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1.  Clinical Evaluation of Patients with Migraine Induced Stroke in Mashhad, Iran 
ARYA Atherosclerosis  2010;6(3):90-93.
BACKGROUND
Migraine Induced Stroke (MIS) is an important cause of brain infarction in the young people.
METHODS
Consecutive patients with MIS admitted in Ghaem hospital, Mashhad during 2006–2010 enrolled a prospective clinical study. All of the patients suspected to MIS had brain MRI with a 0.5 Tesla generation, Philips NT Intra, Netherland. All of the MIS patients underwent a standard battery of diagnostic investigations for detecting etiology of stroke. Disability of MIS patients was detected based on the modified Rankin scale at 90 days post stroke.
RESULTS
32 MIS patients (18 females, 14 males) with mean age 37.2 ± 3.8 years ranged 15–58 years were evaluated. Hypodense area of infarction corresponding to clinical manifestations was detected in MRI in 32% of our MIS patients. The mean disability score in our MIS patients was 1.09 ± 0.32, which is significantly lower than other stroke patients (z = 2.55, P = 0.007)
CONCLUSION
MIS is an important cause of stroke in Persian young adults which have good prognosis.
PMCID: PMC3347820  PMID: 22577422
Migraine; Stroke; Migraine Induced Stroke
2.  The Efficacy of Citroline in the Treatment of Ischemic Stroke and Primary Hypertensive Intracereral Hemorrhage; A Review Article 
ARYA Atherosclerosis  2010;6(3):122-125.
Stroke is a medical emergency with a mortality rate higher than most forms of cancer. It is the second leading cause of death in developed countries and the most common cause of serious, long-term disability in adults.
Primary intracerebral hemorrhage (ICH) is a major clinical problem that accounts for 15% of all acute stroke hospitalizations. Currently, there is no medical therapy available for these patients, with options being limited to supportive care or invasive neurosurgical evacuation. The damage induced by an ICH appears to be related to a combination of different factors. In addition to direct mechanical disruption from the hematoma, surrounding injury secondary to edema formation and ischemia are contributing factors for brain injury following ICH. Citicoline (cytidine-5-diphosphocholine) is an essential precursor for the synthesis of phosphatidylcholine that is key component of cell membranes. Citicoline is a naturally occurring endogenous compound. For clinical use, the sodium salt of this compound usually utilized. During ischemia, phosphatidylcholine is broken down into free fatty acids, which in turn are used to generate free radicals that potentiate ischemic injury. Citicoline is a neuroprotectant drug with some beneficial effects in human ischemic stroke and primary intracerebral hemorrhage (ICH) with an excellent safety profile.
In the current paper, we review published papers regarding use of citicoline in the treatment of human ischemic stroke and primary intracerebral hemorrhage (ICH).
PMCID: PMC3347821  PMID: 22577428
Citicoline; Treatment; Ischemic Stroke; Intracerebral Hemorrhage
3.  Effect of CRP on Some of the in vitro Physicochemical Properties of LDL 
ARYA Atherosclerosis  2010;6(3):85-89.
BACKGROUND
Atherosclerosis is the most important underlying cause of cardiovascular diseases (CVD) which recently has been classified as an inflammatory disorder. Accumulation of large amounts of oxidized LDL in the intima during local inflammation reaction led to increase several factors such as C -reactive protein (CRP). It has also been reported that CRP is able to bind with modified forms of LDL as well as oxidized LDL. These findings suggest possible positive or negative involvement of this protein in atherogenesis. The main objective of the present study was to assess the influence of CRP on LDL oxidation and the possible physical \changes of LDL in the presence of CRP in vitro.
METHODS
In this study, the susceptibility of purified LDL to oxidation was assayed by monitoring of formation of conjugated dienes in different physiological concentrations of CRP (0 - 0.5 -2 µg/ml) using a shimadzu spectrophotometer. Electrophoresis was used to determine the electrophoretic mobility of LDL in those conditions.
RESULTS
CRP significantly reduced the susceptibility of Cu++ -induced LDL oxidation through increasing the lag timeand there was positive relationship between these findings and CRP concentration (P < 0.05). CRP caused a significant reduction in the electrophotretic mobility of LDL compared to native LDL (n-LDL) (P < 0.05).
CONCLUSION
A considerable reduction was shown in LDL oxidation, in higher concentration of CRP, via an unknown mechanism. The electrophoretic mobility of LDL, in the oxidative condition, decreases in the presence of CRP compared to n-LDL, which can be indicative of the effect of this protein on the physical and chemical properties of LDL. It seems that, other pathway than LDL oxidation is responsible for the effect of CRP on the atherogenesis processes.
