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H. H. Virk

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Sep 2026

Burden of Ischemic Heart Disease and its attributable risk factors from 1990 to 2021, and forecasts till 2050: A comparative analysis of Low versus High Socio-demographic Index (SDI) Regions.

Ischemic heart disease (IHD) is the leading cause of mortality among non-communicable diseases globally. We evaluated the influence of sex, risk factors, and the sociodemographic index (SDI) on the burden of IHD. We used data from the Global Burden of Disease (GBD) 2021 project to analyze age-standardized incidence (ASIR), mortality (ASMR), and disability-adjusted life-year rates (ASDR) for IHD across high- and low-SDI regions. We used Joinpoint regression to evaluate temporal trends using annual percentage changes (APCs). We forecasted point-estimate through 2050 using autoregressive integrated moving average models. In 2021, IHD burden was greater in low-SDI than high-SDI regions, with ASIR 444.6 vs. 195.6, ASMR 116.4 vs. 58.4, and ASDR 2,464.1 vs. 1,134.0 per 100,000 population, respectively. Between 1990 and 2021, high-SDI regions demonstrated reductions in ASIR (43%; AAPC -1.81), ASMR (63%; AAPC -3.22), and ASDR (61%; AAPC -3.06). In contrast, low-SDI regions showed only modest declines in ASIR (6%; AAPC -0.23), ASMR (3%; AAPC -0.05), and ASDR (8%; AAPC -0.26). Forecasts suggested a gradual increase in ASMR and ASDR in high-SDI regions by 2050, whereas low-SDI regions were projected to remain high-burden despite gradual declines. Women experienced greater improvements than men in high-SDI regions, with limited progress in low SDI-regions. Men consistently exhibited higher IHD burden across all measures. Metabolic risks. i.e. (blood pressure and LDL cholesterol, were the dominant contributors across both SDI strata. In conclusion, despite declining rates in high-SDI regions, low-SDI regions showed only modest and inconsistent improvement, with persistent sex disparities and substantial metabolic risk-attributable burden.

Minaam Farooq, M. Safiullah, Malik Saad Hayat et al. · American Journal of Cardiolo... · 0 citations

Review Open access Jul 2026

Precision approach for transradial access during PCI: a state-of-the-art review

The transradial approach (TRA) has become the preferred vascular access for coronary angiography and percutaneous coronary intervention (PCI), offering reductions in bleeding and vascular complications compared with the transfemoral approach, and lower mortality in patients with acute coronary syndromes (ACS). Technical refinements have further enhanced procedural success with TRA. Variations in puncture technique (ultrasound-guidance, through-and-through vs. single-wall technique) and the use of vasodilator “radial cocktails” can improve access success and reduce the risk of radial artery spasm (RAS), while adequate anticoagulation, appropriate sheath sizing, and optimized radial band removal techniques help to reduce radial artery occlusion (RAO). Alternative access strategies such as distal radial (dTRA) and ulnar approaches offer advantages including lower RAO rates and preservation of the proximal radial artery for future conduit use, though these techniques are limited by higher crossover rates, longer cannulation times, and the need for additional operator experience. Optimal intraprocedural anticoagulation in the TRA era remains uncertain, as the bleeding advantage of alternatives to unfractionated heparin may be attenuated given the inherently lower access-site bleeding risk. Procedural complications, including hematoma, RAS, RAO warrant prevention and prompt recognition. Future research should refine anticoagulation strategies, personalize access-site selection, and further evaluate dTRA and ulnar approaches as operator experience matures.

Tanawat Attachaipanich, M. Khawaja, H. H. Virk et al. · Frontiers in Cardiovascular... · 0 citations