Introduction: No-reflow
is one of the major complications of primary PCI in patients with acute ST
elevation myocardial infarction. This phenomenon is associated with adverse
outcomes in these patients. In the current study, we evaluated the
effectiveness of CHA2DS2-VASc score in predicting no-reflow phenomenon. CHA2DS2-VASc
score is a risk stratification method to estimate the risk of thromboembolism
in patients with atrial fibrillation.
Methods: In
total, 396 patients with ST elevation myocardial infarction who had undergone primary
PCI were evaluated in our study. Based on post interventional TIMI flow rate
results, the patients were divided into two groups: control group (294
patients) and no-reflow group (102 patients). The CHA2DS2-VASc score was
calculated for each participant. Multivariate regression analysis was performed
to determine the predictive value of this score.
Results: Our
findings showed that CHA2DS2-VASc score can predict no-reflow independently
(odds ratio: 3.06, 95%, confidence interval: 2.23-4.21, P <0 .001).
Moreover, lower systolic blood pressure, higher diastolic blood pressure, grade
0 initial TIMI flow rate and smaller stent size were other independent
predictors of the no-reflow in our study. We also defined a cut off value of ≥
2 for the CHA2DS2-VASc score in predicting the no-reflow with a sensitivity of
88% and specificity of 67%, area under curve: 0.83 with 95% CI (0.79-0.88).
Conclusion: The CHA2DS2-VASc score
could be used as a simple applicable tool in the prediction of no-reflow before
primary PCI in the acute ST elevation myocardial infarction patients.
Background/Objective In the current study, we aimed to explore the effects of rice bran oil (RBO) in adjunct to conventional medical therapy on left ventricular ejection fraction (LVEF), cardiometabolic risk...
Recent observational studies have reported controversial results for the association between different anthropometric indices of obesity and severity of atherosclerosis. The aim of the current study is to determine the associations between anthropometric indices with severity of atherosclerosis in adult population in north of Iran.The cross-sectional study was performed on 610 participants, who were admitted to a hospital for elective angiographyin Rasht, Iran, Anthropometric indices, including waist circumference (WC), waist-to-height ratio (WHtR), conicity index (CI), body mass index (BMI), and hematological factors, were measured using the standard methods. According to angiography reports, severity of atherosclerosis was determined.Sixty-two percent of participants had moderate to severe atherosclerosis. According to BMI, 44% were overweight and 25.8% were obese. Based on WHtR and WC, 90%, and 57% were obese, respectively. The prevalence of moderate to severe atherosclerosis in centrally obese women was significantly higher than in centrally nonobese women (52% vs 28% P = 0.02). According to multivariate adjustment analysis, age, sex, systolic blood pressure, hemoglobin A1c, uric acid, and triglyceride were independently associated with severity of atherosclerosis. BMI, WC, CI, and WHtR had no significant association with severity of atherosclerosis.Our findings showed that anthropometric indices reflective of general and abdominal obesity were not independently related to the severity of atherosclerosis in adults, in northern Iran.
Introduction: Coronary artery disease (CAD) is one of the most common causes of morbidity and mortality in developed countries. SYNTAX (SX) score is a useful index that scores lesion severity during coronary angiography (CA) and can predict the patient’s outcome. Recent studies have associated a number of serum parameters with SX score, including platelet volume, and platelet-to-lymphocyte ratio (PLR). Objectives: We aimed to study the SX score in association with various serum parameters to find a valuable parameter for prediction of CAD severity. Patients and Methods: This study consisted of 363 patients referred to Heshmat hospital (Rasht) from March 2016 to October 2016 with acute coronary syndrome (ACS). Serum laboratory parameters were measured after 12 hours of fasting. Severity of CAD was evaluated during CA by SX score. The associations were analyzed using multinomial logistic regression model. Results: The mean age of patients was 63.68±11.03 years; since 26.2% of cases had severe, 43% had moderate, and 30.8% had mild CAD. Comparing to mild CAD, the multivariate adjusted model showed higher significant odds of severe CAD for one elevation of platelets (odds ratio [OR] =2.18 (95% CI: 1.35-3.50), white blood cells (WBCs) (OR=1.66, 95% CI: 1.17-2.35) RDW (red cell distribution width), (OR=1.59, 95% CI: 1.08-2.35) and serum creatinine (OR=1.75, 95% CI: 1.16-2.63). Conclusion: Plasma platelets, WBC and RDW and also serum creatinine were all independently correlated with severity of CAD.
Introduction: During the recent years, several studies have investigated that hyperuricemia is associated with greater incidence of contrast induced nephropathy (CIN). Most of them are in acute conditions like primary percutaneous coronary interventions. This study aimed to assess the relationship between high serum uric acid and incidence of acute kidney injury in patients undergoing elective angiography and angioplasty. Methods: This prospective study was conducted on 211 patients who were admitted to hospital for elective coronary angiography or angioplasty. The researchers measured serum creatinine and uric acid on admission and repeated creatinine measurement in 48 hours and seven days after the procedure. According to serum uric acid, the patients were divided into two groups; group 1 with normal uric acid and group 2 with hyperuricemia which was defined as uric acid more than 6 mg/dL in women and 7 mg/dL in men. CIN is defined as an increased creatinine level of more than 0.5 mg/dL or 25% from the baseline in 48 hours after the intervention. Results: In total, 211 patients with mean age of 60.58 years were enrolled in the study. Of these, 87 (41.2%) patients were in the high uric acid group and 124 (58.8%) were in the normal uric acid group. CIN was occurred in 16 patients (7.5%). Seven out of 16 (8.04%) were in the high uric acid and nine (7.2%) were in the normal uric acid group. There were no significant differences between the two groups (P =0.831). Conclusion: The frequency of CIN development was not different in the patients with hyperuricemia.
Background
Diverse ethnic groups that exist in Iran may differ regarding the risk factors such as hypertension, hyperlipidemia, dyslipidemia, diabetes mellitus, and family history of non-communicable disease. Premature Coronary Artery Disease (PCAD) is more endemic in Iran than before. This study sought to assess the association between ethnicity and lifestyle behaviors in eight major Iranian ethnic groups with PCAD.
Methods
In this study, 2863 patients aged ≤ 70 for women and ≤ 60 for men who underwent coronary angiography were recruited in a multi-center framework. All the patients’ demographic, laboratory, clinical, and risk factor data were retrieved. Eight large ethnicities in Iran, including the Farses, the Kurds, the Turks, the Gilaks, the Arabs, the Lors, the Qashqai, and the Bakhtiari were evaluated for PCAD. Different lifestyle components and having PCAD were compared among the ethnical groups using multivariable modeling.
Results
The mean age of the 2863 patients participated was 55.66 ± 7.70 years. The Fars ethnicity with 1654 people, was the most subject in this study. Family history of more than three chronic diseases (1279 (44.7%) was the most common risk factor. The Turk ethnic group had the highest prevalence of ≥ 3 simultaneous lifestyle-related risk factors (24.3%), and the Bakhtiari ethnic group had the highest prevalence of no lifestyle-related risk factors (20.9%). Adjusted models showed that having all three abnormal lifestyle components increased the risk of PCAD (OR = 2.28, 95% CI: 1.04–1.06). The Arabs had the most chance of getting PCAD among other ethnicities (OR = 2.26, 95%CI: 1.40–3.65). While, the Kurds with a healthy lifestyle showed the lowest chance of getting PCAD (OR = 1.96, 95%CI: 1.05–3.67)).
Conclusions
This study found there was heterogeneity in having PACD and a diverse distribution in its well-known traditional lifestyle-related risk factors among major Iranian ethnic groups.
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