PMCID: PMC3347822  PMID: 22577421
Atherosclerosis; C reactive protein; Low-density lipoprotein; Inflammation
4.  Effects of 5-Year Interventions on Cardiovascular Risk Factors of Factories and Offies Employees of Isfahan and Najafabad: Worksite Intervention Project-Isfahan Healthy Heart Program 
ARYA Atherosclerosis  2010;6(3):94-101.
BACKGROUND
Effects of 5-year interventions of Worksite Intervention Project from Isfahan Healthy Heart Program on cardiovascular risk factors of factories and offices employees were studied in Isfahan and Najafabad (intervention area) compared to Arak (control area).
METHODS
We had especial interventions for nutrition, physical activity and smoking as well as hypertension and obesity screening systems in all offices and factories, and other risk factors screening systems whenever possible. Before and after the interventions, questionnaires containing demographic and other required data were completed for the two populations; height, weight and blood pressure (BP) were measured and a fasting and 2h blood sample was taken for the measurement of blood sugar (BS) and lipid levels.
RESULTS
The prevalence of hypercholesterolemia, hypertriglyceridemia and central obesity decreased, but low HDL increased in office staff (P < 0.01). Waist circumference, HDL and total cholesterol mean values decreased, and diastolic BP and fasting and 2h BS increased among the intervention group. In factory workers, the prevalence of hypertriglyceridemia and central obesity decreased, while low HDL prevalence increased in intervention group (P < 0.001). Mean values of waist circumference, HDL and total cholesterol, and triglyceride decreased significantly (P < 0.001), while diastolic BP and fasting BS increased.
CONCLUSION
It seems that Worksite Intervention Project has a protective effect on CVD risk factors in factories and offices employees. So, the modifiable project can be used as an applicable tool for health improvement in worksites which creates tangible changes in employees’ lifestyle.
PMCID: PMC3347823  PMID: 22577423
Risk Factors; Cardiovascular Disease; Workplace; Intervention
5.  The Correlation Between Lipid Profile and Stress Levels in Central Iran: Isfahan Healthy Heart Program 
ARYA Atherosclerosis  2010;6(3):102-106.
BACKGROUND
Previous studies suggest that mental status may influence serum lipid levels. This study was conducted on adult population living in rural and urban areas in Central Iran to assess the correlation between stress level and lipid profile disorders.
METHODS
Data was extracted from final evaluation of Isfahan Healthy Heart Program (IHHP) in 2008. Multistage and random cluster methods were used for sampling. The study population consisted of 9752 adults aged ≥19 years living in three districts namely Isfahan, Arak and Najaf Abad. Demographic data, age and sex were recorded. Blood samples were taken to determine the lipid levels including total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), low levels of high-density lipoprotein cholesterol (HDL-C) and triglycerides. Stress levels were assessed using the General Health Questionnaire. Logistic regression and chi-square tests were used for statistical analysis.
RESULTS
The odds ratios of high stress in individuals with high levels of TC, LDL-C and low levels of HDL-C compared to normal individuals after adjustment for age and sex were as follows respectively: 1.05 (1.02,1.15), 1.06 (1.02,1.18), 1.06 (1.01,1.17).
CONCLUSION
Intervention activities towards reduction of stress levels at the community level may be useful as part of the strategy for cardiovascular disease prevention.
PMCID: PMC3347824  PMID: 22577424
Cholesterol; Triglycerides; Stress; Adult
6.  Periodontitis as a Risk Factor in Non-Diabetic Patients with Coronary Artery Disease 
ARYA Atherosclerosis  2010;6(3):106-111.
BACKGROUND
Coronary artery disease (CAD) is responsible for many mortality across the world, especially in our country.The conventional risk factors for atherosclerosis are well understood, but they can account for only about50% to 70% of atherosclerotic events in the general population. The aim of this study was to investigate relationships between prevalent coronary artery disease(CAD) and clinical periodontal disease in patients with angiographic ally proven coronary artery disease.
METHODS
152 consecutive patients with angiographically proven coronary artery disease will be included in this study, who received a complete periodontal examination during visit.
RESULTS
Patients with normal coronary, average plaque index (1.6±1.02) Index of bleeding (1.51±0.92),mean adhesion level (3.57±1.18). But patients with coronary artery disease, the mean plaque index (2.46±0.62) Index of bleeding (1.86±0.92), mean adhesion level (4.13±1.45). This differences are statistically significant. (P <0.05) In this study, average depth of probe entrance on the surface of teeth has had little relation with cardiovascular disease (p=0.051).
CONCLUSION
According to the results of this study, in peoples over 40 years, who had coronary artery disease proved by coronary angiography, gingival inflammation (periodentitis) has a significant relation as a risk factor.
PMCID: PMC3347825  PMID: 22577425
Coronary artery disease (CAD); Gingival. inflammation (periodontitis); Coronary angiography
7.  Prognostic Factors for Survival at 6-Month Follow-up of Hospitalized Patients with Decompensated Congestive Heart Failure 
ARYA Atherosclerosis  2010;6(3):112-117.
