Changes in Heart Rate Variability Parameters after Elective Percutaneous Coronary Intervention

Background: Patients with chronic stable angina often have a state of sympathetic hyperactivity. It is considered associated with myocardial ischemia and disappears after ischemia elimination. The aim of this study was to investigate the changes in heart rate variability parameters, a noninvasive technique for the evaluation of the autonomic nervous system activity, after successful revascularization in these patients to evaluate this theory. Methods: The patients were enrolled among those who underwent successful percutaneous coronary intervention. Short- term heart rate variability analyses of all the patients were obtained, and time-domain indices (standard deviation of normal- to-normal intervals [SDNN], standard deviation of differences of successive R-R intervals [SDSD], root-mean square differences of successive R-R intervals [rMSSD], percentage of R-R intervals differing > 10 ms from the preceding one [PNN10 percentage of R-R intervals differing > 20 ms from the preceding one [PNN20],percentage of R-R intervals differing > 30 ms from the preceding one [PNN30]percentage of R-R intervals differing > 40 ms from the preceding one [PNN40],percentage of R-R intervals differing > 50 ms from the preceding one [PNN50percentage of R-R intervals differing > 60 msfrom the preceding one [PNN60 percentage of R-R intervals differing > 70 ms from the preceding one [PNN70])were analyzed. All the measurements were made before and after percutaneous coronary intervention. Results: This study included 64 patients, comprising 27 men and 37 women at a mean age of 56.8 ± 9.1 years. There was a significant difference only between pre- and post-revascularization SDNN (27.5 ± 19.72 vs. 41 ± 41.4; p value = 0.013). The other parameters showed no significant differences after successful coronary intervention. Conclusion: Our data indicate that the increase in SDNN in patients with stable angina pectoris undergoing percutaneous coronary intervention seems to be prominent

Circulating LncRNA Is Potentially Up-regulated in Coronary Artery Disease

Coronary artery disease (CAD) is one of the leading causes of death and disability all around the world. Recent studies have revealed that aberrantly regulated long non-coding RNA (lncRNA) as one of the main classes of cellular transcript plays a key regulatory role in transcriptional and epigenetic pathways. Recent reports have demonstrated that circulating lncRNAs in the blood can be potential biomarkers for CAD. HOTAIR is one of the most cited lncRNAs with a critical role in the initiation and progression of the gene expression regulation. Recent research on the role of the HOTAIR in cardiovascular disease lays the basis for the development of new studies considering this lncRNA as a potential biomarker and therapeutic target in CAD. In this study, we aimed to compare the expression of HOTAIR lncRNA in the blood samples of patients with CAD and control samples. The expression level was examined by semi-quantitative reverse transcriptase polymerase chain reaction technique. Our data shows that expression of HOTAIR is up-regulated in blood samples of patients with CAD

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 effect of reducing the incidence of gastrointestinal complications in patients treated with aspirin, referred to Imam Hospital, of Ahvaz, Iran

This research contains data which were obtained during the analysis of treated patients with aspirin who were referred to Imam Hospital (Imam H) of Ahvaz, Iran; and the effect of this type of treatment (Helicobacter pylori eradicate (HPE)) on reducing the incidence of gastrointestinal complications. Studies have shown that taking aspirin in patients with Helicobacter pylori infection is associated with a decreasing risk of gastrointestinal bleeding (O'connor et al., 2013) [1]. In this study, 165 patients with positive helicobacter pylori infection test were chosen among those who were referred to Imam H. In this paper, the effects of sex, smoking, renal failer, diabetes, age, blood pressure and aspirin consumption have been studied (Fletcher et al., 2010) [2]. After completion of the observations and records of patient's medical records, the obtained coded data were fed into EXCELL. Data analysis was performed, using SPSS 16. Keywords: Helicobacter pylori, Aspirin, Patients, Imam Hospital, Ira

One-month Outcome of Acute Coronary Syndrome Patients with Positive Creatine Kinase-MB and Negative Troponin; a Brief Report

