Gender differences in the risk of coronary artery disease in Iran

Given gender differences in the risk of coronary artery disease [CAD], the present study sought to investigate these dissimilarities amongst patients who underwent angiography at a major, tertiary heart hospital in Iran. Between 2005 and 2010, 44,820 patients who underwent coronary angiography were enrolled in a registry. Pre-procedural data such as demographics, CAD risk factors, presenting symptoms, and laboratory tests, as well as post-procedural data were collected. The data were, subsequently, compared between the men and women. Out of the 44,820 patients [16,378 women], who underwent coronary angiography, 37,358 patients [11,995 women] had CAD. Amongst the CAD patients, the females were not only significantly older, less educated, and more overweight than were the males but also had higher levels of triglyceride, cholesterol, low-density lipoprotein, high-density lipoprotein, and fasting blood sugar [P< 0.001]. Of all the risk factors, hypertension and diabetes mellitus showed the strongest association in our female CAD patients [OR=3.45, 95%CI: 3.28-3.61 and OR=2.37, 95%CI: 2.26-2.48, respectively]. Acute coronary syndrome was more prevalent in the men [76.1% vs. 68.6%, P< 0.001], and chronic stable angina was more frequent in the females [31.4% vs. 23.9%, P< 0.001]. With respect to post-procedural recommendations, the frequency of recommendations for non-invasive modalities was higher in the females [20.1% vs. 18.6%, P< 0.001] Hypertension and diabetes mellitus had the strongest association with CAD in our female patients. In the extensive CAD patients, medical treatment was recommended to the women more often

Routine use of cerebral protection [filter wire] during carotid artery stenting: results of a single center registry of 37 patients

To evaluate the short-term outcome of patients who underwent carotid stenting with the routine use of cerebral protection devices. In our center, 36 successful carotid stenting procedures [of 38 at tempted] were performed in 37 patients [23 men; aged 66 +/- 7 years]. Cerebral protection involved distal filter devices [n = 36] of which 12 were Accunet and 24 were EZ filter wires. The protection devices were positioned successfully in 36 of the 38 attempted vessels. The 30-day incidence of stroke and neurological death was three. Neurological complications included one major stroke, and one minor stroke. There was also one [sudden cardiac death on the first day]. The proportion of stroke or death was two for symptomatic lesions and one for asymptomatic lesions, and two in patients aged < 80 years and one in those aged >/= 80 years. Protection device-related vascular complications included mild spasm, which occurred after three procedures [8%], none of which led to neurological symptoms. There were another four cardiogenic deaths in 30-day follow-up. In this uncontrolled study, routine cerebral protection during carotid artery stenting was technically feasible and clinically safe. The incidence of major neurological complications in this study was lower than in previous reports of carotid artery stenting without cerebral protection