Background: Acute coronary syndrome (ACS), which ranges from ST- segment elevation myocardial infarction (STEMI) and non- ST-segment elevation MI (NSTEMI) to unstable angina (UA) is a major reason for hospitalization in the United States. Cardiovascular diseases are the leading causes of mortality in Iran (46% of all deaths). The great majority of coronary heart disease (CHD) patients have at least one major risk factor. Dyslipidemia has been identified as one of the most important modifiable risk factors for coronary heart disease.The aim of stady was to evaluate the frequency of dyslipidemia in ACS patients according to National Cholesterol Education Program Adult Treatment Panel III guidelines (NCEP-ATP III). Material and Methods: We performed a descriptive survey of patients admitted in cardiac ward of Loghman hospital from November 2003 to March 2004. In this period of time 611 patients admitted with the primary diagnosis of acute coronary syndrome. Their lipid profile measured at the first 24 hours of their admission.Results: Their final diagnoses were acute myocardial infarction in 32%, Possible unstable angina in 26%, definite/probable unstable angina in 22% and non cardiac chest pain in 20%. Patients with the final diagnosis of acute coronary syndrome were 490 persons with the mean age of 61±2.2 year and 50.6 precent of them were female. Their mean total cholesterol was 214.4±53.8 mg/dl, mean triglyceride was 181.8±122.2 mg/dl, mean HDL-C was 47.1±14.3 mg/dl and mean LDL-C was 132.8±43.8 mg/dl. ACS patients had dyslipidemia in 61.8% and only 18.2% had normal serum lipids. Mean total cholesterol, mean triglyceride and mean LDL-C were significantly higher in women than men (p<0.001, p=0.037, p<0.001 respectively).Great majority (90.5%) of ACS patients had at least one of the major CHD risk factors and only 6.3 precent had LDL-C<70 mg/dl.Conclusion: Dyslipidemia is prevalent in ACS patients and ought to be diagnosed and treated immediately.

Cardiovascular diseases (CVD) comprise of various heart and blood vessels‑, related diseases. Acute coronary syndrome (ACS) is one of them. Basic researchers and cardiologists have witnessed landmark developments related to ACS and despite rapid refinement in our understanding,scientists are seeking answers for more questions. Scientists have mapped wide ranging proteins and intricate protein networks which play central role in the pathogenesis in ACS. In this review, we have attempted to summarize underlying causes of ACS. Better understanding of the disease pathology will enable us to get a step closer to an effective clinical management.

Introduction: Coronary artery disease is one of the most dangerous health problems in developed and undeveloped countries. Annually one million patients admitted in coronary care units in U.S.A due to AMI and about 59 million people suffered from Atherosclerosis. In Europe 54% of C.C.U admissions is due to non Q wave MI and 46% due to Q wave MI. Unfortunately there is no distinct statistic al results concerning the incidence of acute coronary syndrome in Iran. Materials and Methods: This study was carried out to determine prevalence and incidence of acute coronary syndrome during 2002 –5 in Imam Ali Hospital of Kermanshah. Calculated sample size was 621 patients, of whom, all clinical and demographic data were collected. _2 and T-Test were used to analyse the data. Results: 843 patients profiles were studied, 607 males and 236 females aged between 25 to 78 years old. The study showed; 312 patients with unstable angina, 453 patients with Q wave myocardial infarction and 78 patients with non-Q wave myocardial infarction. Incidence and prevalence of acute coronary syndrome were U.A 37%, non-Q wave MI 9.2% and Q wave MI 53.7% respectively. Conclusion: More different incidence and frequency of A.C.S was observed than those reported by developed countries (e.g. 9.2% non Q wave MI vs. 54%). Further studies needed to be done to find different prevalence of ACS in Kermanshah.

Introduction: The use of a predictive scale for acute coronary syndrome (ACS) can play an essential role in screening high-risk individuals. This study aimed to develop the ACS predictive scale (ACS-PS) and investigate its construct validity, reliability, sensitivity and specificity. Methods: This was a retrospective methodological study with the aim of developing a predictive scale for ACS in Iran in 2019. In this study, the content validity (content validity index [CVI] and content validity ratio [CVR]), construct validity, sensitivity, specificity, cutoff point and internal consistency of the 13-item scale for predicting ACS (in Persian) were investigated. Participants included patients with a definite diagnosis of ACS (n=150) and a healthy group without ACS (n=143). Results: The score range of the 13-item scale was 0-130, and with a cutoff point of 11.5, both the sensitivity and specificity of the scale were 0.75. Cronbach’s alpha coefficient was 0.80. Conclusion: The present study introduced a sensitive and specific scale for predicting ACS. The ACS-PS is a partially short-form scale and requires less time to complete.

