The relationship between ultra processed food consumption and premature coronary artery disease: Iran premature coronary artery disease study (IPAD)

BackgroundUltra-processed foods (UPF) consumption may affect the risk of PCAD through affecting cardio metabolic risk factors. This study aimed to evaluate the association between UPFs consumption and premature coronary artery disease (PCAD).MethodsA case–control study was conducted on 2,354 Iranian adults (≥ 19 years). Dietary intake was assessed using a validated 110-item food frequency questionnaire (FFQ) and foods were classified based on the NOVA system, which groups all foods according to the nature, extent and purposes of the industrial processes they undergo. PCAD was defined as having an stenosis of at least single coronary artery equal and above 75% or left main coronary of equal or more than 50% in women less than 70 and men less than 60 years, determined by angiography. The odds of PCAD across the tertiles of UPFs consumption were assessed by binary logistic regression.ResultsAfter adjustment for potential confounders, participants in the top tertile of UPFs were twice as likely to have PCAD compared with those in the bottom tertile (OR: 2.52; 95% CI: 1.97–3.23). Moreover, those in the highest tertile of the UPFs consumption had more than two times higher risk for having severe PCAD than those in the first tertile (OR: 2.64; 95% CI: 2.16–3.22). In addition, there was a significant upward trend in PCAD risk and PCAD severity as tertiles increased (P-trend < 0.001 for all models).ConclusionHigher consumption of UPFs was related to increased risk of PCAD and higher chance of having severe PCAD in Iranian adults. Although, future cohort studies are needed to confirm the results of this study, these findings indicated the necessity of reducing UPFs intake

INVESTIGATING THE RELATIONSHIP BETWEEN SERUM PENTRAXIN3 LEVEL AND ANGIOGRAPHIC FINDINGS IN PATIENTS WITH CORONARY ANGIOGRAPHY

 Objective: Pentraxin3 (PTX3) is an inflammatory single-phase mononuclear polysorbate glycoprotein, synthesized by endothelial, macrophages, and mildew cells; based on reports and research findings, it is also believed to be synthesized in the tissue of atherosclerotic lesions of arterial arteries. Therefore, PTX3 can be considered as a more specific marker for atherosclerosis. The present study examines the relationship between PTX3 serum levels and coronary angiography findings.Methods: A total of 100 patients with stable cardiac status under elective coronary angiography were studied. Meanwhile, serum levels of PTX3 were measured, along with coronary angiography, in these patients. Finally, the relationship between the serum level of this marker and the severity of the angiographic findings of these individuals was compared and contrasted.Results: out of 100 patients examined in the present study, 57 subjects (57.6%) were male and 42 subjects (42.4%) were female. The mean age of participants turned out to be 53±9.16, and the mean serum level of PTX3 was 5.91±12.5. The mean serum level of PTX3 turned out to be lower in patients with normal angiography than in those with coronary artery disease (p<0.0001). Smoking and age did not affect the mean serum levels of this marker. Furthermore, a higher serum level of PTX3 was associated with a higher syntax score in the angiography (p<0.0001).Conclusion: Serum levels of PTX3 can have a predictive value in the diagnosis of coronary artery disease in patients with stable cardiovascular symptoms

No Relationship between Serum and Salivary β2-Microglobulin Levels in A Sample of Adult Diabetic Men with Chronic Kidney Disease without Renal Replacement Therapy

