An observational study on the effect of ranolazine and trimetazidine on angina in hypertrohic cardiomyopathy patients in a tertiary care hospital

Miscellaneous / Indian Heart Journal 69S (2017) S96-S102 S97 view of paucity of data in Indian patients, we aim to assess the frequency of various risk factors associated with NVAF and evaluate the spectrum of CHA2DS2-VASc score and HAS-BLED score for thromboembolic event and bleeding, respectively in NVAF.Methods: A total of 95 consecutive NVAF patients; meeting inclusion and exclusion criteria; presenting to emergency, Cardiology outdoor or indoor department at Sir Gangaram Hospital from May 2016 to June 2017 were enrolled.Results: Mean age of presentation was 67.7 ± 11.9 years with Male preponderance (M: F 1.6:1).Almost 96% patients were symptomatic with shortness of breath (42.1%) being most common followed by palpitation (37.9%).Type of NVAF at enrollment were paroxysmal (54.7%), persistent (34.6%) and permanent (13.7%).Hypertension (70%) was the most common associated risk factor followed by diabetes (50.7%), previous coronary artery disease/myocardial infarction (48.4%) and heart failure (28.4%).Other risk factors were chronic kidney disease (18.9%), chronic obstructive pulmonary disease (14.7%), cardiomyopathy (11.6%), hypothyroidism (11.6%),TIA/stroke (10.5%), sick sinus syndrome (8.4%), obstructive sleep apnea (7.4%) and peripheral artery disease (2.1%).Mean CHA2DS2-VASc score was 3.4 ± 1.6.Almost 86% presenting with high thromboembolic risk (CHA2DS2-VASc score ≥2) of which 63.4% patients were put on oral anticoagulant.Mean HAS-BLED Score was 1.63 ± 1. High bleeding risk (HAS-BLED score ≥3) was seen in 21.1% patients.All patients with high bleeding risk had high thromboembolic risk.Conclusion: This preliminary data suggests that Indian population presents at an earlier age and with multiple risk factors.Improving outcome of these patients requires better control of hypertension, diabetes and optimal management of coronary artery disease (CAD) and heart failure.In view of high concomitant thromboembolic and bleeding risk in Indian subset specific guidelines are needed for deciding optimal therapy.