1
|
Khosravi A, Ghodsi S, Memarjafari M, Nematollahi A, Sheikh-Sharbafan R, Sadre-Bafghi SA, Moosavi SV, Abdollahzadeh M, Jalali A, Moshkani Farahani M. Long-Term Major Adverse Cardiovascular Events in Patients with Moderate and Severe COVID-19: A Focus on Early Statin Use and Previous CVD. J Tehran Heart Cent 2023; 18:183-195. [PMID: 38146416 PMCID: PMC10748661 DOI: 10.18502/jthc.v18i3.14113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 06/23/2023] [Indexed: 12/27/2023] Open
Abstract
Background Limited data exist regarding the status of long-term cardiovascular disease (CVD) outcomes of hospitalized COVID-19 patients. We aimed to examine the efficacy of early statin use after SARS-CoV-2 pneumonia and the impact of prior CVD on the incidence of cardiovascular events. Methods A prospective cohort study was performed on hospitalized COVID-19 patients. The primary endpoint was major adverse cardiovascular events (MACE) as a composite of cardiovascular mortality, stroke, heart failure, venous thromboembolism (VTE), revascularization, and nonfatal myocardial infarction (MI). The secondary endpoints comprised MACE components, all-cause mortality, readmission for COVID-19, and impaired functional classes. Results The mean age of the 858 participants was 55.52±13.97 years, and the median follow-up time was 13 months (11.5-15). Men comprised 63.9% of the patients. Overall, MACE occurred in 84 subjects (9.8%), and 98 patients (11.4%) received ventilation. A multivariate Cox regression model was employed to explore the association between statin use and outcomes, and the following hazard ratios were obtained: MACE (0.831 [0.529 to 0.981]; P=0.044), All-cause mortality (1.098 [0.935 to 1.294]; P=0.255), stroke (0.118 [0.029 to 0.48]; P=0.003), revascularization (0.103 [0.029 to 0.367]; P<0.0001), poor functional capacity (0.827 [0.673 to 1.018]; P=0.073), nonfatal MI (0.599 [0.257 to 1.394]; P=0.234), VTE (0.376 [0.119 to 1.190]; P=0.096), and decompensated heart failure (0.137 [0.040 to 0.472]; P=0.002). Prior CVD predicted MACE (2.953 [1.393 to 6.271]; P=0.005), all-cause death (1.170 [0.960 to 1.412]; P=0.102), and VTE (2.770 [0.957 to 8.955]; P=0.051). Conclusion Previous CVD is a robust predictor of long-term MACE and VTE. Early statin use might decrease the incidence rates of MACE, ischemic stroke, revascularization, and readmission for heart failure.
Collapse
Affiliation(s)
- Arezoo Khosravi
- Atherosclerosis Research Center, Clinical Sciences Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Saeed Ghodsi
- Atherosclerosis Research Center, Clinical Sciences Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
- Department of Cardiology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Cardiovascular Diseases Research Institute, Tehran Heart Center, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammadreza Memarjafari
- Cardiovascular Diseases Research Institute, Tehran Heart Center, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Nematollahi
- Cardiovascular Diseases Research Institute, Tehran Heart Center, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Sheikh-Sharbafan
- Cardiovascular Diseases Research Institute, Tehran Heart Center, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed-Ali Sadre-Bafghi
- Afshar Hospital, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Seyed-Vahid Moosavi
- Atherosclerosis Research Center, Clinical Sciences Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Mansour Abdollahzadeh
- Atherosclerosis Research Center, Clinical Sciences Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Arash Jalali
- Cardiovascular Diseases Research Institute, Tehran Heart Center, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Moshkani Farahani
- Atherosclerosis Research Center, Clinical Sciences Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| |
Collapse
|
2
|
Sheikh Beig Goharrizi MA, Ghodsi S, Mokhtari M, Moravveji SS. Non-invasive STEMI-related biomarkers based on meta-analysis and gene prioritization. Comput Biol Med 2023; 161:106997. [PMID: 37216774 DOI: 10.1016/j.compbiomed.2023.106997] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Revised: 04/01/2023] [Accepted: 05/01/2023] [Indexed: 05/24/2023]
Abstract
BACKGROUND AND AIMS Acute ST-Segment Myocardial infarction (STEMI) is a common cardiovascular issue with a considerable burden of the disease. The underlying genetic basis and non-invasive markers were not well-established. METHODS Here, we implemented a systematic literature review and meta-analyses integration methods on 217 STEMI patients and 72 normal individuals to prioritize and detect the STEMI-related non-invasive markers. Five high-scored genes were experimentally assessed on 10 STEMI patients and 9 healthy controls. Finally, the presence of co-expressed nodes of top-score genes was explored. RESULTS The differential expression of ARGL, CLEC4E, and EIF3D were significant for Iranian patients. The ROC curve for gene CLEC4E revealed an AUC (95% CI) of 0.786 (0.686-0.886) in the prediction of STEMI. The Cox-PH model was fitted to stratify high/low risk heart failure progression (CI-index = 0.83, Likelihood-Ratio-Test = 3e-10). The SI00AI2 was a common biomarker between STEMI and NSTEMI patients. CONCLUSIONS In conclusion, the high-scored genes and prognostic model could be applicable for Iranian patients.
Collapse
Affiliation(s)
| | - Saeed Ghodsi
- Department of Cardiology, Sina Hospital, Tehran University of Medical Sciences Tehran, Iran
| | - Majid Mokhtari
- Department of Bioinformatics, Kish International Campus, University of Tehran, Kish Island, Iran; Laboratory of Personalized Precision Medicine, Bioinformatics Research Institute, Tehran, Iran
| | - Sayyed Sajjad Moravveji
- Department of Bioinformatics, Kish International Campus, University of Tehran, Kish Island, Iran
| |
Collapse
|
3
|
Sheikh Beig Goharrizi MA, Ghodsi S, Memarjafari MR. Implications of CRISPR-Cas9 Genome Editing Methods in Atherosclerotic Cardiovascular Diseases. Curr Probl Cardiol 2023; 48:101603. [PMID: 36682390 DOI: 10.1016/j.cpcardiol.2023.101603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 01/17/2023] [Indexed: 01/21/2023]
Abstract
Today, new methods have been developed to treat or modify the natural course of cardiovascular diseases (CVDs), including atherosclerosis, by the clustered regularly interspaced short palindromic repeats-CRISPR-associated protein 9 (CRISPR-Cas9) system. Genome-editing tools are CRISPR-related palindromic short iteration systems such as CRISPR-Cas9, a valuable technology for achieving somatic and germinal genomic manipulation in model cells and organisms for various applications, including the creation of deletion alleles. Mutations in genomic deoxyribonucleic acid and new genes' placement have emerged. Based on World Health Organization fact sheets, 17.9 million people die from CVDs each year, an estimated 32% of all deaths worldwide. 85% of all CVD deaths are due to acute coronary events and strokes. This review discusses the applications of CRISPR-Cas9 technology throughout atherosclerotic disease research and the prospects for future in vivo genome editing therapies. We also describe several limitations that must be considered to achieve the full scientific and therapeutic potential of cardiovascular genome editing in the treatment of atherosclerosis.
Collapse
Affiliation(s)
| | - Saeed Ghodsi
- Department of Cardiology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | | |
Collapse
|
4
|
Davoodabadi Z, Hosseini Z, Norouzi S, Davoodabadi H, Sheikh-Sharbafan R, Ghodsi S. Cardiogenic shock following acute MI in a young patient with familial hypercholesterolemia, and severe aortic stenosis: A case report. Heliyon 2022; 8:e11909. [PMID: 36506387 PMCID: PMC9732302 DOI: 10.1016/j.heliyon.2022.e11909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 10/15/2022] [Accepted: 11/18/2022] [Indexed: 12/03/2022] Open
Abstract
Background Familial hypercholesterolemia is a relatively rare disorder with various clinical manifestations including premature coronary artery disease. Case presentation A 15-year-old boy presented with acute exacerbation of dyspnea and exertional chest pain with a progressive feature since one month earlier. He had a clustered family history of premature cardiovascular death, hyperlipidemia, and cutaneous lesions in two of his siblings. He presented with acute severe heart failure accompanied with high levels of cardiac troponin and LDL cholesterol. Echocardiography revealed severe LV dysfunction, in concert with valvular and supravalvular Aortic stenosis. He underwent Coronary angiography, which showed involvement of Left main coronary artery and two-vessel disease. The patient was diagnosed with cardiogenic shock secondary to acute non-ST segment elevation myocardial infarction, and phenotype of familial hypercholesterolemia. Conclusions Premature malignant atherogenesis in both aortic root and coronary arteries with early presentation of acute myocardial infarction and severe heart failure is an uncommon constellation in early course of the FH, which leads to confined treatment options.
