Ethnic differences in the lifestyle behaviors and premature coronary artery disease: a multi-center study.

BACKGROUND: Diverse ethnic groups that exist in Iran may differ regarding the risk factors such as hypertension, hyperlipidemia, dyslipidemia, diabetes mellitus, and family history of non-communicable disease. Premature Coronary Artery Disease (PCAD) is more endemic in Iran than before. This study sought to assess the association between ethnicity and lifestyle behaviors in eight major Iranian ethnic groups with PCAD. METHODS: In this study, 2863 patients aged ≤ 70 for women and ≤ 60 for men who underwent coronary angiography were recruited in a multi-center framework. All the patients' demographic, laboratory, clinical, and risk factor data were retrieved. Eight large ethnicities in Iran, including the Farses, the Kurds, the Turks, the Gilaks, the Arabs, the Lors, the Qashqai, and the Bakhtiari were evaluated for PCAD. Different lifestyle components and having PCAD were compared among the ethnical groups using multivariable modeling. RESULTS: The mean age of the 2863 patients participated was 55.66 ± 7.70 years. The Fars ethnicity with 1654 people, was the most subject in this study. Family history of more than three chronic diseases (1279 (44.7%) was the most common risk factor. The Turk ethnic group had the highest prevalence of ≥ 3 simultaneous lifestyle-related risk factors (24.3%), and the Bakhtiari ethnic group had the highest prevalence of no lifestyle-related risk factors (20.9%). Adjusted models showed that having all three abnormal lifestyle components increased the risk of PCAD (OR = 2.28, 95% CI: 1.04-1.06). The Arabs had the most chance of getting PCAD among other ethnicities (OR = 2.26, 95%CI: 1.40-3.65). While, the Kurds with a healthy lifestyle showed the lowest chance of getting PCAD (OR = 1.96, 95%CI: 1.05-3.67)). CONCLUSIONS: This study found there was heterogeneity in having PACD and a diverse distribution in its well-known traditional lifestyle-related risk factors among major Iranian ethnic groups.

Protective factors against suicide attempt in Iranian Kurdish women: a qualitative content analysis.

BACKGROUND: A proper understanding of the protective factors against suicide attempt can provide the basis for planning preventive interventions. This study aimed to identify protective factors against suicide attempt among women. METHODS: This qualitative study was conducted in Kermanshah, Iran between January and May 2021. Participants were 20 Kurdish women, survivors of suicide attempt, selected by purposive sampling method. The data collection method was face-to face and audio-recorded semi-structured interview. Qualitative data analysis was done according to Diekelmann 7-step approach. FINDINGS: According to the results, the main topic was protective factors against suicide attempt in women, with two categories; "Individual factors" and "Social factors". "Individual factors" had five subcategories including coping strategies, reasons for living, resilience, religious beliefs, and fear of death, and "social factors" had two subcategories including social support and effective communication. CONCLUSION: This study showed that women who intend to commit suicide may encounter some individual and social factors that play a protective role against suicide. It is recommended to identify and strengthen these protective factors for the effectiveness of suicide prevention interventions.

Challenging experiences of the elderly with heart failure in the COVID-19 pandemic: a phenomenological study in Iran.

BACKGROUND: Patients with heart failure (HF), especially the elderly, faced many challenges during the COVID-19 pandemic, which need to be explored. The present study aimed to analyse the challenging experiences facing the elderly with heart failure during the pandemic in Iran. To achieve this aim, a qualitative approach to research was employed. METHODS: The present qualitative research employed a phenomenological approach to study 12 elderly with heart failure visiting Imam Ali Hospital during the COVID-19 pandemic in Kermanshah, Iran. The data collection occurred between August 5, 2022, and November 21, 2022. The participants were selected through a purposive sampling method and interviewed using a semi-structured interview. MAXQDA10 software was used for data organisation and the Colizzi analytical technique for data analysis. Guba and Lincoln's criteria were also used to evaluate the trustworthiness of the qualitative research. RESULTS: A total of two categories, 8 subcategories, and 110 primary codes were extracted from the data. The two categories were challenges and coping strategies. The former included the sub-categories of economic issues, fear, anxiety, and fear of death; limited access to health care; quarantine issues; disruption of family life; and medication non-adherence. The subcategories of the latter were faith in God, social support, and self-care behaviors. CONCLUSIONS: The present study revealed the challenges experienced and the coping strategies employed by elderly patients with heart failure during the pandemic in Iran. A knowledge of these challenges and experiences during the COVID-19 pandemic can raise healthcare workers' awareness of the elderly patients' strategies used to cope with the virus.

