Background: MYOCARDIAL INFARCTION is a common and lethal disease, especially in first hours. Rapid and correct decision is essential for priority of advance therapies and this study follows the accuracy of a scoring system for this triage. The aim was to assess the correlation of Thrombolysis in MYOCARDIAL INFARCTION Risk score and Angio score in patients with ST Elevation MYOCARDIAL INFARCTION.Methods: In this cross sectional study, 240 patients with ST elevation MYOCARDIAL INFARCTION from CCU of universal hospitals participated in the study. Thrombolysis in MYOCARDIAL INFARCTION risk score was calculated and during 2 month they underwent angiography and follow up.Findings: Mean age was 60.02 and 79 patients were female. Correlation between thrombolysis in MYOCARDIAL INFARCTION risk and angio score was significant (P<0.001). Correlation between ejection fraction and thrombolysis in MYOCARDIAL INFARCTION risk score (P<0.001) and angio score with age (P<0.001) was significant too. There was no significant correlation between Angio score and recurrent angina (P=0.143), rehospitalization (P=0.524) and death (P=0.179). Pearson's correlation showed significant relation between thrombolysis in MYOCARDIAL INFARCTION risk score and angio score (P<0.001, r=0.556).Conclusion: This correlation shows that thrombolysis in MYOCARDIAL INFARCTION risk score probably can be used for evaluating angiographic extent of coronary artery disease. Simple clinical use of this score at bedside if confirms with a prospective cohort study, makes this score a method to stratify patients in high and low risk groups and accordingly diagnostic– therapeutic strategies.

Background: Depressive symptoms are common among post MYOCARDIAL INFARCTION (MI) patients and may cause negative impacts on cardiac prognosis.35 to 45% of MI patients report depression. While depression is as an independent risk factor for MI, post MI depression has been shown to be as a risk factor for mortality, morbidity and decreased quality of life in post MI patients.The link between depression and MI is bidirectional. Behavioral and biological mechanisms were proposed as the plausible mechanisms involved in this link. The combination of these mechanisms are likely to involve in increasing the risk of mortality.Epidemiological studies have shown the link between depression and increased risk for development of cardiovascular disease, MI and cardiac mortality. The adverse impact of depression on prognosis of heart disease is preventable with the right treatment. A number of therapeutic approaches have been advocated for post-MI depression, including cardiac rehabilitation, social support, cognitive behavior therapy, and antidepressants. Because of adverse effects, it is recommended to avoid prescription of tricyclics for treating post MI depression. If SSRIs are prescribed shortly after MI the important side effects caused by them will be low.

Background: Human enteroviruses (EVs) may have a role as a possible risk factor in the pathogenesis of MI. The aim of this study was to evaluate the presence of enterovirus genomic RNA in peripheral blood samples of patients with acute MYOCARDIAL INFARCTION (MI).Methods: We investigated the presence of enterovirus genomic RNA in the peripheral blood of 115 patients with acute MI hospitalized in the Coronary Care Unit of Imam Reza and Ghaem University Hospitals (Mashhad, Iran) by RT-PCR using the virus specific primers.Results: The subjects' mean (±SD) age was 63.5 (±9.4) years (range: 38-82) and 38.3 % of the subjects were female. Of 115 patient specimens, 3 (2.6%) were positive in RT-PCR.Conclusion: The prevalence of enterovirus in MI patients is considerable. More investigations are needed to determine the causal role of enteroviruses in MI.

Background: The chronobiology of the Acute MYOCARDIAL INFARCTION (AMI) is an interesting matter for recognition of the biological mechanism that might trigger AMI. The present study was aimed to investigate the circadian, seasonal and circannual variation of the AMI occurrence with solar, lunar, and Christian months.Patients and Method: A retrospective study of 1147 cases with diagnosis of AMI was conducted. All the cases were admitted to the coronary care unit of Shahid Beheshti and Yahyanejad Hospital in Babol, north of Iran, between 1990 to 2000. The date was extracted by the day and months of diagnosis based on the solar, lunar and Christian calender from hospital charts. The Chi-square test was used to test the uniformity of the observed frequencies of AMI onset in the different months based on solar, lunar Christian and the days of the week.Results: The result showed that there was a significant trend toward higher rate of MI at the beginning of the week, on Saturday (18.1%) and the least (12.3%) on Fridays. Although, the observed frequency of AMI has tendency to be higher in Ordibehesht of solar month and Shaban in lunar month than other months, the monthly-variation was not statistically significant (P>0.05). However, there was a significant difference in MI occurrence in Christian months with the highest peak in November (P<0.05). Also, we did not find a significant seasonal variation of AMI where 26.2%, 32.1%, 26.8% and 23.9% of MI occurred in spring, summer, fall, and winter respectively (P>0.05).Conclusion: Our result indicated a significant day of week variation in AMI occurrence with higher peak on Saturdays and full moon phase of lunar months.

Dear Editor: Thrombotic thrombocytopenic purpura (TTP) is a microangiopathic hemolytic disorder that is induced by a marked reduction in the level of von Willebrand factor-cleaving protease, a disintegrin and metalloproteinase with a thrombospondin type 1 motif, member 13 (ADAMTS-13).