ARYA Atherosclerosis[JOURNAL]
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200 papers
The Protocol for the Development of Iranian Clinical Practice Guideline on Dyslipidemia.
Ashoorion V, Sarrafzadegan N, Shahidi S … +1 more , Bagherikholenjani F
ARYA Atheroscler · 2023 · PMID 38883849 · Full text
INTRODUCTION: The prevention and control of dyslipidemia, as an important risk factor for cardiovascular diseases (CVDs), is a priority for the healthcare system to reduce the burden of these diseases. The purpose of thi...
INTRODUCTION: The prevention and control of dyslipidemia, as an important risk factor for cardiovascular diseases (CVDs), is a priority for the healthcare system to reduce the burden of these diseases. The purpose of this protocol is to outline the key steps of the first Iranian Dyslipidemia Clinical Practice Guideline development, which can be used by other researchers as a guide to design a standard, comprehensive, evidence-based, and local context-based guideline. METHOD: This guideline will be developed and reported according to the format of the World Health Organization (WHO) Handbook for Guideline Development. All members of the guideline development team will sign the declaration-of-competing-interests (DOI) forms. The development of the authors' guideline will be supported by five groups: the steering committee (SC), the Guideline Developing Group (GDG), the systematic review (evidence synthesis) group, and the external review group. The authors will also establish a patient advisory group to inform guideline development by patients' values and preferences. The SC and GDG will determine the scope of the guideline and will design PICO questions. The systematic review group will systematically search Embase, PubMed, Scopus, Web of Sciences, Cochrane Library, and Google Scholar from inception. The systematic review group will assess the risk of bias and create evidence summaries using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system. The recommendations of this guideline will be divided into strong recommendations and weak or conditional recommendations or suggestions. CONCLUSION: This clinical practice guideline will provide clinicians and healthcare professionals with new evidence-based recommendations for the diagnosis, management, and treatment of dyslipidemia in children and adults.
Comparison of the CPR Feedback Device Effect on the Effective Technique of the CPR in Two Modes of the Device Warning Being On and Off.
Sajjadieh Khajouei A, Rabbani M, Bahrami P
ARYA Atheroscler · 2023 · PMID 38882651 · Full text
INTRODUCTION: Out-of-hospital cardiac arrest is a major public health problem with over 90% case fatality. Although it is known that good quality of cardiopulmonary Resuscitation (CPR) leads to improved patient outcomes,...
INTRODUCTION: Out-of-hospital cardiac arrest is a major public health problem with over 90% case fatality. Although it is known that good quality of cardiopulmonary Resuscitation (CPR) leads to improved patient outcomes, health care practitioners commonly perform sub-optimal CPR. The CPR feedback device is a small device designed to measure the number and depth of chest compressions (CC) and if the rate of compressions or the depth of the compressions is low or high, it will try to correct the CPR operation by announcing a warning to the resuscitator. The aim of this study was to evaluate the effectiveness of this device which was designed and made by the authors' technician study group member in improving CPR operations, to determine the need for it in all hospitals on a routine basis. METHOD: This cross-sectional study was performed on patients who have suffered from cardio-pulmonary arrest in Al-Zahra Hospital in 2020. Patients needed primary CPR for any reason, were randomly divided into two groups using random allocation software. The first group contains patients as the CPR Feedback device is on and alarm is on and warns, if resuscitation is ineffective, the second group also uses the device, but with the difference that the alarm is off. The data was analyzed by general linear model method (repeated measure ANOVA). RESULTS: 80 patients were studied, including 63 men (79%) and 17 women (21%). Patients were divided among two groups. There was no significant difference in demographic characteristics between two groups. The results showed that there was no significant interaction between group and time for the compression depth variable and there was no significant difference in the depth of compressions between the two groups(P>0.05). For the rate of compressions, there was a significant interaction between group and time. These results indicate that turning on the CPR feedback device's warning increases the number of compressions during CPR and, as a result, makes it more effective. The between-group effect which showed the difference in the number of compressions in the two groups, was statistically significant (P<0.001). CONCLUSION: These results indicated that turning on the CPR feedback device's warning increases the rate of compressions during CPR and, as a result, makes it more effective. Therefore, the use of real-time CPR feedback device during chest compression in real-time CPR improves the quality of CPR.
The Incidence of Cardiovascular Events in Small Versus Large Ischemic Stroke; A Three-Year Cohort Study.
Tajmirriahi M, Saadatnia M, Shemirani H … +3 more , Sadeghi M, Chamasemani A, Safaei A
ARYA Atheroscler · 2023 · PMID 38882650 · Full text
INTRODUCTION: Cerebral ischemia and coronary artery disease (CAD), the major leading causes of mortality and morbidity worldwide, are pathophysiologically interrelated. Cerebral ischemic events are categorized as large o...
