Association between apo lipoprotein b levels at admission of patientsand short-term morbidity and mortality after myocardial infarction

Dyslipidemia is an important risk factor in cardiovascular diseases. Different studies have shown that Apolipoprotein B [Apo B] is one of the best predictors in determining cardiovascular diseases and patients follow up after cardiovascular events. We hypothesized that there is a relation between Apo B levels and cardiovascular events in patients who have myocardial infarction [MI]. In addition, Apo B may be an appropriate marker for following these patients after MI. In this study, 220 patients with acute myocardial infarction were allocated at their admission to the hospital. They were followed for three months after MI and their morbidity and mortality rates were evaluated. Apo B levels were measured immunoturbidimetrically. Apo B levels were significantly higher in patients with the events including coronary artery bypass grafting [CABG], percutaneous coronary intervention [PCI] and malignant arrhythmias [P = 0.001]. Apo B levels can be an appropriate indicator of cardiovascular events in patients after MI.

Homocysteine level according to some cardiac risk factors and extent of coronary disease

Hyperhomocysteinemia is accompanied by many cardiovascular risk factors. However it's relation with other cardiac risk factors and with extent of coronary artery disease [CAD] is still a controversial issue. This study was designed to investigate the relationship between total plasma homocysteine [tHcy] levels and other cardiovascular risk factors and the severity of CAD. Fasting plasma tHcy levels were measured in 60 patients with angiographically documented CAD and compared to 56 control subjects matched for age, sex, and smoking habits. Also patients were classified into two groups of low risk [with two or few risk factor] and high risk [with three and more risk factor] according to their major risk factors. Mean of tHcy levels were significantly higher in high risk patients compared to low risk patients [p=0.013]. Also hyperhomocysteinemia rate was higher in the high risk patients compared to low risk patients, OR=5 [CI 95%=1.6-16].There was relationship between coronary risk factors and severe coronary artery disease [three vessels disease] but this relationship was statistically significant only in smokers [P=0.012] and diabetic patients [P=0.035]. Plasma tHcy level was an independent risk factor for high risk patients.

association between serum Lipoprotein [a] and other cardiac risk factors with the severity of coronary artery disease

Several meta-analyses have provided support for an association between lipoprotein [a] [Lp [a]] and coronary disease, but the correlation of Lp [a] and other coronary risk factors with severity of coronary artery disease [CAD] are ambiguous. In this case control study, plasma Lp [a] concentration, lipid profile, diabetes, hypertension, smoking were evaluated in 108 patients with and without CAD [Case: 55 and Control: 53] who were admitted at heart center in Shahid Beheshti hospital of Zanjan in 2009. Also patients were classified into two risk groups according to their major risk factors; low risk [with two or few risk factors] and high risk [with three and more risk factors]. The collected data was analyzed with using chi square, independent sample t-test, fisher's exact test, Mann-Whitney test, Kruskal Wallis test and Pearson's correlation coefficient. The mean concentration of Lp [a] in the case and control groups were 60 +/- 11 mg/dL and 32 +/- 3 mg/dL, respectively [P=0.054]. 41.8% of the case group and 22.6% of the control group have abnormal level of Lp [a] [=30 mg/dL] [P=0.03]. Mean lipoprotein [a] was also higher in three vessels disease compared control group [46 +/- 41 vs. 31 +/- 23] and maximum level of lipoprotein [a] in control group was 92 mg/dL and in three vessels disease was 520 mg/dL. Between other cardiac risk factors, diabetes was more frequent in case than control groups [29.1% vs 5.7%] and had a significant relationship with severity of coronary disease [P=0.001]. The main findings of this study were that mean Lp[a] levels were higher in the three vessels group compared to control and diabetes had significant relationship with the severity of coronary disease

relationship between Serum NT- Pro-BNP levels and prognosis in patients with systolic heart failure

Most studies reported using N-terminal pro-brain natriuretic peptide [NT-proBNP] in diagnosis of heart failure but there is controversy about use of these tests in determining prognosis and classification of severity of heart failure. The objective of this study was to determine the value of plasma NT-proBNP levels assessment in evaluation of mortality and morbidity of patients with systolic left ventricular dysfunction. A cohort study was performed in 150 patients with heart failure since September 2009 until February 2010. The patients were followed for 6 months to assess their prognosis. Patients were divided into two good and bad prognosis groups according to severity of heart failure in New York Heart Association [NYHA] class and frequency of hospital admission and mortality due to cardiac causes. Patients with good prognosis had >1 admission or no mortality or NYHA class>2 and patients that had one of this criteria considered as bad prognosis groups. Pro-BNP levels were measured at baseline and left ventricular ejection fraction [LVEF] was estimated with echocardiography. Data was analyzed with using Chi-square, t-test, ANOVA, Kruskal-Wallis tests. In patients with heart failure that enrolled in this clinical study, ten patients were lost during follow-up. The mean of NT-proBNP is significantly correlated with ejection fraction [p=0. 003] and NYHA class [p<0/001]. In our study among 140 patients who were follow-up for 6 months, 11[9. 7%] of individuals died with mean NT-proBNP of 8994. 8 +/- 8375 pg/ml, in survived patients mean NT-proBNP was 3756. 8 +/- 5645. 6 pg/ml that was statistically significant [P=0. 02]. Mean NT-proBNP in the group with good prognosis was 2723. 8 +/- 4845. 2 pg/ml and in the group with bad prognosis was 5420. 3+/-6681 pg/ml, difference was statistically significant [P=0. 0001]. Our study in consistent with other studies confirms that NT-proBNP is significantly correlated with mortality and morbidity. This could be predicting adverse out come and stratification in patients with heart failure. It is recommended that more research be performed in Iran

Hypertension awareness, treatment, control and prevalence in Zanjan Province, Iran

Hypertension is a frequent and treatable risk factor for cardiovascular, cerebrovascular, renal and peripheral arterial disease. There are simple criteria for its diagnosis and no expensive equipment arterial disease. There are simple criteria for its diagnosis and no expensive equipment is needed. This article aims to determine how many hypertensive subjects are aware of their disease, how many of them actually treat it, what they utilize to treat it, and finally how many complete treatments successfully. A cross-sectional descriptive study was conducted on 1000 people in Zanjan Province in 2007. Random stratified cluster sampling based on postal code was used to enroll people aged between 15 to 67 years old. Their blood pressures were measured three times by automated device in the sitting position from the right arm at home. Hypertension was defined as recorded blood pressure above 140/90mmHg or taking anti-hypertensive medications. Two hundred seventy-eight [27.8%] hypertensive patients were detected in our sample. The prevalence of hypertension after age adjustment was 18.7% [95%, CI, 16.1% - 21.3%] in Zanjan. Only 101 [36.3%] patients were aware of their disease, 38 [13.6%] of all hypertensives took medication, and the blood pressures of only 6 [2.1%] of all hypertensives were controlled. 70 [25.1%] used non-pharmacologic treatment and 27 [9.7%] used traditional medications. The potential for both better detection and treatment would appear to be huge in our region. Implementation of health care systems for this purpose is needed