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Showing 18 results for Myocardial Infarction

Effat Mazaheri , Seyedhashem Sezavar , Adalat Hosseinian , Nasrin Fooladi ,
Volume 2, Issue 4 (12-2002)

  Background & Objective : Today, with changes in health care systems, most of the patients, receive occupational and special cares at home after being discharged from hospital . The aim of this study was to assess the effects of follow up on physical and emotional status of the patients with recent myocardial Infarction .

  Methods : This experimental study was done on 60 patients with acute myocardial infarction, who referred to Boali Hospital during 2000-2001.The patients were chosen randomly and were set in two different groups with 30 subjects in each group . Then, a home care program was designed for case group. but there was no intervention for control group . This home care program was completed and one week later the physical and emotional status of the patients in two groups were analyzed by Spilbergar and Beck tests and finally the results were compared in two groups using X2 test.

  Results : The X2 test showed that there is a significant difference between resting heart rate of two groups with P<0.05 but the difference among systolic and diastolic blood pressure, body weight, anxiety and depression was not statistically significant in two groups.

  Conclusions: Regarding the effects of follow-up on the physical and emotional status of the patients, nurses can improve the quality of the patienys life through active home - care and rehabilitation programs along with social supports.

Adalat Hosseinian , Seyedhashem Sezavar , Mohammadtaghi Nikneghad , Farid Ghosseili, Zahra Mussavi , Eilnaz Mohammadi ,
Volume 3, Issue 2 (6-2003)

 Background & Objective: Despite all improvements in diagnosis and treatment, one third of patients with Myocardial infarction lose their life. Different studies have shown that cardiac arrhythmia are the most common cause of death in MI, and cardiac blocks are one of the important groups of these arrhythmia, which are effective in prognosis, duration of hospitalization and hospital mortality of the patients.

  Methods : In this study, 630 patients with AMI, who were admitted in CCU of Bou-Ali hospital in Ardabil from January 1998 to January 2001 were studied and the data were callected with the help of questionnaires and secondary data analysis method. The data were analyzed with statistical methods.

  Results : 9.4% of cases in this study had AV block and 30.2% had bundle branch block. 40.5% of men and 37.6% of women had at least one kind of block(in AV node or bundle branch), but no significant relation was found between sex and these blocks. Also, 62% of in-hospital mortalities of patients with AMI were in association with blocks (AV or bundle branch) and only 38% of mortalities were without blocks. This showed a meaningful relation between hospital mortality and these kinds of blocks (p <0.05 ).

 Conclusions: The total frequency of AV and bundle branch blocks due to AMI, was 39.6% which is similar to other studies, but what is remarkable in this study, is the higher prevalence of bundle branch blocks due to AMI.

Hosein Noug , Ali Khodadadi, Hamid Bakhshi ,
Volume 4, Issue 1 (4-2004)

  Background &Objective: Infarctian size is the most important prognostic factor in patients with acute myocardial infarction (AMI). Reperfusion therapy using thromboliatics is the most important measure in order to limit the infarction, size. Infarction size on the other hand, associates directly with left ventricular (LV) function. The presence of Q wave on electrocardiogram (ECG) after thrombolytic therapy is associated with increased mortality during first months after AMI. Moreover electrocardiographic changes after thrombolytic therapy can predict LV function. This study is an attempt to evaluate the relationship between electrocardiographic Q wave and LV function after thrmobolytic therapy in patients with MI.

  Methods: 176 patients with first episode of AMI (diagnosed based on WHO criteria) who were receiving streptokinase took part in this analytical study. ECG of the first day after admission and ECG of discharge day (usually the sixth day) were evaluated in terms of the presence of pathologic Q wave. LV function was evaluated by Echocardiography using Simpson method. The data were analyzed by SPSS program using chi-square test.

  Results: On discharge day 82.4% of the patients had pathologic Q wave and 17.6% were without it. 51.6% of patients without pathologic Q wave, had normal LV function (LVGF>55%) while 26.9% of them had Q wave (p= 0.001). 73.3% of males and 56.4% of females had Q wave on ECG.

  Conclusions: Presence of Q wave on ECG in patients with AMI after thrombolytic therapy correlates with LV function and indicates impaired LV function in these patients.

