Arya Atherosclerosis
Volume:9 Issue: 4, Jul 2013

The main aim of this study was to evaluate the association between educational levels and central obesity in northern Iran in 2010. This was a cross-sectional study carried out on 2428 subjects (1227 men and 1201 women) of 15-65 years of age who were chosen by cluster and stratified sampling methods. Subjects were randomly selected from 125 clusters and each cluster included 20 cases. Interviewers recorded the data using a multidimensional questionnaire comprising socio-demographic indexes. Central obesity was seen in 34.8% of all subjects (15.9% male and 56.7% female) and in 15% of uneducated people. In the uneducated group, it was 20.0% and 31.1% higher than in the 1-9 years of schooling and high school or college educated groups, respectively (P = 0.001). The risk of central obesity increased in uneducated people (OR = 4.214, P = 0.001) and in people with 1-9 years of schooling (OR = 2.283, P = 0.001) compared with high school or college educated people. The risk of central obesity was higher in urban areas than in rural area (OR = 1.481, P = 0.001), in women than men (OR = 7.039, P = 0.001), in 40-65 year olds than 15-40 year olds (OR = 3.090, P = 0.001), and in the wealthy economic group than poor economic group (OR = 1.360, P = 0.013). The risk of central obesity increased in urban areas (OR = 2.266, P = 0.001) and the wealthy economic group (OR = 1.732, P = 0.001) after it was adjusted for education. Central obesity as a health problem in northern Iran has been supported in this study, and it had an inverse correlation with educational levels. Public health programs that aim to reduce central obesity should mainly focus on the illiterate and low educated people.

Atherosclerosis is the main cause of cardiovascular disease which is caused by a high-fat diet. Many of these patients use boiled quince leaves for their treatment. However, the supporting scientific information is limit. The aim of this study was to evaluate the effect of quince leaf on the progression of atherosclerosis and whether it can be an appropriate alternative to statins. 24 male rabbits were randomly divided into two groups: normal diet (6 n) and high-cholesterol diet (2% cholesterol, 18 n) for 8 weeks. At the end of the 8 weeks, both groups underwent blood sampling and their biochemical markers were measured. Then, all animals in the normal-diet group and three of the high-cholesterol diet group were killed to investigate atheromic plaque in their coronary artery. The 15 remaining rabbits of the high-cholesterol diet group were randomly divided into 3 groups (5 n) after discontinuation of the fatty diet. The first group was not given any treatment, the second received atorvastatin (0.5 mg/kg) orally, and the third received quince leaf extract (50 mg/kg) orally for 12 weeks. At the end of this period, after blood sampling, biopsy of coronary artery was performed for histological study. The results showed that atorvastatin and quince leaf significantly decreased total cholesterol, triglyceride, LDL, AST, ALT, AP, BUN, and Cr levels compared with the first group of the high-cholesterol diet group (P < 0.05). No significant difference was found between atorvastatin and quince leaf extract groups in biochemical markers and atherosclerotic plaque in coronary artery. Atorvastatin and quince leaf extract can effectively prevent the progression of atherosclerosis in coronary arteries. According to the results of this study and also lower toxic effects of herbal medication compared to synthetic medication, leaf extract can be a substitute for statins in treatment and prevention of cardiovascular disease. The anti-atherosclerotic effect of quince leaf is most likely related to its antioxidant components.

Cardiovascular diseases (CVDs) constitute 53% of deaths above the age of 30; 54% of these deaths are attributed to high blood pressure. Coronary artery disease (CAD) is the main cause of mortality in the world. Hypertension accounts for 13% of mortalities and 6% of morbidities and is one of the main risk factors that cause loss of healthy life years. Blood pressure is not optimally controlled even among those who are aware of their disease. Previous studies showed that apart from pharmacological treatment, lifestyle improvement can also play a significant role in the prevention of high blood pressure CVDs. Self-care among them has been addressed in several previous studies. There are few self-care programs in Iran, but no study has been conducted on blood pressure. In this study the primary model is designed and then revised, and in the pilot study the feasibility of the project was approved and the final model presented. The current project proposes a model for self-care of hypertensive patients and their families, and is based on education of health care providers and patients in such a way that patients can control their illness. The model can be implemented at a national scale.

