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The relationship between serum level of 25 OH-Vitamin D3 and severity of coronary artery disease
Amir Farhang Zand Parsa, Parsa Faryadras , Alireza Esteghamati, Naser Gilani Larimi,
Volume 71, Issue 11 (2-2014)
Abstract
Background: Although a few studies have shown the positive correlation between patients’ serum concentration of 25 OH-Vitamin D3 and type II diabetes mellitus, metabolic syndrome, and insulin resistance, there are controversies regarding the relationship between 25 OH-Vitamin D3 as a risk factor for cardiovascular atherosclerotic diseases that has to be cleared. The aim of this study was to evaluate the association between the rate of 25 OH-Vitamin D3 and the presence and severity of coronary artery disease (CAD) in Patients with suspected CAD. Methods: This study was a cross sectional study that has been conducted in the department of cardiology in Imam Khomeini Hospital complex in collaboration with endocrinology research center. In this study 178 patients with suspected coronary artery disease (CAD) were enrolled. Based on their history and clinical findings coronary angiography was performed in all patients. Severity of CAD has been assessed by using Gensini score, based on their coronary angiography findings. The relationship between severity of CAD and their serum level of 25 OH-Vitamin D3 was evaluated. Serum level of 25OH- Vitamin D3 was measured by the enzyme-linked immunosorbent assay (ELISA) method by Euroimmiune kits (from Germany). Results: Of 178 patients, 50 (28.1%) were female and 128 (71.9%) were male. Mean±SD of their ages was 56.2±11.8 years old. Significant coronary artery stenosis (stenosis more than 50% luminal diameter) was observed in 91 (51.1%) of patients. Mean±SD of serum level of vitamin D3 in patients with CAD was 45±35 nm/l and in patients without CAD was 55±44 nm/l (P= 0.047). Mean±SD of Gensini score was 26.3±21.1, as well. Therefore correlation coefficient between 25 OH-Vitamin D3 and Gensini score was -0.262 (P= 0.043). Conclusion: Although there is a trend toward association between deficiencies of 25 OH-Vitamin D3 and the presence of CAD but their association is not statistically significant. For achieving more convincing findings larger studies are needed.
Vitamin C in prevention of atrial fibrillation after coronary artery bypass graft: double blind randomized clinical trial
Mahmoodreza Sarzaeem , Nasim Shayan ,
Volume 71, Issue 12 (3-2014)
Abstract
Background: Atrial fibrillation is the most common arrhythmia after cardiac surgery. Vitamin C as an antioxidant has an important role in reducing the incidence of postop-erative atrial fibrillation. The present study aimed at administrating vitamin C as a way to reduce the incidence of post-CABG atrial fibrillation. Methods: In this double-blind, parallel clinical trial, 170 patients with coronary artery disease who underwent CABG surgery, by using a table of random numbers are di-vided into intervention and control groups to receive placebo or vitamin C. The clinical and surgical characteristics of the patients in the two groups were similar. The interven-tion group received 2 mg of vitamin C intravenously, the night before surgery. This drug followed by 500 mg, twice a day for five days after surgery. On the other hand patients in the control group received placebo (normal saline intravenously). After operation two groups were compared regarding Important outcomes such as postoperative arrhythmia, ICU stay and hospital stay. Results: One hundred eighteen men and fifty two women with a mean age of 59.1±9.8 years were enrolled in the study in two vitamin C and placebo groups (each consisting of 85 patients). The incidence of postoperative atrial fibrillation was 12.9% in the vita-min C group and 29.4% in the control group (P=0.009). ICU stay in the vitamin C group were 2.5±1.4 days versus 3.0±1.6 days in controls (P=0.035) and hospital stay in the vitamin C group were 6.6±1.5 days versus 8.2±2.3 days in controls (P<0.001). Conclusion: Vitamin C is relatively safe, inexpensive, well tolerated and has a low complication. According to the 44% reduction in the incidence of atrial fibrillation in vitamin C patients undergoing coronary artery bypass grafting surgery, this drug can be prescribed as a prophylaxis for prevention of post-CABG atrial fibrillation.
Low dose Colchicine in prevention of atrial fibrillation after coronary artery bypass graft: a double blind clinical trial
Mahmoodreza Sarzaeem , Nasim Shayan , Jamshid Bagheri , Mohammad Jebelli , Mohammadhosein Mandegar ,
Volume 72, Issue 3 (6-2014)
Abstract
Background: The occurrence of Atrial Fibrillation (AF) is linked to an increased inflam-matory response after cardiac surgery that is significantly decreased by anti-inflammatory treatments. The present study aimed at administrating Colchicine as a way to reduce the incidence of post- Coronary Artery Bypass Graft (CABG) atrial fibrillation. Methods: In this double-blind, parallel clinical trial, 216 patients with coronary artery disease who underwent CABG surgery, by using a table of random numbers are divided into intervention and control groups to receive placebo or Colchicine. The clinical and surgical characteristics of the patients in two groups were similar. The intervention group received 1.0 mg of Colchicine tab, the night before surgery and on the morning of surgery. This drug followed by 0.5 mg twice a day for five days after surgery. On the other hand patients in the control group received only placebo (ineffective pill with similar size to Colchicine). After operation two groups were compared regarding important outcomes such as postoperative arrhythmia, ICU stay and hospital stay. The data were assessed using SPSS software (version 17) and t-test and 2 statistical tests. Results: One hundred fifty six men and sixty women with a mean age of 59.9±9.3 years were enrolled in the study in two Colchicine and placebo groups (each consisting of 108 patients). The incidence of postoperative atrial fibrillation was 14.8% in the Col-chicine group and 30.6% in the control group (P= 0.006). ICU stay in the Colchicine group were 2.4±1.3 days versus 3.1±1.5 days in controls (P< 0.001) and hospital stay in the Colchicine group were 6.6±1.5 days versus 8.1±2.0 days in controls (P< 0.001). Conclusion: Colchicine is an anti-inflammatory medication and has very few side effects at low doses. According to the 48% reduction in the incidence of atrial fibrillation in Colchicine patients undergoing coronary artery bypass grafting surgery, this drug can be prescribed as a prophylaxis for prevention of post-CABG atrial fibrillation.
The effectiveness, side effects and acceptability of locally available brand of Clopidogrel (Osvix) as antiplatelet tablet in CABG patients
Behzad Imani , Reza Safi-Ariyan , Babak Manaafi , Arezo Karampourian , Karim Ghazikhanlou Sani ,