INTRODUCTION: Cerebral ischemia and coronary artery disease (CAD), the major leading causes of mortality and morbidity worldwide, are pathophysiologically interrelated. Cerebral ischemic events are categorized as large or small vessels disease. The current study compares the factors related to CAD events incidence following ischemic large versus small disease CVA. METHOD: The current cohort study was conducted on 225 patients with ischemic stroke in two groups of large (n=75) and small (n=150) vessel disease during 2018-19. The patients' demographic, medical, and clinical characteristics were recruited. They were followed for three years regarding the incidence of CAD events, including ST-elevation myocardial infarction (STEMI), non-ST elevation myocardial infarction (NSTEMI), unstable angina (UA), and sudden cardiac death (SCD). Data about the coronary angiography, computed tomography angiography (CTA), Single Photon Emission Computed Tomography (SPECT), and the therapeutic approach were gathered. RESULTS: There were insignificant differences between the patients with small versus large vessels CVA in terms of ACS incidence (P-value=0.105), type of the events (P-value=0.836), angiographic (P-value=0.671), SPECT (P-value=0.99) and CTA findings (P-value>0.99) and approached CAD (P-value=0.728). Cox regression assessments revealed an increased risk of CAD events due to large versus small vessels disease after adjustments for hypertension, diabetes mellitus, dyslipidemia, re-stroke, and the previous history of IHD (HR=2.005, 95%CI: 1.093-2.988, P-value=0.021). CONCLUSION: According to the findings of this study, large-vessel involvement in an ischemic stroke was associated with more than a two-fold increase in the three-year probability of ischemic heart disease incidencet.
Erosion of Pulmonary Artery Banding into the Cardiovascular System: A First Case Report.
Hekmat M, Ghaderi H, Ansari Aval Z … +2 more , Mirjafari SA, Hekmat M
ARYA Atheroscler · 2023 · PMID 38882649 · Full text
There have been very rare reports on the migration of foreign bodies that are left or implanted in the body, and so far, they have only been reported in the gastrointestinal tract and intestines (a process similar to pha...
There have been very rare reports on the migration of foreign bodies that are left or implanted in the body, and so far, they have only been reported in the gastrointestinal tract and intestines (a process similar to phagocytosis), later manifesting as an obstruction in the lumen. Meanwhile, no such cases have yet been reported in the cardiovascular system. The case reported here is a 14-month-old girl who had undergone pulmonary artery banding (PA band made of PTFE) around the pulmonary artery at the age of 8 months due to severe pulmonary hypertension and failure to thrive. She underwent reoperation six months later for a final treatment. It was discovered that the PA band was no longer around the pulmonary artery and had migrated completely into the pulmonary artery while remaining intact and circular and was drawn into the pulmonary artery in a process similar to phagocytosis. The PA band was removed completely. The uneven surface inside the main pulmonary artery was resected and the artery was repaired end-to-end. A total heart repair surgery was again performed on the patient. No problem was observed in the 2.5-year follow-up after the second surgery. Overall, the authors' case is the first instance of migration of a biologically-neutral foreign body into the cardiovascular system that had occurred six months after the PA-band implantation, and the first case of erosion of a foreign body into the lumen outside the gastrointestinal tract. Although the authors could not find the cause of the presented case, reports on future cases can help find the underlying reason.
Fibrinolytic Therapy in Thrombosis of Mechanical Valves: Outcomes and Complications.
Nasri Nasrabadi A, Yarahmadi F, Amirpour A … +2 more , Zavar R, Akbari M
ARYA Atheroscler · 2023 · PMID 38882648 · Full text
INTRODUCTION: Valvular heart disease presents a significant and escalating global health challenge. Prosthetic valve thrombosis (PVT) following surgical valve replacement is a primary cause of valve failure. The aim of t...
