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Context: The use of registries to Coronary Artery Disease (CAD) data management plays an important role in the improvement of healthcare processes and reduction of outcomes for patients and healthcare providers. The present study aimed to compare the data management processes of CAD registries in the selected countries. Evidence Acquisition: This review study was conducted comparatively in 2019. After selecting countries based on some criteria, the required data were collected by searching valid databases, more useful search engines, and related websites to CAD registries for the selected countries as well as by sending E-mails containing a data extraction form to the related organizations. Results: Totally, five registries were chosen in the selected countries as follows: CADOSA (Australia), APPROACH (Canada), START (Italy), CLARIFY (Spain), and GWTG-CAD (US). The results showed that 60% of the selected registries made use of the electronic case report form for data gathering. The main data elements included demographic and general information, risk factors, vital sings, medication, laboratory tests results, examination results, ECG results, invasive measures and interventions, patient's status on discharge, results of follow-ups, and post-discharge outcomes. Conclusion: Developing CAD registries based on the data management principles provides the context to conduct cohort studies with very low costs. With regard to the study results, attention should be paid to data management processes, include data gathering, data processing, and information distribution, in development of CAD registries. [ABSTRACT FROM AUTHOR]

Background: Ischemic Heart Disease (IHD) is the leading cause of mortality in both developed and developing countries. It accounts for more than 15% of the total mortality worldwide. At the global scale, the massive occurrence of this disease can have tremendously negative effects on economy, especially among young people. Objective: The present study aimed to investigate the relationship between IHD and several important risk factors involved. It also looked into the prevalence of IHD among patients between 20 and 40 years of age. Methods: The present cross-sectional, retrospective survey was conducted in three referral heart hospitals affiliated to Mashhad University of Medical Sciences, Iran. The required data were extracted from integrated Hospital Information System (HIS) from 2010 to 2012. The data included clinical and demographic information, such as age, gender, marital status, occupation, diabetes, blood pressure, blood cholesterol, cigarette smoking, and family history. In the next phase, clustering technique and k-means algorithm were applied using the WEKA (3-6-9) software. Results: Totally, 88623 patients suffered from heart diseases between 2010 and 2012. When the specific inclusion and exclusion criteria were considered, the number of records was restricted to 776, which included 548 males. The clustering technique was done in two phases. Firstly, there were four clusters extracted and secondly, cluster analysis was done in terms of age and gender. According to the findings, cigarette smoking in males aged between 20 and 40 years was the main risk factor. Conclusion: The present research aimed to investigate the risk factors of heart diseases among patients between 20 and 40 years of age. Those below 40 years old were known as the main human resource in the community. The early prevalence of IHD in this population disabled them for the rest of their lives. This disability could also lead to irreparable physiological effects along with financial costs. It could also impose high costs on the society. Recognition of the risk factors of heart diseases at younger ages could contribute to healthcare policies. [ABSTRACT FROM AUTHOR]

Background: Coronary Artery Disease (CAD) is a major cause of morbidity and mortality world-wild. Thus, its early diagnosis and treatment could be life-saving. Mitral Valve (MV) and mitral annular velocities as well as left atrial and left ventricular wall strain have been claimed to be helpful for prediction of the presence of CAD. Objectives: This case-control study aimed to assess the predictive value of these echocardiographic parameters for detection of CAD. Methods: Eighty consecutive individuals referring with acute angina-like chest pain and requiring diagnostic coronary angiography and had a concomitant echocardiographic Left Ventricular Ejection Fraction (LVEF) ≥ 50% were divided into two groups: those with significant CAD (n = 45) and those with non-significant CAD (n = 35). Tissue Doppler Imaging (TDI) was employed for all participants. Peak early and late MV velocities (E and A, respectively), peak longitudinal systolic myocardial velocity (mitral S'), peak early and late diastolic velocities (e' and a', respectively) from medial mitral annulus, E/e' ratio, peak Left Atrial (LA) strain, and Left Ventricular Global Longitudinal Strain (LV GLS) were measured and compared in the two groups. Chi-square and t-test were used to compare the two groups as appropriated. Multiple logistic regression was also performed to detect the impact of categorical variables on the predictors of the presence of CAD. Receiver operating characteristic curves were constructed as needed. A P value ≤ 0.05 was considered to be statistically significant. Results: Mitral S' and E/e' were significantly different in the two groups. Mitral S' was lower and E/e' was higher in the patients with CAD compared to the control group (P = 0.01 and P = 0.03, respectively). Considering 5.3 cm/sec as the cut-off point for mitral S', sensitivity and specificity for significant CAD were 67.40% and 68.60%, respectively with an odds ratio of 0.275. The cut-off point for mitral E/e' was defined as 12.65, with sensitivity and specificity for significant CAD to be 52.17% and 77.14%, respectively with an odds ratio of 1.249. Conclusion: This study showed that mitral S' and E/e' could predict the presence of significant CAD in patients with chest pain and preserved LVEF. Thus, TDI could be used as a simple, reliable, and non-invasive tool to achieve this goal. [ABSTRACT FROM AUTHOR]