Seyedhashem Sezavar , Nayere Aminisani , Seyedalireza Alavizadeh ,
Volume 4, Issue 3 (9-2004)

 Background & Objective: Cardiovascular disease is a major global health problem. Countries with low to moderate income contribute significantly to the global burden of cardiovascular disease accounting for 78% of all deaths and 86.3% of all disabilities. This study was an attempt to determine the factors contributing to premature myocardial infarction among young adults in Ardabil city.

 Methods: In this Case-control study 52 subjects, under 45, with myocardial infarction, admitted to Buali hospital in 2003-2004, were compared with 52 age and sex matched population based controls. Odds ratio and confidence interval of 95% were used to evaluate the risk factors such as smoking, physical activity, family history, history of diabetes and similar factors. Analysis of variance was used to compare the means.

 Results: The mean age of the subjects was 37.2 and 96.2% of them were male. The positive family history of cardiovascular disease with odds ratio of 9.4 (95% CI=2.6-34.3) and current smoking with odds ratio of 2.8 (95% CI=1.3-6.2) associated with myocardial infarction. Mean of the body mass index and mean of concentration of FBS, LDL and HDL were different in case and control groups. Physical activity with odds ratio of 0.4 had protective effect. (95% CI= 0.2-0.8). There was no meaningful relationship between passive smoking, total cholesterol, education and job with myocardial infarction risk.

 Conclusion: Family history, smoking, high Fasting Blood Sugar, high LDL, Low HDL and physical inactivity are the most important factors associated with acute myocardial infarction. Proper health interventions should be considered in order to lower the risk factors among young adults especially those under 45 years of age with a positive family history of myocardial infarction.

Samad Gaffari, Ali Golmohammadi,
Volume 5, Issue 4 (12-2005)

  Background & Objectives: Acute myocardial infarction (AMI) is one of the most common causes of admissions in industrialized countries and each year a lot of deaths occur due to this disease. AMI is commonly associated with leukocytosis and an elevated neutrophil count. It is not clear whether neutrophilia is a cause or effect of acute myocardial injury and heart failure. Nevertheless, proving such a correlation will have a lot of clinical utilities.

  Methods: From among 146 patients hospitalized by AMI diagnosis in the CCU ward of Shahid Madani hospital, 68 patients (having our inclusion criteria) took part in this cross-sectional and analytical study. The criteria for AMI were clinical symptoms, ECG criteria and paraclinical findings. CBCH1 was performed for the patients. All the patients were evaluated for presence or absence of congestive heart failure (CHF) in first 4 days of hospitalization. The data were analyzed with SPSS software using t-test and Chi-square.

  Results: Mean neutrophil count was 11291 in patients with evidence of congestive heart failure (CHF) and 8440 in those without it (P =0.01). This difference was statistically significant. Among 23 patients with CHF, 16 had neutrophil counts >8500, but among 45 patients without CHF only 19 cases showed this value (Odds ratio=3.12, P=0.03). Also among 35 patients with neutrophil counts >8500, 24 patients had ejection fraction (EF) of less than 45% and 11 cases had EF>45%(P=0.015).

Conclusion: In this study we found a direct correlation between neutrophilia on admission and the presence of CHF and echocardiographic left ventricular dysfunction in first 4 days of hospitalization. So the patients with high neutrophilia need more invasive treatments to reduce the possibility of CHF.
Hosein Doostkami , Adalat Hosseinian, Gholam Hosain Fatehi,
Volume 6, Issue 1 (4-2006)

  Background & Objectives: Coronary artery diseases are the leading causes of mortality and morbidity in industrial countries and in Iran. Myocardial infarction and unstable angina are essential clinical syndromes of coronary artery diseases, with the difference that the mortality and morbidity of NonST-elevated myocardial infractions is more than U/A and requires more intensive care. Rapid differentiation and diagnosis of NSTEMI from U/A plays a major role in effective treatment of patients and improvement of their prognosis. This study was designed to determine the incidence of nonST-elevated MI among patients hospitalized with initial diagnosis of U/A.

  Methods: This is a descriptive and analytical study performed on patients hospitalized with U/A diagnosis between 2001 and 2002 in Ardabil Buali hospital. The data (including demographic characteristics, patients’ clinical findings, ECG changes, laboratory findings) were collected using a questionnaire and analyzed by SPSS software using descriptive and analytical statistics.

