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.

Artificial intelligence approaches for tinnitus diagnosis: leveraging high-frequency audiometry data for enhanced clinical predictions.

This research investigates the application of machine learning to improve the diagnosis of tinnitus using high-frequency audiometry data. A Logistic Regression (LR) model was developed alongside an Artificial Neural Network (ANN) and various baseline classifiers to identify the most effective approach for classifying tinnitus presence. The methodology encompassed data preprocessing, feature extraction focused on point detection, and rigorous model evaluation through performance metrics including accuracy, Area Under the ROC Curve (AUC), precision, recall, and F1 scores. The main findings reveal that the LR model, supported by the ANN, significantly outperformed other machine learning models, achieving an accuracy of 94.06%, an AUC of 97.06%, and high precision and recall scores. These results demonstrate the efficacy of the LR model and ANN in accurately diagnosing tinnitus, surpassing traditional diagnostic methods that rely on subjective assessments. The implications of this research are substantial for clinical audiology, suggesting that machine learning, particularly advanced models like ANNs, can provide a more objective and quantifiable tool for tinnitus diagnosis, especially when utilizing high-frequency audiometry data not typically assessed in standard hearing tests. The study underscores the potential for machine learning to facilitate earlier and more accurate tinnitus detection, which could lead to improved patient outcomes. Future work should aim to expand the dataset diversity, explore a broader range of algorithms, and conduct clinical trials to validate the models' practical utility. The research highlights the transformative potential of machine learning, including the LR model and ANN, in audiology, paving the way for advancements in the diagnosis and treatment of tinnitus.

Advancing prognostic precision in pulmonary embolism: A clinical and laboratory-based artificial intelligence approach for enhanced early mortality risk stratification.

BACKGROUND: Acute pulmonary embolism (PE) is a critical medical emergency that necessitates prompt identification and intervention. Accurate prognostication of early mortality is vital for recognizing patients at elevated risk for unfavourable outcomes and administering suitable therapy. Machine learning (ML) algorithms hold promise for enhancing the precision of early mortality prediction in PE patients. OBJECTIVE: To devise an ML algorithm for early mortality prediction in PE patients by employing clinical and laboratory variables. METHODS: This study utilized diverse oversampling techniques to improve the performance of various machine learning models including ANN, SVM, DT, RF, and AdaBoost for early mortality prediction. Appropriate oversampling methods were chosen for each model based on algorithm characteristics and dataset properties. Predictor variables included four lab tests, eight physiological time series indicators, and two general descriptors. Evaluation used metrics like accuracy, F1_score, precision, recall, Area Under the Curve (AUC) and Receiver Operating Characteristic (ROC) curves, providing a comprehensive view of models' predictive abilities. RESULTS: The findings indicated that the RF model with random oversampling exhibited superior performance among the five models assessed, achieving elevated accuracy and precision alongside high recall for predicting the death class. The oversampling approaches effectively equalized the sample distribution among the classes and enhanced the models' performance. CONCLUSIONS: The suggested ML technique can efficiently prognosticate mortality in patients afflicted with acute PE. The RF model with random oversampling can aid healthcare professionals in making well-informed decisions regarding the treatment of patients with acute PE. The study underscores the significance of oversampling methods in managing imbalanced data and emphasizes the potential of ML algorithms in refining early mortality prediction for PE patients.

Long-Term Prognosis in Patients with Coronary Slow Flow.

Background: Coronary slow flow (CSF) is defined as decreased coronary blood circulation velocity and delayed opacification of contrast media during angiography. Evidence is insufficient regarding the course and prognosis of CSF patients. Long-term follow-up can help better understand the physiopathology and outcome of CSF. Accordingly, we assessed the long-term outcomes of CSF patients in this study. Methods: This retrospective cohort study was carried out on 213 CSF patients consecutively admitted to a tertiary health care center from April 2012 through March 2021. After data collection from the patients' files, follow-up was done via telephone call invitations and assessments of existing data in the outpatient cardiology clinic. The comparative analysis was conducted using a logistic regression test. Results: The mean follow-up length was 66.26±15.32 months, 105 patients (52.2%) were male, and the mean age of the patients was 53.81±11.91 years. The left anterior descending was the main affected artery (42.8%). At long-term follow-up, 19 patients (9.5%) required repeated angiography. Three patients (1.5%) had a myocardial infarction and 5 (2.5%) died from cardiovascular etiologies. Three patients (1.5%) underwent percutaneous coronary intervention. No patient required coronary artery bypass grafting. The need for a second angiography had no association with sex, symptoms, and echocardiographic findings. Conclusion: The long-term outcome of CSF patients is good, but their follow-up is necessary for the early diagnosis of cardiovascular-related adverse events.