Introduction: Coronary Artery Anomalies (CAAs) are rare, with their prevalence ranging from 0.6% to 1.3%. Case Presentation: A 33-year-old man with no previous medical history was referred to the emergency department with Sudden Cardiac Arrest (SCA) while playing soccer. Systematic assessment revealed that the SCA was caused by a scarce CAA; the Left Anterior Descending (LAD) artery arising from the Right Sinus of Valsalva (RSV). There was also Left Ventricular (LV) systolic dysfunction with an LV ejection fraction of 35%. The patient subsequently underwent single vessel coronary artery bypass grafting of the Left Internal Mammary Artery (LIMA) to LAD as well as cardioverter-defibrillator placement and had no further incidence of SCA. Conclusions: Comprehensive knowledge of CAAs and the related symptoms shortens the time to correct diagnosis and initiation of proper management and is likely to reduce the frequency of complications. [ABSTRACT FROM AUTHOR]

Background: Acute Heart Failure (AHF) is a common cause of hospitalization in many countries. Rehospitalization due to AHF is also a very important economic issue for health services. Registries for AHF have been made in many countries to characterize such patients, which have provided great information about these patients for better care. To date, there is insufficient information about these patients in Iran and their rehospitalization and short- and long-term follow-up is unclear. Objectives: This study aims to describe the results of a small registry of AHF (HFrEF) patients in Iran and their short-term follow-up. Patients and Methods: This study aimed to describe the earliest results of the AHF registry, which was started from September 2015 in two hospitals (Afshar Heart Center in Yazd and Rajaie Heart Center in Tehran). All patients with diagnosis of AHF and HFrEF were enrolled into this registry. During six months, 352 patients with diagnosis of AHF and HFrEF were entered into this registry. The patients' demographic, clinical, and Para clinical data were collected during hospitalization and they were followed up for all-cause mortality and hospitalization for three months. Patients suffering from heart failure with preserved ejection fraction were excluded because of their small number and incomplete data. Results: The mean age of the patients was 55 ± 16 years and 76% were male. Besides, 77% of the patients had acute decompensation of chronic heart failure and 17% had new-onset AHF. Etiology of heart failure was ischemic heart disease in 52% of the patients. Additionally, the mean left ventricular ejection fraction was 20%. Moreover, length of hospital stay was 10.5±10 days and in-hospital mortality rate was 9.7%. Conclusions: This small and limited registry of patients with AHF (HFrEF) in Iran delineated these patients' characteristics with some discrepancies and similarities with western registries. Thus, a larger nationwide registry is needed for further clarification of the issue. [ABSTRACT FROM AUTHOR]

Background: Cardiovascular disease (CVD) is the most common cause of mortality and morbidity worldwide. Coronary artery disease (CAD) is the leading cause of CVD. In CAD, atherosclerotic plaques lead to coronary artery stenosis, hereby impairing myocardial blood and oxygen supply. The oxidative changes in LDL at the vascular wall play a critical role in the development of atherosclerotic lesions. The paraoxonase 1 (PON1) enzyme present in the HDL surface is capable of destroying oxidized LDL and, therefore has an antiatherogenic activity. Objectives: This study was conducted to investigate the association of two functional polymorphisms in PON1 gene with CAD in northern Iran. Materials and Methods: This study was a case-control study with the case-base sampling method for the control group. Genomic DNA was extracted from the peripheral blood collected from 305 patients with CAD and 302 healthy controls. Two polymorphisms of PON1(L55M)T > A and PON1(Q192R)A > G, for all samples were genotyped by Single-Specific Primer-PCR. GraphPad6 software was used for statistical analysis. Results: Logistic regression analysis showed that age, gender, smoking status, and diabetes mellitus were significantly associated with CAD disease (P < 0.001). There was a significant association between genotype A/A of PON1(L55M)T > A polymorphism and CAD disease (P = 0.011). The results indicated that allele A in this SNP was also significantly associated with the CAD disease (P = 0.005). Analysis of dominant genetic model in PON1 (L55M)T > A showed that one copy of A is sufficient for increased risk (P = 0.016). Conclusions: Our findings, at least in the population of Golestan province, indicated that the PON1(L55M) polymorphism might be associated with atherosclerotic disease. [ABSTRACT FROM AUTHOR]