INTRODUCTION: Valvular heart disease presents a significant and escalating global health challenge. Prosthetic valve thrombosis (PVT) following surgical valve replacement is a primary cause of valve failure. The aim of this study was to ascertain the outcomes and complications of fibrinolytic therapy in patients diagnosed with PVT. METHOD: This cross-sectional study enrolled 81 patients diagnosed with PVT who underwent fibrinolytic therapy between 2008 and 2018. Streptokinase was administered to 87.6% of patients, while 12.4% received reteplase. All demographic and clinical data were gathered from the patients' medical records. The incidence of successful recovery and complications were assessed. RESULTS: The records of 81 patients (43.2% male, mean age: 51.6 ± 13.9 years) were examined. The findings revealed that 59% and 35% of the patients had mitral and aortic PVT, respectively. While 12% of the patients experienced drug complications, 90% achieved successful recovery. Stroke and severe hemorrhage were complications frequently reported by the patients treated with streptokinase (8% and 4% respectively). The patients treated with reteplase demonstrated a 100% recovery rate. Conversely, 89% of the patients treated with streptokinase achieved successful recovery, and 7% of the patients experienced a partial recovery. CONCLUSION: Fibrinolytic agents can serve as an effective treatment with an excellent success rate for managing PVT in patients post-surgical valve replacement.
Association of Admission Systolic Blood Pressure on long-Term Outcomes after ST-Segment Elevation Myocardial Infarction.
Janjani P, Motevaseli S, Salehi N … +1 more , Asadmobini A
ARYA Atheroscler · 2023 · PMID 38882647 · Full text
INTRODUCTION: Hypertension is widely known as a significant factor in the development of cardiovascular diseases. However, there is increasing interest in the potential link between low admission systolic blood pressure...
INTRODUCTION: Hypertension is widely known as a significant factor in the development of cardiovascular diseases. However, there is increasing interest in the potential link between low admission systolic blood pressure (SBP) and higher mortality rates. Therefore, this study aimed to investigate the relationship between admission SBP and the probability of one-year mortality in patients with ST-segment elevation myocardial infarction (STEMI). METHOD: This study, which used data from registries, focused on patients diagnosed with STEMI between July 2018 and December 2019. The patients were divided into three groups based on their admission SBP: normal (< 112 mm Hg), elevated (112-140 mm Hg), and hypertension (≥140 mm Hg), and were followed for one year. The researchers used Cox proportional models to analyze the data, which allowed them to estimate crude and fully adjusted hazard ratios, along with their corresponding 95% confidence intervals (HR, 95% CI). RESULTS: This study, which included 1159 patients with a mean age of 60.71±12.19, 914 (78.86%) were male, and 108 (9.32%) died within one year. Among the patients, 276 had a normal admission SBP, 338 had elevated SBP, and 545 had hypertension. Those with hypertension had a higher-risk profile, including factors such as hyperlipidemia, BMI, LDL levels, anterior myocardial infarction, and a higher prevalence of females. The crude and fully adjusted hazard ratios (HR) for the relationship between elevated admission SBP and mortality were calculated as 0.36 (95% CI: 0.23-0.56) and 0.43 (95% CI: 0.23-0.81), respectively. CONCLUSION: The study's findings indicate a connection between increased admission SBP and a decreased probability of one-year mortality among patients with STEMI. Unlike the general population, where there is a direct linear correlation between SBP and the risk of future cardiovascular events, this research demonstrates an inverse relationship between SBP and one-year mortality.
Pressure Ulcer Patients' Psychological Understanding of Nursing Care Received in Intensive Care Unit.
Akbari M, Shirani F
ARYA Atheroscler · 2023 · PMID 38882646 · Full text
INTRODUCTION: Awareness of the perceptions of patients regarding the nursing services provided during hospitalization can enhance the quality and safety of nursing care. The objective of this study was to elucidate the p...
INTRODUCTION: Awareness of the perceptions of patients regarding the nursing services provided during hospitalization can enhance the quality and safety of nursing care. The objective of this study was to elucidate the psychological perceptions of patients with bedsores regarding the nursing care they received in the intensive care unit. METHOD: This descriptive qualitative study was conducted in 2021. The study population comprised patients admitted to the cardiac intensive care units of Chamran Hospital in Isfahan, Iran. The sample included 10 patients who fulfilled the inclusion criteria. These patients were selected using a purposive sampling technique. Semi-structured interviews were employed for data collection. Sampling continued until data saturation was reached. Data were analyzed using conventional qualitative content analysis. RESULTS: In this study, the codes obtained were classified into 10 subcategories, which were subsequently merged into three main categories. The main categories included "neglected wound care", "empathetic care", and "patient hope and trust". CONCLUSION: The findings of this study revealed that the psychological understanding of patients with bedsores was associated with numerous components and challenges that necessitate the attention and consideration of nurses during the provision of care to these patients.
Cardiac Sarcoidosis: A Contemporary Concept of Forgotten Granulomatosis.