Does coping with pain help the elderly with cardiovascular disease? The association of sense of coherence, spiritual well-being and self-compassion with quality of life through the mediating role of pain self-efficacy.

BACKGROUND: Population ageing is considered one of the biggest challenges facing the world, and the status of the elderly in society and their quality of life (QOL) have proved to be a concern in professional and scientific research circles. As a result, the current study sought to investigate the role of pain self-efficacy (PSE) as a moderator in the relationship between sense of coherence (SOC), spiritual well-being, and self-compassion with QOL in Iranian elderly with cardiovascular disease (CVD). METHOD: This was a correlational study of the path analysis type. The statistical population included all elderly people with CVD who were at least 60 years of age in Kermanshah Province, Iran, in 2022, of whom 298 (181 men and 117 women) were selected using convenience sampling and according to the inclusion and exclusion criteria. The participants answered questionnaires from the World Health Organization on QOL, Paloutzian and Ellison's spiritual well-being, Nicholas's PSE, Antonovsky's SOC, and Raes et al.'s self-compassion. RESULTS: The results of path analysis demonstrated that the hypothesized model of this study has a good fit in the studied sample. There were significant paths between SOC (ß = 0.39), spiritual well-being (ß = 0.13) and self-compassion (ß = 0.44) with PSE. Although there were significant paths between SOC (ß = 0.16) and self-compassion (ß = 0.31) with QOL, there was no significant path between spiritual well-being and QOL (ß = 0.06). Besides, there was a significant path between PSE and QOL (ß = 0.35). Finally, PSE was found to mediate the relationship of SOC, spiritual well-being and self-compassion with QOL. CONCLUSION: The results may provide psychotherapists and counselors working in this field of inquiry with advantageous information to choose or create a useful therapeutic method to work with the elderly with CVD. Meanwhile, other researchers are suggested to examine other variables which may serve a mediating role in the mentioned model.

Attachment styles and happiness in the elderly: the mediating role of reminiscence styles.

BACKGROUND: The current study aims to investigate the relationship between attachment styles and happiness through the mediating role of reminiscence styles in the elderly. METHODS: This was a correlational study of structural equations modelling (SEM) type. The statistical population included all the elderly aged at least 60 years living in Kermanshah province, Iran in 2021, among whom 380 (182 men and 198 women) were selected using convenience sampling method. Participants filled out the questionnaires of Adult Attachment Styles, Oxford Happiness, and Amani et al.'s Reminiscence Styles. RESULTS: The results indicated that secure attachment style has a positive and negative relationship with positive reminiscence (PR) and negative reminiscence (NR), respectively. However, the opposite held true for both avoidant and ambivalent attachment styles. It was also found that secure attachment style has a positive relationship, and avoidant and ambivalent attachment styles have a negative relationship with happiness. Moreover, participants' gender and age had no moderating effect on the mentioned relationships. The results of SEM indicated that secure and ambivalent attachment styles were associated with happiness through both PR and NR, and avoidant attachment style was associated with happiness only through NR. CONCLUSIONS: The findings emphasize the significance of the development of internal working models based on the kind of parent-child's reminiscences and narratives, and the lifelong effects of these models.

Investigation of anemia risk factors and its related outcomes in patients with ST-elevation myocardial infarction.

