Association between parities and duration of breastfeeding and the severity of coronary artery disease in women above 30 years old age (A pilot study).

Background: The prevalence and mortality of CVD in women increase over time. We conducted this research to evaluate the severity of coronary artery disease with the number of live births and breastfeeding duration. Methods: Patients aged 30-50 years old with positive exercise tests or evidence of cardiac ischemia who were candidates for coronary angiography were included. All the participants had at least one child. Syntax score was used to evaluate the severity of coronary arteries. Results: Mean number of children was 3.72±1.85, in those patients with <2 live births no one had a syntax score≥1, but in the>5 live births group most patients had a syntax score≥1. In patients with zero syntax score, it was estimated as 4.91±39.7; in patients with 1≤ syntax score, it was 4.48±7.29 (P =0.76). Among patients with > 5 birth lives, those with higher syntax scores had older ages (P=0.497). After adjusting age, the association between live births and syntax score became non-significant (P=0.850). Conclusion: By increasing the number of live births >5, the severity of coronary artery disease, increases. However, this association was not significant after adjusting the age of patients.

Short-Term High-Dose Vitamin E to Prevent Contrast Medium-Induced Acute Kidney Injury in Patients With Chronic Kidney Disease Undergoing Elective Coronary Angiography: A Randomized Placebo-Controlled Trial.

BACKGROUND: Contrast medium-induced acute kidney injury (CIAKI) is a leading cause of acquired renal impairment. The effects of antioxidants have been conflicting regarding the prevention of CIAKI. We performed a study of vitamin E use to decrease CIAKI in patients undergoing elective coronary angiography. METHODS AND RESULTS: In a placebo-controlled randomized trial at 2 centers in Iran, 300 patients with chronic kidney disease-defined as estimated glomerular filtration rate <60 mL/min per 1.73 m(2)-were randomized 1:1 to receive 0.9% saline infusion 12 hours prior to and after intervention combined with 600 mg vitamin E 12 hours before plus 400 mg vitamin E 2 hours before coronary angiography or to receive placebo. The primary end point was the development of CIAKI, defined as an increase ≥0.5 mg/dL or ≥25% in serum creatinine that peaked within 72 hours. Based on an intention-to-treat analysis, CIAKI developed in 10 (6.7%) and 21 (14.1%) patients in the vitamin E and placebo groups, respectively (P=0.037). Change in white blood cell count from baseline to peak value was greater in the vitamin E group compared with the placebo group (-500 [-1500 to 200] versus 100 [-900 to 600]×10(3)/mL, P=0.001). In multivariate analysis, vitamin E (odds ratio 0.408, 95% CI 0.170-0.982, P=0.045) and baseline Mehran score (odds ratio 1.257, 95% CI 1.007-1.569; P=0.043) predicted CIAKI. CONCLUSIONS: Prophylactic short-term high-dose vitamin E combined with 0.9% saline infusion is superior to placebo for prevention of CIAKI in patients undergoing elective coronary angiography. CLINICAL TRIAL REGISTRATION: URL: https://www.clinicaltrials.gov/. Unique identifier: NCT02070679.

Lack of significant association between Helicobacter pylori infection and homocysteine levels in patients with cardiac syndrome X.

BACKGROUND: Helicobacter pylori (H.pylori) has been implicated in the pathogenesis of several diseases such as cardiac syndrome X (CSX), which includes chest pain, positive exercise stress test and normal angiography. Also, elevation of homocysteine (Hcy) level is associated with CSX, as it can severely disturb vascular endothelial function. We aimed to elucidate whether the infection of H.pylori affect the level of Hcy in CSX. METHODS: Eighty-eight patients with CSX (32 men, 56 women; mean age: 53.8 ± 11.9) and 97 healthy controls (36 men, 61 women; mean age: 45.7 ± 7.3) were enrolled. Plasma samples were tested for the presence of IgG antibody to H.pylori using enzyme linked immunosorbent assay method. Hcy levels were measured enzymatically. RESULTS: Plasma Hcy concentration in CSX patients is higher than control group (13.1 ± 2.6 vs. 11.8 ± 2.5 mmol/L; p = 0.002). There was no significant difference between Hcy in H.pylori(+) and H.pylori(-) individuals in CSX group (13.1 ± 2.7 vs. 12.2 ± 0.6 mmol/L; p = 0.554) and between two groups in controls, respectively (12.1 ± 2.2 vs. 11.4 ± 2.9 mmol/L; p = 0.148). CONCLUSIONS: Although there is Hcy level increase in H.pylori(+) CSX patients and controls comparing to H.pylori(-) subjects, but other factors may affect on Hcy level, too. (Cardiol J 2012; 19, 5: 466-469).

Frequency of Helicobacter pylori and cytotoxine associated gene A antibodies in patients with cardiac syndrome X.

BACKGROUND: Cardiac syndrome X (CSX) is a condition in which patients have the pain of angina despite normal coronary angiogram. Recently, Helicobacter pylori (H. pylori) bacteria has been associated with CSX. However, there is no obvious data about the frequency of its virulent strain (cytotoxine associated gene A: CagA) in patients with CSX. We surveyed the frequency of H. pylori and CagA antibodies in patients with cardiac syndrome X and healthy controls. MATERIALS AND METHODS: Plasma samples from 100 CSX patients (61 females and 39 males; mean age: 51.8 ± 12.3 years) and 100 healthy controls (61 females and 39 males; mean age: 48.9 ± 6.3 years) were tested for the presence of IgG antibody to H. pylori using enzyme linked immunosorbent assay (ELISA) method. Also, infected patients were determined by the presence of IgG antibody to CagA by ELISA method. Statistical analysis was carried out using chi-square test and independent samples T-test. RESULTS: Ninety two percent (92/100) of patients were anti-H. pylori positive (anti-H. pylori+), while only 56.0% (56/100) of control group were anti-H. pylori+ (P<0.01). However, prevalence of anti-CagA positive (anti- CagA+) in H. pylori infected- CSX patients and control groups were 59.8% (55/92) and 60.7% (34/56), respectively (P>0.05). CONCLUSION: Thus, due to the high frequency of anti-H. pylori in CSX patients, and the probable causative effect of chronic infection in vascular diseases, it is suggested that H. pylori has a probable role in the pathogenesis of CSX.