Avagimyan A, Mkrtchyan L, Bairamyan T … +10 more , Jndoyan Z, Navasardyan G, Ginosyan K, Aznauryan A, Sahakyan K, Ionov A, Pavluchenko I, Gogiashvili L, Shafie D, Sarrafzadegan N
ARYA Atheroscler · 2023 · PMID 38882645 · Full text
Sarcoidosis is a complex multisystem inflammatory granulomatous disease that can affect any organ, with a wide range of clinical presentations. A significant number of patients with systemic sarcoidosis may also have car...
Sarcoidosis is a complex multisystem inflammatory granulomatous disease that can affect any organ, with a wide range of clinical presentations. A significant number of patients with systemic sarcoidosis may also have cardiac involvement. Clinical manifestations of cardiac sarcoidosis can include various rhythm and conduction disturbances, as well as heart failure. The structure of sarcoid granulomas is similar to that of tuberculous granulomas, but in contrast, they lack caseous necrosis. Tissue changes in sarcoidosis tissues depend on the stage of development of the disease, progressing from pathological process: macrophage-lymphocytic infiltration to epithelioid cell granuloma formation, and fibrosis. Granulomas can be found in any part of the myocardium, with the most common locations being the free wall of the left ventricle, the basal part of the interventricular septum, and the interatrial septum. Vasculopathy of the pulmonary circulation and coronary arteries is often observed. Advancements in diagnostic imaging techniques, such as computer tomography and magnetic resonance imaging, have facilitated the verification of cardiac sarcoidosis. This article presents an analysis of updated information on cardiac sarcoidosis by a multidisciplinary working group.
Outpatient Cardiovascular Rehabilitation Registry in Iran: The First Rehabilitation Registry Experience at EMR.
Sadeghi M, Rafatifard M, Hadavi M … +8 more , Drostkar N, Naderi M, Zamani S, Yazdekhasti S, Azizi E, Rahban H, Roohafza H, Shokri K
ARYA Atheroscler · 2023 · PMID 38882644 · Full text
INTRODUCTION: The collected information includes demographic profile, medical history, physical examination, patient risk factors, anthropometric evaluation, medications, echocardiographic results, and exercise testing o...
INTRODUCTION: The collected information includes demographic profile, medical history, physical examination, patient risk factors, anthropometric evaluation, medications, echocardiographic results, and exercise testing of all patients who participated in the outpatient cardiac rehabilitation program in Cardiac Rehabilitation Department since 1996 until now. Each patient was assigned an electronic code by which the patient's information could be identified. Subsequently, standard questionnaires were used, such as International physical activity questionnaire (IPAQ) to assess physical activity, MAC NEW to assess the quality of life, Spielberg to measure anxiety, Beck to assess depression, and nutritional questionnaires. RESULTS: The findings were recorded, and the data were analyzed by the web and SPSS software. For all patients, the forms were filled based on a number of variables including backgrounds, registration components, type of referral, diagnosis of underlying heart disease, methods of data collection and entry, details of the educational program, return to work, psychiatric condition, drug regimen, clinical condition, echocardiography findings, functional capacity and exercise test response, smoking status, nutritional habits, and finally their 5-year follow-up for events and re-hospitalization. CONCLUSION: It is necessary for the authors to establish a cardiac rehabilitation registration that can properly display care quality indicators and collect and report standard data from different nations to improve the quality of cardiac rehabilitation services and identify weaknesses.
A Hospital-Based Case-Control Study on Whole- and Refined-Grain Intake and Risk of Stroke.
Shirani F, Saadatnia M, Shakeri F … +3 more , Hassanzadeh Keshteli A, Saneei P, Esmaillzadeh A
ARYA Atheroscler · 2023 Jul · PMID 38881999 · Full text
INTRODUCTION: The aim of the present study was to ascertain the correlation between the intake of whole and refined grains and the risk of stroke in the Iranian adult population. METHOD: This hospital-based case-control...
INTRODUCTION: The aim of the present study was to ascertain the correlation between the intake of whole and refined grains and the risk of stroke in the Iranian adult population. METHOD: This hospital-based case-control study was conducted at Alzahra University Hospital, Isfahan, Iran, in 2008. The cases (n=195) were stroke patients admitted to the neurology ward, and the controls (n=195) were patients admitted to other wards in this center, with no prior history of cerebrovascular accident or any neurological disorders. The usual dietary intakes of the study participants during the previous year were assessed using a validated semi-quantitative food frequency questionnaire. Whole and refined grains were defined according to the definition of the American Association of Cereal Chemists International; foods that contained at least 8 g per 30 g of their weight were considered as whole grains. RESULTS: The mean age of the case and control groups was 68.0 (±13.5) and 61.5 (±10.5) years, respectively; 40% of the cases and 53.3% of the controls were female. The total intake of whole grains (27.8±4.3 vs. 29.4±3.6 g/d, P=0.77) and refined grains (264±11 vs. 296±13 g/d, P=0.07) was not significantly different between the cases and controls. After adjusting for potential confounders, individuals in the second tertile of refined grain intake had a two-fold higher odds of stroke (OR: 2.02; 95% CI: 1.08-3.71), compared to those in the first tertile. Furthermore, no significant relationships were observed between the consumption of whole grains and the risk of stroke, before or after adjustment for confounding variables. No significant trend was found between the tertiles of refined or whole grain intake and the risk of stroke. CONCLUSION: The authors did not find a statistically significant association between the intake of whole and refined grains and the risk of stroke. Further prospective studies on the relationship between both whole and refined grains and stroke are warranted.
