Search

Tea leaves and their infusion have been interested in the populations because of their therapeutic and relaxing effects. However, tea plant is prone to heavy metals' bioaccumulation. Regarding the high consumption of tea infusion, concentration of arsenic, cadmium, and lead in black tea infusion was determined by inductively coupled plasma mass spectrometry. Tea infusion was prepared by addition of 45 mL deionized water to 1 g tea leaves followed by heating at 90°C for 10 min. After analysis, carcinogenic and noncarcinogenic risks of heavy metals were investigated by Monte Carlo simulation in two age groups of children and adults younger and older than 15 years old, respectively. According to the results, Hazard Quotient (HQ) of three heavy metals in both children and adults was equal and lower than 0.01. Furthermore, incremental lifetime cancer risk (ILCR) of arsenic in Iranian black tea consumers (<1.5 × 10−6) and lead in all consumers (about 2.55 × 10−7) was within the acceptable range introduced by US EPA (≤10−6). ILCR of arsenic in children and adults consuming foreign tea infusion was within the range of 10−6–10−4. Our further investigation revealed that the highest area (75%–85%) of cumulative frequency distribution for arsenic ILCR in foreign tea consumers was related to ILCR ≤10−5 which is the acceptable range determined by the World Health Organization. Therefore, there was no serious concern about the intake of heavy metals by tea infusion in Iranian children and adults. [ABSTRACT FROM AUTHOR]

Introduction: This study was aimed to evaluate the sex-based differences in baseline characteristics and one-year outcomes of men and women undergoing mitral valve repair for infective endocarditis. Methods: This cross-sectional study was performed at Imam Ali Hospital affiliated with the Kermanshah University of Medical Science. From March 21, 2014, to October 21, 2021, all patients who underwent mitral valve repair for infective endocarditis were enrolled in this study. Data were obtained using a checklist developed based on the study’s objectives. Independent samples t-tests, paired samples t-tests, and chi-squared test (or Fisher’s exact test) were used to assess the differences between subgroups. Results: Of 75 patients, 26 were women (34.7%) and 49 were men (65.3%). Women were more likely to have diabetes mellitus (20.4% vs. 57.7%, P=0.0001), hypertension (49% vs. 80.8%, P=0.007), and hypercholesterolemia (55.1% vs. 80.8%, P=0.027). Conversely, men were more likely to have a history of smoking (38.8% vs. 7.7%, P=0.004). After one year, women had significantly higher mortality (0% vs. 7.7%, P=0.049), major adverse cardiac and cerebrovascular events (51.0 vs. 76.9, P=0.029), mitral valve reoperation (8.1% vs. 34.6%, P=0.003), and treatment failure (30.6% vs. 61.5%, P=0.009) rates than men. Conclusion: Mortality, major adverse cardiac and cerebrovascular events, mitral valve reoperation, and treatment failure rates were higher in women than in men. The worse outcomes in women may be explained by their more adverse clinical risk profile. [ABSTRACT FROM AUTHOR]

Copyright of Acta Facultatis Medicae Naissensis is the property of Nis University, Faculty of Medicine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: Contrast-induced nephropathy is one of the most common adverse consequences of contrast media use. The purpose of this study was to investigate the efficacy of pentoxifylline to prevent contrast-induced nephropathy in patients undergoing percutaneous coronary intervention. Methods: This prospective, single-blind, quasi-experimental study was performed on 68 patients with ST-elevation myocardial infarction who were admitted for percutaneous coronary intervention at Imam Ali Hospital, affiliated with Kermanshah university of medical science (KUMS), Kermanshah province, Iran. Patients were assigned randomly to the control (n = 34) and pentoxifylline (n = 34) groups. Normal saline 0.9% at 0.5-1 mL/kg/h was prescribed from 12 hours before to 12 hours after angioplasty. Pentoxifylline was prescribed at a dose of 400 mg 3 times per day from 24 hours before to 48 hours after angioplasty. Serum creatinine level was measured for both groups at the time of referral and after 72 hours of angioplasty. Independent samples t-tests, chi-square test, and Fisher’s exact test were used to assess the differences between groups. Results: No significant difference was found between the 2 groups regarding demographic and baseline clinical characteristics. The mean serum creatinine level (time of referral) was 1.52 ± 0.11 mg/dL and 1.55 ± 0.14 mg/dL in pentoxifylline and control groups, respectively (P = .999). Seventy-two hours after angiography, the mean serum creatinine level was 1.54 ± 0.13 mg/dL and 1.56 ± 0.17 mg/dL in pentoxifylline and control groups, respectively (P = .999). We found that contrast-induced nephropathy occurred in 7 patients (10.3%); 4 controls (11.8%), and 3 patients (8.8%) in the pentoxifylline group, which was not significantly different between the 2 groups (P = .690). Conclusion: The findings of the current study showed that oral administration of pentoxifylline to patients at higher risk for developing contrast-induced nephropathy undergoing coronary angioplasty may decrease the occurrence of contrast-induced nephropathy, but this decrease is not statistically significant. [ABSTRACT FROM AUTHOR]

