mohammad javad alemzadeh

There is some controversy over the efficacy of statins for the prevention of contrastinduced nephropathy (CIN). There have also been reports on varying efficacies of different statins. Hence, in this study the efficacy of atorvastatin and rosuvastatin for the prevention of CIN was assessed. This single-blind randomized clinical trial was performed on 495 random patients with myocardial infarction with ST-segment elevation undergoing primary percutaneous coronary intervention (PCI) in a training referral hospital in 2015. Patients were randomly assigned to receive either atorvastatin 80 mg at admission and daily or rosuvastatin 40 mg at admission and daily. CIN was defined based on serum creatinine elevation after 48 hours from the PCI. The incidence of CIN was observed in 63 patients (21.4%) After 48 hours from primary PCI. Of those, 17% (n = 50) were grade 1 CIN, while 4.4% (n = 13) were grade 2 CIN. There was no significant difference between rosuvastatin group compared with atorvastatin group, regarding the CIN grading (P = 0.14). Our results indicate that atorvastatin and rosuvastatin have similar efficacy for the prevention of CIN.

Rheumatic heart disease is the major cause of cardiovascular death in children and young adults in developing countries. In the present study, we investigated the changes in cardiac biomarker levels before and after percutaneous balloon mitral commissurotomy (PMC).
Patients with severe mitral stenosis undergoing elective PMC were prospectively enrolled. The blood sample was taken for the measurement of cardiac biomarkers (CKMB and CTnI) before and then 6 hours and 12 hours after PMC. The maximum level of the biomarkers after the procedure was determined for analysis.
Of a total of 56 patients (mean age =44.0±14.1 y), 91.1% were female. Except for 1 patient, all the other patients had cardiac biomarkers before the procedure in normal ranges. The serum levels of CTnI and CKMB increased significantly after the procedure. The patients who underwent complex septostomy had a significantly higher rise in CKMB (9.4±9.34 IU/L vs. 3.17±12.39 IU/L; P=0.03) and CTnI (0.15±0.20 µg/L vs. 0.07±0.12 µg/L; P=0.002).
The serum levels of CTnI and CKMB increased significantly following the procedure, especially in patients who underwent complex septostomy.

Although maintenance dialysis in patients with end-stage renal disease prevents death from uremia, patient survival remains an important issue. This study is the first in Iran to evaluate long-term survival of patients with ESRD. This retrospective study was conducted on 1861 patients with ESRD referred to 12 hemodialysis centers in Khuzestan province, Iran. The period of study was 21 years, which was between 1989 to may 2010. The median follow-up duration was 46.0 months. Patients who died within 90 days of commencing dialysis were excluded. The patient''s death as outcome measure was recorded and the survival was estimated by the Kaplan-Meier method. The mean age of 1861 patients at initiation of hemodialysis was 51.2 ± 17.2 years, and 1120 were men (60.2%). Diabetes mellitus (32.9%) and hypertension (24.1%) were the most common known causes of ESRD in our patients. Regardless of the cause of ESRD, 1-, 5-, 10-, and 15-year survival of hemodialysis patients was 83%, 25.2%, 3.8%, and 1.0% respectively. Survival of diabetic patients was significantly lower than nondiabetic patients (P