Volume 72, Issue 4 (7-2014)
Abstract
Background: Platelet activation and aggregation plays an essential role in the for-mation of coronary artery thrombosis. Nowadays, the Clopidogrel is administered oral-ly as an inhibitor of platelet aggregation. Due to the high price of the original brand of Clopidogrel (Plavix), an Iranian brand of Clopidogrel (Osvix) has been produced. This study was conducted to evaluate the effectiveness, side effects and acceptability of lo-cally available brand of Osvix as anti platelet tablet in coronary artery bypass grafting patients in comparison to the original brand (Plavix) by means of platelet aggregation indexes. Methods: This clinical study, was conducted at Heart Center of Ekbatan university Hospital in Hamadan in October 2011 to May 2012. In this study 80 patients undergo-ing coronary artery bypass grafting (CABG) were participated in two independent treatment groups. One group used the Iranian brand of Osvix and other one used the original brand (Plavix) as an inhibitor of platelet aggregation. To evaluate the effective-ness of these two in-inhibiting platelets regimens, blood samples were taken from the patients and platelet aggregation test was performed using Helena Biosiences Europe, PACKS4 aggrigometry system (made in France). Results: Mean platelet-rich plasma amount for the Osvix and Plavix treatment group was 236.260 and 153.290 plt/µl respectively. Results showed a statistically significant difference in the rate of platelet-rich plasma by two above mentioned treatment groups. There was no observed statistical difference in side effects of two studied treatment groups. It must be noted that the effectiveness of Plavix tablet regimen as a platelet aggregation inhibitor in patients undergoing CABG was higher than the Osvix tablet treatment regimen. Conclusion: This study showed the Iranian brand of Clopidogrel (Osvix) is significantly different from the original brand (Plavix) in terms of performance factors in preventing platelet aggregation in patients undergoing coronary artery bypass grafting.
Histological and biochemical characteristics of arteries and veins in patients candidate for coronary bypass surgery
Nasim Dana , Shiva Safavi , Nafiseh Nili , Badrodin Ebrahim Seyed Tabatabaei, Shaghayegh Haghjooy Javanmard ,
Volume 72, Issue 6 (9-2014)
Abstract
Background: The occlusion of the artery and vein grafts are currently a major problem in coronary bypass surgery. Degradation of collagen and elastin, the most abundant extracellular matrix proteins in the vessel wall by matrix metalloproteinase (MMPs), leads to a rearrangement of the extracellular matrix and vascular wall structure. The present study aimed to compare the histological and biochemical characteristics of arteries and veins which could have a role in the failure of the graft. Methods: This study was a cross-sectional study of 80 patients conducted at Heart Hospitals in Isfahan, Iran, between July 2012 and November 2013. Samples were collected from the remains of vessels used in bypass surgery of 11 male nondiabetic patients. The histologic, collagen elastin ratio and MMPs levels of the vessels were investigated. MMPs were determined using the Gelatin Zymography method. For elastin and collagen content measurement, the sample was digested by cyanogen bromide and hydrochloric acid and then hydroxyproline was measured with a spectrophotometer. Results: The amount of active and inactive MMP-2 and MMP-9 of the left internal mammary artery (Lima) was similar to aorta, but the amount of MMP-2 and MMP-9 in the radial artery and saphenous vein were significantly higher than aorta. Elastin to collagen ratio in Lima (1.92±1.15) was similar to the aorta (3.4±1.66), but this proportion in saphenous vein (1.07±0.47) and radial artery (1.14±0.39) was significantly lower in the aorta (P≤0.05). Most patients had atherosclerotic plaque in radial while there was atherosclerotic plaque in Lima of only one case. Conclusion: The presence of atherosclerotic plaques in radial and thickening of the intimal layer of the saphenous vein in the majority of patients and decrease of collagen to elastin ratio and the high level of matrix metalloproteinase enzymes in the radial and saphenous vein can induce early pathological conditions, and remodeling of the vessels involved. So the results of this study confirm that Left Internal Mammary Artery (LIMA) is the most suitable candidate for bypass surgery.
Prevalence of cardiovascular risk factors in patients undergoing CABG: brief report
Habib Yaribeygi , Hojjat Taghipour , Hamidreza Taghipour ,
Volume 72, Issue 8 (11-2014)
Abstract
Background: Cardiovascular complications have very high incidence and are the main cause of mortality in human. Although the cardiovascular risk factors among apparently healthy subjects have been studied, these factors among patients who have undergone coronary artery bypass graft surgery have not evaluated clearly. Methods: The present study is a descriptive, cross-sectional survey on 1592 patients which suffered coronary artery bypass surgery (CABG) from May 2009 to May 2013 in Baqiyatallah Hospital, Tehran. Before surgery, all patients were carefully assessed and typical and atypical cardiovascular risk factors were determined and the desired data were collected. Results: More than 70.8% of subjects were men and 29.2% were women. Average age of all patients was 60.39±7.5 years and the mean weight was 73.91±6.3 kg. Typical risk factors including: smoking, plasma cholesterol level, hypertension, diabetes mellitus and family history of cardiac problems, were common in these patients. Forty seven percent of patients had diabetes mellitus, 79.4% had hypercholesterolemia, 34.3% had a smoking history, 64.5% had hypertension and 44.2% of patients had a family history of cardiovascular disease. Among atypical risk factors, various types of angina (chest pain) had high prevalence (88.8% of all). Also, mean body mass index (BMI) were higher than normal (27.46±2.1) which showed the incidence of obesity among these patients. But, other atypical risk factors did not have high incidence. Conclusion: We demonstrated that typical and well known risk factors have also high prevalence in CABG patients. Our results indicates that we can recognize high risk persons with continuous and accurate screening as a safe and inexpensive preventive tool. This can be done in both apparently healthy subjects and in cardiovascular patients. We can prevent the occurrence of severe degrees of atherosclerosis and also CABG. So the cost and performing surgeries will be decreased.
Association of usf1s2 variant in the upstream stimulatory factor 1 gene with premature coronary artery disease in southern population of Iran
Najmeh Jouyan , Babak Saffari , Elham Davoudi-Dehaghani, Negar Saliani , Sara Senemar , Marzieh Bahari , Neda Jouyan , Mohammad Ali Ostovan ,