  Results: mean patient age was 61 and prevalence of nonST-elevated MI among patients with U/A was 23 patients (22.1%). Mean age of patients with NSTEMI was 60.5 and its prevalence was greater in male (69.9%) than in female (30.4%). The most prevalent ECG change in patients was T wave inversion and ST depression (78.3%) and in U/A patients it was T wave inversion (60.5%). The difference was statistically significant (p<0.001). 64.7% of the NSTEMI patients and 27.4% of the patients with U/A had severe chest pain (p<0.004).

  Conclusion: Prevalence of NSTEMI was about 1/5 of patients hospitalized with diagnosis of U/A and ECG changes among these patients (as T wave inverison and ST depression along with negative T wave) is more prevalent compared to those with U/A. Clinical manifestation and complications were more severe in these patients than U/A group.

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Volume 6, Issue 2 (6-2006)

Background & Objectives: Coronary artery diseases and acute myocardial infarction are among the most common causes of death worldwide. Revascularization techiques have a major role in the management of this disease. Thrombolytics especially stereptokinase have been widely used because they do not require any expertise. Stereptokinase therapy may cause reperfusion of infarct area which in turn can result in arrhythmia. This study was performed to determine the sensitivity and specificity of developing reperfusion arrhythmias in predicting left ventricle function in patients with anterior myocardial infarction.

Methods: This descriptive and cross-sectionel study was conducted on 100 patiens with acute anterior myocardial infarction who were admitted to CCU ward of Buali hospital and received stereptokinase. The patients with history of heart failure and contraindication to stereptokinase therapy and patients who had died in the first 6 hours of myocardial infarction were excluded from the study. During the first 24 hours after admission echocardiography was performed for obtaining left ventricle ejection fraction. The data were gathered and analyzed with SPSS saftware using descriptive and inferential statistics.

Results: 52% of the patients encountered arrhythmia during receiving stereptokinase,  33% of whom had normal left ventricle function and 19% encountered significant dysfunction of left ventricle. From remaining 48% who didn’t encounter arrhythmia, 21% had normal function of left ventricle and in the rest of them it was impaired.

Conclusion:This study showed that the creation of arrhythmia due to reperfusion can predict the consistency of LV functioning with a sensitivity of 61% and a specificity of 58%. Moreover, there is a meaningful relationship between reperfusion arrhythmia and continuation of left ventricle functioning after treatment with streptokinase.

Hosein Dostkami , Effat Mazaheri ,
Volume 6, Issue 3 (9-2006)

  Background & Objective: Myocardial infarction is a comman cause in hospitalized patients with mortality rate of about 30%. Ontime diagnosis, earlier management and simply (time) factor have very important role in effective treatment, prevention of progression of injury and improvement of prognosis in the patients. Nearly 60% of mortality in this disease is in the first hour after onset of symptoms. Therefore this study was done to evaluate the refferal process, admission and hospitalization in patients with myocardial in farction at Buali hospital Ardabil.

  Methods: This descriptive and cross-sectional study was done on 77 patients with primary diagnosis of acute myocardial infarction based on clinical findings and ECG changes in the form of 1mm ST segment elevation in two adjacent leads or new LBBB or LBBB with unknown onest. Fourteen subjects were excluded from the study based on subsequent examination of continuous ECG and enzymatic evidence rulling out the presence of MI. Data were analyzed with descriptive and inferential statistics.

  Results: Referral time of patients after onset of symptom was 6.72 ± 5.53 hours. 73.02% of the patients referred with delay (90 minutes after onset of symptom). Mean referral time after onset of symptoms was 7.15±7.07 hours, 60.32% of the patients were outpatients, 34.92% were samples referred by other medical centers and 4.76% by emergency service in the latter group there was no delay in referring time. Mean admission time from emergency room to CCU was 1.04±0.94 hours. 47.62% of the patients underwent thrombolytic therapy with stereptokinase. In this group mean time from entrance to emergency until beginning thrombolytic therapy (Door to Needle time) was 1.22±0.34 houre.

  Conclusion: Because earlier beginning of thromolytic therapy had important role in decreasing mortality and morbidity in patients with myocardial infarction, we can increase survival rate in these patients by recognizing factors delaying, admission and earlier initiation of treatment.

Bahram Sohrabi , Behnaz Pourasghar , Saeid Dastghiri ,
Volume 6, Issue 4 (12-2006)

 Background & Objectives: Different studies have reported conflicting results on increased rate of early mortality after acute myocardial infarction (AMI) in females compared to males after adjustment for age and other confounding factors. The female gender plays a crucial role in early mortality after AMI. The aim of this study was to assess the role of gender as an important key factor in early mortality after acute myocardial infarction.

