Abbas Andishmand

Background: Coronary artery disease (CAD) is a major cause of morbidity and mortality worldwide. Inflammation plays a central role in the pathogenesis of atherosclerosis, with neutrophils and high‐density lipoprotein cholesterol (HDL‐C) being key components. The neutrophil‐to‐HDL‐C ratio (NHR) has recently been proposed as a potential biomarker of CAD. This study is aimed at evaluating the association of NHR with the presence and angiographic severity of CAD. Methods: This retrospective, cross‐sectional study was conducted on 250 patients who were referred for suspected CAD and underwent coronary angiography at Afshar Hospital, Yazd, Iran. Demographic, clinical, and laboratory data were collected, and the severity of CAD was assessed using the Gensini score. NHR was calculated as the neutrophil count (×10 ³ / μ L) divided by HDL‐C (mmol/L). Multivariable logistic regression and receiver operating characteristic (ROC) analyses were performed; the model adjusted for age, sex, smoking, body mass index, and blood pressure (Model III) was designated as the primary model, and a fully adjusted model (Model IV) served as a sensitivity analysis. Results: The findings showed that patients with CAD had a significantly higher NHR than patients without CAD (3.9 ± 1.8 vs. 3.1 ± 1.28, p = 0.001). NHR increased across Gensini score tertiles ( p = 0.04). In the primary adjusted model, each 1‐SD increase in NHR was independently associated with CAD (OR = 2.01, 95% CI 1.28–3.14; p = 0.002) and a high Gensini score (OR = 1.56, 95% CI 1.14–2.12; p = 0.005). Bootstrap resampling (1000 replicates) confirmed the stability of these estimates. These findings were consistent in the fully adjusted model (OR = 2.31 and 1.62, respectively). NHR showed only modest discriminative ability for CAD (AUC = 0.638) and a high Gensini score (AUC = 0.620). Conclusion: NHR was independently associated with the presence and severity of CAD in patients referred for coronary angiography. However, its discriminative ability was modest, and its incremental value and prognostic utility require validation in independent prospective cohorts.

Background: Pulmonary embolism (PE) is a significant public health concern. This retrospective cohort study examines the clinical profiles and outcomes of patients diagnosed with PE at a medical center in central Iran, aiming to identify mortality predictors during hospitalization and follow-up. Methods: Data from 109 patients diagnosed with PE were analyzed, with a median follow-up of 23 months. The collected information included demographic and clinical characteristics, laboratory findings, treatment protocols, and outcomes. Logistic regression and Kaplan-Meier survival analysis were used to identify independent mortality predictors and assess survival impact. Results: The mean age was 59.2 years (±19.7), with 51.4% male. Common symptoms included dyspnea (86%) and chest pain (53%), with non-massive PE being the most prevalent (63%). Independent mortality predictors identified were age (odds ratio [OR] 1.065 per year, P<0.001), female sex (OR 4.421, P=0.009), and PE severity (OR 0.262, P=0.023). Kaplan-Meier analysis showed reduced survival probabilities in females (P=0.009), those with provoked PE (P=0.002), patients over 65 (P=0.016), and individuals with comorbidities (P=0.018). In-hospital mortality was 10.1%, linked to provoked massive PE, absence of thrombolytic therapy, and reduced left ventricular ejection fraction (LVEF). Conclusion: In this cohort, age, sex, and PE severity were significant mortality predictors, while provoked PE, advanced age, and comorbidities were associated with lower mid-term survival probabilities.

Introduction: Coronary artery anomalies (CAAs) are associated with an increased risk of cardiovascular events, including sudden cardiac death, especially in young people. A different prevalence has been reported based on the USED diagnostic modality. This study aimed to determine the prevalence and type of these anomalies using coronary computed tomography angiography (CCTA). Methods: This single-center retrospective study was performed on 3016 consecutive cases who underwent CCTA for cardiac symptoms from March 2015 to August 2020 and the prevalence and types of CAAs were evaluated. Results: 38 cases (overall prevalence of 1.26%) including 21 men (55.3%) and 17 women (44.7%) were retrospectively diagnosed with CAAs. The most common anomalies were the Anomalous origin of LCX from the right coronary sinus (11 cases, 28.9%), Anomalous origin of RCA from the left coronary sinus (11 cases, 28.9%), and Anomalous origin of LM from the right coronary sinus (6 cases, 15.8%). There was no difference in the prevalence of CAAs in terms of patient’s gender (P value=0.16) and age (P value=0.61). Conclusion: The prevalence of CAAs among patients who underwent CCTA was 1.26%. The most common anomalies observed were the anomalous origin of the LCX arising from the right coronary sinus, the anomalous origin of the RCA arising from the left coronary sinus, and the anomalous origin of the LM arising from the right coronary sinus. These findings emphasize the importance of CCTA in detecting and characterizing coronary artery anomalies, which may have clinical implications for patient management and treatment decisions.

Background: Congenital heart disease (CHD) is a major health problem and its prevalence is different around the world. The aim of study was determination of the epidemiological aspects of CHD in central and southern district of Iran. Materials and Methods: In this descriptive and analytical study, 3714 medical records were evaluated from March 21, 2001 to December 18, 2011. Medical records of inpatients from angiography and outpatients in the Heart Clinic of Afshar hospital (a referral hospital in center and south of Iran) were the source of information. Types of CHD and demographic data including age, sex and residential location are collected. The data were analyzed by SPSS (version 17) software. Chi-square and Fisher's exact tests were used to compare variables between groups. Results: At the study, the mean age of the patients at diagnosis time was 8.8 ± 11.6 year (at the range of one day to 76 years with median of 4 years). The percentage of females and males was 54.2 (n: 2014) and 43.8 (n: 1627), respectively. The chi-square test showed that there was significant difference in frequency of CHDs between females and males (P value < 0.0001). Ventricular septal defect (VSD) was found to be the most frequent of CHDs (27%). Patent ductus arteriosus (PDA) (16.8%), atrial septal defect (ASD) (15.8%), pulmonary stenosis (PS) (11%) and Tetralogy of Fallot (TOF) (8.9%) were more prevalent in CHDs after VSD. Conclusions: The frequency of CHDs in female was more than male and VSD, PDA, ASD, PS, and TOF were most common in CHDs, respectively.