Volume 72, Issue 12 (3-2015)
Abstract
Background: Polymorphisms of the upstream transcription factor 1 (USF1) have been associated with familial combined hyperlipidemia (FCHL), type 2 diabetes and coronary heart diseases (CHD). In the current investigation, the association of USF1s2 variant of human USF1 gene with premature coronary artery disease (PCAD) was evaluated in a population from southern Iran. USF1s2 has the best potential as a functional variant .in the USF1 gene. Methods: In a case-control study USF1s2 variant of human USF1 gene was determined by polymerase chain reaction- restriction fragment length polymorphism (PCR-RFLP) technique using BsiHKA I restriction enzyme for 186 women under 55 years of age and 135 men less than 50 years of age who underwent diagnostic coronary angiography in Saadi, Nemazee and Kowsar Hospitals of Shiraz, between July 2009 and March 2012. Data on the history of familial myocardial infarction or other heart diseases, hypertension, and smoking habit were collected by a simple questionnaire. Blood sugar level and serum lipid profile of all participants were also obtained by measuring the levels of fasting blood sugar (FBS), total cholesterol (TC), triglycerides (TG), low density lipoprotein (LDL) and high-density lipoprotein cholesterol (HDL). Results: Frequencies of the major (G) and minor (A) alleles of usf1s2 gene variant were 0.74 and 0.26 in the whole population, respectively. Meanwhile, the prevalence of the minor allele was significantly higher in PCAD patients compared with control subjects. This difference remained significant even after adjustment for confounding parameters. Indeed, subjects with mutant homozygous genotype (AA) were about 5 times more likely to suffer from early-onset CAD than those with wild-type homozygous genotype (GG). Moreover, the baseline characteristics of the control subjects and patients were statistically similar for almost all parameters except for the number of male individuals there was no significant difference among various genotypes in the patient group for any of these investigated variables. Conclusion: It appears that the usf1s2 variant in upstream transcription factor 1 gene is an independent predictor of premature coronary artery disease in our population and applies its effects without affecting blood sugar and lipid levels.
Multifactorial analysis of dietary patterns in healthy and coronary artery disease patients: brief report
Ali Maleki , Mahnaz Ashjaearvan , Ashraf Karimi ,
Volume 73, Issue 1 (4-2015)
Abstract
Background: The effects of consumption of nutrients on coronary artery disease (CAD) are widely observed. The aim of this study is to assess the exclusive Iranian dietary pattern on coronary artery diseases (CAD) and its risk factors. Methods: In this description-cross sectional study, 801 inhabitants of Borujerd City were included by random stratification method and a questionnaire regarding micro- and macronutrients for subjects over 35 years old from March 2011 to February 2012 was filed out. Of all the subjects consent to participate were prepared by volunteers. The complete description and a standard questionnaire to record demographic and socioeconomic status of people were taken. The prevalence of coronary artery disease and its risk factors determined Based on rose questionnaire and Monica questionnaire respectively. Results: In this study mean age of the subjects were 54.8±1.2 years, 388 male and 413 female. There was no meaningful relation between red meat consumption and coronary artery disease (P= 0.117). Nut consumption was higher in patients with CAD (P= 0.028). Use of fresh and cooked vegetables, dried fruit, animal oils cakes, french fries and some dairies are correlated with CAD (P< 0.05). However, artificially flavored soda in contrast to ordinary soda was not associated with coronary artery disease. Conclusion: Although there are some differences between dietary pattern in patient with coronary artery disease, nutritional attitudes are not significantly different in normal and CAD patients. However, according to the importance of diet in CAD, balancing these attitudes should be on the educational system high priority.
Coenzyme Q10 effect in prevention of atrial fibrillation after Coronary Artery Bypass Graft: double-blind randomized clinical trial
Jalal Moludi , Seyedali Keshavarz , Hosseinzadeh-Attar Mohammad Javad, Abas Rahimi Frooshani , Ali Sadeghpour , Sajad Salarkia , Farhad Gholizadeh ,
Volume 73, Issue 2 (5-2015)
Abstract
Background: Atrial fibrillation (AF) is the most common arrhythmia after cardiac surgery. AF leads to longer duration of hospitalization, thromboembolism, and impaired hemodynamics after heart surgery. One of the most important causes of postoperative AF, inflammation, and oxidative stress status. For this reason, it is useful to control the dysrhythmia. Coenzyme Q10 (CoQ10) as an antioxidant that has an important role in reducing the incidence of postoperative AF. The present study aimed at administering CoQ10 as a way to reduce the incidence of post-CABG atrial fibrillation. Methods: In this double-blind randomized controlled trial study, 80 patients with coronary artery disease who underwent coronary artery bypass graft surgery (CABG) in Rajaie Cardiovascular, Medical and Research Center from April to November 2014, randomized are divided into intervention and control groups to receive placebo or CoQ10 The surgical characteristics of the patients in two groups were similar. The intervention group will receive the oral CoQ10 supplement 150 mg/d for 7 days before surgery. After operation two groups were compared regarding important outcomes such as postoperative arrhythmia, intensive care unite (ICU) stay and hospital stay. Atrial arrhythmias are considered significant If more than 10 minutes duration atrial and with a shorter duration of arrhythmia, but with recurrence again. Results: Thirty-eight women and forty-two men with a mean age of 58.37±7.98 years were enrolled in the study in two CoQ10 and placebo groups (each consisting of 40 patients). The incidence of postoperative AF was 45% in the control group to 20% in the intervention group decreased after supplementation (P=0.030). ICU stay and length of in-hospital stay did not significant. The incidence of arrhythmias ventricular tachycardia (VT) and VF in this period was not significant (P=0.865). Conclusion: Q10 supplements have low side effects. Due to the reduction in the incidence of AF in patients after, CABG, these supplements can be recommended for the prevention of AF.
Relationship of fatty acids content of LDL particles with their electrical charges in patients with coronary artery disease
Rouhangiz Babakhanianzadeh, Nahid Masoudian , Amirnader Emami Razavi, Gholam Basati ,
Volume 73, Issue 7 (10-2015)
Abstract