 Methods: In this research, patients (80 females and 174 males) with acute myocardial infarction were studies for six months (2003-2004) in terms of risk factors of coronary artery diseases, clinical conditions at admission, treatment modalities in the hospital and at the time of discharge, clinical accidents at the hospital and mortality and during one month after acute myocardial infarction and after being discharged.

 Results: Intrahospital mortality odds ratio for females compared to males was 2 (confidence interval 95%: 0.951-4.208). Mortality odds ratio during one month after acute myocardial infarction and discharge for females compared to males was 4.586 (confidence interval 95%: 1.294-16.252). This rate after adjustment for age was 3.15 (confidence interval 95%: 0.857-11.579) and after adjustment for confounders was 5.387 (confidence interval 95%: 1.296-22.393). In severe clinical conditions females referred to hospitals with more delay compared to men. Females were treated less than males with streptokinase, aspirin, betablockers and invasive diagnostic and treatment procedures. They received calcium channel blockers and nitrate much more than males.

 Conclusions : Females in comparison with males were at higher risk for early mortality (during one month after acute myocardial infarction and discharge). Age was not considered as the most important and potential factor for this higher rate.

Adalat Hosseinian , Shahram Habibzadeh , Saeid Sadegieh Ahari , Akbar Mokhtarpoor,
Volume 7, Issue 1 (4-2007)

  Back grounds and objectives : Arthrosclerosis is the major cause of cerberovascular disorders and major problems of industrial countries. Mortality from chronic diseases such as arthrosclerosis and mortality from infectious diseases have a reverse, relationship with economic and educational levels of people. For this reason, investigating the relationship of MI with other risk factors such as infections has been of great interest.

  Methods: This was a case- control study. 60 patients with MI and 60 matched cases were selected from other wards of Boali Hospital. All of the patients who had been admitted with myocardial infarction diagnosis in the time of study were selected and information about them was recorded in a researcher made questionnaire. Serum sample from patients and control case were sent to determinations of IgG Anti Chlamydia antibodies with enzyme immune assay. Control case were selected from other wards of hospital who matched in age, sex and same test in serum sample was done.

  Results: In this study in each group 48 persons (80%) were male and 12 persons (20%) were female. The range of age group was 35-80. Mean age group was 58.83±12.6 (SD) and mean age of control tools was 59.08±11.59.All of the patients in each group had anti Chlamydia antibodies (IgG) (titer more than 5U/ml). The mean range IgG in both groups were compared through t-test and there was no significant difference between them (p=0.85).

  Conclusion: In this study all of the cases and controls had anti Chlamydia antibodies. (IgG) high prevalence due to cold climate and high crowd of people in this area may be related to Chlamydia infection.

Samad Ghaffari, Reza Zerehpoush,
Volume 7, Issue 4 (12-2007)

  Background & Objective: Electrocardiography is a useful method in predicting coronary artery occlusion site, left ventricular function and the prognosis of patients with acute myocardial infarction. Accurate localization of coronary artery occlusion and the extent of ischemic area are very important in decision making for invasive procedures to restore coronary perfusion.

  Methods: In this prospective study the abnormal findings of first recorded electrocardiogram in 100 patients with acute myocardial infarction w ere compared with coronary angiography findings and the value of ST-T changes in predicting coronary artery occlusion site was evaluated.

  Results: In acute anterior wall infarction, ST elevation in aVR (p=0.001), right bundle branch block (p=0.001) and ST depression in V5 strongly predicts LAD occlusion at its proximal part. Also ST depression, especially equal or more than 1 mm, in inferior leads indicates proximal LAD occlusion. The absence of such ST depression in these inferior leads correlates with distal LAD occlusion (p=0.01).ST depression of aVL also is a sign of distal LAD occlusion (p=0.01).In acute inferior wall infarction ≥ 1 mm ST depression in leads I, aVL and greater ST elevation in lead III than lead II refers to RCA involvement.

  Conclusion: In acute anterior myocardial infarction electrocardiography can help to differentiate proximal LAD lesion from its distal involvement. Also it is useful in determining the culprit vessel in acute inferior wall infarction and helps to recognize high risk patients with major benefit from invasive reperfusion strategies.

