An Application of Deep Belief Networks in Early Warning for Cerebrovascular Disease Risk

To reduce the incidence of cerebrovascular disease and mortality, identifying the risks of cerebrovascular disease in advance and taking certain preventive measures are significant. This article was aimed to investigate the risk factors of cerebrovascular disease (CVD) in the primary prevention, and to build an early warning model based on the existing technology. The authors use the information entropy algorithm of rough set theory to establish the index system suitable for early warning model. Then, using the limited Boltzmann machine and direction propagation algorithm, the depth trust network is established by building and stacking RBM, and the back propagation is used to fine-tune the parameters of the network at the top layer. Compared with the LM-BP early-warning model, the deep confidence network model is more effective than traditional artificial neural network, which can help to identify the risk of cerebrovascular disease in advance and promote the primary prevention.

TO STUDY THE USE OF GUIDELINES IN STATINS PRESCRIPTION AT TERTIARY CARE CENTRE OF NORTH INDIA

Background: To study the use of guidelines in statins prescription at tertiary care centre of North India Methods: Study was conducted on Patients with indications for statins presenting to cardiology OPD,Medicine OPD and Endocrinology OPD and started on statins at PGIMER, Chandigarh, within a period of 9 months. Results: In our study, 81.9% of total study population were receiving statins according to guideline and 18.1% were receiving statins not according to guideline. In the primary prevention group,91(83.5%) patients were receiving statins according to guideline and 18(16.5%) were receiving not according to guideline. In the secondary prevention group, 108(80.6%) patients were receiving statins according to guideline and 26(19.4%) patients were receiving statins not according to guideline. Concluded: In our study, more than two third of patients in our study were receiving prescriptions according to guideline Keywords: Statin, Guideline, Use

STUDY OF OUTCOME OF STATIN THERAPY IN PATIENTS BY CHECKING LIPID PROFILE AFTER 3 MONTHS OF STARTING TREATMENT IN STATIN NAIVE PATIENTS

Background: To describe the outcome of statin therapy in patients by checking lipid profile after 3 months of starting treatment in statin naive patients Methods: Study was conducted on Patients with indications for statins presenting to cardiology OPD, Medicine OPD and Endocrinology OPD and started on statins at PGIMER, Chandigarh, within a period of 9 months. Results: The mean decrease in total cholesterol, triglycerides, VLDL and LDL levels in primary prevention group mean decrease in after 3 months of statin treatment in comparison to baseline were 17.24%,21.24%, 22.83 % and 33.19% respectively and increase in mean HDL level was 9.55%. The mean decrease in total cholesterol, triglyceride, VLDL and LDL levels in secondary prevention group after 3 months of statin treatment in comparison to baseline were 14.35% 15.80%, 16.17% and 36.92% respectively and increase in mean HDL level was 8.77%. Concluded: So there was statistically significant change in lipid profile from baseline in both primary and secondary prevention groups after 3 months of statin treatment. Keywords: Statin, LDL,VLDL, HDL

STUDY REGARDING ETHICAL VERSUS GENERIC PRESCRIPTION OF STATINS

Background: To study the ethical versus generic prescription of statins Methods: Study was conducted on Patients with indications for statins presenting to cardiology OPD,Medicine OPD and Endocrinology OPD and started on statins at PGIMER, Chandigarh, within a period of 9 months. Results: In our study population, amongst the primary prevention group, a larger percentage about 56% were receiving generic prescription of statins and about 44% were receiving ethical prescription of statins .Whereas in secondary prevention group, about 45.5% of patients were receiving generic prescription and 54.5% were receiving ethical prescription . Concluded: In our study population patients were equally prescribed on ethical (49.8%) and generic prescriptions (50.2%). Keywords: Statin, Ethical, Generic

