Evaluation of cardiovascular diseases and their risk factors in hospitalized patients in east Azerbaijan province, northwest Iran: a review of 18323 cases

Coronary artery disease [CAD] is accountable for more than 30% of deaths worldwide and is, thus, deemed the most important factor in terms of disease burden around the globe. This study aimed to evaluate CAD and its risk factors in hospitalized patients in the East Azerbaijan Province, northwest Iran, from 2006 to 2007. Data on 18.323 patients hospitalized due to cardiovascular diseases were collected to evaluate the diseases and their risk factors in 15 hospitals in the East Azerbaijan Province, northwest Iran. We assessed the main diagnosis of cardiovascular disease on admission in each hospital. Also, types of interventional and surgical procedures were assessed and all these variables were compared between men and women. The study population consisted of 56.6% male and 43.4% female patients. The median and range between quartile 1 and 3 [Q1-Q3] ages of the males and females were 59 [49-70] and 62 [51-71] years, respectively. Ischemic heart diseases were diagnosed in 68.4%, electrophysiological disorders in 6.5%, and valvular heart diseases in 4.5% of the patients. The frequencies of the studied risk factors were as follows: cigarette smoking [47.5%]; hypertension [66.95%]; diabetes mellitus [35.9%]; and history of cerebrovascular accident [16.4%] and renal disease [13.4%]. Medical therapy was performed in 79.23%, surgery in 6.28%, and cardiovascular interventional therapy in 13.99% of the patients. The in-hospital mortality rate was 1.57% [1.42% in the males and 1.76% in the females; p value = 0.009]. The most frequent known risk factors in the hospitalized patients were smoking, alcohol consumption, and diabetes. In the northwest of Iran, age at hospitalization due to cardiovascular diseases is slightly lower than that in the Western populations; however, sex distribution, diagnoses, and treatment modalities are not significantly different from those reported in Western countries

Quality of life in cardiovascular patients in Iran and factors affecting it: a systematic review

Cardiovascular diseases are always one of the major causes of mortality in the world affecting all aspects of patients' lives. Therefore, this study was conducted to summarize and provide a clear view of quality of life in these patients in Iran through a systematic review on the results of previously conducted studies. In a systematic review, required information was collected by searching keywords of Iran, quality of life, heart failure, cardiac, heart, and their Persian equivalents in databases of Science Direct, Pubmed, IRAN doc, SID, Medlib and Magiran. The selected time period for searching articles was since 2000 to 2012. Inclusion criteria were: releasing of article during 2000 to 2012, articles reporting patients' quality of life in any domains of heart diseases, and articles published in Persian and English. Extracted results first were summarized in Extraction Table, and then analyzed manually. Finally 18 of 1592 found articles were included in the study. A total of 3,797 cardiac patients' quality of life was measured using six different tools, the most important one of which was SF36 questionnaire. Among eight dimensions of SF36 questionnaire, the highest mean was for social role functioning with average score of 58.37 and the lowest for physical limitation [physical role functioning] with score of 42.95. Overall, mean of eight dimensions was 53.19. Among 4 general domains of quality of life, physical activity had the lowest average of 43.63 and average of general dimensions of quality of life was 47.65. The most important factors affecting quality of life were sex, age, education, marital status, occupational status, suffering duration, number of hospitalizations etc. The results of the studies showed relatively low quality of life of cardiovascular patients in general. Therefore, according to the introduced effective factors in this study, it is necessary to consider regular programs for improving quality of life in these patients and providing suitable and qualitative services

Incidence of Cardiovascular Risk Factors in Oskoo (Northwest Iran]: an Approach through WHO CVD-risk Management Package for Low-and Medium-Resource Settings on 37,329 Adults >/=30 Years Old

The aim of this study was to determine incidence of cardiovascular disease [CVD] risk factors [hypertension [HTN], obesity, Dyslipidemia[DLP], diabetes mellitus [DM] and smoking] in Oskoo. This study was planned according to WHO protocol [WHO CVD-risk management package for low and medium-resource settings] and named [East Azerbaijan healthy heart program]. The pilot study of this program was done in Oskoo in 2007-2009. In this study, demographic data and CVD risk factors of 37, 329 adults aged>30 years old living in Oskoo were collected. In addition, blood samples of 17, 388 adults>40 years old were taken [free of charge] for assessment of serum glucose and lipid profile. The study covered 93.52% of Oskoo town population aged>30 years old. We studied 18637 male [M] [91.50% coverage] and 18692 female [F] [95.52% coverage] participants. The incidence of HTN [SBP>140 and DBP>90 mmHg] was 16.25% [M:15.08%, F: 17.29%], pre-hypertension [SBP-120-139 and DBP-80-89 mmHg] -37.78% [M:41.38%, F:34.18%], DM [fast blood glucose [FBS]>126mg/dl] was 7.45% [M:6.35%, F:8.54%], smoking was 9.40% [M: 17.00%, F:1.57%], hypercholesterolemia [>200mg/dl] was 47.64% [M:42.46%, F:52.81%] and obesity [body mass index [BMI] >27] was 50.47% [M:38.79%, F:62.09%]. Considering high incidence of CVD risk factors [except smoking] in Oskoo adults >30 years, it is recommended that this pilot study expanded to all of East Azerbaijan. Free of charge taking blood samples from people > 40 years to evaluate lipid profile and glucose levels is worthy to early detecting the prevalent