Objective: Β2-microglobulin (β2M) associated amyloidosis is an inevitable complication of chronic kidney disease (CKD). Testing β2M in the blood is invasive and expensive. On the other hand, oral fluid is a perfect medium to be explored for public health and disease surveillance. However, it has never been studied if salivary concentration of β2M reflects its concentration in the serum. The current study; therefore, aimed to examine the relationship between salivary and serum β2M in a sample of adult diabetic men with CKD. Materials and Methods: Among diabetic patients referred to the Nephrology Department of The Golestan Hospital of Ahvaz due to CKD, 40 men not requiring renal replacement therapy were consecutively recruited for this cross-sectional study. Patients were excluded if they had any disease or were using any drugs that might affect the oral mucosa or saliva. The concentration of β2M was measured in both serum and saliva. The correlation between serum and salivary β2M was measured by calculating spearman’s ρ. Results: The Spearman’s ρ for correlation between serum and salivary β2M was -0.017 (p=0.917), indicating lack of correlation. Serum and salivary creatinine (Spearman’s ρ=0.54; p value<0.001) as well as serum and salivary urea nitrogen levels (Spearman’s ρ=0.39; p value=0.014) were correlated. Conclusion: Salivary β2M levels poorly agreed with serum β2M levels, and thus may not be used as a surrogate for serum β2M in CKD patients who did not require replacement therap

Defining the at risk patients for contrast induced nephropathy after coronary angiography; 24-h urine creatinine versus Cockcroft-Gault equation or serum creatinine level

Background: Definitions of chronic kidney disease (CKD) in many catheterization laboratories have relied on the serum creatinine (Scr) rather than glomerular filtration rate (GFR). Regarding that CKD is the primary predisposing factor for contrast induced nephropathy (CIN), we compared the sensitivity of calculated GFR by 24-h Urine creatinine with Cockcroft-Gault (CG) equation and Scr level to define at risk patients for CIN who were undergone coronary angiography (CAG). Materials and Methods: Two hundred fifty four subjects who were candidate for CAG and had normal creatinine level were enrolled. Before CAG, GFR was calculated from a 24-h urine collection, CG equation and a single Scr sample regarding to previously described protocol. Contrast volume used for each case <100 ml. CIN was defined as a 0.5 mg/dL or 25% elevation in the Scr. Results : CIN occurred in 10.6%. Baseline GFR, the volume of contrast agent, and diabetes were the independent risk factors for CIN. GFR was less than 60 ml/min/1.73 m2 in 28% and 23.2% of patients regarding to 24-h urine creatinine and CG equation, respectively. In CIN prediction, 24-h urine creatinine estimated GFR had 85.2%, 59.3% and CG equation GFR had 78.9%, 81.1% sensitivity and specificity, respectively. Conclusion: Although, GFR estimated by CG equation has less sensitivity than GFR calculated from 24-h creatinine in CIN probability, but it is better than Scr alone and because of cost-effectiveness and convenience using of this method, we suggest at least using CG equation for GFR calculation before CIN, especially in diabetic and/or older than 60 years cases

The relationship between nut consumption and premature coronary artery disease in a representative sample of Iranians; Iran-premature coronary artery disease study (I-PAD)

Abstract Objective: The cardioprotective effects of nuts are well established. However, the positive impacts of nuts in preventing cardiovascular disease at a younger age, a condition known as premature coronary artery disease (PCAD), is still debated. Therefore, we aim to determine the association between nuts and PCAD occurrence and its severity in different Iranian ethnicities. Design: This case-control study was conducted within the framework of the IPAD, an ongoing multi-centric study on Iranian patients of different ethnicities. Setting: This multicentric case-control study was conducted in among 3253 persons under the age of 70 years in women and 60 years in men from different ethnicities in Iran. Participants: Information on nut consumption was collected using a validated food frequency questionnaire. Subjects were selected from among the candidates for angiography. Cases were those whose coronary angiography showed stenosis of more than 75% in at least one vessel or more than 50% of the left main artery, while the control group participants had normal angiography results. Results: In the crude model, compared to the first quartile, the highest quartile of nut consumption was significantly associated with a lower risk of PCAD (OR=0.26, 95% CI: 0.21, 0.32; P for trend= 0.001). In the top quartile of nut intake, a substantial decrease in PCAD was observed after controlling for putative confounders (OR = 0.32; 95% CI = 0.24, 0.43; P trend= 0.001). Additionally, a 75% decrease in the risk of severe PCAD was observed in the participants in the highest quartile of nut intake. Conclusion: A significant inverse association was observed between nut intake and the risk and severity of PCAD in the Iranian population. Large-scale clinical trials are required to confirm these findings