Background: Various infectious agents like Helicobacter pylori and Chlamydia pneumoniae have been suggested for the development of atherosclerosis. The seroepidemiological association between Chlamydia pneumonia infection and coronary artery disease is still controversial. The purpose of this study is to investigate the association between anti-chlamydia pneumoniae antibodies (IgG and IgA) and acute coronary syndrome.Methods: 87 patients and 87 controls (matched by age and sex) were recruited into this case-control study from February 2009 to January 2010. Sampling was done and anti-Chlamydia pneumonia antibodies were measured using micro immunofluorescence method. Characteristics of population were recorded and statistical analysis was performed using SPSS software.Results: The overall prevalence of anti-Chlamydia pneumoniae IgG and IgA were 43% and 10%,respectively.38 (43.7%) patients and 38 (43.7%) controls were positive for IgG (OR=1). 8 (9.2%) patients and 11 (12.6%) controls were positive for IgA (OR=0.69). There was no statistically significant difference between patients and controls in seropositivity of Chlamydia pneumoniae in uni- and multi-variate analysis.Conclusion: There is no association between Chlamydia pneumoniae seropositivity and acute coronary syndrome in this case-control study. More investigations are suggested because of controversial results.

Background and aims: The present time evidences show that adherence of clinical guideline by cardiologists in Acute Coronary Syndrome is sub optimal. The aim of this studywas to investigate the extent adherence by cardiologists from clinical guidelines in acute coronary syndrome on admission in hospitals in Isfahan. Methods: This cross sectional study was conducted on medical records of Acute Coronary Syndrome patients (unstable angina and myocardial infarction). The pharmacological adherence calculated from prescription of 4 recommended medications from clinical guidelines utilizing aspirin clopidogrel, beta blockers, statins, ACEI (angiotensin-converting enzyme inhibitor) or ARB (angiotensin II receptor blockers). Pharmacological adherence were divided into two groups of good-adherence equals or above %75 (4. 3, 4. 4) and poor-adherence below %75 (1. 4, 2. 4). Results: This research performed on 200 medical records of Acute Coronary Syndrome (ACS) patients. On admission%99, %80, %58 and %96. 5 of patients received antiplatelet, beta blockers, ACEI/ARB and statins, respectively. In general, the extent of pharmacological adherence to updated clinical guidelines on admission was%58. 5 which was poor. Conclusion: Poor adherence to updated clinical guidelines by cardiologists due to secondary prevention of ACS is very worrisome. It is necessary to investigate the reasons of non-adherence regarding aging society and the prevalence of cardiac disease.

Background: The purpose of this study was to examine symptoms of acute coronary syndrome (ACS) with resect to sex differences.Methods: This comparative cross-sectional study was performed on patients older than 20 years with ACS who were hospitalized at cardiac wards. Sampling was performed through stratified sampling on the basis of sex. Five hundred male and female patients met all eligiblity criteria. The questionnaire included demographic, disease characteristics, and the Iranian version of the accompanying symptom checklist. Data collection completed over one year. SPSS version 21 was used for data analyses by using Chi-square test, independent t test and Multiple logistic regression. The level of significance was specified at 0.05.Results: Men reported tiredness (77.2%), weakness (72.4%), diaphoresis (70.0%) and anxiety (83.6%) as their most frequent symptoms. For women, the most frequently chosen symptoms were anxiety (94.8%), tiredness (90.0%), palpitation (85.2%), and weakness (82.8%). Statistically significant differences were observed between women and men with regard to symptoms. Multiple logistic regression indicated that sex was the most important explanatory variable, which is independently associated with different symptoms.Conclusion: According to the results, significant differences were observed between women and men regarding ACS symptoms. The major implication of this investigation is the need for accurate cardiac assessment according to sex. Further research should investigate the nature and consequences of sex differences in language use of initial presentation with coronary symptoms, through the referral process.