Echocardiographic Parameters Associated with Bendopnea in Patients with Systolic Heart Failure.

Background: Bendopnea, defined as dyspnea while bending, can be observed in patients with heart failure (HF). In this study, we investigated the frequency of this symptom in patients with systolic HF and its association with echocardiographic parameters. Methods: In this study, patients with left ventricular ejection fraction (LVEF) ≤45% and decompensated HF referred to our clinics were prospectively recruited. All the patients were examined by cardiologists for collecting data on the presence of bendopnea and baseline characteristics. They also underwent electrocardiographic and echocardiographic examinations. All findings were compared between the patients with or without bendopnea. Results: A total of 120 patients at a mean age of 65.19±12.62 years were evaluated, and 74.8% were men. Bendopnea was observed in 44.2% of the patients. The etiology of HF was ischemic in most patients (81.9%), and the functional class of most patients (85.9%) was III or IV. The mortality rate at the 6-month follow-up was comparable between the patients with or without bendopnea (6.1% vs 9.5%; P=0.507). The waist circumference (odds ratio [OR], 1.037, 95% confidence interval [CI], 1.005 to 1.070; P=0.023), paroxysmal nocturnal dyspnea (OR, 0.338, 95% CI, 0.132 to 0.866; P=0.024), and right atrial size (OR, 1.084, 95% CI, 1.002 to 1.172; P=0.044) were associated with bendopnea. Conclusion: Bendopnea can be frequently found among patients with systolic HF. This phenomenon is associated with obesity and baseline symptoms of patients and right atrial size upon echocardiographic examinations. It can help clinicians with the risk stratification of HF patients.

Severe acute respiratory syndrome coronavirus-2- or pregnancy-related cardiomyopathy, a differential to be considered in the current pandemic: a case report.

BACKGROUND: There are limited data on cardiovascular complications of coronavirus disease 2019 in pregnancy, and there are only a few case reports on coronavirus disease 2019 related cardiomyopathy in pregnancy. Differentiation between postpartum cardiomyopathy and coronavirus disease 2019 related cardiomyopathy in pregnant women who develop severe acute respiratory syndrome coronavirus-2 infection during peripartum could be challenging. Here, we present a case of possible coronavirus disease 2019 related cardiomyopathy in a pregnant patient, followed by a discussion of potential differential diagnosis. CASE PRESENTATION: In this case report, we present the case of a young pregnant Iranian woman who developed heart failure with pulmonary edema after cesarean section. She was treated because of low left ventricular ejection fraction and impression of postpartum cardiomyopathy, and her severe dyspnea improved by intravenous furosemide. On day 3, she exhibited no orthopnea or leg edema, but she was complaining of severe and dry cough. Further evaluation showed severe acute respiratory syndrome coronavirus-2 infection. CONCLUSIONS: The possibility of severe acute respiratory syndrome coronavirus-2 infection should be considered in any pregnant woman who develops cardiomyopathy and pulmonary edema.

The association between T wave inversion in leads with ST-elevation and patency of the infarct-related artery.

BACKGROUND: Up to over half of the patients with ST-segment elevation myocardial infarction (STEMI) are reported to undergo spontaneous reperfusion without therapeutic interventions. Our objective was to evaluate the applicability of T wave inversion in electrocardiography (ECG) of patients with STEMI as an indicator of early spontaneous reperfusion. METHODS: In this prospective study, patients with STEMI admitted to a tertiary referral hospital were studied over a 3-year period. ECG was obtained at the time of admission and patients underwent a PPCI. The association between early T wave inversion and patency of the infarct-related artery was investigated in both anterior and non-anterior STEMI. RESULTS: Overall, 1025 patients were included in the study. Anterior STEMI was seen in 592 patients (57.7%) and non-anterior STEMI in 433 patients (42.2%). Among those with anterior STEMI, 62 patients (10.4%) had inverted T and 530 (89.6%) had positive T waves. In patients with anterior STEMI and inverted T waves, a significantly higher TIMI flow was detected (p value = 0.001); however, this relationship was not seen in non-anterior STEMI. CONCLUSION: In on-admission ECG of patients with anterior STEMI, concomitant inverted T wave in leads with ST elevation could be a proper marker of spontaneous reperfusion of infarct related artery.