Background: Low density lipoprotein (LDL) particles have shown to be heterogeneous structures with distinctive electrical charges. Alteration in the fatty acids content of the LDL particles is known to affect their structural features, electrical charges, and ultimately physiologic properties and, in this way, may play a role in the pathology of coronary artery disease (CAD). On the basis of evidences, in the present study, the relationship of fatty acids content of LDL particles and their electrical charge was assessed in patients with CAD in comparison with control subjects. Methods: In the current case- control study, from subjects who referred to the Mostafa Khomeini Hospital in Ilam during a time period from December 2013 to October 2014, 40 CAD patients and 40 control subjects were selected based on the clinical and angiographic parameters. The fatty acids content and electrical charges of LDL particles were measured by using a gas chromatography system, equipped with a flame ionization detector GC-FID, Acme 6000 M (Young Lin Co., Korea) as well as a Zetasizer (Malvern Instruments Ltd., UK), respectively. Results: In the present study, CAD patients and control subjects were matched for age, sex, and body mass index (BMI). The electrical charge amounts of LDL particles in the patients group was significantly lower than those in the control subjects (P= 0.0001). There was an inverse correlation between the electrical charge amounts of the LDL particles and the saturated fatty acids as well as linoleic acid contents of them in CAD patients group. However, we found a direct correlation between the unsaturated fatty acids (monounsaturated fatty acids and some of the polyunsaturated ones) content of the LDL particles and their electrical charge amounts (P= 0.02). Conclusion: Results of the present study demonstrated that the increased saturated fatty acids as well as the linoleic acid contents of the LDL particles are associated with decreased electrical charge amounts of these particles and this situation may engage in pathogenesis of CAD.


