Cardiovascular research institute, Isfahan University of Medical Sciences ARYA Atherosclerosis Journal 1735-3955 19 4 2023 07 01 The Effect of High-dose Allopurinol Pretreatment on Inflammatory Biomarkers and Post-revascularization Coronary Blood Flow in Non-STEMI Patients: A Randomized Double Blind Clinical Trial 1 10 26226 10.48305/arya.2022.11886.2722 EN Hamid Sanei Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran Kiyan Heshmat-Ghahdarijani Heart Failure Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran Ali Asadi Hypertension Research Center, Cardiovascular Research Institute; Isfahan University of Medical Sciences, Isfahan, Iran 0000-0002-9332-173X Mohammad Kermani-Alghoraishi Interventional Cardiology Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran 0000-0002-3701-3572 Ali Safaei Isfahan Cardiovascular Research Center, Cardiovascular Research Institute; Isfahan University of Medical Sciences, Isfahan, Iran 0000-0001-8718-6650 Masoumeh Sadeghi Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran 0000-0001-7179-5558 Journal Article 2022 02 01 INTRODUCTION: The use of allopurinol has shown promising outcomes in reducing oxidative processes responsible for atherogenic-related cardiovascular events. The current study aims to assess the effects of high-dose allopurinol on the post-revascularization coronary blood flow and inflammatory biomarkers in patients with non-ST segment elevated myocardial infarction (NSTEMI). METHOD: Eighty NSTEMI patients were randomly divided into two groups: the intervention group (n=40), medicated with a high loading dose of 600 mg allopurinol before the coronary angiography, and the control group (n=40), treated with a placebo. The highly sensitive C-reactive protein (hs-CRP) was measured at baseline and within 24 hours after the cardiac interventions and compared between the case and control groups. Post percutaneous coronary intervention (PCI) Thrombolysis in Myocardial Infarction (TIMI) flow grading was also evaluated as a revascularization endpoint. RESULTS: The two groups of the study were similar in terms of demographic, clinical, laboratory, and angiographic characteristics (P-value>0.050). The assessed TIMI flow was similar between the cases and the controls both prior to (P-value=0.141) and after (P-value=0.395) the coronary angioplasty. The hs-CRP (P-value=0.016) was significantly higher in the control group. Post-angiographic assessment of hs-CRP revealed an insignificant difference between the groups (P-value=0.104). CONCLUSION: In conclusion, premedication with a high dose of allopurinol in NSTEMI patients did not affect the inflammatory biomarker or the revascularization endpoint.

https://arya.mui.ac.ir/article_26226_1e360e456bb346d5ec2e9d6b411a323f.pdf

Cardiovascular research institute, Isfahan University of Medical Sciences ARYA Atherosclerosis Journal 1735-3955 19 4 2023 07 01 Preoperative Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio for prediction of major complications following Coronary Artery Bypass Grafting 11 18 26251 10.48305/arya.2022.39237.2834 EN Sina Raeisi School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran Mohsen Mirmohammadsadeghi Department of surgery, Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran Saba Raeisi School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran Pouya Mirmohammadsadeghi Department of surgery, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran Journal Article 2022 07 07 INTRODUCTION: The Neutrophil to Lymphocyte Ratio (NLR) and Platelet to Lymphocyte Ratio (PLR) have recently been reported as potentially useful indicators of inflammation. In this study, the authors investigated their predictive role for postoperative complications of Coronary Artery Bypass Graft (CABG). METHOD: This study was conducted on the medical records of patients who had undergone isolated CABG in 2019-2020 in Isfahan, Iran. The baseline clinical characteristics were obtained from medical records. The diagnosis of postoperative Acute Kidney Injury (AKI) was defined based on the Kidney Disease Improving Global Outcomes guideline. The postoperative bleeding amount was measured from the total chest tube output during the Intensive Care Unit (ICU) admission after surgery. NLR and PLR were measured by dividing the neutrophil and platelet counts by the lymphocyte count, respectively. All data were analyzed using the Statistical Package for Social Sciences (SPSS) version 24. RESULTS: Of 356 patients, data of 280 patients, including 219 males and 61 females, were recruited. The mean age among all patients was 63.78±9.07 years. There were no significant differences between the bleeding group and non-bleeding group regarding NLR (2.33(1.89-2.73) vs. 2.20(1.63-3)) and PLR (119.26(94.41-146.39) vs. 110.26(82.13-136.34)) (p=0.742, p=0.228 respectively). NLR and PLR were significantly higher in AKI-positive patients (P< 0.001 and P=0.002, respectively). Only NLR showed the potential ability to predict postoperative AKI in the crude model (P<0.001) based on the regression tests. Moreover, no significant correlation was seen between both NLR and PLR and hospital stay time, ICU stay time, and in-hospital mortality. CONCLUSION: The authors found that an increased NLR is associated with a higher risk for AKI after CABG. The authors also found no significant correlations between NLR and PLR with bleeding, hospital stay, ICU stay, and mortality.

