Coronary artery disease (CAD) is a major global problem. In addition, it is higher risk of mortality for women more than men are when develop in female gender Atherosclerotic plaques consist of deposits of fatty material in the tunica intima. The role of inflammatory process in CAD has been known from 1980・s. Several studies investigated the innate immunity and adaptive immunity roles in atherosclerosis and they concluded that it plays a key role in atherosclerosis. Coronary artery bypass grafting (CABG) is a widely used method for the treatment of CAD. Based on the literature, CABG is the most common surgical operation done worldwide. In During the first 10 years after CABG, up to 50% of saphenous grafts will occlude. Graft restenosis is beginning with acute thrombosis, intima hyperplasia, and plaque formation. In this review, some molecular pathways of graft failure and restenosis such as apoptosis and nuclear factor kappa B (NF-kB) are described.

Background: Early diagnosis of CAD could lead to proper treatment of patients and Coronary artery calcification is considered to be a valuable index in detecting Coronary artery disease using a noninvasive technique.Objective: To evaluate the relation between calcification and stenosis of Coronary artery.Methods: This was a cross sectional study in which 760 patients suffering from typical chest pain and as candidates for Coronary angiography were evaluated for calcification of Coronary artery by fluoroscopy. All patients signed a consent form while the whole procedures were fully explained in a comprehensible language. Following fluoroscopy and angiography, the results were reviewed by two different cardiologists, separately. The presence of any significant stenosis greater than 75% was considered as a sign for severe CAD. The data were analyzed by X2 followed by determination of sensitivity and specificity.Findings: Abnormal angiogram was found in 402 cases of our patients. In general, the positive and negative predictive values for calcification were 81.8% and 26%, respectively. The positive and negative predictive values were 87.1% and 63.4% in females and 79.7 and 47.3% in males respectively. The highest predictive value was seen in patients below 40 years old (100%). Coronary calcification in patients with abnormal Coronary angiogram was found to be 5.4 times higher than those with normal angiogram.Conclusion: According to our results, the noninvasive fluoroscopic technique for detection of Coronary artery calcification could be regarded as a screening tool to reveal significant Coronary involvement.

Background: Serum uric acid (SUA), a byproduct of purine metabolism, is linked to Coronary artery disease (CAD) development and progression. Elevated SUA levels are considered an independent risk factor for cardiovascular mortality and may indicate endothelial dysfunction. The aim of the study was to evaluate the association of the SUA level with the angiographic severity of CAD. Methods: This observational cross-sectional descriptive study included 150 patients who had undergone Coronary angiography in the Department of Cardiology at Seyed al-Shohadah Hospital in Urmia, Iran, from October 2022 to November 2022. Coronary atherosclerosis, with stenosis>50% in each Coronary artery, was categorized as single-vessel, two-vessel, three-vessel, or normal CAD according to angiography findings. The association of the SUA levels with CAD prevalence, severity, and clinical outcomes was assessed by statistical analyses. Results: Of 150 patients, the female gender was predominant (n=96, 64%), and the difference between uric acid levels and gender was statistically significant (P=0.049). Regarding age groups, 58% of the patients were under 65 years (42.5±68.6), and 42% were older than 65 years (41.8±69.1). A significant number of patients were hypertensive (60%). More than half of the studied patients were not affected by diabetes mellitus (68%). Similarly, no significant difference was found in patients with a history of hyperlipidemia (42%, P=0.701). According to the initial diagnosis, 36.7% of the patients had a condition without some degree of Coronary involvement. Therefore, 30%, 12%, and 21.3% had single-, two-, and three-vessel Coronary obstructions, respectively. When relating these conditions to the levels of obtained uric acid, there was no evidence of difference between the different groups (P=0.191). Conclusion: The present study suggests that hyperuricemia in patients with conventional cardiovascular risk factors may be associated with more severe CAD and an elevated overall cardiovascular risk.