Effect of vitamin C supplementation in the prevention of atrial fibrillation
Jalal Moludi , Seyedali Keshavarz , Reza Pakzad , Naser Sedghi , Taraneh Sadeghi , Foad Alimoradi,
Volume 73, Issue 11 (2-2016)
Abstract

Background: Recently, the role of inflammation and oxidative stress in the pathophysiology of atrial fibrillation (AF) after cardiac surgery has been emphasized. Vitamin C as an antioxidant important role in reducing the incidence of postoperative atrial fibrillation. This study aimed to investigate, administration of vitamin C, as a way to reduce the incidence of atrial fibrillation after coronary bypass surgery.

Methods: In this double-blind clinical study, 290 patients in Rajaee Heart Center, from March 2013 to December 2014 who underwent coronary artery bypass surgery were randomly divided into intervention and control groups to receive vitamin C and placebo. The intervention group before the surgery in the operating room received 2 grams of vitamin C intravenously then one gram per day for four days prior to surgery. After the operation, the two groups were compared in terms of the following: Atrial and ventricular arrhythmias after surgery, ICU stay and hospital stay and duration of intubation.

Results: 113 cases and 177 controls (191 men and 99 women) with a mean age of 55.40±14.40 years in both groups (vitamin C and placebo) were enrolled. The incidence of postoperative atrial fibrillation was 55% in the placebo group to 35% in the vitamin C group decreased (P= 0.001). Duration of intubation in the intervention group 11.8 and the control group was 14.14 hours (P= 0.004). The amount of drainage was lower in vitamin C group (P= 0.003). Vitamin C had no effect on the rates of hospital and ICU stay (P= 0.075). There was no significant reduction in threatening arrhythmia (VT) and VF in this period (P= 0.159).

Conclusion: Vitamin C supplements may reduce atrial fibrillation after coronary artery bypass surgery also can improve conditions such as reducing the duration of intubation. With regard to the safety, these supplements can be recommended for the prevention of atrial fibrillation before coronary artery bypass surgery.


Relationship between chest pain severity and physiological indexes in patients with coronary artery disease
Ali Fakhr-Movahedi , Abbasali Ebrahimian , Majid Mirmohammadkhani , Saeedeh Ghasemi ,
Volume 74, Issue 2 (5-2016)
Abstract

Background: Coronary artery disease is considered as main factor for patients’ hospitalization. Chest pain is the most common symptoms of patients and its assessment is an important factor in coronary artery disease. So, this study aimed to determine the relationship between the severity of chest pain with physiological indexes in patients with coronary artery disease.

Methods: This study was a descriptive-analytical design that performed on 80 patients with that were hospitalized in coronary care unit of Shahid Mofatteh Hospital in Varamin city, Iran, from March to September, 2014. In this study, the relationship between the chest pain severity and blood pressure, pulse rate, respiratory rate, O2 saturation and ST segment alterations were assessed. Finally, the gathered data were analyzed by descriptive and inferential statistics.

Results: The mean of chest pain severity was 6.51±2.14 in patients. Patients’ age was between 26 to 85 years old and the mean of age was 60.79±13.79 and there was no significant correlation between age and chest pain severity (P=0.985). Also male and female patients were equal. There was no significant difference between chest pain severity of men and women (P=0.471). The findings of study showed no correlation between chest pain severity and heart rate (r=-0.174 and P=0.122), respiratory rate (r=-0.013 and P=0.909), O2 saturation (r=0.051 and P=0.651), ST segment alterations (r=0.07 and P=0.539). Also, there was no significant difference between chest pain severity and systolic pressure (P=0.353), diastolic blood pressure (P=0.312) and body mass index (P=0.256) among patients.

Conclusion: In this study, there were not enough evidences for relation between chest pain and physiological indexes in patients with coronary artery disease. So performing more studies in another settings and conditions recommended.


Correlation between serum levels of cystatin C and coronary slow flow and body mass index in men
Roghaiyeh Afsargharehbagh, Mirhosein Seyedmohammadzad , Aliakbar Nasiri , Kamal Khademvatan , Sima Ghaemimirabad , Abbas Malandish ,
Volume 76, Issue 9 (12-2018)
Abstract
Background: Cystatin C (Cys C) as a cysteine protease inhibitor is produced in a constant level from all nucleated cells. The purpose of this study was to investigate the correlation between serum levels of Cys C and coronary slow flow (CSF) and body mass index (BMI) in men.
Methods: This investigation is in the form of a descriptive-analytical study. The statistical population was all non-active male aged 34-73 years with CSF candidate for angiography referring to Seyedoshohada University Hospital, Urmia, Iran, from March 2015 to February 2017. After obtaining an inform consent, 74 male patients (mean age 54.77±9.00 years, height 1.74±0.12 cm, weight 73.13±6.85 kg, and BMI 26.98±3.83 kg/m2) were selected by convenience non-random sampling as the sample size (patients were eligible for diagnostic coronary artery angiography for the first time and referring to Seyedoshohada University Hospital in Urmia). Then all the patients were placed under angiography with one mobile angiography system. Patients were assessed for coronary blood flow with a quantitative method using corrected thrombolysis frame count in myocardial infarction (CTFC). All the patients with TFC larger than two standard deviation pre-published area for a specific vessel were counted as CSF. Demographic characteristics of age, height, weight, and BMI in male patients were measured by wall-meter with an accuracy of one millimeter, digital scale with precision of 100 g, and weight/hieght2 formula, respectively. The traditional risk factors including smoking, diabetes mellitus (DM), high blood pressure (HBP), dyslipidemia, and family history were also assessed using a checklist. Serum levels of Cys C were measured by ELISA machine.
Results: The mean demographic and physiological variables of subjects were: age 54.77±9.00 yr, height 1.74±0.12 cm, weight 73.13±6.85 kg, and BMI 26.98±3.83 kg/m2. Also, the results of this study showed that there were no significant correlations between serum levels of Cys C with CSF and BMI in male patients’ candidate for angiography referring to Seyedoshohada University Hospital (P=0.871 and P=0.494, respectively).
Conclusion: The results of this study suggest that serum levels of Cys C had no significant correlations with the CSF and BMI in male patients’ candidate for angiography aged 34-73 years.

