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Volume 64, Issue 6 (8-2006)
Background: Hypertention and diabetes are important risk factors for cardiovascular disease. studies have shown that microalbuminuria is a strong predictor of cardiov-ascular disease in different population.In this study the relation of microalbuminuria with diabetes and hypertention as risk factors of atherosclerosis disease were investi-gated.
Methods: Two hundered twenty eight patients with angiographically confirmed coronary atherosclerotic lesions, (mean age 60 ± 0.5 SD) referred to Madani Hospital, Tabriz, Iran were studied .This patients according to the number of diseased vessels were classified in two groups. The levels of glucose and creatinine and that of post parandial glucose were determined in venous blood samples by standard methods. Immunoturbidimetric method was employed in the measurement of microalbuminuria. The results were analysed by statistical tests.
Results: The increased albumin/creatinine ratio was markedly correlated with fasting blood sugar, systolic and diastolic blood pressure (P < 0.05 in all cases). Significant correlation was noticed between microalbuminuria, diabetes according to the extension of the disease lesions (P < 0.05). No relationship was observed between microalbumin-uria, high levels of blood pressure according to the number of diseased vessels (P > 0.05). Conclusion: The relationship between diabetes and microalbuminuria was meaningful. According to atherosclerotic lesions a marked correlation was also noticed between microalbuminuria and diabetes. These facts may contribute to the higher cardiovascular risk in diabetic patients. An associated between hypertension and microalbuminuria was noticed. The result suggests that although risk factors such as hypertension and diabetes are known to cause cardiovascular disease, microalbuminuria may in fact be a better indicator of established microvascular damage and better predictor of cardiov-ascular events.
Volume 67, Issue 8 (11-2009)
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Background: One of the clinical manifestations of Human Immunodeficiency Virus (HIV)
infected patients is cardiovascular disorder. The aim of this study was to
evaluate the prevalence of cardiovascular disorders in HIV
infected patients for the beginning treatment of these patients and reducing
mortality and morbidity in these patients.
Methods: This cross-sectional study was performed on 134 HIV
infected patients who referred to Imam Khomeini hospital, Tehran University of
Medical sciences, Tehran Iran during years 2007-2008.
Demographic characteristics, history of smoking and opium addiction,
antiretroviral therapy, class of drugs and duration of consumption were
recorded. After completion of physical examination, electrocardiography and
echocardiography studies were done.
Results: In this study 98(73.1%) patients were male.
The mean age of the patients was 36.5±10.3
years. The mean of the CD4 number were 296±181. Injection drug users were 54.4%
of the study patients. Cardiovascular disorders were found in 84(62.7%)
patients. Among patients with heart diseases, 75%
were male. The most Electrocardiographic change was the axis deviation of the
heart found in 32(23.7%) patients.
Pericardial effusion and LVEF<50% were
noted in 7(5.2%) and 23(17.2%)
patients respectively. The involvement of the mitral valve
in 59(44%), tricuspid valve in 21(15.7%)
and aortic valve in 6(4.5%) patients were
noted. Myocardial dysfunctions existed in 10(7.4%)
patients.
Conclusions: Our results showed a high prevalence of cardiovascular disorder in HIV
infected patients. We recommend the evaluation of the cardiovascular
system in all HIV infected patients
even if they are symptom free.
Volume 67, Issue 11 (2-2010)
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Background: Diabetes and dysglycemia have a high prevalence in
Iranian population but the information about their impact on the cardiovascular
disease (CVD) risk is scarce in this population. This study aimed
to determine the risk of CVD according to glucose tolerance status.
Methods: We ascertained cases with incident CVD in a
population of 1752 men and 2273 women, 40 years old and over and free of CVD at the
beginning of study, during a follow up with a median of 7.6 years. To
calculate hazard ratio (HR) for CVD, we controlled traditional risk factors, including
age, body mass index, waist, total cholesterol, HDL-cholesterol, triglycerides,
systolic blood pressure, diastolic blood pressure, education, smoking,
hypertension medication, lipid lowering medication and family history of
premature CVD and diabetes.
