Association of Paraoxonase-1 Genotype and Phenotype with Angiogram Positive Coronary Artery Disease

Funding Information: This study was supported by Mashhad and Isfahan University of Medical Sciences. The authors would like to thank technicians of Sina, Sadi, Ghaem catheterization laboratory and technicians of Isfahan Alzahra genetics laboratory.Peer reviewedPublisher PD

Nicorandil in patients with acute coronary syndrome and stable angina undergoing Percutaneous Coronary Intervention: literature review

Percutaneous coronary intervention is an option for the treatment of coronary artery disease such as acute coronary syndrome and stable angina.Acute coronary syndrome has two groups including acute myocardial infarction and unstable angina.Periprocedural myocardial infarction is a frequent and prognostically important complication of percutaneous coronary intervention and can be easily monitored by measuring myocardial enzymes. Coronary microvascular dysfunction in patients undergoing primary percutaneous coronary intervention for the treatment of ST-segment elevation myocardial infarction is associated with poor prognosis. Even after recanalization, reperfusion injury often occurs including no-reflow or slow-flow in which sufficient myocardial blood flow cannot be obtained and results in a poor outcome of cardiac function in the long term.Nicorandil is the opener of the adenosine triphosphate-sensitive potassium channel and is known to have an antiarrhythmic effect and myocardial protective functions such as reduction of the coronary microvascular resistance by relaxing the smooth muscles of blood vessesl and preconditioning.In this literature review, we evaluate articles about acute coronary syndrome and stable angina undergoing PCI.

SUCCESS RATE OF PERCUTANEOUS CORONARY INTERVENTION IN PATIENTS WITH CHRONIC TOTAL OCCLUSION OF CORONARY ARTERIES

Abstract &nbsp;&nbsp; BACKGROUND: Chronic total occlusion of coronary arteries (CTO) remains one of the most challenging lesion subsets in interventional cardiology even with the development of medical devices and operator expertise. This study sought to determine the overall success rate of percutaneous coronary intervention (PCI) for this lesion in the center and to examine the relationship between variables such as patients&rsquo; characteristics, clinical risk factors, lesion characteristics and procedural success rate. &nbsp;&nbsp; METHODS: Clinical and coronary angiographic data of 58 patients with CTO who underwent PCI between May 2004 and November 2006 in Ghaem Hospital were retrospectively analyzed. A P value of less than 0.05 was considered statistically significant. Analyses were performed using the software packages SPSS (11.5 version). &nbsp;&nbsp; RESULTS: In this study, there were 58 CTO lesions in 41 men (70.7%) and 17 women (29.3%) with a mean occlusion time of 5 months. The overall success rate of PCI was 77.6%. There was no significant correlation between the success rate of PCI and the patient&rsquo;s age, sex, clinical risk factors, history of recent MI and duration of occlusion (P &gt; 0.05). The success rate was not affected by target vessel, location of lesion, presence of stump, presence of side branch at the site of occlusion and TIMI flow of artery (P &gt; 0.05). The success rate of PCI was decreased with increase in the length of occlusion and presence of bridging collaterals (P &lt; 0.05).&nbsp; &nbsp;&nbsp; CONCLUSION: The length of occlusion and presence of bridging collaterals affected the success rate adversely. Whereas the patients&rsquo; characteristics, clinical risk factors and other characteristics of coronary artery lesion had no statistically significant effect on success rate of PCI. Despite the technical difficulty of PCI in CTO lesions, this procedure can be done safely with relatively high success rate. &nbsp; &nbsp;&nbsp; Keywords: Chronic total occlusion (CTO), percutaneous coronary intervention (PCI), coronary arteries.</p

Global coronary arteries spasm in a young patient

BACKGROUND: Coronary artery spasm is a transient narrowing of coronary arteries that slows or stops blood flow through the artery. CASE REPORT: We present a 42-year-smoker man without any medical problem who developed syncope. Coronary angiography revealed diffuse significant narrowing of proximal left anterior descending artery (LAD), 90% osteal stenosis of large obtuse marginal (OM), 90% diffuse narrowing of proximal right coronary artery (RCA), which was relieved by intracoronary administration of nitrate. He was discharged on calcium channel blockers and nitrates but one month later developed syncope again and died. CONCLUSION: Multivessel coronary artery spasm should be considered in young smoker patients without any other coronary risk factors who present with syncope. &nbsp; Keywords: Syncope, Implantable Cardiac Defibrillators, Variant Angina&nbsp;</p

The effects of pentoxifylline administration on NFΚB P50 transcription factor expression

BACKGROUND: Pentoxifylline has anti-inflammatory properties and could suppress some inflammatory processes including tumor necrosis factor-alpha (TNF-&alpha;) production. We assessed the effects of a two-month administration of pentoxifylline on nuclear factor-kappa B (NF&kappa;B) pathways in patients with coronary artery disease (CAD) in which inflammatory pathways, especially NF&kappa;B transcription factors, have a critical role. &nbsp;&nbsp; METHODS: A double-blind randomized placebo-controlled study design was used. Forty CAD patients were randomized to either 2 months of pentoxifylline treatment (1200 mg/day) (n = 20) or placebo treatment (n = 20). Blood samples were obtained just before and after two months of treatment. P50 protein concentration in peripheral blood mononuclear cells (PBMCs) was measured by Enzyme Linked ImmunoSorbent Assay (ELISA) method. &nbsp;&nbsp; RESULTS: P50 concentration did not significantly change during two months of pentoxifylline administration. &nbsp;&nbsp; CONCLUSION: Longer pentoxifylline administration is needed to see its favorable effects on NF&kappa;B family elements. &nbsp; Keywords: Coronary Artery Diseases, Inflammation, NF&kappa;B, Pentoxifylline. &nbsp;</table