Double Embolism: A Very Rare Presentation of Concurrent Pulmonary Embolism and Embolic Stroke without Arterivenous Shunt.
Pourkia R, Mohamadi A, Naghshineh H … +2 more , Haddad Zavareh MS, Dehghani-Tafti F
ARYA Atheroscler · 2023 Jul · PMID 38881998 · Full text
Embolic material forms in many parts of the body and can affect anywhere in the body. Pulmonary embolism and embolic stroke are the most common presentations of embolic disorders in the body. Embolic events have differen...
Embolic material forms in many parts of the body and can affect anywhere in the body. Pulmonary embolism and embolic stroke are the most common presentations of embolic disorders in the body. Embolic events have different causes, and the heart is one of the most important places where emboli originate. One of the uncommon causes of embolic events is non-bacterial thrombotic endocarditis (NBTE), which can occur in patients with advanced cancer. NBTE can lead to embolism. Embolisation may occur in some organs including the central nervous system, kidneys, spleen, limb extremities, and coronary arteries. The authors aim to describe a rare case with concurrent pulmonary embolism (PE) and embolic stroke caused by non-bacterial thrombotic endocarditis (NBTE) in a woman with breast cancer.
The Effect of High-dose Allopurinol Pretreatment on Inflammatory Biomarkers and Post-revascularization Coronary Blood Flow in Non-STEMI Patients: A Randomized Double Blind Clinical Trial.
Sanei H, Heshmat-Ghahdarijani K, Asadi A … +3 more , Kermani-Alghoraishi M, Safaei A, Sadeghi M
ARYA Atheroscler · 2023 Jul · PMID 38881997 · Full text
INTRODUCTION: The use of allopurinol has shown promising outcomes in reducing oxidative processes responsible for atherogenic-related cardiovascular events. The current study aims to assess the effects of high-dose allop...
INTRODUCTION: The use of allopurinol has shown promising outcomes in reducing oxidative processes responsible for atherogenic-related cardiovascular events. The current study aims to assess the effects of high-dose allopurinol on the post-revascularization coronary blood flow and inflammatory biomarkers in patients with non-ST segment elevated myocardial infarction (NSTEMI). METHOD: Eighty NSTEMI patients were randomly divided into two groups: the intervention group (n=40), medicated with a high loading dose of 600 mg allopurinol before the coronary angiography, and the control group (n=40), treated with a placebo. The highly sensitive C-reactive protein (hs-CRP) was measured at baseline and within 24 hours after the cardiac interventions and compared between the case and control groups. Post percutaneous coronary intervention (PCI) Thrombolysis in Myocardial Infarction (TIMI) flow grading was also evaluated as a revascularization endpoint. RESULTS: The two groups of the study were similar in terms of demographic, clinical, laboratory, and angiographic characteristics (P-value>0.050). The assessed TIMI flow was similar between the cases and the controls both prior to (P-value=0.141) and after (P-value=0.395) the coronary angioplasty. The hs-CRP (P-value=0.016) was significantly higher in the control group. Post-angiographic assessment of hs-CRP revealed an insignificant difference between the groups (P-value=0.104). CONCLUSION: In conclusion, premedication with a high dose of allopurinol in NSTEMI patients did not affect the inflammatory biomarker or the revascularization endpoint.
Coronary Artery Bypass Grafting in advance aged patients.
Sadeghi R
ARYA Atheroscler · 2023 Jul · PMID 38881996 · Full text
INTRODUCTION: This study aimed to assess the impact of coronary artery bypass grafting (CABG) on outcomes in elderly patients compared to younger patients. METHOD: An observational case-control study was conducted involv...