BACKGROUND
The prevalence of Congestive Heart Failure (CHF) is increasing in recent years. Factors associated with mortality in CHF patients are important to be determined in order to select therapeutic modality by physicians. The purpose of the current study was to declare predictors of 6-months survival in patients hospitalized for decompensated CHF in Isfahan.
METHODS
A cohort of 301 hospitalized patients with decompensated CHF were recruited in this study. The diagnosis of CHF was based on previous hospitalizations and Framingham criteria for heart failure (HF). Information regarding past history, accompanying diseases such as cerebrovascular accidents (CVA), chronic obstructive pulmonary diseases (COPD), clinical data, medications and echocardiography were obtained by a cardiologist. Patients were followed for their survival for 6 months by telephone calls. Kaplan-Meier method was used for uni variate survival analysis and Cox proportional hazard model was used for multivariate analysis.
RESULTS
Mean age of patients was 71.9 ± 12.2 years and 59.8% was male. During 6-months follow-up 138 (45.8%) patients died. Mean survival was 119.2 ± 4.4 days (Mean ± SEM). Significant prognostic factors for 6 months survival were high education level (HR = 0.74, CI 95% 0.59—0.93), COPD (HR = 1.91, CI 95% 1.2—3.04), CVA (HR = 1.69, CI 95% 1.03—2.78), Angiotensin Converting enzyme (ACE) inhibitors use (HR = 0.44, CI 95% 0.3—0.66) and Diuretics (HR = 0.63, CI 95% 0.41-0.96).
CONCLUSION
Six-month survival of hospitalized decompensated CHF patients in Iran is not favorable. Many factors particularly accompanying diseases and medications affected the patient's 6-months survival.
PMCID: PMC3347826  PMID: 22577426
Heart failure; Survival; Mortality
8.  What Every Cardiologist Should Know about H1N1? 
ARYA Atherosclerosis  2010;6(3):118-121.
The world is witnessing ever fastest growing pandemic with high morbidity and mortality that excessive volume of airline travels spread influenza infection; so physicians with various specialties should know and consider the impact of current pandemic on their daily practice. Among influenza A viruses that infect humans, an influenza A virus emerged that had shifted to H1N1. Primarily, the results of pandemic of H1N1 were in younger humans without preexisting immunity. Attack rates of swine influenza are relatively high, but mortality is relatively low and mortality rate is highest in the very young, the very old, and the immunosuppressed. In this new pandemic, there is not more evidence of the interface of H1N1 with chronic diseases; however, we expect that the Swine flu such as the previous influenza pandemics can change the course of many chronic diseases.
In this review, we want to show the impacts of swine flu on cardiovascular system and disease. We will also discuss the importance of vaccination in chronic cardiovascular disease.
PMCID: PMC3347827  PMID: 22577427
H1N1 virus; Vaccination; Cardiovascular disease; Myocarditis
9.  Relationship Between Carotid Intima-Media Thickness with some Inflammatory Biomarkers, Ghrelin and Adiponectin in Iranians with and without Metabolic Syndrome in Isfahan Cohort Study 
ARYA Atherosclerosis  2010;6(2):56-61.
BACKGROUND
Recent studies have confirmed inflammatory factors and metabolic syndrome (MetS) as important cardiovascular disease (CVD) risk factors. Recently measurement of carotid intima-media thickness (IMT) has been used for evaluation of early atherosclerosis. This study was designed to assess the correlation between IMT with some inflammatory biomarkers, ghrelin and adiponectin in people with and without MetS in a cohort sample in Isfahan province.
METHODS
Among participants of Isfahan Cohort Study (ICS) by random sampling, 88 participants were selected and divided into case (with MetS) and control (without MetS) groups. A questionnaire including demographic data and CVD risk factors was completed for all of the participants. Physical examination and blood pressure, height, weight and waist circumference measurements were done for all subjects. Vascular echocardiography was done for evaluation of IMT of each carotid artery of both sides. Interlukin-6 (IL-6), interlukin-10 (IL-10), highly sensitive C-reactive protein (hs-CRP), ghrelin and adiponectin levels were measured using ELIZA method. Data were entered in SPSS15 software and analyzed by t-test, chi square, Pearson correlation and linear regression analyze.
RESULTS
The mean waist circumference, BMI, systolic blood pressure, diastolic blood pressure, hs-CRP and IMT of left carotid artery were significantly higher in participants with Mets. There was significant correlation between left carotid IMT and IL-6 level in all patients (P = 0.03). After adjustment for age and sex, significant relationship in groups with MetS was only reported between the left IMT and IL-6 (P = 0.02). There was no relation between IMT and other inflammatory markers in subjects with and without MetS.
CONCLUSION
Significant correlation between IL-6 and IMT was reported in patients with MetS. While no significant correlation between IL-10, adiponectin and ghrelin with IMT was observed in metabolic syndrome group.
