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Background: In recent years, several trials investigated the role of anti-inflammatory agents in reducing cardiovascular events. Trehalose is a natural disaccharide able to reduce inflammation by enhancing macrophage autophagic activity. This action has been demonstrated to attenuate atherosclerotic plaque development in various pro-atherogenic animal models. However, at present, no data about the efficacy of this compound in human subjects have been published. Methods: We performed a randomized, double-blind trial involving 15 patients with history of myocardial infarction and evidence of systemic inflammation (defined as C-reactive protein > 2 mg/L). The patients were randomly assigned, in 2:1 ratio, to receive either intravenous trehalose (15 g once weekly) or placebo for 12 weeks. The primary efficacy end-point was the change in arterial wall inflammation, assessed by quantifying 18F-FDG PET/CT uptake in carotid arteries and ascending aorta. Results: The MDS TBR change of the index vessel at 3-month follow-up was not significant in treatment and placebo groups. Furthermore, we could not demonstrate any significant difference between the trehalose group and control group in changes of cIMT from baseline to 3 months in the overall population. No significant changes in echocardiographic measurement were noted after trehalose treatment. Except for the change in urea level in placebo group (31.00 ± 6.59 vs. 25.60 ± 6.402 P = 0.038) no other changes were detected after treatment. Also, there was a significant difference between changes in alanine aminotransferase (ALT) trehalose and placebo groups. Conclusion: This was the first study that specifically assessed the effects of intravenous trehalose on atherogenesis in human subjects. Trehalose treatment was characterized by an optimal safety profile, but no significant reduction in arterial wall inflammation could be observed. This might be a consequence of the small sample size of this trial. Larger studies are needed to better assess the efficacy of this compound in this clinical context.

Orally administered curcumin has been found to have a moderate therapeutic effect on dyslipidemia and atherosclerosis. The present study was conducted to determine lipid-modulating and antiatherosclerosis effects of injectable curcumin in the rabbit model of atherosclerosis induced by a high cholesterol diet (HCD). New Zealand white male rabbits were fed on a normal chow enriched with 0.5% (w/w) cholesterol for 8 weeks. Atherosclerotic rabbits were randomly divided into three groups, including a control group receiving intravenous (IV) injection of the saline buffer, two treatment groups receiving IV administration of the injectable curcumin at low (1 mg/kg/week) and high (10 mg/kg/week) over 4 weeks. Plasma lipid parameters, including low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides (TG), and total cholesterol (TC) were measured. Aortic arch atherosclerotic lesions were assessed using hematoxylin and eosin (HE) staining. The low dose of curcumin significantly reduced plasma levels of TC, LDL-C, and TG by -14.19 ± 5.19%, -6.22 ± 1.77%, and - 29.84 ± 10.14%, respectively, and increased HDL-C by 14.05 ± 6.39% (p 0.05). High dose of curcumin exerted greater lipid-modifying effects, in which plasma levels of TC, LDL-C, and TG were significantly (p 0.05) decreased by -56.59 ± 10.22%, -44.36 ± 3.24%, and - 25.92 ± 5.57%, respectively, and HDL-C was significantly increased by 36.24 ± 12.5%. HE staining showed that the lesion severity was lowered significantly in the high dose (p = 0.03) but not significantly (p 0.05) in the low-dose curcumin groups, compared to control rabbits. The median (interquartile range) of plaque grades in the high dose and low dose, and control groups was found to be 2 [2-3], 3 [2-3], and 4 [3-4], respectively. The injectable curcumin could significantly improve dyslipidemia and alleviate atherosclerotic lesion in HCD-induced atherosclerotic rabbits.

