Correlation between overweightness and the extent of coronary atherosclerosis among the South Caspian population

Background: Reported effects of obesity on the extent of angiographic coronary artery disease(CAD) have been inconsistent. The present study aimed to investigate the relationships between the indices of obesity and other anthropometric markers with the extent of CAD. Methods: This study was conducted on 1008 consecutive patients who underwent coronary angiography. Body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR) were separately calculated for each patient. Extent, severity, and complexity of CAD were determined by the Gensini and SYNTAX scores. Results: According to the results, there was a significant inverse correlation between the SYNTAX score with BMI (r = - 0.110; P < 0.001), WC (r = - 0.074; P = 0.018), and WHtR (r = - 0.089; P = 0.005). Furthermore, a significant inverse correlation was observed between the Gensini score with BMI (r = - 0.090; P = 0.004) and WHtR (r = - 0.065; P = 0.041). However, the results of multivariate linear regression analysis did not show any association between the SYNTAX and Gensini scores with the indices of obesity and overweight. On the other hand, the patients with an unhealthy WC had a higher prevalence of diabetes mellitus (DM) (P = 0.004) and hypertension (HTN) (P < 0.001), compared to the patients with healthy values. Coexistence of HTN and DM was more prevalent in subjects with an unhealthy WC and WHR, compared to that in those with healthy values (P = 0.002 and P = 0.032, respectively). Conclusion: It seems that the anthropometric indices of obesity are not the predictors of the angiographic severity of CAD. However, they are associated with an increased risk of cardiovascular risk factors and higher risk profile. © 2020 The Author(s)

The role of topogram views on dose indices and image quality in thorax and abdomen-pelvis CT scan

This study was designed to investigate the effect of the different topograms (AP and dual AP/Lateral) on patient dose indices and image quality in thorax and abdomen-pelvis CT. Size-specific dose estimation (SSDE), volumetric CT dose index (CTDIvol), milliampere seconds (mAs), effective dose, as well as signal to noise ratio (SNR) and contrast to noise ratio (CNR) of 60 thorax and 60 abdomen-pelvis CT scans were analyzed. In thorax CT, SSDE, mAs, CTDIvol and effective dose were significantly reduced by using dual topograms (p  0.05). There was no significant difference between CNR parameter in the two groups for thorax CT (p > 0.05) and SNR parameter in abdomen-pelvic CT (p < 0.05) and all images were diagnostically acceptable. The use of two topograms in thorax CT is an efficient approach to reduce dose indices without decreasing the image quality

Remote ischemic preconditioning to reduce contrast-induced acute kidney injury in chronic kidney disease: a randomized controlled trial

Abstract Background The impact of contrast-induced acute kidney injury (CI-AKI) on patients with chronic renal disease is well-known. Remote ischemic preconditioning (RIPC) is a non-invasive method that can reduce the risk of CI-AKI, but studies on RIPC have had different results. The aim of the present study was to assess the potential impact of RIPC on CI-AKI. Methods In a randomized, double blinded, controlled trial, 132 patients with chronic renal dysfunction (glomerular filtration rate < 60 mL/min/m2) who underwent coronary angiography or angioplasty received adequate hydration. RIPC was performed in 66 patients by applying an upper arm blood pressure cuff. The cuff was inflated four times for 5 min to 50 mmHg above the systolic blood pressure, followed by deflation for 5 min. In the control group, the blood pressure cuff was inflated only to 10 mmHg below the patient’s diastolic blood pressure. The primary endpoint was an increase in serum cystatin C ≥ 10% from baseline to 48–72 h after exposure to the contrast. Results The primary endpoint was achieved in 48 (36.4%) patients (24 in each group). RIPC did not show any significant effect on the occurrence of the primary endpoint (P = 1). In addition, when the results were analyzed based on the Mehran risk score for subgroups of patients, RIPC did not reduce the occurrence of the primary endpoint (P = 0.97). Conclusions In patients at moderate-to-high risk of developing CI-AKI when an adequate hydration protocol is performed, RIPC does not have an additive effect to prevent the occurrence of CI-AKI. Trial registration The clinical trial was registered on (Identification number IRCT2016050222935N2, on December 19, 2016 as a retrospective IRCT)