ARYA Atherosclerosis最新文献

Background: This study was conducted to estimate the power of anthropometric markers to predict 10-year CVD across different age groups in the Yazd Healthy Heart cohort.

Methods: A total of 1,623 individuals aged 20 to 74, who were free of CVD, participated in the study. A conditional time-dependent receiver operating characteristic (ROC) curve was used to estimate the predictive power of anthropometric indices, including the Abdominal Volume Index (AVI), Body Adiposity Index (BAI), and Waist-to-Height Ratio (WHtR), adjusted for age and sex.

Results: Of the 1,623 participants, 818 were males (50.40%) and 805 were females (49.60%). The Area Under the Curve (AUC) for the BAI ranged from 0.50 to 0.70 for males aged 40 to 70 years. In females, the BAI biomarker demonstrated considerable to excellent predictive power (AUC > 0.8) for individuals aged 20 to approximately 33 years. For males, AVI and WHtR showed fair to considerable predictive power in participants aged 20 to 30 years. In the age group of 30 to approximately 68 years, the predictive power varied from poor to ineffective, except for individuals close to 50 years old. In females, the predictive power of the AVI and WHtR biomarkers ranged from fair to considerable for those aged 20 to around 33 years.

Conclusion: This study found that AVI and WHtR can fairly predict 10-year CVD risk in young individuals of both sexes, while the BAI was specifically applicable for predicting risk in young women. These markers are valuable and affordable tools for youth CVD screening.

Background: Intravascular ultrasound (IVUS)-guided percutaneous coronary intervention (PCI) is useful for stent optimization. Outcomes of the ultrathin Supralimus Tetriflex stent (Sahajanand Medical Technologies Pvt. Ltd., India) using IVUS were evaluated among patients with short (≤ 20 mm) versus long lesions (≥ 20 mm).

Methods: A total of 207 patients underwent PCI, and IVUS was performed post-deployment. The primary outcome was optimal stent deployment, defined as (a) mean surface area (MSA) >5.0 mm²; (b) plaque burden <50%; (c) complete apposition; and (d) no edge dissection. Secondary outcomes were target lesion failure (TLF)-a composite of cardiac death, target vessel myocardial infarction (TVMI), and target lesion revascularization (TLR)-stent thrombosis, and major adverse cardiovascular events (MACE; a composite of death, MI, stent thrombosis, and repeat revascularization).

Results: Suboptimal deployment was significantly more frequent among patients with longer lesions (30.1% vs. 23.3%; p=0.03) due to higher rates of malapposition (17.3% vs. 10.6%) and MSA <5 mm² (9.6% vs. 7.7%). Following post-dilatation, suboptimal deployment was observed in 7.6% and 5.8% of patients, respectively. Residual plaque burden was 4.5% and 5.7%, respectively. The MSA in both groups was 6.3 mm² and 6.5 mm². Minimum and mean stent expansions were 82.1% versus 81.7% and 106.3% versus 109.8%, respectively, with no significant differences. TLF and stent thrombosis were observed in 0.9% versus 0.9% and 2.9% versus 3.8% of patients, respectively, with no significant differences. However, MACE was significantly higher (10.5% vs. 8.7%; p=0.05) among patients with longer lesions.

Conclusion: Supralimus Tetriflex stent has very good optimal deployment based on angiogram and becomes better with IVUS imaging, making it safe among long lesions (≥ 20mm).

Sarcoidosis is a challenging disease characterized by the formation of granulomas in multiple organs. It presents with a variety of clinical symptoms, making diagnosis difficult for physicians. Myocardial involvement in sarcoidosis is rare, but it worsens prognosis and can lead to mortality. Physicians face challenges in diagnosing cardiac sarcoidosis due to its wide range of symptoms. Cardiac sarcoidosis that affects only the heart without involvement of other organs is extremely uncommon. In this case, we examine the scenario of a middle-aged man who experienced palpitations and was diagnosed with ventricular tachycardia. He remained in stable condition without any other clinical signs suggestive of sarcoidosis. This case highlights the importance of considering sarcoidosis as a potential diagnosis in patients presenting with palpitations and ventricular tachycardia on electrocardiogram, particularly when these symptoms are accompanied by sudden new-onset systolic dysfunction despite normal coronary arteries.

Background: Traumatic aortic injuries are predominantly caused by high-impact motor vehicle collisions, often due to sudden deceleration. This report presents a rare case of localized dissection and partial aortic arch rupture resulting from a fire suppressant explosion.

