common and usually needs open heart surgery to improve blood flow.

In this case, the patient came in with severe breathlessness and chest pain. He was diagnosed with severe hypertrophic cardiomyopathy, in which blood flow to the heart gets majorly obstructed through a thickened muscle. “The only way to treat it is to open the heart and cut off the obstructing thickened muscle. But, looking at the patient’s condition, we decided to avoid morbidity that comes with open heart surgery. With the patient’s consent, we decided to perform the alcohol septal ablation treatment,” said Dr Rahul Sawant, senior cardiologist at Noble Hospital.

Explaining the procedure, he said, “It includes injecting absolute alcohol in a tiny branch of the coronary artery using a long thin tube. This further induces a small heart attack, which later controls obstruction of blood flow across the main chamber of the heart within 10 minutes.”

During the operation, the patient was injected with 1.5 ml of 100 per cent alcohol into a small branch artery, triggering an attack. “This not only affected the diseased thickened muscle, but also killed it, helping normalise the blood flow,” said Sawant, adding, “In this condition, the muscle usually becomes abnormally thick, making it harder for the heart to pump blood. Often, it goes undiagnosed as many live with no significant symptoms. However, a small number of people suffer from shortness of breath, chest pains or problems in the heart’s electrical system, resulting in abnormal rhythms or sudden death.”

He further said, “We have never performed this procedure on any patient so far. This is a first. And, he has improved dramatically since.”

Several other cardiologists stressed on the expertise and skills required to perform the uncommon procedure successfully. Dr Rahul Patil, senior cardiologist at Ruby Hall Clinic, said, “It is an extremely critical procedure. Not many can perform it, so it is avoided. The alcohol content and timely control of the heart attack requires great patience. Also, often alcohol is avoided to prevent religious issues from cropping up; so, this option goes undiscussed. However, once performed, the treatment can give extended life; open heart surgery carries chances of severe morbidity and mortality.”

Dr Ranjit Patil, consultant cardiologist at Sahyadri Hospital, said, “There are very few doctors across India that perform this procedure, and only a handful of these have done it successfully so far. The thickened muscle is usually resolved by going under the knife, but alcohol septal ablation or injecting alcohol in the heart is very uncommon and needs well-trained doctors. It is a procedure that can be risky, too, in case alcohol content is not handled properly. Pune has pulled off a unique instance.”

Tell the doctor your symptoms and how you feel in your own words, tell him about how symptoms developed. And do not tell him what you think the cause might be.

Effective communication skills are fundamental to success in many aspects of life. Many jobs require strong communication skills and people with good communication skills usually enjoy better interpersonal relationships with friends and family. You believe this! Good communication skill can save your life in case of acute heart attack too. Good communication is crucial to help your doctor to make the right diagnosis and treatment.

This article tells you how to talk to doctors and other healthcare providers to make sure you get the best possible care. Remember, it is your heart, and no one knows your body like you do. Don’t give up until you get the care you need. Tell the doctor your symptoms and how you feel in your own words, tell him about how symptoms developed. And do not tell him what you think the cause might be. Be as much precise and specific; describe how your symptoms feel, where you feel them, don’t shy to locate it with finger if you can, how bad they are, and how long you have had them. Every human being is different. Patients are from varied backgrounds, cultures and have different dialects and they will express their feelings differently. Make it clear that these symptoms are not normal for you and you think something is seriously wrong. If you feel something is seriously wrong you may even use words like “I have never felt this before”. This helps doctor to realize that something is seriously wrong and help to decide much needed course of treatment. Having a heart attack is very frightening, but being unstable and upset will not help you, stay calm. Keep describing your symptoms until you feel you are understood. Listen to questions healthcare team may ask you and answer them carefully. Take your time to frame answer correctly. Do not downplay your symptoms—now is not the time to “be tough”, tell the intensity and exact location of pain honestly. Don’t be afraid to ask questions. Make sure the doctor or nurse knows how you are feeling. Having heart attack symptoms is a stressful experience. Trust your instincts and be willing to fight for your health. Never stop seeking care as long as you have a problem.

If you are precise and specific in telling symptoms to healthcare team it will speed-up medical help in right direction and chances of survival are more. Precisely you communicate, better will be outcome.

Ref: 1. Dracup K, Moser DK, Eisenberg M, Meischke H, Alonzo AA, Braslow A. Causes of delay in seeking treatment for heart attack symptoms.

The article has been contributed by : Dr. Rahul D. Sawant, MD (Medicine), CCT, Cardiology (UK), MRCP (UK), Interventional Fellow, New York, USA, Consultant Interventional Cardiologist, Asst. Professor, Cardiology, Bharti Vidyapeeth’s Medical College & Hospital, Pune.


Read More