Coronary Artery Disease Presentation and Its Association with Shortened Activated Partial Thromboplastin Time.

Background: Standard coagulation screening tests are important constituents of basic examinations in clinical laboratories. There is no clear evidence of a relation between the type of clinical presentation and coagulation parameters in patients with suspected coronary artery disease. Methods: This cross-sectional study included 539 patients who underwent coronary angiography in Tehran Heart Center between November 2012 and January 2013. Patients presented with ST-segment-elevation myocardial infarction (STEMI), non-STEMI, unstable angina, or stable angina. Prothrombin time (PT), international normalized ratio (INR), and activated partial thromboplastin time (APTT) were measured before angiography and compared between the clinical presentation groups. Results: The mean age of the patients was 59.156 ± 11.05 years, and 47.7% were male. STEMI was reported in 41(7.6%) patients, non-STEMI in 42 (7.8%), unstable angina in 304 (56.4%), and stable angina in 152 (28.2%). No difference in the mean PT and INR was found between the groups. The mean APTT was significantly lower among the patients presenting with STEMI and non-STEMI (26.58 ± 2.32 s in the STEMI, 26.85 ± 2.41 s in the non-STEMI, 27.64 ± 2.54 s in the unstable, and 27.93 ± 2.53 s in the stable angina groups, respectively, p value = 0.005). After adjustment, the association between the patients' presentations and APTT was significant (OR for 5 s increase in APTT = 1.661, 95% CI = 1.184 to 2.332; p value = 0.003). Conclusion: We observed that the patients who presented with STEMI had the lowest value of APTT, whereas those who presented with stable angina had the highest. The value of APTT in patients undergoing coronary angiography may have a potential to predict the extent and severity of coronary stenosis.

Public preferences for donor kidney allocation: a study in Iran.

INTRODUCTION: Fair allocation of donor organs is essential to maintain public trust in a public healthcare system. A study of the public's views and opinions of this could clarify non-medical prioritization criteria. We report our survey of public opinion of criteria for donor kidney allocation. METHODS: This was a cross-sectional study using random digit dialing to phone interview 706 Tehran residents. Patient scenarios were presented to determine interviewee opinions on nine recipient criteria: probability for survival, previous transplant history, time on the waiting list, age, an individual's role in developing their kidney failure, gender, marital status, social status, and financial situation. Each scenario introduced two patients and interviewees then chose the better candidate for transplantation. RESULTS: More than 50% of the participants chose length of waiting time, a patient's role in causing their disease, age, and survival time after transplantation as important allograft allocation criteria. CONCLUSION: This study disclosed other criteria in addition to the likelihood for successful transplantation-the patient's role in the development of their disease and patient age-which should be prioritization considerations.

Public opinion of organ donation: a survey in Iran.

INTRODUCTION: The objective of this study was to assess the views of Tehran citizens in regard to donating their organs in case of brain death. METHODS: In this cross-sectional study, conducted between February 2009 and November 2010, two interviewers contacted 1379 people through random digit dialing for phone interviews. Phone calls were made between 6 and 9 pmon a workday, and those reaching companies or organizations were excluded. The interviewee was selected randomly from among the household members, and those 18 yr and older were included in the study. RESULTS: Of the 1379 people eligible for entering the study, 706 consented to have the interview (response rate = 51%). Among the respondents, 84.6% were willing to donate. Of these, 94.6% were willing to complete a donor card as well, but only 10.7% of them already had one. CONCLUSION: There should be simple processes for the public to declare their decision about organ donation in case of brain death. People should be encouraged to communicate their wishes with others so that family members can decide about their organ donation more easily.