Background: Anemia is one of the symptoms of hospital patients suffering from ST-elevation myocardial infarction (STEMI), which may have a predictive role in short- or long-term complications. This study aimed to identify anemia risk factors and related short- or long-term outcomes in STEMI patients. Methods: This was a prospective study of patients older than 18 years diagnosed with STEMI who admitted to Imam Ali hospital from 2014 to 2015. To collect demographic and clinical information related to anemia, a questionnaire compiled by researchers was administered. The collected data were analyzed by SPSS (version 20); also, independent t test and multiple logistic regression analyses were applied to find related risk factors of anemia in STEMI patients. Significance level was set at p < 0.05 for all statistical tests. Results: In total, 49 (11.7%) out of 423 patients suffered from anemia. STEMI patients with anemia were more likely to be female (OR = 2.92; CI 95% = 1.58-5. 38), diabetic (OR = 2.5; CI 95% = 1.32- 4.74), ≥ 60 years old (OR = 2.42; CI 95% = 1.24-4.73), nonsmokers (OR = 2.18; CI 95% = 1.07- 4.4), and susceptible to require in-hospital cardiopulmonary resuscitation (CPR), (OR = 3.12; CI 95% = 1.35- 7.1). In the final analysis, using the Forward Wald model in logistic regression, anemia remained significantly related to female gender (OR = 2.76; CI 95% = 1.42-5.36), diabetes mellitus (OR = 2.38; CI 95% = 1.2-4. 74), and a history of MI (OR = 2.5; CI 95% = 1.04-6.11). Conclusion: STEMI patients with anemia are more susceptible to have in-hospital outcomes. Furthermore, female gender, hyperglycemia, and history of MI were factors related to anemia that might have major role in the complications of STEMI.

The relationship between the meaning of life, psychological well-being, self-care, and social capital, with depression and death anxiety in the elderly living in nursing homes: The mediating role of loneliness.

The current study aims to investigate the meaning of life, psychological well-being, self-care, and social capital, with depression and death anxiety in the elderly living in nursing homes through the mediating role of loneliness. The statistical population included all the elderly aged at least 60 years living in Tehran, Qazvin and Zanjan, Iran in 2020, among whom 489 (273 men and 216 women) were selected using convenience sampling method. Participants filled out Steger's Meaning of Life, Ryff and Singer's Psychological Well-Being Scale, Söderhamn et al.'s Self-Care Ability, Nahapiet and Ghoshal's Social capital, Beck's depression, Templer's Death Anxiety, Russell et al.'s Loneliness questionnaires. The results indicated that meaning of life, psychological well-being, self-care, and social capital are negatively associated with loneliness, which in turn, is positively associated to depression. Furthermore, meaning of life, psychological well-being, self-care, and social capital are negatively associated with loneliness, which in turn, is positively associated to death anxiety. Moreover, the results of path analysis revealed that the hypothesized model of the current study has an excellent fit in the study sample. That is, meaning of life, psychological well-being, self-care, and social capital are related to depression and death anxiety through mediating role of loneliness.

A qualitative study on the challenges of Afghan child labourers in Tehran.

Afghan refugees child labourers face many challenges as they are labelled as refugees. In an attempt to explore these challenges, the present study was conducted in Tehran with a qualitative approach. The present qualitative research was conducted using a conventional content analysis approach with 25 Afghan child labourers in 2022 in Tehran. Child labourers were selected through purposive and snowball sampling and interviewed in a semi-in-depth interview. The data were analysed based on Granheim and Lundman's criteria, as well as those of Guba and Lincoln, to further enrich the findings. A total of 3 categories, 13 sub-categories, and 183 initial codes were extracted from the data analysis, including: "psychological challenges" (history of harassment and abuse, negative effects, high-risk behaviours, and family detachment); "health challenges" (physical problems, inappropriate accommodation, medical/therapeutic problems, and health threats); and "social challenges" (neglected childhood, dual identity, educational limitations, inadequate social support, social isolation, and social humiliation). At the individual level, it is possible to meet the child labourers' health needs and make them aware of the hazards of working in the streets through physical examination at certain intervals and holding training workshops on harassment prevention, anger control, prevention of high-risk behaviours, prevention of infectious diseases such as hepatitis, and strengthening self-confidence to improve health. Also, the Afghan child labourers' work could be intervened at the social and familial level by providing accommodation in more suitable neighbourhoods, providing health insurance for child labourers, creating the chances of studying in schools, preventing dropouts, and strengthening social relations in order to improve children's health.

Comparison of quality of life in patients with mitral valve replacement and mitral valve repair in Imam Ali Hospital during 2014 to 2020: a cross-sectional study.