Background: Although several studies have been conducted on the association between lipid profile and sexual function among men with coronary artery disease, there is a paucity of knowledge about this association among women with coronary artery disease. Objectives: Our study aimed to evaluate the link between lipid profile and sexual function in men and women with coronary artery disease. Methods: One hundred and twenty patients with documented coronary artery disease were consecutively sampled from an outpatient cardiovascular clinic. he patients were assessed for lipid profile and sexual relationship using the Relation and Sexuality Scale (RSS). In addition, the Hospital Anxiety and Depression Scale (HADS) was used to measure the symptoms of anxiety and depression. he characteristics of chest pain were also measured using the Rose Angina Questionnaire. he data were analyzed through linear regression analysis. Results: his study was conducted on 91 males (75.8%) and 29 females (24.2%). Multivariate analysis showed that low-density lipoprotein cholesterol was correlated with sexual function (B = 0.01, P = 0.010) and total sexual relationship (B = 0.01, P = 0.050). A correlation was also observed between the level of high-density lipoprotein and sexual frequency score (B = -0.02, P = 0.040). Gender moderated these correlations. Among males, serum cholesterol (r = 0.193, P = 0.047) and low-density lipoprotein (r = 0.224, P = 0.037) were correlated to sexual function. In females, however, low-density lipoprotein was correlated to the total sexual relationship (r = 0.426, P = 0.021) and high- density lipoprotein was correlated to sexual frequency (r = -0.334, P = 0.046). Conclusions: he findings of this study showed a relationship between lipid profile and sexual relationship among both male and female patients with coronary artery disease. he link between lipid profile and sexual function of the patients with coronary artery disease is thus beyond just the effect of lipid profile on erectile dysfunction. [ABSTRACT FROM AUTHOR]

Background: This study aimed to investigate the interaction between gender and other socio-economic characteristics on sleep quality of the patients with Coronary Artery Disease (CAD). Methods: This cross sectional study was conducted on 717 patients with CAD. The socio-economic status (education level, income, marital status, and place of residence) was considered as the independent variable. Besides, the study outcome was the quality of sleep which was measured using Pittsburgh Sleep Quality Index (PSQI). Gender was considered as a possible effect modifier. Two-way ANOVA was used to evaluate the interaction between gender and socio-economic factors on sleep quality. As defined by Baron and Kenny, moderator was defined as a variable that affected the direction or magnitude of the association of interest. Results: Female gender, low education level, and low income were predictive of poor sleep quality. Among female (10.0 ± 4.3 vs. 7.6 ± 5.0, P < 0.05), but not male patients (6.7 ± 4.2 vs. 7.0 ± 4.2, P > 0.05), low education was associated with poor sleep quality. Also, among female (10.0 ± 4.3 vs. 5.7 ± 2.5, P < 0.05), but not male patients (7.0 ± 4.2 vs. 6.0 ± 3.8, P > 0.05), low income was predictive of poor sleep quality. Gender did not modify the effect of other socio-economic factors on sleep quality. Conclusions: Among female but not male patients with CAD, low education and income were associated with poor sleep quality. This information helps us better understand the mechanisms behind the poor sleep quality of the female patients with CAD. This is important because poor sleep is a prognostic factor among the CAD patients. [ABSTRACT FROM AUTHOR]