Orally administered curcumin has been found to have a moderate therapeutic effect on dyslipidemia and atherosclerosis. The present study was conducted to determine lipid-modulating and antiatherosclerosis effects of injectable curcumin in the rabbit model of atherosclerosis induced by a high cholesterol diet (HCD). New Zealand white male rabbits were fed on a normal chow enriched with 0.5% (w/w) cholesterol for 8 weeks. Atherosclerotic rabbits were randomly divided into three groups, including a control group receiving intravenous (IV) injection of the saline buffer, two treatment groups receiving IV administration of the injectable curcumin at low (1 mg/kg/week) and high (10 mg/kg/week) over 4 weeks. Plasma lipid parameters, including low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides (TG), and total cholesterol (TC) were measured. Aortic arch atherosclerotic lesions were assessed using hematoxylin and eosin (H&E) staining. The low dose of curcumin significantly reduced plasma levels of TC, LDL-C, and TG by −14.19 ± 5.19%, −6.22 ± 1.77%, and − 29.84 ± 10.14%, respectively, and increased HDL-C by 14.05 ± 6.39% (p 0.05) in the low-dose curcumin groups, compared to control rabbits. The median (interquartile range) of plaque grades in the high dose and low dose, and control groups was found to be 2 [2-3], 3 [2-3], and 4 [3-4], respectively. The injectable curcumin could significantly improve dyslipidemia and alleviate atherosclerotic lesion in HCD-induced atherosclerotic rabbits.

Introduction: Platelets activation and aggregation play a major role in thrombosis formation of coronary arteries in patients with Acute Coronary Syndrome (ACS) and is responsible for most ischemic complications during PCI. There is little information on the benefits and side effects of intracoronary and intravenous injection of Eptifibatide ,a potent antiplatelet agent; therefore, this study was performed with aim to compare coronary blood flow velocity by measurement of TIMI frame count in intravenous versus intracoronary bolus administration of Eptifibatide during PCI in ACS patients. Methods: This non-randomized clinical trial study was performed on 103 patients with acute coronary syndromes who referred to the cardiac emergency ward of Ghaem hospital, Mashhad University of Medical Sciences, and were candidates for urgent coronary angiography and PCI. 48 cases received intracoronary bolus Eptifibatide and 55 intravenous Eptifibatide. TIMI Frame Count and Corrected TIMI Frame Count were used to compare the effect of these two methods on coronary blood flow velocity. Data were analyzed by SPSS software (version 22). To compare the quantitative variables in the two groups, according to the distribution of variables, the T test was used if it was normal or the Mann-Whitney test was used if it was not normal. Chi-square test was also used to compare qualitative variables in two groups. P

Pulmonary prosthetic valve thrombosis is a serious and rare complication with high mortality. Using reteplase for treatment of prosthesis thrombosis is rarely reported. We report the first case in Iran of a thrombosed pulmonary valve in a patient who had undergone repair of tetralogy of Fallot, which was successfully treated twice with intravenous thrombolytic therapy with reteplase.

Background: Patients with Contrast-Induced-Nephropathy (CIN) are at a greater risk of in-hospital complications, longer hospitalization, and long-term mortality in comparison with those without CIN. Despite many studies on the helpful effects of statins in preventing contrast-nephropathy, there is not enough evidence comparing different statins in inhibiting CIN. So, we planned this study to compare the efficacy of rosuvastatin and atorvastatin in prevention of contrast-induced nephropathy. Methods: This was a randomized clinical trial. The efficacy of two known statins, atorvastatin and rosuvastatin were compared in prevention of CIN in patients with ST-Elevation Myocardial Infarction (STEMI) who underwent Primary Percutaneous Intervention (PPCI) between May 2015 and April 2016 in Qaem and Imam Reza hospital, Mashhad, Iran. Subjects were divided randomly to 80-mg atorvastatin or 40-mg rosuvastatin group before PPCI. Participants’ characteristics including echocardiographic, laboratory and demographic data were recorded and incidence of CIN was assessed. Results: Two hundred cases with STEMI undergoing PPCI were recruited in the study and randomized to 80-mg atorvastatin (n = 98) or 40-mg rosuvastatin (n = 102) group before PPCI. The incidence of CIN was 5.67% (n = 13) in all participants; 6.3% (n = 7) in the rosuvastatin group and 5.1% (n = 6) in the atorvastatin group. There was a significant difference between creatinine and Glomerular Filtration Rate (GFR) after 48 hours of PPCI. Creatinine was lower and GFR was higher in the rosuvastatin group (P = 0.029, P = 0.005). Conclusion: There was a little trend for prevention of CIN in patients after PPCI in rosuvastatin group compared to atorvastatin group, in full dose. However, this preference was not clinically relevant.

