Background: The optimal target for revascularization in patients with history of CORONARY artery bypass graft surgery (CABG) is unclear. This study was designed to compare the outcome of percutaneous CORONARY intervention (PCI) on saphenous vein grafts (SVG) and that on native VESSELS in patients with previous CABG in terms of major adverse cardiac events (MACE).Methods: The study drew upon data on consecutive patients hospitalized for PCI and MACE rate during a nine-month follow- up period. The patients were divided according to the target vessel for PCI into two groups: SVG and native vessel.Results: Between 2003 and 2007, 226 patients underwent PCI 6.57 ± 4.55 years after CABG. Their mean age was 59.52±9.38 years, and 176 (77.9%) were male. PCI was performed on the SVG in 63 (27.9%) patients and on the native CORONARY artery in the rest. During a nine-month follow-up period, 9 (4%) patients suffered MACE; the prevalence of MACE was not significantly different between the SVG group (4.8%) and the native vessel group (4.9%), (p value=0.999).Conclusion: PCI on grafted and native VESSELS did not affect MACE in patients undergoing PCI after CABG.

Diabetes mellitus, hypertension, hyperlipidemia and cigarette smoking are major CORONARY artery disease risk factors. This study was performed to detect the correlation between major CORONARY risk factors and the number of diseased VESSELS in CORONARY angiography.Methods: This descriptive study was performed on 196 patients with CORONARY artery disease who underwent CORONARY angiography in Shafa hospital of Kerman during a six-month period. Data were collected by a questionnaire that was used to record CORONARY risk factors and number of involved VESSELS in angiography.Narrowing of more than 50% of the vessel was considered remarkable stenosis.T-test Chi-Square, Man-Whitney and Kruscal-Wallis tests were used for data analysis.Results: The sample included 142 (72%) males, 54 (28%) females, and the mean age was 55.1% years. Single, two and three vessel involvement was detected in 42.3% and 23% 42.3% of the patients, respectively. Patients with one vessel disease had diabetes mellitus and hypertension in comparison with those who had two or three vessel involvement (P<0.05). There was no significant relation between hyperlipidemia and cigarette smoking with the number of involved vessel. In the diabetic patients, the likelihood of two or three vessel involvement was higher than that in non-diabetics (odds ratio = 2).Conclusion: In our study, hypertension and diabetes mellitus were the main risk factors for the presence of three vessel disease. Diabetic patients were at high risk with respect to the number of vessel involvement because of accelerated atherosclerosis process in diabetes.

Background: In angioplasty of chronic total occlusion categorizing lesion characteristics may be useful for their impact on procedural success. There is controversy about the role of bridging collateral VESSELS in chronic total occlusion procedural outcome. This study investigated the effect of bridging collateral VESSELS on the success of CORONARY angioplasty in  patients with chronic total occlusions.Methods: Seventy seven consecutive patients undergoing CORONARY angioplasty for chronic total occlusion were classified into two groups. Group I patients had chronic total occlusion with bridging collateral VESSELS (27 patients), and patients in group II had not such VESSELS (50 patients). Results: Procedural success was achieved in 11 patients in group I and in 41 patients in group II (40.7% vs 82%; P=0.0002; relative risk 3.9; 95% confidence interval 1.7-6.4). Of 52 patients with successful results than patients with ≥3 months (63.5% vs 47.5%; P= 0.0001; relative risk 1.8; 95% confidence interval 1.3-2.6). Presence of a side branch of ≤2mm at occlusion point was a predictor of unsuccessful result (p=0.007; relative risk 2.9;95% confidence confidence interval 1.5-5.6). Conclusion: There are some morphologic variables which may be useful in guiding angioplasty in patients with chronic total CORONARY occlusion . presence of bridging collateral VESSELS is one of them , which appear to be inversely related to procedural success.

Background- In angioplasty of chronic total occlusion, categorizing lesion ‎characteristics may be useful for their impact on procedural success. There is ‎controversy about the role of bridging collateral VESSELS in chronic total occlusion ‎procedural outcomes. This study investigated the effect of bridging collateral VESSELS ‎on the success of CORONARY angioplasty in patients with chronic total occlusions‏.‏ Methods- Seventy-seven consecutive patients undergoing CORONARY angioplasty for ‎chronic total occlusion were classified into two groups. Group I patients had chronic ‎total occlusion with bridging collateral VESSELS (27 patients), and patients in group II ‎had no such VESSELS (50 patients‏). Results- Procedural success was achieved in 11 patients in group I and in 41 patients ‎in Group II (40.7% vs. 82%; p=0.0002; relative risk 3.9; 95% confidence interval 1.7 ‎‎- 6.4). Of 52 patients with successful angioplasty, patients with an estimated duration ‎of occlusion of less than 3 months had more successful results than patients with ‎occlusions of over 3 months (63.5% vs. 47.5%; p=0.0001; relative risk 1.8; 95% ‎confidence interval 1.3-2.6). The presence of a side branch 2mm or less from the ‎occlusion point was a predictor of an unsuccessful result (p=0.0007; relative risk 2.9; ‎‎95% confidence interval 1.5-5.6‎‏). Conclusion- There are some morphologic variables which may be useful in guiding ‎angioplasty in patients with chronic total CORONARY occlusion. Presence of bridging ‎collateral VESSELS is one of them, which appears to be inversely related to procedural ‎success (Iranian Heart Journal 2003; 4 (4):16-21‎‏).

