ARYA Atherosclerosis
Year:2016 | Volume:12 | Issue:1|Papers Count:8

BACKGROUND: The potential risk of vascular complications associated with heparin, the dose of heparin therapy has not been exactly examined in patients undergoing transradial angiography.Thus, this study was aimed to compare referral arterial thrombosis, hematoma and hemorrhagic complications with 2500 and 5000 IU arterial heparin and the association of these complications with predictors in patients undergoing diagnostic angiography.METHODS: This prospective, randomized, double-blind controlled trial was carried out on 441 patients aged ≥ 18-year-old in Isfahan, Iran. They were referred for diagnostic coronary angiography with radial access. First participants were randomized into to inject either 2500 IU (group A) or 5000 IU (group B) of heparin. Study’s primary endpoints were thrombosis, hematoma, and hemorrhage.RESULTS: The frequency of thrombosis was 25.5% in group A vs.2.3% in group B (P<0.001), while the frequency of hematoma had no significant differences in group A and B. None of patients in both groups had hemorrhage. Using 5000 IU of heparin protected the occurrence of thrombosis by 95% [odds ratio (OR): 0.05, 95% confidence interval (CI): 0.02-012] after adjustment for confounders.CONCLUSION: The low dose (2500 IU) versus standard dose (5000 IU) of heparin use increased the risk of thrombosis following trans-radial diagnostic coronary angiography, with no effect on hematoma and bleeding.

BACKGROUND: The aim of this study was to investigate knowledge, attitude and practice (KAP) of cardiovascular disease (CVD) patients about their oral health status.METHODS: In this cross-sectional study, we analyzed the data of 150 CVD patients that collected by a self-administered questionnaire consists of demographic characteristics and KAP. Oral health indicators calculated based on the results of oral examination by an expert dentist.RESULTS: CVD patients had an overall moderate level of knowledge and attitude, but their practice was lower than moderate. There were important associations between knowledge scores with gender, education, residential area and financial status, between attitude scores with education and residential area, and between practice scores with education and financial status.There were no associations between KAP and age, marital status or job. Significant positive correlations were found between KAP components. Significant negative correlations were found between oral hygiene index with knowledge and practice.CONCLUSION: The practice of heart disease patients about their oral health was poor, and declares that increasing awareness and attitude may not promote practice. Efficient programs are needed to promote oral health practice of adult populations in special groups.

BACKGROUND: The aim of this study was to present age-sex standardized prevalence of overweight and obesity as well as central obesity and its associated variables in an adult population of Iran.METHODS: Around 5900 adult individuals aged 15-75 years enrolled to the study from 2009 to 2011 applying randomized cluster household survey in Kerman, southeastern of Iran. Overweight was defined as body mass index (BMI) 25-29.9 kg/m2, obesity was considered as BMI ≥ 30 kg/m2, and central obesity was regarded as waist circumference (WC)>88 cm for women and 102 cm for men.RESULTS: The overall age-sex standardized prevalence of overweight, obesity and central obesity was 29.6% (29.5% men, 29.7% women), 13.0% (9.3% men, 16.9% women) and 14.4% (7.5% men, 21.5% women), respectively. "Overweight/obesity" increased by age, [adjusted odds ratio (AOR): 7.9 95% confidence interval (CI): 5.8, 10.7)] for 65-75 years old, 11.7 (95% CI: 9, 15.3) for 55-65 years old, 10.1 (95% CI: 7.8, 13) for 45-54 years old compared with the first age group), female gender [AOR: 1.5 (1.3, 1.8), P<0.001], higher education (AOR>1.5 compared with illiterate individuals, P<0.001), and low physical activity [AOR: 1.4 (95% CI: 1.1, 1.8), P=0.006] and decreased by smoking [AOR: 0.4 (95% CI: 0.3, 0.6), P<0.001] and opium using [AOR: 0.5 (95% CI: 0.4, 0.7), P<0.001]. Female gender [AOR: 4.1 (95% CI: 3.3, 5), P<0.001], advanced (AOR>7 for age groups ≥ 35 years old, P<0.001) positively, while smoking [AOR: 0.6 (0.4, 0.8), P=0.004] negatively were the most significant predictors for abnormal WC.CONCLUSION: Our data reveal that overweight and obesity affected almost half of the adult population (43.0%), and central obesity was around 15.0%, which reflect the high prevalence of this abnormality. In addition, several demographic, social and lifestyle factors were associated with obesity. Appropriate interventions and strategies with a concentration of the general population are needed to deal with its potential subsequent consequences.