Results: Cardiovascular events
occurred in 197 men and 143 women. Its incidence density was 11.8 per 1000 person-years
(95%
confidence interval: 10.6 to 13.1) totally. Multiple adjusted HR in women with
known diabetes was 3.88 (95%CI: 2.40 to 6.27) and with newly diagnosed was 2.34 (95%CI: 1.39 to 3.95) and the
corresponding values for men were 1.72 (95%CI: 1.00- 2.95) and 1.52 (95%CI: 1.01- 2.31) respectively. Impaired fasting glucose and impaired
glucose tolerance increased 56% the risk of CVD in women (HR:
1.56 with 95% CI, 1.00 to 2.45), just in
the age adjusted model.
Conclusion: All diabetic patients should receive primary
prevention for CVD
intensively, regardless of whether they are newly diagnosed or are known cases
specially, females who have abnormal glucose metabolism.
Volume 68, Issue 8 (11-2010)
Background: Gall stone is an important health problem in the world for which different risk factors have been characterized. Gall stone and cardiovascular disease have common risk factors. Homocysteine is accepted as one of the risk factors for cardiovascular disease. We aimed to study the effect of homocysteine level on gall stone formation.
Methods: 54 patients with gall stone-related diseases and 54 patients without stone (control group) were studied from January 2007 to December 2008. Control group consisted healthy subjects with ultrasound proven normal gallbladder. Serum homocysteine level was checked in both groups. Homocysteine level of equal or more than 15 mmol/l was considered as abnormally high.
Results: Cases included 43 women (79.6%) and had mean age of 50.76±15.23 years. Homocysteine level was significantly higher in patients with gallstone in comparison to control group (p=0.014). Risk of gall stone increased 3.4 times in persons who have homocysteine level equal or greater than 15mmol/l (p=0.019). The mean level of homocysteine was higher in men than women (p=0.03). The mean level of homocysteine did not differ significantly in patients with simple gallstone and patients with gallstone-related inflammation disorders (cholecystitis, cholangitis, and pancreatitis). Additionally, one unit increase in BMI level was associated with 1.12 times increase in the risk for gall stone formation (p=0.035).
Conclusion: The homocysteine level is increased in patients with gall stone-related diseases. Homocysteine may be considered as a risk factor of gall stone formation.
Volume 69, Issue 6 (9-2011)
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Background: This study was designed to explore the contribution of risk factors for
coronary artery disease (CAD) in patients with
indication for coronary angiography. Coronary angiography is defined as the
radiographic visualization of the coronary vessels after injection of radio
opaque contrast media. Despite the recognition of risk factors for
CAD, the association between related risk factors and angiographic
findings remains controversial. The aim of the present study was to explore the
association between Gensini scores and major cardiovascular risk factors in
patients with indications for coronary angiography.
Methods: We retrospectively enrolled 495 patients who had
been hospitalized at Dr. Shariati Hospital during September 2009
to September 2010 and had undergone
coronary angiography. The patients were evaluated for the severity of coronary
lesions on the angiogram by Gensini scoring system. The patients were also
evaluated for the presence or absence of DM,
hypertension, family history of cardiac diseases, low HDL,
hyperlipoproteinemia, hypertriglyceridemia and cigarette smoking. Statistical
analysis wad done to find any relationship between Gensini scores and cardiovascular
risk factors.
Results: The study population consisted of 249
men (50.3%) and 245
woman (49.5%) with a mean age of 58.1±10.3
years. A positive correlation
was found between age (P=0.04), sex (P=0.008),
HDL (P=0.04) smoking (P=0.0001)
and diabetes (P<0.013) with Gensini scores.
Conclusion: In
patients with indications of angiography, Gensini scores provide valuable
prognostic information on cardiovascular risk factors. Age, sex, HDL, smoking
and diabetes are related to the severity of coronary
lesions on the angiograms.
Volume 70, Issue 7 (10-2012)
Background: There are conflicting reports about zinc, a trace element, in the pathogenesis of hypertension and other cardiovascular diseases. The aim of this study was to evaluate the role of zinc in high blood pressure.
Methods: We conducted this study on 80 patients with primary (idiopathic) hypertension and 80 normotensive people with similar age who attended to Tehran Heart Center between 2007 and 2008. We examined the effect of zinc concentration on blood pressure in both sexes in four age groups (41-50, 51-60, 61-70 and 71-80 years old). We measured plasma zinc concentration by atomic absorption.
