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:Ultrasound measurement of carotid Intima-Media Thickness (IMT) is a suitable method to evaluate subclinical arteriosclerosis.Objectives:The current study aimed to present a new computerized algorithm to detect instantaneous changes of the IMT to Common Carotid Artery (CCA) of IMT in sequential ultrasound images by applying the maximum gradient and the dynamic programming.Patients and Methods:In a cross-sectional design, an examination was performed on thirty healthy human subjects with the mean age of 44 ± 6 years from April 2013 to June 2013 in Beheshti Hospital, Kashan, Iran. In all individuals, the instantaneous changes of the far wall IMT on the CCA were extracted. Local measurements of vessel intensity, intensity gradient, and boundary continuity were extracted for all of the sequential ultrasonic 2D-frames throughout three cardiac cycles. The Pearson correlation coefficients and Bland-Altman analysis were performed to assess the relationship and agreement between IMT measured by the proposed and conventional manual methods.Results:There was no significant difference between the proposed and manual methods with paired t-test analysis (in systole: 0.57 ± 0.10 vs. 0.56 ± 0.10 mm; P = 0.188 and in diastole: 0.63 ± 0.16 vs. 0.62 ± 0.10 mm; P = 0.122 for the manual and proposed methods, respectively). The Pearson correlation coefficients were r = 0.94 and r = 0.93 for IMTs and IMTd, respectively (both P < 0.001). Limit of agreements were narrow and considerable agreement was found between the two methods.Conclusions:The present study demonstrated that the proposed computerized analyzing method can provide accurate measurements of the IMT of the CCA in sequential 2D ultrasonic images.

Introduction: Interventional procedures are becoming substantial contributors to collective radiation dose due to their increasing rate of application. This study examined the relationships between effective dose data derived from five developed algorithms (Netherlands Commission on Radiation Dosimetry (NCS) and National Council on Radiation Protection and Measurements (NCRPs) algorithms for single dosimetry and Niklason, NCRPd and Clerinx algorithms for double dosimetry) to assess whether they can be used interchangeably in the assessment of staff effective dose in interventional cardiology. Material and Methods: The study population consisted of thirteen radiation workers (eight cardiologists, two technicians and three nurses) were involved in cardiac interventional procedures. Effective doses with thermoluminescence dosemeters were estimated for the duration of two months using five algorithms. The linear correlation and Bland-Altman analysis were performed to assess relationships and the agreement between effective doses calculated by the algorithms respectively. Results and Conclusion: We found significant correlation coefficients between the all effective doses calculated using the algorithms. Comparisons of two algorithms showed significant differences between estimated effective doses (p < 0 05) with the exception of results obtained by NCS versus NCRPd and NCS versus Niklason algorithms (p > 0 05). Limit of agreements were wide (NCS vs. NCRPd: −0.406 to 0.280 mSv and NCS vs. Niklason: −0.035 to 0.401 mSv, respectively) and considerable disagreement was found between these algorithms and despite strong correlations, should not be used interchangeably for assessment of effective dose.