BACKGROUND: Elderly patients constitute a rapidly growing proportion of the population, and hence the increasing rises in the number of patients with ST-segment-elevation myocardial infarction (STEMI). Primary percutaneous coronary intervention (PCI), which is now established as the preferred reperfusion strategy in STEMI patients, has been inadequately investigated in this high-risk group. The aim of the present study was to investigate the inhospital and 6-month outcomes of primary PCI in elderly patients (≥ 75 years) with STEMI.METHODS: A total of 100 elderly patients with STEMI including those with cardiogenic shock were included. Primary PCI procedures were performed in a tertiary referral center between 2009 and 2014. In-hospital and 6-month outcomes of patients were recorded and analyzed.RESULTS: The average age of the patients was 79.6±3.8 years (range=75-90 years) and 27.0% were women. Cardiovascular risk factors and prior events were common. Nearly, half of the patients had three-vessel disease and the left anterior descending artery (LAD) was the most common infarct-related artery. The presence of cardiogenic shock but not the other variables was associated with less anatomic and procedural success (P<0.001). It was also the major independent predictors of 6-month mortality in the patients aged ≥ 75 years, [hazard ratio (HR) =8.02, 95% confidence interval (CI): 1.75-25.97, P<0.001]. In-hospital mortality was 2.4% in the patients without and 83.0% in those with cardiogenic shock.CONCLUSION: Primary PCI in aged patients could be associated with low complication rates and improved survival if performed in high-volume centers with experienced operators. Considering the very high rate of mortality in patients with cardiogenic shock, there should be measures to treat these patients before the onset of hemodynamic instability.

BACKGROUND: Extracts of Vernonia amygdalina (V. amygdalina) have been shown to affect the serum lipid profile of some laboratory animals in previous studies. Its impact on serum lipid profile and the histological changes in atherosclerosis has not been studied. Our aim was to determine the effects of V. amygdalina on atherosclerotic lesions induced in rabbits on highcholesterol diet.METHODS: 18 male rabbits were randomly divided into three groups of control, atherogenic diet, and atherogenic diet+200 mg/kg of V. amygdalina. The rabbits were fed a normal diet (control group) or a diet supplemented by 0.5% cholesterol and 1% methionine (second and third groups, respectively) for 12 weeks. The fasting sera of all animals were collected at baseline and at the end of the 12 weeks, to determine the levels of lipid profile and the aortas underwent pathomorphological examination.RESULTS: The two groups on the atherogenic diet had significantly increased serum total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) compared to the control group. The serum triglyceride (TG) was not statistically different in all three groups. Highdensity lipoprotein cholesterol (HDL-C) was significantly increased in the V. amygdalina group, compared to the control group but there was no statistically significant difference between the two groups on atherogenic diet. The two groups of rabbits that were on high-cholesterol diet (atherogenic diet group, as well as the atherogenic diet+200 mg/kg of V. amygdalina) developed histological evidence of atherosclerosis. However, there was no histological difference between the lesions observed in these two groups.CONCLUSION: The use of 200 mg/kg of aqueous extract of V. amygdalina in rabbits did not appear to exert a significant effect on the serum lipid profile. It also did not appear to have any beneficial effect on the development of atherosclerotic lesions.