Collapse
Affiliation(s)
- Zeinab Davoodabadi
- Department of Cardiology, Shahid Beheshti Hospital, Qom University of Medical Sciences, Qom, Iran
| | - Zahra Hosseini
- Department of Cardiology, Shahid Beheshti Hospital, Qom University of Medical Sciences, Qom, Iran
| | - Somayyeh Norouzi
- Department of Cardiology, Shahid Beheshti Hospital, Qom University of Medical Sciences, Qom, Iran
| | - Hassan Davoodabadi
- Department of General Surgery, Shahid Beheshti Hospital, Qom University of Medical Sciences, Qom, Iran
| | - Reza Sheikh-Sharbafan
- Department of Cardiology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Saeed Ghodsi
- Department of Cardiology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran,Corresponding author.
| |
Collapse
|
5
|
Sadre-Bafghi SA, Mohebi M, Hadi F, Parsaiyan H, Memarjafari M, Tayeb R, Ghodsi S, Sheikh-Sharbafan R, Poorhosseini H, Salarifar M, Alidoosti M, Haji-Zeinali AM, Amirzadegan A, Aghajani H, Jenab Y, Hosseini Z. Impact of Baseline Estimated Glomerular Filtration Rate Using CKD-EPI Equation on Long-term Prognosis of STEMI Patients: A Matter of Small Increments! Crit Pathw Cardiol 2022; 21:153-159. [PMID: 35994724 DOI: 10.1097/hpc.0000000000000296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Baseline biomarkers including glomerular filtration rate (GFR) guide the management of patients with ST-segment elevation myocardial infarction (STEMI). GFR is a tool for prediction of adverse outcomes in these patients. OBJECTIVES We aimed to determine the prognostic utility of estimated GFR using Chronic Kidney Disease Epidemiology Collaboration in a cohort of STEMI patients. METHODS A retrospective cohort was designed among 5953 patients with STEMI. Primary endpoint of the study was major adverse cardiovascular events. GFR was classified into 3 categories delineated as C1 (<60 mL/min), C2 (60-90), and C3 (≥ 90). RESULTS Mean age of the patients was 60.38 ± 5.54 years and men constituted 78.8% of the study participants. After a median of 22 months, Multivariate Cox-regression demonstrated that hazards of major averse cardiovascular event, all-cause mortality, cardiovascular mortality, and nonfatal myocardial infarction were significantly lower for subjects in C3 as compared with those in C1. Corresponding hazard ratios (HRs) for mentioned outcomes regarding C3 versus C1 were (95% confidence interval) were (HR = 0.852 [0.656-0.975]; P = 0.035), (HR = 0.425 [0.250-0.725]; P = 0.002), (HR = 0.425 [0.242-0.749]; P = 0.003), and (0.885 [0.742-0.949]; P = 0.003), respectively. Normal GFR was also associated with declined in-hospital mortality with HR of C3 versus C1: 0.299 (0.178-0.504; P < 0.0001). CONCLUSIONS Baseline GFR via Chronic Kidney Disease Epidemiology Collaboration is associated with long-term cardiovascular outcomes following STEMI.
Collapse
Affiliation(s)
- Seyed-Ali Sadre-Bafghi
- From the Afshar Hospital, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mehrnaz Mohebi
- Research Department, Tehran Heart Center, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Hadi
- Department of Obstetrics and Gynecology, Imam Hossein Medical Center, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hanieh Parsaiyan
- Research Department, Tehran Heart Center, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammadreza Memarjafari
- Research Department, Tehran Heart Center, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Roya Tayeb
- Research Department, Tehran Heart Center, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Saeed Ghodsi
- Department of Cardiology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Sheikh-Sharbafan
- Research Department, Tehran Heart Center, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamidreza Poorhosseini
- Department of Cardiology, Tehran Heart Center, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mojtaba Salarifar
- Department of Cardiology, Tehran Heart Center, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Alidoosti
- Department of Cardiology, Tehran Heart Center, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali-Mohammad Haji-Zeinali
- Department of Cardiology, Tehran Heart Center, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Amirzadegan
- Department of Cardiology, Tehran Heart Center, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Hassan Aghajani
- Department of Cardiology, Tehran Heart Center, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Yaser Jenab
- Department of Cardiology, Tehran Heart Center, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Hosseini
- Research Department, Tehran Heart Center, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
6
|
Ghodsi S, Memarjafari M, Hadi F, Tayeb R, Hosseini Z. Echocardiographic measurements of right heart pressures in recipients of heart transplant. Clin Cardiol 2022; 45:820. [PMID: 35702816 PMCID: PMC9346969 DOI: 10.1002/clc.23873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 05/16/2022] [Indexed: 12/05/2022] Open
Affiliation(s)
- Saeed Ghodsi
- Department of Cardiology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammadreza Memarjafari
- Research Department, School of Medicine, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Hadi
- Department of Obstetrics and Gynecology, School of Medicine, Imam Hossein Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Roya Tayeb
- Research Department, School of Medicine, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Hosseini
- Research Department, School of Medicine, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
7
|
Hosseini Z, Tayeb R, Ghodsi S, Sadre Bafghi SA, Mollazadeh R. An overview of genetic variants regarding efavirenz-related dysthymias in HIV-infected patients: Response to a letter to the editor. Clin Cardiol 2022; 45:329-330. [PMID: 35170776 PMCID: PMC9019889 DOI: 10.1002/clc.23789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Accepted: 01/12/2022] [Indexed: 11/26/2022] Open
Affiliation(s)
- Zahra Hosseini
- Department of Research, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Roya Tayeb
- Department of Research, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Saeed Ghodsi
- Department of Research, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed-Ali Sadre Bafghi
- Department of Research, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Mollazadeh
- Department of Cardiology, School of Medicine, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
8
|
Ghodsi S, Jenab Y, Mohebi M, Kamranzadeh H, Mohammadi Z. ST-Segment-Elevation Myocardial Infarction Unmasking Underlying Systemic Lupus Erythematosus or Representing Thrombotic Thrombocytopenic Purpura? Report of a Challenging Case. J Tehran Heart Cent 2022; 16:84-88. [PMID: 35082877 PMCID: PMC8742866 DOI: 10.18502/jthc.v16i2.7391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Accepted: 03/24/2021] [Indexed: 11/24/2022] Open
Abstract
Thrombotic thrombocytopenic purpura (TTP) is a multisystem disorder that frequently manifests itself with renal and neurological involvements. Cardiac involvement, however, has been rarely reported. In this report, we present a rare case of acquired TTP with acute myocardial infarction (AMI) as the initial manifestation. Although AMI was successfully managed by percutaneous coronary intervention, the patient developed hemolytic anemia, fever, marked thrombocytopenia, oliguria, and renal dysfunction, requiring treatment with plasma exchange and corticosteroids. TTP, albeit extremely rare, should be considered in cases with unexpected thrombocytopenia during acute-phase treatment for AMI as it can be highly lethal if not treated immediately.