OBJECTIVE: Mitral valve failure is one of the most common valvular heart diseases worldwide. Valve replacement and repair have an impact on the quality of life of patients. Therefore, the present study was conducted to compare the quality of life in patients with mitral valve replacement and those who underwent mitral valve repair. METHODS: In this cross-sectional study, we considered all cardiac patients with ischemic mitral insufficiency who underwent mitral valve repair and patients with a history of valve replacement in Imam Ali Hospital of Kermanshah between 2014 and 2020. Two Minnesota and general quality of life questionnaires along with a checklist for demographic variables were used for data collection. Data analysis was performed using SPSS version 21 software. RESULTS: The mean quality of life score based on the general quality of life scale in the valve repair group was 32.33 (SD = 2.29) and in the valve replacement group 32.89(SD = 2.60), (p = 0.917). Also, mean quality of life, as measured by the Minnesota MLHFQ was 60.89(SD = 17.67) in the valve repair group and 63.42 (SD = 12.13) in the valve replacement group (p = 0.308). The results showed that the average general quality of life was different in study groups regarding education. Tukey's post hoc test showed that the average general quality of life in illiterate people is significantly lower than in people with academic degrees (P-value = 0.001). CONCLUSION: The quality of life of the patients in both the valve repair and replacement groups was at an average level. There was no significant difference between the general quality of life and the Minnesota scales, suggesting that both tools can be effectively used to measure patients' quality of life. The study's findings can be valuable for monitoring patients, screening for conditions, and enhancing communication between doctors and patients.

Global prevalence of sexual dysfunction in cardiovascular patients: a systematic review and meta-analysis.

BACKGROUND: Sexual dysfunction poses a significant challenge for patients with cardiac conditions. Concerning the prevalence of sexual disorders in cardiovascular patients, several seminal studies conducted in various regions of the world have provided diverse facts and figures pertaining to sexual dysfunction among cardiovascular patients. Therefore, the present study aimed to analyze, summarize, and integrate the findings of seminal studies on the effect of underlying factors and estimate the global rate of sexual disorders in cardiovascular patients. METHODS: The present systematic review and meta-analysis included studies conducted in 2003-2023. To find the relevant published academic papers, SID, MagIran, PubMed, Scopus, Web of Science (WOS), and Google Scholar databases were searched for keywords using MeSH/Emtree until January 14, 2023. The GRADEpro software was used to evaluate the quality of evidence. The heterogeneity of studies was checked using the I2 index. RESULTS: An initial number of 2122 studies were found in the first search. Following a precise screening process based on predefined inclusion criteria, a total of 17 studies were deemed suitable for inclusion in the meta-analysis. The global prevalence of sexual disorders in cardiovascular patients was estimated at 62.6% (95% CI: 49.8-73.8%). As the results of the meta-regression showed that as the sample size increased, there was a significant decrease in the overall prevalence of sexual disorders among cardiovascular patients. Additionally, as the study years progressed, both age and JBI score exhibited an upward trend. CONCLUSION: The present findings showed a high prevalence of sexual disorders among cardiovascular patients. Therefore, it is recommended that experts and health policymakers enhance their focus on effectively preventing and controlling these disorders. Besides the evidence achieved very low certainty, it is important for the treatment team to prioritize the sexual relations of cardiovascular patients and focus on improving their sexual function. This should be seen as an essential aspect of their overall recovery process.

Psychometric properties of the mental health continuum-short form in Iranian adolescents.

Introduction: Psychological tests are necessary to assess the mental state of individuals. Mental health is one of the important psychological indicators and is increasingly considered as having various aspects of well-being. The Mental Health Continuum-Short Form (MHC-SF) is a 14-item instrument that assesses mental health, focusing on emotional, psychological, and social well-being. The present study, the psychometric properties of the Persian version of the MHC-SF were examined in relation to its factor structure, internal consistency, construct validity, and gender measurement invariance among adolescents. Methods: The population of this study was Iranian adolescents between 11-and 18-year-old who were enrolled in the seventh to twelfth grades. A convenience sample of 822 Adolescents from four large cities in the Iran (Tehran, Zanjan, Hamedan and Ghazvin) participated in the present study. Questionnaires were completed online. Statistical analyses to evaluate the factor structure, internal consistency, construct validity, gender and age factorial invariance were performed in SPSS and LISREL. Results: According to the results of confirmatory factor analysis, the MHC-SF is composed of three factors: emotional, psychological, and social well-being. Reliability was confirmed by Cronbach's alpha method and composite reliability (>0.7). Measurement invariance were confirmed among girls and boys. Convergent and divergent validity were also evaluated and confirmed by correlating the test score with similar and different tests. Conclusion: This study confirmed the psychometric properties of MHC-SF in the Iranian adolescent community. This instrument can be used in psychological research and diagnostic evaluations.