<span style='font-size:14.0pt;font-family:"Arial","sans-serif";mso-bidi-font-family: "B Nazanin"'><span style='mso-spacerun:yes'> ADDIN EN.REFLIST <span style='mso-element: field-separator'>Introduction: Biochemical markers of myocardial injuries have radical importance in diagnosis or dismissing cardiac events, especially in cases that electrocardiographic findings are not present. Therefore, this study was designed aiming to appraise 1-month outcome of patients presenting to emergency department (ED) following acute coronary syndrome (ACS) with positive creatine kinase-MB (CK-MB) and negative troponin. Methods: This prospective cross-sectional study was done on patients presenting to ED with complaint of acute chest pain and diagnosis of ACS. Patients who did not have a clear electrocardiographic finding indicating acute myocardial infarction (MI) (ST segment elevation) and had positive CK-MB and negative troponin in laboratory tests of serum were included. Demographic data and baseline characteristics, CK serum level, CK-MB, troponin, and 30-day outcome of the patients were analyzed using SPSS version 19. Results: 13759 patients had visited the ED with complaint of chest pain during the study period (57% female). 1003 (7.3%) patients had positive troponin test and 12704 (92.3%) had negative CK-MB index and were therefore eliminated from the study. Finally, 52 (0.4%) had both positive CK-MB and negative troponin indices. 35 (67.3%) of them were discharged from ED after serial electrocardiography and negative troponin test. 11 (21.2%) were admitted to critical care unit but were discharged due to having 2 negative troponin tests in 12 hours and normal serial electrocardiogram. 6 (11.5%) were referred for surgical interventions. No mortality was seen in 1-month follow-up. Conclusion: Based on the results of the present study, only 0.4% of ACS patients presenting to the studied ED had positive CK-MB and negative troponin indices. During 1-month follow-up, no case of mortality or MI was observed among them. Only 2 (3.8%) cases needed surgical intervention. <span style='font-size:14.0pt;line-height:107%; font-family:"Arial","sans-serif";mso-fareast-font-family:Calibri;mso-fareast-theme-font: minor-latin;mso-bidi-font-family:"B Nazanin";mso-ansi-language:EN-US; mso-fareast-language:EN-US;mso-bidi-language:AR-SA'><span style='mso-element: field-end'><![endif]--

پیامد یکماهه بیماران مبتلا به سندرم کروناری حاد با کراتین کیناز- ام بی مثبت و تروپونین منفی؛ یک گزارش کوتاه