Adalat Hosseinian , Firouz Amani , Ebrahim Hajizadeh , Shahram Habibzadeh ,
Volume 8, Issue 4 (12-2008)

 Background & Objectives: Cardiovascular disease is the most important cause of death in the world. Statistics shows that mortality and morbidity from cardiovascular disease in Iran is going up, so quality of management and treatment of these patients need to be better. For these reasons, determination of survival rates and factors affecting it is important and is also the aim of this study.

  Methods: This is a survival analytic prospective study, done on 800 patients, admitted in Ardabil Bouali Hospital CCU. All of the patients were followed up one year and a questionnaire about them was obtained. Statistical analysis was done with SPSS. For survival analysis Kaplan Maier, life table, logReng test and Cox regressions model were used.

 Results: Mean age of patients was 60.6±12.4 years. Total number of mortality in one year was 84 persons (10.5%). 582 patients were men and 218 were women. 47.4% were smokers, 33.4% had hypertension, 18.1% had diabetes mellitus, 15.3% had hyperlipidemia and 30% had arrhythmia. Survival rate in the first 10 days, 28 days and one year were 94%, 93% and 90% respectively.

 Conclusion: Factors that affected survival in Cox regress ional model were: diabetes mellitus, age, use of streptokinase, left ventricular ejection fraction, heart rate and heart block. Knowledge from survival rates and relative risks can help health managers in better health service preparation.

Seyed Hashem Sezavar , Maryam Valizadeh , Mazyar Moradi , Mohammad Hosein Rahbar,
Volume 10, Issue 1 (4-2010)

  Background & Objectives : In spite of effective advances in diagnosis and management, ST Elevation Myocardial Infarction (STEMI) is a major health problem in industrialized world and an increasingly important problem in developing countries. Considering the role of age and gender in Myocardial Infarction (MI) and socioeconomic and cultural changes in Iran in recent decades which can affect the epidemiology of the disease, we aimed to determine trend of changes in age and gender of patients with first STEMI in recent decade.

  Methods :This observational cross-sectional study was based on completing check lists for patients with first STEMI in Rasul-e-Akram Hospital from 1998 to 2007. The Data were analyzed with ANOVA, chi2 and Mann-Whitney tests at = 0.05 using SPSS 14.

  Results :Out of 1829 patients with first STEMI, 76.4% were men and 23.6% women who had mean age of 59.09 ± 12.7 years totally. The mean age of men (56.9 ± 12.2 years) was significantly lower than women (66.1 ± 11.6 years) (p < 0.001) ­.

  Trend of change in mean age for men, women and overall had no specific patterns of change in 10 years. Premature MI occurred in 15% of patients without any particular change during study period. No statistically significant change in proportions of gender and risk factors was seen in a period of 10 years. The most common risk factors were smoking (43.7%) and hypertension (32.8%) respectively. 23 . 7% of patients had hyperlipidemia and 18.8% were diabetics.

  Conclusion: Trend of changes in age and gender of mentioned patients had no significant change over 10 years which can indicate main role of biologic factors. Although this was an observational study unchanged major risk factors in a decade may mark out inadequate primary prevention.

Adalat Hoseinian , Farhad Pourfarzi, Nasrin Sepahvand , Shahram Habibzadeh, Behzad Babapour , Hosein Doostkami , Nasrin Fouladi, Mehri Seyed Javadi ,
Volume 12, Issue 1 (4-2012)

  Background & Objectives: Myocardial infarction is one of the most common causes of mortality throughout the world. Utilization of thrombolytic drugs at the first hours upon MI leads to decrease in the rate of mortality. Streptokinase (SK) is commonly used because of its cost and availability. The golden time for maximum effect of SK appeared to be first hours after MI. The drug efficiency diminishes after 3 hours and it will be ineffective after 12 hours.

  This study was aimed to investigate interval between onset of the clinical symptoms and streptokinase receiving in patients with acute myocardial infarctionadmitted for drug reception.

  Methods: This cross-sectional study was conducted in 150 patients with STEMI (ST elevation Myocardial Infarction ) who were attended to emergency room of Imam Khomeini hospital and fulfilled a questionnaire containing the data about age, sex, educational level, onset of symptoms, referring time to emergency room, SK utilization, past medical history of cardiac diseases, type and location of AMI, contraindications and side effects of SK.