Background: The association between Coronary angiographic findings and the level of anxiety symptoms among patients who undergo Coronary angiography is not known. The aim of this study was to investigate the association between the extent of Coronary stenosis and anxiety symptoms in patients who undergo Coronary angiography. Methods: In a cross-sectional study, 106 patients who underwent Coronary angiography and had varying degrees of Coronary artery disease were enrolled. Demographic characteristics (i. e., age and gender), socioeconomic status (i. e., educational attainment, income, and marital status), and traditional risk factors (i. e., hypertension, diabetes mellitus, hyperlipidemia, and smoking) were measured. The independent variable was the extent of Coronary stenosis shown by Coronary angiography, coded as single-vessel disease (n = 19), 2-vessel disease (n = 28), or 3-vessel disease (n = 59). The main outcome was symptoms of anxiety measured using the Hospital Anxiety Depression Scale (HADS). The Kruskal– Wallis test was used for bivariate analysis, and linear regression was applied for multivariable analysis. Results: Participants were mostly men (n = 78, 73%), at a mean age of 50. 14 ± 10. 60 years. We found an inverse association between the extent of Coronary stenosis and anxiety symptoms in our samples. Anxiety symptoms were lowest in the patients with 3-vessel disease and highest in those with single-vessel disease. The above association remained significant in a linear regression model, controlled for the demographic, socioeconomic, and traditional risk factors. Conclusion: An inverse association may exist between the extent of Coronary stenosis and the severity of anxiety symptoms in patients who undergo Coronary angiography. Patients who undergo angiography and have fewer angiographic findings require screening for anxiety symptoms.

Introduction: Aortic surgery has made much progress recently. Yet the combination of aortic surgery and Coronary artery bypass grafting has remained a major issue for the surgeons.Patient and Observation: Herein, we present a case of severe aortic insufficiency with aortic aneurysm concomitant with single Coronary artery disease on the right Coronary artery. The patient underwent Bentall procedure for the correction of severe AI and aortic aneurysm. Subsequently, due to the lack of proper site for proximal anastomosis of the saphenous vein graft on the ascending aorta, we decided to perform Coronary-Coronary artery bypass for the right Coronary artery lesion instead of conventional implantation of saphenous vein graft on the ascending aorta.Conclusions: Coronary-Coronary artery bypass could be performed safely for special conditions like porcelain aorta and when the ascending aorta is not suitable for the proximal saphenous vein graft.

Background/ Objective: Coronary vessel calcification is an obvious sign of atherosclerotic disease of Coronary arteries. Electron beam CT scan is currently the imaging modality of choice for assessing Coronary artery calcifications. However, its high cost makes it unavailable to a large number of medical centers. We carried out this study to compare the diagnostic yield of spiral CT scans as an alternative, to Coronary angiography.Patients and Methods: A hundred patients suspicious of having Coronary artery disease (CAD) underwent angiography as well as spiral CT scan of the heart. On CT scan, calcification of >90 Hounsfield on a surface area of >0.5 mm2, anatomically superimposed on Coronary arteries were highlighted as calcified areas using the volumetric feature of the scanner. The findings were compared to angiographic results.Results: Of 100 patients enrolled (62 males), 69 had Coronary artery obstruction (>50% stenosis on angiography). Angiography was normal in the rest. Spiral CT scan had a sensitivity of 94% and a specificity of 61% for the diagnosis of Coronary artery disease. The PPV and NPV were 84% and 79%, respectively. Among the Coronary arteries, LAD findings had the highest sensitivity (92%) and the lowest specificity (65%) in the diagnosis of CAD. With age, spiral CT scan had more sensitivity and less specificity for CAD.Conclusion: Detecting calcification by spiral CT scanning could be a useful non-invasive method for diagnosis and evaluation of Coronary artery stenosis.

Atherosclerosis is a chronic slow-developing condition affecting medium-size and large blood vessels. It is the principal underlying pathology of Coronary heart disease and stroke. In some countries, Coronary artery disease (CAD) is the cause of nearly half (48%) of the deaths and, loss of productivity life. Peripheral arterial disease (PAD) is defined as atherosclerosis in peripheral arteries instead of Coronary arteries. CAD and PAD have same risk factors and underlying pathophysiological processes. Therefore, patient with CAD should be considered for PAD. Ankle brachial index (ABI), duplex sonography, and some other non-invasive techniques are recommended for PAD diagnosis in patients with the history of CAD. Pharmacotherapy, endovascular interventions, and surgical management could be chosen according to the patient’s situation. Cardiologists and general practitioners should consider PAD in a patient with CAD or DM as a strong correlated disease.