mir hossein seyed mohammad zad

Vitamin D deficiency has been linked to cardiovascular diseases, but its impact on outcomes in myocardial infarction (MI) patients remains unclear. This study investigated the relationship between serum vitamin D levels and short-term and medium-term outcomes in patients with myocardial infarction. Ischemic heart diseases (IHD) are the most common cause of death in the world. Identifying risk factors and predictors can play a critical role in identifying high-risk people in screenings, identifying high-risk patients during admission to the hospital, and adjusting these risk factors in patients to improve prognosis.  This prospective observational study was conducted on 212 patients diagnosed with myocardial infarction at Seyed al-Shohada Hospital in Urmia, Iran. Having been admitted, the patients had their serum vitamin D levels measured using the same blood sample for routine tests. Levels of vitamin D were categorized as normal (>30 ng/ml), insufficient (21-29 ng/ml), or deficient (<20 ng/ml). The patient's files provided the demographic, clinical, and biomedical information, echocardiography, and angiography data. The patients were followed for at least six months post-MI, with a maximum follow-up of 11 months.  Follow-up occurred through monthly phone calls and outpatient clinic visits as needed. Primary outcomes included in-hospital complications (such as death, significant bleeding, acute pulmonary edema, cardiogenic shock, and arrhythmias), cardiac readmissions, and mortality. Logistic regression and Cox regression analyses were used to examine the connection between outcome variables and vitamin D levels, adjusting for potential confounders including age, gender, blood pressure, diabetes, blood lipids, creatinine, disease severity (SYNTAX score*), and left ventricular ejection fraction. The mean serum level of vitamin D in patients on admission was 33. 62 ng/dL. The average number of hospitalization days was 4.8 days, and the rate of re-hospitalization was 26.6% in the six-month follow-up and 30.3% in the 9-month follow-up. The hospital mortality rate was equal to 1.4%, and the mortality rate at the end of the follow-up period was equal to 8.3%. The most common complication during hospitalization among the patients was ventricular tachycardia. However, in follow-up, re-hospitalization due to previous issues was the most common complication.  The mean serum vitamin D level was 33. 62 ng/ml,with 52.8% of patients having insufficient or deficient levels. The most common in-hospital complication was ventricular tachycardia (11.5%). Vitamin D deficiency was not significantly associated with in-hospital complications. However, during the follow-up period, vitamin D deficiency was significantly related to increased risk of readmission to hospital (HR: 6.984, 95% CI: 3.500-13.936, p<0.001). The 6-month readmission rate was 26.6%, increasing to 30.3% at 9 months. Vitamin D deficiency was also associated with increased cardiac mortality (HR: 12.936, 95% CI: 1.494-112.016, p=0.020) during follow-up. The 9-month mortality rate was 8.3%. Other factors contributing to cardiac mortality included disease severity (SYNTAX score) and female gender.  While vitamin D deficiency did not impact short-term complications, it was associated with increased risk of hospitalreadmission and mortality in MI patients during medium-term follow-up. These findings suggest that vitamin D status can significantly impact long-term outcomes for MI patients.

Premature coronary artery disease (CAD) is common in men and women under 45 and 55 years, respectively. It has been demonstrated that R202Q mutation of MEFV gene may increase the risk of cardiovascular disease in individuals with metabolic syndrome. The goal of the present investigation was to evaluate the frequency of MEFV gene mutation R202Q in exon 2 in Iranian patients with premature CAD (West Azerbaijan province of Iran).

A total of 100 patients with premature CAD and 100 healthy individuals participated in this hospital-based study. Cases and controls were selected based on strict criteria, including a minimum of one documented angiography with at least 50% stenosis of the coronary artery. PvuII based PCR-RFLP technique was used for the detection of R202Q mutation in the tested samples.

R202Q mutation was not found in any of the healthy controls; whereas 12 out of 100 patients with premature CAD were heterozygote for R202Q mutation (12%) (12% vs. 0%). Considering the heterozygosity of the R202Q mutation in the patients, the allele frequency was 0.06 (12 out of 200 chromosomes).

Our results indicate that the R202Q mutation in the MEFV gene is frequent in patients with premature CAD. Further studies are necessary to analyze more details regarding variable expressivity or incomplete penetrance of R202Q mutation in the tested population.

Cardiac syndrome X (CSX) has been associated with endothelial dysfunction and inflammation. We conducted a case-control study to evaluate the association between platelet‎ and endothelial-derived microparticles (PMPs and EMPs), as specific quantitative plasma markers of endothelial dysfunction, and the presence of CSX.

The present study was conducted on 40 CSX patients and 19 healthy individuals. C-reactive protein (CRP), and hematological and biochemical parameters were evaluated. The MP concentration in platelet-poor plasma (PPP) was quantitatively determined through flow cytometry using specific anti-human CD31, CD41a, CD62E, and CD144antibodies.