  Results: In 111 men (74%) and 39 women (26%), the mean for interval between onset of symptoms and drug injection was 8 hour and 27 minutes ± 8 hour and 18 minutes .Only 41% of patients received streptokinase in less than 3 hours after chest pain. The main reasons for delaying in drug consumption were delayed decision to come to hospital in 61% of persons, long distance to hospital for 22% of individuals, delayed admission tor CCU for 13% of cases and delay in physician diagnosis for 0.043% of patients. To have a male sex and residency in city where the hospital was establilished were associated with less-delayed treatment start. However, the educational level, age and history of MI were not correlated with onset of treatment.

  Conclusions: Our results clearly show that the majority of patients receipt streptokinase more than 3 hours after chest pain. With considering the factors associated with delay to receive SK, teaching the patients with ischemic heart disease and giving information about golden time for thrombolytic therapy and its effect in prognosis as well as extending cardiac disease treatment centers in suburbs are recommended.

Hosein Douste Kami , Adalat Hosseinian , Effat Mazaheri, Naser Aslanabadi , Samad Ghaffari , Bahram Sohrabi , Eiraj Mohammadzadeh , Farhad Pourfarzi , Naser Moaiiednia ,
Volume 13, Issue 3 (9-2013)

  Background & Objectives: Coronary bifurcation lesions are important, complex lesions with different therapeutic strategies. In this study, patients with Coronary bifurcation lesions were treated and clinical results in these patients were followed during the nine-month period.

  Methods: This descriptive analytical study was performed between January 2007 to December 2008 at Tabriz Shahid Madani Cardiovascular Center. We have studied 96 patients (83 male and 13 female). Patients on the basis of one or two stents were placed in one group and the other groups were divided based on the use of Drug Eluting Stent and Bare Metal Stent. After diagnostic angiography if coronary bifurcation lesions were present based on Medina classification, appropriate angioplasty treatment was carried out. In a situations including chest pain, electrocardiographic changes or the objective evidence of ischemia and indication of angiography, appropriate diagnostic tests during follow up period were done. Clinical outcomes including acute coronary events were recorded. And result analyzed using SPSS version 16 . Chi-square ، Fisher and T tests were used to compare the relationship between variables.

  Results: In this study 86.5% was male and 13.5% female. The mean age of these patients was 56±9.9 years old. The most prevalent risk factor was HTN with 41.7% incidence and 55.2% of patient had chronic stable angina and 26% of them had history of acute myocardial infarction, 7.2% with history of PCI and 5.2% with history Of CABGS. Most prevalent site of bifurcation was ALD/diagonal with 65.5% incidence. The most prevalent complication was mild bleeding from puncture site with 10.4% and 5.2% of patients had mild hematoma. Among patients with two stents versus one stent presence of AMI presentation with CSA, ST Elevation in ECG was statistically significant. Also involvement of SB (side branch) lesions lengths at SB, kissing ballooning after implantation of two stents were statistically significant. Among patients with DES versus BMS usage of stent in RCA, LAD, lesion lengths at PMB (proximal main branch), DMP (distal main branch) and SB, procedure time, radiation dose, fluoroscopy time were statistically significant. Among two groups MACE (major acute coronary event) in two stents patient between 1-3 month and total MACE at first 6 month were statistically significant

  Conclusion: The age of patients treated with CBL was low, also more usage of BMS and stenting of BFLs with two BMS had weak results in this study but surprisingly total results of BMS and DES did not have significant difference after 9 months follow up between two groups.

Adalat Hosseinian , Vahideh Kasayi , Alireza Mohammadzade , Shahram Habibzadeh , Fariba Saghi , Mahnaz Davari , Azam Barzegar, Mehri Seyedjavadi ,
Volume 14, Issue 1 (4-2014)

  Background & Objectives : Nowadays, coronary artery disease is the most common cause of death in developed countries and in the whole world. According to the WHO reports, it will be the main cause of death in 2020. Myocardial infarction is the most common diagnosis among hospitalized patients in industrialized countries. This disease causes more mortality and morbidity than others. Coronary artery bypass grafting surgery (CABGS) is one of the common treatments for ischemic heart disease but it may have some complications. In this study we wanted to evaluate the incidence of CABGS complications in Imam Khomeini Hospital of Ardabil in the first month after CABG.

  Methods: This study was a cross sectional analytic descriptive type and performed on all of the patients underwent CABGS in Imam Khomeini Hospital during 2011-2012. All of the data from patients (like demographic, past medical history, physical exam findings, paraclinical findings and CABGS complications) were inserted in special forms after gathering, and analyzed by SPSS v.16.

