amir sajjadieh

Acute coronary syndrome (ACS) is a common condition that needs appropriate treatment like percutaneous coronary intervention (PCI). Glycoprotein IIb/IIIa inhibitors (GPI) like eptifibatide prevent procedural ischemic complications after PCI. Eptifibatide has increased the risk of bleeding complications, although it is effective in reducing mortality and morbidity. Eptifibatide is routinely used in bolus and infusion forms and the aim of this study is to evaluate the efficacy of bolus-only dose and bolus + infusion strategy for administrating eptifibatide in bleeding complications and consequences after PCI. This randomized clinical trial was conducted on subjects who experienced PCI after incidence of myocardial infarction (MI). Patients were randomly divided into two groups who received bolus-only dose (n = 51) or bolus + infusion form of eptifibatide (n = 50). Then, PCI blood pressure, mean time duration of hemostasis after arterial sheath removal, laboratory data, need for blood transfusion, and presence of bleeding complications were evaluated. After 6 months, patients were followed for needs for additional coronary interventions. The mean age of participants was 61.68 ± 1.50 years. The prevalence of men was 70.29%. There was no significant difference in mean of systolic blood pressure (SBP) and diastolic blood pressure (DBP) during hospitalization (P > 0.050). The mean time duration of hemostasis was 8.13 ± 0.45 minutes in the bolus-only group and 16.46 ± 0.71 minutes in the bolus + infusion group (P < 0.001). There was no significant difference in the hemoglobin (Hb) level, platelet count, white blood cell (WBC), blood urea nitrogen (BUN), and creatinine level (P > 0.050). The results of this study suggested that bolus-only dose of eptifibatide before PCI could be able to decrease significantly bleeding complication and other clinical and cardiovascular outcomes.

There are a few literature data on the correlation between metabolic syndrome (MetS) and coronary disease among Iranian population. This study aimed to find relationship between MetS and severity of coronary artery disease (CAD) in presence of diabetes.
Total of 192 patients were consecutively enrolled in the study who were admitted to coronary care unit because of acute coronary syndrome (ACS) and then underwent coronary angiography. MetS was defined by Iranian criteria. A coronary atherosclerosis score was used to quantify the extent of atherosclerotic involvement. The relationship between MetS and angiographic coronary artery disease (CAD) severity or clinical presentation was compared between them after adjusting for diabetes.
Individuals with MetS (n = 125) had a higher prevalence of ST-elevation myocardial infarction (71% vs 30%, P MetS was related to the severity of CAD both clinically and by angiographic scores but diabetes was a challenging factor and may independently increase the severity of CAD.

Multislice computed tomography (CT) angiography is a robust imaging method for noninvasive assessment of coronary artery diseases, which is associated with high radiation dose. Having knowledge of the various parameters used to estimate the dose plays an important role in increasing the understanding of dose delivered to patients and help operators and technologist to reduce the dose. In this research, the amounts of Weighted Computed Tomography Dose Index (CTDIW) for coronary CT angiography exams were measured in Isfahan city, Iran.
To calculate the dose, an ionization chamber (Piranha, X-ray Analyzer, RTI Electronics and Sweden) and acrylic body phantom were used. Common conditions of coronary CT angiography used in two centers were applied for this project. Finally, CTDIW of all the scans were calculated using the related formulation.
Findings: The amount of mean CTDIW for calcium score exams in Sina and Alzahra hospitals were 0.468 ± 0.190 and 2.354 ± 0.610 mGy, respectively (P = 0.007); and for coronary CT angiography scans in Sina and Alzahra hospitals were 6.221 ± 1.290 and 5.299 ± 0.840 mGy, respectively (P = 0.860).
CTDIW for the calcium score was significantly different in the two centers, but there was not significant difference in the two centers for coronary CT angiography scans. In this study, the amount of CTDIW was much lower than the measured in other centers. Since scan parameters have an important effect on the dose value, training and precision of technologist result in dose reduction and patient radiation protection.