PMCID: PMC3347812  PMID: 22577415
Intima-media thickness (IMT); Carotid artery; hs-CRP; Ghrelin; Adiponectin IL-6; IL-10
10.  Rare Occurrence of Simultaneous Dissection, Perforation and Thrombosis of External Iliac Artery Following Diagnostic Coronary Angiography: A Case Report 
ARYA Atherosclerosis  2010;6(2):82-84.
Lower extremity complications are the most common problems encountered during transfemoral diagnostic coronary artery angiography. Dissection, thrombosis and perforation of arteries of lower extremities although not uncommon, very rarely occur simultaneously. We did not find any report in the literature in this issue. In this report we describe a case of simultaneous occurrence of all three complications during coronary angiography in one patient. It also represents some of our uncertainties regarding the best management of the patient. In this patient, arterial perforation and dissection was managed conservatively, but we applied an invasive treatment (surgical thrombectomy) for arterial thrombosis with excellent short and long-term results.
PMCID: PMC3347813  PMID: 22577420
Perforation; Dissection; Thrombosis; External iliac artery; Acute arterial occlusion
11.  Some Notes on Stem Cell Therapy in Cardiovascular Diseases 
ARYA Atherosclerosis  2010;6(2):78-81.
Cardiovascular diseases have become an increasing clinical issue worldwide. Acute ischaemic injury and chronic cardiomyopathies lead to permanent loss of cardiac tissue and ultimately heart failure. Current therapies widely aim to attenuate the pathological changes that occur after injury and to reduce risk factors of cardiovascular diseases. However, they do not improve the patient's quality of life or the prognosis more than moderate. A new challenge in the treatment of the cardiovascular disease is cellular transplantation or cellular cardiomyoplasty. Different types of stem cells have been used for stem cell therapy. Clinical trials using primary bone-marrow-derived cells and skeletal myoblasts have also shown some encouraging results. An additional clinical and pre-clinical study to further enhance the beneficial effects of cell therapy is necessary. Recent studies have shown that there are various pools of putative resident stem cells in an adult heart, raising the hope that these cells can contribute to the treatment of cardiovascular diseases.
PMCID: PMC3347814  PMID: 22577419
Stem Cell Therapy; Cardiovascular Disease; Iran
12.  Iatrogenic Femoral Artery Pseudoaneurysm (REVIEW OF TREATMENT OPTIONS) 
ARYA Atherosclerosis  2010;6(2):74-77.
BACKGROUND
Atherosclerosis, which is a result of gradual deposition of lipids in the lower part of blood vessel endothelium, is the leading cause of mortality and morbidity around the world. It has been proved that some inflammatory blood markers such as fibrinogen can predict the risk for cardiovascular disease conditions, not only in cardiovascular patients, but also in those who do not have any manifestations of the atherosclerotic development. In this study, the effect of cornus mas l. was evaluated on fibrinogen of hypercholesterolemic rabbits and it was also compared with lovastatin drug.
METHODS
In this study, 25 New Zealand adult male rabbits were randomly divided into five groups of five. They were treated for 60 days by 5 different diets, namely basic, high cholesterol, regular plus 1 g/kgBW cornus mas L. powder, high cholesterol plus 1 g/kgBW cornus mas L. powder, and high cholesterol plus 10 mg/kgBW lovastatin. At the beginning and at the end of this period, blood samples were collected from the rabbits and their serum fibrinogen levels were measured.
RESULTS
Cornus mas L. powder and lovastatin significantly decreased fibrinogen levels in comparison with high cholesterol group (P < 0.05). Furthermore cornus mas L. powder could reduce the fibrinogen level more than lovastatin (P < 0.05).
CONCLUSION
The results indicated that consumption of cornus mas L. might be beneficial in atherosclerotic patients due to its reducing effects on fibrinogen.
PMCID: PMC3347815  PMID: 22577418
Atherosclerosis; Fibrinogen; Lovastatin; Rabbits
13.  Effect of Different Physical Activity Training Methods on Overweight Adolescents 
ARYA Atherosclerosis  2010;6(2):45-49.
BACKGROUND
In view of the growing trend of obesity around the world, including in our country, and the effect of reduced physical activity in increasing the incidence of obesity and overweight in children and adolescents and limitations of families in providing transport for their children to attend exercise classes, as well as time limitations of students in taking part in these classes, accessing appropriate methods for presenting physical activity training seems essential.
METHODS
This non-pharmacological clinical trial was performed during six months from May to November 2007 on 105 children and adolescents aged 6-18 years with obesity, randomly assigned to 3 groups of thirty-five. Nutrition and treatment behavior were the same in all groups, but physical activity training in the first group was taking part in physical activity training classes twice a week, in the second group by providing a training CD, and in the third group via face-to-face training. Before and after the intervention, anthropometric indicators were measured and recorded.