The pathophysiology of coronary arteries slow flow phenomenon is related to the microvascular and endothelial disorder. The role of copper and selenium in the development of microvascular and endothelial disorders, as well as atherosclerosis, has been proven in previous studies. The aim of this study was to evaluate the serum copper and selenium concentrations in patient with coronary slow flow phenomenon to find a probable relationship between them. In this study, 125 patients who referred to Ghaem Hospital in Mashhad for angiography were selected based on entry and exit criteria. Patients were divided into 5 groups according to the results of angiography. Blood samples of these patients were evaluated about the levels of copper and selenium. Finally the correlation between these levels and the intensity of coronary arteries slow flow (based on TIMI scores) was evaluated. In the present study, serum selenium and copper concentrations did not show a significant correlation with the intensity of coronary arteries slow flow (P>0.05). In the present study, no significant correlation was found between copper and selenium serum concentrations and coronary arteries slow flow based on TIMI. Further studies are recommended to investigate this association.

Contrast-induced nephropathy (CIN) is the most common cause of iatrogenic acute kidney injury. It is happened more commonly in patients with underlying kidney diseases. It is appeared that the oxidative stress is the main mechanism of contrast nephropathy. Curcumin is suggested as an herbal antioxidant agent, so we decided to assess the effect of curcumin in preventing of this complication in patients with underlying chronic kidney disease (CKD) who need coronary angiography.We conducted double blind, placebo-controlled clinical trial in 60 moderate to severe CKD patients who underwent coronary angiography or angioplasty. Adjusted dose of Iodixanol was used as contrast agent in all of them. Curcumin or placebo administered orally, 1.5 g daily from 2 days before procedure to 3 days after it. CIN was defined by an increased serum creatinine level≥0.3mg/dl or an increase to ≥1.5 times of the baseline within 48 hours after procedure. Urinary NGAL test was also done the next day after angiography.CIN occurred in 12(20%) of patients, 5(16.7%) in Curcumin group and 7(23.3%) in placebo group (odds ratio [OR], 0.56; 95% confidence interval [CI], 0.18 to 2.36; P0.51). Serum Creatinine was increased after72 hours of intervention from 1.65±0.26 mg/dl to 1.79±0.33 mg/dl in Curcumin group and from 1.61±0.23 mg/dl to 1.86±0.35 in placebo group. There is no significant difference between the mean increase in serum creatinine concentration in the placebo group and Curcumin group (difference of 0.006 mg/dL; 95% CI, - 0.06 to 0.08; P0.85). Urinary NGAL test was significantly higher in patients with AKI (p=0.000), but there weren't differences in its level in two groups (p=0.761) Conclusion: It is appeared prophylactic oral Curcumin hasn't protective effects on CIN in high risk patients who have undergone coronary procedure.

Background Cardiovascular disease is the most common cause of mortality and morbidity in diabetic patients. Insulin resistance has been shown to be reduced by the secretion of irisin from muscle and adipose tissues. This study was aimed at determining the relationship between serum irisin levels and angiographically defined coronary artery disease (CAD) in type II diabetic patients. Methods In this case-control study, 30 diabetic subjects with angiographically defined CAD were compared with 30 age- and sex-matched diabetic subjects without CAD in terms of clinical and laboratory parameters including serum irisin levels. Results Serum levels of Irisin were significantly higher in the diabetic group without CAD compared with the group with CAD (P = 0.048). Serum irisin levels showed a significant positive correlation with BMI (r = 0.374, P = 0.004) and fasting insulin (r = 0.303, P = 0.021), and a significant negative correlation with diabetes duration (r = −0.384, P = 0.002). Based on the results of the binary logistic regression model, circulating levels of irisin were associated with the presence of CAD in diabetes (p = 0.038) after adjusting for potential confounders. Conclusion Serum irisin levels were lower in the diabetic patients with cardiovascular complication compared with the uncomplicated diabetic patients. Therefore, additional larger scale studies are needed to determine the role of irisin in monitoring CAD in diabetic patients.