Background: Retroperitoneal Hematoma (RPH) is one of the most serious complications after Intra-Aortic Balloon Pump (IABP) insertion. Although advances in clinical experience regarding IABP insertion have led to a decrease in vascular complications such as RPH, its rate has remained considerably high. Objectives: This study aimed to evaluate the factors predicting RPH following IABP insertion site injury. Methods: This retrospective cohort study of 2508 patients undergoing off-pump Coronary Artery Bypass Graft (CABG) surgery over 4.5 years allowed the identification and evaluation of all patients with RPH. The patients were divided into with RPH and without RPH groups. RPH prediction was analyzed by multivariate stepwise logistic regression analysis. SPSS, version 22 (SPSS Inc., Chicago, IL) was used for statistical analysis. Results: RPH developed in 16 patients (overall prevalence: 0.63%), with the highest frequency in low ejection fraction patients (3%). Female gender, compartment syndrome, IABP insertion site, preoperative Clopidogrel usage, use of post-operative inotropic drugs, and body surface area were the predictors of RPH in multivariate analysis. Moreover, in-hospital mortality was significantly higher in the patients who had developed RPH compared to those who had not (50% vs. 1.9%, P = 0.004). Conclusions: RPH is a serious vascular access site complication of IABP, which has been associated with high morbidity and mortality. The current study findings indicated that such factors as female gender, BSA, IABP insertion site, preoperative Clopidogrel usage, IABP usage, and post-operative inotrope drugs use could predict RPH. Identification of RPH risk factors could in turn prevent this problem. [ABSTRACT FROM AUTHOR]

BACKGROUND: Circadian variation is known as an important factor in acute myocardial infarction (AMI). Moreover, the circadian pattern may help in disease prevention and better medication prescription. Therefore, the aim of our study was to investigate the circadian pattern of symptom onset in patients with ST-segment elevation myocardial infarction (STEMI). METHODS: This cross-sectional study was conducted on 777 patients admitted to the Imam Ali Cardiovascular Center, Kermanshah, Iran, with a diagnosis of STEMI from March 2018 to February 2019. Data were collected using a checklist developed based on the study's objectives. Differences between subgroups were assessed using one-way analysis of variance (ANOVA) with post-hoc testing and chi-square test (or Fisher's exact test). RESULTS: Out of the 777 patients, 616 (79.3%) were men. The mean and standard deviation (SD) of age of the patients was 60.93 ± 12.86 years. 380 patients (48.9%) were current smoker, 40.3% were hypertensive, 21.1% had hypercholesterolemia, 18.3% had diabetes mellitus (DM), 25.2% had history of angina, and about 15.0% had history of myocardial infarction (MI). The occurrence of STEMI was most common during hours between 06:01-12:00 (27.7%), followed by 12:01-18:00 (27.3%), 00:00-06:00 (24.3%), and 18:01-24:00 (20.7%), respectively. Gender was significantly associated with circadian pattern of STEMI. Women showed a double peak of symptom onset in 06:01-12:00 and 12:01-18:00. CONCLUSION: The present study of Iranian patients displayed circadian pattern of STEMI with 2 peaks in the morning and afternoon, and the both peaks were dominated by women. [ABSTRACT FROM AUTHOR]

