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Abstract Book JIC 2020 January 3-5, 2020 Abstract Book Annual Scientific GMERS th Medical College, Symposium Sola, 16 Ahmedabad 25th Year of Academics 2020 16th Annual Scientific Symposium JIC 25th Year of Academics January 3-5, 2020 LOCAL ORGANIZING COMMITTEE Conference Chairman : Dr. Keyur Parikh CIMS Hospital, Ahmedabad Conference Patron : Dr. Nitin Vora GMERS, Sola, Ahmedabad Chairman, Scientific Committee : Dr. Milan Chag CIMS Hospital, Ahmedabad Organizing Secretary : Dr. Satya Gupta CIMS Hospital, Ahmedabad : Dr. Tejas V. Patel CIMS Hospital, Ahmedabad Conference Advisor : Dr. R.M. Jitea GMERS, Sola, Ahmedabad Dr. Ajesh Desai GMERS, Sola, Ahmedabad Dr. H.R. Jadav GMERS, Sola, Ahmedabad ASSOCIATION OF PHYSICIANS OF AHMEDABAD Dr. Ashvin Gadhavi President (APA) Dr. Anil Kulshrestha Hon Secretary (APA) Conference Directors & Co-ordinators Dr. Hemang Baxi Dr. Hiren Dholakia Dr. Pranav Modi Dr. Jayesh V. Patel Dr. Jignesh Shah Dr. Sneha Baxi Dr. Manish Gandhi Dr. Ajay Naik Dr. Mayur Patil Dr. Pranav Shah Dr. Sagar Betai Dr. T.K.B. Ganpathy Dr. Dhaval Naik Dr. Ashka Prajapati Dr. Manisha Shah Dr. Darshan Bhansali Dr. Sneha Gohil Dr. Parth Parekh Dr. Hardik R. Shah Dr. Nitesh Shah Dr. Niren Bhavsar Dr. Parth Goyal Dr. Maulik Parmar Dr. Divyesh Sadadiwala Dr. Deepa Shah Dr. Devang Bhavsar Dr. Kishor Gupta Dr. Gunvant Patel Dr. Vineet Sankhla Dr. Kirtan Shah Dr. Maulik Bhensdadia Dr. Krunal H. Patel Dr. Chandni Patel Dr. Praveen Sarda Dr. Rupesh Shah Dr. Parloop Bhatt Dr. Rajiv Harshe Dr. Vivek Patel Dr. Urmil Shah Dr. Nimish Sharma Dr. Reena Sharma Dr. Keyur Buch Dr. Abhinav Jain Dr. Prashant Patel Dr. Dhiren Shah Dr. Chintan Sheth Dr. Amit Chandan Dr. Rahul Jaiswal Dr. Mayank Patel Dr. Shaunak Shah Dr. Kashyap Sheth Dr. Anish Chandarana Dr. Pranav Joshi Dr. Rushi Patel Dr. Bhagyesh Shah Dr. Rachit Sheth Dr. Parvin Chandarana Dr. Vikramjit Kanwar Dr. Purna Patel Dr. Hemal Shah Dr. Samip Sheth Dr. Amit Chitaliya Dr. Vipul Kapoor Dr. Devang Patel Dr. Umakant Shah Dr. Puja Srivastava Dr. Rashmi Chovatia Dr. Anand Khakhar Dr. Tarang Patel Dr. Jeegar Shah Dr. Mahavir Tadaiya Dr. Dipak Desai Dr. Vatsal Kothari Dr. Ashok Patel Dr. Chirag Shah Dr. Vipul Thakkar Dr. Pradip Dabhi Dr. Surabhi Madan Dr. Natoo Patel Dr. Bhavini Shah Dr. Bhavesh Thakkar Dr. Parindra Desai Dr. Reedham Mehta Dr. Satish Patel Dr. Rechal Shah Dr. Deepa Trivedi Dr. Chirag Desai Dr. Uma Mehta Dr. Amit Patel Dr. Shalin Shah Ms. Reena Trivedi Dr. Prapti Patel Desai Dr. Ankita Midha Dr. Malhar Patel Dr. Chintan Shah Dr. Deven Zaveri GMERS Organization Team Dr. Jignasa Bhalodia Dr. H.R. Jadav Dr. Kiran Rami Dr. Falguni Shah Dr. Neena Bhalodiya Dr. Rajesh Mehta Dr. Krina Patel Dr. Bhavesh Jesalpura Dr. Parul Bhatt Dr. Prakash Mehta Dr. Nehal Patel Dr. Deepika Singhal Dr. Pranav Chakravarty Dr. Nehal Naik Dr. Ila Patel Dr. Nidhi Sood Dr. Ajesh Desai Dr. Jigesh Shah Dr. Sunil Patni Dr. Mukesh Vora Jointly Organized by Care Institute Medical Society for Research and GMERS Medical College , Education (CIMSRE) & GMERS Medical College, Sola, Sola, Ahmedabad and in association with Ahmedabad Association of Physicians of Ahmedabad. 