INTRODUCTION: This study aimed to assess the impact of coronary artery bypass grafting (CABG) on outcomes in elderly patients compared to younger patients. METHOD: An observational case-control study was conducted involving 535 patients, divided into two groups: older adults (≥75 years) and younger adults (<75 years). All patients underwent CABG following a similar protocol. The primary endpoints focused on early post-procedure outcomes, including in-hospital mortality and the duration of ICU or hospital stay. Patients were followed up for six months, and secondary study endpoints included long-term mortality, left ventricular ejection fraction, re-hospitalization rates, and repeated revascularization. RESULTS: 535 patients who underwent CABG were enrolled in this study. The smoking habit was significantly higher among younger adults (38.2% vs. 12.5%, P=0.001). Hypertension was more prevalent among older adults than younger adults (75% vs. 60%, P=0.044). LDL cholesterol serum levels were higher among younger adult patients (94.9±32.5 vs. 80.9±32.9, P=0.028). In-hospital death was not significantly different between younger and older adults (2.8% vs. 5.0%, P=0.34). Mortality in the six-month follow-up was non-significantly higher in the elderly (2.1% vs. 8.1%, P=0.06).A significant proportion of patients in both groups (46.9% in younger patients vs. 40% in older ones, P=0.40) received dual antiplatelet therapy (DAPT) prior to CABG due to a recent myocardial infarction and receipt of a new stent, but without increased major bleeding in both groups. CONCLUSION: CABG should be considered a viable treatment option for elderly patients with acceptable operative risk in current clinical practice.
Epidemiology of Stroke 2 Years Before and During COVID-19 Pandemic in Kerman (south of Iran): a Hospital-Based Study.
Iranmanesh F, Seifadini R, Dehesh T … +1 more , Mashayekhi MH
ARYA Atheroscler · 2023 Jul · PMID 38881995 · Full text
INTRODUCTION: Stroke is the second leading cause of death worldwide. Recent studies have shown that the COVID-19 pandemic has been associated with a higher frequency of stroke. This study aimed to investigate the epidemi...
INTRODUCTION: Stroke is the second leading cause of death worldwide. Recent studies have shown that the COVID-19 pandemic has been associated with a higher frequency of stroke. This study aimed to investigate the epidemiologic aspects of stroke two years before and during the COVID-19 pandemic in Kerman. METHOD: This cross-sectional study was conducted in Kerman. The participants included all patients with a confirmed diagnosis of stroke. COVID-19 confirmation was based on a positive PCR test. The data was analyzed with SPSS.V24 software. RESULTS: In this study, 4152 patients with stroke were evaluated. The frequency of stroke before and during the COVID-19 pandemic was the same. The total number of stroke patients with COVID-19 was 298 (8.16%). The frequency of ischemic stroke patients before the COVID-19 pandemic was 1751 and during the pandemic was 1770. Before and after the pandemic, the mean age of ischemic stroke patients was 67.42±14.14 and 64.49±14.46 respectively, which showed a statistically significant difference (P>0.001). Our findings showed a significant difference between the NIHSS of ischemic stroke before and after the pandemic (P<0.001). The mortality rate of stroke patients was 111 before COVID-19 and 115 patients in the first two years of COVID-19. Except for the mortality rate (P<0.001), there was no significant difference in other demographic variables between ischemic stroke patients with and without COVID-19. CONCLUSION: The patients with ischemic stroke during the COVID-19 pandemic were younger and had more neurological deficits than the ischemic stroke patients before the pandemic. COVID-19 was associated with higher mortality in patients with ischemic stroke.
Preoperative Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio for prediction of major complications following Coronary Artery Bypass Grafting.
Raeisi S, Mirmohammadsadeghi M, Raeisi S … +1 more , Mirmohammadsadeghi P
ARYA Atheroscler · 2023 Jul · PMID 38881994 · Full text
INTRODUCTION: The Neutrophil to Lymphocyte Ratio (NLR) and Platelet to Lymphocyte Ratio (PLR) have recently been reported as potentially useful indicators of inflammation. In this study, the authors investigated their pr...