Collapse
Affiliation(s)
- Saeed Ghodsi
- Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Yaser Jenab
- Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehrnaz Mohebi
- Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Hosein Kamranzadeh
- Hematology-Oncology and Stem Cell Transplantation Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Zohre Mohammadi
- Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
9
|
Ghodsi S, Masoudkabir F, Hosseini Z, Davarpasand T, Yavari N, Mohebi M, Talasaz AHH, Jalali A, Tafti SHA, Bagheri J, Hasanzadeh H. Steroid Use for Recovery of advanced atrioVentricular block Immediately after VALvular surgery (SURVIVAL): a preliminary randomized clinical trial. J Cardiovasc Electrophysiol 2022; 33:575-585. [DOI: 10.1111/jce.15378] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 11/05/2021] [Accepted: 11/18/2021] [Indexed: 11/26/2022]
Affiliation(s)
- Saeed Ghodsi
- Cardiac Primary Prevention Research Center, Tehran Heart Center, Tehran University of Medical SciencesTehranIran
| | - Farzad Masoudkabir
- Cardiac Primary Prevention Research Center, Tehran Heart Center, Tehran University of Medical SciencesTehranIran
- Department of CardiologyTehran Heart Center, Tehran University of Medical SciencesTehranIran
| | - Zahra Hosseini
- Cardiac Primary Prevention Research Center, Tehran Heart Center, Tehran University of Medical SciencesTehranIran
| | - Tahereh Davarpasand
- Department of CardiologyTehran Heart Center, Tehran University of Medical SciencesTehranIran
| | - Negin Yavari
- Cardiac Primary Prevention Research Center, Tehran Heart Center, Tehran University of Medical SciencesTehranIran
| | - Mehrnaz Mohebi
- Cardiac Primary Prevention Research Center, Tehran Heart Center, Tehran University of Medical SciencesTehranIran
| | | | - Arash Jalali
- Cardiac Primary Prevention Research Center, Tehran Heart Center, Tehran University of Medical SciencesTehranIran
| | | | - Jamshid Bagheri
- Department of Cardiac SurgeryTehran Heart Center, Tehran University of Medical SciencesTehranIran
| | - Hakimeh Hasanzadeh
- Department of Cardiac SurgeryTehran Heart Center, Tehran University of Medical SciencesTehranIran
| |
Collapse
|
10
|
Aghajani H, Aghajani M, Ghodsi S, Jenab Y, Hajhossein Talasaz A, Ghram A, Tofighi S. Acute Pulmonary Embolism in Women: Focus on Estrogen Therapy as a Predisposing Factor. ACTA 2021. [DOI: 10.18502/acta.v59i6.6894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Acute pulmonary embolism (APE) is a potentially fatal disorder. The literature shows that estrogen therapy is correlated with an increase in mortality and morbidity. Accordingly, the purpose of the present study was to investigate the prevalence and prognostic significance of the recent history of estrogen therapy in women with APE. This study was conducted on female patients admitted to our hospital between January 2008 and January 2016. A total of 276 patients (mean age=62.66±08 y) with confirmed APE were divided into groups with and without recent estrogen therapy. The relationships between estrogen and clinical findings, risk factors, imaging findings, and in-hospital mortality were analyzed. Among the 276 women with APE at presentation, 37 (13.4%) patients had a recent history of estrogen therapy. The estrogen group had a lower frequency of hypertension (21.6% vs49.8%; P< .001), immobilization of at least 3 days (16.2% vs 33.5%; P= .035), and pleural effusion (0% vs16.7%; P= .007) than the group without recent estrogen use. Among the 276 patients, the rate of 1 year’s mortality was 15.8% for the group without recent estrogen therapy. No death occurred in the estrogen group. Older age, tachycardia, tachypnea, malignancy, and lack of obesity were the predictors of 1 year’s mortality. Among the patients with APE in our study, 13.4% had a history of recent estrogen therapy. No death occurred during the 1-year follow-up of these patients.
Collapse
|
11
|
Hosseini Z, Mollazadeh R, Dehghan-Manshadi SA, Mohebi M, Eslami M, Sadre-Bafghi SA, Akbari A, Ghodsi S. Association between exposure to Efavirenz and substrates of dysrhythmia in HIV-infected young adults. Clin Cardiol 2021; 44:1448-1456. [PMID: 34328227 PMCID: PMC8495077 DOI: 10.1002/clc.23705] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 07/09/2021] [Accepted: 07/13/2021] [Indexed: 11/15/2022] Open
Abstract
Background Dysrhythmia and sudden cardiac arrest occur more likely in HIV patients than healthy subjects. Thus, we need to examine dysrhythmias adverse effects of medications including Efavirenz as early as possible especially in young subjects. Hypothesis Efavirenz might have contributed to increased risk of developing common types of dysrhythmia in young HIV infected patients. Methods We performed a retrospective cohort study among 62 patients on Efavirenz and 38 controls. All participants were under 40 years old without cardiovascular disease. Total significant dysrhythmia in 24‐hour ECG monitoring was the primary endpoint determined as the composite of high premature ventricular contraction (PVC) (>500 beats per 24 hours), high premature atrial contraction (PAC) (>500 bp24h), sinus pause, atrioventricular blocks, ventricular tachycardia, prolonged QTc, and low heart rate variability (HRV). Modified composite dysrhythmia consisted of low HRV (SD of normal‐to‐normal [SDNN]), high PVC and prolonged QT. Results Mean heart rate, Efavirenz regimen, male gender, and CD4 count predicted total dysrhythmia. Odds ratios were 1.108, 2.90, 4.36, and 0.96, respectively. The incidence of total dysrhythmia, high PVC, high PAC, low HRV(SDNN), and prolonged QTc were 54.8%, 41.85%, 9.71%, 45.2%, and 12.9% in patients on Efavirenz against 42.11%, 31.64%, 0%, 34.2%, and 7.91% in controls, respectively (p‐values: .031, .001, <.0001, .063, and .043 respectively). Modified composite dysrhythmia was also more frequent in Efavirenz group than that of control group (69.42% vs. 52.60%, respectively p = .032). Conclusions We found that patients with Efavirenz had higher prevalence of frequent PVC, frequent PAC, total significant dysrhythmia, Low HRV and prolonged QTc than controls.
Collapse
Affiliation(s)
- Zahra Hosseini
- Department of Cardiology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Mollazadeh
- Department of Cardiology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed-Ali Dehghan-Manshadi
- Department of Infectious and Tropical diseases, HIV-AIDS Research Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehrnaz Mohebi
- Department of Research, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Masoud Eslami
- Department of Cardiology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed-Ali Sadre-Bafghi
- Department of Research, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Akbari
- Biomedical Engineering Hill-Rom (Mortara) Sale and Technical Expert, Iranbehdasht Co, Tehran, Iran
| | - Saeed Ghodsi
- Department of Cardiology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
12
|
Masoudkabir F, Ghodsi S, Hosseini Z, Davarpasand T, Haj Hossein Talasaz A, Jalali A, Bagheri J. Steroid use for recovery of advanced atrioventricular block immediately after valvular surgery (survival): a randomized clinical trial. Europace 2021. [DOI: 10.1093/europace/euab116.320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Limited inconsistent evidence support use of steroids in recovery of atrioventricular block (AVB) after trans-catheter aortic valve implantation. However, there is no study to examine the efficacy of steroids in recovery of high-grade AVB following valvular surgery.
Purpose
To assess the effect of high-dose dexamethasone on recovery of advanced AVB following valvular heart surgery.
Methods
In this randomized controlled trial, patients with advanced postoperative AVB (either Mobitz type II or third degree) were randomly assigned to receive either dexamethasone (0.4 mg /kg, maximum 30 mg /day in three divided doses) intravenously for three days or conservative care only. Primary endpoint was recovery rate in day five since randomization. Secondary endpoints were recovery rate in day 7 and day 10, cumulative AVB time, PPM implantation rate, length of stay in critical care units, and post-operative major adverse events (MAE) during one month. We defined MAE as composite of all-cause mortality, all-type infections, major bleeding, prolonged sternal dehiscence, new stroke, postoperative MI, complicated uncontrolled hyperglycemia and readmission for decompensated heart failure.
Results
We enrolled 139 subjects (48.9% male) with mean age of 59.9 years who were randomly allocated to intervention group (n= 69) and control group (n= 70). Dexamethasone led to higher recovery rates at day 5 (82.6% vs. 62.9%, P= 0.009) and day 7 (88.4% vs. 61.4%, P< 0.0001) respectively. Random 24-hours ECG Holter monitoring of patients at day 5 revealed the same results and confirmed the superiority of dexamethasone for recovery of AVB (80.5% vs 61.2%, respectively, P = 0.024). Although this benefit ceased at day 10 (83.05 vs 78.6 %, P = 0.547), Generalized Estimating Equation analysis for recovery over 10 days favored intervention (odds ratio: 2.56, 95% CI: 1.27- 5.15, P = 0.008). Median cumulative AVB time was shorter in dexamethasone group compared to control group (41 hours vs 64 hours, P = 0.044). PPM implantation rates were similar between the dexamethasone and control groups (15.9% vs 17.1 %, respectively, P = 0.849). Median length of stay in ICU (10 days vs 12 days, P= 0.03) and MAE (17.4 % vs 25.7%, P = 0.133) tended to be lower with dexamethasone.