Effect of citrate phosphate dextrose solution on reperfusion injury in coronary artery bypass surgical patients undergoing cardiopulmonary bypass

Reperfusion injury is one of the most common phenomena associated with coronary artery bypass graft [CABG] .The mechanism of ischemia and reperfusion injury is not known precisely, but may be free radicals and other activated oxygen metabolites have an important role in tissue damage following reperfusion injury. This study was to evaluation of citrate solution effects on oxidative stress and cardiac function and Cardiac enzymes in patient's candidate to CABG. In Double blind clinical trial study in Tabriz University of medical science, 50 patients candidate to CABG randomly divided in two groups and matched together according to sex, age and NYHA class. In intervention group after surgery and before the opening of the aortic clamping solution warm blood containing citrate phosphate dextrose [CPD; 3cc/100cc], value [100cc/min/m2BSA] for three minutes was administered. In control group, only pure blood administered. Oxidative stress markers measured in five stages and cardiac enzymes measured in three stages of surgery. Mean age 62.3 +/- 9.1 years including 30[60%] men and 20[40%] women. Ejection fractions between two groups were not significant before and after treatment. Administration of CPD was not significant effects on cardiac enzyme. Measurement of oxidative stress in different time were not different in Malonil Di Aldehid, superoxide dismutase and GPx but total antioxidant status were improved after intervention in compared with control group [p<0.001]. Results showed that CPD were positive effects of increasing in total antioxidant status after CABG. but in reduction of other oxidative markers were unlabeled

Evaluation of hs-CRP, antioxidant markers and MDA in patients of coronary artery disease [CAD] containing non-smokers and non-diabetics

Background: The oxidative stress and inflammation are cooperative events involved in atherosclerosis development. In the present study we assessed the association of MDA, antioxidant markers, high sensitive C - reactive protein [hs-CRP] and lipid status parameters in the patients with coronary artery disease [CAD]. Significant risk factors such as cigarette and diabet were excluded from the study. Methods: Oxidative stress parameters for example Malondialdehyde [MDA], antioxidant markers including: erythrocyte superoxide dismutase[SOD], Glutathion peroxidase [GPX], Total antioxidant capacity[TAC], The inflammation marker and serum lipid status parameters were measured in 120 subjects including 60 CAD patients with angiographically diagnosed CAD and 60 CAD-free subjects as a control group, also diabetics, smoking patients, patients with malignancy, renal and liver disease, and other disease were excluded from the study. Results: The serum MDA and hs-CRP levels were increased significantly as compared to controls. However, erythrocyte SOD, GPX activities and TAC level were reduced significantly in patients [P‹0.05 in all cases]. The levels of total cholesterol, Triglyceride, LDL-C were significantly higher and that of HDL-C was meaningfully lower than those of control [P‹0.05 in all cases]. Conclusion: The association between oxidative stress parameters, antioxidant markers, the inflammation index and lipid status parameters suggest their involvement in atherosclerosis development that may lead to CAD progression

Causes and risk factors for chest reexploration after coronary artery bypass grafting surgery

To determine causes and risk factors for chest reexploration after coronary artery bypass grafting surgery [CABG]. In a retrospective study, the medical records of 105 patients that had chest reexploration CABG surgery from 2004 to 2006 in Madani Heart Hospital were assessed. Frequency of reexploration was 105 1904 [5.5%]. In addition, the records of 195 patients without chest reexploration that randomly selected from 1799 patients, were assessed,the medical records of patients were studied regarding demographic characteristics, causes and risk factors of chest reexploration. Data analysis was conducted by SPSS software using descriptive and inferential statistics. The findings indicated that most frequent causes for chest reexploration were bleeding [36.2%] and cardiac tamponade [30.5%]. In addition, risk factors for chest reexploration were weight and body mass index [BMI] of patient, preoperative PT value, and preoperative use of Plavix. Reexploration rate in this study was close to other studies results

History of fertility and coronary artery disease in Iranian women older than 50 years old

Coronary artery disease [CAD] is a leading cause of mortality and disability in Iranian population. In this study, the association between parity and the presence of CAD in women more than 50years old age has been investigated in case [100 female patients with documented angiography-defined CAD] and control [320 female subjects with normal echocardiogram] group. Logistic regression analysis revealed that number of pregnancies and hysterectomy with ovarectomy was independent risk factors associated with CAD in this study

Comparison of oxidative stress content during on-pump and off-pump coronary artery bypass surgery

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