The mean platelet volume (MPV) and positive CRP rate (≥ 3.8 mg/l) were higher in patients compared to controls (P = 0.02 and P = 0.01, respectively). The CD62E+, CD144+, and CD31+41− EMPs, as well as CD41+ and CD31+CD41+ PMPs showed significant increase in CSX patients compared to controls (P < 0.05). There were direct correlations between the mean percentage of detected EMPs and PMPs as well as between their expression intensity; however, a reverse correlation was seen between the percentage of MPs and CD144and CD41. Moreover, the MP level was reversely associated with prothrombin time (PT) and partial thromboplastin time (PTT) values. Only CD31+CD41+ PMP was correlated with CRP.

It seems that EMPs and PMPs increase in CSX, which may contribute to various processes involved in the development of this syndrome.

It is still unclear whether platelet count can predict the outcomes of acute myocardial infarction. In this study, we assessed the relationship between the initial platelet count on the degree of ST-segment depression and coronary flow rate among patients with MI who underwent percutaneous coronary intervention (PCI).

In this study, a total of 218 patients suffering from MI, who underwent primary PCI during 2016-2017 (Seyed-Shohada hospital, Urmia, Iran) were selected by consensus method. Demographic information and past medical history such as diabetes mellitus (DM), cigarette smoking, using Integrilin, and door-to-balloon (DTB) time were recorded. All patients were investigated in terms of cell blood count. Serial electrocardiogram (ECG) was also performed and the degree of ST-segment elevation was measured.

The mean (SD) age of participants was 58.67 (11.44) years. The initial platelet count was similar between patients with and without improvement in the ST-segment (P=0.275). There was no significant difference regarding thrombolysis in myocardial infarction (TIMI) between patients with and without improved ST-segment (P=0.380).

According to our results, the initial platelet count in patients who underwent angioplasty was not associated with coronary flow and echocardiographic responses to treatment

Recent studies have shown that some of the MEFV gene mutations are common in patients with coronary artery disease. The present study was designed to investigate the presence or absence of E148Q mutation in exon 2 of MEFV gene in patients with premature coronary artery disease. In this study, 90 patients with coronary artery disease were voluntarily selected for molecular analysis of the E148Q mutation in the exon 2 of the MEFV gene. 2-3 ml of peripheral blood was collected in tubes containing EDTA. Genomic DNA was extracted using "salting out" method. RFLP-PCR was used to determine the E148Q mutation. Of 90 patients studied, 7 (7.8%) patients were heterozygous for the E148Q mutation. In other words, of 180 chromosomes examined, 7 chromosomes (3.9%) had a mutated allele regarding E148Q mutation. In this study, the E148Q mutation was not found to be homozygote in tested samples. It can be concluded that E148Q mutation is not a risk factor for coronary artery disease in the tested group.

Premature coronary heart disease (PCHD) affects public health and leads to death. PCHD has several genetic and environmental risk factors. The aim of this study was to analysis of the mutations in exon 10 of MEFV gene in patients with PCHD in West Azerbaijan province of Iran.
Totally 41 PCHD patients who were admitted to the cardiology unit of Sayedoshohada hospital (Urmia, Iran) enrolled in the study. Selection of the patients was done based on the strict criteria, that is, who had a minimum of one angiographically documented coronary artery with the stenosis of 50%. Mutations in exon 10 of MEFV gene were found by direct sequencing.
V726A, M680I, K695R, and A744S mutations with 2.44%, 1.22%, 1.22%, and 1.22%, allelic frequency were found, respectively. Five patients (12.2%) with PCHD carried at least one mutated MEFV allele. Heterozygote V726A was the most frequent mutation among tested cases (4.88%), followed by heterozygote M680I, heterozygote K695R, and heterozygote A744S.
The results of the present study imply that the frequency of the MEFV gene exon 10 is significantly high in PCHD patients. This is the first report in its own kind in clinically diagnosed PCHD pa­tients of Iranian Azeri Turkish population.

The high mortality rate of myocardial infarction (MI) before admission to hospital, particularly at younger ages, is a major health challenge. In fact 90% of MI deaths among patients < 55 years occur before arrival at hospital. This study sought to examine the association between methods of transfer with MI-related outcomes. The study was conducted among patients admitted to Taleghani Teaching Hospital (Urmia, Iran) with chest pain and symptoms of early MI. These patients were studied for endpoints including treatment (thrombolytics) and survival. Information was collected using a previously developed and validated questionnaire. Data analysis was performed by examining frequency, means and standard deviations for a range of variables. We estimated the association between method of transfer and outcome using paired t-test and one way ANOVA. Among 274 eligible patients with admissions for MI, 41 (15%) were transferred by ambulances using emergency telephone hotlines while the remainder used alternative means. Among those not using ambulance services, 143 were not aware of the existence of those services and 76 did not believe they were experiencing MI. 48.5% of all patients received thrombolytic (streptokinase) therapy. Patients arriving by ambulance were significantly more likely to receive thrombolytic therapy than other patients (p-value =0.001), although there was no significant difference in mortality between the groups (p-value =0.88). This hospital-based study from Iran has identified lack of knowledge about emergency ambulance services as well as lack of awareness about symptoms of heart attack to be major barriers to using available facilities.