ARYA Atherosclerosis
Year:2018 | Volume:14 | Issue:5|Papers Count:8

BACKGROUND: It has been indicated that the acute exercise increases the thrombotic events that stem from platelet hyper-reactivity. The present randomized controlled trial study was carried out with the aim to compare high-intensity interval exercise (HIIE) with moderate intensity continuous exercise (MICE) in terms of platelet indices and function in patients who had undergone post coronary artery bypass graft (CABG). METHODS: 30 men with a history of CABG were recruited and divided into 3 groups (MICE, HIIE-1, and HIIE-2). The MICE protocol consisted of running for 40 minutes with 65% of maximal heart rate (HRmax). Subjects in HIIE-1 group performed an interval exercise with work to rest ratio of 1: 1 in which 10 rounds of running (95% HRmax) were followed by active recovery (35% HRmax). HIIE-2 subjects performed an interval exercise with work to rest ratio of 2: 1 in which 7 rounds of running (85% HRmax) were followed by active recovery (45% HRmax). Before and immediately after the exercise protocols, blood samples were taken from subjects and analyzed to measure the variables. RESULTS: Although platelet count (PLT) and hematocrit (HCT) were increased significantly after HIIE-1 and HIIE-2 in comparison to MICE (P < 0. 050), the other platelet indices [mean platelet volume (MPV), platelet distribution width (PDW), plateletcrit (PCT)] were not significantly changed among groups (P > 0. 050). The platelet aggregation and fibrinogen were further increased after HIIE-1 and HIIE-2 as compared with MICE; however, such increment were significant between HIIE-2 and MICE (P < 0. 050). CONCLUSION: It seems that HIIE, regardless of the type, has higher thrombotic potentials compared with MICE. Accordingly, MICE is safer than HIIE for rehabilitation in patients undergoing CABG.

BACKGROUND: Growth of cardiovascular disease (CVD), variation in provision of medical services, rising costs, and increasing information availability through the media are making patients more actively involved in decision-making process of their treatment. The aim of this study was to better understand the components of patient competence in the context of coronary artery disease (CAD) and to further evaluate their relations with medical, demographic, and psychosocial characteristics. METHODS: In this cross-sectional study, 148 patients with at least one year diagnosis of acute coronary syndrome (ACS) were enrolled in the study from April to June 2014. Data on demographic characteristics, depression, anxiety, quality of life (QOL), social support, and drug adherence were collected from participants. Pearson correlation, one way analysis of variance (ANOVA), and multiple linear regression tests were performed for analyzing data. RESULTS: The mean age of patients was 53. 63 ± 5. 15. Of the participants, 58 (39. 5%) and 61 cases (41. 5%) were found to be depressed and anxious, respectively. Higher levels of selfregulation correlated with higher education years and social support, and also with lower depression and anxiety (P < 0. 050). Stress management and confronting the threat were linked to education years, depression, anxiety, QOL, and social support (P < 0. 050). CONCLUSION: The patients with CAD, in order to be involved in the proper treatment process and manage their emotions during this process, need to have the required competencies. Patient competence as a whole and its components have been related to medical, demographic, and psychosocial characteristics.

BACKGROUND: There has been a change in the risk factor profile of patients with coronary artery disease (CAD) in the western world. We sought to compare the risk factor profile of patients undergoing coronary artery bypass graft (CABG) surgery in northern part of Iran in 2010 and 2016. METHODS: In a cross-sectional study, medical records of 296 CABG patients in 2010 and 500 patients in 2016 were collected from a referral university hospital in Guilan province, Iran. We compared the risk factor profile using chi-square test or independent t-test as needed in the two time points, 2010 and 2016. RESULTS: The age of CABG patients significantly decreased from 62. 49 ± 8. 05 to 58. 09 ± 9. 20 over time. The frequency of hypertension (HTN) (66. 2% vs. 59. 1%, P = 0. 045), diabetes mellitus (DM) (51. 8% vs. 43. 6%, P = 0. 025), smoking (35. 6% vs. 28. 0%, P = 0. 028), and patients with multimorbidity (31. 8% vs. 26. 7%, P = 0. 001) increased in the second period compared to the first period of study. Whereas, the prevalence of hypercholesterolemia and positive family history of coronary heart disease (CHD) remained stable over time (49. 6% vs. 49. 0%, P = 0. 870; 10. 5% vs. 11. 1%, P = 0. 810, respectively). CONCLUSION: We observed a dramatic increase in DM, HTN, and cigarette smoking as well as the multimorbidity prevalence in 2016 compared to 2010. Even with considering all study limitations, primary and secondary prevention program to decrease cardiovascular disease is required.

