ARYA Atherosclerosis最新文献

Background: Cardiovascular disease (CVD) is a global health challenge. Various studies have shown that genetic and environmental factors play roles in the development and progression of CVD. Small non-coding RNAs, namely microRNAs (miRs), regulate gene expression and have key roles in essential cellular processes such as apoptosis, cell cycle, differentiation, and proliferation. Currently, clinical studies highlight the critical role of platelets and miRs in coronary thrombosis, atherosclerosis, and CVD.

Methods: Using search engines such as PubMed and Scopus, articles studying platelet miRs and their effects on atherosclerosis and cardiovascular disease were reviewed.

Results: This article presents a comprehensive analysis of the association of platelet-related miRs as prognostic, diagnostic, and therapeutic biomarkers with the pathogenesis of atherosclerosis and cardiovascular disease.

Conclusion: Taken together, data show that platelet-related miRs not only play important roles in the initial development of atherosclerosis and cardiovascular disease (CVD), but they are also considered prognostic and diagnostic biomarkers in CVD.

Background: Patients with ischemic heart disease often exhibit various psychological factors that increase the risk of future cardiovascular events. Therefore, in addition to rehabilitation programs, there is a need for more interventional psychotherapy. Bioenergy Economy-based Health Improvement (BEHI) is a mind-body intervention that may address these issues. This study aimed to evaluate the effectiveness of the BEHI program on laboratory, clinical, and psychological factors in post-myocardial infarction (MI) patients.

Methods: In this study, 52 post-MI patients were randomly divided into two groups. One group received cardiac rehabilitation combined with the BEHI program, while the other group received only cardiac rehabilitation. Laboratory data, clinical characteristics, and psychological variables were evaluated at baseline, immediately after the intervention, and four months post-intervention (follow-up).

Results: Among the participants, the mean age was 59.97 ± 6.32 years, and 98.07% were male. The results showed a significant improvement in the mean scores of metabolic equivalents (METs), depression, and anxiety in participants who received the BEHI program and the rehabilitation program (p values: 0.006, 0.038, and 0.028, respectively).

Conclusion: These findings suggest that incorporating mind-body interventions like the BEHI program into cardiac rehabilitation can enhance physical and psychological outcomes for patients recovering from MI.

Background: Ischemic heart disease (IHD) is the leading cause of 16% of deaths globally. Percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) are the main treatment options. Saphenous vein grafts (SVGs) remain the most frequently used conduits for CABG. In addition, PCI in cases previously undergoing CABG is related to worse long-term outcomes. This study aimed to evaluate PCI's short-term and long-term clinical outcomes on SVGs.

Methods: Sixty-three patients who underwent PCI on SVGs from 2017 to 2019 were enrolled. Short-term and long-term cardiac outcomes of patients in the 6-month follow-up, including major adverse cardiac events (MACE) and all causes of death, were collected. The collected data were also analyzed through statistical methods.

Results: The mean age of the subjects was 63.26 ± 8.74 years. Out of 63 patients, five patients (7.94%) died. Two of them died because of cardiac death a day after PCI, and three other cases passed away during the 6 months after angioplasty. Four and three cases had non-fatal myocardial infarction and stroke 6 months after PCI, respectively.

Conclusion: In conclusion, in patients with coronary artery disease, PCI and CABG are complementary therapies. Revascularization on saphenous vein grafts seems to be a safe and practical technique in patients.

Background: The relationship between hemoglobin A1c (HbA1c) levels and coronary artery disease (CAD) severity is still a matter of debate in non-diabetic patients. This study aimed to determine the association between HbA1c and the severity of CAD in non-diabetic patients.

Methods: The present cross-sectional study was conducted in 2018-2019 on 133 non-diabetic patients with stable angina, unstable angina, or myocardial infarction (MI). They were selected through systematic random sampling. The data were collected by taking a complete medical history, calculating the SYNTAX score, and measuring HbA1c.

Results: A SYNTAX score of >22 was significantly correlated with age, left ventricular ejection fraction, HbA1c, and total cholesterol. The mean SYNTAX score was higher in male patients, those with HbA1c >5.6, and patients with a primary clinical presentation of MI. The association between the SYNTAX score and HbA1c was found to be statistically significant (r = 0.659; P < .001). The odds of having a SYNTAX score of >22 for those with HbA1c >5.6 was 5.48 times higher than for those with HbA1c ≤ 5.6 (odds ratio [OR], 5.48; P < .001). The odds of three-vessel disease in individuals with an HbA1c level greater than 5.6 were found to be 4.80 times higher than in those with HbA1c levels at or below 5.6 (OR, 4.80; P = 0.002).

