Which risk factor best predicts coronary artery disease using artificial neural network method?

BACKGROUND: Coronary artery disease (CAD) is recognized as the leading cause of death worldwide. This study analyses CAD risk factors using an artificial neural network (ANN) to predict CAD. METHODS: The research data were obtained from a multi-center study, namely the Iran-premature coronary artery disease (I-PAD). The current study used the medical records of 415 patients with CAD hospitalized in Razi Hospital, Birjand, Iran, between May 2016 and June 2019. A total of 43 variables that affect CAD were selected, and the relevant data was extracted. Once the data were cleaned and normalized, they were imported into SPSS (V26) for analysis. The present study used the ANN technique. RESULTS: The study revealed that 48% of the study population had a history of CAD, including 9.4% with premature CAD and 38.8% with CAD. The variables of age, sex, occupation, smoking, opium use, pesticide exposure, anxiety, sexual activity, and high fasting blood sugar were found to be significantly different among the three groups of CAD, premature CAD, and non-CAD individuals. The neural network achieved success with five hidden fitted layers and an accuracy of 81% in non-CAD diagnosis, 79% in premature diagnosis, and 78% in CAD diagnosis. Anxiety, acceptance, eduction and gender were the four most important factors in the ANN model. CONCLUSIONS: The current study shows that anxiety is a high-prevalence risk factor for CAD in the hospitalized population. There is a need to implement measures to increase awareness about the psychological factors that can be managed in individuals at high risk for future CAD.

Low physical activity is the strongest factor associated with frailty phenotype and frailty index: data from baseline phase of Birjand Longitudinal Aging Study (BLAS).

BACKGROUND: Frailty is the most complicated expression of aging that is related to disability or multi-morbidity. The aim of the present study was to estimate the prevalence of frailty and its associated factors among community-dwelling aged population. METHODS: A total of 1529 eligible community- dwelling older adults (≥ 60 years) were enrolled in the baseline phase of Birjand Longitudinal Aging Study (BLAS) from 2019 to 2020. Their frailty status was assessed using the Fried's frailty phenotype and frailty index. Sociodemographic factors, including sex, age, marital status, and education level, were collected. Health status assessment included the history of hypertension, diabetes mellitus, cardiovascular disease, Alzheimer's diseases and dementia, and other health conditions. Furthermore, functional assessment (ADL, IADL) and anthropometric measurements including height, weight, waist, calf, and mid-arm circumference were made and the body mass index was calculated. The nutrition status and polypharmacy (use 3 or more medication) were also evaluated. RESULTS: The prevalence of frailty was 21.69% according to the frailty phenotype and 23.97% according to the frailty index. A multiple logistic regression model showed a strong association between low physical activity and frailty phenotype (OR = 36.31, CI = 16.99-77.56, P < 0.01), and frailty index (OR = 15.46, CI = 5.65-42.34, P < 0.01). Other factors like old age (≥80), female sex, malnutrition, polypharmacy, obesity, and arthritis were also associated with frailty. The Kappa coefficient of the agreement between these two instruments was 0.18. CONCLUSION: It seems that low physical activity is the most important determinant of frailty. Low physical activity and some other factors may be preventable or modifiable and thus serve as clinically relevant targets for intervention.

Gym and home-based combined training in men with primary hypertension: are they equally effective on functional fitness profile, body composition components, and biochemical parameters of hypertension?

OBJECTIVE: This study aimed to compare the effects of 10 weeks of gym versus home-based combined training on the functional fitness, body composition, and biochemical parameters of hypertension in primary hypertensive men. METHODS: Forty-six patients (age 48 ± 9 years, BMI 30 ± 4 kg/m2) assigned into three groups: a gym-based combined training (GBCTr: n = 16; resistance at 60-80% of 1RM, using pin-loaded resistance equipment, aerobic at 40-60% HRR, and stretching), home-based combined training (HBCTr: n = 15; resistance at 12-15 RPE, using an elastic exercise band, aerobic at 40-60% HRR, and stretching), and control (CTR, n = 15). RESULTS: Following GBCTr and HBCTr, the functional aerobic capacity (P = .005 and P = .004, respectively), flexibility (P = .01 and P = .004, respectively), and lower limb muscle strength (P = .01 and P = .02, respectively) was increased significantly compared with the CTR group. The body weight (P = .02), body mass index (P = .008), hip circumference (P = .02), and nitric oxide level in GBCTr and HBCTr group (P = .002 and P = .02, respectively) was decreased significantly compared with the CTR group. No significant changes found in the plasma levels of NADPH oxidase 5, thioredoxin-2, thioredoxin reductase-2, and resting blood pressure after GBCTr and HBCTr compared with the CTR group. CONCLUSION: These results suggest that in hypertensive men, HBCTr equally to GBCTr improved functional fitness and body composition remarkably without necessarily reducing resting blood pressure. Therefore, they can be advisable substitutes for gaining health benefits.