The factors that affect blood and blood products usage in coronary artery graft surgery
Kianoush Saberi , Shahnaz Sharifi, Mehrdad Salehi , Paniz Mihandoost,
Volume 76, Issue 11 (2-2019)
Abstract
Background: Coronary artery bypass surgery is one of the surgeries in which high blood transfusions are needed. About 20% of all surgical operations require a blood transfusion. Packed cell administration increases perioperative morbidity and mortality. In the United States, from every 1000 people, one has undergone a coronary artery bypass graft surgery, and it is estimated that around 800,000 coronary artery bypass grafts undergo each year. Knowledge about relative blood administration during coronary artery bypass graft surgery improves the ability of blood transfusion centers in healthy and adequate blood donations. For this purpose, this study was conducted to determine the effective factors in the need for blood in a coronary artery bypass graft surgery.
Methods: This cross-sectional study was performed on 317 patients undergoing coronary artery bypass graft surgery in the heart surgery operating room of Imam Khomeini Hospital in Tehran, Iran, from September 2017 to February 2018. Sampling method has been available. The data of this study were extracted from patient files. The products analyzed in the study included packed cell, fresh frozen plasma and platelets. Demographic data, type of surgery, transfusion of blood and products, and hemoglobin level have been reported. P-value less than 0.05 was reported as meaningful.
Results: In this study, 317 patients underwent coronary artery bypass graft surgery. 236 cases (74.4%) were male and the rest were women. The mean of administration of packed cell in women was 2.74±1.3 and in men it was 2.29±1.09 (P<0.001). The mean packed cell administration in patients with hemoglobin levels less than 10 g/dl was 3.27±1.8 and in patients with hemoglobin levels greater than 10 g/dl was 0.99±2.25 (P<0.0001).
Conclusion: The present study showed that the mean transfusion of packed cells in women were more than men in coronary artery bypass graft surgery. Also, hemoglobin levels were the only factor that had a significant effect on infusion of packed cells.

Investigation the frequency of asymptomatic hemorrhagic transformation of infarction in CT scan of acute ischemic stroke patients
Babak Mansour Afshar , Mohammad Reza Gheini, Tayeb Ramim ,
Volume 76, Issue 12 (3-2019)
Abstract
Background: Asymptomatic hemorrhagic transformation infarct (AHTI) is known as a complication of ischemic attack and maybe occurs in the entire stroke. However, the role of AHTI in the result of the treatment is still not clear, because it is based on the definition of an asymptomatic and not identifiable. The aim of this study was assessment and evaluation frequency of AHTI in acute ischemic stroke patients.
Methods: This prospective cross-sectional study was done in Neurologic Department, Tehran University of Medical Sciences, Tehran, Iran, from April 2015 to April 2016. Second evaluation was done about new neurologic signs and symptoms ten days after stroke. In addition, brain CT scan was used to diagnose of hemorrhagic event in infarct area. If the hemorrhagic event was occur in different area, the patient was consider as a non-hemorrhagic transformation and excluded from the study. Other exclusion criteria include intracranial hemorrhage (ICH), trauma to the head during admission, cerebral vein thrombosis, coagulation disorder, anti-coagulant (heparin, warfarin) administration, induced transformation within 10 days of onset of ischemia, lacunar ischemic and unobservable in thirty T-brain scan, patient's lack of referral for examination and CT scan 10 days after the onset of symptoms, died before CT was considered.
Results: Three hundred and eighty seven patients had inclusion criteria. 249 cases were excluded due to lost following, vein thrombosis of the brain, lacunar ischemia, anti-coagulants recipient (heparin, warfarin), asymptomatic hemorrhagic transformation and death. Finally, 138 cases (86 men, 52 women) with 66.61±9.37 years (50-101 years) were participated in data analysis. Frequency of positive CT scan was evaluated for ischemic stroke evidence in two stages. Of the 138 patients who participated in the study, 75 (54.3%) were positive in the first and 63 (45.7%) cases in the second time. 27 cases (19.6%) had AHTI.
Conclusion: Coronary artery bypass graft (CABG) had significant correlation with ATHI in acute ischemic attack. However, stroke history correlated with decreasing of ATHI. Concerning smoking and consuming the results showed that smoking did not affect the asymptomatic hemorrhagic transformation. Also, the results showed that the use of aspirin and Plavix also had no significant effect on increasing the incidence of ATHI.