Case presentation: A 36-year-old male was transferred following a fire suppressant explosion at a copper smelter. He presented with central chest pain and stable hemodynamics, with no signs of external chest trauma. Computed tomography (CT) imaging revealed a localized dissection of the ascending aorta and a partial rupture of the aortic arch, in addition to fractures in the hand and foot caused by suppressant debris. The patient subsequently became hemodynamically unstable and required urgent surgical intervention. He underwent ascending aortic and aortic arch repairs. Postoperatively, his course was complicated by a pulmonary embolism, which was managed medically. He was eventually discharged after recovering from his injuries.

Conclusion: Aortic injuries resulting from small-scale blasts can occur. Successful management relies on a high index of suspicion and timely surgical intervention.

Background: Nitroglycerin (NTG) improves cardiac ischemia, but one of its side effects is headache. This study aimed to compare the effects of lavender aromatherapy and acetaminophen as preemptive interventions on comfort and NTG-induced headache in patients with acute coronary syndrome (ACS).

Methods: This three-arm randomized clinical trial was conducted on 90 patients divided into three groups of 30. In the acetaminophen group, patients were given 500 mg of oral acetaminophen approximately 15 minutes before IV nitroglycerin infusion. In the lavender group, 15 minutes before nitroglycerin IV infusion, cotton gauze soaked in three drops of 2% lavender essential oil was used. In the control group, patients received routine care for the treatment of NTG-induced headaches. The severity of patients' headaches was evaluated using the visual analog scale (VAS) at 5, 10, 15, and 60 minutes after starting nitroglycerin infusion.

Results: The mean headache intensity at the 60th minute in the lavender and control groups was 1.37 ± 1.10 and 2.50 ± 2.43, respectively, while no headaches were reported in the acetaminophen group. The highest mean pain severity recorded at different times was 2.12 ± 0.86 in the control group. Headache severity varied across the intervention minutes among the three groups (p < 0.001). Additionally, post-intervention comfort was significantly higher in the acetaminophen and lavender groups compared to the control group (p < 0.001), with a significant difference observed between the groups (p < 0.001).

Conclusion: The results of this study suggest that acetaminophen can be used as a preemptive agent to reduce NTG-induced headaches and improve the comfort of ACS patients.

Background: Nonbacterial thrombotic endocarditis (NBTE) is a rare yet critical complication in cancer patients, with high embolic risk and poor prognoses. This systematic review investigates the clinical presentation, valve involvement, embolic risk, vegetation management, and prognostic variability across cancer types in NBTE cases.

Methods: Adhering to PRISMA guidelines, we conducted a comprehensive literature search in PubMed, Scopus, and Embase for studies from 2000 to September 2024. Extracted data included demographics; cancer type and site; NBTE diagnosis timing; valve characteristics; embolic events; and patient outcomes. Chi-square and regression analyses evaluated associations among clinical variables and outcomes. Quality was appraised using the Joanna Briggs Institute tool.

Results: From 38 studies comprising 40 cases, the mean patient age was 50.5 years (±12.5), with equal gender distribution (20 males, 20 females). Pancreatic adenocarcinoma (17.5%) and lung adenocarcinoma (15.0%) were most frequently associated with NBTE. Mortality rates varied significantly by cancer type, with gastrointestinal and urogenital cancers showing the highest rates. A significant association was found between cancer type and vegetation management strategy (χ² = 24.41, p = 0.018). Further correlations indicated that longer cancer histories necessitated more invasive management, and concurrent embolic events correlated with poorer prognoses. Quality assessment reinforced the findings' reliability (65% high quality).

Conclusion: NBTE in cancer patients shows distinct clinical and prognostic patterns, with cancer type impacting both management and outcomes. These insights highlight the importance of tailored management approaches and provide a basis for future research to enhance care and prognostic assessments in NBTE cases within oncology.

Background: Despite controversial findings regarding the association between thyroid hormones and heart failure with preserved ejection fraction (HFpEF), thyroid dysfunction is widely assumed to be independently associated with this condition. Herein, we sought to systematically review the existing literature and estimate the prevalence of thyroid dysfunction in patients with HFpEF.

Methods: We conducted a comprehensive search in PubMed, Scopus, Web of Science, Embase, and ProQuest up to the end of November 2024. Observational studies assessing thyroid dysfunction prevalence in patients with HFpEF were included in this study. The prevalence of overt thyroid dysfunction, low T3 syndrome, and subclinical hypothyroidism (SCH) was pooled using a random-effects model. Duval and Tweedie's Trim and Fill test, funnel plot, and Egger's test were utilized for publication bias assessment. All analyses were conducted with R Version 4.5.1 and Comprehensive Meta-Analysis Version 3 software.

Results: Fourteen studies involving 3,931 subjects with HFpEF were included in this analysis. The pooled prevalence of overt thyroid dysfunction, based on six studies, was 15% (95% CI: 7%-29%). The pooled prevalence of low T3 syndrome was 22% (95% CI: 20%-25%), and for SCH, it was 15% (95% CI: 1%-68%).