Effect of a Persian medicine preparation, Ma'aljobon, on constipation in patients with hypertension.

BACKGROUND: Constipation is a common and prevalent digestive problem. Forcing and straining due to constipation may have a negative effect on some parts of the body, including the heart. The aim of the study was to evaluate the effect of Ma'aljobon (a kind of whey) on functional constipation in hypertensive patients. MATERIALS AND METHODS: The present double-blind, placebo-controlled randomized clinical trial was a part of the study about the effect of Ma'aljobon on stage 1 hypertension, performed in 2017-2018. Hypertensive patients accompanying constipation were included in the study. Patients were randomly divided into two groups: Group A (n = 19) received 25 g of Ma'aljobon powder and Group B (n = 22) received 25 g of maltodextrin powder, twice a day for 6 weeks. The number and quality of defecation during a day were evaluated at baseline and at the end of the study within and between groups. Data were analyzed by SPSS software (version: 17) using Chi-square or Fisher's exact test. P <0.05 was considered as significant level. RESULTS: Forty-one patients had inclusion criteria, of whom 34 patients completed the study (19 in Group A and 15 in Group B). The mean ± standard deviation age of patients was 53.86 ± 8.92 years (range: 34-80 years). Before intervention, there was no significant difference between the two groups with respect to constipation; however, after 6 weeks' treatment, the frequency of constipation was significantly different between groups (P < 0.001). At the end of 6th week, constipation in the Group A was improved completely in terms of the number of defecation and stool consistency; but, in the Group B, eight (53.33%) patients still suffered from constipation (P < 0.001). No specific complications were reported in both groups. CONCLUSION: Ma'aljobon can improve constipation in hypertensive patients without any adverse effect.

Comparison of atherogenic index and lipid profiles in candidates for coronary artery bypass graft surgery versus normal people.

Information on incidence and risk factors of cardiovascular disease (CVD) is rare in the Middle East. This study aims to compare Iranian candidates for coronary artery bypass graft (CABG) surgery and healthy controls in terms of lipid profile, atherogenic index of plasma (AIP), and atherosclerosis index (ASTI). The individuals recruited in this study were 135 CVD patients before CABG surgery and 135 healthy subjects matching in age with the cases. Lipid profiles of the two groups were analyzed with a commercial kit. The AIP and ASTI indexes were calculated with related formula. The TC, TG, LDL-C and HDL-c parameters were dramatically changed (p<0.01) between study groups. AIP and ASTI indexes were significantly higher in patients than in healthy people (p=0.001). In individuals with CVD, it is suggested to measure these indexes in order for effective diagnosis before CABG surgery.

The effect of a 10-week high-intensity interval training and ginger consumption on inflammatory indices contributing to atherosclerosis in overweight women.

BACKGROUND: Most of the cardiovascular diseases can be prevented by doing regular physical exercises and using herbal supplements. The present study is aimed at assessing ginger supplement and high-intensity interval training (HIIT) on inflammatory indices contributing to atherosclerosis in overweight women. MATERIALS AND METHODS: The present study is a randomized, experimental, and controlled one in which thirty healthy overweight women aged 20-30 years were randomly divided into three equal groups, namely, ginger, ginger + HIIT, and placebo + HIIT. The training groups performed high-intensity interval exercises (i.e. 40-m maximal shuttle run) for ten consecutive weeks. The supplement groups daily took 3 g of ginger pills and the third group took placebo. RESULTS: Paired t-test revealed a significant decrease in the density of type 1 monocytes chemo tactic protein (MCP-1) in HIIT + ginger (P = 0.026) and HIIT + placebo (P = 0.001) groups. Besides, maximum aerobic capacity in the two training groups significantly increased P = 0.002 and P = 0.000, respectively. In spite of this, analysis of variance showed no significant differences in three groups regarding the three indices such as intercellular adhesion molecule-1 (ICAM-1) (P = 0.093), MCP-1(P = 0.075), and serum interleukin-10 (IL-10) (P = 0.164). CONCLUSION: A 10-week intensive interval exercise, by itself or together with ginger supplement, improved MCP-1 and maximum oxygen consumption in overweight women, without any significant effect on soluble ICAM-1 and IL-10. These findings indicate the relative and efficient role of HIIT in overweight women without the necessity to combine with ginger as an antioxidant/anti-inflammatory supplement.