Ethnicity based differences in statin use and hypercholesterolemia control among patients with premature coronary artery disease-results of I-PAD study

Background: Statins use is the most important treatment for high LDL cholesterol in patients with premature coronary artery disease (CAD). Previous reports have shown racial and gender differences in statin use in the general population, but this wasn't studied in premature CAD based on different ethnicities. Methods and results: Our study includes 1917 men and women with confirmed diagnosis of premature CAD. Logistic regression model was used to evaluate the high LDL cholesterol control in the groups and the OR with 95% confidence interval (CI) was reported as the effect size. After adjustment for confounders, the odds of controlling LDL in women taking Lovastatin, Rosuvastatin, and Simvastatin were 0.27 (0.03, 0.45) lower in comparison with men. Also, in participant who took 3 types of statins, the odds of controlling LDL were significantly different between Lor and Arab compared with Fars ethnicity. After adjustment to all confounders (full model), the odds of controlling LDL were lower for Gilak in Lovastatin, Rosuvastatin, and Simvastatin by 0.64 (0.47, 0.75); 0.61 (0.43, 0.73); 0.63 (0.46, 0.74) respectively and higher for Arab in Lovastatin, Rosuvastatin, and Simvastatin by 4.63 (18.28, 0.73); 4.67 (17.47, 0.74); 4.55 (17.03, 0.71) respectively compared to Fars. Conclusions: Major differences in different gender and ethnicities may have had led to disparities in statin use and LDL control. Awareness of the statins impact on high LDL cholesterol based on different ethnicities can help health decision-makers to close the observed gaps in statin use and control LDL to prevent CAD problems

Ethnic differences in the lifestyle behaviors and premature coronary artery disease: a multi-center study

Background: Diverse ethnic groups that exist in Iran may differ regarding the risk factors such as hypertension, hyperlipidemia, dyslipidemia, diabetes mellitus, and family history of non-communicable disease. Premature Coronary Artery Disease (PCAD) is more endemic in Iran than before. This study sought to assess the association between ethnicity and lifestyle behaviors in eight major Iranian ethnic groups with PCAD. Methods: In this study, 2863 patients aged ≤ 70 for women and ≤ 60 for men who underwent coronary angiography were recruited in a multi-center framework. All the patients’ demographic, laboratory, clinical, and risk factor data were retrieved. Eight large ethnicities in Iran, including the Farses, the Kurds, the Turks, the Gilaks, the Arabs, the Lors, the Qashqai, and the Bakhtiari were evaluated for PCAD. Different lifestyle components and having PCAD were compared among the ethnical groups using multivariable modeling. Results: The mean age of the 2863 patients participated was 55.66 ± 7.70 years. The Fars ethnicity with 1654 people, was the most subject in this study. Family history of more than three chronic diseases (1279 (44.7%) was the most common risk factor. The Turk ethnic group had the highest prevalence of ≥ 3 simultaneous lifestyle-related risk factors (24.3%), and the Bakhtiari ethnic group had the highest prevalence of no lifestyle-related risk factors (20.9%). Adjusted models showed that having all three abnormal lifestyle components increased the risk of PCAD (OR = 2.28, 95% CI: 1.04–1.06). The Arabs had the most chance of getting PCAD among other ethnicities (OR = 2.26, 95%CI: 1.40–3.65). While, the Kurds with a healthy lifestyle showed the lowest chance of getting PCAD (OR = 1.96, 95%CI: 1.05–3.67)). Conclusions: This study found there was heterogeneity in having PACD and a diverse distribution in its well-known traditional lifestyle-related risk factors among major Iranian ethnic groups