Conclusion
Our findings suggest that dexamethasone may serve as a safe and effective medication to improve recovery of advanced AVB after valvular surgery. Further studies are needed to confirm these findings, particularly regarding subsequent PPM implantation rate.
Collapse
Affiliation(s)
- F Masoudkabir
- Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran (Islamic Republic of)
| | - S Ghodsi
- Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran (Islamic Republic of)
| | - Z Hosseini
- Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran (Islamic Republic of)
| | - T Davarpasand
- Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran (Islamic Republic of)
| | - A Haj Hossein Talasaz
- Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran (Islamic Republic of)
| | - A Jalali
- Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran (Islamic Republic of)
| | - J Bagheri
- Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran (Islamic Republic of)
| |
Collapse
|
13
|
Ghodsi S, Mohebi M, Sadre-Bafghi SA, Poorhosseini H, Salarifar M, Alidoosti M, Haji-Zeinali AM, Amirzadegan A, Aghajani H, Jenab Y, Hosseini Z. Prognostic implications of calculated Apo-lipoprotein B in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention: Outcome is tied to lower cut-points. Clin Cardiol 2021; 44:824-832. [PMID: 33942349 PMCID: PMC8207970 DOI: 10.1002/clc.23610] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 04/06/2021] [Accepted: 04/09/2021] [Indexed: 01/24/2023] Open
Abstract
Background Debates still surround using lipoproteins including Apo‐B in risk assessment, management, and prognosis of patients with coronary artery disease. During an acute ST‐segment elevation myocardial infarction, Apo‐B might help to achieve incremental prognostic information. Objective We sought to determine the potential prognostic utility of calculated Apo‐B in a cohort of patients with STEMI undergoing primary PCI. Methods A retrospective cohort study was conducted enrolling 2,259 patients with a diagnosis of acute STEMI who underwent primary PCI. Apo‐B was obtained using a valid equation based on initial lipid measurements. High Apo‐B was defined as a level of 65 or higher. Primary endpoint of the study was major adverse cardiovascular events (MACE). Results Mean age of the participants was 59.54 years and 77.9% of them were male. After a Median follow up of 15 (6.2) months, high Apo‐B was associated with MACE and the OR (95% CI) was 3.02 (1.07–8.47), p = .036. Odds ratios for prediction of MACE pertaining to LVEF, and smoking were 0.97 (p = .044), and 1.07 (p = .033), respectively. However, High Apo‐B was not able to predict suboptimal TIMI flow. Accordingly, the Odds ratio was 0.56 (0.17–1.87), p = 0.349. The power of High LDL‐C and Non‐HDLC for prediction of MACE were assessed in distinct models. Attained odds ratios were [2.40 (0.90–6.36), p = .077] and [1.80 (0.75–4.35), p = 0.191], respectively. Conclusion Calculated Apo‐B appears to be a simple tool applicable for prediction of cardiovascular events in patients with STEMI superior to both Non‐HDLC and LDL‐C.
Collapse
Affiliation(s)
- Saeed Ghodsi
- Research department, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehrnaz Mohebi
- Research department, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed-Ali Sadre-Bafghi
- Research department, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamidreza Poorhosseini
- Department of Cardiology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mojtaba Salarifar
- Department of Cardiology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Alidoosti
- Department of Cardiology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Alireza Amirzadegan
- Department of Cardiology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Hassan Aghajani
- Department of Cardiology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Yaser Jenab
- Department of Cardiology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Hosseini
- Research center at department of Cardiology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
14
|
Amirzadegan A, Sadre-Bafghi SA, Ghodsi S, Soleimani H, Mohebi M, Nematipour E, Haji-Zeinali AM, Salarifar M, Pourhosseini H, Nozari Y, Tajdini M, Aghajani H, Alidoosti M, Jenab Y, Omidi N, Jalali A, Hosseini Z. One-Year Outcome of Patients with Coronary Artery Ectasia Undergoing Percutaneous Coronary Intervention: Clinical Implications and Question Marks. J Tehran Heart Cent 2021; 15:171-177. [PMID: 34178086 PMCID: PMC8217191 DOI: 10.18502/jthc.v15i4.5943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Background: Coronary artery ectasia (CAE) is a rare condition with unclear pathophysiology, optimal treatment, and prognosis. We aimed to determine the prognostic implications of CAE following coronary angioplasty. Methods: We conducted a retrospective cohort study on 385 patients, including 87 subjects with CAE, who underwent percutaneous coronary intervention (PCI). Major adverse cardiovascular events (MACE) were considered to consist of mortality, nonfatal myocardial infarction (MI), repeated revascularization, and stroke. Results: The mean age of the participants was 57.31±6.70 years. Multivariate regression analysis revealed that patients with diabetes, ST-segment–elevation MI at presentation, and high thrombus grades were more likely to have suboptimal post-PCI thrombolysis in myocardial infarction (TIMI) flow. However, CAE was not a predictor of a decreased TIMI flow (OR: 1.46, 95% CI: 0.78–8.32; P=0.391). The Cox-regression model showed that CAE, the body mass index, and a family history of MI were risk factors for MACE, while short lesion lengths (<20 vs >20 mm) had an inverse relationship. The adjusted hazard ratio (HR) for the prediction of MACE in the presence of CAE was 1.65 (95% CI: 1.08–4.78; P=0.391). All-cause mortality (HR: 1.69, 95% CI: 0.12–3.81; P=0.830) and nonfatal MI (HR: 1.03, 95% CI: 0.72–4.21; P=0.341) occurred similarly in the CAE and non-CAE groups. Conversely, CAE increased urgent repeat revascularization (HR: 2.40; 95% CI: 1.13–5.86; P=0.013). Conclusion: Although CAE had no substantial short-term prognostic effects on post-PCI TIMI flow, considerable concerns regarding adverse outcomes emerged during our extended follow-up. Stringent follow-ups of these patients should be underscored due to the high likelihood of urgent revascularization.
Collapse
Affiliation(s)
| | | | - Saeed Ghodsi
- Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Mehrnaz Mohebi
- Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Ebrahim Nematipour
- Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Mojtaba Salarifar
- Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Yones Nozari
- Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Masih Tajdini
- Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Hassan Aghajani
- Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Alidoosti
- Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Yaser Jenab
- Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Negar Omidi
- Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Arash Jalali
- Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Hosseini
- Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
15
|
Sattarzadeh R, Ghodsi S, Eslami M, Mollazadeh R, Safaei Nodehi R, Hosseini Z. Secondary Cardiac T-Cell Lymphoma Presenting with Syncope and Refractory Complete Atrioventricular Block: A Case Report. J Tehran Heart Cent 2021; 15:183-188. [PMID: 34178088 PMCID: PMC8217187 DOI: 10.18502/jthc.v15i4.5945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Cutaneous T-cell lymphomas constitute a rare category of non-Hodgkin lymphomas, which may involve the heart in the timeline of their natural course as an infrequent picture with a poor prognosis. Syncope, either due to outflow obstruction or conduction block, is also an uncommon presentation of cardiac metastasis. We herein describe a 35-year-old man, who presented with weight loss, dyspnea of 6 months’ duration, an indolent skin ulcer in the left flank, lower limb deep vein thrombosis (DVT), and recurrent syncope. He underwent implantation of a permanent pacemaker due to a complete heart block and received anticoagulants for the DVT. Skin biopsy demonstrated a T-cell lymphoma. The syncopal episodes ceased thereafter. Echocardiography and computed tomography scan revealed cardiac metastasis, which responded to systemic chemotherapy. In the first follow-up visit after 3 months, he was still pacemaker-dependent. However, the DVT was partially resolved, and the symptoms had disappeared.