RESULTS
Mean body mass index (BMI) of participants in group attended physical activity training classes, and in the group undergone training with CD, after the interventions was significantly lower than that before the intervention.
CONCLUSION
Our findings demonstrated that training using CDs can also be effective in reducing BMI in overweight and obese children and adolescents as much as face-to-face education and participation in physical training classes. Extending such interventions can be effective at the community level.
PMCID: PMC3347816  PMID: 22577413
Children; Adolescents; Physical activity; Education; Obesity; Treatment
14.  Efficacy of Glucose-Insulin-Potassium Infusion on Left Ventricular Performance in Type II Diabetic Patients Undergoing Elective Coronary Artery Bypass Graft.Dy 
ARYA Atherosclerosis  2010;6(2):62-68.
BACKGROUND
Glucose-insulin-potassium (GIK) may improve cardiovascular performance after coronary artery bypass graft surgery (CABG). Our study investigated whether an infusion of GIK during elective CABG surgery in type II diabetic patient improved left ventricular performance.
METHODS
We measured left ventricular ejection fraction and troponin (Tn), a myofibrillar structural protein. In this research, after ethics committee approval, 50 patients with type 2 diabetes mellitus (DM) were enrolled into a randomized simple sampling, prospective, double-blind clinical trial study. In the case group, 500 cc dextrose water 5% plus 80 IU regular insulin and 40 mEq KCL were infused at the rate of 30 cc/hr. Patients in control group received 5% dextrose solution at the rate of 30cc/hr. Venous blood samples were taken before induction of anesthesia, after removal of the aortic clamp and before discharging from hospital. The Mann-Whitney-test was used to test for differences in troponin concentration between the groups. Fisher's exact test was used to determine whether there was a difference in the proportion of patients with a low ejection fraction (<45%) in the case group compared with that in the control group. Changes in potassium and glucose concentrations over time within the groups were examined by ANOVA and paired t-tests. P < 0.05 was regarded as significant level for all tests.
RESULTS
In this study, 50 patients with type 2 DM were evaluated in case and control groups. The mean age ± SD in the case group was 57.7 ± 9.9 years and in the other group was 61.2 ± 8.4 years. The groups were well-matched for age, sex and number of bypass grafts. Randomization did not give an equal distribution of male and female patients. There wasn't any significant difference in ejection fraction between the case and control groups before and after CABG (P > 0.05). Troponin concentration in the case group was 3.3 ± 5.0 and in the control group was 3.9 ± 5.1. There was no significant difference in Tn between the two groups before and after CABG (P > 0.05). There was not any significant difference in hospitalization time between the two groups.
CONCLUSION
The results suggested that GIK can't improve left ventricular performance in routine CABG surgery.
PMCID: PMC3347817  PMID: 22577416
Cardiovascular surgery; Glucose-Insulin-Potassium; Cardiac troponin
15.  Evaluation of Leptin and Adiponectin Levels in Patients with Stable Angina Pectoris 
ARYA Atherosclerosis  2010;6(2):50-55.
BACKGROUND
Leptin and adiponectin are two adipose tissue hormones and their association with the incidence of cardiovascular diseases is under evaluation. The aim of this study was to determine the relationship of leptin and adiponectin with coronary artery diseases.
METHODS
One hundred and seventy patients with angina pectoris and indications of coronary angiography underwent angiography. Serum levels of blood lipids, leptin, and adiponectin were measured. The gathered data was evaluated using SPSS15 software, by multivariate variance analysis.
RESULTS
Analysis of the data demonstrated that 45.1% of the patients had positive angiographic findings. The serum levels of leptin and adiponectin were significantly lower than the minimum levels specified by the kit. However, the two groups, i.e., patients with positive angiographic findings and those with negative findings were not significantly different according to the serum levels of the hormones. Moreover, no significant correlation between the serum levels of the hormones and serum lipids was observed.
CONCLUSION
Various studies have demonstrated that high serum level of leptin and the incidence of coronary artery diseases are correlated. On the other hand, they have reported that adiponectin has cardioprotective role. Confirmation of these findings requires more detailed studies.
PMCID: PMC3347818  PMID: 22577414
Leptin; Adiponectin; Coronary artery disease
16.  Can Timi Risk Score Predict Angiographic Involvement in Patients with St-Elevation Myocardial Infarction? 
ARYA Atherosclerosis  2010;6(2):69-73.
BACKGROUND
In most studies, the agreeable risk scores for ST-elevation myocardial infarction (STEMI) consist of thrombolytic in myocardial infarction (TIMI) risk score and modified Gensini risk score. Researchers showed significant relations between TIMI with angiography scores in patients with UA/NSTEMI. We studied this relation in patients with STEMI.
