Search

Background: This article introduces the first national guidelines for the management including diagnosis, treatment, and secondary prevention of acute coronary syndrome (ACS) in Iran. Materials and Methods: The members of the guideline development group (GDG) were specialists and experts in fields related to ACS and were affiliated with universities of medical sciences or scientific associations in the country. They carefully examined the evidence and clinical concerns related to ACS management and formulated 13 clinical questions that were sent to systematic review group who developed related evidence using Grade method. Finally the GDG developed the recommendations and suggestions of the guideline. Results: The first three questions in the guideline focus on providing recommendations for handling a patient who experience chest pain at home, in a health house or center, during ambulance transportation, and upon arrival at the emergency department (ED) as well as the initial diagnostic measures in the ED. Subsequently, the recommendations related to the criteria for categorizing patients into low,intermediate and high-risk groups are presented. The guideline addressed primary treatment measures for ACS patients in hospitals with and without code 247 or having primary percutaneous coronary intervention (PCI) facilities, and the appropriate timing for PCI based on the risk assessment. In addition, the most efficacious antiplatelet medications for ACS patients in the ED as well as its optimal duration of treatment are presented. The guideline details the recommendations for therapeutic interventions in patients with ACS and acute heart failure, cardiogenic shock, myocardial infarction with nonobstructive coronary arteries (MINOCA), multivessel occlusion, as well as the indication for prescribing a combined use of anticoagulants and antiplatelet during hospitalization and upon discharge. Regarding secondary prevention, while emphasizing the referral of these patients to rehabilitation centers, other interventions that include pharmaceutical and nonpharmacological ones are addressed, In addition, necessary recommendations for enhancing lifestyle and posthospital discharge pharmaceutical treatments, including their duration, are provided. There are specific recommendations and suggestions for subgroups, such as patients aged over 75 years and individuals with heart failure, diabetes, and chronic kidney disease. Conclusion: Developing guidelines for ACS diagnosis, treatment and secondary prevention according to the local context in Iran can improve the adherence of our health care providers, patients health, and policy makers plans. [ABSTRACT FROM AUTHOR]

BACKGROUND: The National Persian Registry of Cardiovascular Disease (N-PROVE) has been established to provide a comprehensive database of cardiovascular diseases in the Iranian community for further investigations and to develop national guidelines for the diagnosis, treatment, and prevention of cardiovascular disease (CVD). As with most clinical registries, a quality control audit is necessary to ensure a comprehensive and accurate registry; the current study aims to assess the validity and quality of the N-PROVE/Angiography/Percutaneous Coronary Intervention (PCI) registry. METHODS: The current cross-sectional quality assessment study serves as an example of data quality assessment in N-PROVE on a sample of patients registered in the N-PROVE/Angiography/PCI registry since 2020. Accordingly, data of 194 patients, including comorbidities, angiography, and angioplasty characteristics, were collected from the N-PROVE/Angiography/PCI registry as the main database and reevaluated by a panel consisting of a cardiologist and two coronary intervention fellowships as a test database. RESULTS: The quality control of the population-based healthcare database, the N-PROVE/PCI, revealed that the average error rate in terms of comorbidities, angiography characteristics, angioplasty characteristics, and in total were 3.8%, 2.3%, 3%, and 3.03%, respectively. CONCLUSION: According to the findings of this study, the N-PROVE/PCI registry had an average error of less than 4% in the assessed dimensions, including comorbidities, angiography, and angioplasty characteristics. Therefore, this registry appears valid and may be used for contemporary epidemiological studies. [ABSTRACT FROM AUTHOR]

Objective: To identify ultra-processed foods (UPF) contribution to daily energy and nutrient intake in Iranians and examine whether UPF intake is associated with nutrient profile and diet quality.Design: In this cross-sectional study, a validated FFQ was used to evaluate usual dietary intake over the preceding year. NOVA system was applied to categorise foods based on their levels of processing. Diet quality was evaluated using the nutrient adequacy ratio (NAR), Nutrient Rich Food Index (NRF) and hybrid nutrient density.Setting: The LIPOKAP study conducted in five cities of Iran (Isfahan, Birjand, Bandar Abbas, Kermanshah and Shahrekord).Participants: A total of 1994 adults aged ≥18 years were recruited using stratified multistage random cluster sampling method.Results: UPF were responsible for 8·5 % of daily energy intake. In the adjusted model, UPF consumption was inversely associated with carbohydrate, protein, refined and whole grains, fibre, fruit and meat, but was positively linked to energy, total fat, saturated and trans fatty acids and cholesterol. Compared with those in the lowest tertile, individuals in the highest tertile of UPF had smaller NAR for Ca, Mg, Zn, Fe, phosphorus, thiamin, niacin, folate and vitamin C. Both NRF and hybrid nutrient density decreased when the share of daily energy intake from UPF increased.Conclusion: The higher consumption of UPF is associated with poorer diet quality and lower nutrient intake. It is recommended that UPF be replaced with minimally processed foods to improve diet quality and nutrient profile. [ABSTRACT FROM AUTHOR]