Collapse
Affiliation(s)
- Roya Sattarzadeh
- Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Saeed Ghodsi
- Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Masoud Eslami
- Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Mollazadeh
- Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Safaei Nodehi
- Cancer Research Center, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Hosseini
- Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
16
|
Abstract
The pandemic of COVID-19 as a global concern has emerged the need for data aggregation about various clinical pictures particularly cardiovascular complications. Although the incidence of advanced atrioventricular block (AVB) in these patients is not well established, few cases have been reported. We have reported a 48-year-old man with COVID-19 infection who presented with prodromal symptoms for 5 days preceding complete AVB found at the emergency department. Pulmonary involvement and PCR confirmed the diagnosis. The block persisted after recovery of the patient for more than 1 month. Pathophysiology of advanced AVB following COVID-19 infection is not well understood. Several factors including inflammatory response, immune system over activity, myocarditis, and medications have been underlined. Although conservative management may lead to spontaneous recovery of AVB, pacemaker implantation is reasonable in case of persistent conduction defect.
Collapse
Affiliation(s)
- Zahra Hosseini
- Department of Cardiology, Shahid Beheshti Hospital, Qom University of Medical Sciences, Qom, Iran
| | - Saeed Ghodsi
- Department of Cardiology, Shahid Beheshti Hospital, Qom University of Medical Sciences, Qom, Iran.,Research Department, Tehran Heart Center, Tehran University of Medical Sciences, North Kargar Street, Tehran, 14111713138 Iran
| | - Seyed Fakhreddin Hejazi
- Department of Cardiology, Shahid Beheshti Hospital, Qom University of Medical Sciences, Qom, Iran
| |
Collapse
|
17
|
Asl Fallah S, Ghodsi S, Soleimani H, Mohebi M, Hossein Sabet A, Ariannejad H, Shirani S, Jahanian S, Jenab Y. Incidence and predictors of chronic thromboembolic pulmonary hypertension following first episode of acute pulmonary embolism. Adv Respir Med 2020; 88:539-547. [DOI: 10.5603/arm.a2020.0200] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 10/14/2020] [Accepted: 11/07/2020] [Indexed: 11/25/2022]
|
18
|
Hosseini Z, Ghodsi S, Sadre-Bafghi SA, Mohebi M, Meysamie A, Tofighi S, Soleimani H. Association of GFR, Fiber-Rich Regimen and Metabolic Syndrome With Elevated C-Reactive Protein Levels: Results of a Multicenter National Survey. ACTA 2020. [DOI: 10.18502/acta.v58i5.3953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
The present study investigates the association of cardiovascular risk factors such as metabolic syndrome (MetS), fiber-rich regimen, and Glomerular Filtration Rate (GFR) with elevated high-sensitivity C-reactive protein (hsCRP) levels. We designed a cross-sectional study based on data of the third National Survey of non-communicable diseases (SuRFNCD-2007); among 2125, Iranian adults (1168 women) aged 25-64 years. Demographic and anthropometric characteristics were collected. Biochemical assessments, were determined on venous blood samples. Quantitative highly sensitive CRP was measured via enzyme-linked immunoassay. Elevated CRP was defined as values above 3 mg/l. Metabolic syndrome was defined according to the ATP III (Adult Treatment Panel III report, 2005). GFR was calculated with the MDRD formula. Multivariable logistic regression accompanied by complex sample survey analysis, including stratified weighting, were recruited. The fiber-rich regimen was determined by the daily consumption of more than five units of vegetables or fruits. Mean age of the population was 39.4±4.5 years. Adjusted odds ratios for prediction of high CRP pertaining to High LDL, Low Physical activity, BUN, MetS ATP III, Declined GFR (per 30 units reduction), optimal Fiber intake, and Current Smoking were calculated. Corresponding values with 95 % CI were 1.36 (1.04-1.85), 1.31(1.11-4.20), 1.04(1.04-1.12), 1.47 (1.04-2.09), 1.22 (1.11-3.36), 0.84 (0.87-1.48), 1.74 (0.39-1.38), respectively. We figured out that MetS, declined GFR in early stages of CKD, and low physical activity were related to high inflammatory state, while fiber-rich regimen decreased the likelihood of high CRP in smokers.
Collapse
|
19
|
Saadatagah S, Ghodsi S, Omidi N, Poorhosseini H, Salarifar M, Sadeghian S, Alidoosti M, Kassaian SE, Aghajani H, Mortazavi SH, Hosseini K, Geraiely B. Twelve-Year History of STEMI Management in Tehran Heart Center: Concomitant Reduction of In-Hospital Mortality and Hospitalization Length. Arch Iran Med 2020; 23:514-521. [PMID: 32894962 DOI: 10.34172/aim.2020.53] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Accepted: 06/02/2020] [Indexed: 11/09/2022]
Abstract
BACKGROUND Cardiovascular-related death remains the major cause of mortality in Iran despite significant improvements in its care. In the present study, we report the in-hospital mortality, hospitalization length, and treatment methods for patients with ST-elevation myocardial infarction (STEMI) in Tehran Heart Center (THC). METHODS Records pertaining to patients with STEMI from March 2006 to March 2017 were extracted from the databases of THC. Besides a description of temporal trends, multivariable regression analysis was used to find factors associated with in-hospital mortality. RESULTS During the study period, 8,295 patients were admitted with STEMI with a mean age of 60.4 ± 12.5 years. Men accounted for 77.5% of the study population. Hospitalization length declined from 8.4 to 5.2 days, and in-hospital mortality was reduced from 8.0% to 3.9% (both P values < 0.001). In a multivariable model adjusted for age, sex, conventional cardiac risk factors, prior cardiac history, and indices of event severity, primary percutaneous coronary intervention (PCI) (OR: 0.280, 95% CI: 0.186 to 0.512; P<0.001), coronary artery bypass graft (CABG) surgery (OR: 0.482, 95% CI: 0.220 to 0.903; P=0.025), and rescue or facilitated PCI (OR: 0.420, 95% CI: 0.071 to 0.812; P=0.001) were all associated with reduced in-hospital mortality in comparison with medical treatment. Furthermore, primary PCI was a crucial protective factor against prolonged length of hospital stay (OR: 0.307, 95% CI: 0.266 to 0.594; P<0.001). CONCLUSION In-hospital mortality and hospitalization length were almost halved during the study period, and primary PCI has now replaced thrombolysis in the management of STEMI.
Collapse
Affiliation(s)
| | - Saeed Ghodsi
- Tehran Heart Center (THC), Tehran University of Medical Sciences, Tehran, Iran
| | - Negar Omidi
- Tehran Heart Center (THC), Tehran University of Medical Sciences, Tehran, Iran
| | | | - Mojtaba Salarifar
- Tehran Heart Center (THC), Tehran University of Medical Sciences, Tehran, Iran
| | - Saead Sadeghian
- Tehran Heart Center (THC), Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Alidoosti
- Tehran Heart Center (THC), Tehran University of Medical Sciences, Tehran, Iran
| | | | - Hassan Aghajani
- Tehran Heart Center (THC), Tehran University of Medical Sciences, Tehran, Iran
| | | | - Kaveh Hosseini
- Tehran Heart Center (THC), Tehran University of Medical Sciences, Tehran, Iran
| | - Babak Geraiely
- Tehran Heart Center (THC), Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
20
|
Saadat N, Saadatagah S, Aghajani Nargesi A, Alidoosti M, Poorhosseini H, Amirzadegan A, Lashkari R, Mortazavi SH, Jalali A, Ghodsi S, Salarifar M. Short-term safety and long-term benefits of stent postdilation after primary percutaneous coronary intervention: Results of a cohort study. Catheter Cardiovasc Interv 2019; 95:1249-1256. [PMID: 31318488 DOI: 10.1002/ccd.28396] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 05/25/2019] [Accepted: 07/02/2019] [Indexed: 11/07/2022]
Abstract
AIM Achieving the optimal apposition of coronary stents during percutaneous coronary intervention is not always feasible. The risks and benefits of stent postdilation in primary percutaneous coronary intervention (PPCI) in patients with ST-elevation myocardial infarction (STEMI) have remained controversial. We sought to evaluate the immediate angiographic and long-term outcomes in patients with and without stent postdilation. METHODS A cohort of patients (n = 1,224) with STEMI, treated with PPCI (n = 500 postdilated; n = 724 controls), were studied. The flow grade, the myocardial blush grade, and the frame count were considered angiographic outcomes. The clinical outcomes were major adverse cardiovascular events (MACE)-comprising cardiac death, nonfatal MI, and repeat revascularization-and the device-oriented composite endpoint (DOCE)-consisting of cardiac death, target lesion revascularization, and target vessel revascularization. RESULTS The flow and myocardial blush grades were not different between the two groups, and the frame count was significantly lower in the postdilation group (15.7 ± 8.4 vs. 17 ± 10.4; p < .05). The patients were followed up for 348 ± 399 days. DOCE (2.2% vs. 5.8%) and cardiac mortality (1.2% vs. 3.2%) were lower in the postdilation group. In the fully adjusted propensity score-matched analysis, postdilation was associated with decreased DOCE (HR = 0.40 [0.18-0.87], p = .021). CONCLUSIONS Selective postdilation improved some angiographic and clinical outcomes and could not be discouraged in PPCI on patients with STEMI.