Background: Little is known about the predictors of left ventricular ejection fraction (LVEF) --an important predictor of mortality-- after primary percutaneous coronary intervention (PCI) in low- and middle-income countries. Methods: In a prospective cohort study at Imam Ali hospital, Kermanshah, Iran, we enrolled consecutive ST-elevation myocardial infarction (STEMI) patients treated with primary PCI (2016-2018) and followed them up to one year. LVEF levels were measured by echocardiography, at baseline and one-year follow-up. Determinants of preserved/improved LVEF were assessed using multivariable logistic regression models. Results: Of 803 patients (mean age 58.53±11.7 years, 20.5% women), baseline LVEF levels of ≤35% were reported in 44%, 35-50% in 40%, and ≥50% in 16% of patients. The mean ± SD of LVEF increased from 38.13%±9.2% at baseline to 41.49%±9.5% at follow-up. LVEF was preserved/improved in 629 (78.3%) patients. Adjusted ORs (95% CIs) for predictors of preserved/improved LVEF showed positive associations with creatinine clearance, 1.01 (1.00-1.02) and adherence to clopidogrel, 2.01 (1.33-3.02); and inverse associations with history of myocardial infarction (MI), 0.44 (0.25-0.78); creatine kinase MB (CK-MB), 0.997 (0.996-0.999); door-balloon time (3rd vs. 1st tertile), 0.62 (0.39-0.98); number of diseased vessels (2 and 3 vs. 1: 0.63 (0.41-0.99) and 0.58 (0.36-0.93), respectively); and baseline LVEF (35-50% and ≥50% vs. ≤35%: 0.45 (0.28-0.71) and 0.19 (0.11-0.34), respectively). Conclusion: Adherence to clopidogrel, short door-balloon time, high creatinine clearance, and lower baseline LVEF were associated with preserved/improved LVEF, while history of MI, high CK-MB, and multi-vessel disease were predictors of reduced LVEF. Long-term drug adherence should be considered for LVEF improvement in low- and middle-income countries. [ABSTRACT FROM AUTHOR]

Background: Acute Myocardial Infarction (AMI) is the leading cause of global mortality. Moreover, Left Ventricular Ejection Fraction (LVEF) is the most important predictor of post-AMI mortality. Thus, the present study aimed to investigate the relationship between smoking cessation and LVEF following one year from the STEMI., Method: The present study was a part of the Kermanshah STEMI Registry and included 825 smokers admitted to Imam Ali Hospital, Kermanshah, Iran, with AMI during a 2-year study period. Data collection was performed using the standardized case report form by the European Observational Registry Program (EORP). Moreover, multiple logistic regression was used to compare LVEF between the patients who had quit smoking post-AMI and those who were still smokers after one year. Also, one-to-one Propensity Score Matching (PSM) was used to reduce the assessment error and selection bias, increase the result accuracy, and minimize the effects of confounders on the LVEF-smoking relationship., Results: Following one year after AMI, 219 (26.55%) patients had quit smoking, while 606 (73.45%) still smoked. Using the PSM, a total of 168 ex-smokers were matched to 168 current smokers. Moreover, it was shown that LVEF was higher in current smokers compared to ex-smokers. However, the difference was not significant. Also, multiple logistic regression showed that the Odds Ratio (OR) of LVEF reduction was insignificantly higher in ex-smokers (OR=1.13; 95% CI: 0.98-1.29) compared to current smokers. Multivariate regression analysis found similar results even after the application of PSM (OR = 1.02; 95% CI: 0.82-1.22)., Conclusions: Given the low rate of smoking cessation after MI, physicians are recommended to ask about the smoking status of MI patients at each office visit or re-admission and strongly recommend quitting smoking., (© 2023 Isfahan Cardiovascular Research Center & Isfahan University of Medical Sciences.)

Background: Obesity is strongly associated with increased cardiovascular diseases (CVD) and cardiovascular risk factors, such as diabetes mellitus, hypertension, and dyslipidemia. However, numerous studies have suggested the existence of an "obesity paradox" in which overweight and mildly obese patients often exhibit a better outcome than their leaner counterparts. Therefore, this study aimed to characterize the association between BMI and in-hospital and one-year outcomes., Method: This hospital-based research was conducted as a part of the Kermanshah STEMI Registry. Following the application of inclusion criteria, a total of 2,397 STEMI patients were evaluated. The data were collected using a standardized case report developed by the European Observational Registry Program (EORP). Body mass index (BMI) (kg/m 2 ) was classified into underweight (<18.5), normal weight (18.5-24.9), overweight (25-29.9), class I/mild obese (30-34.9), and class II/extreme obese (≥35) categories. The independent predictors of the in-hospital and one-year outcomes were assessed using multivariable logistic regression models., Results: Out of the 2397 patients, 43 (1.79%) were underweight, 934 (38.97%) were normal, 1038 (43.30%) were overweight, 322 (13.43%) were class I obese, and 60 (2.50%) were class II obese. The results of the crude analysis showed that class I obesity was protective against CV death (OR 0.50; 95% CI 0.30-0.84), MACE3 (MI, stroke, and death) (OR 0.47; 95% CI 0.29-0.76), and MACE5 (MACE3 plus unstable angina and heart failure) (OR 0.59; 95% CI 0.44-0.79)., Conclusions: Multivariate adjustment eliminated the protective effect of class I obesity against death and MACE events. Therefore, it is possible that this protective effect does not exist and instead reflects the impact of confounding variables such as age., Competing Interests: The authors have no conflict of interest to declare., (© 2023 Isfahan Cardiovascular Research Center & Isfahan University of Medical Sciences.)