Abstract Background Shock index (SI) and age shock index (ASI) are less frequently used for assessment of major adverse cardiovascular events (MACE) among patients with ST-segment elevation myocardial infarction (STEMI), and their reported cut-off points are controversial. Objectives We aimed to define proper cut-off value of these indices for MACE prediction among Iranian patients with STEMI. Methods This study was in the context of the ST-Elevation Myocardial Infarction Cohort in Isfahan (SEMI-CI) study. SI and ASI were calculated by division of heart rate (HR) over systolic blood pressure (SBP) and age multiplied by SI, respectively, in 818 subjects with STEMI. Receiver operating characteristic (ROC) curve analysis was used to determine optimal SI and ASI cut-off values. Chi-square test, independent t test, and analysis of variance were employed for nominal and numerical variables, as appropriate, with consideration of p values < 0.05. MACE was defined as a composite of non-fatal reinfarction, heart failure (HF), recurrent percutaneous intervention (PCI), rehospitalization for cardiovascular diseases, and all-cause mortality. Results Mean age was 60.70 ± 12.79 years (males: 81.7%). Area under curve (AUC) values from ROC curve analysis for SI and ASI were 0.613 (95% confidence interval [CI]: 0.569 to 0.657, p < 0.001) and 0.672 (95% CI: 0.629 to 0.715, p < 0.001), respectively. Optimal SI and ASI cut-offs were 0.61 (sensitivity: 61%, specificity: 56%) and 39.5 (sensitivity: 65%, specificity: 66%), respectively. Individuals with SI ≥ 0.61 or within the highest quartile (SI ≥ 0.75) had significantly higher frequency of one-year MACE compared to the reference group (34.7% versus 22.2%, p < 0.001 and 42.4% versus 20.6%, p < 0.05, respectively). Similar relations were observed in terms of ASI values (ASI ≥ 39.5 versus ASI < 39.5: 43.6% versus 17.3%, p < 0.001, ASI Q4 ≥ 47.5 versus ASI Q1 ≤ 28.8: 49% versus 16.6%, p < 0.05). Conclusions SI and ASI cut-off values of 0.61 and 39.5 could reliably predict MACE occurrence among Iranian patients with STEMI. (MACE STsegment ST segment STEMI, STEMI , (STEMI) cutoff cut off controversial STElevation Elevation SEMICI SEMI CI (SEMI-CI HR (HR SBP (SBP respectively 81 (ROC Chisquare Chi square test variables appropriate 005 0 05 0.05 nonfatal non fatal reinfarction HF, HF (HF) PCI, PCI (PCI) diseases allcause all cause mortality 6070 60 70 60.7 1279 12 79 12.7 males (males 81.7%. 817 81.7% . 7 81.7%) AUC (AUC 0613 613 95% 95 (95 [CI] 0569 569 0.56 0657 657 0.657 0001 001 0672 672 0.67 0629 629 0.62 0715 715 0.715 cutoffs offs 061 61 0.6 sensitivity (sensitivity 61% specificity 56% 56 395 39 5 39. 65 65% 66%, 66 66% 66%) 0.75 075 75 oneyear one year 34.7% 347 34 (34.7 222 22 2 22.2% 0.00 424 42 4 42.4 206 20 6 20.6% respectively) 436 43 43.6 173 17 3 17.3% Q 475 47 47. 28.8 288 28 8 49 166 16 16.6% 0.05) (STEMI 00 0.0 (HF (PCI 607 60. 127 1 12. 81.7 9 (9 [CI 056 0.5 065 0.65 000 067 67 062 62 071 71 0.71 06 0. 0.7 07 34.7 (34. 22.2 42. 20.6 43. 17.3 28. 16.6 81. ( 34. (34 22. 20. 17. 16. (3

ABSTRACT Objective We examined the accuracy of novel anthropometric indices in predicting the progression of prediabetes to diabetes. Subjects and methods This study was performed on the pre-diabetic sub-population from Isfahan Cohort Study (ICS). Participants were followed up from 2001 to 2013. During every 5-year follow-up survey, patients’ data regarding the incidence and time of incidence of diabetes were recorded. We evaluated the association between the risk of developing diabetes and novel anthropometric indices including: visceral adiposity index (VAI), lipid accumulation products (LAP), deep abdominal adipose tissue (DAAT), abdominal volume index (AVI), A body shape index (ABSI), body roundness index (BRI) and weight-adjusted waist index (WWI). We categorized the indices into two groups according to the median value of each index in the population. We used Cox regression analysis to obtain hazard ratios (HR) using the first group as the reference category and used receiver operating characteristics (ROC) curve analysis for comparing the predictive performance of the indices. Results From 215 included subjects, 79 developed diabetes during the 13-year follow-up. AVI, LAP, BRI, and VAI indicated statistically significant HR in crude and adjusted regression models. LAP had the greatest association with the development of diabetes HR = 2.18 (1.36-3.50) in multivariable analysis. ROC curve analysis indicated that LAP has the greatest predictive performance among indices (area under the curve = 0.627). Conclusion Regardless of baseline confounding variables, prediabetic patients with a higher LAP index may be at significantly higher risk for developing diabetes. pre diabetic subpopulation sub population ICS. ICS . (ICS) 200 2013 5year year 5 followup follow survey recorded including VAI, , (VAI) (LAP) DAAT, DAAT (DAAT) AVI (AVI) ABSI, ABSI (ABSI) BRI (BRI weightadjusted weight WWI. WWI (WWI) (HR (ROC 21 subjects 7 13year 13 followup. up. models 218 2 18 2.1 1.363.50 136350 1.36 3.50 1 36 3 50 (1.36-3.50 area 0.627. 0627 0.627 0 627 0.627) variables (ICS 20 201 (VAI (LAP (DAAT (AVI (ABSI (WWI 2. 363 1.363.5 13635 136 1.3 350 3.5 (1.36-3.5 062 0.62 62 1.363. 1363 1. 35 3. (1.36-3. 06 0.6 6 1.363 (1.36-3 0. (1.36- (1.36 (1.3 (1. (1 (