METHODS
We studied CCU patients with STEMI hospitalized in several hospitals of Isfahan, Iran from September 2007 to June 2008. Sampling method of 240 patients was random and simple. Exclusion criteria were incomplete history, nonspecific electrocardiogram changes, left bundle branch block and not accomplished angiography or accomplished angiography after 2 months of STEMI. Questionnaire indices collected on the basis of TIMI (0–14 points). Echocardiography and angiography were done and then, we used Gensini (0–400 points) to review films of angiography. Spearman‘s rank test and Pearson correlation coefficient were used to study the relation between these scores.
RESULTS
One hundred and sixty one patients were male and their average age was 60.02 years. Averages of TIMI and Gensini scores were 6.30±2.5 and 120.77±50.4, respectively. Study showed significant relation between TIMI, age and LVEF (P<0.001, r=−0.46). Also, between Gensini and age, gender and LVEF significant relation was found (P<0.001). But, a meaningful correlation didn't exist between TIMI and the gender (P=0.08). Our study proved direct relation between TIMI risk scores and modified Gensini scores (P<0.001, r=0.55).
CONCLUSION
We may decide quickly and correctly in emergency room to distinguish which patients with STEMI could derive a benefit from invasive strategies using TIMI score. Also, TIMI risk score can be a good predictor to determine the extension of coronary artery disease in patients with STEMI. As a result, we suggest determination of TIMI score for any patient entered emergency room. Also, this score should be recorded at the time patient's discharge.
PMCID: PMC3347819  PMID: 22577417
TIMI Risk Score; Modified Gensini Risk Score; LVEF; STEMI
17.  Liver-Protective Effects of Hydroalcoholic Extract of Allium Hirtifolium Boiss. in Rats with Alloxan-Induced Diabetes Mellitus 
ARYA Atherosclerosis  2010;6(1):11-15.
BACKGROUND
Diabetes mellitus is one of the most common endocrine disorders accompanied with many metabolic syndromes. Use of herbal medicines has always been an option to treat a great number of diseases such as diabetes and its complications. In this study the liver-protective effects of hydroalcoholic extract of Allium hirtifolium on liver enzymes level in rats with alloxan-induced diabetes mellitus was investigated.
METHODS
Thirty five male rats were randomly divided into five groups of seven; group 1: nondiabetic control, group 2: diabetic control, group 3: diabetic treated with shallot extract (0.1 g/kg), group 4: diabetic rats treated with shallot extract (1 g/kg), and group 5: diabetic treated with glibenclamide (0.6 mg/kg). Using intraperitoneal (IP) injection of alloxan monohydrate, diabetes mellitus was induced in rats. Diabetic rats were treated with intraperitoneal injection for 4 weeks. At the end of the experimental period fasting blood samples were collected.
RESULTS
Statistical analysis of the data indicated that hydroalcoholic extract of shallot can significantly decrease serum contents of liver enzymes (ALP, AST, and ALT) in treated groups. In most cases, the effectiveness of the extract on reduction of these enzymes is more than glibenclamide.
CONCLUSION
Antioxidant compounds in the extract may recover liver damages caused by free radicals in diabetic rats.
PMCID: PMC3347804  PMID: 22577407
Diabetes; Allium hirtifolium; Shallot; Alloxan monohydrate; Liver; Rat
18.  Comparing the Effects of Lovastatin and Cornus Mas Fruit on Fibrinogen Level in Hypercholesterolemic Rabbits 
ARYA Atherosclerosis  2010;6(1):1-5.
BACKGROUND
Atherosclerosis, which is a result of gradual deposition of lipids in the lower part of blood vessel endothelium, is the leading cause of mortality and morbidity around the world. It has been proved that some inflammatory blood markers such as fibrinogen can predict the risk for cardiovascular disease conditions, not only in cardiovascular patients, but also in those who do not have any manifestations of the atherosclerotic development. In this study, the effect of cornus mas l. was evaluated on fibrinogen of hypercholesterolemic rabbits and it was also compared with lovastatin drug.
METHODS
In this study, 25 New Zealand adult male rabbits were randomly divided into five groups of five. They were treated for 60 days by 5 different diets, namely basic, high cholesterol, regular plus 1 g/kgBW cornus mas L. powder, high cholesterol plus 1 g/kgBW cornus mas L. powder, and high cholesterol plus 10 mg/kgBW lovastatin. At the beginning and at the end of this period, blood samples were collected from the rabbits and their serum fibrinogen levels were measured.
RESULTS
Cornus mas L. powder and lovastatin significantly decreased fibrinogen levels in comparison with high cholesterol group (P < 0.05). Furthermore cornus mas L. powder could reduce the fibrinogen level more than lovastatin (P < 0.05).
CONCLUSION
The results indicated that consumption of cornus mas L. might be beneficial in atherosclerotic patients due to its reducing effects on fibrinogen.
