Arya Atherosclerosis
Volume:16 Issue: 6, Nov 2020

The feasibility and safety of coronary angiography (CAG) and angioplasty via trans-snuffbox approach (TSA) is still concerned; therefore, in this study, we aimed to assess possible complications occurring after TSA versus trans-radial approach (TRA).

This prospective observational study was undertaken from June 2017 till March 2018. Individuals aged at least 18 years who were admitted for CAG through upper extremity were eligible and categorized to TSA (n = 70) and TRA (n = 56) groups. Occurrence of complications including hematoma, pain or paresthesia, pseudoaneurysm formation, arterial obstruction, limb ischemia, and major adverse cardiovascular events (MACE) including death, myocardial infarction (MI), stroke, and emergency vessel revascularization was assessed after the procedure and in two separate visits three and six months afterwards.

The mean age of participants in TSA and TRA groups was 55.1 ± 9.7 and 56.5 ± 9.6 years, respectively (P = 0.415). Men were the dominant group in both approaches [TSA: 44 (62.8%), TRA: 36 (64.3%), P = 0.868]. Success rates in TSA and TRA were 88.6% and 94.6%, respectively (P = 0.230). Radial artery occlusion (RAO) was reported in two (3.2%) and one (1.8%) case in TRA and TSA, respectively (P = 0.653). MACE incidence was not significantly different in TSA compared with TRA group (1.8% vs. 4.8%, respectively, P = 0.389). There was no major procedural complication, neither in TSA nor in TRA category.

Our results revealed that TSA could be classified as an alternative modality to other common CAG and angioplasty methods due to its high safety rate and lower complications. Several comprehensive population-based studies are necessary for confirming these findings. Keywords: Radial Artery; V

The progression of atherosclerosis is an ongoing struggle between cell division and cell death. Lectin-like oxidized low-density lipoprotein receptor-1 (LOX-1), a novel receptor for oxidized low-density lipoprotein (ox-LDL), mediates ox-LDL-induced apoptosis of monocytes. The anti-atherogenic function of plasma high-density lipoprotein (HDL) includes the ability to inhibit apoptosis of macrophage, although the exact mechanism and consequences of apoptosis in the development and progression of this disease are still controversial. Thus, in the present study, the effect of normal HDL (nHDL) and reconstituted HDL (rHDL) on ox-LDL-induced cellular responses in differentiated monocytes in view of apoptosis and LOX-1 receptor expression was investigated.

The expression of B-cell lymphoma-2 (Bcl-2), B-cell lymphoma-extra large (Bcl-xL), caspase-3, and cytochrome c (cyt c) was assessed and substantiated in 30 hyper-LDL and control subjects. To assess the expression of LOX-1 on differentiated THP-1 cells, western blotting was carried out, followed by statistical analysis in 30 patients and control subjects.

nHDL/rHDL inhibited the ox-LDL-induced apoptosis in the differentiated human monocytic cells, THP-1 cells, and differentiated monocytes of patient and control subjects. Enhanced expression of scavenger receptor, LOX-1, in the differentiated monocytes was also downregulated in presence of nHDL/rHDL. nHDL/rHDL could inhibit the ox-LDL-induced mitochondrial apoptotic pathway and aberrant expression of LOX-1 in patients. Double immunostaining using fluorescein isothiocyanate (FITC)-conjugated ox-LDL and LOX-1 in apoptotic cells indicates its significant role in the differentiated monocytes.

It was observed that nHDL/rHDL could promote macrophage survival by preserving mitochondrial integrity from ox-LDL-induced apoptosis.

Atrial fibrillation (AF) is the most common tachyarrhythmia in patients with cardiovascular diseases (CVDs) and may have significant complications such as stroke. The present study aims to evaluate endothelial dysfunction in patients with lone atrial fibrillation (LAF) through flow-mediated dilation (FMD) in the brachial artery, as a non-invasive method for evaluating functional and structural markers of endothelial dysfunction.

In this case-control study, 43 patients with LAF were selected. 51 age and sex-matched healthy individuals were selected as the control group. The brachial artery diameter of the subjects in both groups was measured through FMD. The obtained data were analyzed by SPSS software.

Patients with LAF and healthy subjects did not have any difference in terms of gender, heart rate (HR), and systolic blood pressure (SBP) (P > 0.05 for all). FMD of the patients with AF was significantly lower (P = 0.04) than FMD of the healthy controls.

Our findings showed that LAF was associated with systemic endothelial dysfunction. AF plays an important and independent role in reducing FMD.

Circadian variation is known as an important factor in acute myocardial infarction (AMI). Moreover, the circadian pattern may help in disease prevention and better medication prescription. Therefore, the aim of our study was to investigate the circadian pattern of symptom onset in patients with ST-segment elevation myocardial infarction (STEMI).