https://arya.mui.ac.ir/article_26251_2a6b82244c72e226480452c163136992.pdf

Cardiovascular research institute, Isfahan University of Medical Sciences ARYA Atherosclerosis Journal 1735-3955 19 4 2023 07 01 Effect of Education Based on Health Belief Model on the Dietary Intake of Patients with a Myocardial Infarction 19 28 26250 10.48305/arya.2022.41123.2848 EN Fatemeh Fatahian Student Research Committee, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran Hossein Shahnazi Department of health education and promotion, School of health, Isfahan University of Medical Sciences, Isfahan, Iran Akbar Hassanzadeh Instructor, Department of Epidemiology and Biostatistics, Isfahan University of Medical Sciences, Isfahan, Iran Noushin Mohammadifard Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran 0000-0003-1776-1060 Journal Article 2022 09 22 INTRODUCTION: Dietary modification significantly impacts reducing myocardial infarction (MI) mortality and its recurrence. This study aimed to investigate the effect of education on the dietary intake of patients with MI based on the health belief model. METHOD: This quasi-experimental study was conducted on patients with MI from October 2021 to January 2022. A total of 72 MI cases were randomly divided into intervention and control groups. The intervention group received an educational intervention based on the health belief model for three months in four sessions. The structures of the health belief model were measured using a questionnaire before the intervention and one and three months following it. Dietary intake was measured with a three-day dietary record before and after three months of the intervention. RESULTS: After the educational intervention, a significant difference was observed between the two groups in terms of the average scores of awareness, perceived susceptibility, perceived severity, perceived benefits, and self-efficacy (P<0.01). However, no significant difference was observed concerning the perceived obstacles. Although there were no significant differences between dietary intake at the baseline, the intake of energy, cholesterol, and energy percent from carbohydrate, total fat, and saturated fatty acids were lower, and fiber intake was higher in the intervention group versus the control group after the intervention (all P<0.05). CONCLUSION: Given the positive effect of the health belief model in this study, it is suggested to use this model for designing education for MI patients focusing on nutrition.

https://arya.mui.ac.ir/article_26250_605ceeb06db02fc8a0bf1ec291ea2399.pdf

Cardiovascular research institute, Isfahan University of Medical Sciences ARYA Atherosclerosis Journal 1735-3955 19 4 2023 07 01 Epidemiology of Stroke 2 Years Before and During COVID-19 Pandemic in Kerman (south of Iran): a Hospital-Based Study 29 36 30884 10.48305/arya.2023.41443.2880 EN Farhad Iranmanesh Professor of Neurology, Stroke fellowship, Neurology Research Center, Kerman University of Medical Sciences, Kerman, Iran 0000-0001-6088-6120 Rostam Seifadini Assistant Professor of Neurology, Neurology Research Center, Kerman University of Medical Sciences, Kerman, Iran Tania Dehesh Associated professor of Biostatics, Department of Epidemiology and Biostatics, School of Public Health, Kerman University of Medical Sciences, Kerman, Iran Mohammad Hadi Mashayekhi Neurologist, Neurology Research Center, Kerman University of Medical Sciences, Kerman, Iran Journal Article 2023 01 23 INTRODUCTION: Stroke is the second leading cause of death worldwide. Recent studies have shown that the COVID-19 pandemic has been associated with a higher frequency of stroke. This study aimed to investigate the epidemiologic aspects of stroke two years before and during the COVID-19 pandemic in Kerman. METHOD: This cross-sectional study was conducted in Kerman. The participants included all patients with a confirmed diagnosis of stroke. COVID-19 confirmation was based on a positive PCR test. The data was analyzed with SPSS.V24 software. RESULTS: In this study, 4152 patients with stroke were evaluated. The frequency of stroke before and during the COVID-19 pandemic was the same. The total number of stroke patients with COVID-19 was 298 (8.16%). The frequency of ischemic stroke patients before the COVID-19 pandemic was 1751 and during the pandemic was 1770. Before and after the pandemic, the mean age of ischemic stroke patients was 67.42±14.14 and 64.49±14.46 respectively, which showed a statistically significant difference (P>0.001). Our findings showed a significant difference between the NIHSS of ischemic stroke before and after the pandemic (P<0.001). The mortality rate of stroke patients was 111 before COVID-19 and 115 patients in the first two years of COVID-19. Except for the mortality rate (P<0.001), there was no significant difference in other demographic variables between ischemic stroke patients with and without COVID-19. CONCLUSION: The patients with ischemic stroke during the COVID-19 pandemic were younger and had more neurological deficits than the ischemic stroke patients before the pandemic. COVID-19 was associated with higher mortality in patients with ischemic stroke.

