Prevalence and predictors of slow coronary flow phenomenon in Kermanshah province

Introduction: This study was conducted to investigate prevalence and predictors of slow coronary flow phenomenon (SCF) phenomenon. Methods: This cross-sectional study was performed at Imam Ali Cardiovascular Hospital affiliated with the Kermanshah University of Medical Sciences (KUMS), Kermanshah province, Iran. From March 2017 to March 2019, all the patients who underwent coronary angiography were enrolled in this study. Data were obtained using a checklist developed based on the study’s aims. Independent samples t tests and chi- square test (or Fisher exact test) were used to assess the differences between subgroups. Multiple logistic regression model was applied to evaluate independent predictors of SCF phenomenon. Results: In this study, 172 (1.43%) patients with SCF phenomenon were identified. Patients with SCF were more likely to be obese (27.58±3.28 vs. 24.12±3.26, P<0.001), hyperlipidemic (44.2 vs. 31.7, P<0.001), hypertensive (53.5 vs. 39.1, P<0.001), and smoker (37.2 vs. 27.2, P=0.006). Mean ejection fraction (EF) (51.91±6.33 vs. 55.15±9.64, P<0.001) was significantly lower in the patients with SCF compared to the healthy controls with normal epicardial coronary arteries. Mean level of serum triglycerides (162.26±45.94 vs. 145.29±35.62, P<0.001) was significantly higher in the patients with SCF. Left anterior descending artery was the most common involved coronary artery (n = 159, 92.4%), followed by left circumflex artery (n = 50, 29.1%) and right coronary artery (n = 47, 27.4%). Body mass index (BMI) (OR 1.78, 95% CI 1.04-2.15, P<0.001) and hypertension (OR 1.59, CI 1.30-5.67, P=0.003) were independent predictors of SCF phenomenon. Conclusion: The prevalence of SCF in our study was not different from the most other previous reports. BMI and hypertension independently predicted the presence of SCF phenomenon

Daily, Monthly, and Seasonal Pattern of ST-Segment Elevation Myocardial Infarction (STEMI) Occurrence in Western Iran; a Cross-Sectional Study

Introduction: Acute myocardial infarction (AMI) is a leading cause of death and disability worldwide. Determining seasonal pattern of AMI may contribute to disease prevention and better treatment. Objective: The present study was conducted to investigate daily, monthly, and seasonal pattern for symptoms҆ onset in the patients with ST-segment elevation myocardial infarction (STEMI), and also other possible associated factors. Methods: This cross-sectional study was conducted on 777 patients diagnosed with STEMI admitted at the Imam Ali Cardiovascular Hospital affiliated with Kermanshah University of Medical Sciences (KUMS), Kermanshah province, Iran 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) followed by Tukeys҆ post‐hoc test and Chi-Square test (or Fishers҆ exact test). Results: Out of 777 patients, 616 (79.3%) of them were male. Mean age of the patients was (mean±SD) equal to 60.93±12.86 years old. Occurrence of STEMI was most common in winter (38.4%), followed by autumn (27.8%), spring (22.9%), and summer (10.9%), respectively. Monthly occurrence of AMI was at the highest level in January (10.8%) and December (9.9%), and it was at the lowest level in July (4.9 %). Most patients were admitted on Fridays (15.8%) and Wednesdays (15.6%). Hypercholesterolemia, prior congestive heart failure (CHF), prior MI, prior stroke, prior atrial fibrillation (AF), low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglycerides, total cholesterol, creatine phosphokinase (CPK), and creatine kinase myocardial band (CK-MB) were significantly associated with seasonal pattern of STEMI (p-value<0.05). Conclusions: Results of the present study on Iranian patients with STEMI revealed that AMI occurred more frequently on Wednesdays and Fridays and during winter from December to January compared to the other days of the week, months, and seasons