Primary percutaneous coronary intervention (PCI) is the main treatment for patients with ST-segment elevation myocardial infarction (STEMI). We investigated factors affecting the major complications of this procedure. This case-control study assessed 200 patients receiving primary PCI for STEMI. Effects of some factors including age, sex, coronary artery risk factors, left ventricular function, thrombolysis in myocardial infarction (TIMI) flow, and number of involved vessels on major adverse cardiac events (MACE) were studied. Two thirds of patients were male but sex had no significant effect on MACE. Similarly, age, hypertension, and hyperlipidemia did not significantly affect the incidence of MACE. However, Killip class, left ventricular ejection fraction, diabetes, TIMI flow, and type of involved vessels had significant relations with the incidence of MACE. According to our findings, factors such as diabetes, left ventricular function, left anterior descending artery involvement, and low TIMI flow are risk factors of MACE.

Obesity is recognized as a chronic low grade and systemic inflammatory disease. Angiogenesis is critical for adipose tissue expansion. Several evidences have demonstrated that angiogenesis sustains inflammation by preparing oxygen and nutrients for inflammatory cells and inflammation in turn can cause insulin resistance, type 2 diabetes, and cardiovascular disease. The understanding of mechanisms of obesity especially main roles of inflammation and angiogenesis in fat mass expansion can lead to therapeutic approaches in growing field of obesity and its related disorders. In this review, we studied the relationship between obesity, angiogenesis, and inflammation.

Truncus arteriosus communis (TAC) is a rare heart disorder with the prevalence of approximately 1%, mostly in male newborns. In this disease, aorta and pulmonary artery have not been separated during fetus development and both originate jointly from left ventricle. In addition, various disorders are reported like ventricular septal defect (VSD), mitral and tricuspid valves defects, aortic septal defect (ASD), reduction of lung and lung vessels’ resistance, pulmonary hypertension, increase in heart rate, high perspiration, bad digestion, and tetralogy of Fallot.CASR REPORT: Parents of deceased patient were referred for genetic counseling after the death of third girl due to severe cardiac disorder. Cardiologist declared the disease in deceased girl as TAC based on findings along with VSD, ASD and hypoplastic aortic arch which resulted to death in the first day of birth. There was no chromosomal disorder in chromosome analysis of patient’ skin. Parents were interested to have another child, so they were referred to university''s Genetic Counseling Center to become aware of their next child’s condition. This disorder is genetically heterogeneous and multifactorial and because all external factors are not recognized, the accurate estimation of risk is not possible and the probability of risk for the next child is about 10% to 20%.

Coronary artery spasm is a transient narrowing of coronary arteries that slows or stops blood flow through the artery.CASE REPORT: We present a 42-year-smoker man without any medical problem who developed syncope. Coronary angiography revealed diffuse significant narrowing of proximal left anterior descending artery (LAD), 90% osteal stenosis of large obtuse marginal (OM), 90% diffuse narrowing of proximal right coronary artery (RCA), which was relieved by intracoronary administration of nitrate. He was discharged on calcium channel blockers and nitrates but one month later developed syncope again and died. Multivessel coronary artery spasm should be considered in young smoker patients without any other coronary risk factors who present with syncope.

Increased incidence of cardiovascular diseases, especially coronary artery disease (CAD), during recent decades shows this disease entity to be the leading cause of death in the world. On the other hand many successes were achieved in the treatment of these diseases with new technology, which has its own side effects and threats for the patient. Among these new strategies is percutaneous coronary intervention (PCI), especially with stent implantation. Although coronary stents are effective in the treatment of dissection and prevention of restenosis, many side effects and even death have been observed, from 5-10% per year. Some studies showed that there is a relation between high sensitivity C-reactive protein (hs-CRP), as a laboratory marker for early detection of thrombosis and/or restenosis, and early complications of percutaneous coronary intervention. The aim of this study is to evaluate hs-CRP level in patients after PCI and to investigate if this can be a prognostic value for detection of early complication. This is a descriptive, analytical study done in Shahid Chamran Hospital (Isfahan, Iran) in 2011–2012. 87 patients who had undergone PCI were studied. Their hs-CRP level was measured before and after the study. Moreover, early stent complications were detected during the first 24 hours after insertion. The data was recorded in a researcher-constructed checklist and analyzed by SPSS for Windows (version 18; SPSS Inc., Chicago, IL., USA). The mean ± SD of hs-CRP level in patients with and without complication were 1.36 ± 0.97 and 3.09 ± 1.8, respectively. According to Student’s t-test, the hs-CRP level in patients with early complications was higher than patients without early complications of stent implantation; the difference was statistically significant (P < 0.001). The hs-CRP serum concentrations of patients with, and without early stent complications were significantly different. According to the control diseases center (CDC) guideline, patients with a high level of hs-CRP need special care and attention.