https://arya.mui.ac.ir/article_30884_3fbe25e98c055443d115ff2eda3e76a7.pdf

Cardiovascular research institute, Isfahan University of Medical Sciences ARYA Atherosclerosis Journal 1735-3955 19 4 2023 07 01 Coronary Artery Bypass Grafting in advance aged patients 37 45 30954 10.48305/arya.2023.41535.2884 EN Roxana Sadeghi Prevention of Cardiovascular Disease Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran 0000-0001-9447-8483 Journal Article 2023 02 11 INTRODUCTION: This study aimed to assess the impact of coronary artery bypass grafting (CABG) on outcomes in elderly patients compared to younger patients. METHOD: An observational case-control study was conducted involving 535 patients, divided into two groups: older adults (≥75 years) and younger adults (<75 years). All patients underwent CABG following a similar protocol. The primary endpoints focused on early post-procedure outcomes, including in-hospital mortality and the duration of ICU or hospital stay. Patients were followed up for six months, and secondary study endpoints included long-term mortality, left ventricular ejection fraction, re-hospitalization rates, and repeated revascularization. RESULTS: 535 patients who underwent CABG were enrolled in this study. The smoking habit was significantly higher among younger adults (38.2% vs. 12.5%, P=0.001). Hypertension was more prevalent among older adults than younger adults (75% vs. 60%, P=0.044). LDL cholesterol serum levels were higher among younger adult patients (94.9±32.5 vs. 80.9±32.9, P=0.028). In-hospital death was not significantly different between younger and older adults (2.8% vs. 5.0%, P=0.34). Mortality in the six-month follow-up was non-significantly higher in the elderly (2.1% vs. 8.1%, P=0.06). A significant proportion of patients in both groups (46.9% in younger patients vs. 40% in older ones, P=0.40) received dual antiplatelet therapy (DAPT) prior to CABG due to a recent myocardial infarction and receipt of a new stent, but without increased major bleeding in both groups. CONCLUSION: CABG should be considered a viable treatment option for elderly patients with acceptable operative risk in current clinical practice.