Introduction: Biochemical markers of myocardial injuries have radical importance in diagnosis or dismissing cardiac events, especially in cases that electrocardiographic findings are not present. Therefore, this study was designed aiming to appraise 1-month outcome of patients presenting to emergency department (ED) following acute coronary syndrome (ACS) with positive creatine kinase-MB (CK-MB) and negative troponin. Methods:This prospective cross-sectional study was done on patients presenting to ED with complaint of acute chest pain and diagnosis of ACS. Patients who did not have a clear electrocardiographic finding indicating acute myocardial infarction (MI) (ST segment elevation) and had positive CK-MB and negative troponin in laboratory tests of serum were included. Demographic data and baseline characteristics, CK serum level, CK-MB, troponin, and 30-day outcome of the patients were analyzed using SPSS version 19. Results: 13759 patients had visited the ED with complaint of chest pain during the study period (57% female). 1003 (7.3%) patients had positive troponin test and 12704 (92.3%) had negative CK-MB index and were therefore eliminated from the study. Finally, 52 (0.4%) had both positive CK-MB and negative troponin indices. 35 (67.3%) of them were discharged from ED after serial electrocardiography and negative troponin test. 11 (21.2%) were admitted to critical care unit but were discharged due to having 2 negative troponin tests in 12 hours and normal serial electrocardiogram. 6 (11.5%) were referred for surgical interventions. No mortality was seen in 1-month follow-up. Conclusion: Based on the results of the present study, only 0.4% of ACS patients presenting to the studied ED had positive CK-MB and negative troponin indices. During 1-month follow-up, no case of mortality or MI was observed among them. Only 2 (3.8%) cases needed surgical intervention.  مقدمه: مارکرهای بیوشیمیایی مربوط به آسیب میوکارد به خصوص در مواردی که یافته های الکتروکاردیوگرافیک وجود ندارند، اهمیتی بنیادی در تشخیص یا رد عارضه قلبی دارند. لذا مطالعه حاضر با هدف بررسی پیامد یک ماهه بیماران مراجعه کننده به بخش اورژانس به دنبال سندرم کروناری حاد با کراتین کیناز-ام بی مثبت و تروپنين منفي طراحی شده است.روش کار: این مطالعه مقطعی آینده نگر بر روی بیماران مراجعه کننده به بخش اورژانس با شکایت درد حاد قفسه سینه و تشخیص سندرم کروناری حاد صورت پذیرفته است. بیمارانی که یافته الکتروکاردیوگرافیک واضحی به نفع سکته قلبی حاد نداشتند (بالا رفتن قطعه ST) و از طرفی در بررسی آزمایشگاهی سطح سرمی کراتین کیناز-ام بی مثبت و تروپونین منفی داشتند وارد مطالعه شدند. متغیرهای دموگرافیک و پایه، سطح سرمی کراتین کیناز، کراتین کیناز-ام بی و تروپونین و پیامد 30 روزه بیماران با نرم افزار آماریSPSS  نسخه 19 مورد آنالیز قرار گرفتند.یافته ها: 13759 بیمار در طول زمان مطالعه با شکایت درد قفسه سینه به بخش اورژانس مذکور مراجعه کرده بودند (57 درصد زن). 1003 (3/7 درصد) بیمار دارای تست تروپونین مثبت و 12704 (3/92 درصد) مورد اندکس کراتین کیناز-ام بی منفی داشتند و درنتیجه از مطالعه حذف شدند. در نهایت52 (4/0 درصد) نفر اندکس کراتین کیناز-ام بی مثبت و تروپونین منفی داشتند. 35 (3/67 درصد) بیمار با انجام نوار قلب سریال و تست تروپونین منفی از بخش اورژانس ترخیص گردیدند. 11 (2/21 درصد) بیمار در بخش سی سی یو بستری شدند که در فاصله زمانی 12 ساعت دو بار تروپونین منفی و نوار قلبی سریال نرمال داشته و ترخیص شدند.6 (5/11 درصد) بیمار نیز جهت انجام مداخلات جراحی ارجاع شدند. هیچ مورد مورتالیتی در پیگیری یک ماهه مشاهده نگردید.نتیجه گیری: بر اساس نتایج مطالعه حاضر تنها 4/0 درصد از بیماران مبتلا به سندرم کروناری حاد مراجعه کننده به بخش اورژانس مذکور دارای اندکس کراتین کیناز-ام بی مثبت و تروپونین منفی بودند که در بررسی پیامد یک ماهه هیچ موردی از مرگ و میر و سکته قلبی در آنها مشاهده نگردید. تنها 2 (8/3 درصد) مورد نیازمند مداخله جراحی شدند.

Carriage of Neisseria meningitidis in the Hajj and Umrah mass gatherings

Meningococcal disease is a serious public health threat, especially during mass gatherings such as Hajj and Umrah which provide optimal conditions for disease transmission. The disease is caused by Neisseria meningitidis and transmitted mainly via asymptomatic carriers. A review of the literature on asymptomatic N. meningitidis carriage among Hajj and Umrah pilgrims and their household contacts was performed. Carriage studies reported carriage rates to be higher in Hajj pilgrims compared to Umrah pilgrims and that these events promote acquisition of carriage among pilgrims. With some outliers, most studies found carriage rates among pilgrims to be comparable to those in populations under non-epidemic settings. However, these results should be interpreted with caution, taking into account the limitations within the studies identified. A wide variety of N. meningitidis serogroups appear to be circulating among Hajj and Umrah pilgrims, with serogroups W135 and B being most prominent. Current Hajj and Umrah meningococcal disease preventative measures do not necessarily prevent carriage and transmission, which may result in local and international outbreaks among susceptible populations. Monitoring carriage states of visitors and local inhabitants in the Kingdom of Saudi Arabia, as well as the implementation of preventive measures that impact carriage, are warranted to reduce the risk of Hajj and Umrah-related meningococcal disease outbreaks