Assessment of cognitive impairments following coronary artery bypass surgery with emphasis on working memory performance
Mohadeseh Mozafari , Seyyed Abolghasem Mehri Nejad , Jamshid Bagheri , Mehrangiz Peyvstegar , Masoud Saghafinia ,
Volume 78, Issue 3 (6-2020)
Abstract
Background: Previous researches have provided contradictory results about on working memory performance after the coronary artery bypass graft (CABG). In addition, studies have focused on the elderly community. For this reason and with regard to the importance and direct effects of working memory on the quality of life human. This study was designed to compare working memory of young CABG patients with age range of 30-55 years one year postoperatively with healthy subjects.
Methods: In this Case-control study, which was conducted from February 2017 to October 2018, two groups of people, 40 patient men with coronary artery bypass graft that admitted to the heart center of Tehran in last year and 64 healthy males were selected with using available sampling method. Both groups were tested with Wechsler's working memory scale.
Results: The results of the study showed that the mean and standard deviation of the age of coronary artery bypass graft patients were 52.65 and 5.559, respectively, and the mean and standard deviation of healthy subjects were 41.81 and 8.619, respectively. The results showed that The two group had significantly difference (P<0.01), in the sub scales of the working memory including of the forward auditory memory and reverse auditory memory, total score of auditory memory, reverse visual memory and auditory memory span and the two groups had significantly difference (P<0.05), in the total score of visual memory. But the two group had not significantly difference (P>0.05) in the forward visual memory (CABG [mean=5.40 & standard deviation=1.41] Healty people [mean=6.13 & standard deviation=3]) and visual memory span (CABG [mean=5.35 & standard deviation=1.12] Healty people [mean=5.56 & standard deviation=1.97]). The results showed that Patients with CABG than healthy people have overall poorer results for all sub scales the of working memory test.
Conclusion: The results of this study confirm the prevalence of relatively high cognitive decline, especially in working memory after CABG, and provide a pattern of persistence of cognitive decline after one year of coronary artery bypass surgery in young patients aged 30 to 55 years.

The effect of high-intensity interval training (HIIT) with Quercetin supplementation on oxidative stress and level of concentric pathologic hypertrophy in cardiovascular patients after angioplast
Khalilullah Moonikh, Majid Kashef , Khalil Mahmoudi, Mojtaba Salehpour,
Volume 78, Issue 5 (8-2020)
Abstract
Background: Hypertension induces cardiac hypertrophy. Oxidative stress plays an important role in the pathogenesis of hypertension induced cardiac hypertrophy. Exercise and Quercetin (as activators of Sirtuins) reduce oxidative stress. The aim of this study was to investigate the effect of high-intensity interval training (HIIT) with Quercetin supplement on oxidative stress and level of concentric pathologic hypertrophy in patients with hypertension and coronary heart disease after angioplasty.
Methods: The present study was conducted experimentally randomized, placebo-controlled and double‑blind on 24 men with hypertension and coronary heart disease after angioplasty aged 40-60 since years May to August 2019 at the Exercise Physiology department of Sport Sciences Faculty, Shahid Rajaee Teacher Training University, Tehran, Iran. The subjects were randomly divided into two groups of HIIT+quercetin (n=12) and HIIT+placebo (n=12) and were followed during 8 weeks of high-intensity interval training (30 seconds of activity and 30 seconds of rest) and quercetin consumption (250 mgr of quercetin supplement or placebo pills daily). Echocardiography was used to investigate morphological factors such as posterior wall dimension (PWd) and left ventricular end diastolic diameter (LVEDd). Plasma total antioxidant capacity (TAC) and malondialdehyde (MDA) were measured by colorimetric method.
Results: The results showed that MDA and The relative wall thickness (RWT) decreased after 8 weeks in HIIT+ supplement and HIIT+placebo groups and TAC level and LVEDd increased significantly (P<0.05). PWd decreased significantly only in the exercise+supplement group (P<0.05). No significant difference between groups in any other variables was detected (P>0.05).
Conclusion: Eight weeks of high-intensity interval training alone or with quercetin by reducing oxidative stress(increasing total antioxidant capacity (TAC) and reducing malondialdehyde (MDA) reduces level of concentric pathologic hypertrophy in men with hypertension and coronary heart disease after angioplasty. So that high-intensity interval training with quercetin supplementation has relatively more effects.
 

The effect of diabetes mellitus on coronary artery ectasia: brief report
Mostafa Bahremand, Ehsan Zereshki, Behzad Karami Matin, Samira Mohammadi,
Volume 78, Issue 5 (8-2020)
Abstract
Background: Coronary artery ectasia (CAE) is dilatation of an arterial segment to a diameter at least 1.5 times that of the adjacent normal coronary artery. The incidence of coronary artery ectasia is distinct in different countries that can be found in 1.2% to 5% of angiographic examinations.
Methods: This is a retrospective study that was conducted from September 2019 to February 2020 in Kermanshah University of Medical Sciences and the results were reported briefly. To obtain the desired articles, electronic searches were conducted in databases including the Scopus, PubMed, and Science Direct databases without time limited until October 2019. The keywords used were Coronary Artery Ectasia AND (Diabetes OR "Diabetes Mellitus"). This was done by two individuals separately and the final results were confirmed by a third person. Mixed method appraisal tool (MMAT) was used to evaluate the quality of studies. The structure of writing and the process of performing and reporting the study are based on the PRISMA checklist.
Results: Based on the search strategy carried out at PubMed, Scopus and Science Direct databases, 106 studies were found, which resulted in 24 articles being analyzed based on inclusion and exclusion criteria of which three were conducted in China, 18 in Turkey and one in Sweden, Egypt, and France. Finally, 24 articles were analyzed and the results showed a direct and effective relationship between diabetes mellitus and CAE (OR=1.19, CI: 0.94, 1.51).
Conclusion: Based on these results, the risk of CAE in subjects with diabetes mellitus was 19% higher than in subjects without diabetes mellitus.