BACKGROUND: To investigate the effects of comprehensive, integrated interventions on dyslipidemia Knowledge and Practices (LIPOKAP) using population and high-risk approaches. METHODS: The baseline of this national, multicentric community trial was conducted on three groups: the general population (adults over the age of 18 and their children aged 6-18), patients with dyslipidemia and their caregivers, and health professionals (physicians, nurses, health providers, and health workers). The general population was selected using multi-stage random sampling, while patients and health professionalswere recruited using the consecutive sampling method. The research was carried out in urban and rural areas of five Iranian counties. The sampling method and sample size were similar in baseline and post-intervention surveys. Approximately 8-month intervention programs were carried out on the target groups, which generally included educational strategies. The intervention activities addressed the management, prevention, and control and were tailored to each target group, focusing on lifestyle and self-care. RESULTS: All questionnaires' content validity ratio, content validity index, and Cronbach's alpha were over 0.68, 0.83, and 0.73, respectively. We enrolled 2456 adults and 850 of their children, 3331 dyslipidemia patients, 1699 caregivers, and 1800 health professionals. CONCLUSIONS: The validity and reliability of all developed questionnaires that can examine knowledge and practice changes as a result of intervention activities were acceptable. [ABSTRACT FROM AUTHOR]

Background: There is limited evidence regarding the risk factors and nutritional patterns in patients with premature coronary artery disease (PCAD). This study aims to investigate the relationship between different dietary patterns and risk factors in patients with PCAD. Methods: This cross-sectional study was conducted on PCAD patients, including men younger than 55 years and women younger than 65 years, who underwent coronary angiography in the Angiography Department of the Shahid Mohamadi Hospital, Bandar Abbas, Iran. Anthropometric and clinical examination, demographic questionnaires, and containing dietary intake and physical activity questionnaires were filled for all participants. Results: The most prevalent risk factors for obstructive PCAD in the 65 selected patients were family history of coronary artery disease (CAD) (73%), hypertension (52%), and overweight/obesity (50%). Daily consumption of hydrogenated fats (P = 0.008) and high-fat milk (P < 0.001) were significantly higher in obstructive PCAD patients compared to non-obstructive and non-PCAD patients. Daily consumption of fruits was significantly higher in non-obstructive and non-PCAD patients compared to obstructive PCAD patients (P = 0.039). Conclusion: Family history of CAD, hypertension, and obesity were found to be the most common risk factors among obstructive PCAD patients. According to the findings, increased consumption of high-fat milk and hydrogenated fats may increase the risk of PCAD, whereas, daily consumption of fruits may reduce the risk of PCAD. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the association between demographic and socio-economic determinants of environmental tobacco smoke (ETS) at work and at home. Using baseline data from the Kong Cohort Study (KCS), the present prospective research was conducted among subjects between 40 and 70 years of age in Kong County of Hormozgan Province to calculate adjusted and crude odds ratios (ORs) at 95% confidence intervals (CIs) to test the independent association of ETS with determinants. multivariate analysis showed that men were exposed to ETS 12.5 times as much as women; rural residents were exposed to ETS at work 5 times as much as urban residents. Holding a university degree decreased the chances of exposure for 52% at work. Women were exposed to ETS 2 times as much as men at home. Rural residents were exposed to ETS at home 2 times as much as urban residents. The elderly (above 65 years) were exposed to ETS 60% less than the young (<45 years) at home. In the light of the present findings, it can be concluded that ETS determinants at home and at work differ significantly. In the Kong County, compared to the urban areas, people in the rural areas are at a higher risk of ETS exposure. [ABSTRACT FROM AUTHOR]