PMCID: PMC3347805  PMID: 22577405
Atherosclerosis; Fibrinogen; Lovastatin; Rabbits
19.  Delay and its Related Factors in Seeking Treatment in Patients with Acute Myocardial Infarction 
ARYA Atherosclerosis  2010;6(1):35-41.
BACKGROUND
Early diagnosis and treatment of myocardial infarction can prevent life-threatening complications such as dysrhythmias and death. The aim of this study was to determine the length of delay and its related factors in seeking treatment among a group of patients with myocardial infarction.
METHODS
In a cross-sectional design, all the patients who had referred to a general teaching hospital (Kashan, Iran) for treatment of myocardial infarction from April 2004 to March 2005 were recruited. Demographic characteristics, the amount of delay, and the causes of having delay were recorded.
RESULTS
Two hundred patients were recruited for this study from which 131 (69%) patients had delay in seeking treatment. Factors such as gender, age, economical status, educational level, referring to a general physician before referring to the hospital, the severity of symptoms, residential place (urban vs. rural), and the time of the onset of the symptoms (day vs. night) were determined to be related to having delay. The most important causes of having delay were: "hoping the symptoms to alleviate spontaneously", "attributing the symptoms to other problems other than heart problems", and "disregarding the symptoms".
CONCLUSION
Regarding the most important causes of having delay in this study, the importance of educating people about the symptoms of myocardial infarction and the importance of early referral to the hospitals is clarified.
PMCID: PMC3347806  PMID: 22577411
Prehospital delay; Myocardial infarction; Onset-to-door time
20.  The Association of General and Central Obesity with Major Dietary Patterns in Adult Women Living in Tehran, Iran 
ARYA Atherosclerosis  2010;6(1):23-30.
BACKGROUND
Using dietary pattern analysis method could provide more information about nutritional etiology of chronic disease such as obesity. The aim of this study is to determine the association between major dietary patterns and general and central obesity among adult women living in Tehran.
METHODS
A cross-sectional study was conducted in Tehran, Iran, with 460 women aged 20-50 years. Dietary intake in last year was collected by a semi-quantitative food frequency questionnaire. Weight, height and waist circumstance (WC) were measured with standard methods and body mass index (BMI) was calculated. General obesity was defined as BMI ≥ 30 kg/m2 and central obesity as WC ≥ 88 cm. Factor analysis was used for identifying major dietary patterns. The association between major dietary patterns and general and central obesity were assessed by logistic regression analysis.
RESULTS
Two major dietary patterns were extracted: "Healthy" and "Unhealthy" dietary pattern. After adjusting for confounders, individuals in the highest quartile of the unhealthy dietary pattern score were more likely to be generally (OR = 7.33, 95% CI: 2.39-22.51) and centrally obese (OR = 4.99, 95% CI: 2.08-11.94); whereas, those in the upper quartile of healthy dietary pattern were less likely to be generally (OR = 0.38, 95% CI: 0.15-0.98) and centrally obese (OR = 0.33, 95% CI: 0.16-0.71).
CONCLUSION
Major dietary patterns of Tehrani women had a significant association with general and central obesity. Further prospective researches are required to confirm such associations.
PMCID: PMC3347807  PMID: 22577409
Dietary patterns; Factor analysis; Obesity; Women; Iran
21.  The Relationship Between Ankle-Brachial Index and Number of Involved Coronaries in Patients with Stable Angina 
ARYA Atherosclerosis  2010;6(1):6-10.
BACKGROUND
Atherosclerosis is the commonest cause of vascular disease which can involve peripheral and/or cardiac vessels. This study was conducted to evaluate the possible link between Ankle-Brachial Index (ABI) and coronary vessel involvement in patients with stable angina.
METHODS
This cross-sectional study was conducted in 2008 on 120 individuals who were hospitalized in Chamran Heart Center and underwent coronary angiography. A questionnaire was completed to obtain demographic information, history of previous heart disease and smoking. Body height and weight, as blood pressure on hand and foot were measured. The patients underwent angiography and the extent of coronary involvement (> 75%) was determined. After12-14-hour of fasting, blood sugar was obtained to measure total cholesterol, triglyceride, low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C). The Ankle Brachial Pressure Index (ABI) was calculated as the ratio of the blood pressure in the ankles to the blood pressure in the arms. The data were analyzed by SPSS-15 using ANOVA, T-Student test, Spearman's rank correlation coefficient, and discriminant analysis.
RESULTS
Samples were 46 women (38.33%) and 74 men (61.67%) with a mean age of 55.50 ± 10.49. Mean and SD of ABI in men and women was 0.72 ± 0.20 and 0.80 ± 0.19 with no significant difference (P=0.012). The correlation between ABI and extent of coronary involvement was 0.47 (P < 0.0001). The group with lower ABI had the highest levels of coronary involvement (triple vessel, P < 0.05).