Association of Admission Systolic Blood Pressure on long-Term Outcomes after ST-Segment Elevation Myocardial Infarction.

INTRODUCTION: Hypertension is widely known as a significant factor in the development of cardiovascular diseases. However, there is increasing interest in the potential link between low admission systolic blood pressure (SBP) and higher mortality rates. Therefore, this study aimed to investigate the relationship between admission SBP and the probability of one-year mortality in patients with ST-segment elevation myocardial infarction (STEMI). METHOD: This study, which used data from registries, focused on patients diagnosed with STEMI between July 2018 and December 2019. The patients were divided into three groups based on their admission SBP: normal (< 112 mm Hg), elevated (112-140 mm Hg), and hypertension (≥140 mm Hg), and were followed for one year. The researchers used Cox proportional models to analyze the data, which allowed them to estimate crude and fully adjusted hazard ratios, along with their corresponding 95% confidence intervals (HR, 95% CI). RESULTS: This study, which included 1159 patients with a mean age of 60.71±12.19, 914 (78.86%) were male, and 108 (9.32%) died within one year. Among the patients, 276 had a normal admission SBP, 338 had elevated SBP, and 545 had hypertension. Those with hypertension had a higher-risk profile, including factors such as hyperlipidemia, BMI, LDL levels, anterior myocardial infarction, and a higher prevalence of females. The crude and fully adjusted hazard ratios (HR) for the relationship between elevated admission SBP and mortality were calculated as 0.36 (95% CI: 0.23-0.56) and 0.43 (95% CI: 0.23-0.81), respectively. CONCLUSION: The study's findings indicate a connection between increased admission SBP and a decreased probability of one-year mortality among patients with STEMI. Unlike the general population, where there is a direct linear correlation between SBP and the risk of future cardiovascular events, this research demonstrates an inverse relationship between SBP and one-year mortality.

Evaluating the access of slum residents to healthcare centers in Kermanshah Metropolis, Iran (1996-2016): A spatial justice analysis.

Background: Proper access to health care centres and services is one of the key indicators of health justice, and it is more than ever important in slums. Objective: This aim of this research is to evaluate the accessibility of health care centres to slum residents in the Kermanshah metropolis, Iran during the period 1996-2016. Methods: In this cross-sectional study, data was obtained from the Census of Iran for the periods 1996, 2006 and 2016. Information on the number and location of health care centres was collected from the Kermanshah University of Medical Sciences. Network Analysis modelling method in Arc/GIS10.6 software was used to evaluate the accessibility of people to health centres. Results: The results show that the spatial pattern of health centres in Kermanshah was random during 1996, 2006 and 2016, but the spatial pattern of poverty in the metropolis was clustered. In addition, the distribution of health centres was not consistent with the population densities. However, the overall population with inappropriate access to health centres in the slums of Kermanshah metropolis decreased over the study period (1996-54.02%, 2006-51.09%, and 2016-34.71%). Conclusions: The findings of the study reveal that access to health care services by the slum population is not consistent with the increase of health care centres. This means that health policymakers were unsuccessful to provide the required health care services for the slums.

Global prevalence of depression, anxiety, and stress in cardiac patients: A systematic review and meta-analysis.

BACKGROUND: Cardiovascular disease is one of the most common chronic and life-threatening diseases. Due to the changes made in the normal living conditions of people after suffering from cardiovascular diseases, the appearance of symptoms of depression, anxiety, and stress is common among these patients. The results of the studies show the different prevalence of these disorders, so this study aimed to standardize the global prevalence of depression, anxiety, and stress in Cardiac patients by a systematic review and meta-analysis approach. METHODS: The present systematic review and meta-analysis were conducted from 2000 to 2022. National and international databases were considered to retrieve related studies, including SID, Magiran, Scopus, Embase, PubMed, and Web of Science (WoS). Joanna Briggs Institute (JBI) checklist was used to evaluate studies qualitatively. Heterogeneity between studies was assessed by I2 index, and data analysis was performed in Comprehensive Meta-Analysis software. RESULTS: After reviewing the retrieved studies, finally 68 studies on the prevalence of depression with a sample size of 110,219, 36 studies on the prevalence of anxiety with a sample size of 72,374 and 5 studies on the prevalence of stress with a sample size of 533 considered for the meta-analysis. Based on the results of the Meta-Analysis, the overall estimation of the prevalence of depression was 31.3 % (95 % confidence interval: 25.4/0.38 %), anxiety prevalence; 32.9 % (95 % confidence interval: 21.9-46.6 %) and stress prevalence was 57.7 % (95 % confidence interval: 45.3-3.3 %). CONCLUSION: The result of the present study shows the high prevalence rate of depression, anxiety, and stress in cardiac patients. Therefore, it is recommended that health professionals and policymakers pay more attention to preventing and controlling these disorders.