OBJECTIVE: To investigate the relation between major depressive disorder and metabolic risk factors of coronary heart disease. INTRODUCTION: Little evidence is available indicating a relationship between major depressive disorder and metabolic risk factors of coronary heart disease such as lipoprotein and apolipoprotein. METHODS: This case-control study included 153 patients with major depressive disorder who fulfilled the criteria of the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV), and 147 healthy individuals. All participants completed a demographic questionnaire and Hamilton rating scale for depression. Anthropometric characteristics were recorded. Blood samples were taken and total cholesterol, high-and low-density lipoproteins and apolipoproteins A and B were measured. To analyze the data, t-test, χ2 test, Pearson correlation test and linear regression were applied. RESULTS: Depression was a negative predictor of apolipoprotein A (β = -0.328, p<0.01) and positive predictor of apolipoprotein B (β = 0.290, p<0.05). Apolipoprotein A was inversely predicted by total cholesterol (β = -0.269, p<0.05) and positively predicted by high-density lipoprotein (β = 0.401, p<0.01). Also, low-density lipoprotein was a predictor of apolipoprotein B (β = 0.340, p<0.01). The severity of depression was correlated with the increment in serum apolipoprotein B levels and the decrement in serum apolipoprotein A level. CONCLUSION: In view of the relationship between apolipoproteins A and B and depression, it would seem that screening of these metabolic risk factors besides psychological interventions is necessary in depressed patients

OBJETIVO: Avaliar a prevalência cumulativa dos fatores de risco para a doença cardiovascular aterosclerótica numa amostra de adolescentes iranianos. MÉTODOS: Foi realizado um estudo transversal com 1000 meninas e 1000 meninos, com idade entre 11 e 18 anos, selecionados através de uma amostragem aleatória multietapas à base de conglomerados das áreas urbana e rural de três cidades iranianas. RESULTADOS: As taxas de prevalência de inatividade física, dislipidemia, tabagismo, pressão arterial alta e obesidade (índice de massa corporal >P95) foram 66,6, 23,7, 8,7, 5,7 e 2,2%, respectivamente. Dentre os indivíduos estudados, 79,1% apresentaram pelo menos um e 24,6% tiveram dois fatores de risco para doença cardiovascular. A prevalência de inatividade física foi significativamente menor entre os meninos que entre as meninas [53,9 contra 79,3%, respectivamente, OR IC95%, 0,44 (0,39-0,51)]. A prevalência de tabagismo foi maior nos meninos que nas meninas [13,1 contra 4,2%, respectivamente, OR IC95%, 3,4 (2,4-4,9)]. CONCLUSÃO: Considerando a alta prevalência de fatores de risco para doença cardiovascular em adolescentes, deve-se garantir intervenções que sejam adequadas à idade e sensíveis a aspectos culturais para que medidas preventivas possam ser tomadas em tempo hábil.

OBJECTIVE: To evaluate the cumulative prevalence of atherosclerotic cardiovascular disease risk factors in a representative sample of Iranian adolescents. METHODS: The subjects of this cross-sectional study were 1,000 girls and 1,000 boys, ages 11-18 years, selected by multi stage-random cluster sampling from urban and rural areas of three cities in Iran. RESULTS: The prevalence of physical inactivity, dyslipidemia, smoking, high blood pressure and obesity (body mass index >95th percentile) were 66.6, 23.7, 8.7, 5.7 and 2.2%, respectively. Of subjects studied, 79.1% had at least one and 24.6% had two cardiovascular disease risk factors. The prevalence of physical inactivity was significantly lower in boys than girls [53.9 vs. 79.3%, respectively, OR 95%CI, 0.44 (0.39-0.51)]. The prevalence of smoking was higher in boys than girls [13.1 vs. 4.2%, respectively, OR 95%CI, 3.4 (2.4-4.9)]. CONCLUSION: Considering the high prevalence of cardiovascular disease risk factors in adolescents, age-appropriate and culturally sensitive interventions for lifestyle change are warranted, so that preventive measures can be taken in a timely manner.