Arya Atherosclerosis
Volume:7 Issue: 4, Winter 2012

Pentoxifylline has anti-inflammatory properties and could suppress some inflammatory processes including tumor necrosis factor-alpha (TNF-α) production. We assessed the effects of a two-month administration of pentoxifylline on nuclear factor-kappa B (NFκB) pathways in patients with coronary artery disease (CAD) in which inflammatory pathways, especially NFκB transcription factors, have a critical role. 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. P50 concentration did not significantly change during two months of pentoxifylline administration. Longer pentoxifylline administration is needed to see its favorable effects on NFκB family elements.

There are few literatures evaluating the association between cytotoxin-associated gene A (CagA) positive strains of Helicobacter pylori (HP) and the severity of coronary heart disease (CHD). This study was designed to investigate this association. Medical and drug history of 112 consecutive patients who were candidate for coronary angiography were taken. Fasting blood samples were obtained to measure C-reactive protein (CRP), anti Helicobacter pylori immunoglobulin G (anti-HP IgG), anti-CagA antibody (Ab) and interlukine-6 (IL6). According to angiography reports, participants were divided into patients with mild (n = 69) and with sever CHD (n = 36). To measure the association between CagA positive strains of HP with the severity of CHD, multivariate logistic regression tests were used by adjusting age, sex, history of diabetes mellitus (DM), and/or dyslipidemia (DLP), and/or hypertension (HTN), CRP status and IL-6 level. The analysis was concluded on 105 subjects. HP infection and CagA Ab were not significantly higher compared to the patients with severe and mild CHD (P = 0.28 and P = 0.68, respectively). Colonization of CagA positive HP did not significantly associate with severity of CHD (OR 1.05, 95% CI 0.33-3. 39). Colonization of CagA positive HP was not an independent risk factor for severe coronary heart disease.

associated with increased risk of stroke. This study aimed to determine the type of stroke and the role of fibrinogen in stroke type. This case-control study comprised 58 hospitalized patients with intracranial hemorrhage (ICH) and ischemic stroke. Demographic and clinical characteristics, type of strokeand fibrinogen level were collected after starting the treatment. The prevalence of ICH was higher in men than in women so that 60% of men and39.3% of women in this study were diagnosed with this type of stroke. In contrast, the corresponding figures for ischemic stroke were 40% and 60.7%, respectively. Statistical analysis by chi-square test revealed significant difference in the type of stoke in terms of gender (P = 0.026). The mean fibrinogen levels was lower in patients with ICH (348 ± 96 mg/dl) than in patients with ischemic stroke (381 ± 126 mg/dl), however this difference was not statistically significant (P = 0.12). Fibrinogen levels were significantly higher in women than in men (390 ± 111 vs. 340 ± 110 mg/dl, respectively, P = 0.017). Although the mean fibrinogen level was not significantly different in ICH andischemic stroke patients, it is recommended to examine the serum fibrinogen and its related factors at least for those patients with non-modifiable risk factors and in particular for those with family history and genetic background.

Hypercholesterolemia is among the most common health problems treated withtraditional remedies. Nigella sativa (NS) is an effective plant for treating hypercholesterolemia. However, the effects of this herb on hematologic factors and hemostasis system have not been elucidated. This study was designed to investigate the effects of NS on these factors in bothnormal and hypercholesterolemic rabbits. In this research, twenty rabbits were randomly distributed into four groups of five. The groups received four different diets, namely normal, normal + NS (5%), hypercholesterolemic (1٪cholesterol), and hypercholesterolemic (1٪ cholesterol) + NS (5%), for 8 weeks. After this period, WBC (white blood cell), RBC (red blood cell), HTC (hematocrit), HGB (hemoglobin content), PLT (platelet), fibrinogen (FIB) and factors VII (F VII) were measured. Using NS significantly increased PLT count in the normal group. In addition, it significantly decreased WBC counts in the hypercholesterolemic group (P < 0. 05). However, dietary use of NS did not have any effects on other hematologic factors including RBC, HTC, HGB, FIB, and F VII (P < 0. 05). Increased PLT numbers might cause enhanced coagulation. The achieved results call for more research on the effects of various diets (hypercholesterolemic and normal diet) supplemented with NS on different coagulation factors and hemostasis system.

