Predictors of side branch occlusion and its early complications after angioplasty in bifurcation lesions

Coronary angioplasty in bifurcation lesions has lower success rate and more complications than other lesions. We performed this study to define early complications of angioplasty in these Lesions and to find the predictive factors of major side branch [more than 1mm] occlusion. In this study, 104 consecutive patients with bifurcation lesion in a single center were evaluated. The side branches were classified based on diameter and morphology of the lesions. In 41 [39.4%] patients side branch compromise [SBC] occurred. In patients with SBC 34.1% had chest pain and in 3 [2.9%] patients non-Q wave myocardial infarction [MI] occurred, all after SBC. The incidence of non-Q wave MI after SBC was 7.3%. The probability of SBC in patients with ostial Lesion of more than 50% was significantly higher [p=0.021] than patients without such a lesion. Also, if the main branch Lesion was more than 80%; SBC was significanty higher [p=0.011] than patients without such lesions. Using multiple logistic regression analysis, only more than 80% stenosis in the main branch had significant relation with SBC [OR: 5.91; 95% CI [1.28-27.3]; p=0.023]. SBC had no statistically significant relation with age, sex, Length of the lesion and ejection fraction. In angioplasty of bifurcation lesions, the presence of more than 80% stenosis of main branch increases the probability of SBC and more classifications may be unnecessary

Serum zinc level in dilated and ischemic cardiomyopathy

Serum trace element alteration has been reported in dilated and ischemic cardiomyopathy. The reports were controversial. We have studied serum Zinc level in cardiomyopathy patients in northern province of Mazandaran and compared them with healthy volunteers. Serum Zinc level was measured in 30 ischemic and 18 dilated cardiomyopathy patients against 27 healthy volunteers. It was measured using atomic absorption spectrophotometry. Statistical analysis was performed using SPSS for Windows version 14 and independent t-test was used for comparing serum Zinc level in ischemic and dilated cardiomyopathy. Pearson correlation and ANOVA tests were used for numeric variables in three different groups. P<0.05was considered as statistically significant. The mean serum Zinc level was 0.97 +/- 0.25, 1.05 +/- 0.27, 1.21 +/- 0.42 mg/L for idiopathic dilated cardiomyopathy, ischemic cardiomyopathy and healthy volunteers respectively. There was no significant difference between three groups. There was also no correlation between echocardiography data and serum Zinc level. This study showed serum Zinc level might not have a role in pathogenesis of ischemic and dilated cardiomyopathy. As intracellular Zinc level play a role in heart subjected to ischemia- reperfusion, measuring intracellular Zinc may give us a better clue about role of Zinc or other trace elements in pathogenesis of cardiomyopathy