Conclusion: The present findings showed that HbA1c has the potential to predict the severity of CAD in non-diabetic individuals. HbA1c, even at levels within the normal range, was significantly correlated with SYNTAX scores.

Background: The study explores the enduring challenges of cardiovascular disease mortality, emphasizing myocardial infarction rates as a proxy for cardiovascular disease in Iran. It analyzes the 28-day mortality trends after Acute Myocardial Infarction (AMI) from 2000 to 2017.

Methods: This retrospective cohort study is based on data from a multi-centric hospital-based registry in Isfahan. Univariate and multivariate frailty Cox regression analyses were performed to identify Hazard Ratios (HRs) for the 28-day mortality rate of AMI based on age, gender, and living region.

Results: The study enrolled 121,284 patients with an average age of 62.00±12.82 years. Older age than 65 years was found to be associated with an increased risk of AMI (HR: 3.2, 95% CI: 2.7-3.8 from 2000 to 2002 and HR: 4.6, 95% CI: 3.7-5.7 for 2015-2017). There was also an association between living in the urban region and a decreased risk of AMI from 2000 to 2005 (HR: 0.64, 95% CI: 0.46-0.90), from 2000 to 2002 (HR: 0.55, 95% CI: 0.43-0.71 for 2003-2005). Results showed that the trend of change in 28-day mortality declined more significantly from 2006 to 2017 compared to 2000-2002. Younger age (61.76±12.69 vs 71.12±11.73), female gender (HR:0.77, 95%CI: 0.67,0.89), and living in urban regions (HR: 0.69, 95%CI: (0.52,0.94) were the protective factors for the 28-days mortality rate of AMI.

Conclusion: It can be concluded that 28-day mortality had a descending trend from 2006 to 2017. Older age, male gender, and living in a rural region were the risk factors that affected the 28-day mortality rate of AMI.

Background: There is a high mortality rate in cyanotic patients with congenital heart disease (CHD) due to cardiovascular complications. The cardiovascular prognosis is negatively affected by endothelium dysfunction, increased arterial stiffness, and impaired vascular system. This study aimed to determine carotid intimal mean thickness (CIMT) and flow-mediated dilatation (FMD) in a group of children with cyanotic CHD (CCHD).

Methods: FMD and CIMT were evaluated for 45 children with CHKD and 38 patients who did not have CHKD over the period 2021 to 2022, as part of this case-control study. In terms of age and gender, the case group has been compared to controls.

Results: Men accounted for 61.3% of the participants, with a mean standard deviation age of 7.8 5.39 years. In subjects with CCHD, CIMT increased non-significantly and FMD decreased significantly, but systolic blood pressure was significantly higher in patients than in the healthy group. (P=0.003).

Conclusion: FMD was reduced in children with CCHD, but in controls, systolic blood pressure and CIMT were lower. The risk of developing atherosclerosis in CCHD patients may be increased by an increase in CIMT and systolic blood pressure.

Background: Secundum Atrial Septal Defects (ASDs) are the most common type of atrial septal defects. Today, using different types of occluders, transcatheter closure is widely used to treat ASD and has replaced the surgical procedure in anatomically suitable patients. This study was performed to evaluate the short-term clinical outcomes of treatment of adult patients requiring an ASD device closure referred to Shahid Chamran Cardiovascular Center in Isfahan, Iran.

Methods: All patients who underwent ASD treatment using transcatheter closure at Shahid Chamran Cardiovascular Center in 2020 and 2021 were recruited in this retrospective descriptive study. The characteristics of the treated lesion and the cardiovascular complications during treatment were recorded immediately and one month after treatment.

Results: A total of 70 patients (47 females and 23 males) with a mean age of 39.81±12.56 years were investigated in this study. The number of difficult anomalies was 46 (65.7%), and the most common type was the deficient aortic rim. In terms of the incidence of vascular complications, hematoma, bleeding, and pseudoaneurysm were observed in 8 patients. The most common cardiac complication was atrial fibrillation, which occurred in 12 patients. No cardiovascular complications were observed during the one-month follow-up.

Conclusion: The results of this single-institute study showed that ASD treatment by the transcatheter procedure using an ASO device at Shahid Chamran Cardiovascular Center was performed safely and successfully with very few complications. The short-term analysis of the outcomes indicated no major complications, deaths, or device malposition.