The concertina phenomenon is the occurrence of new and transient angiographic series of pseudolesions in a tortuous vessel induced mainly by a stiff guide wire. Here, we describe a 53-year-old man who experienced a concertina effect in the left anterior descending CORONARY artery (LAD) during an elective percutaneous CORONARY intervention. After the diagnosis of the concertina phenomenon in the LAD, a percutaneous CORONARY intervention was performed following the withdrawal of the soft guide wire to the mid level of the LAD. After the intervention, the patient remained in very good clinical status and was discharged on the third postprocedural day.

Aneurysms of the left main CORONARY artery are exceedingly rare clinical entities, encountered incidentally in approximately 0.1% of patients who undergo routine angiography. The most common cause of CORONARY artery aneurysms is atherosclerosis.Angiography is the gold standard for diagnosis and treatment. Depending on the severity of the coexisting CORONARY stenosis, patients with left main CORONARY artery aneurysms can be effectively managed either surgically or pharmacologically.We herein report a case of left main CORONARY artery aneurysm in a 72-year-old man with a prior history of hypertension presenting to our hospital because of unstable angina. The electrocardiogram showed ST-segment depression and T-wave inversion in the precordial leads. All the data of blood chemistry were normal. Echocardiography showed akinetic anterior wall, septum, and apex, mild mitral regurgitation and ejection fraction of 45%. CORONARY angiography revealed a saccular aneurysm of the left main CORONARY artery with significant stenosis in the left anterior descending, left circumflex, and right CORONARY artery. The patient immediately underwent CORONARY artery bypass grafting and ligation of the aneurysm. At six months’ follow-up, he remained asymptomatic.

Background: CORONARY artery disease is the most important cause of death due to cardiovascular diseases and the main treatment is angioplasty. The purpose of this study was to evaluate the results of angioplasty in patients based on angiographic results, SYNTAX score, clinical conditions, cardiovascular risk factors and non-invasive tests. Additionally, the matching of angioplasty procedure with clinical guidelines was investigated.Methods: This was a cross-sectional study on 2297 patients referred to cardiac centers in Isfahan City (Chamran, Sina, Sepahan, Sa' adi, and Shahid Sadughi), Iran, for angioplasty during the second half of the year 2015. Demographic data, history of diabetes, hypertension, or hyperlipidemia, family history of heart disease, and current use of cigarettes were recorded. The extension of CORONARY artery disease was assessed using SYNTAX score.Findings: Among 2297 patients, 1577 (69.1%) were men and 706 (30.9%) were women. In 87% of patients, angioplasty was performed according to the guideline; and in 13% of them, open heart surgery or medical treatment was appropriate treatment instead of angioplasty. Significant correlation between the extent of CORONARY artery disease and the risk factors as age, diabetes, and hyperlipidemia was observed based on SYNTAX score system.Conclusion: In patients undergoing CORONARY angiography, SYNTAX score has an acceptable value in association with heart risk factors to demonstrate the generalizability of this association. A prospective cohort study can be used as a way to risk assessment for the patients and selection of appropriate diagnostic or medical strategy.

Introduction: Some studies have found a correlation between the presence of breast artery calcification (BAC) observed on routine mammograms, and CORONARY artery disease (CAD) and its risk factors in agod postmenopausal women. The aim of this study was to investigate whether such calcification could predict the presence of CAD in young premenopausal women and whether any association exists between BAC and carotid intima-media thickness (IMT) in this population.Methods: Of 250 women aged less than 55 years referring for CORONARY angiography between 2000 and 2003, 84 individuals aged between 33 and 55 years with serum FSH levels below 40 IU/L were selected. Mammography, carotid Doppler ultrasonography for measurement of IMT, and old and new risk factors of CAD (FBS, TG, CHOL, HDL, LDL, Lpa, CRP and Fibrinogen level) were measured.Results: 40.5% of this population had CAD in CORONARY angiography. Women in CAD group had higher prevalence of hypertension, diabetes mellitus and hyperlipidemia. There was no association between BAC and CAD. There was a correlation between BAC and FBS (Pearson correlation=0.43, P-value=0.008); and BAC and IMT in common carotid (Pearson correlation=0.42, P-value=0.04).Discussion: Despite the correlation between BAC and some CAD risk factors in young premenopausal women, BAC does not predict the presence of CAD in CORONARY angiography in this population.

A 48-year-old woman was admitted to the emergency department with complaints of typical chest pain, cold sweat, and dyspnea of 24 hours’ duration. She had a history of hypertension, hyperlipidemia, and diabetes mellitus for many years. On admission, her electrocardiogram (ECG) revealed normal sinus rhythm and dynamic T inversion in the precordial leads. Her enzyme levels were normal. Transthoracic echocardiography showed a left ventricular ejection fraction of 60%, with mild mitral regurgitation...