Association of Stress hyperglycemia and adverse cardiac events in acute myocardial infarction – A cohort study

Background: Stress hyperglycemia is a common phenomenon in patients presenting with acute myocardial infarction (MI). We aim to evaluate the association of stress hyperglycemia at the time of hospital presentation and adverse cardiac events in myocardial infarction during the course of hospital stay. Methods: Subjects with age ≥18 years with acute MI were recruited on hospital admission and categorized based on admission blood glucose (<180 and ≥180 mg/dl, 50 patients in each group). Both groups were compared for clinical outcomes, adverse cardiac events and mortality. We also compared the adverse cardiac outcomes based on HbA1c levels (<6% and ≥6%). Results: Patients with high blood glucose on admission (stress hyperglycemia) had significant increased incidences of severe heart failure (Killip class 3 and 4), arrythmias, cardiogenic shock and mortality (p value = 0.001, 0.004, 0.044, and 0.008 respectively). There was no significant association between adverse cardiac events and HbA1c levels (heart failure 18.8% vs. 25%, p value = 0.609 and mortality 16.7% vs. 17.3%, p value = 0.856). Conclusions: Stress hyperglycemia is significantly associated with adverse clinical outcomes in patients with MI irrespective of previous diabetic history or glycemic control. Clinicians should be vigilant for admission blood glucose while treating MI patients.

Biological and clinical implications of TNF-α promoter and CYP1B1 gene variations in Coronary Artery Disease susceptibility

Background: Background: Cardiovascular diseases (CVD) are important causes of death worldwide. Atherosclerosis is a chronic inflammatory disorder. It is the major cause of CVD and is manifested by ischemic heart disease or coronary artery disease (CAD). TNF-α is a pro-inflammatory cytokine that regulates immune response and promotes the development of atherosclerosis. Cytochrome p450 1B1 (CYP1B1) is an enzyme involved in the metabolism of endogenous and exogenous substrates. Objectives: This study aimed at examining the association of TNF-α rs1800629 G >A and CYP1B1 rs1056827 G>T gene polymorphisms with CAD susceptibility in an Indian cohort. Methods: AS-PCR and direct DNA sequencing were used to examine the association of TNF-α rs1800629 G >A and CYP1B1 rs1056827 G>T gene polymorphism with CAD in an Indian cohort. A total of 100 clinically confirmed cases of CAD and 110 matched apparently healthy controls were genotyped. Results: Allelic and genotypic frequencies did not deviate from Hardy-Weinberg equilibrium in the controls (p>0.05) for TNF-α G-308A and CYP1B1 rs1056827G>A. There was no significant difference between the TNF-α rs1800629 A>G genotype distribution between cases and controls (P-value >0.05). A significant difference was observed between the CYP1B1 rs1056827 G>T genotype distribution between CAD cases and controls (P<0.0003). Our result indicated that in the codominant model, the GA genotype of the CYP1B1 rs1056827 G>T was associated with CAD with OR= 2.21(1.17 to 4.15), RR=1.38(1.07 to 1.78), and P<0.013. In the dominant model, the (GA+AA) genotype was associated with CAD with OR=2.79(1.54 to 5.05) and P<0.007. The CYP1B1 rs1056827 ‘A’ allele was associated with CAD with OR = 2.30 (1.55 to 3.42) and P< 0.0001. Our results indicated that TNF-α 1800629 gene polymorphism was strongly associated with hypercholesteremia (P<0.0009), HDL (P<0.0001), TGL (P<0.039), hypertension (P<0.0001), and smoking (P<0.0001) in patients with Coronary Artery Disease. Similar correlations of CYP1B1 rs1056827 genotypes were reported with cholesterol (P<0.020), HDL (P<0.002), LDL (P<0.006), hypertension (P<0.03), and smoking (P<0.005). Conclusion: It was reported that the GA genotype of the CYP1B1 rs1056827 G>T was strongly associated with susceptibility to Coronary Artery Disease with OR= 2.21(1.17 to 4.15)) and P<0.013, and similarly, its A allele was associated with predisposition to CAD with OR = 2.30(1.55 to 3.42) and P< 0.0001. Our results indicated that TNF-α 1800629 gene polymorphism is not associated with predisposition to Coronary Artery Disease. Nevertheless, these results should be taken with caution and further validated with larger-scale studies before being introduced in the clinical setting.