Background: Necrotizing fasciitis is a life-threatening soft tissue infection characterized by rapid tissue necrosis, often leading to sepsis and multisystem organ failure. Necrotizing fasciitis can rarely occur as a post-procedural complication, particularly following cardiac catheterization or angiography. This case report presents the clinical presentation and management of a 64-year-old female with a history of chronic endocarditis and valvular involvement who developed necrotizing fasciitis after femoral coronary angiography.

Case presentation: A 64-year-old female with a history of chronic endocarditis and valvular involvement underwent femoral coronary angiography as part of her cardiac evaluation. On the first postoperative day, the patient developed worsening pain, swelling, and redness in her right lower extremity, which worsened despite antibiotic therapy and pain management. The patient was diagnosed with necrotizing fasciitis. An emergent right lower extremity fasciotomy was performed to debride the necrotic tissue and release the tension caused by acute compartment syndrome.

Conclusion: This case underscores the importance of maintaining a high index of suspicion for NF in patients with persistent soft tissue infection symptoms post-procedure. Early recognition, prompt diagnosis, and aggressive surgical intervention are crucial for the successful management of post-procedural NF following femoral coronary angiography. This report emphasizes the need for a multidisciplinary approach and vigilance in caring for patients to ensure optimal outcomes in such rare but severe complications.

Background: Type 1 diabetes (T1D) carries a significant risk of atherosclerosis as the main driver for cardiovascular events. Atherosclerosis is initiated by the activation of the endothelium by various risk factors through the inflammation process. The anti-inflammatory cytokine TGF-β1 may inhibit the development of atherosclerosis.

Methods: In a cross-sectional study, a total of 40 patients aged 14.5±3.16 years old with T1D and 40 healthy controls aged 14.7±0.99 years old were involved. Common carotid artery IMT (cIMT) was measured by real-time M-echocardiography mode (Affinity 50G Philips) and Flow Mediated Dilatation (FMD), using high-resolution ultrasonography and Doppler flow characteristics. The TGF-β1 level was measured by indirect ELISA at Saiful Anwar Hospital Laboratory.

Results: There were no differences in age, gender, Body Mass Index (BMI), duration of diabetes, renal function, or nutritional status between the T1D and healthy groups (p>0.05). A significant difference in cIMT was observed between the T1D group and the healthy group (0.567 ± 0.87 mm vs. 0.387 ± 0.57 mm, p = 0.000), FMD (7.17 ± 3.98 mm vs. 11.22 ± 5.48 mm, p = 0.000), and the level of TGF-β1 cytokine (39.83±13.51 vs. 73.67±15.34 pg/ml, p = 0.000). A significantly negative correlation between TGF-β1 and cIMT (p = 0.000; r = -0.685) and a significantly positive correlation between TGF-β1 and FMD (p = 0.000; r = +0.55) were found.

Conclusion: Atherosclerosis is an inflammatory disease accelerated by diabetes. The inflammation process is more prominent in T1D patients. T1D patients show a decreased level of TGF-β1, increased measurement of cIMT (>0.5 mm), and a decreased measurement of FMD.

Background: In this study, we aimed to investigate the prognostic implications of lead aVR ST-segment elevation in an initial electrocardiogram (ECG) in patients diagnosed with acute coronary syndrome (ACS). Furthermore, we evaluated the association between electrocardiographic changes in lead aVR and objective measures such as angiographic findings and Syntax score.

Methods: This retrospective cohort study, conducted as a pilot study, encompassing both a retrospective cross-sectional analysis and a longitudinal follow-up, took place at Chamran Hospital from November 2017 to October 2019. A 6-month follow-up was conducted via phone interviews to assess patient outcomes.

Results: During the study period, there were 76 admissions with the final diagnosis of acute coronary syndrome and lead aVR ST-segment elevation on ECG. ARB intake and the severity of right coronary artery stenosis were significantly higher in patients with STE-aVR ≥1.5 mm. The clinical pathway analysis and 6-month follow-up outcomes concerning ST-segment changes in lead aVR did not reveal statistically significant differences in the distribution of various intervention strategies and clinical events. The overall ST-change was a significant risk factor for 6-month follow-up angiography (OR: 1.10; 95% CI: 1.002 to 1.213) and was also significantly associated with any stenosis in the RCA territory (OR: 1.10; 95% CI: 1.004 to 1.21). There was no significant association between ST-change and other follow-up hospital and angiography outcomes.

Conclusion: The findings suggest that medication history, particularly with angiotensin receptor blockers, may shape the observed ST-segment changes in lead aVR. However, further investigation is needed to better understand the clinical implications of these trends.