Lipid Profiles and Prevalence of Dyslipidemia in Eastern Iranian Adolescents, Birjand, 2012.

BACKGROUND: Cardiovascular risk factors begin in childhood and adolescence. This study aimed at assessing serum lipids and prevalence of Dyslipidemia in 11-18 year old students of Birjand. METHODS: The present cross-sectional, descriptive, and analytical study was done on 2,643 middle and high school students of Birjand aged 11-18 years (1,396 girls and 1,247 boys). Blood samples were collected for the measurement of blood lipids, including Cholesterol, Triglyceride, HDL, and LDL after a 12-hour fasting period. The defined borderline and abnormal values stated in 2011 by the American Academy of Child, was used. RESULTS: According to our results, it is concluded that: (i) 34.3% (31.3% girls and 37.6% boys) of adolescents had at least one dyslipidemia. (ii) 24.7% of the individuals had HDL lower than 40, where 14% of them TG≥130, 6.1% of cases TC≥200, and 3.5% of cases LDL≥130. Lipid disorder within low HDL type and hypertriglyceridemia were significantly higher in boys (P<0.05) than girls. Hypercholesterolemia and hypertriglyceridemia in the age group of 11-14 years and low HDL in the age group of 15-18 years showed the highest values (P<0.05). CONCLUSION: Adolescents of Birjand have high prevalence of dyslipidemia. Preventive measures are recommended to improve lifestyle, including healthy nutrition, encouraging adolescents to exercise, and more mobility.

Marfan syndrome in an Iranian family: a case series.

Marfan syndrome (MFS) is a genetic disorder which is inherited by autosomal dominant traits. In MFS, lens displacement and cardiovascular involvement are important causes of morbidity and mortality in the clinical course of the disease. In this case study, the ocular involvement in a family with severe penetration of MFS is reported. Twelve members of a family (father, two daughters, three sons, and six grandchildren) had MFS. Lens ectopia was the most common ophthalmic involvement among the family (100%). Other ocular involvements were as follows; Hypoplastic iris or ciliary's muscle hypoplasia (50%), on gated eyeball (42%), flat cornea (30%), glaucoma and cataract (25%), retinal detachment (16%). Three members of the family underwent eye surgery including lens extraction, glaucoma surgery and retinal surgery.

Protective effects of carvacrol on lipid profiles, oxidative stress, hypertension, and cardiac dysfunction - A comprehensive review.

Cardiovascular diseases (CVDs) are a class of illnesses that affect the heart or blood vessels, leading to the most common causes of death worldwide. In 2017, CVD caused approximately 17.8 million deaths that were increased approximately to 20.5 million deaths in 2021, globally. Also, nearly 80% of worldwide CVD deaths occur in some countries. Some herbs and their constituents due to their several pharmacological activities have been used for medicinal purposes. Carvacrol is a phenolic mono-terpenoid found in the oils of aromatic herbs with several biological properties. The possible therapeutic effects of carvacrol on lipid profiles, oxidative stress, hypertension, and cardiac dysfunction were summarized in the current study. The data from this review article were obtained by searching the terms including; "Carvacrol", "Hypertension", Hypotensive, "Cardiac dysfunction", "Ischemia", "Lipid profile", and Oxidative stress in several web databases such as Web of Sciences, PubMed Central, and Google Scholar, until November 2023. The results of the reviewed studies revealed that carvacrol inhibits acetylcholinesterase (AchE) activity and alters lipid profiles, reducing heart rate as well as systolic and diastolic blood pressure (BP). Carvacrol also decreased the proinflammatory cytokine (IL-1ß), while increasing secretion of anti-inflammatory cytokine (IL-10). Moreover, carvacrol improved oxidative stress and mitigated the number of apoptotic cells. The pharmacological effects of carvacrol on CVD might be through its antioxidative, anti-inflammatory, and antiapoptotic effects. The mentioned therapeutic effects of carvacrol on lipid profile, hypertension, and cardiac dysfunction indicate the possible remedy effect of carvacrol for the treatment of CVD.