BACKGROUND: Slow coronary flow (SCF) phenomenon is an angiographic finding which is defined as slow contrast passage through coronary arteries which may predispose patients to serious cardiac complications such as fatal arrhythmias. P-wave and QT-interval dispersion are electrocardiographic findings which are related to atrial fibrillation and ventricular tachyarrhythmias. In the present study, the relation between SCF and presence of P-wave and QT-interval dispersion in electrocardiography has been evaluated. METHODS: 47 patients with normal coronary arteries and SCF and 40 patients with normal coronary artery flow without SCF were enrolled in this case control study. Standard electrocardiogram (ECG) was analyzed for P-wave and QT-interval dispersion. SCF was identified in normal coronary vessels by use of Thrombolysis in Myocardial Infarction (TIMI) frame count (TFC) method (TFC ˃ 27). Corrected TIMI frame count (CTFC) of coronary vessels as well as mean CTFC along with QT-interval and P-wave dispersion were compared between 2 groups. The study data were analyzed by SPSS software and P value less than 0. 050 was considered to be significant. RESULTS: QT-interval [76. 17 (35. 23) ms versus 39. 25 (19. 26) ms] and P-wave [39. 74 (17. 48) ms versus 19. 50 (8. 54) ms] dispersion were significantly higher among patients with SCF phenomenon (P ˂ 0. 050). In addition, there was a positive significant linear correlation between TFC and P-wave and QT-dispersion (r = 0. 857, r = 0. 861, respectively, P ˂ 0. 050). CONCLUSION: According to the results, increasing TFC among patients with SCF will result in P wave and QT interval dispersion and therefore this finding can be considered as an indicative marker for cardiac events.

BACKGROUND: High lipid accumulation in hepatocyte and blood vessels can lead to nonalcoholic fatty liver disease (NAFLD) and heart diseases, respectively. These disorders are the main reasons of mortality in various countries. In this experiment, we evaluated the effect of leaf extracts of Anethum graveolens (AG), also known as Dill, and AG tablet on expression of lowdensity lipoprotein receptor (LDLR) and liver lipid in hypercholesterolemic hamsters. METHODS: In this experimental study, 36 male golden hamsters were divided into 6 groups: 1) standard diet + 0. 5% cholic acid + 2% cholesterol [high cholesterol diet (HCD)], 2) HCD + 100 mg/kg hydroalcoholic extract of Dill, 3) HCD + 200 mg/kg hydroalcoholic extract of Dill, 4) HCD + 100 mg/kg Dill tablet, 5) HCD + 200 mg/kg Dill tablet, 6) chow. At the end of study (30th day), hamsters were anesthetized and blood sample and liver tissue were collected. Biochemical factors and antioxidant parameters were determined. LDLR messenger ribonucleic acid (mRNA) level was measured using real time polymerase chain reaction (RT-PCR). Histopathological change of liver was determined using light microscope. RESULTS: Compared to HCD group, blood lipids (P < 0. 0010) and liver enzymes (P < 0. 0010) markedly reduced in AG-treated groups. The expression of LDLR did not change significantly in animals which received low dose of hydroalcoholic extract or AG tablet, but it increased in animals receiving high dose of extract or tablet (P < 0. 0100). Liver antioxidant significantly increased by AG (P < 0. 0010). Liver histopathological changes were normalized by AG. CONCLUSION: AG can significantly increase LDLR gene expression in HCD animals. This study showed that both AG extract and AG tablet had potential antioxidant and hypolipidemic effects in hamsters.

BACKGROUND: Research indicates that the age of onset of first acute myocardial infarction (AMI) is an essential element in the life expectancy that has been decreasing in developing countries. There are various studies performed in Iran reporting a range of ages at time of AMI. Thus, this meta-analysis study is designed to determine the mean age at first AMI in the Iranian population. METHODS: All studies that met the inclusion and exclusion criteria were reviewed using standard keywords in the databases from 2000 to 2016. Two raters verified a total of 658 articles. Sixteen studies met the inclusion criteria of this study for meta-analysis. Cochran test and I-squared (I2) were used for samples’ homogeneity. Pooled estimates of mean were calculated using the random effects inverse-variance model. RESULTS: The mean age of AMI varied between 55. 9 to 62. 9 years among the primary studies. The pooled mean age of first AMI with a 95% confidence interval (CI) for the total sample, men, and women were 59 (58. 9, 60. 4), 58. 7 (58. 3, 59. 2), and 64. 2 (63. 5, 64. 8), respectively. CONCLUSION: Our meta-analysis shows that the mean age of first onset of AMI in Iranian people is slightly lower than that reported elsewhere; and it is lower for men than for women.

BACKGROUND: Trans-radial coronary intervention is a popular technique due to patient comfort and lower complication rate. The main complications of this method are artery spasm, vessel perforation, and formation of pseudo-aneurysm. CASE REPORT: In this report, an unusual complication of radial access angiography was encountered. Shortly after the procedure, the patient’ s right arm began to swell and a pulsating mass grew over the medial aspect of the arm. Right brachial artery angiography was performed immediately for rolling out brachial artery perforation. There was no evidence of extravasation in brachial angiography. Surprisingly, the mass began to disappear after some active flexion and extension at elbow joint. The same problem occurred again after percutaneous coronary intervention (PCI) on left anterior descending artery (LAD) in this case 2 days later and was resolved by the same maneuver. CONCLUSION: It can be conculded that the brachial artery path was shifted and became entrapped after the procedure due to low soft tissue support.

We read the article “ Relationship between highsensitivity C-reactive protein (hs-CRP) serum levels and the severity of coronary artery stenosis in patients with coronary artery disease (CAD)” written by Seyedian et al., with a great interest. 1 Their results showed that the mean levels of hs-CRP in patients with unstable angina was significantly higher compared to patients with stable angina and patients with normal coronary angiography. It also appeared that the level of hs-CRP in patients with unstable angina is associated with the severity of coronary stenosis. Previously, patients with cardiac syndrome X were detected to have significantly higher plasma hs-CRP level in comparison with the controls.