Results: The mean plasma zinc concentrations were 0.456±0.04 µg/ml and 0.551±0.055 µg/ml in patients with hypertension and in normotensive people, respectively, (P≤0.05). Nevertheless, the mean plasma zinc concentrations were 0.494 µg/ml and 0.486 µg/ml in men with and without hypertension, respectively. The mean plasma zinc concentrations of women with and without hypertension, respectively were 0.415 µg/ml and 0.596 µg/ml, showing a significant difference between two groups (P≤0.001). Moreover, there was a significant difference in plasma zinc concentration between hypertensive and normotensive people in 51 to 60 years age group (P≤0.05), but difference were not significant between other age groups.
Conclusion: The results of this study revealed the relationship between the decrease in plasma zinc concentration and increase in blood pressure in women and in the men aged 51 to 60 years.
Volume 72, Issue 12 (3-2015)
Background: In Nov 2013, the instruction for controlling high cholesterol has been released by the American College of Cardiology (ACC) and the American Heart Association (AHA) which need to be assessed in the different communities. Methods: Of total 6275 individual aged 40-75 years who entered at the Tehran Lipids and Glucose Study from March 1999 to 20 March 2010 in first examination cycle, 5153 with the median follow-up of more than ten years were eligible to enter in this study. The 10-year risk of hard cardiovascular disease (Hard CVD) for Statin therapy based on ACC/AHA clinical guideline was calculated and this risk was calculated for each subgroup of the guideline who recommended for statin therapy comparing to the risk in individuals with prevalent CVD. Results: Of nearly 6.5 million urban population of Iran (according to the 1996 census) about 4 million individuals (2.55 million men and 1.4 million women) were eligible for statin therapy. With respect to the urban population growth from the 1996 to the 2011 census (about 2.5 percent increases) the number of individuals for receiving statin increased by 50% (5 million men and 3 million women). Also, the risk in non-diabetic men with calculated risk of 5-7.5% and diabetic women with calculated risk of <5% for hard CVD was lower than 0.2. By removing these people from total eligible population, the burden of statin therapy will reduced about 8% which is about 540.752 persons, according to the Census 1996 and 1.155.079 individuals based on the census 2011. Conclusion: The new guideline of ACC/AHA for statin therapy is relatively reasonable except for some subgroups. To reduce the burden of medical expenses, statin prescription can be ignored by physicians in these subgroups. Of course further research is required to calculate the net benefit for estimating the clinical usefulness of statin therapy in recommended guideline subgroups.
Volume 74, Issue 9 (12-2016)
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Background: Cardiopulmonary resuscitation, commonly well-known as CPR, is an emergency technique that includes chest compression often with artificial ventilation in an exertion to manually preserve complete brain task until additional measures are taken to return spontaneous blood circulation and breathing in a person who is in cardiac arrest. According to the International Liaison Committee on Resuscitation Guidelines, CPR includes chest compressions for adults between 5 cm (2.0 in) and 6 cm (2.4 in) deep and at a rate of at least 100 to 120 per minute. Cardiopulmonary resuscitation is aimed to reverse vital organs as like as heart, lungs and for subsistence of patients. Several researches showed that different factors affect the resuscitation results. The current study was designed to assess the results of resuscitation and its association factors. |
Methods: This retrospective, descriptive and analytic study was carried out in Baharloo Hospital, Tehran, Iran during March 2014 and February 2015. In current work, all resuscitated patients were imported and patients with uncompleted files and died before entrance to hospital were excluded. The data was obtained from medical records units, office files unit and the unit of quality improvement. Data were analyzed by use of SPSS version 22 (Armonk, NY, USA) software and Chi-square test and Student’s t-test.
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Results: From 891 patients, 813 cases were entered the study that 498 (61.3%) were male and 315 (38.7%) were female. 41.1% of resuscitation were successful and 58/9% were unsuccessful. The mean and standard deviation time of resuscitation was 28.80 and 12.6 minutes; the most frequent primary diagnosis was cardiovascular disease. In this study there was a significant difference between age and duration of the resuscitation with successful resuscitation (P= 0.02) but, in the variables of ward and resuscitation team were not significant (P> 0.05). Conclusion: The results of this study showed that resuscitation in younger group, short duration of resuscitation and patients without heart diseases are more successful. |
Volume 74, Issue 12 (3-2017)
Background: Air pollution, especially the phenomenon of dust and particulate matter can cause mortality of many civilians, and causes various diseases including cardiovascular and respiratory diseases. One of the major pollutants in the air is particulate matter that concentration has increased over recent years. So, present study with aim of Quantification Health Endpoints Attributed to particulate matter in Tehran, Capital of Iran during the past decade (2005-2014) by AirQ software, version 2.2.3 (WHO European Centre for Environment and Health) was performed.