The association of the apolipoprotein B/A1 ratio and the metabolic syndrome in children and adolescents: a systematic review and meta-analysis.

Objectives: Metabolic syndrome (MetS) is a constellation of coexisting cardiovascular risk factors. This study aimed to assess the evidence for the association between the apolipoprotein B/A1 ratio, apolipoprotein B, and apolipoprotein A1, and the MetS in children and adolescents. Methods: The English electronic databases including PubMed, Embase, Web of Science, and Scopus were searched up to February 28, 2022. To ascertain the validity of eligible studies, modified JBI scale was used. Standardized mean differences (SMDs) with 95% confidence intervals (CIs) were pooled using the random-effects model to evaluate the association between the apolipoprotein B/A1 ratio, apolipoprotein B, and apolipoprotein A1 and the MetS. Heterogeneity amongst the studies was determined by the use of the Galbraith diagram, Cochran's Q-test, and I2 test. Publication bias was assessed using Egger's and Begg's tests. Results: From 7356 records, 5 studies were included in the meta-analysis, representing a total number of 232 participants with MetS and 1320 participants as control group. The results indicated that increased levels of apolipoprotein B/A1 ratio (SMD 1.26; 95% CI: 1.04, 1.47) and apolipoprotein B (SMD 0.75; 95% CI: 0.36, 1.14) and decreased levels of apolipoprotein A1 (SMD -0.53; 95% CI: -0.69, -0.37) are linked to the presence of MetS. The notable findings were, children and adolescents with MetS had elevated levels of the apolipoprotein B/A1 ratio, apolipoprotein B, and decreased levels of apolipoprotein A1. Conclusions: Our results suggest the need to evaluate the levels of apolipoproteins for detecting the risk of MetS in children and adolescents. Supplementary Information: The online version contains supplementary material available at 10.1007/s40200-023-01235-z.

The effects of opium consumption on severity of disease on hospitalized COVID-19 patients in East of Iran, a prospective cohort study.

There are few theories and little empirical evidence about the bilateral impact of substance use and coronavirus disease 2019 (COVID-19), so a logical and accurate picture of this area is required. We investigated the effects of opium use on severity of disease on hospitalized COVID-19 patients in east of Iran. Demographic and clinical characteristics, vital signs, laboratory tests, mortality rate, type and duration of opium consumption in hospitalized patients who recovered from COVID-19 in the follow-up after 3 months were evaluated. In this study, 60 (20%) participants were the opium user and 251 (80%) were the non-user patients. Based on clinical symptoms, hypertension and systolic blood pressure in opium user were significantly higher than non-user patients (p < 0.05). In the laboratory tests, only the level of urea was higher in the opium positive group (37 [26.5-48.5] vs. 32 [23-43], respectively) and the percent of lymphocytes were lower in the opium positive (17 [8.2-25.8] vs. 18.7 [13.85-26.35], respectively). The initial therapies of both opium positive and negative infected patients showed not any significant changes (p > 0.05). Among the studied groups, one deceased case with COVID-19 was related to a drug user patient. Although, uses of opium reduced the levels of some risk factors, vital signs at admission and initial therapies during hospitalization in COVID-19 patients but it increased lung and heart diseases. Also, the severity of COVID-19 including hospitalization and mortality were associated with opium consumption.

Evaluation of the effect of the COVID-19 pandemic on the all-cause, cause-specific mortality, YLL, and life expectancy in the first 2 years in an Iranian population-an ecological study.