Correction to: The use of intravenous immunoglobulin gamma for the treatment of severe coronavirus disease 2019: a randomized placebo-controlled double-blind clinical trial.

An amendment to this paper has been published and can be accessed via the original article.

The use of intravenous immunoglobulin gamma for the treatment of severe coronavirus disease 2019: a randomized placebo-controlled double-blind clinical trial.

BACKGROUND: Coronavirus disease 2019 (COVID-19) has infected people in many countries worldwide. Discovering an effective treatment for this disease, particularly in severe cases, has become the subject of intense scientific investigation. Therefore, the objective of this study was to evaluate the efficacy of intravenous immunoglobulin (IVIg) in patients with severe COVID-19 infection. METHODS: This study was conducted as a randomized placebo-controlled double-blind clinical trial. Fifty-nine patients with severe COVID-19 infection who did not respond to initial treatments were randomly assigned into two groups. One group received IVIg (human)-four vials daily for 3 days (in addition to initial treatment), while the other group received a placebo. Patients' demographic, clinical, and select laboratory test results, as well as the occurrence of in-hospital mortality, were recorded. RESULTS: Among total study subjects, 30 patients received IVIg and 29 patients received a placebo. Demographics, clinical characteristics, and laboratory tests were not statistically different (P > 0.05) between the two groups. The in-hospital mortality rate was significantly lower in the IVIg group compared to the control group (6 [20.0%] vs. 14 [48.3%], respectively; P = 0.022). Multivariate regression analysis demonstrated that administration of IVIg did indeed have a significant impact on mortality rate (aOR = 0.003 [95% CI: 0.001-0.815]; P = 0.042). CONCLUSIONS: Our study demonstrated that the administration of IVIg in patients with severe COVID-19 infection who did not respond to initial treatment could improve their clinical outcome and significantly reduce mortality rate. Further multicenter studies with larger sample sizes are nonetheless required to confirm the appropriateness of this medication as a standard treatment. TRIAL REGISTRATION: A study protocol was registered at the Iranian Registry of Clinical Trials ( www.IRCT.ir ), number IRCT20200501047259N1 . It was registered retrospectively on May 17th, 2020.

Prognostic value of platelet indices in patients with acute pulmonary thromboembolism.

Introduction: Given the role of platelets in thrombus formation, markers of platelet activation may be able to predict outcomes in patients with acute pulmonary thromboembolism (PTE). Methods: In a prospective cohort study, 492 patients with acute PTE were enrolled. Patients were evaluated for platelet indices including mean platelet volume (MPV), platelet distribution width (PDW), and platelet-lymphocyte-ratio (PLR), as well as for the simplified Pulmonary Embolism Severity Index (PESI) risk score. The primary endpoint was in-hospital all-cause mortality. Major adverse cardiopulmonary events (MACPE, composite of mortality, thrombolysis, mechanical ventilation and surgical embolectomy during index hospitalization) and all-cause death during follow-up were secondary endpoints. Results: MPV, PDW and PLR were 9.9±1.0 fl, 13.5±6.1%, and 14.7±14.5, respectively, in the total cohort. Whilst MPV was higher in those with adverse events (10.1±1.0 vs 9.9±1.0 fl; P= 0.019), PDW and PLR were not different between two groups. MPV with a cut-off point of 9.85 fl had a sensitivity of 81% and a specificity of 50% in predicting in-hospital mortality, but it had lower performance in predicting MACPE (Area under the curve: AUC 0.58; 95%CI 0.52-0.63) or long-term mortality (AUC 0.54; 95% CI 0.47-0.61). The AUC for all these three markers were lower than the AUC calculated for the simplified PESI score (0.80; 0.71-0.88). Conclusion: Platelet indices had only fair-to-good predictive performance in predicting in-hospital all-cause death. Established PTE risk scoring models such as simplified PESI outperform these indices in predicting adverse outcomes.

Evaluation of Tpeak to end/QT and Tpeak to end/QTc ratios in patients with STEMI undergoing percutaneous intervention vs. thrombolytic therapy.