Creatinine clearance is key to solving the enigma of sex difference in in-hospital mortality after STEMI: Propensity score matching and mediation analysis.

BACKGROUND: The precise impact of sex difference on in-hospital mortality in ST-elevation myocardial infarction (STEMI) patients are unclear, and the studies are no longer consistent. Therefore, we sought to evaluate the impact of sex differences in a cohort of STEMI patients. METHODS: We analyzed the data of 2647 STEMI patients enrolled in the Kermanshah STEMI Cohort from July 2017 to May 2020. To accurately clarify the relationship between sex and hospital mortality, propensity score matching (PSM) and causal mediation analysis was applied to the selected confounder and identified intermediate variables, respectively. RESULTS: Before matching, the two groups differed on almost every baseline variable and in-hospital death. After matching with 30 selected variables, 574 male and female matched pairs were significantly different only for five baseline variables and women were no longer at greater risk of in-hospital mortality (10.63% vs. 9.76%, p = 0.626). Among the suspected mediating variables, creatinine clearance (CLCR) alone accounts for 74% (0.665/0.895) of the total effect equal to 0.895(95% CI: 0.464-1.332). In this milieu, the relationship between sex and in-hospital death was no longer significant and reversed -0.233(95% CI: -0.623-0.068), which shows the full mediating role of CLCR. CONCLUSION: Our research could help address sex disparities in STEMI mortality and provide a consequence. Moreover, CLCR alone can fully explain this relationship, which can highlight the importance of CLCR in predicting the short-term outcomes of STEMI patients and provide a useful indicator for clinicians.

Anxiety, coping style and hopelessness during COVID-19 pandemic: An Iranian population-based study.

Background and Aims: The COVID-19 pandemic has caused new conditions such as nationwide quarantine, a dramatic decrease in-person interaction and an increase in death anxiety for governments and people. The pandemic of an unpredictable disease with no definite treatment can pose physical and psychological risks to individuals. The present study aimed to investigate the state of anxiety, coping styles, and hopelessness of people in the lockdown period and reopening in Iran. Methods: In this national population-based cross-sectional study, a total of 1191 people who had access to social networks from all over Iran completed the anxiety, hopelessness, and coping style questionnaires online using the snowball sampling method. Analysis was conducted using Stata software version 12 (Stat Corp). The significance level was set at 0.05. Results: The results of the study suggested that women experienced higher levels of anxiety than men, and, in stressful situations, women were more likely to use emotion-focused coping styles, while men frequently used problem-focused coping styles. The majority of participants reported moderate levels of anxiety and low levels of hopelessness (64.04%). The results of multiple linear regression show any level of anxiety mild (ß = 0.59, 95% confidence interval [CI]: 0.32-0.85), moderate (ß = 0.72, 95% CI: 1.36-1.08), and severe (ß = 2, 95% CI: 1.36-2.56) relative to the none anxiety significantly increase the hopelessness, Furthermore, showing a negative significant adjusted association with the problem-focused coping style (ß = -0.06, 95% CI: -0.07 to -0.04), and a significant positive association with the emotion-focused coping style (ß = 0.04, 95% CI: 0.02-0.06). Conclusion: Our findings could be used to prevent psychological damage in societies and suggested addressing problem-focused coping style, especially during a crisis, and providing people with preprepared mental health protocols at this pandemic.

Smoker pseudo-paradox in ST-segment elevation myocardial infarction patients.

