The effect of opium addiction on arrhythmia following acute myocardial infarction

The effect of opium addiction on the appearance of different types of arrhythmias after acute myocardial infarction (AMI) has been assessed in few studies. This study is aimed to determine the effect of opium on post-MI arrhythmia and also to address the differences in the appearance of different types of arrhythmias after AMI between opium addicted and non-addicted patients. In this comparative study, participants were classified into two groups with opium addiction (n=94) and without opium addiction (n=106). Post-MI arrhythmias were determined among each group. Study populations were included all patients with first AMI admitted within 6 hours of the onset of chest pain to coronary care units (CCU) of two teaching hospitals affiliated to Kerman University of Medical Sciences (KUMS) in the city of Kerman, Iran. Opium addicted subjects had significantly more frequency of arrhythmia than non-opium addicted subjects (80.9 vs. 22.6, respectively; P<0.001). Opium addiction was a strong predictor for the occurrence of post-MI arrhythmias in two models of crude analysis (crude OR=14.4, P<0.001) and after adjusting for potential confounder factors (adjusted OR = 21.9, P<0.001). The prevalence of sinus tachycardia, sinus bradycardia and atrial fibrillation in opium addicts were significantly higher than non opium addicts (P<0.05). The results of our study showed that opium addiction is a potential and strong risk for occurring post-MI arrhythmias. © 2012 Tehran University of Medical Sciences. All rights reserved

The Effect of Opium Addiction on Cardiac Arrhythmia after Acute Myocardial Infarction

Abstract: Background & Aims: This study was carried out to assess the effect of opium addiction on the incidence of different types of arrhythmias after acute myocardial infarction (AMI). Methods: The study population consisted of 200 patients with first AMI admitted within 6 hours of the onset of chest pain to the coronary care units (CCU) of two hospitals affiliated to Kerman University of Medical Sciences, Kerman, Iran. The participants were classified into two equal groups of with post-MI arrhythmias and without post-MI arrhythmias. Opium addiction in each group was determined. Results: In the group with post-MI arrhythmia, the most common arrhythmias were sinus tachycardia (15.2%), premature ventricular complex (12.5%) and ventricular tachycardia (12%). Opium addication was significantly (P<0.001) higher in patients with arrhythmia (76%) than in the group without arrhitmia (18%). Opium addiction was a strong predictor for the appearance of arrhythmias following AMI (OR = 14.66, P<0.001). The most common type of post-MI arrhythmia following opium use was premature ventricular complex (21.3%) followed by ventricular tachycardia (20%). The corresponding values of these two types of arrhythmia in non-addict group were respectively 4.7% and 5.6% (P<0.001). Conclusion: Although all AMI patients are at risk of arrhythmia and mortality due to it, opium-addicts are at higher risk. This emphasizes the necessity of early refeming to medical centers in these patients. Keywords: Myocardial infarction, Opium, Arrhythmias, Addictio

Assessing Time between Arriving to Hospital and Administration of Streptokinase in Patients with Acute Myocardial Infarction in Emergency Department of Kerman University of Medical Sciences in 2003-4

Abstract: Introduction: Acute myocardial infarction is one of the major causes of mortality in developing countries such as Iran. One of the most important progresses in acute myocardial infarction is early administration of therombolytic agents such as streptokinase. This study was performed to determine the time interval from patients’ referral to the emergency wards to the introduction of thrombolytic therapy and the factors associated with delay in drug administration. Methods: In a period of 8 months, 130 patients with presumed acute myocardial infarction were investigated. In order to determine the causes of delay in streptokinase administration, duration of symptoms onset to drug administration was divided into 4 specified periods and measured in minutes. Results were analyzed using ANOVA and t-test. Results: Findings showed a mean elapsed time of 298 minutes between pain onset and referring to the emergency ward, 73 minutes between patient’s arrival and streptokinase administration. Mean time from symptom onset to drug infusion was 370 minutes. There was a delay of 2 hours in drug administration in 18% of patients. The most important causes of delay were long distance and delay of physicians and staff. Conclusion: Considering the findings, increasing people’s knowledge about the symptoms of heart problem, providing medical facilities and instruction of medical staff play important role in decreasing delay time in drug administration and increasing streptokinase output. Keywords: Myocardial infarction, Streptokinas

Serum level of plasminogen activator inhibitor type-1 in addicted patients with coronary artery disease