PATTERNS OF PRESCRIPTION OF STATINS IN A TERTIARY CARE CENTRE OF NORTH INDIA

Background: To study the pattern of prescription of statins in a tertiary care centre. Methods: Study was conducted on Patients with indications for statins presenting to cardiology OPD, Medicine OPD and Endocrinology OPD and started on statins at PGIMER, Chandigarh, within a period of 9 months. Results: Atorvastatin was found to be more commonly prescribed (n=179), which is about73.7%compared to Rosuvastatin (n=64) which is about 26.3%. In our study, 75 (68.8%)patients of primary prevention group and 104(77.6%) patients of secondary prevention group were receiving Atorvastatin and 34 (31.2%) patients of primary prevention group and 30(22.4%)patients of secondary prevention were receiving Rosuvastatin on their prescription. Concluded: In our study, there were prescriptions with only Atorvastatin and Rosuvastatin. No prescription with other statins was found. Atorvastatin was being more commonly prescribed to rosuvastatin. Keywords: Statin, Atorvastatin, Rosuvastatin

INDICATIONS OF PRESCRIPTION OF STATINS IN TERTIARY CARE CENTRE OF NORTH INDIA

Background: To determine the indications for which statins are being prescribed Methods: Study was conducted on Patients with indications for statins presenting to cardiology OPD,Medicine OPD and Endocrinology OPD and started on statins at PGIMER, Chandigarh, within a period of 9 months. Results: In our study, out of 243 prescriptions, 55.1%(n=134) were prescribed statins for secondary prevention and 44.9%(n=109) had statins prescribed for primary prevention. Overall coronary artery disease (37.03%) was the leading indication followed by Diabetes mellitus without ASCVD(70.64%).Other indications of secondary preventionincluded newly diagnosed statin naïve patients diagnosed with stable coronary artery disease ,unstable coronary artery disease /acute coronary artery disease , ischemic cardiovascular accidentsand peripheral arterial disease .64.22 percent patients in primary prevention group were diabetics in our study . Concluded: We concluded that secondary prevention was found to the more common indication of statin prescription than primary prevention (ratio 1.22:1). Keywords: Statin, CAD, Prevention

Our Efforts for Ideal Stroke Prevention and Treatment in Japan

In the present short review for the Sherman Award, Dr Yamaguchi introduces studies at the National Cerebral and Cardiovascular Center, Osaka, which included development of intravenous thrombolysis using low-dose alteplase that was officially approved in Japan, long-term dual antiplatelet therapy using cilostazol together with aspirin or clopidogrel, and others. He also discusses efforts to ensure the passage of the “Stroke and Cardiovascular Disease Control Act,” the aims of which are better primary prevention, better acute treatment, rehabilitation, and secondary prevention of stroke for people living in Japan.

Cardiac device implantation and device usage in Fabry and hypertrophic cardiomyopathy

Background Fabry disease (FD) is a treatable X-linked condition leading to progressive cardiac disease, arrhythmia and premature death. We aimed to increase awareness of the arrhythmogenicity of Fabry cardiomyopathy, by comparing device usage in patients with Fabry cardiomyopathy and sarcomeric HCM. All Fabry patients with an implantable cardioverter defibrillator (ICD) implanted in the UK over a 17 year period were included. A comparator group of HCM patients, with primary prevention ICD implantation, were captured from a regional registry database. Results Indications for ICD in FD varied with 72% implanted for primary prevention based on multiple potential risk factors. In FD and HCM primary prevention devices, arrhythmia occurred more frequently in FD over shorter follow-up (HR 4.2, p < 0.001). VT requiring therapy was more common in FD (HR 4.5, p = 0.002). Immediate shock therapy for sustained VT was also more common (HR 2.5, p < 0.001). There was a greater burden of AF needing anticoagulation and NSVT in FD (AF: HR 6.2, p = 0.004, NSVT: HR 3.1, p < 0.001). Conclusion This study demonstrates arrhythmia burden and ICD usage in FD is high, suggesting that Fabry cardiomyopathy may be more ‘arrhythmogenic’ than previously thought. Existing risk models cannot be mutually applicable and further research is needed to provide clarity in managing Fabry patients with cardiac involvement.