Correlation of early and late ejection fractions with CCL5 and CCL18 levels in acute anterior myocardial infarction

Background: Acute Myocardial Infarction [AMI] is the leading cause of disability and death in Iran and many other countries

Objective: To investigate the prognostic value of CCL5 and CCL18 in patients with acute myocardial ischemia

Methods: In this cohort study we recruited and followed 50 patients with acute anterior myocardial infarction [AAMI] for developing cardiovascular accidents in a 6-month period. CCL5 and CCL18 levels were measured on admission, at day 5 and at day 180 posthospitalization

Results: CCL18 and CCL5 levels at day 180 were higher in patients with late [day 180] and early [day 5] LVEF less than 35% compared to those with higher LVEF [p=0.05 and p=0.042, respectively]. There was a negative correlation between early and late LVEF and regional wall motion abnormalities [p=0.001 and p=0.002, respectively]. There was also a trend of negative correlation between CCL18 levels at day 5 and LVEF levels at day 180 post-hospitalization [p=0.06]

Conclusion: CCL18 has a correlation with cardiac function in patients with AAMI and it might be considered as an indicator of poor LVEF in patients with AAMI

Outcome and Graft Patency in Coronary Artery Bypass Grafting with Coronary Endarterectomy

BACKGROUND: Controversy persists regarding the use of coronary endarterectomy (CE) in patients with severe coronary artery disease. We compared the comorbidities and perioperative characteristics of patients undergoing coronary artery bypass grafting (CABG) with and without CE. METHODS: This study was performed in two private hospitals in Shiraz, Iran from May 2010 to December 2011 on 967 patients who underwent CABG without CE and 84 patients who underwent CABG with CE (the CE+ group). After follow-up at 9.66+/-3.65 months post-surgery, 28 patients from the CE+ group underwent angiography to evaluate the patency of grafts and native coronary vessels. RESULTS: Patients in the CE+ group had a more prevalent history of diabetes (48% vs. 36%) and number of diseased vessels (2.88+/-0.39 vs. 2.70+/-0.85). The overall hospital mortality was 1.8%, and no significant difference was observed between the two groups. In the 28 patients who underwent reangiography, 113 vessels were bypassed and 29 endarterectomies were performed, mostly on the left anterior descending artery (12 endarterectomies) and the right coronary artery (8 endarterectomies). In the endarterectomized vessels, a 66% patency rate was found in both the grafts and the native vessels. The native coronary vessels were more likely to be patent when the left internal mammary artery was used as a conduit than when a saphenous vein bypass graft was used. CONCLUSION: The lack of a significant difference in postoperative complications in patients who underwent CABG with or without CE may indicate that CE does not expose patients to a higher risk of complications. Since most of the endarterectomized vessels were shown to be patent during the follow-up period, we propose that endarterectomy is a viable option for patients with severely diseased vessels.

Mental health and depression after coronary artery bypass graft

Mental health of those with ischemic heart disease [IHD] has been a focus of attention of researchers since it has always been considered as a psychosomatic disorder. The present study was designed to investigate mental health status of a group of patients before and after coronary artery bypass graft [CABG]. In this longitudinal descriptive study 63 candidates for CABG, referred by cardiologist and cardiac surgeon in a 6 month period were asked to take part in the study if they didn't have any exclusion criteria. The patients were the out-patients of cardiac clinics in Shiraz, Iran. The patients were assessed by general health questionnaire [GHQ-28] and beck depression inventory [BDI] at 3 phases, before surgery, 1 month after surgery and three months after surgery. The analysis did not show significant statistical change in GHQ-28 and BDI measures before and after CABG. There were statistically significant differences in the mentioned measures between male and female participants in initial assessment, i.e., women scores were higher than men in distress scores measured by GHQ-28 and BDI. In our study, we observed no statistically significant differences between pre and post operation in general health and depression scales. However women showed higher degrees of depressed mood at any step of assessment