Background: Coronary Artery Disease (CAD) is the most important cause of mortality in the world. About half of cardiovascular risk factors have not been completely understood. Oxidation of LDL by oxidants such as iron plays a central role in atherogenesis. As a result, evaluation of the iron stores is important in the risk evaluation of the atherosclerotic disease. Methods: This cross sectional study was performed on 337 patients with chronic stable angina hospitalized in Sari heart center, Mazandaran University of Medical Sciences from February 2010 to July 2012. Coronary angiography was performed and the angiograms were evaluated by two cardiologists. Moreover, blood samples were collected after a 14-hour fast immediately before the coronary angiography in order to measure the total cholesterol, HDL- cholesterol, and glucose. The patients were divided into four groups to evaluate the severity of Coronary Artery Disease (CAD) according to Syntax scoring system. Results: The study results revealed a significant difference among the four study groups regarding the iron serum level. It was significantly higher in the sever atherosclerosis group compared to the normal (P=0.0122), mild (P=0.023), and moderate CAD groups (P<0.001). Conclusions: The findings indicated that the serum level of iron was higher in the atherosclerotic patients and increased with the severity of CAD. Therefore, a basic relationship probably exists between the serum iron level and CAD. Further prospective and experimental studies are needed to confirm the association between the iron status and atherosclerosis. [ABSTRACT FROM AUTHOR]

Background: Traditional cardiovascular risk factors are strong predictors of an increased likelihood for premature CHD. Considering the benefits of risk factors" management, it is imperative to find and treat them before looking for more unknown and weak risk factors. Objectives: Limited information is available about the demographic and historical characteristics of the patients with premature Coronary Heart Disease (CHD) in IR Iran. The main objective of this study was to determine the prevalence of the traditional risk factors in these patients. Also, the researchers hypothesized that there are insufficient risk assessment and preventive intervention methods for the asymptomatic adult population. Methods: This study was conducted on 125 patients with premature CHD (age<50 years) who were admitted in two academic hospitals with acute coronary syndromes. The patients were accepted since they had a definite CHD on the basis of acute myocardial infarction (elevated cardiac enzymes) or documented CAD in coronary angiography. Results: The mean age of the study population was 42.50+5.65 (26 to 49 years). Among the patients,92 (73.6%) were male, 113 (90.4%) were married, 58 (46.4%) were smokers,19 (15.2%) were opium users, 97 (77.6%) had dyslipidemia, 44 (35.2%) had hypertension, and 33 (26.4%) had diabetes mellitus. In addition, family history was presented in 54 patients (43.2%). Among the study population, 120 patients (96%) had at least one of the traditional risk factors, including dyslipidemia, hypertension, diabetes mellitus, cigarette smoking, and family history of CHD. However, none of the dyslipidemic patients had controlled total cholesterol, LDL, HDL, and triglyceride. Also, none of the diabetic patients had hemoglobin A1C<7%. Among the 44 hypertensive patients, blood pressure of 15 ones (34%) was within the normal range. Besides, only 3 patients (2.4%) had regular physical activity (at least 30 minutes, three times a week). Conclusions: Premature Coronary Heart Disease is a public health problem. However, there is lack of effective and intensive treatments of well-defined traditional risk factors and prevention methods for the majority of the patients experiencing premature CHD. In sum, there is still plenty of room for improvement of risk management in IR Iran. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to evaluate the clinical outcomes, one year after primary percutaneous coronary intervention(PCI). Patients and Methods: From September 2009 to March 2012, primary PCI was performed on 70 cases, and the data relating to their catheterization were recorded. Peri-interventional treatment data included PCI with drug-eluting or bare-metal stent or balloon angioplasty alone. Results: The mean age of the patients was 61.34+11.31 years, and 72.9% of them were males. The ratios of patients with diabetes, hypertension and, hyperlipidemia were 61.4%, 71.4%, and 52.9% respectively. In clinical follow-up, total incidence of death was 4.3%, with no death occurring during 30 days. However, 3 patients died after one-year, of which one patient (1.4%) had cardiac problem and the other 2 (2.9%) died because of non-cardiac reasons. Target vessel revascularization, reinfarction within 30 days, and mechanical complication or stroke were not found in any of the patients. Patients with hypertension (6%) and those with LAD ST-elevation myocardial infarction (5%) died after one year (P= 0.263 and P= 0.319 respectively). However, no mortality was reported in patients with RCA and LCX ST-elevation myocardial infarction. Of subjects with multivessel disease, 7% died after one-year (P= 0.161), but there was no reported mortality in those with single vessel disease. Conclusions: The prognosis was satisfactory in patients undergoing PCI after one year clinical follow up. [ABSTRACT FROM AUTHOR]

