ABSTRACT
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.
ABSTRACT
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
ABSTRACT
PON1 [Paraoxonase 1] is an esterase enzyme which is associated with high density lipoprotein [HDL]. The enzyme prevents the peroxidation of low density lipoprotein [LDL]. The susceptibility of LDL for oxidation is the proven risk factor for coronary artery diseases. The aim of this study is to survey the effect of atherogenic diet with or without enzyme inhibitors on the incidence and progression of atherosclerosis in rabbits. Twenty four New Zealand white rabbits divided into three groups [control, under the atherogenic diet, atherogenic diet and nandrolone decanoate - paraoxonase inhibitor therapy] and were treated for two months. At the beginning and end of the treatment, 5 mL of blood was obtained to determine the levels of total antioxidant capacity [TAC], HDL, mallon dialdehide [MDA] and PON1. After sixty days rabbits anesthetized under standard conditions, and sampling carried out from heart arteries for pathological examinations. Data were analyzed using statistical software SPSS/15 and one way ANOVA and paired t-test statistical tests. The results showed that the plasma levels of TAC, HDL, MDA and PON1 had significant changes in this study [P<0.05]. The pathological study showed that in the presence of PON1, the formation and progression of atheroma is diminished. The results of this study showed that cholesterol-rich diet decreased serum level of PON1 which in turn led to a reduction in formation and progression of atheroma. It was shown that the enzyme inhibitor helps accelerating the development of atheroma.
ABSTRACT
Tissue Doppler imaging [TDI] is a relatively new method that measures regional myocardial velocities on the basis of color Doppler imaging. The aim of this study was to investigate both systolic and diastolic parameters to diagnose coronary stenosis at rest. We examined 73 patients without previous myocardial infarction who underwent coronary angiography. Peak early and late diastolic velocities, systolic velocity, time to peak systolic velocities were measured at rest. The patients were divided to those with coronary artery disease [CAD] in the presence of stenosis of more than 50% in one coronary artery and the control group. We found no significant differences between two groups. Tissue Doppler imaging is not a reliable tool for diagnosis of CAD at rest. Systolic and diastolic velocities by pulsed-wave tissue Doppler imaging were not sensitive for diagnosing the coronary stenosis
ABSTRACT
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.
ABSTRACT
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
ABSTRACT
Background: According to previous studies elevated blood total homosyteine has been suggested to be an independent risk factor for cardiovascular disease. The aim of this study was evaluation of homosyteine serum in smoker and nonsmoker patients with acute coronary syndrome [ACS]. Methods: Eighty five patients were enrolled in this study. Forty eight patients [21smoker and 27non-smoker] diagnosed with acute myocardial infarction [AMI], 37 patients [14smoker and 23non-smoker] with unstable angina [UA] that admitted in Shahid Madani Heart center in Tabriz in 2008-2009. The mean age of patients with AMI and UA were 61.83 +/- 13.78 and 59.90 +/- 11.95 years, respectively. Homocysteine serum Levels were measured by Hitachi Auto analyzer. Results: The mean age of patients with AMI was 61.83 +/- 13.78 years and in patients with UA was 59.90 +/- 11.95 years [p=0.53]. Mean serum levels of homocysteine were not significant difference between AMI and UA patients [17.61 +/- 11.25 µmol/L vs. 22.25 +/- 12.44, p=0.78]. There was also a significant correlation between high levels of homocysteine with AMI and UA diseases in comparison with normal reference values. There were not statistically significant differences in serum homocysteine levels between smoker and nonsmoker patients in both AMI and UA groups. Conclusion: The Mean levels of Homocysteine in AMI and UA groups were not significantly different. Our study showed age of smoker patients in AMI and UA groups were significantly lower than nonsmoker patients
ABSTRACT
Ischemia- reperfusion is the common cause of apoptosis in most of cells specially myocytes. Prevention and reduction of apoptosis in myocardium can be one of the main medical goal before surgical operation, angioplasty and after infarction. Erythropoietin receiving effect 24 hours before hypoxia beginning on myocytes apoptosis rate and inflammatory process following half an hour hypoxia and 1.5 hour reperfusion are aim of this study. 40 Rats were divided randomly into two groups. 24 hours before surgical operation, 5000 Iu/Kg erythropoietin was injected to experimental group. During operation 12 rats from experimental group and 11 rats from control group were lost. After anesthesia, using ligation in left coronary artery for 30 minutes hypoxia and 1.5 hours reperfusion were applied. Then Thorax was opened and after bleeding, the animal's heart was isolated and two tissue samples of infarct and non-infarct area were separated and fixed. Then blood serum samples separated and incubated in -76[degree] C. Apoptosis intensity in heart tissue was measured by tunel method CK-MB level by method and DGKC, hsCRP by Elisa using Immunodiagnostic kit. The results were calculated Mean +/- SD. Then using paired student's t- test their deference were shown. Level of statistical significant was considered P< 0.05. Activity level of CK-MB [1550U/L to 340] in experimental group was less than control group [P
ABSTRACT
Previous studies suggest a protective role of the essential trace elements against cardiovascular disease, whereas wistful epidemiological data remains controversial. We aimed to investigate the serum concentration of zinc [Zn] and copper [Cu] in patients presented with acute coronary syndrome [ACS] considering status of cigarette smoking. Baseline Zn and Cu concentrations were measured in 100 individuals [50 with unstable angina [UA] and 50 with acute myocardial infarction [AMI]; then these parameters were compared with normal reference values. Current smoking status of patients in each group was analyzed considering values of serum trace elements concentration. In those patients who were admitted with ACS, mean serum Zn [62.1 +/- 13.4 [micro]g/dL] and Cu [66.5 +/- 14.1 [micro]g/dL] levels were lower compared to normal reference values [p < 0.001]. No significant differences were observed between AMI and UA patients in serum Zn [59.6 +/- 2.9 vs. 65.7 +/- 14.2 [micro]g/dL; p=0.28] and Cu [64.9 +/- 13.3 vs. 68.1 +/- 15.0 [micro]g/dL; p=0.79] levels. Also there were not any statistically significant differences in Cu and Zn levels between smoker and non-smoker patients in each study group [p values> 0.05]. Lower Zn and Cu serum concentration was found in patients with ACS but these relatively low levels are not significantly different between AM1 and UA patients. Also, it seems that cigarette smoking dose not considerably affect serum levels of Zn or Cu in ACS patients
ABSTRACT
In contrast to conventional on-pump coronary artery bypass grafting [CABG] surgery only mild increase of parameters of oxidative stress is reported during and after off-pump coronary artery bypass grafting. In this study, we attempted to determine the role of off-pump CABG in the myocardial and systemic inflammatory responses. One hundred patients who underwent elective CABG were divided to three groups: I] patients underwent off- pump CABG or 2] on-pump CABG surgery with controlled reperfusion and 3] on-pump CABG with noncontrolled reperfusion. We took patients systemic venous blood samples for the measurement of serum level malondialde hyde [MDA], Troponin [cTnI] and total antioxidant [TAC] and blood level superoxiddismotas [SOD], before and after Ischemia and reperfusion. Mean values of decrease left ventricular ejection fraction [LVEF] after surgery in patients group 3 were higher than patients group2 and also [LVEF] in patients group2 were higher than patients group l [P