Background: COVID-19 pandemic resulted in excess mortality and changed the trends of causes of death worldwide. In this study, we investigate the all-cause and cause-specific deaths during the COVID-19 pandemic (2020-2022) compared to the baseline (2018-2020), considering age groups, gender, place of residence, and place of death in south Khorasan, east of Iran. Methods: The present ecological study was conducted using South Khorasan Province death certificate data during 2018-2022. The number of death and all-cause and cause-specific mortality rates (per 100,000 people) were calculated and compared based on age groups, place of residence, place of death, and gender before (2018-2020) and during the COVID-19 pandemic (2020-2022). We also calculated total and cause-specific years of life lost (YLL) to death and gender-specific life expectancy at birth. Results: A total of 7,766 deaths occurred from March 21, 2018, to March 20, 2020 (pre-pandemic) and 9,984 deaths from March 21, 2020, to March 20, 2022 (pandemic). The mean age at death increased by about 2 years during the COVID-19 pandemic. The mortality rate was significantly increased in the age groups 20 years and older. The most excess deaths were recorded in men, Aged more than 60 years, death at home, and the rural population. Mortality due to COVID-19 accounted for nearly 17% of deaths. The highest increase in mortality rate was observed due to endocrine and Cardiovascular diseases. Mortality rates due to the genitourinary system and Certain conditions originating in the perinatal period have decreased during the COVID-19 pandemic. The major causes of death during the pandemic were Cardiovascular diseases, COVID-19, cancer, chronic respiratory diseases, accidents, and endocrine diseases in both sexes, in rural and urban areas. Years of life lost (YLL) increased by nearly 15.0%, which was mostly due to COVID-19, life expectancy at birth has steadily declined from 2018 to202 for both genders (from 78.4 to 75). Conclusion: In this study, we found that All-cause mortality increased by 25.5% during the COVID-19 pandemic, especially in men, older adult, Rural residents, and those who died at home (outside the hospital). Considering that the most common causes of death during the COVID-19 pandemic are also non-communicable diseases. It is necessary to pay attention to non-communicable diseases even during the pandemic of a serious infectious disease like COVID-19. The years of life lost also increased during the COVID-19 pandemic, which is necessary to pay attention to all age groups, especially the causes of death in young people. In most developing countries, the first cause of death of these groups is accidents.

Prevalence of Metabolic Syndrome and Its Associated Potential Factors among the Elderly in the East of Iran.

BACKGROUND AND AIMS: This cross-sectional study aimed to determine potential factors with a strong association with metabolic syndrome (MetS) among obesity and lipid-related parameters, and liver enzymes, fasting blood glucose (FBG), and blood pressure (BP) as well as some sociodemographic factors in elderly over 60 years old from a sample of Birjand Longitudinal Aging Study (BLAS). METHODS: A total of 1366 elderly Birjand participants were enrolled and divided into non-MetS (n = 512) and MetS (n = 854) groups based on the status of MetS from January 2018 to October 2018. The anthropometric parameters, blood lipid profiles, liver enzymes, and disease history were evaluated and recorded. RESULTS: 62.5% of the participants from our sample of elderly Birjand have MetS (33.4% in males and 66.6% in females). The prevalence of MetS in females was significantly higher than in males (P < 0.001). The increasing trend in the number of MetS components (from 0 to 5) was observed in females (p < 0.001). Odds ratio showed a strong association between female gender [8.33 (5.88- 11.82)], obesity [8.00 (4.87-13.14)], and overweight [2.44 (1.76-3.40)] with MetS and acceptable association between TG/HDL [(1.85 (1.62-2.12)] with MetS. CONCLUSION: This study indicated that the female sex, overweight and obesity have a strong association with MetS and TG/HDL has an acceptable association found in the sample of the elderly Birjand population. However, due to the obvious limitations of our study including the homogeneous sex and race of population, and no adjustment for several important confounding factors including sex, different ages, stage in the elderly, alcohol consumption, smoking, married status, physical activity, diet, and family history of CVD, more epidemiological investigations are needed to address this question.

Trace element concentration and cognitive dysfunction in elderly residents in Birjand.

Trace elements were suggested to have a main role in modulating cognitive function. However, there are several controversial findings regarding the association between serum trace element concentration and cognitive function in patients with cognitive disorders. Thus, this study aimed to evaluate the changes in serum trace element concentrations in elderly with cognitive dysfunction versus the participants with normal cognitive function. This cross-sectional study included 191 older adults over 60 years from Birjand County, Iran. Participants were assessed for cognitive performance and serum trace elements concentration including aluminum (AL), cobalt (Co), cadmium (Cd), Chrome (Cr), copper (Cu), Iron (Fe), magnesium (Mg), manganese (Mn), selenium (Se) and zinc (Zn). Our findings showed no significant difference in the serum concentration of AL, Co, Cr, Zn, Fe, Mg, Mn, and Se of elderly with cognitive dysfunction versus the subjects with normal cognitive function. However, the concentration of Cu significantly increased in the serum of the elderly with cognitive dysfunction versus participants with normal function. In conclusion, our study indicated an increase in the serum concentration of Cu in the elderly with cognitive dysfunction in the sample of the Birjand Longitudinal Aging Study. However, due to the main limitations of our study including low sample size and cross-section design, these findings should be interpreted with caution.