BACKGROUND: Plasminogen activator inhibitor-1 (PAI-1) is a glycoprotein with inhibitory effects on the formation of plasmin from plasminogen by plasminogen activator. Thus, it prevents clot lysis in vessel walls. Several evidences prove the relationship between coronary artery disease and response to fibrinolytic therapy in patients with myocardial infarction (MI) with PAI-1 level. Opium addiction is one of the most important factors in causing MI and cardiovascular events. This is due to it causing imbalance between coagulation and anticoagulation factors in the blood. This study was designed and implemented to determine the levels of PAI-I in opium-addicted patients with coronary artery disease in comparison with non addicts. METHODS: In this case-control study, 160 patients with coronary heart disease (CHD), which was confirmed by angiography results, were enrolled. All of the patients had a medical history, their creatinine levels and lipid profile were evaluated, morphine urine test was performed, and after that a blood sample was taken to determine the levels of PAI-1. Thus, the 80 patients who had a positive morphine urine test result formed the case group, and the control group was constituted of the 80 patients with negative morphine test results. The two groups were matched. FINDINGS: Average level of PAI-1 in the control group was 2.4 ± 2.6 and in the case group was 8.8 ± 9.1 and it was statistically significant (P < 0.001). The frequency of two vessel disease was higher in opium addicted patients than non-addicted patients and this was statistically significant (P = 0.030). However, the frequency of single vessel and three vessel disease was the same in the two groups. The two groups had no differences in age, lipid profile, and creatinine level. Moreover, females are at a higher risk of high PAI-1 levels. CONCLUSION: PAI-1 levels in opium addicted patients with CHD are higher than other patients. In these patients, the risk of atherosclerosis and MI is higher than normal

Peptide binding domains determined through chemical modification of the side-chain functional groups.

A clear understanding of the specific secondary structure and binding domain resulting from the interactions of proteins and peptides with lipid surfaces will provide insight into the specific functions of biologically active molecules. We have shown in earlier studies that the stationary phases used in reverse-phase high-performance liquid chromatography represent a model artificial lipid surface for the study of induced conformational states of peptides on lipid interaction. We have now used reverse-phase high-performance liquid chromatography to determine the binding domains of peptides and, by extension, of proteins to a lipid surface. This approach consists of performing chemical modifications of specific amino acid side-chain functionalities after the interaction of the peptides with the reverse-phase high-performance liquid chromatography C18 groups. The susceptibility to oxidation was also studied after binding of the same peptides to liposomes. Oxidation of a single methionine residue "walked" through an amphipathic alpha-helical 18-mer peptide was selected to illustrate this approach. The extent of oxidation was found to be clearly dictated by the accessibility of the methionine residue to the aqueous mobile phase. The binding domain found for the peptide in its lipid-induced conformational state was unequivocally the entire hydrophobic face of the amphipathic alpha-helix

Coronary Artery Disease Risk Factors in an Urban and Peri-urban Setting, Kerman, Southeastern Iran (KERCADR Study): Methodology and Preliminary Report

Background: This article was to present the sampling and measurements methods and the main preliminary findings of the KERCADR cohort study (first round) in an urban and peri-urban setting, Kerman, southeastern Iran2009-11. Method: 5900 (3238 female) people aged between 15 to 75 years were recruited in the household survey by non-proportional to size one-stage cluster sampling. Trained internal specialists, general practitioners, clinical psychologists and dentists have assessed the study subjects by person-assisted questionnaires regarding different NCD risk factors including cigarette and opium smoking, physical activity, nutrition habits, anxiety, depression, obesity, hypertension and oral health. Blood samples were also collected for determining FBS, HbA1c, cholesterol and triglyceride. Weighted standardized prevalence estimates were calculated by STATA 10 survey analysis package. Results: The participation rate was more than 95% in all subgroups. Cigarette smoking (18.4% vs. 1.2%), opium use (17.8% vs. 3.0%) and triglyceridemia (16.1% vs. 12.0%) were significantly higher among men than women. In contrast, women were presented with higher level of sever anxiety (29.1% vs. 16.7%), obesity (16.8% vs. 9.2%), low-physical activity (45.1% vs. 39.2%) and uncontrolled diabetes (60.2% vs. 31.0%). More than 68% of all subjects have presented with moderate to severe gingival index scores. Conclusion: The first round of the KERCADR cohort with sufficient sample size and response rate provided precise estimates for the main clinical and para-clinical NCD risk factors. These evidences need to be translated into public health interventions and monitored in the next rounds of the cohort

Tropoelastin bridge region positions the cell-interactive C terminus and contributes to elastic fiber assembly

The tropoelastin monomer undergoes stages of association by coacervation, deposition onto microfibrils, and cross-linking to form elastic fibers. Tropoelastin consists of an elastic N-terminal coil region and a cell-interactive C-terminal foot region linked together by a highly exposed bridge region. The bridge region is conveniently positioned to modulate elastic fiber assembly through association by coacervation and its proximity to dominant cross-linking domains. Tropoelastin constructs that either modify or remove the entire bridge and downstream regions were assessed for elastogenesis. These constructs focused on a single alanine substitution (R515A) and a truncation (M155n) at the highly conserved arginine 515 site that borders the bridge. Each form displayed less efficient coacervation, impaired hydrogel formation, and decreased dermal fibroblast attachment compared to wild-type tropoelastin. The R515A mutant protein additionally showed reduced elastic fiber formation upon addition to human retinal pigmented epithelium cells and dermal fibroblasts. The small-angle X-ray scattering nanostructure of the R515A mutant protein revealed greater conformational flexibility around the bridge and C-terminal regions. This increased flexibility of the R515A mutant suggests that the tropoelastin R515 residue stabilizes the structure of the bridge region, which is critical for elastic fiber assembly