Dr Seshasayee Narasimhan
Conjoint Senior Lecturer
School of Medicine and Public Health
- Bachelor of Medicine, Bachelor of Surgery, University of Madras
Fields of Research
|110201||Cardiology (incl. Cardiovascular Diseases)||100|
|Dates||Title||Organisation / Department|
|21/10/2012 -||Cardiologist||Hunter New England Health
Director of Medicine
||Hunter New England Health
|Dates||Title||Organisation / Department|
|21/10/2012 -||Conjoint Senior Lecturer||Hunter New England Health
For publications that are currently unpublished or in-press, details are shown in italics.
Journal article (28 outputs)
Stawiarski K, Kataria R, Bravo CA, Villablanca P, Mohananey D, Narasimhan S, Ramakrishna H, 'Dual Antiplatelet Therapy Guidelines and Implications for Perioperative Management', Journal of Cardiothoracic and Vascular Anesthesia, 32 1072-1080 (2018) [C1]
Saraswat A, Narasimhan S, 'Lex parsimoniae', Journal of Cardiology Cases, 15 187-189 (2017)
© 2017 Japanese College of Cardiology We present a noteworthy case of dual pathology in a 62-year-old female with recurrent chest pains and extensive cardiac risk factors. From co... [more]
© 2017 Japanese College of Cardiology We present a noteworthy case of dual pathology in a 62-year-old female with recurrent chest pains and extensive cardiac risk factors. From computed tomography coronary angiography, a left anterior descending artery lesion was identified and successfully revascularized with a drug-eluting stent. Due to persistent chest pain, further investigation revealed a descending aortic dissection, which was conservatively managed. This case highlights the potential challenges of diagnosis in dual pathologies and emphasizes initiating appropriate investigations. <Learning objectives: It is important to consider all differential diagnoses in atypical presentations of possible acute coronary syndrome. As clinical presentations and risk factors may be similar, initiating appropriate diagnostic and management pathways are crucial to avoid misdiagnosis.>
Baker D, Wilsmore B, Narasimhan S, 'Adoption of direct oral anticoagulants for stroke prevention in atrial fibrillation', Internal Medicine Journal, 46 792-797 (2016) [C1]
© 2016 Royal Australasian College of Physicians Background: Direct oral anticoagulants (DOAC) are being increasingly utilised for stroke prevention in atrial fibrillation (AF) and... [more]
© 2016 Royal Australasian College of Physicians Background: Direct oral anticoagulants (DOAC) are being increasingly utilised for stroke prevention in atrial fibrillation (AF) and atrial flutter. Aims: To analyse the adoption and application of these drugs in a regional hospital inpatient cohort and compare with national prescribing data. Methods: Digital medical records identified prescribed anticoagulants for patients admitted with AF and atrial flutter during 2013¿2014. Analysis of patient demographics and stroke risk identified trends in prescribing DOAC versus warfarin. For broader comparison, data from the Pharmaceuticals Benefits Scheme were sourced to determine the nation-wide adoption of DOAC. Result: Of the 615 patients identified, 505 (255 in 2013, 250 in 2014) had sufficient records to include in the study. From 2013 to 2014, DOAC prescriptions increased from 9 to 28% (P < 0.001), warfarin and aspirin remained comparatively stable (38¿34%, 22¿20%), and those prescribed no medication declined (17¿8%, P < 0.001). DOAC were prescribed to patients with lower CHA2DS2VASc scores than warfarin (3.6 vs 4.4; P = 0.005), lower HAS-BLED scores (1.7 vs 2.3; P < 0.01), higher glomerular filtration rates; 70 vs 63 ml/min; P = 0.002) and younger age (74 vs 77 years; P = 0.006). Nationally, warfarin prescriptions are higher in total numbers but increasing at a slower rate than DOAC, which increased 10-fold (101 158 in 2013, 1 095 985 in 2014). Conclusion: DOAC prescribing grew rapidly from 2013 to 2014, regionally and nationally. Warfarin prescriptions have remained stable, indicating that more patients are being appropriately anticoagulated for AF who previously were not. DOAC were found to be prescribed to patients with lower CHA2DS2VASc and HAS-BLED scores, younger age and higher glomerular filtration rates. Aspirin therapy remains over utilised in AF.