Collapse
Affiliation(s)
- Nasser Saadat
- Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Arash Aghajani Nargesi
- Division of Nephrology and Hypertension, Department of Medicine, Mayo Clinic, Rochester, MN
| | - Mohammad Alidoosti
- Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | | | - Reza Lashkari
- Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Arash Jalali
- Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Saeed Ghodsi
- Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mojtaba Salarifar
- Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
21
|
Ashoori A, Pourhosseini H, Ghodsi S, Salarifar M, Nematipour E, Alidoosti M, Haji-Zeinali AM, Nozari Y, Amirzadegan A, Aghajani H, Jalali A, Hosseini Z, Jenab Y, Geraiely B, Omidi N. CHA2DS2-VASc Score as an Independent Predictor of Suboptimal Reperfusion and Short-Term Mortality after Primary PCI in Patients with Acute ST Segment Elevation Myocardial Infarction. ACTA ACUST UNITED AC 2019; 55:medicina55020035. [PMID: 30717292 PMCID: PMC6409514 DOI: 10.3390/medicina55020035] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Revised: 01/18/2019] [Accepted: 01/22/2019] [Indexed: 01/09/2023]
Abstract
Background and objectives: We aimed to demonstrate the clinical utility of CHA2DS2-VASc score in risk assessment of patients with STEMI regarding adverse clinical outcomes particularly no-reflow phenomenon. Materials and Methods: We designed a retrospective cohort study using the data of Tehran Heart Center registry for acute coronary syndrome. The study included 1331 consecutive patients with STEMI who underwent primary angioplasty. Patients were divided into two groups according to low and high CHA2DS2-VASc score. Angiographic results of reperfusion were inspected to evaluate the association of high CHA2DS2-VASc score and the likelihood of suboptimal TIMI flow. The secondary endpoint of the study was short-term in-hospital mortality of all cause. Results: The present study confirmed that CHA2DS2-VASc model enables us to determine the risk of no-reflow and all-cause in-hospital mortality independently. Odds ratios were 1.59 (1.30–2.25) and 1.60 (1.17–2.19), respectively. Moreover, BMI, high thrombus grade, and cardiogenic shock were predictors of failed reperfusion (odds were 1.07 (1.01–1.35), 1.59 (1.28–1.76), and 8.65 (3.76–24.46), respectively). We showed that using a cut off value of ≥ two in CHA2DS2-VASc model provides a sensitivity of 69.7% and specificity of 64.4% for discrimination of increased mortality hazards. Area under the curve: 0.72 with 95% CI (0.62–0.81). Conclusions: Calculation of CHA2DS2-VASc score applied as a simple risk stratification tool before primary PCI affords great predictive power. Furthermore, incremental values are obtained by using both CHA2DS2-VASc and no-reflow regarding mortality risk assessment.
Collapse
Affiliation(s)
- Ammar Ashoori
- Tehran Heart Center, Tehran University of Medical Sciences, Tehran 1411713138, Iran.
| | | | - Saeed Ghodsi
- Tehran Heart Center, Tehran University of Medical Sciences, Tehran 1411713138, Iran.
| | - Mojtaba Salarifar
- Tehran Heart Center, Tehran University of Medical Sciences, Tehran 1411713138, Iran.
| | - Ebrahim Nematipour
- Tehran Heart Center, Tehran University of Medical Sciences, Tehran 1411713138, Iran.
| | - Mohammad Alidoosti
- Tehran Heart Center, Tehran University of Medical Sciences, Tehran 1411713138, Iran.
| | | | - Yones Nozari
- Tehran Heart Center, Tehran University of Medical Sciences, Tehran 1411713138, Iran.
| | - Alireza Amirzadegan
- Tehran Heart Center, Tehran University of Medical Sciences, Tehran 1411713138, Iran.
| | - Hassan Aghajani
- Tehran Heart Center, Tehran University of Medical Sciences, Tehran 1411713138, Iran.
| | - Arash Jalali
- Tehran Heart Center, Tehran University of Medical Sciences, Tehran 1411713138, Iran.
| | - Zahra Hosseini
- Department of Cardiology, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran 1411713138, Iran.
| | - Yaser Jenab
- Tehran Heart Center, Tehran University of Medical Sciences, Tehran 1411713138, Iran.
| | - Babak Geraiely
- Tehran Heart Center, Tehran University of Medical Sciences, Tehran 1411713138, Iran.
| | - Negar Omidi
- Tehran Heart Center, Tehran University of Medical Sciences, Tehran 1411713138, Iran.
| |
Collapse
|
22
|
Saadat M, Masoudkabir F, Afarideh M, Ghodsi S, Vasheghani-Farahani A. Discrimination between Obstructive Coronary Artery Disease and Cardiac Syndrome X in Women with Typical Angina and Positive Exercise Test; Utility of Cardiovascular Risk Calculators. Medicina (Kaunas) 2019; 55:E12. [PMID: 30646563 PMCID: PMC6359077 DOI: 10.3390/medicina55010012] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 01/08/2019] [Accepted: 01/09/2019] [Indexed: 11/17/2022]
Abstract
Introduction: Nearly 40% of women with typical angina and a positive exercise tolerance test (ETT) have normal or near normal coronary angiography (CAG) labeled as cardiac syndrome X (CSX). Objective: We performed this study to evaluate the power of common cardiovascular risk calculators to distinguish patients with CSX from those with coronary artery disease (CAD). Methods: 559 women participated in the study. Three risk scores, including (1) newly pooled cohort equation of American College of Cardiology/American Heart Association (ACC/AHA) to predict 10 years risk of first atherosclerotic cardiovascular hard event (ASCVD), (2) Framingham risk score (FRS) for the prediction of 10 years coronary heart disease, and (3) the SCORE tool to estimate 10-year risk of cardiovascular mortality (SCORE), were applied. Results: CAD was diagnosed in 51.5% of the patients. 11.6% of the population had ASCVD < 2.5%, and only 13.8% of these patients had CAD on their CAG. By choosing FRS, 14.4% of patients had FRS < 7.5%, and only 11.3% of these patients had recorded CAD on CAG, while the rest of the patients were diagnosed as CSX. Using the SCORE model, 13.8% of patients had the least value (<0.5%) in whom the prevalence of CAD was 19.9%. The area under receiver operating characteristic curve (AUROC) to discriminate CSX from CAD was calculated for each scoring system, being 0.750 for ASCVD, 0.745 for FRS, and 0.728 for SCORE (p value for all AUROCs < 0.001). The Hosmer⁻Lemeshow chi squares (df, p value) for calibration were 8.787 (8, 0.361), 11.125 (8, 0.195), and 10.618 (8, 0.224) for ASCVD, FRS, and SCORE, respectively. Conclusions: Patients who have ASCVD < 2.5% or FRS < 7.5% may be appropriate cases for noninvasive imaging (Such as coronary CT angiography). CAG is indicated for patients with ASCVD ≥ 7.5% and FRS ≥ 15%, whereas the patients with intermediate risk need comprehensive patient⁻physician shared decision-making.
Collapse
Affiliation(s)
- Mohammad Saadat
- Cardiac Primary Prevention Research Center, Tehran Heart Center, Tehran University of Medical Sciences, Tehran 1411713138, Iran.