https://arya.mui.ac.ir/article_30954_272eb64a1ed0103ccc0bf44e8cdf6770.pdf

Cardiovascular research institute, Isfahan University of Medical Sciences ARYA Atherosclerosis Journal 1735-3955 19 4 2023 07 01 A Hospital-Based Case-Control Study on Whole- and Refined-Grain Intake and Risk of Stroke 46 56 30883 10.48305/arya.2023.11749.2380 EN Fatemeh Shirani Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran Mohammad Saadatnia Neuroscience Research Center, Isfahan University of Medical Sciences, Isfahan, Iran Forough Shakeri Students' Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran Ammar Hassanzadeh Keshteli Department of Medicine, University of Alberta, Edmonton, Alberta, Canada Parvane Saneei Department of Community Nutrition, School of Nutrition and Food Science, Nutrition and Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran Ahmad Esmaillzadeh Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran Journal Article 2021 02 14 INTRODUCTION: The aim of the present study was to ascertain the correlation between the intake of whole and refined grains and the risk of stroke in the Iranian adult population. METHOD: This hospital-based case-control study was conducted at Alzahra University Hospital, Isfahan, Iran, in 2008. The cases (n=195) were stroke patients admitted to the neurology ward, and the controls (n=195) were patients admitted to other wards in this center, with no prior history of cerebrovascular accident or any neurological disorders. The usual dietary intakes of the study participants during the previous year were assessed using a validated semi-quantitative food frequency questionnaire. Whole and refined grains were defined according to the definition of the American Association of Cereal Chemists International; foods that contained at least 8 g per 30 g of their weight were considered as whole grains. RESULTS: The mean age of the case and control groups was 68.0 (±13.5) and 61.5 (±10.5) years, respectively; 40% of the cases and 53.3% of the controls were female. The total intake of whole grains (27.8±4.3 vs. 29.4±3.6 g/d, P=0.77) and refined grains (264±11 vs. 296±13 g/d, P=0.07) was not significantly different between the cases and controls. After adjusting for potential confounders, individuals in the second tertile of refined grain intake had a two-fold higher odds of stroke (OR: 2.02; 95% CI: 1.08-3.71), compared to those in the first tertile. Furthermore, no significant relationships were observed between the consumption of whole grains and the risk of stroke, before or after adjustment for confounding variables. No significant trend was found between the tertiles of refined or whole grain intake and the risk of stroke. CONCLUSION: The authors did not find a statistically significant association between the intake of whole and refined grains and the risk of stroke. Further prospective studies on the relationship between both whole and refined grains and stroke are warranted.

https://arya.mui.ac.ir/article_30883_1da76f4e60189995aa60cc1d19993ae9.pdf

Cardiovascular research institute, Isfahan University of Medical Sciences ARYA Atherosclerosis Journal 1735-3955 19 4 2023 07 01 A Review of the Surgical Treatment for Constrictive Pericarditis 57 66 27381 10.48305/arya.2023.41472.2882 EN Imran Khan Prince Talal Street, Al Mana General Hospital, Cardiothoracic department 0000-0002-7088-8637 Journal Article 2023 01 25 Chronic constrictive pericarditis results in the signs and symptoms of heart failure due to the chronic compression of the myocardium. When the pericardium becomes thickened and fibrosed, surgery is the sole curative management strategy. Surgery leads to an improvement in functional status and survival, but it is associated with significant mortality and morbidity. Over the years, the surgical approach to this pathology has largely remained unchanged, but there has been a shift in the etiological mechanism of constrictive pericarditis from predominantly tuberculous to post-cardiac surgery and idiopathic pathologies. This review offers an overview of the surgical management of constrictive pericarditis.

https://arya.mui.ac.ir/article_27381_cf5139a6d67298ed2ff533b7bc4fe709.pdf

Cardiovascular research institute, Isfahan University of Medical Sciences ARYA Atherosclerosis Journal 1735-3955 19 4 2023 07 01 Double Embolism: A Very Rare Presentation of Concurrent Pulmonary Embolism and Embolic Stroke without Arterivenous Shunt 67 71 31073 10.48305/arya.2023.11560.2104 EN Roghayeh Pourkia Department of Cardiology, School of Medicine, Babol University of Medical Sciences, Babol, Iran Asghar Mohamadi Cardiovascular Research Center, Shahid Rahimi Hospital, Lorestan University of Medical Sciences, Khorramabad, Iran Hoda Naghshineh School of Medicine, Babol University of Medical Sciences, Babol, Iran Mahmoud Sadeghi Haddad Zavareh Infectious Disease and Tropical Medicine Research Center, Health Reseach Institute, Babol University of Medical Sciences, Babol, Iran Faezeh Dehghani Tafti Department of Cardiology, School of Medicine, Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran 0000-0001-9266-8128 Journal Article 2020 01 15 Embolic material forms in many parts of the body and can affect anywhere in the body. Pulmonary embolism and embolic stroke are the most common presentations of embolic disorders in the body. Embolic events have different causes, and the heart is one of the most important places where emboli originate. One of the uncommon causes of embolic events is non-bacterial thrombotic endocarditis (NBTE), which can occur in patients with advanced cancer. NBTE can lead to embolism. Embolisation may occur in some organs including the central nervous system, kidneys, spleen, limb extremities, and coronary arteries. The authors aim to describe a rare case with concurrent pulmonary embolism (PE) and embolic stroke caused by non-bacterial thrombotic endocarditis (NBTE) in a woman with breast cancer.

https://arya.mui.ac.ir/article_31073_683768cf9ad8eecfd2e847498002cd29.pdf