01 2020 16th Annual Scientific Symposium JIC 25th Year of Academics January 3-5, 2020 FROM THE DESK OF ORGANIZING COMMITTEE We proudly announce JIC 2020 (January 3-5, 2020) in Ahmedabad, India. First of all, we would like to thank you for your immense support and active participation in JIC every year. With each passing year, JIC is strongly identified as a great scientific learning experience. We do our utmost to deliver interactive, case-based sessions for you to become active participants in the program. Panel Discussions and Question-Answer at the end of each session go on to create a collaborative and interactive experience for delegates. This year we have introduced for the first time 'An All Women Clinician Session' to recognise, appreciate and acknowledge the growing role of women in the medical field. On January 3-4 we have a 'Town Hall Meeting Session' which makes for great interaction and open forum for your questions to be answered. JIC 2020 has an exhaustive and comprehensive Scientific Agenda with an eminent list of speakers from all over the globe. We look forward to meeting you at JIC 2020. Dr. Keyur Parikh Dr. Milan Chag Dr. Satya Gupta Dr. Tejas V. Patel Conference Chairman Chairman, Scientific Committee Conference Secretary Conference Secretary See you at JIC 2020 Ahmedabad, India PANDIT DINDAYAL UPADHYAY AUDITORIUM Rajapth Club Road, Ahmedabad 02 2020 16th Annual Scientific Symposium JIC 25th Year of Academics January 3-5, 2020 INTERNATIONAL FACULTY Dr. Claire D. Brindis Dr. Ralph Brindis Dr. Ramesh Daggubati Dr. Bhavin Dalal Dr. Ashit Jain Dr. Samir Kapadia Dr. Neil Mehta Dr. Roosha Parikh Dr. Apurva Patel CANADA GERMANY Prof. Dr. Carsten Tschöpe HUNGARY USA Dr. Peter Lin Dr. Geza Fontos NATIONAL FACULTY Dr. Amit Gupte Mumbai Dr. Keyur Panchal Mumbai Dr. Parag Shah Ahmedabad Dr. Uday Jadhav Mumbai Dr. Sanjeev Phatak Ahmedabad Dr. Manoj Vithlani Ahmedabad Dr. Ashish Nabar Mumbai Dr. P. Piraman Chennai Dr. Preyas Vaidya Mumbai Dr. Sandeep Nayar Delhi Dr. Banshi Saboo Ahmedabad Dr. Mayur Patel Ahmedabad Dr. Rajesh Sainani Mumbai 03 2020 16th Annual Scientific Symposium JIC 25th Year of Academics January 3-5, 2020 Introduction to 25 years of Academics /Lipid Guidelines: 2020 - We Should all Adapt Dr. Keyur Parikh Care Institute of Medical Sciences, Ahmedabad, India Corresponding E-mail id: [email protected] The main principles for LDL-Lowering therapy: There is a causal relationship between low-density lipoprotein cholesterol (LDL-C) and the development of atherosclerotic cardiovascular disease (ASCVD). Trials of LDL Lowering indicate relative risk reduction is proportional to the absolute reduction in LDL-C. Lower LDL-C is better. Using statin, ezetimibe, or Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors is safe and effective down to < 1 mmol/L (40mg/dl). According to new 2019 ESC/EAS Guidelines, intensity of LDL lowering should be based on risk, irrespective of the cause(s) (e.g., primary or secondary prevention, diabetes, or CKD). Figure 1: The 2019 ESC/EAS Guidelines New Lipid Goals: Greater Benefit from Ezetimibe added to statin in High-Risk patients: TIMI Risk Score for secondary prevention (TRS 20 P) applied to IMPROVE-IT to identify high-risk patients and data suggest the benefit of adding EZETIMIBE is much more in high risk group patients. In order to be aligned with these new findings, the ESC/EAS Guidelines have proposed new LDL-C