Conclusion: Despite heterogeneity among the included studies, our findings suggest that thyroid dysfunction is relatively common in patients with HFpEF and may be associated with more severe symptoms and worse outcomes.

Background: Paroxysmal Supraventricular Tachycardia (PSVT) is a broad term referring to any rapid heart rhythm originating above the heart's ventricles. Atrioventricular Nodal Reentrant Tachycardia (AVNRT) is a specific type of PSVT characterized by abnormal circuits or pathways within the atrioventricular (AV) node, a crucial component of the heart's electrical conduction system. AVNRT can cause rapid heartbeats due to abnormal electrical impulses circulating within the AV node. This study aimed to explore the association between the QT, PR, and QRS intervals before and after RF ablation.

Methods: In this cross-sectional study, 115 children with recurrent cardiac arrhythmias were screened and included between 2010 and 2023. The management of arrhythmias followed established guidelines and consensus statements.

Results: The mean age of the 115 children was 9.91 ± 3.30 years, and 52.2% were female. Statistical analysis revealed a significant difference in cycle length (p=0.001), ventricular drive cycle length (p=0.001), atrioventricular Wenckebach (p=0.002), and antegrade effective refractory period of the AV node (p=0.013) before and after ablation.

Conclusion: Supraventricular arrhythmias in children present complex cases that require individualized treatment approaches. Assessing the QT, PR, and QRS intervals before and after RF ablation provides a valuable tool for evaluating the success of these procedures, particularly in cases involving AVNRT.

Background: Finding the relation between complete blood count (CBC) parameters and ischemic electrocardiogram (ECG) changes among a large normal population, for the first time.

Methods: Participants of the first phase of the MASHAD cohort study were enrolled in this cross-sectional study. Twelve-lead ECGs were taken from participants. According to the Minnesota codes, we divided the ischemic ECG changes into major and minor. Major ischemic changes included major Q-wave changes, minor Q-wave plus ST-T changes, and major isolated ST-T changes. Minor changes included minor isolated Q/QS waves, minor ST/T changes, and ST-segment elevation. The mean of the CBC parameters was compared between individuals with and without ischemic changes. The backward stepwise logistic regression model was implemented to estimate the odds ratios of ECG changes and eliminate confounders. Data were analyzed using SPSS version 20, with significance set at p < 0.05.

Results: Among 9,106 participants, 510 individuals (5.6%) had minor and major ischemic changes, with a preference for males. Major ischemic changes were not associated with CBC parameters. However, the odds of having minor ischemic changes increased 1.96-fold with increasing red blood cell (RBC) count (OR = 1.96 [1.31-2.94], p = 0.001); though, they decreased by 0.18 units with increasing hemoglobin (OR = 0.81 [0.73-0.92], p = 0.001). Additionally, high mean corpuscular volume (MCV) increased the odds of minor ischemic changes (OR = 1.05 [1.01-1.08], p = 0.004).

Conclusion: Among Mashhad's normal population, major ischemic changes were not associated with CBC parameters. Also, minor and major ischemic changes were positively associated with WBC count.

Background: The burden of stroke can be reduced by controlling its mortality risk factors. We aimed to identify the predictors of mortality within six months after ischemic stroke.

Methods: This prospective cohort study was performed on 703 ischemic stroke patients in Tehran, Iran, during 2018-2019. Data on demographic and clinical characteristics were collected through interviews and hospital records. The patients' survival status was followed up by telephone interviews at 28 days, 3 months, and 6 months after stroke. Cox proportional hazard model and extended Cox model were used to determine the predictors of mortality after stroke.

Results: The 6-month mortality rate was 19.50% (95% CI: 16.70-22.67). Age (HR=1.01; 95% CI: 1.001-1.03), higher educational levels (HR=1.05; 95% CI: 1.01-1.10), and blood sugar levels on admission (HR=1.04; 95% CI: 1.01-1.08) were significantly associated with an increase in 6-month mortality. However, alcohol consumption (HR=0.09; 95% CI: 0.02-0.38), alteplase administration (HR=0.65; 95% CI: 0.43-0.98), and higher hemoglobin values (HR=0.80; 95% CI: 0.72-0.88) were associated with a decrease in 6-month mortality. The hazard ratio of death for diastolic blood pressure, socioeconomic status, cholesterol levels, and stroke severity varied over time.

Conclusion: Some characteristics significantly increased or decreased the risk of mortality after stroke. Additionally, the effect of some variables changed over time, suggesting that stroke prognosis may be associated with dynamic risk factors. Identifying and addressing these factors can inform targeted strategies to improve post-stroke survival outcomes.