Mostafa Ahmadi,1 Ramin Khameneh Bagheri,1 Faeze Keihanian,2,3 Amin Saeidinia4 1Atherosclerosis Prevention Research Center, Imam Reza Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran; 2Pharmaceutical Research Division, Booali Research Center, Mashhad University of Medical Sciences, Mashhad, Iran; 3Cardiology Department, Imam Reza and Qaem Hospitals, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran; 4Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Background: Although there is ongoing progress in coronary artery-bypass graft (CABG) surgery and percutaneous coronary intervention techniques and supplies, the risk of cardiac complications remains high compared with the normal population. Aim: In this study, our aim was to compare fluoroscopy times in engagement of three different catheters in saphenous vein grafts (SVGs) in post-CABG patients undergoing angiography. Methods: This was a single-center, cross-sectional, comparative study. We evaluated patients with previous CABG referred for invasive coronary diagnostic angiography. Patients having had SVG–obtuse marginal artery, SVG–diagonal, and SVG–posterior descending artery CABG were included. All patients underwent diagnostic angiography by each of a right diagnostic Judkins catheter, right modified Amplatz catheter, and right guiding Judkins catheter. Demographics and clinical history of patients and fluoroscopy time in different groups were evaluated. Results: A total of 61 patients were evaluated. The distribution of baseline characteristics in the three groups of our study was normal. Mean fluoroscopy time in SVG–obtuse marginal artery was 25.70±6.70 seconds in group A, 22.23±6.51 seconds in group B, and 17.35±7.82 seconds in group C. Mean total fluoroscopy time was 86.35±16.28 seconds in group A, 73.80±10.00 seconds in group B, and 51.90±10.22 seconds in group C, which was significant (P

Heart failure is a major public health concern and one of the most common reasons for a cardiac hospital admission. Heart failure may be classified as having a reduced or preserved ejection fraction and its severity is based on the symptom score. Given the aging population, it is predicted that admissions with heart failure will increase. Whilst pharmacological therapy has improved the associated morbidity and mortality, there is a need for additional therapies to improve the clinical outcome as the death rate remains high. Curcumin is a natural product derived from turmeric that appears to have cardiovascular benefit through a number of mechanisms. In this review, we have assessed the mechanisms by which curcumin may exert its effects in different models of heart failure and show that it has promise as a complementary treatment in heart failure.

Atherothrombotic cardiovascular disease is a major cause of mortality throughout the world. Platelet activation and aggregation play a central role in hemostasis and thrombosis. Herbal medicines have been traditionally used in the management of cardiovascular disease and can help in modifying its progression, particularly in hemostasis and the coagulation process, as well as altering platelet function tests and some coagulation parameters. Curcumin is a polyphenol derived from the Curcuma longa plant and has been used extensively in complementary and alternative medicine, as it is nontoxic and safe with various therapeutic properties. Modern scientific research has demonstrated its anti-inflammatory, antioxidant, anti-carcinogenic, antithrombotic, and cardiovascular protective effects. The present study reviewed previous studies in the literature, which support the positive activity of curcumin in hemostasis, anticoagulation, and fibrinolysis. We also presented molecular mechanisms associated with the antiplatelet and anticoagulant activities of curcumin and potential implications for the treatment of cardiovascular disease.

Background: Dobutamine stress echocardiography (DSE) is a non-invasive technique to detect coronary artery diseases (CAD). There are limited studies on evaluation of the right ventricular function by stress echocardiography. The appropriate evaluation of RV function and early diagnosis of its failure can help to improve outcomes for the patients undergoing cardiac surgery. Objective: To determine right ventricular dysfunction in patients with three-vessel CAD by using DSE. Methods: This cross-sectional study was among 13 patients who were candidates for coronary artery bypass grafting (CABG) referred to Ghaem Hospital, Mashhad, Iran; from September 2015 to May 2016. After a physical examination and initial measures, DSE was performed and echocardiographic parameters were recorded by a cardiologist. Paired-samples t-test was performed using SPSS Software v.16.0 for data analysis. Results: The study included 13 patients (9 males) with a mean age of 65.4±7.6 years. The mean of TAPS was 16.9±4.5 mm and 15.7±2.9 mm before and after stress echocardiography, respectively (p=0.69). Systolic right ventricular (SRV) peak increased from before DSE compared with after DSE (8.0±2.2 vs. 13.7±4.2 mm/s, p