Methods: This study is a descriptive-analytic investigation. The process of performance this study lasted 12 months. Subject of this the study and research was in Environmental Health Engineering Department of Iran University of Medical Sciences. Exact data of every hour pollutants were taken from Department of environmental (DOE) Islamic Republic Iran and Air Quality Control Company of Tehran. Then validated according to the World Health Organization (WHO) guidelines and Statistical parameters for quantifying health effects were calculated in excel software. Finally, assessment of cases total mortality, cardiovascular mortality, respiratory mortality and cardiovascular disease and respiratory disease, with AirQ software was performed.
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Results: The results of this study showed that the number of total mortality, cardiovascular mortality and respiratory mortality caused by exposure to Particulate matter smaller than 10 microns (PM10) in the past decade is 11776, 12121 and 33066 cases respectively. Also the total number of hospital admission due to cardiovascular disease and respiratory disease in the past decade is 20990 and 54352 cases in 2005-2014 years. Conclusion: According to the results of this study, during the last decade the level of air pollution and Concentration of pollutants in Tehran Increased. Effects and health consequences due to exposure to Particulate matter smaller than 10 microns (PM10) in Tehran Metropolis Is very severe and increased mortality and cardiovascular and respiratory diseases among the citizens of Tehran. |
Volume 77, Issue 3 (6-2019)
Methods: This experimental study was performed for microemulsion preparation and animal test at Ferdowsi University of Mashhad and Cardiovascular Research Center of Mashhad University of Medical Sciences, Mashhad, Iran, respectively, from April 2015 to January 2017. To prepare the microemulsion samples, Tween 80 and span 80 were selected as surfactant couple and surfactant ratios of 8:1, 9:1 and 10:1 were determined for construction of pseudo-ternary phase diagrams. The Zealand white rabbits were categorized in three groups: receiver of base diet group, high cholesterol diet and high cholesterol diet plus microemulsion.
Results: The average particle size of the samples was in the range of 16.64±0.1 to 21.16±0.2 nm with a uniform particle size distribution. Zeta potential was in the range of -10.7 to 18.4 mV, refraction index was approximately 1.39. Electrical conductivity coefficient was in the range of 297 to 311 μz and pH of all the samples were approximately 6.42 for all samples. All of the microemulsion samples were physically stable and the prepared sample with 9:1 surfactant ratio was selected to investigate the animal test due to the higher oil percentage in comparison with the other samples that be stable over 6 months. Significant decrease in the levels of fibrinogen and factor VII in the third group of rabbits was observed compared to the other groups.
Conclusion: The results of this study showed the effective performance of nanostructured drug delivery systems in the form of microemulsion to improve the aqueous solubility and therapeutic effects of hydrophobic compounds such as vegetable oils.
Volume 78, Issue 6 (9-2020)
Methods: This is an analytical descriptive study that was performed on 59 End-Stage Renal disease patients referred to the dialysis department of Special Disease Center, Birjand University of Medical Sciences Birjand, Iran. The levels of neutrophil to lymphocyte ratio, erythrocyte sedimentation rate, and C reactive protein were measured and cases divided into 4 groups according to the NLR: less than 1, 1-1.5, 1.5-2.5, 2.5-3.5, and>3.5. All patients were followed up for one year to determine rate of mortality, cardiovascular and infectious events.
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Results: The mean NLR was 2.89±1.38. There was no significant difference in mortality rate between groups according to NLR with P=0.052, also no remarkable difference in infectious and cardiovascular morbidity events in groups with P=0.09 and P=0.21, respectively. The mean NLR in patients with cardiovascular or infectious events was 4.2 and 3.75 respectively, which were notably higher than patients without cardiovascular (NLR:2.49) and infectious (NLR:2.68) events, P=0.02 and P=0.03 respectively. In the bivariate correlation analysis, NLR was positively correlated with CRP in hemodialysis patients.