Effects of Nicorandil on the Clinical and Laboratory Outcomes of Unstable Angina Patients after Coronary Angioplasty

Introduction: Ischemic preconditioning mediated by potassium channels is a physiological protective mechanism, . It is hypothesized that Nicorandil, which is a potassium channel activator, could protect the heart via preconditioning. Materials and Methods:This clinical trial was conducted on 162 patients undergoing percutaneous coronary intervention (PCI) in Quem hospital, from Jan2013 to Jan 2014,patients  divided into two groups. The first group received standard treatment plus Nicorandil (10 mg, twice daily) for three days before and after angioplasty. The second group received standard treatment after PCI. Results: Cardiac enzyme levels were significantly lower in the Nicorandil group at 6 and 12 hours after angioplasty,(p value=0.001) while no significant differences were observed in the symptoms and four-month prognosis of the study groups(p value=0.8). Conclusion:It is recommended that a randomized clinical trial be conducted for the close evaluation of the effects of Nicorandil on unstable angina patients

Acute effect of treatment of mitral stenosis on left atrium function

Aim: Peak atrial longitudinal strain (PALS) is used to evaluate left atrium (LA) function in patients with mitral stenosis (MS), before and after percutaneous transmitral commissurotomy (PTMC) and mitral valve replacement (MVR). Methods: Patients with severe symptomatic MS, who were referred to our echocardiographic laboratory for a diagnostic examination before cardiac surgery or PTMC from October of 2014 to October of 2015, were included in the study. Result: The peak systolic global LA strain improved post-PTMC (P < 0.001) and post-MVR (P = 0.012). This difference was statistically highly significant. Conclusion: PALS is impaired in patients with severe symptomatic MS and improved acutely after treatment and may be a good indicator of LA function and may predict the right time for intervention on mitral valve

Acute effect of treatment of mitral stenosis on left atrium function

Aim: Peak atrial longitudinal strain (PALS) is used to evaluate left atrium (LA) function in patients with mitral stenosis (MS), before and after percutaneous transmitral commissurotomy (PTMC) and mitral valve replacement (MVR). Methods: Patients with severe symptomatic MS, who were referred to our echocardiographic laboratory for a diagnostic examination before cardiac surgery or PTMC from October of 2014 to October of 2015, were included in the study. Result: The peak systolic global LA strain improved post-PTMC (P < 0.001) and post-MVR (P = 0.012). This difference was statistically highly significant. Conclusion: PALS is impaired in patients with severe symptomatic MS and improved acutely after treatment and may be a good indicator of LA function and may predict the right time for intervention on mitral valve

Effect of Renal Artery Stenting on Blood Pressure, Glomerular Filtration Rate and Left Ventricular Mass in Hypertensive Patients with Severe Atherosclerotic Renal Artery Stenosis

Background Many small trials showed a significant improvement in blood pressure following renal artery stenting in patients with severe atherosclerotic renal artery stenosis, but data on renal function improvement is more conflicting. Recently, few trials have been conducted to evaluate the effect of this procedure on Left Ventricular Mass (LVM) and Left Ventricular Mass Index (LVMI). Objectives The aim of this study is to determine the effect of renal artery stenting on Blood Pressure, estimated Glomerular Filtration Rate (eGFR), Left Ventricular Mass (LVM), and Left Ventricular Mass Index (LVMI) in patients with severe atherosclerotic renal artery stenosis. Methods This is a prospective interventional study performed on forty patients with ischemic heart disease and medication resistant hypertension, who had severe (≥ 70%) atherosclerotic renal artery stenosis and underwent renal artery stenting. Blood pressure, LVM, LVMI and eFGR before renal artery stenting and after six months were assessed in these patients. Results There were significant reduction in systolic blood pressure (from 175.50 ± 17.28 mmHg to 137.30 ± 13.21 mmHg) (P < 0.001), and diastolic blood pressure (from 103.45 ± 8.91 mmHg to 84.30 ± 7.33 mmHg) (P < 0.001). Also, there were significant decrease in LVM (from 307.73 ± 108.13 g to 259.34 ± 92.17 g) (P = 0.004) and LVMI (from 174.70 ± 58.26 to 148.01 ± 49.77) (P = 0.004). LVM reduction was independent of SBP and DBP reduction (P = 0.376 and P = 0.196, respectively). Conclusions Renal artery stenting reduces Blood pressure and leads to regression of LVM independent of blood pressure reduction. Regardless of baseline eGFR, our study failed to find a significant increase in glomerular filtration rate

The effect of different factors on the size of radial and ulnar arteries

Background: Heart disease is still one of the leading causes of mortality in our country and coronary angiography is still one of the golden methods of diagnosis for heart disease.There has always been some influence of factors such as age, sex and BMI, history of diabetes, hypertension, and clinical and paraclinical factors on the size of the arteries. Aim: To evaluate the size of the radial and ulnar arteries and the factors affecting them in patients undergoing coronary angiography. Method: This cross sectional study was done on 178 patients candidate for angiography or angioplasty referred to Imam Reza and Ghaem Hospitals of Mashhad from 2014 to 2015. We estimated ulnar, radial and brachial arteries size via angiography with calibration software in SIEMENS angiography machine. We also used a questionnaire for demographic data. Result: One hundred seventy eight patients included in this study (Age: 59.71±12.08, 70 female and 108 male). There was no significant change about ulnar and radial size between sex and age parameters (P>0.05). The size of ulnar and radial arteries was significantly lower in diabetes and obese patients and higher in hypertensive groups (P< 0.05). We also reported the coronary anomalies and complications of the procedure. Conclusion: We concluded that hypertension, Diabetes and obesity can effect on radial and ulnar size as an access for angiography or angioplasty. © 2020 Lahore Medical And Dental College. All rights reserved