Cardiovascular disorders are an important public health problem worldwide.They are also the leading cause of mortality and morbidity. Therefore, American Heart Association proposed cardiac rehabilitation program as an essential part of care for cardiac patients to improve functional capacity. The aim of this study was to evaluate the effectiveness of cardiac rehabilitation program on functional status and some hemodynamic responses in patients after coronary artery bypass graft (CABG) surgery. Thirty two patients were selected for this study. All patients underwent cardiacsurgery two months before admission. They were allocated to two groups. While the rehabilitationgroup (n =17, mean age: 62 ± 12 years) completed the cardiac rehabilitation program fortwo months, the reference group (n = 15, mean age: 58.5 ± 12.5 years) did not have any supervisedphysical activity during this period. Cardiac rehabilitation program consisted of exercise,nutritional, psychological consultation and risk factor management. At the beginning of the study, functional capacity of patients was evaluated by exercise test, 6-minute walking test and echocardiography. Functional capacity was evaluated for a second time after two months of cardiac rehabilitation. Data were analyzed by SPSS15. For comparing the mean of outcomes, Mann-Whitney test and Wilcoxon signed ranks test were used. As a result of cardiac rehabilitation, a significant improvement was observed in thedistance walked in the rehabilitation group (P < 0.01) compared to the reference group (P = 0.33). It also caused a significant development in hemodynamic responses to exercise such as resting and maximum systolic and diastolic blood pressure, resting and maximum heart rate,ejection fraction and rate pressure product. Cardiac rehabilitation significantly improves functional capacity and some hemodynamic responses post coronary artery bypass grafting. Therefore, patients need to be referredto rehabilitation units.

This study aimed to compare Iranian elderly with the youth and middle aged population in terms of the prevalence of metabolic syndrome and its components in Iranian elderly This cross-sectional study was conducted using the information from the third phase of Isfahan Healthy Heart Program. Male and female residents of Isfahan who aged over 19 years were selected by multistage cluster random sampling. A questionnaire including demographic characteristics, health status, medical history, medications used, as well as waist circumference, weight, height and systolic and diastolic blood pressures was completed for all participants. Fasting blood samples were obtained from all subjects and examined for fasting blood sugar and lipid profile. The prevalence of metabolic syndrome in individuals aged over 60 years was significantly higher than those under 60 (49.5% vs. 17.5%, respectively; P < 0.001). It was also more prevalent among elderly females than in males (59.2% vs. 39.8%, respectively; P < 0.005). Some anthropometric measures such as height, body mass index, abdominal circumference, waist-hip ratio, and waist to height ratio were significantly different in men and women below 60 years in comparison with those over 60 years (P < 0.05). Moreover, there were significant differences in most studied parameters between the elderly and non-elderly women (P < 0.001). Based on the findings of this study, the risk factors for cardiovascular diseases were significantly more prevalent in men and women over 60 years. T-test and Mann-Whitney were used for quantitative data and the square-chi test is performed for qualitative data. This study showed that metabolic syndrome has a relatively high prevalence in Iranian elderly people (especially in women). Therefore, early diagnosis and management of the complication are recommended among this high-risk group.

Myocardial infarction (MI) is an irreversible cardiomyocytes injury which begins after 15-20 minutes of coronary artery occlusion. The extent of infarction is modulated by a number of factors including collateral blood supplies, medications, and ischemic preconditioning. Although angioplasty and thrombolytic agents can relieve the cause of the infarction, the time from the occlusion onset to reperfusion determines the degree of irreversible myocardial injury. Experimental studies suggested that stem cells and progenitor cells derived from bone marrow can be used in the repair of cardiac tissue after acute MI. This study was designed to investigate the feasibility, safety and initial clinical outcome of intracoronary infusion of autologous progenitor cells in patients with acute MI. Patients with a history of anterior MI and a left ventricular ejection fraction (LVEF) less than 35 % who were candidates for coronary angioplasty were randomly allocated in a 1:1 ratio to either control or bone marrow cell groups (each including 16 patients). Thallium scan and 17-segment echocardiography analysis for regional wall motion abnormality were performed before and 1 and 6 months after intracoronary infusion of bone marrow cells. The same tests were also conducted for the control group at identical time intervals. Categorical variables were compared by one way analysis of variance (ANOVA). Statistical significance was assumed at a value of P < 0.05. LVEF in the case and control groups increased to 39.37 ± 24.7% and 31.00 ± 1.87%, respectively (P = 0.069 and 0.1, respectively). Wall motion abnormality index (WMAI) decreased insignificantly in both groups. Perfusion defect scores (PDSs) decreased significantly in the case group. In this study, autologous mesenchymal stem cell transplantation by intracoronary catheter during angioplasty in patients with a history of severe LV dysfunction caused mild increases in LVEF.