BACKGROUND: Atherosclerotic event is one of the most causes of death in the world. Coronary artery disease (CAD) is one manifestation of atherosclerosis. It is well-known that several risk factors, such as diabetes mellitus (DM), smoking, hypertension (HTN), have effects on it. It is proposed that infection can lead to atherosclerosis or even make its process faster. Here, we discuss about the effect of some of infectious agents on the atherosclerosis and CAD.METHODS: In this study, first we did a comprehensive search in PubMed, Scopus, and Science Direct using some related keywords such as atherosclerosis, CAD, myocardial infarction (MI), infection, and name of viruses and bacteria. After finding the related papers, we reviewed the correlation between some microbial agents and risk of CAD.RESULTS: Literature has reported several infectious agents (viruses, bacteria, and parasites) that can be associated with risk of CAD. This association for some of them like Helicobacter pylori (H. pylori), Chlamydia pneumonia (C. pneumoniae), and Cytomegalovirus (CMV) is a very strong. On the other hand, there are some other agents like influenza that still need to be more investigated through original studies. Furthermore, different mechanisms (general and special) have been reported for the association of each agent with CAD.CONCLUSION: Based on the studies in databases and our literature review, it is so clear that some microbes and infectious agents can be involved in the process of atherosclerosis.Therefore, controlling each type of infections especially among people with a traditional risk factor for atherosclerosis should be taken into account for reducing the risk of CAD and atherosclerosis.

BACKGROUND: Isolated left ventricular apical hypoplasia with several different unrecognized dimensions is a newly discovered congenital anomaly of the heart.CASE REPORT: In this report, we describe a case of cardiomyopathy of this type occurring in a 13-year-old male with a history of mental retardation and sudden cardiac death (SCD) of second-degree relatives. The patient was referred for an evaluation of cardiac status. An echocardiography analysis demonstrated a spherical left ventricle (LV) appearance with mild mitral regurgitation. Cardiac magnetic resonance imaging (MRI) confirmed a spherical and truncated LV appearance. The right ventricle was found to have elongated and wrapped around the LV, and diverticulum was also seen in the cardiac MRI.CONCLUSION: To the best of our knowledge, this is to present the first case of LV apical hypoplasia combined with LV diverticulum and a family history of SCD. As more cases featuring this cardiomyopathy type are recognized, it will be easier to elucidate the natural history and management of such cardiac anomalies.

BACKGROUND: Vertebrobasilar dolichoectasia (VBD) is a rare vasculopathy. The etiology of this disease is unknown. Transient ischemic attacks (TIAs) of vertebrobasilar system refer to a transient (<24 hours) lowering of blood flow in the posterior circulation of the brain. We present a case of dolichoectasia in the vertebrobasilar artery that presented with TIAs.CASE REPORT: A hypertensive 54-year-old man with true vertigo, nausea, imbalance, dysarthria, dysmetria, horizontal nystagmus, and gait ataxia was referred to Alzahra Hospital, Isfahan, Iran.The symptoms improved in the 1st day, but recurred in the 2nd day, lasting for 6-7 hours. According to clinical manifestations, a diagnosis of TIAs in the vertebrobasilar circulation was made. Imaging studies showed vascular anomaly. The vascular anomaly was considered as the cause of the patient’s symptoms. A medical management was started using antiplatelet and antihypertensive drugs. The patient was referred for a more evaluation for other vascular anomalies.CONCLUSION: Dolichoectasia usually affects vertebral and basilar arteries and simultaneous involvement of carotid arteries is rare seen in only 0.5% of these patients. The usual symptom of dolichoectasia is ischemia and rarely hemorrhages. The most common type of ischemic stroke is lacunar type. Ischemia evolves from embolic that originate from thrombi or plaques in the walls of the ectatic artery. While hemodynamic effects are the most common cause of the presenting signs and symptoms of the anomaly. We report a case of dolichoectasia that presented with TIAs of the verterbrobasilar artery. VBD is a distinct arteriopathy known as stroke risk.