Statin treatment and serum low-density lipoprotein (LDL) level in the Birjand elderly dwellers: Birjand Longitudinal Aging Study (BLAS) Wave3.

Background: Elderly people have a greater risk than others to develop atherosclerotic disorders. Statins are the most efficient treatments against atherosclerosis; however, the pros and cons of the treatment should be put in balance in regard to the target level of low-density lipoprotein cholesterol (LDL-C). This study evaluates the level of LDL in the Birjand elderly population and determines the achievement of target LDL-C level, according to the American College of Cardiology (ACC) guidelines. Methods: A retrospective observational study of statin therapy was performed from October 2018 using Birjand community health assessment data of the BLAS project. We used the 2018 ACC/AHA guidelines to determine the achievement of target LDL level in statin treated patients with clinical atherosclerotic cardiovascular diseases (ASCVD), or elderly high risk diabetic patients and dyslipidemia ones, in the Birjand elderly dwellers, stratified by statin treatment intensity. Statin and non-statin users were also compared in terms of demographic and laboratory findings. Mann-Whitney U test and Chi-Square test were used for data analysis. Results: Out of 1418 elderly residents in this study, 683 individuals (48.2%) were male with a mean age of 69.73±7.56 years. The total mean level of LDL-C in elderly participants was 122.83±36.21 mg/dL. The mean level of LDL-C in statin use and none statin use group was 104.97±36.01 and 129.09±34.14, respectively. Only 304 (29.2%) of participants who were eligible for statin administration used the statin. While 69 (18.3%) individuals from 378 (26.7%) were using statin though they were not eligible for it. In the clinical ASCVD group, 39 (28.3%) of elderly participants achieved target LDL-C based on the ACC/AHA guideline. This was 58 (37.4%) for other participants with LDL-C ≥190 mg/dL, diabetic or participants with Framingham Risk Score (FRS) ≥10%. Conclusions: The majority of patients who were eligible for high or moderate-intensity statin treatment had not received statin. Only one third of clinical ASCVD patients and almost half of high risk patients achieved LDL-C target values. Findings illustrate current treatment may need to be reconsidered in Birjand elderly dwellers treated with statin and physicians, should be updated on the use of statins.

Epidemiological, imaging, laboratory, and clinical characteristics and factors related to mortality in patients with COVID-19: a single-center study.

OBJECTIVE: Coronavirus disease 2019 (COVID-19) is a novel pandemic. Considerable differences in disease severity and the mortality rate have been observed in different parts of the world. The present study investigated the characteristics and outcomes of patients hospitalized with COVID-19 in Iran. METHODS: We established a retrospective cohort to study hospitalized COVID-19 patients in Iran. Epidemiological, imaging, laboratory, and clinical characteristics and outcomes were recorded from medical documents. The chi-square test, t-test, and logistic regression models were used to analyze the data. A p<0.05 was considered to indicate statistical significance. RESULTS: In total, 364 cases (207 males and 157 females) were analyzed. The most common symptoms were cough, fever, and dyspnea. Multifocal bilateral ground-glass opacities with peripheral distribution were the predominant imaging finding. The mean age of patients was 54.28±18.81 years. The mean age of patients who died was 71.50±14.60 years. The mortality rate was 17.6%. The total proportion of patients with a comorbidity was 47.5%, and 84.4% of patients who died had a comorbidity. Sex, history of diabetes mellitus, and dyslipidemia were not significantly associated with mortality (p>0.05). However, mortality showed significant relationships with body mass index; age; history of hypertension, chronic kidney disease (CKD), ischemic heart disease, cerebrovascular accident (CVA), pulmonary disease, and cancer; and abnormal high-resolution computed tomography (HRCT) findings (p<0.05 for all). Cancer had the highest odds ratio. CONCLUSION: Comorbidities (especially cancer, CKD, and CVA), severe obesity, old age, and abnormal HRCT findings affected the health outcomes of patients hospitalized with COVID-19.

Association Between Retinoid X Receptor Gene Variants and Dyslipidemia Risk in an Iranian Population.

