فهرست مطالب عباس اندیشمند

Atherosclerosis is an inflammatory disease and is one of the leading causes of cardiovascular disease. Vascular plaques are formed on the inner surface of hardened arteries and gradually develop, reducing the diameter of the arteries. CXCR4 is one of the most important chemokine receptors, whose presence has been confirmed in cardiac plaques. Our aim was to determine the relationship between genetic diversity of CXCR4 gene (rs2228014) and atherosclerosis among the population of patients.

The present study included 254 participants who referred to the Cardiac Angiography Department of Afshar Hospital in Yazd City. The main criteria for admission to the case group were coronary artery stenosis with angiography testing, and in the control group, the clients did not have coronary artery disease. The age and sex matching of the two groups were considered. Blood specimens were taken, and after DNA extraction, the SNP genotype of the CXCR4 gene was determined using ARMS-PCR. Statistical analysis of the data carried out using SPSS software version 19 and Chi-square test.

Genetic models of rs2228014 variant were evaluated in patients with atherosclerosis in comparison with the control group and a significant difference between allelic (P = 0.333), homozygous (P = 0.087), heterozygous (P = 849.0), dominant (P = 0.570) and recessive (P = 0.086) genetic models of rs2228014 polymorphism was not observed.

In the current study, no significant difference was observed between genetic models of rs222801 polymorphism in patients with atherosclerosis and healthy individuals. Based on our findings, the rs222801 polymorphism of the CXCR4 gene might not be considered as a predisposing factor for atherosclerosis.

Unstable angina as a clinical condition includes a major group of patients manifested with acute coronary syndrome. Misdiagnosis of this clinical syndrome causes myocardial infarction (MI) and death. Conventional and advanced forms of treatment are used with the aim of rapid stabilization of unstable angina. Although infusion of glucose - insulin - potassium (GIK) solution has had good results in acute MI, no major trial has studied its effect in unstable angina. The main goal of this study was evaluation of the effectiveness of GIK solution on prognosis of hospitalized unstable angina patients.

This randomized clinical trial included patients with class II and III unstable angina (two groups of 94 patients, each ) with a mean age of 62.47±13.20 years and Female /Male ratio of 1.35 admitted in the CCU’s of Yazd from September 2003 to May 2004 .

There was no significant difference between the study and control groups regarding mean age, sex ratio and unstable angina class (P=0.15, P=0.77 and P=0.76). The study group had significant reduction in recurrent chest pain and duration of hospitalization (P=0.001 and P=0.02). The most common adverse effect of GIK solution was pain at infusion site.

Use of GIK solution causes early stabilization of unstable angina patients without any significant or life threatening adverse effect.

Several studies have evaluated the association of admission blood glucose levels and short and long term mortality after myocardial infarction and have had different results. The aim of this study was evaluation of association between admission blood glucose levels and in-hospital and one year mortality in non-diabetic patients with AMI.

In this study, demographic, clinical and Para clinical data of 120 non-diabetic patients with AMI on admission was collected and analyzed. The patients were followed for one year. Blood glucose level ≥ 140 mg/dl was defined as hyperglycemia.

78% of patients were men. The mean age and admission blood glucose level was 63+13 years and 146+76mg/dl, respectively. Death due to cardio vascular causes was seen in 20% of patients in hospital and 9.8% during the one year follow up. The mean admission blood glucose level in patients who died in hospital was significantly more than live patients and also had an influence on the in-hospital outcome. Every 100mg/dl increase in blood glucose level was associated with 11% increase in in-hospital mortality risk in non-diabetic patients.

Our results demonstrate that admission blood glucose level is a good marker for diagnosing patients with worse prognosis after AMI. We suggest that later studies should focus on optimal control of hyperglycemia with insulin in patients with AMI.

Previous studies have shown that various factors such as emotional stress can trigger of MI in susceptible persons. More studies are needed to evaluate the characteristics of patients regarding to emotional stress, heavy work, routine activity, infection or rest before occurrence of MI.

We studied 608 consecutive hospitalized in CCUs from May 2000 to October 2001. For patients, questionnaires including demographic, clinical and paraclinical characteristics were completed and data analyzed.

In this study rest (33.4%) and ordinary activity (32.4%) were more prevalent among the MI situations and infection had the lowest prevalence (0.7%). In patients higher than 45 years we had similar results, but in age group younger than 45 year ordinary activity (30.6%) and after heavy work (20.8%) had the highest prevalence before occurring of MI. In Diabetic patients, MI developed in sleep situation more frequently.(17.8%),(P=0.03) 52.5% of MI mortality occurred in rest situation.(P=0.009)

Rest had the highest prevalence of MI compared to other situations but in age group younger than 45 years MI after heavy work had the highest prevalence. Autonomic neuropathy may be one of the reason of higher prevalence of MI in sleep situation.