Complications in Patients with Cardiac Penetrating Trauma

Background: Cardiac penetrating trauma is a medical emergency that mostly affects young people. Based on the type of injury and associated complications, it can present as a surgical challenge and can lead to mortality. Objective: The aim of this study is to evaluate the complications of penetrating heart trauma among patients referred to Shahid Madani Hospital. Methods: In this retrospective descriptive study, the data of penetrating cardiac trauma patients referred to Shahid Madani hospital, Karaj, Tehran, from 2016-2019, were investigated. Information, including age, sex, cause of trauma, traumatized area and complications, was extracted and recorded in a data collection form. The data were evaluated statistically using SPSS v18. Results: A total of 44 patients were included in the study, where the mean age of the patients was 25 years. 73.3% of these patients were men and 26.7% were women. Knife stab wounds were the most prevalent cause of the trauma, present in 93.3% of patients. 73.3% of the patients had cardiac tamponade and 20% had a pneumothorax. The right ventricle was the most common site of the injury in 46.7% of the patients. A mortality rate of 3.4% was reported in this study. Conclusion: The results of this study showed that the highest penetrating heart rate trauma occurred among young people, and the most common cause of the trauma was a knife stab. The most common area of the injury was the right ventricular, and cardiac tamponade was the most common complication.

Erythrocyte Indices and Long-term Blood Pressure Variability in Military Males

Backgrounds: Severe microcytic anemia has been associated with BP changes. Aims and Objectives: Whether the erythrocyte indices are associated with long-term BPV is unknown. This study aimed to investigate the association of hemoglobin levels and erythrocyte size with long-term blood pressure variability (BPV) in young males. Methods: This study included 1,112 healthy military males, averaging 32 years of age, in Taiwan. All participants took a measurement of systolic and diastolic BP (SBP and DBP) every two-year from 2012 to 2018 (2012-14, 2014-15, 2015-16, 2016-18). Lev-els of hemoglobin and mean corpuscular volume (MCV) of erythrocytes were obtained at the first visit. Long-term BPV was assessed by the standard deviation (SD) and aver-age real variability (ARV). Multivariate linear regression analysis with adjustment for the baseline BP levels and other covariates was used to elucidate the association. Results: Hemoglobin levels were borderline positively correlated with SD DBP (β and standard errors = 0.016 (0.009), P =0.06). In those with hemoglobin levels of 10.0-13.9 g/dL, hemoglobin was negatively correlated with SDSBP (β= -0.039 (0.018), P =0.03). In contrast, MCV levels were borderline positively correlated with SDSBP (β =0.085 (0.052), P =0.09). In those with MCV levels <80 fL, MCV was positively correlated with SDSBP and ARVSBP (β= 0.445 (0.210) and 0.286 (0.149), p = 0.03 and 0.05, re-spectively). Conclusion: There were inconsistent patterns for the associations of erythrocyte indices with long-term BPV. We found a U-shaped relationship of hemoglobin levels with sys-tolic BPV, whereas there was a positive linear relationship of hemoglobin and MCV levels with diastolic BPV, respectively.

