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Background: Opium consumption is associated with an increased risk of atherosclerosis and a hyper-inflammatory state that are suggested as contributing factors to the development of coronary artery ectasia (CAE). We aimed to determine if opium consumption is an independent risk factor of CAE. Methods: In this propensity score-matched study, we enrolled patients who underwent elective coronary angiography between September 2004 and March 2017 in Tehran Heart Center. We studied patients with CAE and without coronary artery disease as cases. The control group, patients with normal coronary angiograms, were selected after applying the propensity score matching to match for age, sex, diabetes mellitus, hypertension, hyperlipidemia, family history of coronary artery disease, and cigarette smoking.Results: We studied 242 patients with pure CAE and selected 968 control patients. The prevalence of opium consumption was not significantly different across these groups, 17 (7.5%) in the pure CAE group compared to 76 (8.6%) in the control group (Odds ratio: 0.81; p=0.455). Amongst the patients with pure CAE, Markis scores were not significantly different between opium consumers and non-consumers (p=0.136).Conclusions: We found no significant difference regarding opium consumption between patients with pure CAE and patients with normal coronary angiograms. In addition, there is no correlation between opium consumption and Markis scores in patients with pure CAE.

Background: Left bundle branch block (LBBB) is an important and independent determinant of mortality among patients with cardiovascular disease (CVD). Close follow-up and management of isolated LBBB to prevent cardiomyopathy is controversial. Methods: In this retrospective cohort study, patients with isolated LBBB, with no concomitant evident cardiac disease, or risk factors of heart failure with reduced EF such as hypertension or diabetes mellitus (DM) were included. The mean follow-up of the patients was 56 months. At the onset of the study, coronary angiogram and EF of the patients were normal. Patients with reduced EF underwent coronary angiogram at the end of their follow-up interval. Results: In this study, 36 patients, with the mean age 62.1 years (45 - 81) were followed. LV ejection fraction (EF) was reduced in 24 patients, and the other 11 patients continued to have a normal EF during the follow-up. The follow-up interval between the 2 groups was not statistically different (Mann-Whitney, P = 0.9). Most of the patients with reduced EF were male (Mann-Whitney, P = 0.01). New- onset HTN had a negative correlation with a decrease in EF% (Spearman correlation coefficient = -0.36, P = 0.031). Based on surface ECG parameters, 8 new notched-QRS were detected, all of which had decreased EF during follow-up. Conclusions: Not all patients with isolated LBBB develop cardiomyopathy at a definite time interval. Male gender, notched-QRS in ECG, and longevity of conduction delay are important predictors of cardiomyopathy among these patients. They may benefit from anti-remodeling drugs and routine close follow-ups with echocardiogram.

Background There is no established minimum data set (MDS) for cardiovascular implantable electronic devices (CIEDs), which have led to a lack of standardized assessment criteria in this field to ensure access to a reliable and coherent set of data. Objective To establish the minimum data set of CIEDs implantation that enables consistency in data gathering, uniform data reporting and data exchange in clinical and research information systems. Methods This descriptive and cross-sectional study was conducted in 2018. That comprised a literature review to provide an overview of cardiovascular documents, registries, guidelines and medical record forms to extract an initial draft of potential data elements then asked from experts to review the initial draft of variables to score the items according to the importance perceived by them based on a five-point Likert scale. The items scored as important or highly important by at least 75% of the experts were included in the final list of minimum data set. Results Initial dataset were refined by experts and essential data elements was selected in eight data classes including administrative data, past medical history, sign and symptoms, physical examinations, laboratory results, procedure session, post procedure complications and discharge outcomes. For each category required variables and possible respondents where determined. Conclusions The minimum dataset will facilitate standardized and effective data management of CIEDs implantation; and presents a platform for meaningful comparison across contexts.