goals, as well as a revised CV risk stratification, which are especially relevant to high- and very-high-risk patients. Table 1: Intensifying Lipid-Lowering Treatment to Reach LDL-C Goals: 04 2020 16th Annual Scientific Symposium JIC 25th Year of Academics January 3-5, 2020 In the 2019 ESC/EAS Guidelines, patients classified as being at very high risk are those with documented ASCVD; patients with diabetes with target organ damage; patients with familial hypercholesterolaemia with ASCVD or another major risk factor, and patients with severe chronic kidney disease. The 2019 ESC/EAS guidelines recommend both a ≥50% LDL-C reduction from baseline and an absolute LDL-C treatment goal of <1.4 mmol/L (<55 mg/dL) for very high-risk patients. For patients at high risk, a ≥50% LDL-C reduction and an LDL-C goal of <1.8 mmol/L (<70 mg/dL) are recommended. A high-intensity statin should be prescribed up to the highest tolerated dose to achieve specified goals. DL-C levels tend to decrease during the first days of ACS and therefore a lipid profile should be obtained as soon as possible after admission for ACS. Patients do not have to be fasting as this has little impact on LDL-C levels. Lipid-lowering treatment should be initiated as early as possible to increase patient adherence after discharge. Lipid levels should be re-evaluated 4–6 weeks after ACS to determine whether treatment goals have been achieved and to check for any safety issues; the therapeutic regimen can then be adapted accordingly. Possible reasons for failure to meet LDL-C goals are as below: Lack of adherence, drug intolerance, patient characteristics, lack of lifestyle changes, failure to titrate/switch to more potent dose/statin, underuse of additional lipid-lowering therapies and inadequate follow-up. Importance of adherence to lipid lowering agent with high intensity lipid lowering drugs have been found to be associated with better CV outcomes. Decreased likelihood of reaching LDL-C goal: female, stable angina, obese, sedentary lifestyle, current smokers. Increased likelihood of reaching LDL-C goal: patients with T2D or CKD (and high CV risk). Conclusion: Statins remain the mainstay in reducing CV risk. The addition of ezetimibe provides further LDL-C lowering. Very low LDL-C levels can lead to regression of atherosclerosis. New lipid guidelines endorse lower LDL-C goals, particularly for patients with very high-risk ASCVD. According to 2019 ESC/EAS guidelines only about one-quarter of very high-risk patients need an additional LDL-C lowering with ezetimibe and/or PCSK9 inhibitor. 05 2020 16th Annual Scientific Symposium JIC 25th Year of Academics January 3-5, 2020 History of Angioplasty and the Way Ahead into 2020 - 40 years of Innovation Dr. Keyur Parikh Care Institute of Medical Sciences, Ahmedabad, India Corresponding E-mail id: [email protected] Introduction: To answer the question of how balloon angioplasty was invented, it is necessary to know how the idea of using a balloon to dilate a coronary artery was successfully tested, and how this intuition opened up a new era in the treatment of coronary artery disease. Andreas Grüntzig’s dream was to treat vascular disease percutaneously with a catheter in conscious and alert patients.
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