INTRODUCTION: The Neutrophil to Lymphocyte Ratio (NLR) and Platelet to Lymphocyte Ratio (PLR) have recently been reported as potentially useful indicators of inflammation. In this study, the authors investigated their predictive role for postoperative complications of Coronary Artery Bypass Graft (CABG). METHOD: This study was conducted on the medical records of patients who had undergone isolated CABG in 2019-2020 in Isfahan, Iran. The baseline clinical characteristics were obtained from medical records. The diagnosis of postoperative Acute Kidney Injury (AKI) was defined based on the Kidney Disease Improving Global Outcomes guideline. The postoperative bleeding amount was measured from the total chest tube output during the Intensive Care Unit (ICU) admission after surgery. NLR and PLR were measured by dividing the neutrophil and platelet counts by the lymphocyte count, respectively. All data were analyzed using the Statistical Package for Social Sciences (SPSS) version 24. RESULTS: Of 356 patients, data of 280 patients, including 219 males and 61 females, were recruited. The mean age among all patients was 63.78±9.07 years. There were no significant differences between the bleeding group and non-bleeding group regarding NLR (2.33(1.89-2.73) vs. 2.20(1.63-3)) and PLR (119.26(94.41-146.39) vs. 110.26(82.13-136.34)) (p=0.742, p=0.228 respectively). NLR and PLR were significantly higher in AKI-positive patients (P< 0.001 and P=0.002, respectively). Only NLR showed the potential ability to predict postoperative AKI in the crude model (P<0.001) based on the regression tests. Moreover, no significant correlation was seen between both NLR and PLR and hospital stay time, ICU stay time, and in-hospital mortality. CONCLUSION: The authors found that an increased NLR is associated with a higher risk for AKI after CABG. The authors also found no significant correlations between NLR and PLR with bleeding, hospital stay, ICU stay, and mortality.
A Review of the Surgical Treatment for Constrictive Pericarditis.
Khan I
ARYA Atheroscler · 2023 Jul · PMID 38881993 · Full text
Chronic constrictive pericarditis results in the signs and symptoms of heart failure due to the chronic compression of the myocardium. When the pericardium becomes thickened and fibrosed, surgery is the sole curative man...
Chronic constrictive pericarditis results in the signs and symptoms of heart failure due to the chronic compression of the myocardium. When the pericardium becomes thickened and fibrosed, surgery is the sole curative management strategy. Surgery leads to an improvement in functional status and survival, but it is associated with significant mortality and morbidity. Over the years, the surgical approach to this pathology has largely remained unchanged, but there has been a shift in the etiological mechanism of constrictive pericarditis from predominantly tuberculous to post-cardiac surgery and idiopathic pathologies. This review offers an overview of the surgical management of constrictive pericarditis.
Effect of Education Based on Health Belief Model on the Dietary Intake of Patients with a Myocardial Infarction.
Fatahian F, Shahnazi H, Hassanzadeh A … +1 more , Mohammadifard N
ARYA Atheroscler · 2023 Jul · PMID 38881992 · Full text
INTRODUCTION: Dietary modification significantly impacts reducing myocardial infarction (MI) mortality and its recurrence. This study aimed to investigate the effect of education on the dietary intake of patients with MI...
INTRODUCTION: Dietary modification significantly impacts reducing myocardial infarction (MI) mortality and its recurrence. This study aimed to investigate the effect of education on the dietary intake of patients with MI based on the health belief model. METHOD: This quasi-experimental study was conducted on patients with MI from October 2021 to January 2022. A total of 72 MI cases were randomly divided into intervention and control groups. The intervention group received an educational intervention based on the health belief model for three months in four sessions. The structures of the health belief model were measured using a questionnaire before the intervention and one and three months following it. Dietary intake was measured with a three-day dietary record before and after three months of the intervention. RESULTS: After the educational intervention, a significant difference was observed between the two groups in terms of the average scores of awareness, perceived susceptibility, perceived severity, perceived benefits, and self-efficacy (P<0.01). However, no significant difference was observed concerning the perceived obstacles. Although there were no significant differences between dietary intake at the baseline, the intake of energy, cholesterol, and energy percent from carbohydrate, total fat, and saturated fatty acids were lower, and fiber intake was higher in the intervention group versus the control group after the intervention (all P<0.05). CONCLUSION: Given the positive effect of the health belief model in this study, it is suggested to use this model for designing education for MI patients focusing on nutrition.
Clinical performance and safety of the Vector® percutaneous transluminal coronary angioplasty balloon catheter: A single-arm, multicenter, retrospective post-marketing clinical study.
Vani P, Patel A, Abhishek K … +1 more , Goyal K
ARYA Atheroscler · 2024 · PMID 40103629 · Full text
BACKGROUND: The present post-marketing clinical study was conducted over a 12-month follow-up period to monitor the clinical outcomes of patients treated with the Vector® Percutaneous Transluminal Coronary Angioplasty (P...