Sebastianski M, Narasimhan S, Graham MM, Toleva O, Shavadia J, Abualnaja S, et al., 'Usefulness of the ankle-brachial index to predict high coronary syntax scores, myocardium at risk, and incomplete coronary revascularization', American Journal of Cardiology, 114 1745-1749 (2014)
© 2014 Elsevier Inc. Peripheral artery disease (PAD) is strongly associated with coronary artery disease and poor outcomes after coronary revascularization. The aim of this study ... [more]
© 2014 Elsevier Inc. Peripheral artery disease (PAD) is strongly associated with coronary artery disease and poor outcomes after coronary revascularization. The aim of this study was to test the hypothesis that patients with PAD diagnosed by a low ankle-brachial index (ABI; =0.90) have more complex coronary artery disease and more myocardium at risk than patients with normal ABIs (1.00 to 1.40) and that subsequent coronary revascularization is less complete. Adults referred for coronary angiography underwent ABI measurement using a standard Doppler ultrasound technique. Blinded reviewers calculated SYNTAX scores and Duke jeopardy scores at baseline and 3 months after angiography. Of 814 patients, 8% had PAD (ABI =;0.90), 9% had borderline PAD (ABI 0.91 to 0.99), 77% were normal (ABI 1.00 to 1.40), and 7% had vascular calcification artifact (ABI >1.40). Patients with PAD were more likely to have high SYNTAX scores (=33), with an odds ratio of 4.3 (95% confidence interval 1.2 to 14.9), compared with those with normal ABIs after adjustment for traditional cardiovascular risk factors. Similarly, there was a positive association between baseline high Duke jeopardy score (=8) and PAD (adjusted odds ratio 3.5, 95% confidence interval 1.7 to 7.1). Postrevascularization high Duke jeopardy scores (=5) were also positively associated with PAD (adjusted odds ratio 3.0, 95% confidence interval 1.1 to 8.8). In conclusion, PAD is associated with higher SYNTAX scores, more myocardium at risk, and less complete coronary revascularization than in patients with normal ABIs. More complex coronary artery disease and incomplete revascularization may contribute to worse cardiovascular outcomes in patients with PAD.
Jayasinghe R, Narasimhan S, Tran TH, Paskaranandavadivel A, 'Rapid rule out of myocardial infarction with the use of copeptin as a biomarker for cardiac injury', Internal Medicine Journal, 44 921-924 (2014)
© 2014 The Authors. Internal Medicine Journal. © 2014 Royal Australasian College of Physicians. Copeptin is a non-specific marker of an endogenous stress response. A dual biomarke... [more]
© 2014 The Authors. Internal Medicine Journal. © 2014 Royal Australasian College of Physicians. Copeptin is a non-specific marker of an endogenous stress response. A dual biomarker marker approach involving the simultaneous use of troponin and copeptin assays may assist early exclusion of acute coronary syndrome in Australian emergency departments. The utility and limitations of this approach are discussed.
Hiew C, Williams T, Hatton R, Narasimhan S, O'Connor S, Baker F, et al., 'Influence of age on long-term outcome after emergent percutaneous coronary intervention for ST-elevation myocardial infarction', Journal of Invasive Cardiology, 22 273-277 (2010) [C1]
Narasimhan S, McKay K, Attia JR, 'Staff perspectives of a cardiac short stay unit', Australian Journal of Advanced Nursing, 26 23-28 (2009) [C1]
|Show 25 more journal articles|
Conference (1 outputs)
Lim J, Sarwar G, Narasimhan S, 'Characterising Heart Failure with Reduced Ejection Fraction and its Management in Regional New South Wales', Heart, Lung and Circulation (2016)