This cross-sectional study was conducted on 777 patients admitted to the Imam Ali Cardiovascular Center, Kermanshah, Iran, with a diagnosis of STEMI from March 2018 to February 2019. Data were collected using a checklist developed based on the study's objectives. Differences between subgroups were assessed using one-way analysis of variance (ANOVA) with post-hoc testing and chi-square test (or Fisher’s exact test).

Out of the 777 patients, 616 (79.3%) were men. The mean and standard deviation (SD) of age of the patients was 60.93 ± 12.86 years. 380 patients (48.9%) were current smoker, 40.3% were hypertensive, 21.1% had hypercholesterolemia, 18.3% had diabetes mellitus (DM), 25.2% had history of angina, and about 15.0% had history of myocardial infarction (MI). The occurrence of STEMI was most common during hours between 06:01-12:00 (27.7%), followed by 12:01-18:00 (27.3%), 00:00-06:00 (24.3%), and 18:01-24:00 (20.7%), respectively. Gender was significantly associated with circadian pattern of STEMI. Women showed a double peak of symptom onset in 06:01-12:00 and 12:01-18:00.

The present study of Iranian patients displayed circadian pattern of STEMI with 2 peaks in the morning and afternoon, and the both peaks were dominated by women.

Atrial septal defect (ASD) is among the most common congenital anomalies that its neglect may cause severe right ventricular (RV)-associated cardiac dysfunction. Percutaneous closure of ASD is an efficient technique used commonly worldwide. Varieties of techniques have been used to assess postoperative changes of cardiac function. The current study has aimed to assess outcomes of percutaneous ASD closure using two-dimensional speckle tracking echocardiography (2D-STE).

This non-experimental research was conducted on 22 patients who volunteered for percutaneous ASD closure between 2016 and 2018. Cases were assessed three times including prior to percutaneous ASD closure, after 24 hours, and a month after procedure. Cases outcomes were assessed and compared during the time.

Strain rate in RV middle septal wall was significantly different (P < 0.05) between before and one month after the procedure. Comparison of indices post procedure and one month later showed better RV strain pattern but they did not have a significant difference (P > 0.05).

Based on this research, STE is a quick simple method of assessing cardiac chambers and function in details. It seems that this method can replace other traditional echocardiographic methods for cardiac function tests; thus, further studies with larger groups and longer follow-up duration are strongly recommended.

Premature coronary artery disease (CAD) is still prevalent worldwide and may differ in various ethnicities. Due to the presence of different ethnicities in Iran, the Iran-premature coronary artery disease (I-PAD) study aimed to determine the frequency of premature CAD and related risk factors based on each ethnicity.

In this multi-center case-control study, 4000 patients with premature CAD from ten different ethnicities who lived in different cities of Iran and underwent coronary angiography were enrolled (women aged ≤ 70 and men ≤ 60 years). Patients with CAD defined as obstruction equal or above 75% in at least a single coronary artery or left main ≥ 50% were included in the case group, while patients with normal coronary arteries were included in the control group. Lifestyle behaviors, cardiometabolic risk factors, anthropometric measurements, and other variables were collected. Serum, whole blood, buffy coat, plasma, urine, stool, and saliva samples were stored.

The number of patients enrolled until April 2020 was 2071. The mean age of patients was 53.51 ± 7.52 and 934 (45.09%) of patients were women. To date, about 39.6% of the patients were normal. Also, about 26.0% were with one-vessel disease (1VD), 15.0% with two-vessel disease (2VD), and 15.2% with three-vessel disease (3VD). More than 30000 patients' biosamples from across the country have been stored.

Knowing the frequency of premature CAD according to different ethnicities with major differences in their lifestyle behaviors and risk factors can assist health decision-makers. In addition, I-PAD biosamples will be an invaluable source. Keywords: Coronary Artery Disease; Ethnic Groups; Risk

Myocardial infarction (MI) is a multifactorial disease caused by the suspension of blood circulation in a part of the myocardium. Understanding the genetic basis of MI can provide insight regarding the pathogenesis of the disease. The aim of this study was to investigate the association between pathogenic mutations and early-onset MI in five families with familial MI and without common MI risk factor.

Patients with MI younger than 50 years with family history of MI and without common diagnostic criteria (obesity, diabetes, familial hypercholesterolemia, opium/alcohol use) were evaluated for pathogenic mutations by whole exome sequencing (WES) and mutation was confirmed by polymerase chain reaction (PCR)-Sanger sequencing.

The c.2855G>A missense mutation with homozygous autosomal recessive inheritance was identified in low-density lipoprotein receptor-related protein 8 (LRP8) gene in all patients of a family.

The c.2855G>A (R952Q) mutation in LRP8 gene in homozygous state could be considered as a possible etiology of early-onset familial MI.