  Results: In this study, 211 patients were studied. About 145 (68.72%) of them were male and 66 (31.28%) were female. Seventy patient (33.17%) were more than 70 years old. About 33.22% of patients had a history of cigarette smoking and 9.95% were opioid abused. The 34.12% of patients had hypertension (HTN) history, 40.28% diabetes mellitus (DM), 17.06% history of hyperlipidemia and 63.98% had a history of the previous MI. Chest pain was the most common complication among the patients (93.36%). According to our study the prevalence rate of post CABGS complications were: bleeding after surgery 13.27%, postoperative myocardial infection 8.05%, neurological disorders 12.32%, renal complications 2.36%, respiratory symptoms 11.37% and 34.59% for cardiovascular complications. Also the total mortality was 5 (2.36%) persons. The data analysis showed that there was a significant relationship between sex with survival status, local infection and neurological disorders, and also there was a significant relationship between age with post CABGS survival, bleeding after surgery and renal complications. There was also a significant relationship between DM and post CABGS survival, local infections and respiratory complications and between HTN and local infections.

  Conclusion: According to the results of this study, the most common post CABGS complications were cardiovascular complications, especially arrhythmias.

B Zamani, M Azari, A Hosseinian , A Shokrdargahy, A Mardi , Sh Azari,
Volume 15, Issue 2 (6-2015)

Background & objectives: Myocardial infarction (MI) isone of the most commonly heart diseases in all countries with the mortality rate of about 30%. Reperfusion of blocked coronary arteries plays an important role in reducing mortality and enhancing the quality of life of patients after acute MI. 

Methods: This clinical trial is to compare the efficacy of streptokinase administered intravenously in a two slow and accelerated groups: control group (slow intravenous infusion during 1 hour) and case group (half-hour accelerated intravenous infusion of streptokinase) with the sample size of 100 patients (divided randomly to 50 patients in each group). The data tool was a questionnaire, included the collected ECG changes before and after echocardiography and laboratory tests of patients. Data analyzed with SPSS software using chi-square test. 
Results:After reperfusion of the coronary artery, in the both case and control groups, elevation of ST segment has decreased statistically in two groups (60% and 84%, respectively). The complications rate following injection of SK in both case and control groups were 46% and 56%, respectively. The fraction in which 30% and 38% belong to cardiac complications, 32% and 22% to allergic symptoms and hematologic effects were 32% and 22%, in two groups, respectively and there was no statistically significant difference between two groups. 
Conclusion:According to the results of this study the accelerated (30 minutes) SK infusion can be fruitful for improving coronary reperfusion in patients with MI.

Roghayeh Eqbali Ziyarat , Shahrzad Ghiasvandian, Masoumeh Zakeri Moghadam , Anooshirvan Kazemnejad,
Volume 17, Issue 4 (1-2018)

Background & objectives: Appropriate nutritional behavior is effective in controlling many diseases such as cardiovascular diseases. This study aimed to determine the effectiveness of nutrition counseling in improving  nutritional behavior, lifestyle and healthy nutrition in patients with myocardial infarction.
Methods: In this interventional study, 120 patients admitted to the cardiac care units of the hospital, were selected by convenience sampling method and randomly assigned into two groups. Data were collected using  MEDFICTS and demographic questionnaires. After running the questionnaire, interventional group (n=60) with a score of more than 70 received nutritional counseling. After the end of nutritional counseling (3 sessions, 90 minutes), the subjects were re-evaluated for nutritional behavior. Data were analyzed using t-test in SPSS20 software.
Results: The mean age of the participants was 62.73±11.56 years, and 53.7% of them were female. The mean MEDFICTS scores before the consultation in the interventional group and control group were 43.2±14.8 and 43.5±18.2, respectively. The difference between the two groups was not statistically significant (p=0.3). The mean MEDFICTS scores at the end of the study in interventional and control groups were 13.14±62.6 and 23.3±2.24, respectively. This difference was significant between groups (p<0.001).
Conclusion: MEDFICTS scores improved in patients with myocardial infarction receiving nutritional counseling. It seems that the operation of nutritional counseling in patients with myocardial infarction can be effective in reducing the incidence of this disease

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مجله دانشگاه علوم پزشکی اردبیل Journal of Ardabil University of Medical Sciences
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