The detrimental effects of partially hydrogenated vegetable oils (PHVOs) on apolipoproteins have been reported from several parts of the world. However, little data is available in this regard from the understudied region of the Middle East. The present study therefore tried to evaluate the association between type of vegetable oils and serum lipids and apolipoprotein levels among Iranians. In this cross-sectional study, data from 1772 people (795 men and 977 women) aged 19-81 years, who were selected with multistage cluster random sampling method from three cities of Isfahan, Najaf Abad and Arak in "Isfahan Healthy Heart Program" (IHHP), was used. To assess participant's usual dietary intakes, a validated food frequency questionnaire was used. Hydrogenated vegetable oil (commonly consumed for cooking in Iran) and margarine were considered as the category of PHVOs. Soy, sunflower, corn, olive and canola oils were considered as non-HVOs. After an overnight fasting, serum cholesterol (total, low density lipoprotein (LDL) and high density lipoprotein (HDL) cholesterol) and triglyceride as well as apolipoproteins A and B were measured using standard methods. Participants with the highest intakes of non-HVOs and PHVOs were younger and had lower weight than those with lowest intakes. High consumption of non-HVOs and PHVOs was associated with lower intakes of energy, carbohydrate, dietary fiber, and higher intakes of fruits, vegetables, meat, milk and grains. No overall significant differences were found in serum lipids and apolipoprotein levels across the quartiles of non-HVOs and PHVOs after controlling for potential confounding. We did not find any significant associations between hydrogenated or non-hydrogenated vegetable oil and serum lipid and apolipoprotein levels. Thus, further studies are needed in this region to explore this association.

This study was designed to assess the effectiveness of stress managementtraining in improving the ability of coping with stress in a large population. Five cross-sectional studies using multistage cluster random sampling were performed on adults aged ≥ 19 years between 2000 to 2005 in Isfahan and Najaf Abad as intervention cities and Arak as the control city within the context of Isfahan Healthy Heart Program. Stress management training was adapted according to age and education levels of the target groups. In a 45-minute home interview, demographic data, General Health Questionnaire (GHQ) and stress management questionnaires were collected. Data was analyzed by t-test,linear regression and general linear model. Trends of both adaptive and maladaptive coping skills and GHQ scores frombaseline to the last survey were statistically significant in both intervention and reference areas (P <.001). While adaptive coping skills increased significantly, maladaptive coping skills decreased significantly in the intervention areas. Furthermore, stress levels decreased significantly in the intervention compared to the reference area. Stress management programs could improve coping strategies at the ommunity level and can be considered in designing behavioral interventions.

This study aimed to assess the effects of a 6-year-long communityparticipatoryprogram including school-based interventions on mean values and prevalence of cardiometabolic risk factors among adolescents. The interventions of this community trial, conducted from 2000 to 2007 in Iran, targeted the whole population (of nearly two millions) living in two cities considered as the intervention area (IA) in comparison with a reference area (RA). Data from surveys conducted before and after interventions was used to compare the differences between the secondary school students of the IA and RA. The prevalence of hypercholesterolemia and hypertriglyceridemia declined significantly in girls and boys in the IA (P < 0.01). The prevalence of high LDL-C decreased significantly in the girls in the RA (P = 0.002). Among both sexes in the IA, the prevalence of low HDL-C increased significantly (P < 0.001), whereas it decreased in the girls and boys in the RA (P = 0.04). Although in the IA, the prevalence of overweight and obesity decreased significantly in girls (P = 0.001), it increased in boys (P = 0.001) as well as in the girls of the RA (P = 0.01). By performing school-based interventions, our study was successful, at least inpart, in controlling some cardiometabolic risk factors in adolescents. Such modifications may have long-term impacts on non-communicable diseases prevention in adulthood.

Hypertension prevention and control are among the most important public health priorities. We evaluated the impacts of a workplace intervention project "Stop Hypertension in Mobarakeh Steel Company" (SHIMSCO) on controlling hypertension in industrial workers. The study was carried out in Mobarakeh Steel Company in Isfahan among 7286 male workers and employees. All individuals were evaluated for the presence of hypertension (HTN). According to examinations, 500 subjects with systolic blood pressure (SBP) ≥ 140 mmHg, and/or diastolic blood pressure (DBP) ≥ 90 mmHg, and/or those using antihypertensive medications were confirmed to have HTN and thus included in this study. They were questioned for sociodemographic characteristics, past medical history and medication use. They received an educational program including healthy lifestyle and self-care recommendations of HTN management and control as well as training for accurate blood pressure measurement and home monitoring for two years. SBP, DBP, weight, height and routine lab tests were measured for all hypertensive subjects before and after the interventions. Paired t-test, generalized estimation equation (GEE) and ordinary linear regression (OLR) were used for statistical analysis in SPSS. The comparison of SBP and DBP before and after the educational program showed significant reductions in both parameters (-7.97 ± 14.72 and -2.66 ± 9.96 mmHg, respectively). However, a greater decrease was detected in case of DBP. GEE showed SBP and DBP to decrease about -0.115 and -0.054 mmHg/month. OLR also revealed reductions of 4.88 and 2.57 mmHg respectively in SBP and DBP upon adding each antihypertensive drug. SHIMSCO, a 3-year interventional project in workplaces, was effective in reducing SBP and DBP among hypertensive employees and workers. We conclude that implementing simple educational programs in worksites can improve the management and control of hypertension and perhaps other chronic diseases.