CONCLUSION
ABI had a significant relationship with the degree of coronary involvement and a significant predictive value. Therefore ABI seems to be a reliable indicator of high coronary risk.
PMCID: PMC3347808  PMID: 22577406
Ankle to brachial index; Coronary involvement; Stable angina
22.  Effect of Hydrogenated, Liquid and Ghee Oils on Serum Lipids Profile 
ARYA Atherosclerosis  2010;6(1):16-22.
BACKGROUND
Trans fatty acids are known as the most harmful type of dietary fats, so this study was done to compare the effects of hydrogenated, liquid and ghee oils on serum lipids profile of healthy adults.
METHODS
This study was a randomized clinical trial conducted on 129 healthy participants aged from 20 to 60 years old who were beneficiaries of Imam-e-Zaman charitable organization. Subjects were randomly divided into 3 groups and each group was treated with a diet containing cooking and frying liquid, ghee, or hydrogenated for 40 days. Fasting serum lipids, including total cholesterol (TC), triglyceride (TG), LDL-cholesterol (LDL-C), HDL-cholesterol (HDL-C), apoprotein A (Apo A), and apoprotein B (Apo B) were measured before and after the study.
RESULTS
TC, TG and Apo B had a significant reduction in the liquid oil group compared to the hydrogenated oil group. In the ghee group TG declined and Apo A increased significantly (P < 0.01). Liquid oil group had a significant reduction in HDL-C, compared to the ghee oil group (P < 0.05).
CONCLUSION
It was concluded that consuming liquid oil along with frying oil caused to reduce all serum lipid levels. However, ghee oil only reduced TG and increased HDL-C levels.
PMCID: PMC3347809  PMID: 22577408
Serum lipids; Apoproteins; Liquid oil; Hydrogenated oil; Ghee; Clinical trial
23.  Pulmonic Valve Endocarditis with Pulmonary Artery Endarteritis in a Young Man with Congenital Ventral Septal Defect 
ARYA Atherosclerosis  2010;6(1):42-44.
BACKGROUND
Isolated pulmonic valve endocarditis is a rare condition. The clinical and laboratory finding are not specific and experiences about that are limited. Most cases of that occur in children with congenital heart disease or in intravenous drug abusers and the main predisposing factor in adults is intravenous drug abuse. The most common pathogens are staphylococcus aurous and coagulase negative staphylococcus.
CASE REPORT
In this case report we present a 27 years old man with chronic fever (4 months) and a history of congenital ventral septal defect (VSD). Echocardiography revealed the pulmonic valve and pulmonary artery vegetations. He referred for surgery after 3 weeks of intravenous antibiotic therapy.
CONCLUSION
Careful evaluation of pulmonic valve in echocardiography should be done, when ever vegetation is not detected in other valves, and clinical suspicion for infective endocarditis is high.
PMCID: PMC3347810  PMID: 22577412
Infective endocarditis; Pulmonic valve; Vegetation; Endartritis
24.  Is there any Relationship Between C-Reactive Protein Level and Complex Coronary Plaques in Patients with Unstable Angina? 
ARYA Atherosclerosis  2010;6(1):31-34.
BACKGROUND
Coronary artery disease is a leading cause of death in developed countries. On the other hand, increased level of CRP has been seen in atherosclerosis. According to this finding, we decided to conduct this study to assess the relationship between CRP and complex lesions of coronary arteries in patients with unstable angina.
METHODS
In this analytical cross sectional study which was conducted in 2007 in Chamran hospital, samples were collected using simple sampling and included 80 patients who referred to the hospital due to angina pectoris, had the diagnosis of unstable angina and were candidates of angiography. At first, a questionnaire was filled for each patient including demographic factors and their medical history. Then a blood sample was taken to assess level of CRP, FBS, and lipid profiles. The results of angiographic studies were considered by three cardiologists and abnormal patients were classified into simple and complex groups according to Ambrose criteria. Data was analyzed using SPSS version 15, t-student and chi-square tests.
RESULTS
Mean age of samples was 58.27 ± 6.23 years old. Considering the risk factors, most simple and complex lesions happened in obese patients however the only significant difference was observed in BMI between two groups (P < 0.05). Mean level of CRP in the population under study was 6.05 ± 4 mg/dl which was 1.37 ± 2 and 8.01 ± 6 in simple and complex groups respectively (P < 0.05). CRP mean was significantly higher in the group with complex lesions, less than 1 mg/dl in simple lesion and more than 4 mg/dl in complex lesions.
CONCLUSION
According to our findings, there is a significant difference considering CRP level in unstable angina patients who have complex lesions compared with simples ones. As complex plaques are more susceptible to develop coronary events, patients with a higher probability of complicated lesions can be screened.
PMCID: PMC3347811  PMID: 22577410
CRP; Simple and complex lesion; Unstable angina; Angiography

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