The current practice of Iranian physicians for in-hospital "medical management" of patients with acute coronary syndrome (ACS) has already been known.
→What this article adds:The present study is the first to describe the current practice of "percutaneous coronary intervention" on patients with ACS in Iran.
Background: Finding patients at risk of developing contrast-induced acute kidney injury (CI-AKI) is important because of its associated complications. In the present study, the contribution of different variables, such as the presence of metabolic syndrome (MetS), the volume creatinine clearance (V/CrCl) ratio, the iodine-dose (I-dose)/CrCl ratio, or hypertension, to CI-AKI was evaluated. Methods: A total of 255 patients undergoing elective coronary angiography with or without intervention were enrolled and divided into a MetS and a control group. All patients were assessed for the development of CI-AKI after the procedures. Results: CI-AKI occurred in 39.23% (51 of 130) of the MetS patients and 14.4% (18 of 125) of the control group (p < 0.001). The multivariable regression model showed that male sex and the use of statins decreased the risk of CI-AKI, and high triglyceride levels, I-dose/CrCl > 0.52, MetS, CrCl ≤60 mL/min, and age ≥70 years increased the risk of CI-AKI, independent of confounding factors. The difference in the mean V/CrCl ratio was statistically significant between patients who developed CI-AKI and those who did not show renal impairment (2.36 ± 1.35 vs. 1.43 ± 0.89, respectively; p < 0.001). The ROC curve analysis of I-dose/CrCl determined the best cutoff value for patients with and those without MetS as 0.51 and 0.63, with a sensitivity value of 68 and 72% and a specificity value of 73 and 74%, respectively. Conclusions: We showed that MetS is a strong risk factor for CI-AKI in nondiabetic patients undergoing elective coronary interventions; and the I-dose/CrCl ratio is a strong predictor of CI-AKI in these patients. We suggest that clinicians identify MetS patients and calculate their I-dose/CrCl ratio before coronary interventions.
Myocardial infarction (MI) is one of the most important health burdens worldwide. Aspirin as an non- Steroid Anti—inflammatory drug, has been proven to be a protective factor to decrease the incidence, however its effect of MI size is still unknown. We designed this study to compare the biomarkers after MI in patients with and without aspirin intake. 378 patients were enrolled and the results showed lower cardiac troponin T and Creatine Kinases in patients with protective dose of aspirin intake. In addition, Creatine Kinases were significantly higher in patients with no history of MI. We conclude that aspirin can reduce the size of the infraction. Also, higher enzymes can be due to higher muscle content in patient without MI history.[GMJ. 2012;1(1):35-37]
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