Background: Retrospective studies and clinical trials have indicated that β-receptor blockers have an influential role in improving survival and reducing risk of recurrent infarction in patients with myocardial infarction. However, there is still controversy regarding the effects of β-receptor blockers on the markers of myocardial infarction following percutaneous coronary interventions (PCI). Objective: The aim of this study was to evaluate the pre-treatment effect of Carvedilol on markers of myocardial injury in patients undergoing elective PCI. Method and Materials: In this clinical trial patients undergoing elective PCI were categorized randomly in the Carvedilol group including 100 patients who received two doses of 12.5 mg, 6 and 12 hours prior to PCI, and the control group (105 patients). Blood samples were obtained to analyse cardiac biomarker, 12 and 24 hours after PCI. Results: The clinical features were not significantly different between the two groups. A increase in the level of Troponin I was observed in the control group 24 hours following PCI (P=0.042), whereas this rise in troponin I was slight and insignificant in the Carvedilol group (P>0.05). some difference was observed between the two groups in regard to the level of CPK-MB after PCI (P=0.041). Conclusion: The findings of our study indicate that pre-treatment with Carvedilol confers cardio-protection by limiting the rise of markers of myocardial injury following PCI. [ABSTRACT FROM AUTHOR]

Objective: The aim of the present investigation was to explore probable association of renal artery stenosis (RAS) with coronary artery disease (CAD) and the prevalence of renal artery stenosis (RAS) in patients with CAD. Patients and methods: This study comprised 165 consecutive patients with CAD, including 52.7% males and 47.2% females with respective mean ages of 60.3 ±8.9 and 59.5±10.1. The patients underwent simultaneous coronary and renal angiographies, and the lumen reduction of 50% or more was considered as significant stenosis. Indeed, stenosis of more than 70% of the arterial lumen was regarded as severe. Results: According to our findings, the prevalence of renal artery stenosis in our hypertensive and normotensive patients were 46.2% and 19.5% respectively (p=0.002). Renal artery angiography revealed that 64 (38.8%) of the patients had simultaneous renal artery stenosis. RAS is more common in females than males (p=0.031). Multivariate analysis revealed that among all examined factors, hypertension and serum creatinine were associated with RAS. There was no correlations found between gensini score and RAS (p=0.63). Conclusion: We found a relatively high prevalence of RAS including 46.2% in hypertensive and 19.5% in normotensive patients in our patients with CAD. [ABSTRACT FROM AUTHOR]

Background: The effect of opium on glycemic control in diabetics is a controversial issue, as some studies have shown glucose lowering effect of opium in diabetes while the results of other studies do not support this idea. The possible role of opioid peptides in the regulation of food intake has been previously investigated. However, there is no data available about relationship between opium using and dietary pattern. Objectives: The aim of the present study was to determine the daily intake of different nutrients in opium addict with diabetes diagnosed with coronary artery disease (CAD). Methods: This study comprised 232 consecutive diabetic patients with CAD, and candidates for isolated coronary artery bypass surgery in Tehran Heart Center. Of these, 26 patients were opium addicts. Nutritional assessment was obtained by a validated semi- quantitative food frequency questionnaire (FFQ). Results: In opium addicts compared to non-addicts, consumption of carbohydrates (360.0±120.9 versus 447.8±249.8 Gr/day, P=0.016) and vitamin A (1170.4±570.2 versus 1496.3±889.6 µg/d as Retinol Activity Equivalent (RAE), P=0.040) was lower than non-addicts and intake of other nutrients were similar across two group of patients. Conclusions: Opium addiction in diabetic patients may lead to decrease of vitamin A and carbohydrate intake. This study showed that carbohydrate intake in addicted diabetic patients is lower than their non-addict counterpart. Thus, the so called lowering effect of opium on blood sugar may be due to nutritional habit of addicted patients. [ABSTRACT FROM AUTHOR]

Balloon valvulotomy is the procedure of choice for relief of mitral stenosis. Inoue technique is the most widely accepted technique which uses the right femoral vein to access the interatial septum. Due to technical issues, left femoral vein approach is less recommended. We report an unusual case in which the right femoral vein was not accessible and mitral balloon valvulotomy was done via left femoral approach. Left femoral vein may be used in special cases where the right femoral vein is not accessible. [ABSTRACT FROM AUTHOR]

We report a case with a left atrial mass who underwent coronary angiography to rule out coronary artery disease. Coronary angiography revealed an anomalous tortuous vascular structure originating from the left circumflex coronary artery to the left atrial tumor suggestive of neovascularization. Preoperative coronary angiography is useful for coronary artery evaluation and also provides additional information regarding the feeding vessel supplying the mass. [ABSTRACT FROM AUTHOR]