INTRODUCTION: The patients with ST-segment Elevation Myocardial Infarction (STEMI) are significantly at increased risk of arrhythmia. Repolarization of myocardium has been evaluated by a series of electrical parameters including T wave peak to T wave end (Tp-Te) and Tp-Te/QT ratio. Which were compared with survival outcomes between two groups of STEMI patients treated with Primary Percutaneous Coronary Intervention (PPCI) and recombinant Tissue Plasminogen Activator (r-TPA). METHODS: In this prospective study, 188 patients with STEMI were included in the study. 12­Lead ECGs were obtained from all patients on time of admission and after 24 h after treatment. After dividing the patients into two groups based on their type of treatment (PPCI or r-TPA), The Tp-Te/QT and Tp-Te/QTc ratios were calculated using ECG records. The survival outcomes were compared between two groups. RESULTS: 95 patients (50.5%) underwent PPCI and 93 patients (49.5%) received r-TPA. Tp-Te/QT and Tp-Te/QTc ratios after administration of the treatments were significantly decreased in both groups (P-value = .001) with lower Tp-Te/QT and Tp-Te/QTc ratios in PPCI group (P-value = .001). 7 patients in PPCI group (7.3%) and 16 patients in r-TPA group (17.2%) were died during their hospitalization period (P-value = .04). The best combination of sensitivity and specificity of post treatment Tp-Te/QT ratio was at cutoff points of 29.4 with 82% sensitivity and 83% specificity. CONCLUSION: Our study demonstrated that Tp-Te/QT and Tp-Te/QTc ratios decrease significantly after both PPCI and r-TPA therapies, but with PPCI these indexes decrease more than r-TPA, resulting a better survival outcome in patients with STEMI.

Short-term mortality of patients with saddle pulmonary embolism: A single-center study.

OBJECTIVE: Although hemodynamic instability has been identified as the most established mortality predictor in acute pulmonary embolism (PE), the debate is still open about the prognostic significance of saddle pulmonary embolism (SPE). This study determined the in-hospital mortality rate of SPE patients diagnosed via computed tomographic pulmonary angiography (CTPA) and compared these cases with non-SPE patients. METHODS: The presence of SPE observed on CTPA was used to classify 492 consecutive patients into SPE and non-SPE groups. Different features were compared between the 2 groups, and independent predictors of in-hospital mortality in acute PE were identified. RESULTS: A total of 70 patients (14.2%) had SPE. In univariate analysis, the SPE group was seen to have a higher in-hospital mortality rate, as well as a lower oxygen saturation level and systolic and diastolic blood pressure in comparison with the non-SPE group (all p values <0.005). Multivariate analysis revealed that SPE was an independent predictor of in-hospital mortality in acute PE patients (Odds ratio: 9.21, 95% confidence interval: 3.40-24.89; p value <0.001). CONCLUSION: The results of this study indicated that SPE had a statistically significant importance in predicting in-hospital mortality and adverse events in PE patients. These findings were not consistent with many prior studies.

Cardiovascular Complications of Chronic Opium Consumption: A Narrative Review Article.

Opiates are the second most prevalent abused illicit substance after cannabis in the world. The latest United Nations Office on Drugs and Crime (UNODC) report estimated 30% increment in opium cultivation worldwide. High prevalence of opium consumption in eastern countries may be due to the high availability and traditional misconceptions. Opium consumption has been linked to hypertension, diabetes mellitus, dyslipidemia, and coronary artery diseases (CAD). In this review, we will review the association between opium use, cardiovascular diseases, and clinical outcomes. The present evidence suggests that chronic opiate consumption may increase the risk of cardiovascular diseases and related mortality.

Trigonella foenum-graecum seed extract modulates expression of lipid metabolism-related genes in HepG2 cells