Vitamin C inhibits Angiotensin-Converting Enzyme-2 in Isolated Rat Aortic Ring

Aims: The study aimed to assess the inhibitory effect of Vitamin C on angiotensin-converting enzyme 2. Background: Coronavirus disease 2019 (COVID-19) is a disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which uses angiotensin-converting enzyme 2 (ACE-II) as the first route to infect human cells. Accordingly, agents with potential inhibition of ACE-II receptors might be effective in the prevention and management of COVID-19. Objective: The goal of this work was to assess the possible inhibitory effect of ACE-II on ascorbic acid using an ex vivo approach based on the inhibition of diminazene-induced vasorelaxation. Material and Methods: In the present study, diminazene was used as a known specific inhibitor of ACE-II. Then, the vasorelaxant effect of ascorbic acid on diminazene-induced relaxation was examined using isolated aortic rings. All experiments of this study were evaluated on isolated aortic rings precontracted by epinephrine. Results: The results confirmed that diminazene-induced vasorelaxation in a dose-dependent manner. More interestingly, ascorbic acid inhibited diminazene-induced vasorelaxation in a dose-dependent manner. Conclusion: This investigation provides valuable experimental proof of the efficacy of ascorbic acid (Vitamin C) on inhibiting ex vivo vascular angiotensin-converting enzyme II, which is known among the pharmacological targets of anti-Covid-19 drugs.

Antihyperglycemic Activity of Aqueous Extract of Euphorbia guyoniana in Streptozotocin-Induced Diabetic Rats

Aims: This work assessed the antihyperglycemic effect of Euphorbia guyoniana. Background: Euphorbia guyoniana (Boss. and Reut.) is widely used in traditional medicine. Objective: This study was designed to confirm this traditional use by assessing its antihyperglycemic capacity in vivo. Methods: The effect of the aqueous extract of Euphorbia guyoniana (Boss. and Reut.) (60 mg/kg) on glycemia in both normal and diabetic rats was evaluated. The glycogen content in the liver and skeletal muscles (extensor digitorum longus and soleus) was measured. Furthermore, liver histopathological analysis was performed. Results: The findings showed that Euphorbia guyoniana (Boss. and Reut.) exhibited a significant decrease in glycaemia in diabetic rats (from 20±2 mmol/l to 5.5 mmol/l after 6 hours of oral administration; p<0.0001 and from 20±2 mmol/l to 4.5 mmol/l after 7 days of once-daily repeated oral administration of the aqueous Euphorbia guyoniana extract; p<0.0001). In addition, the extract increased the glycogen content in the liver (41±4 mg/g versus 70±5 mg/g in normal and diabetic rats respectively) and extensor digitorum longus (39±4 mg/g versus 60±1 mg/g in normal and diabetic rats, respectively), and partially restored corporal weight in diabetic rats. Furthermore, this aqueous extract has been shown to suppress hyperglycemia induced by glucose load in treated diabetic rats. Additionally, hepatic histology in diabetic rats has been improved. This plant revealed the presence of several phytochemical constituents and possessed antioxidant activity. Conclusion: The current study evidenced that Euphorbia guyoniana (Boss. and Reut.) has a beneficial effect on improving hyperglycemia and glycogen depletion in the diabetic state.

Aqueous Extract of Brassica rapa Exerts Antihyperglycemic Activity in Streptozotocin-induced Diabetic Rats

Aims: The aim of the study was to assess the antihyperglycemic effect of Brassica rapa. Background: Brassica rapa (turnip) is used as an antidiabetic plant. Objective: This work aimed to evaluate the effect of the aqueous extract of Brassica rapa seeds (AEBRS) on glycemia in vivo. Methods: The effect of AEBRS (60 mg/kg) on glycemia and lipid profiles was evaluated. Besides, preliminary phytochemical analysis and the in vitro antioxidant effect were evaluated. Results: AEBRS caused a significant reduction in blood glucose levels in diabetic rats (p<0.0001). In contrast, no significant effect was observed on lipid profiles, whereas antioxidant potential of this extract has been shown. Phytochemical analysis showed the presence of many important phytochemical families. Conclusion: The present study shows that AEBRS has a potent antihyperglycemic ability in diabetic rats.