BACKGROUND: The present post-marketing clinical study was conducted over a 12-month follow-up period to monitor the clinical outcomes of patients treated with the Vector® Percutaneous Transluminal Coronary Angioplasty (PTCA) Balloon Catheter for the dilatation of coronary lesions. The semi-compliant balloon improves balloon-to-vessel wall apposition and minimizes balloon slippage during PTCA, which could reduce complications and improve clinical outcomes. This investigation aimed to assess the safety and effectiveness of the Vector® PTCA Balloon Catheter in real-world settings. METHODS: A retrospective study was conducted to investigate the safety and efficacy of the Vector® PTCA Balloon Catheter in 125 patients who underwent pre-dilatation and post-dilatation. The primary outcome of the study was major adverse cardiac events (MACE), a composite endpoint encompassing target-lesion revascularization (TLR), cardiac death, and myocardial infarction (MI). RESULTS: The Vector® PTCA Balloon Catheter has shown promising results in a small group of patients undergoing dilatation of normal and intricate coronary artery lesions, reflecting a 100% procedural success rate. The successful delivery to the target lesion, deployment, and subsequent retrieval of the device during the index procedure led to a 100% device success rate without any technical issues. A total of 3.2% (4) patients experienced MACE during the 12-month follow-up, with 1.6% (2) MI, 1.6% (2) TLR, and no cardiovascular deaths.. CONCLUSION: This study demonstrated the favorable safety and reliability of the Vector® PTCA Balloon Catheter in patients with angina, MI, and a history of coronary artery disease in a real-world setting.
A case report of chordal systolic anterior motion without hypertrophic cardiomyopathy misdiagnosed with acute coronary syndrome.
Haji Aghajani M, Omidi F, Hamneshin Behbahani R … +1 more , Ebrahimi M
ARYA Atheroscler · 2024 · PMID 40103628 · Full text
Chordal systolic anterior motion (SAM) refers to the anterior motion of the mitral valve towards the left ventricular outflow tract (LVOT) that occurs during systole. Chordal SAM is a potentially fatal condition. Chordal...
Chordal systolic anterior motion (SAM) refers to the anterior motion of the mitral valve towards the left ventricular outflow tract (LVOT) that occurs during systole. Chordal SAM is a potentially fatal condition. Chordal SAM is linked to an elevated risk of sudden death and can lead to significant obstruction of the left ventricular outflow tract (LVOT) and mitral regurgitation. It is crucial to acknowledge and consider this phenomenon when assessing individuals experiencing dyspnea and chest discomfort. By doing so, unnecessary therapies related to heart failure and heart attack might be avoided. Ensuring timely diagnosis is crucial in order to prevent unnecessary and potentially dangerous therapies that can aggravate LVOT obstruction and lead to hemodynamic instability. In this paper, we present a 47-year-old woman who experienced sudden chest pain and dyspnea. The patient had a history of hypertension and previous myocardial infarction. ST-elevation was observed in the first ECG. The primary treatment for acute coronary syndrome was initiated. Coronary angiography demonstrated that coronary vessels were not obstructed. The diagnosis of chordal SAM was initially overlooked during the echocardiography, but it was later identified during a subsequent echocardiography after cardiac catheterization. When using beta-blockers, her clinical condition improved.
Safety and efficacy of using amplatzer ductal occluder type I and II for peri membranous ventricular septal defect closure: A systematic review.
Ghaderian M, Ramezani S, Behdad S … +4 more , Gharipour M, Dianatkhah M, Hovesepian S, Salemi N
ARYA Atheroscler · 2024 · PMID 40103627 · Full text
BACKGROUND: Ventricular septal defect (VSD) is a common congenital heart defect that affects many individuals. Transcatheter closure has become a successful treatment method. However, certain devices used for closure can...
BACKGROUND: Ventricular septal defect (VSD) is a common congenital heart defect that affects many individuals. Transcatheter closure has become a successful treatment method. However, certain devices used for closure can lead to life-threatening complications such as complete heart block. This systematic review aimed to assess the efficacy and safety of Amplatzer duct occluders (ADOs) types I and II for closing perimembranous VSDs (pmVSDs). METHODS: This review followed the PRISMA 2020 guidelines and searched multiple databases for English articles on pmVSD closure using ADO I/II published up to 2022. Relevant keywords were used and the data were categorized to report the incidence of common complications. RESULTS: The study, which involved 1,691 patients with primary pmVSD and ages ranging from 6 months to 15 years, found that ADO type I had a high success rate with low rates of complete heart block and other complications. ADO type II had a higher rate of severe complications, particularly complete heart block. The overall estimated success rate for device implantation was 97.3%, with only one procedure-related death. The occurrence of complete heart block was 2.3%, and residual shunts were the most frequent complication (4.8%). CONCLUSION: The findings of this systematic review provide valuable insights into the use of ADO types I and II for closing pmVSDs. Healthcare professionals should be aware of these findings and closely monitor patients who undergo ADO device closure for pmVSDs. Further research is recommended to determine the specific indications for using each type of Amplatzer device in the relevant population.
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