Objective: To investigate anti-dyslipidemic effects of hydroalcoholic fenugreek seed extracts, diosgenin, and 4-OH-Ile on HepG2 cell line. Methods: HepG2 cells were treated with hydroalcoholic fenugreek seed extracts, diosgenin, 4-OH-Ile, and orlistat. IC20 was calculated using the MTT method. The cells were then pre-treated with IC20 concentrations for 24 and 48 h. Real time PCR was employed to measure expression of liver X receptor alpha (LXRα), sterol regulatory element-binding protein-1C (SREBP-1C), acetyl-CoA carboxylase (ACC), fatty acid synthase (FAS), fibroblast growth factor 21 (FGF21), peroxisome proliferator-activated receptor gamma (PPARγ), and low-density lipoprotein receptor (LDLR). Results: The results showed that LXRα (P=0.003, P<0.001), SREBP-1C (P<0.001, P<0.001), ACC (P=0.002, P=0.006), and FAS (P<0.001, P<0.001) were downregulated significantly, while FGF21 (P<0.001, P<0.001), PPARγ (P=0.004, P<0.001), and LDLR (P<0.001, P<0.001) were upregulated significantly in HepG2 cells treated with the IC20 of hydroalcoholic fenugreek seed extracts, diosgenin, 4-OH-Ile, and orlistat in 24 and 48 h, respectively. Conclusions: Hydroalcoholic fenugreek seed extracts, diosgenin, and 4-OH-Ile significantly modulate the expression of some important lipid metabolism related genes, which is similar to orlistat. Trigonella foenum-graecum seed extract or its derivatives should be further investigated for their dyslipidemia effects and its complications.

Comparison between Negative T waves characteristics in acute coronary syndrome and pulmonary embolism.

BACKGROUND: Electrocardiogram (ECG) is the first available modality used in patients with chest pain and dyspnea in emergency rooms. We aimed to study differences between acute coronary syndrome (ACS) and acute pulmonary embolism (APE) in patients presented primarily with abnormal negative T waves on their admission Electrocardiogram. METHODS: This research was a retrospective study in which 297 patients (97 patients with APE and 200 with ACS) were included. The patients were admitted to the emergency ward of a tertiary heart center between 2015 and 2017. In addition to the evaluation of distribution of negative T waves, the depth of the inverted precordial T waves was measured. RESULTS: The mean age of patients was 62.0 ±â€¯11.4 in ACS group and 60.7 ±â€¯17.6 in APE group (P value = 0.563). Total negative T in V3 and V4 in ACS and APE groups was 9.1 mm and 4.2 mm respectively (P value <0.001). Total magnitude of negative T in anterior leads divided by total magnitude of negative T in inferior leads for ACS and APE groups were 15.1 ±â€¯12.0 and 5.4 ±â€¯3.6 respectively (P value = 0.001). ROC curves showed that total magnitude of negative T in V4 divided by negative T in V1 can be valuable. A cutoff point of 1.75 with sensitivity of 73.5% and specificity of 84.9% (95% CI 0.79-0.91 P < 0.001) could differentiate APE patients from ACS patients. CONCLUSION: This study suggests that total magnitude of negative T in left precordial leads divided by right precordial leads can be valuable in differentiating APE from ACS.

Factors associated with elevated cardiac troponin levels in patients with acute pulmonary thromboembolism.

PURPOSE: We aimed to investigate the factors that are associated with increased cardiac troponin I (cTnI) leakage in the acute pulmonary embolism (PTE) setting and their alignment with patient outcome. METHODS: Adult patients with a diagnosis of PTE were enrolled in this prospective cohort study. The primary endpoint of interest was major adverse cardio-pulmonary events (MACPE), defined as the composite of in-hospital all-cause mortality, need for thrombolysis and mechanical ventilation and surgical embolectomy during index hospitalization. Multivariable regression analysis is used to assess factors associated with MACPE. RESULTS: 16.6% of 627 patients with acute PTE, had elevated serum cTnI. MACPE occurred in 56.7% of patients with positive cTnI and in 28.8% of patients with negative cTnI (p<0.001). Blood urea nitrogen (BUN) (OR 1.048; 1.001-1.096), alanine transaminase (ALT) (OR 1.007; 1.001-1.014), and neutrophil-lymphocyte ratio (NLR) (OR 0.829; 0.698-0.984) were independent predictors of elevated cTnI. Elevated cTnI increased the risk of MACPE 2.72 times (p<0.001). CONCLUSION: cTnI was an independent predictor of short-term outcome following an episode of PTE. BUN and ALT were directly and NLR was inversely associated with the leakage of cTnI and therefore, they could potentially serve as useful markers of risk assessment after PTE.