- Department of Cardiology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran 1411713138, Iran.
| | - Farzad Masoudkabir
- Cardiac Primary Prevention Research Center, Tehran Heart Center, Tehran University of Medical Sciences, Tehran 1411713138, Iran.
- Department of Cardiology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran 1411713138, Iran.
| | - Mohsen Afarideh
- Department of Cardiology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran 1411713138, Iran.
| | - Saeed Ghodsi
- Cardiac Primary Prevention Research Center, Tehran Heart Center, Tehran University of Medical Sciences, Tehran 1411713138, Iran.
- Department of Cardiology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran 1411713138, Iran.
| | - Ali Vasheghani-Farahani
- Cardiac Primary Prevention Research Center, Tehran Heart Center, Tehran University of Medical Sciences, Tehran 1411713138, Iran.
- Department of Cardiology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran 1411713138, Iran.
- Department of Electrophysiology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran 1411713138, Iran.
| |
Collapse
|
23
|
Abstract
INTRODUCTION Zirconia is suggested in many clinical situations due to acceptable biocompatibility, lower price compared with gold restorations, and better appearance than traditional metal ceramic restorations. New translucent monolithic zirconia has been developed to merge strength with improved tooth-colour matching. This work aims to review relevant articles on new translucent zirconia restorative materials. METHODS The published articles on translucent zirconia were searched through PubMed, Medline, Google scholar, and indexed journals using the following keywords: translucent zirconia, transparent zirconia, and tooth colored zirconia. The most relevant articles were selected and reviewed. RESULT Introduction of translucent zirconia, has brought the advantages such as less tooth preparation, biological compatibility, high strength, good mechanical properties, and less antagonist wear. However, the effects of altering material constituents to increase translucency on properties such as phase transformation and low temperature degradation may warrant further investigations. CONCLUSION Translucent zirconia can be prescribed in many clinical situations and may provide less complicated procedures compared with the production of multilayer restorations of opaque zirconia cores and translucent feldspathic veneers. This may otherwise decrease fabrication time and defects, improve biological properties, reduce abutment tooth reduction, and result in less antagonist tooth attrition.
Collapse
Affiliation(s)
- S Ghodsi
- Dental School-Tehran University Of Medical Sciences
| | - Z Jafarian
- Dental School-Tehran University Of Medical Sciences
| |
Collapse
|
24
|
Meysamie A, Salarvand F, Khorasanizadeh M, Ghalehtaki R, Eskian M, Ghodsi S, Ghalehtaki S, Abbasi M, Etemad K, Asgari F, Esteghamati A. Cardiovascular risk assessment by FRS and SCORE in Iranian adult population. J Diabetes Metab Disord 2017; 16:35. [PMID: 28852642 PMCID: PMC5568064 DOI: 10.1186/s40200-017-0316-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Accepted: 08/15/2017] [Indexed: 01/15/2023]
Abstract
BACKGROUND Handling the growing epidemic of coronary heart disease in developing nations hinges on primary prevention, which logistically requires directing preventive interventions to those at the highest risk. Therefore, implementing cardiovascular risk assessment profiles is crucial to distinguish high risk groups who truly need extensive preventive measures. We aimed to draw a picture of the cardiovascular risk profiles in the Iranian adult population for the first time. METHODS Demographic, anthropometric, and laboratory data as well as blood pressure and smoking status of 3944 subjects participating in the 2011 national surveillance of risk factors for non-communicable diseases were used to calculate the mean estimated risk of coronary artery disease and the relative frequency of low-, medium- and high-risk subjects based on FRS and SCORE indices in general population as well as different age, sex, and residence subgroups. RESULTS The average 10-year risk of coronary artery disease (FRS) and 10-year risk of fatal coronary and cerebrovascular accidents (SCORE) in the 25 to 64 year-old population was 13.82 and 0.72 respectively. The relative frequency of the intermediate- and high- risk subjects was 25.8 and 22.6% based on FRS and 9.2 and 1.8% based on SCORE respectively. Average FRS and SCORE were significantly higher among men than women, but were not significantly different among urban and rural residents. CONCLUSIONS A significant proportion of the Iranian population, based on FRS model, will be at moderate to high risk of coronary events in the next 10 years. Urgent preventive plans are needed at the national level.
Collapse
Affiliation(s)
- Alipasha Meysamie
- Department of Community and Preventive Medicine, Faculty of Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Fereshteh Salarvand
- Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Reza Ghalehtaki
- Radiation Oncology Research Center, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahsa Eskian
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Saeed Ghodsi
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Shirin Ghalehtaki
- School of Medicine, Ahvaz Jondishapour University of Medical Sciences, Ahvaz, Iran
| | - Mehrshad Abbasi
- Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Koroush Etemad
- Center for Disease Control, Ministry of Health, Tehran, Iran
| | | | - Alireza Esteghamati
- Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
25
|
Ghodsi S, Meysamie A, Abbasi M, Ghalehtaki R, Esteghamati A, Malekzadeh MM, Asgari F, Gouya MM. Non-high-density lipoprotein fractions are strongly associated with the presence of metabolic syndrome independent of obesity and diabetes: a population-based study among Iranian adults. J Diabetes Metab Disord 2017; 16:25. [PMID: 28596946 PMCID: PMC5463311 DOI: 10.1186/s40200-017-0306-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Accepted: 05/31/2017] [Indexed: 01/11/2023]
Abstract
BACKGROUND Non-HDL-C as a valuable predictor of premature atherosclerosis, coronary events like first Myocardial infarction and cardiovascular mortality has a high accuracy of measurement both in fasting and non-fasting individuals. Metabolic syndrome (MetS) can promote the development of diabetes mellitus, endothelial dysfunction and atherosclerosis. A common pathway for cross linking of metabolic abnormalities and non-HDL-C has been suggested. In this study we aimed to describe the potential association between non-HDL cholesterol fractions and metabolic syndrome. METHODS Data of third national surveillance of the risk factors of non-communicable diseases (SuRFNCD-2007) were analyzed. We defined metabolic syndrome (MetS) according to the Adult Treatment Panel III (ATPIII) and International Diabetes Federation (IDF) criteria for 2125 subjects aging 25-64 years. The receiver operating characteristic (ROC) curves were used to determine the optimal cut-points for the diagnosis of MetS. The curves were depicted for non-high-density lipoprotein cholesterol (non-HDL-C) and difference of total non-HDL-C and LDL-C (Differential cholesterol or Diff-C) as predictors of MetS. Logistic regression was also performed in a complex sample analysis scheme. RESULTS The area under the curve (AUC) with 95% Confidence intervals of total non-HDL-C was computed. Values were 0.693 (0.670-0.715) for IDF-defined MetS and 0.719 (0.697-0.740) for ATPIII criteria. The optimal non-HDL-C cut-point we recommend for both criteria is 153.50 mg/dl (sensitivity: 75.7%, specificity: 57.2%, with ATPIII; sensitivity: 73.2%, specificity: 57.1%, with IDF). Using IDF criteria, the accuracy of predictors were greater in non-diabetic subjects. AUC of Diff-C in DM (-) vs. DM (+) were 0.786 (0.765-0.807) vs. 0.627(0.549-0.705). Adults with high non-HDL-C were 4.42 times more likely to have ATPIII-defined MetS (≥190 vs. < 190 mg/dL). Elevated Diff-C corresponded to increased risk of the MetS (ORs: 10.71 and 26.29 for IDF and ATP III criteria, respectively. All P-values <0.001). CONCLUSIONS A significant robust association exists between non-HDL-C and MetS whether applying conventional or new thresholds.
