Objective Smoking is a risk factor for coronary artery disease (CAD) and a known factor influencing the severity and pattern of CAD. We summarized evidence regarding the effect of smoking on the number of occluded coronary arteries and the severity and pattern of CAD. Methods We extracted data from observational studies reporting the pattern and severity of CAD in smokers. The quality of studies was assessed using the Strengthening the Reporting of Observational Studies in Epidemiology checklist, and results are reported in the Garrard table. The review process followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Results We screened 11 studies including 6037 samples. Six studies reported no relationship between smoking and the number of damaged arteries. One study reported that smoking was related to occlusion in the left anterior descending artery, but there was no relationship between smoking and the location of occlusion in the arteries. Smoking was related to CAD severity in five studies. Conclusions Smoking was found to be related to CAD severity and location of the damaged artery in the heart. However, there was no significant association of smoking with the number of damaged arteries and location of arterial occlusion.

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Introduction: This study was conducted to investigate prevalence and predictors of slow coronary flow phenomenon (SCF) phenomenon. Methods: This cross-sectional study was performed at Imam Ali Cardiovascular Hospital affiliated with the Kermanshah University of Medical Sciences (KUMS), Kermanshah province, Iran. From March 2017 to March 2019, all the patients who underwent coronary angiography were enrolled in this study. Data were obtained using a checklist developed based on the study’s aims. Independent samples t tests and chi- square test (or Fisher exact test) were used to assess the differences between subgroups. Multiple logistic regression model was applied to evaluate independent predictors of SCF phenomenon. Results: In this study, 172 (1.43%) patients with SCF phenomenon were identified. Patients with SCF were more likely to be obese (27.58±3.28 vs. 24.12±3.26, P<0.001), hyperlipidemic (44.2 vs. 31.7, P<0.001), hypertensive (53.5 vs. 39.1, P<0.001), and smoker (37.2 vs. 27.2, P=0.006). Mean ejection fraction (EF) (51.91±6.33 vs. 55.15±9.64, P<0.001) was significantly lower in the patients with SCF compared to the healthy controls with normal epicardial coronary arteries. Mean level of serum triglycerides (162.26±45.94 vs. 145.29±35.62, P<0.001) was significantly higher in the patients with SCF. Left anterior descending artery was the most common involved coronary artery (n = 159, 92.4%), followed by left circumflex artery (n = 50, 29.1%) and right coronary artery (n = 47, 27.4%). Body mass index (BMI) (OR 1.78, 95% CI 1.04-2.15, P<0.001) and hypertension (OR 1.59, CI 1.30-5.67, P=0.003) were independent predictors of SCF phenomenon. Conclusion: The prevalence of SCF in our study was not different from the most other previous reports. BMI and hypertension independently predicted the presence of SCF phenomenon.

IntroductionAcute coronary syndrome (ACS), including myocardial infarction (MI), is a costly condition and the leading cause of mortality in both women and men throughout the world. 1,2 The incidence of MI is constantly increasing worldwide, mostly due to population aging and sedentary lifestyle. 3,4 Many risk factors, directly or indirectly, may affect the outcomes of patients with MI. 5 The outcomes disparity between women and men after acute myocardial infarction (AMI) has been reported frequently but with a wide variety in different ethnic and demographic groups. [5][6][7][8][9] The reasons for the sex-based differences have not been clear yet, though, the known risk factors for MI such as diabetes mellitus (DM), hypercholesterolemia, and hypertension (HTN) in women are more frequent than men. 10-12 After adjustment for possible confounders such as age and other risk factors, some researchers found no differences in the mortality rate between men and

Introduction: Acute myocardial infarction (AMI) is a leading cause of death and disability worldwide. Determining seasonal pattern of AMI may contribute to disease prevention and better treatment. Objective: The present study was conducted to investigate daily, monthly, and seasonal pattern for symptoms҆ onset in the patients with ST-segment elevation myocardial infarction (STEMI), and also other possible associated factors. Methods: This cross-sectional study was conducted on 777 patients diagnosed with STEMI admitted at the Imam Ali Cardiovascular Hospital affiliated with Kermanshah University of Medical Sciences (KUMS), Kermanshah province, Iran from March 2018 to February 2019. Data were collected using a checklist developed based on the study's objectives. Differences between subgroups were assessed using one-way analysis of variance (ANOVA) followed by Tukeys҆ post‐hoc test and Chi-Square test (or Fishers҆ exact test). Results: Out of 777 patients, 616 (79.3%) of them were male. Mean age of the patients was (mean±SD) equal to 60.93±12.86 years old. Occurrence of STEMI was most common in winter (38.4%), followed by autumn (27.8%), spring (22.9%), and summer (10.9%), respectively. Monthly occurrence of AMI was at the highest level in January (10.8%) and December (9.9%), and it was at the lowest level in July (4.9 %). Most patients were admitted on Fridays (15.8%) and Wednesdays (15.6%). Hypercholesterolemia, prior congestive heart failure (CHF), prior MI, prior stroke, prior atrial fibrillation (AF), low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglycerides, total cholesterol, creatine phosphokinase (CPK), and creatine kinase myocardial band (CK-MB) were significantly associated with seasonal pattern of STEMI (p-value<0.05). Conclusions: Results of the present study on Iranian patients with STEMI revealed that AMI occurred more frequently on Wednesdays and Fridays and during winter from December to January compared to the other days of the week, months, and seasons.

Background:There is considerable disagreement over the effects of percutaneous coronary intervention (PCI) on left ventricular diastolic function that has necessitated the investigation of diastolic indices. The present study was conducted to evaluate left ventricular diastolic function and its indices, three months after performing the PCI procedure in patients with coronary artery disease (CAD).Methods:In a quasi-experimental clinical trial study (before and after), 51 patients with CAD scheduled for elective PCI were investigated provided that their Ejection Fraction (EF) was > 30%. Before and three months after PCI, echocardiography was carried out to evaluate left ventricular diastolic indices including the E/Ea as the most important criteria for diagnosis of diastolic heart failure (DHF).Results:Based on the E/Ea indices and after PCI, the number of patients with DHF decreased significantly: 40 patients (78.4%) before PCI versus 28 patients (54.9%) after PCI (p<0.05). The Mean and Standard error of deceleration time (DT), isovolumic relaxation time (IVRT), early diastolic mitral annulus velocity; Ea (E’), E/Ea and left ventricular ejection function (LVEF) indices underwent significant changes. In addition, MVA dur/PVA dur, PVs/PVd, and E/Ea indices had changed significantly after PCI in both genders. However, no significant difference was reported for the other indices.Conclusion:The E/Ea ratio as an important criterion for diagnosis of DHF was improved after PCI. Improvement of several other diastolic indices was observed after the PCI procedure. It can be concluded that PCI can be an effective treatment modality in patients with left ventricular diastolic indices.

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