Effect of crocin carotenoid on BDNF and CREB gene expression in brain ventral tegmental area of morphine treated rats

Objective: To investigate the effect of crocin carotenoid on BNDF and CREB gene expression in the brain ventral tegmental area (VTA) and the serum level of BDNF in morphine-treated rats compared to control. Methods: In this study, 40 male Wistar rats (200-250 g) were used in 5 experimental groups: 1) non morphine treat rats (control); 2) non morphine-treated rats with 25 mg/kg crocin carotenoid (i.p., for 21 d); 3) morphine treated rats (10 mg/kg twice a day, s.c., 21 d); 4 and 5) morphine-treated rats with 12.5 and 25 mg/kg crocin carotenoid, respectively. By the end of research, BDNF and CREB expression was determined by real-time-PCR method. ELISA analysis was also applied for assessing the serum BDNF level. Results: The data indicated that morphine treatment could cause a significant decrease in BDNF and CREB gene expression (P<0.01 and P<0.001, respectively) in brain VTA as well as serum level of BDNF (P<0.01) in comparison to control group. Treatment with 25 mg/kg crocin carotenoid caused a significant enhancement in BDNF and CREF gene expression (P<0.01 and P<0.05, respectively) and serum level of BDNF (P<0.01) in morphine-treated rats in comparison to morphine-treated group. Conclusions: Regarding to obtained results, crocin carotenoid can inhibit unfavorable effects of morphine on the neural system to some extent through enhancing BDNF and CREB gene expression in brain VTA and serum level of BDNF.

Air pollution and admissions due to ST elevation myocardial infarction-a time-series study from northwest of Iran.

We investigated the association between the levels of air pollutants and the number of daily admissions due to ST segment elevation myocardial infarction (STEMI) in a metropolitan in the northwest of Iran. Daily concentrations of common air pollutants were obtained for the greater city of Tabriz for a period of 2 years. These reports included sulfur dioxide (SO2), nitrogen dioxide (NO2), nitric oxide (NO), nitrogen byproducts (NOx), carbon monoxide (CO), ozone (O3), and particulate matters < 10 µm (PM10). The census of admissions for STEMI was retrieved for the same period from hospital registries. The association of daily variations in air pollutant levels and the daily number of STEMI admissions were investigated in a time-series analysis. In the multi-pollutant model adjusting for long-term trend, seasonality, and temperature, a significant association was found for 1-h [NO2] and 24-h [CO]. A marginally significant association was observed for 24-h [NO2] and 8-h [CO]. The 24-h [CO] had the strongest association with the number of admissions with STEMI. Maximum 1-h concentrations of NO2 on the same day and on the prior day as well as 24-h concentrations of CO on the prior day were independently associated with increased number of STEMI admissions. However, daily concentrations of SO2, NO, O3, and PM10 were not associated with the frequency of hospital admissions for STEMI.

The value of peripheral blood eosinophil count in predicting in-stent restenosis in patients with stable angina pectoris undergoing drug eluting stenting.

INTRODUCTION: In-stent restenosis (ISR) remains a major limitation of percutaneous coronary intervention (PCI). A role for peripheral blood cells as major regulators of immune and inflammatory systems has been proposed. We aim to evaluate the relationship between eosinophil count and development of restenosis after drug-eluting stent (DES) implantation. METHODS: In this prospective study, all consecutive patients undergoing elective DES implantation for chronic stable angina (CSA) in a university-affiliated heart center within a 6-month period were enrolled and followed for another 6 months. Complete blood count with differentiation was performed 6 weeks after the index procedure. During the follow-up period, the cohort of patients who developed ISR was compared to the cohort of patients without ISR, descriptively and the total number of eosinophilic white cells was used to predict the occurrence of ISR. RESULTS: 153 men and 48 women with CSA underwent PCI with DES implantation, from which, 26 patients needed repeat coronary angiography for recurrent symptoms. There was an established ISR in 17 (8.5%) patients. The total number of eosinophils in their peripheral blood was 267 ± 132 cells/µL in patients with ISR, significantly higher than the number of eosinophils in those without ISR 174 ± 133 cells/µL (P-value < 0.010). Eosinophil count remained an independent predictor of ISR in multivariate analysis as the eosinophil count value over 242 cells/µL had sensitivity of 66.7% and specificity of 84.5% for the presence of ISR. CONCLUSION: The total number of eosinophils, counted 6 weeks after DES implantation, prevails as the sole predictor of ISR occurrence in our study. This suggests an association between immune sensitivity reaction to DES material and development of ISR in patients after PCI.