Collapse
Affiliation(s)
- Saeed Ghodsi
- Department of Community and Preventive Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Alipasha Meysamie
- Department of Community and Preventive Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehrshad Abbasi
- Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Ghalehtaki
- Radiation Oncology Research Center, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Esteghamati
- Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Masoud M. Malekzadeh
- Digestive Disease Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Fereshteh Asgari
- Center for Disease Control, Ministry of Health and Medical Education, Tehran, Iran
| | - Mohammad M. Gouya
- Center for Disease Control, Ministry of Health and Medical Education, Tehran, Iran
| |
Collapse
|
26
|
Meysamie A, Ghodsi S, Ghalehtaki R, Esteghamati A, Asgari F, Gouya MM. Distributions of High-Sensitivity C-Reactive Protein, Total Cholesterol-HDL Ratio and 10-Year Cardiovascular Risk: National Population-Based Study. Acta Med Iran 2017; 55:218-227. [PMID: 28532132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/16/2017] [Indexed: 06/07/2023] Open
Abstract
The present study aimed to evaluate the distributions of High-Sensitivity C-reactive protein, TC-HDL ratio and 10-year risk of cardiovascular diseases among Iranian adult population. We conducted a cross-sectional study on a total of 2125 adults aged 25 to 65. Data of the Third National Surveillance of Risk Factors of Non-Communicable Diseases (SuRFNCD-2007) was used. Anthropometric indices, blood pressure and biochemical measurements had been obtained. Ten-year risk of cardiovascular events was also calculated using different models. Median (interquartile range) and geometric means (95% CI) of hs-CRP were 5.1(3.9) and 4.1(4.38-4.85), respectively. Mean TC-HDL ratio±(SD) was 5.94±2.84 in men and 5.37±1.97 in women (P<0.001). In spite of risk scores (FRS and SCORE), no significant gender and age-related differences were observed in hs-CRP levels. Exclusion of CRP levels≥10 did not change the results. The proportion of high-risk categories using SCORE and FRS models were 3.6 % and 8.8 %, respectively. In comparison with other published data, greater means and median values of High-Sensitivity C-reactive protein were observed. Higher TC-HDL ratio and cardiovascular risk in men than in women were also demonstrated. The issue of screening for cardiovascular diseases has yet to be addressed due to considerable prevalence of elevated CRP and increased risk of cardiovascular events among various subgroups.
Collapse
Affiliation(s)
- Alipasha Meysamie
- Department of Community and Preventive Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Saeed Ghodsi
- Department of Community and Preventive Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Ghalehtaki
- Department of Community and Preventive Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Esteghamati
- Endocrinology and Metabolism Research Center (EMRC), Vali-e-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Fereshteh Asgari
- Center for Disease Control, Ministry of Health and Medical Education, Tehran, Iran
| | - Mohammad Mehdi Gouya
- Center for Disease Control, Ministry of Health and Medical Education, Tehran, Iran
| |
Collapse
|
27
|
Sepanlou SG, Malekzadeh R, Poustchi H, Sharafkhah M, Ghodsi S, Malekzadeh F, Etemadi A, Pourshams A, Pharoah PD, Abnet CC, Brennan P, Boffetta P, Dawsey SM, Kamangar F. The clinical performance of an office-based risk scoring system for fatal cardiovascular diseases in North-East of Iran. PLoS One 2015; 10:e0126779. [PMID: 26011607 PMCID: PMC4444120 DOI: 10.1371/journal.pone.0126779] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2015] [Accepted: 03/11/2015] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Cardiovascular diseases (CVD) are becoming major causes of death in developing countries. Risk scoring systems for CVD are needed to prioritize allocation of limited resources. Most of these risk score algorithms have been based on a long array of risk factors including blood markers of lipids. However, risk scoring systems that solely use office-based data, not including laboratory markers, may be advantageous. In the current analysis, we validated the office-based Framingham risk scoring system in Iran. METHODS The study used data from the Golestan Cohort in North-East of Iran. The following risk factors were used in the development of the risk scoring method: sex, age, body mass index, systolic blood pressure, hypertension treatment, current smoking, and diabetes. Cardiovascular risk functions for prediction of 10-year risk of fatal CVDs were developed. RESULTS A total of 46,674 participants free of CVD at baseline were included. Predictive value of estimated risks was examined. The resulting Area Under the ROC Curve (AUC) was 0.774 (95% CI: 0.762-0.787) in all participants, 0.772 (95% CI: 0.753-0.791) in women, and 0.763 (95% CI: 0.747-0.779) in men. AUC was higher in urban areas (0.790, 95% CI: 0.766-0.815). The predicted and observed risks of fatal CVD were similar in women. However, in men, predicted probabilities were higher than observed. CONCLUSION The AUC in the current study is comparable to results of previous studies while lipid profile was replaced by body mass index to develop an office-based scoring system. This scoring algorithm is capable of discriminating individuals at high risk versus low risk of fatal CVD.
Collapse
Affiliation(s)
- Sadaf G. Sepanlou
- Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Malekzadeh
- Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Poustchi
- Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Sharafkhah
- Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Saeed Ghodsi
- Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Malekzadeh
- Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Arash Etemadi
- Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, United States of America
| | - Akram Pourshams
- Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Paul D. Pharoah
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Christian C. Abnet
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, United States of America
| | - Paul Brennan
- International Agency for Research on Cancer, Lyon, France
| | - Paolo Boffetta
- The Tisch Cancer Institute, and Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
| | - Sanford M. Dawsey
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, United States of America
| | - Farin Kamangar
- Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Department of Public Health Analysis, School of Community Health and Policy, Morgan State University, Baltimore, Maryland, United States of America
| |
Collapse
|
28
|
Ghodsi S, Rasaeipour S, Vojdani M. Oral rehabilitation of a patient with amelogenesis imperfecta using removable overlay denture: a clinical report. J Contemp Dent Pract 2012; 13:227-31. [PMID: 22665754 DOI: 10.5005/jp-journals-10024-1127] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
AIM The aim of this study was oral rehabilitation of 17-year old patient with amelogenesis imperfecta using removable overlay denture in order to satisfy her esthetic and functional expectations and enhance her self-image. BACKGROUND Amelogenesis imperfecta (AI) is a group of genetic disorders that primarily affect the quality and quantity of amelogenesis in both primary and permanent dentitions. The main clinical characteristics are severe attrition, tooth sensitivity and unesthetic appearance. CASE REPORT This clinical report illustrates the oral rehabilitation of a 17-year-old girl with hypoplastic-hypomature type of AI with cobalt-chromium (Co-Cr) overlay removable partial denture (ORPD) that is one of the most economical and biocompatible replacements for noble metal and nickel-chromium (Ni-Cr) alloy. CONCLUSION The presented case report suggests that Co-Cr ORPD can be a good temporary or even permanent treatment option for AI patients with limited budget, low esthetic concerns or medical limitations. CLINICAL SIGNIFICANCE There are major advantages in cast metal ORPDs; they are simpler, less traumatic and less expensive than fixed prosthetic options. This case report supports their use in patients with amelogenesis imperfecta.
Collapse
Affiliation(s)
- S Ghodsi
- Department of Prosthodontics, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | | |
Collapse
|
29
|
Ghodsi S, Gharavi S, Ghadam P. Cloning the hbs gene from Bacillus subtilis and expression of the HBsu protein in Escherichia coli. Iran J Microbiol 2010; 2:152-6. [PMID: 22347565 PMCID: PMC3279786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND OBJECTIVES Bacillus subtilis HBsu is a 10 kD heat-stable protein shown to be involved in binding to DNA and is encoded by the hbs gene. Large-scale production for biochemical analysis is achieved through cloning and expression of the recombinant protein. MATERIALS AND METHODS This gene was amplified from B. subtilis ATCC 6633 using PCR and cloned into pET28a (+) expression vector. The construct was used to transform Escherichia coli BL21 (DE3). The expression of the protein was induced by the addition of 1mM IPTG. To confirm the expression of the cloned gene, SDS-PAGE was carried out and production of an approximately 11 KD recombinant tagged protein was confirmed for the cloned hbs gene. RESULTS AND CONCLUSION The identity of the recombinant HBsu was verified and characterized by SDS-PAGE which can then be utilized for further applications.
Collapse
Affiliation(s)
| | - S Gharavi
- Corresponding author: Sara Gharavi Ph.D. Address: Biology Department, Faculty of Sciences, Alzahra University, Vanak, Tehran, IR Iran. Tel: +98-2188044052-2709 (Ext), Fax: +98-2188058912, E-mail:
| | | |
Collapse
|
30
|
Ghodsi S, Sadr AM, Moussavi A. Synovial sarcoma of the tongue: report of a case. Acta Med Iran 1974; 17:155-60. [PMID: 4377807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
|
31
|
|