INTRODUCTION: Cigarette smoking is a preventable cause of cardiovascular morbidity and mortality. Despite the adverse effects of smoking, some studies have reported the term "smoker's paradox', meaning better outcomes in smokers following acute myocardial infarction. AIM: The aim of the present study was to evaluate the relationship between smoking status and one-year mortality in patients with ST-segment elevation myocardial infarction (STEMI). MATERIALS AND METHODS: This was a registry-based cohort study of STEMI patients from Imam-Ali hospital, Kermanshah, Iran. Consecutive STEMI patients (July 2016-October 2018) were stratified by smoking status and followed for one year. Cox proportional models were used to estimate crude, age-adjusted, and full-adjusted hazard ratios with 95% confidence intervals (HR, 95%CI). RESULTS: Of 1975 patients (mean age 60.1 years, 76.6% male) included in the study, 48.1% (n=951) were smokers (mean age 57.7 years, 94.7% male). Crude and age-adjusted HR (95% CI) for the associations of smoking and mortality were 0.67 (0.50-0.92) and 0.89 (0.65-1.22), respectively. After adjusting for age, sex, hypertension, diabetes, body-mass index, anterior wall myocardial infarction, creatine kinase-MB, glomerular filtration rate, left ventricular ejection fraction, low-density lipoprotein cholesterol, and hemoglobin, smoking was associated with increased risk of mortality: HR (95% CI: 1.56 (1.04-2.35). CONCLUSIONS: In our study, smoking was associated with an increased risk of mortality. Although the smokers had a better outcome, this would be reversed after controlling for age and the other STEMI associated factors.

Assessing exposure to secondhand smoke among Iranian patients with cardiac diseases; a cross-sectional study.

Introduction: Studies have linked secondhand smoke (SHS) exposure to adverse health effects. The high prevalence of heart disease necessitates the need for studies in this field. Therefore, the aim of the present study was to assess the exposure to SHS in cardiac patients. Method: This study is a cross-sectional descriptive study. A total of 430 patients who were referred to Imam Ali Hospital in Kermanshah, Iran, in 2020 were included in the study based on predetermined inclusion and exclusion criteria. The researchers collected and recorded demographic information, disease history, and exposure to secondhand smoke (SHS) through a digital questionnaire. Bivariate analysis was conducted using a chi-square test and an independent T-test, depending on the variable scale. Results: The results of the study showed that 237 patients were male (55.12 %) and 193 were female (44.8 %). The prevalence of exposure to secondhand smoke was 72.09 %. Notably, the highest rate of exposure to secondhand smoke was associated with 'exposure to tobacco smoke in public places' with a rate of 69.30 %. Additionally, it was observed that approximately 39.07 % of patients reported exposure to secondhand smoke in public places at least once a week. Conclusion: The present study has found that cardiac patients frequently experience secondhand smoking exposure, with public settings being the primary location of exposure. Implementing intervention strategies and enacting laws that prohibit smoking can effectively mitigate the negative impact of SHS exposure.

Investigation of the influencing factors with the uptake of the COVID-19 vaccine booster dose among the general population of Ardabil, Iran: A cross-sectional study.

Background and Aims: Vaccination is one of the most efficient approaches to combating COVID-19 if it is adequately embraced by the general population. Numerous factors influence the uptake or refusal of the booster dose. The goal of this study was to look at the different factors that affect how the general population in Ardabil feels about getting vaccine boosters (annual boosters) for COVID-19 and to evaluate those feelings. Methods and Materials: In the city of Ardabil, general population, perceptions towards the COVID-19 vaccine booster (annual boosters) dose were evaluated using a cross-sectional survey design between January 2 and March 25, 2022. A questionnaire was developed and filled out by 662 subjects via phone calls from healthcare providers. Descriptive statistics, the Chi-square test, the correlation coefficient, and regression analysis were run for the analysis of quantitative data. Results: The findings of the research revealed that 238 participants, or 35.9%, had previously gotten the booster dose of the COVID-19 vaccination, while 198 participants, or 29.2%, expressed a desire to do so as soon as feasible. A total of 187 (28.2%) respondents reported not wanting to get a booster dose, and 39 (5.7%) could not decide. In the factors found to affect decisions not to accept regular doses, adverse effects (45.4%) and the presence of misinformation (30%) were the most important. Regression in educational achievement, and following the COVID-19 news showed to be the major predictors of the subjects' attitudes toward the regular COVID-19 vaccine. Conclusion: The present findings revealed that low confidence in the efficiency of the booster shot and misinformation are two critical factors to consider in educational planning and interventions.