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BACKGROUND: Today, the fractional flow reserve (FFR) guides the physician to select suitable patients with intermediate severity coronary lesions in angiography that should be treated or not with stent. The aim of this study was to evaluate the impact of using FFR in the selection of appropriate treatment strategy in angiographic intermediate coronary lesions and their short-term outcome in a sample of Iranian population. METHODS: In a prospective cohort, 34 patients who had intermediate coronary artery lesion(s), defined as having a 40-70% diameter stenosis, as determined by visual estimation or quantitative coronary angiography were enrolled through a convenience sampling method. All patients underwent FFR measurement to decide whether percutaneous coronary intervention should be performed. The results of visual assessment, quantitative coronary angiography, and functional assessment of the severity of coronary stenosis were compared. Significant stenosis was defined as FFR < 0.80. All patients were followed for 6 months for the incidence of major advanced cardiac events. RESULTS: In this study, 34 patients (22 male and 12 female) with mean age of 57 ± 8 (range 45-70) were included. In 26.47% (9/34) of patients, FFR was < 0.80, they underwent coronary angioplasty. The correlation between visual estimation and quantitative assessment of lesion diameter was 0.804 (P < 0.001). During the follow-up period, no major advanced cardiac events were reported. In addition, 5.88 (2/34) of patients had a left main (LM) lesion with FFR > 0.80 and stenting was done to the other vessels with significant coronary lesions. CONCLUSION: Measurement of FFR is a useful approach in making clinical decisions about revascularization procedures in patients with moderate coronary artery lesion severity, especially in LM and multivessel disease. This study showed that not only FFR can change treatment plan of the patients, but also it would improve clinical outcomes.

Background:Ischemic heart disease is the leading cause of mortality and morbidity in the world. Vascular inflammation is the noticeable risk factors of ischemic heart disease. In this study the relation between intravascular adhesion molecule (ICAM) and vascular adhesion molecule (VCAM) as inflammation indicator with extent of coronary involvement were evaluated. Methods: In this cross sectional study, 82 patients with stable angina who candidates for angiography were studied. Those with acute coronary syndrome, and recent surgery, inflammatory disease, some drug consumption, kidney and liver disease, Phlebitis and PTE are excluding from study. Then blood sampling for biochemical VCAM and ICAM analysis were drawn. After it, coronary angiography was done via standard method. Findings: Mean ages of the patients were 58.4 ± 10.1 year old with 72% male. The mean of ICAM and VCAM were 183.9 ± 78 and 150.3 ± 136 ng/dl, respectively. There isn’t any correlation between VCAM and ICAM and the severity of coronary artery disease. In linear regression analysis even with considering of hypertension, hyperlipidemia and diabetes as cofounders, there was not any relation between these factors and CAD. Conclusion:According to our findings, inflammatory markers (VCAM and ICAM) didn’t add any further information about extent of CAD. Key words:ICAM, VCAM, Stable angina, Severity of CAD.

Background:Drivers have a higher risk of cardiovascular disease and the frequencies of risk factors and IHD is prevalent among them. Methods: 176 bus drivers were participated in the study. Frequency of risk factors and Positive exercise stress test were evaluated. Findings: The average age of studied subjects was 47.47 years. The waist circumference in 23.19% of them was more than 102cm. The prevalence of obesity and overweight in drivers were 75.5% and 30.7% of them had hypertension and 60.2% were smoker. Exercise stress test was positive in 9.7% of drivers. Conclusion: Frequency of cardiovascular risk factors in drivers was considerably high. However, frequency of positive exercise stress test was not higher than other population in similar study. The reason of normal incidence of positive exercise stress test in drivers, despite the poorer risk profile, may be due to overall lower ischemic heart disease in Iranian population. key words: Exercise stress test, Risk factor, Driver.

BACKGROUND: In most studies, the agreeable risk scores for ST-elevation myocardial infarction (STEMI) consist of thrombolytic in myocardial infarction (TIMI) risk score and modified Gensini risk score. Researchers showed significant relations between TIMI with angiography scores in patients with UA/NSTEMI. We studied this relation in patients with STEMI. METHODS: We studied CCU patients with STEMI hospitalized in several hospitals of Isfahan, Iran from September 2007 to June 2008. Sampling method of 240 patients was random and simple. Exclusion criteria were incomplete history, nonspecific electrocardiogram changes, left bundle branch block and not accomplished angiography or accomplished angiography after 2 months of STEMI. Questionnaire indices collected on the basis of TIMI (0-14 points). Echocardiography and angiography were done and then, we used Gensini (0-400 points) to review films of angiography. Spearman`s rank test and Pearson correlation coefficient were used to study the relation between these scores. RESULTS: One hundred and sixty one patients were male and their average age was 60.02 years. Averages of TIMI and Gensini scores were 6.30 ± 2.5 and 120.77 ± 50.4, respectively. Study showed significant relation between TIMI, age and LVEF (P CONCLUSION: We may decide quickly and correctly in emergency room to distinguish which patients with STEMI could derive a benefit from invasive strategies using TIMI score. Also, TIMI risk score can be a good predictor to determine the extension of coronary artery disease in patients with STEMI. As a result, we suggest determination of TIMI score for any patient entered emergency room. Also, this score should be recorded at the time patient’s discharge. Keywords: TIMI Risk Score, Modified Gensini Risk Score, LVEF, STEMI.

Background: Excessive body fat is associated with increasing risk of ischemic heart disease (IHD). Some fat cell mediators such as adiponectin and leptin have been recognized as possible new IHD risk factors. We assessed the association of fat cell’s size and number, serum leptin and adiponectin with IHD. Methods: The study was designed as a “case control” study in 40 to 60 years old patients with ischemic heart disease symptoms underwent coronary angiography. The cases had significant stenosis in coronary angiography. The control subjects had normal angiography. Serum lipid levels, adiponectin, leptin, and insulin were examined in all cases and controls by Enzymayic method. The biopsies from abdominal and gluteal fat tissue regions were fixed and stained using the Hematoxilin-eosin method. Slides were photographed with a microscopic digital camera. Fat cell’s size and number were assessed using Image tool V3 software. Data were analyzed with SPSS software. Findings: There were no significant difference between cases and controls in fat cell’s size and number, serum leptin and adiponectin. However, serum leptin was correlated not only to waist circumference (r = 0.31, P = 0.036), but also to body mass index (r = 0.32, P = 0.033). Conclusion: Although Leptin and adiponectin are correlated with obesity and are introduced as IHD risk factors; they showed no association with ischemic heart disease in our study. More investigation is required to confirm this relationship in the Iranian population.