Background: Cardiac disease increases morbidity and mortality in pregnant patients. This is found in both developing countries and underdeveloped countries. Cardiovascular demand increases with pregnancy, causing additional stress on a diseased heart. This then poses a greater risk of complications; thus, specialized care involving an Obstetric-Gynecologist and a Cardiologist is warranted. The Modified WHO Classification of Maternal Cardiovascular Risk, CARPREG, and CARPREG II predict risk among gravidocardiac patients and corresponding needed medical attention perinatally. Little data has been known on the clinical outcomes of pregnancy among gravidocardiac patients in the Philippines. This study aims to gauge the clinical outcomes of gravidocardiac patients admitted to a tertiary hospital in Dumaguete City. Methods: A retrospective, cross-sectional descriptive study was carried out among all gravidocardiac patients admitted for labor and delivery between January 2015 and December 2019. A chart review of the cases satisfying the inclusion criteria was done. Data gathered were tabulated, and a Chi-Square was used to assess if there was a significant relationship between the cardiac condition and the mode of delivery, duration of pregnancy, maternal outcomes, and fetal outcomes. Results: Cardiac lesions noted among gravidocardiac patients include mitral valve prolapse, which comprised the majority of cases, patent ductus arteriosus, ventricular septal defect, mitral valve regurgitation, aortic valve regurgitation, atrial septal defect, and peripartum cardiomyopathy. Pregnancies were mainly carried to term with vaginal delivery as the primary mode of birth. Maternal outcomes were generally favorable, with no deaths recorded. Fetal outcomes were variable among cases, and fetal mortality was recorded at 3.92%. A significant relationship was seen between maternal cardiac condition and maternal outcomes of the pregnancies. Conclusion Among pregnant patients with cardiac conditions, maternal outcomes of pregnancy can be predicted in association with the cardiac condition. There is a great need to educate the public on the need for proper perinatal care when a cardiac condition in pregnancy is detected.

Introduction: Erectile dysfunction (ED) has numerous links to cardiovascular disease. Numerous studies show the severity of ED is strongly associated with atherosclerosis and endothelial dysfunction implicated in the pathogenesis of coronary artery disease (CAD). These common vascular pathways have led to evidence that ED onset may be used as a marker of the severity of CAD as well as a preclinical marker of early onset-CAD. The researchers aim to determine the association of ED and CAD in terms of prevalence, clinical presentation and severity and extent of vessel involvement by SYNTAX score among CAD patients undergoing coronary angiography. Methods: This is a prospective, cross sectional, analytical study design set at Perpetual Succour Hospital – Cebu Heart Institute, a private, tertiary hospital with cardiac specialty units located in Cebu City. This study includes all Filipino patients admitted at Perpetual Succour Hospital suspected to have coronary artery disease based on symptoms of angina, dyspnea or other anginal equivalent with indications to undergo coronary angiography during the period of October 1, 2014 to September 30, 2015 were included. Results: A total of 160 patients were included in the study. The mean age is 57.23 years with most of the patients admitted for stable ischemic heart disease (SIHD) of 54.7%, non-ST elevation acute coronary syndromes (NSTEACS) 33.5% and ST-elevation myocardial infarction (STEMI) 11.8% with multiple cardiovascular risk factors like hypertension, diabetes mellitus, smoking and dyslipidemia. Eighty-two percent complained of ED symptoms with a mean International Index of Erectile Function (IIEF) score of 15.15. Most ED patients identified had mild to moderate ED (31.7%), mild ED (21.7%), moderate ED (17.4%) and severe ED (11.8%). There were only 17.4% of patients who had undergone coronary angiography for CAD complaints that had no ED symptoms on admission. Per clinical presentation, there was a significant association between patients presenting with severe ED, moderate ED and mild to moderate ED with those presenting with SIHD and ACS-NSTEMI on admission, moderate ED and mild to moderate ED. ED was significantly associated with obstructive CAD (p=0.001) and correlated directly with the number of vessels involved (p<0.01) and inversely related to SYNTAX scores (p<0.001). ED symptoms were noted to precede CAD diagnosis by 4.9 to 5.9 years. Conclusion In conclusion, there is a high prevalence of ED among CAD patients and its existence is significantly associated with obstructive CAD varying directly with extent and number of vessel involvement. There is a significant inverse relationship with severity of ED and SYNTAX scores. The existence of ED was present in all subsets of CAD patients, regardless of presentation of admission and preceded CAD symptoms and diagnosis by four to five years.
Erectile Dysfunction ; Coronary Artery Disease

BACKGROUND: Studies have shown that inflammation plays a role in the pathogenesis of acute coronary syndrome (ACS). The use of platelet-to-lymphocyte ratio (PLR) as a marker for inflammatory conditions such as malignancy, systemic lupus erythematosus, and rheumatoid arthritis has been demonstrated in several studies. The aim of this study is to determine whether an elevated PLR taken on admission is associated with in-hospital mortality and major adverse cardiac events among ACS patients. METHODS: This is a single-center, retrospective correlational study. It included all ACS STsegment elevation myocardial infarction and non–ST-segment elevation myocardial infarction adult patients admitted from January 2011 to December 2020. Complete blood count on admission was used to derive the PLR. Patient’s course in the ward was reviewed for development of adverse clinical outcomes such as in-hospital mortality, arrhythmias, heart failure, cardiogenic shock, and reinfarction. Primary outcome for this study was in-hospital mortality, and the secondary outcomes were the development of other complications previously mentioned. Optimal cutoff value associated with in-hospital mortality was determined using receiver operating characteristic curve. RESULTS: A total of 342 patients were included in the study. Forty-three (12.57%) of the sample had in-hospital mortality and was noted to have higher PLR compared with patients who did not develop complications. Univariate logistic regression analysis showed a significant relationship between a high PLR and occurrence of in-hospital mortality (P = 0.0039). The optimal cutoff value of PLR that can predict in-hospital mortality is 165, with 52.17% sensitivity, 56.76% specificity, and an area under the curve of 59.69%. On the other hand, a high PLR did not show association with the development of complications during the hospital stay. CONCLUSION A PLR of >165 is a cheap, readily available marker that can be used to predict in-hospital mortality among Filipino patients with ACS.
Acute Coronary Syndrome