Frailty effects and euro score system evaluation in postoperative outcomes of cardiac surgery patients
Behnam Askari, Mojgan Hajahmadi-Poor Rafsanjani , Parin Hamidi-Azar ,
Volume 79, Issue 3 (6-2021)
Abstract
Background: Several scoring systems are available to evaluate the cardiac surgery risk. Frailty increases the risk of adverse outcomes after surgery. The Frailty evaluation system is a relatively new method, and in this study, we compared the frailty scoring method with the conventional Euroscore method.
Methods: This cross-sectional study was performed on 88 elderly patients (over 65 years of age) undergoing coronary artery bypass graft surgery in Seyed al Shohada Heart Center, Urmia, Iran, from October 2019 to March 2020. Patients undergoing other cardiac surgeries, patients with left main coronary artery involvement, patients with low-threshold chest pain, and life-threatening emergencies were excluded. At the preoperative period and based on the CAF (the Comprehensive Assessment of Frailty) Scoring System and the EuroScore system, the total score was calculated for each patient. Patients were followed up until one month after surgery in terms of morbidity and mortality. Patients' data were analyzed and the correlation between the total score of both systems and the postoperative consequences were statistically analyzed.
Results: In this study, the mean age of patients was 70.84±5.07 (65-91) years and most of the patients were male, 65(73 9%).The mean ejection fraction of patients was 44.13±5%. Twelve patients (13.6%) had mild frailty (CAF score of 1 to 8), 74 patients (84.1%) had moderate frailty (CAF score of 9 to 18) and 2 patients (2.3%) had severe frailty (CAF score of 19 to 28). In the postoperative period, there were two cases of mortality (2.3%) and four cases of complications (4.55%). The mean serum creatinine level in dead patients was significantly higher than in discharged patients. We did not find any significant relationship between frailty CAF score and EuroSocre with postoperative complications. In a comparison of two methods for predicting surgery outcomes: the mean EuroScore in the two dead patients was significantly higher than discharged patients (8.11 vs 2.89 with p value=0.001).
Conclusion: EuroSocre evaluation was a better predictor of postoperative mortality and its measurement is easy.

Relationship between some indices of cardiovascular functions and pulse pressure as a predictor index for heart diseases: a case-control study
Salman Daliri, Mohammad Khanbeigi, Reza Heidary Moghadam , Parisa Asadollahi, Khairollah Asadollahi,
Volume 79, Issue 8 (11-2021)
Abstract
Background: Pulse pressure has recently been considered as a predictor of coronary heart disease. The difference between systolic and diastolic blood pressure is called pulse pressure. Various factors including increased age, vascular stiffness, stenosis, and hypertension are associated with pulse pressure. The present study, therefore, aimed to investigate the relationship between some cardiovascular function indicators such as vascular stenosis, blood pressure and cardiac output with pulse pressure as a predictor of cardiovascular diseases.
Methods: This case-control study was performed on 544 patients who were referred to Imam Ali Hospital in Kermanshah, Iran, from March 2015 to February 2016. In this study, according to the angiographic findings, individuals with artery stenosis were considered as the case group (n=272) and those without artery stenosis were considered as the control group (n=272). Statistical analysis was performed using descriptive statistics, Chi-square and odds ratio estimation by SPSS22 software.
Results: According to the findings of this study, ages over 50 (OR: 3.3, 95% CI: 2.1-5.2), high systolic blood pressure (OR: 8, 95% CI: 4.3-15.2), high diastolic blood pressure (OR: 4.9, 95% CI: 2.0-11.7), cardiac output less than 50% (OR: 1.8%, 95% CI: 1.3-2.7) and vascular stenosis (OR: 3.5, 95% CI: 2.4-5.1) were associated with high pulse pressure. The male gender had a preventive role in increasing of pulse pressure (OR: 0.7, 95% CI: 0.5-0.9). A significant relationship was demonstrated between systolic blood pressure and pulse pressure (P<0.0001).
Conclusion: Based on the findings of the present study, the chances of having high pulse pressure are high among individuals over 50 years of age, female gender, those with elevated systolic and diastolic blood pressure, and individuals with high coronary artery stenosis. This chance is associated with decreased cardiac output and coronary stenosis. Increased pulse pressure is a predictive indicator of cardiovascular disease and it is recommended that pulse pressure measurements of all referrals, especially those who are being referred to cardiology clinics, are taken into account by medical professionals to prevent adverse clinical outcomes.

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