Background Dyslipidemia is a complex trait that is influenced by various genetic and environmental factors. While the exact cause of dyslipidemia is still unknown, some studies have shown that genetic factors such as single nucleotide polymorphisms (SNPs) have been primarily associated with dyslipidemia. Based on the available data, it appears that retinoid X receptor (RXR) genes are jointly or separately associated with lipid homeostasis and that SNPs may affect RXR gene functions in lipid metabolism. Methods To study the possible role of the RXR genes in genetic susceptibility of dyslipidemia, three selected polymorphisms, rs3132294 located in RXRA (RXR-alpha) gene and rs2651860 and rs1128977 located in RXRG (RXR-gamma) gene, were investigated in 391 individuals with the use of tetra-primer amplification refractory mutation system polymerase chain reaction (T-ARMS PCR) method. Results For the rs3132294 SNP, the genotype frequencies in the case group were GG 58.5%, GA 33.2%, and AA 8.3%, and in the control group, they were GG 51.8%, GA 36.3%, and AA 11.9%. The genotype distribution of rs2651860 SNP in the case group were TT 43.2%, TG 52.1%, and GG 4.7%, and in the control group, they were TT 50.8%, TG 46.2%, and GG 3%. Genotype frequencies for the rs1128977 SNP in the case group were CC 34.7%, CT 47.6% and TT 17.7%, compared with CC 37.8%, CT 44.3%, and TT 17.9% in the control group. When the clinical characteristics of the case and control groups were stratified by allele carrier status for each SNP, the rs1128977 SNP was associated with increased levels of HDL-cholesterol, body mass index, waist circumference, and diastolic blood pressure (P< 0.05). In contrast, the alleles of the rs2651860 and rs3132294 SNP were not associated with an increased prevalence of dyslipidemia or clinical characteristics in the case group compared to the control group. Conclusion The present study suggests that rs1128977 SNP in the RXRG gene may affect the clinical characteristics in cases. However, further genetics association studies on large samples are required to validate our findings.

Twenty Years' Follow-up of a Family with Marfan Syndrome: A Case Series.

Marfan syndrome is a rare connective tissue disorder manifesting with cardiovascular pathologies which are also the leading cause of death. Herein, we present the past 20 years follow up of a family with 17 members afflicted with Marfan syndrome. 3 members of the family were deceased and none were due to cardiovascular events. We assume to some extent traumas are a neglected cause for a part of mortality in Marfan syndrome.

One-year survival cohort of patients with reduced ejection fraction heart failure in Iranian population: A single center study.

BACKGROUND: Cardiovascular diseases (CVDs) are one of the main concerns of health care systems. The aim of this study was to investigate the most important prognostic factors of heart failure (HF) and their survival outcomes in patients in Birjand, East of Iran. METHODS: A total of 194 systolic HF patients hospitalized in Birjand Valiasr hospital were followed up for 12 months in 2016, and those with reduced left ventricle ejection fraction (LVEF < 50%) were included in this study. Kaplan-Meier and Cox proportional hazard analysis were used to determine the association of each factor with events. RESULTS: The mean age of patients was 68.23 ± 13.40 (27-95) years, and 57.2% (111 out of 194) were women. Mean survival time was 294.7 ± 9.924 days. Pervious history of myocardial infarction (MI) [2.141 (1.101-4.161)] increased the risk of cardiovascular hospitalization. Elevated blood levels of potassium [2.264 (1.438-3.564)] was found to be a risk factor for all-cause and cardiovascular mortality. Moreover, there was a reverse relationship between body height [0.942 (0.888-0.999)] and cardiovascular death. Patients with opium addiction [4.049 (1.310-12.516)] are at a higher risk of cardiovascular mortality. Lower levels of LDL-C [0.977 (0.960-0.996)] and living in rural areas [3.052 (1.039-8.964)] increased all-cause mortality levels. Lack of pervious history of chronic obstructive pulmonary disease (COPD) decreased cardiovascular hospitalization [0.265 (0.062-1.122)]. CONCLUSION: In our study, serum potassium, LDL-C, and uric acid levels in patients with HF were identified as prognostic factors. The height of patients, which can be an indicator of the functional state of their respiratory system, and the history of COPD were also recognized as prognostic factors. Opium use and rural living were identified as social factors influencing patients' prognosis.