Conclusion: ESRD patients with NLR>2.5 have higher cardiovascular and infectious events than patients with NLR<2.5 but there was no difference in mortality rate between them. |
Volume 79, Issue 2 (5-2021)
Background: Chest pain is the most common reason for patients to be referred to the emergency department of hospitals. This study was performed to compare the GRACE and TIMI scores in predicting important cardiovascular events in patients.
Methods: This descriptive-analytical study was performed on 862 cardiac patients who were referred to the emergency department of Taleghani Hospital in Urmia in the period of April 1, 2016 to the end of September 2016 by census method. A checklist containing demographic information, medical history and risk factors was used to collect data. After scoring patients, we examined and followed up both groups over the next 30 days and recorded any cardiovascular events such as sudden death, AMI or immediate revascularization. The data were tested using SPSS16 and descriptive statistics tests. T-test and ROC curve were analyzed.
| Results: The results showed that in general, out of 862 patients who were studied (50.3%), 433 were female and (49.7%) 429 were male. Most of the patients were under 65 years old 627 (72.7%) and the age range was (17-91). The highest initial diagnosis of nonSTEMI patients was UA with 811 (94.9%) cases. On the other hand, the highest risk factors of patients were HTN 449(52%), CAD 314 (36.425) and DM 22 (25.55). The highest blood pressure was between (100-120) with 328 cases and serum creatinine between (0.6 to 1.3) with 770 cases. MACE after 30 days in GRACE system 17 people (32.69%) were in high risk group and in TIMI 3 people (37.5%) were in high risk group. In MACE evaluation, the specificity of GRACE system (cutoff point=30) was 89.27 vs. 52.24, the specificity of TIMI system (cutoff point=7.3) and the sensitivity of GRACE 93 (cutoff point=10) versus TIMI 85.71 (cutoff point=8.3) is. Conclusion: The results showed that GRACE was more sensitive and characteristic than TIMI. |
Volume 79, Issue 10 (1-2022)
Background: In patients with ST-segment elevation myocardial infarction (STEMI), Primary percutaneous coronary intervention (PCI) is the preferred reperfusion therapy. Timely primary PCI is essential in improving the clinical outcomes of these patients. The aim of this study was to evaluate the factors affecting balloon delay in STEMI treated patients by primary PCI and its relationship with major adverse cardiac events (MACE).
Methods: This prospective observational study was conducted on 143 cases of STEMI patients, who had the inclusion criteria and were treated by primary PCI, after obtaining written consent in Imam Khomeini hospital in Ahvaz, between May 2019 to May 2020. All-time components from symptom onset to PCI treatment include symptom-to-balloon time or ischemic time, symptom-to-door time and door-to-balloon time calculated. The incidence of major adverse cardiovascular events (MACE) including decompensated heart failure (DHF), acute coronary syndrome (ACS), sudden cardiac death (SCD) and cerebrovascular accident (CVA) was evaluated during 12 months follow up after primary PCI. left ventricular ejection fraction (LVEF) changes were evaluated 3 months after primary PCI.
| Results: The median symptom-to-door time was 200.5 minutes (IQR: 90-438.75 min), the median ischemic time was 406 minutes (IQR: 231-671 min), and most patients had an ischemic time ≥120 minutes (92.4%) and door-to-device time ≥90 minutes (64.3%). The most common delay for treatment was in the symptom-to-door time (76.9%) and then the decision for primary PCI to transfer to the cat lab (17.5%). Overall, 59 (41.3%) of the patients experienced MACE during 1-year of follow-up, including ACS (13.3%), DHF (22.4%), cardiac death (9.8%) and CVA (2.1%). The patients age (OR: 0.96, P=0.020), LVEF changes (OR: 1.123, P=0.005) and STEMI type (OR: 0.705; P=0.039) predicted in-hospital MACE, while the symptom-to-balloon time (P=0.607) and door-to-balloon time (P=0.347) were not associated with MACE. Conclusion: None of the time intervals were associated with the occurrence of MACE in one-year follow-up, and most STEMI patients were admitted to the hospital with a long delay. Therefore, efforts to shorten the time of hospitalization admission can help improve the MACE in STEMI patients under primary PCI in our medical centers. |
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