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Adverse consequences of the coronavirus disease 2019 (COVID-19) vaccination which have been reported in scientific papers are varied. One possible but rare consequence is myocarditis, which may have a diversity of clinical manifestations. We report a case of a 70-year-old man who presented to the hospital for some syncope, 3 days after his first COVID-19 AstraZeneca Vaccination. Initial electrocardiogram (ECG) showed a long QT interval (QTc = 600 milliseconds). Laboratory tests revealed elevated troponin and lack of evidence of viral infection. Further investigations revealed the vaccine-induced myocarditis and arrhythmias linked to it. Within one week of magnesium treatment, the QT interval was completely corrected, and the patient discharged with no typical syncope attacks. This case like the previous reported one confirms that myocarditis is a complication of COVID-19 vaccine, but implies its clinical manifestations may be varied and even may happen after the single dose of vaccination.

The Mediterranean diet (Med-Diet) is widely recognized for its protective effect in cardiovascular diseases (CVDs), less is known about the associations between health and adherence to the Prime Diet Quality Score (PDQS). This study investigates the relationship between adherence to the Med-Diet and PDQS with the risk of premature coronary artery disease (PCAD) in an Iranian population. A total of 3287 participants were included in this multicenter case-control study across various ethnic groups in Iran, categorized into PCAD cases ( n  = 2106) and controls ( n  = 1181). PCAD cases were defined as individuals with at least one coronary artery exhibiting ≥ 75% stenosis or a left main coronary artery with ≥ 50% stenosis, while controls had normal coronary arteries. Dietary intake was assessed using a semi-quantitative food frequency questionnaire (FFQ), previously validated for accuracy in the Iranian population Adherence to the Med-Diet was assessed using a standardized scoring system, awarding one point for higher consumption of beneficial food groups (such as vegetables, whole grains, legumes, fish, nuts, and a high monounsaturated-to-saturated fat ratio) and one point for lower consumption of less favorable foods (such as red and processed meats). The total score ranged from 0 to 9, with higher scores indicating greater adherence to the Med-Diet. The PDQS, a dietary quality index, evaluated adherence across 14 healthy and 7 unhealthy food groups, with higher scores reflecting better diet quality. Logistic regression models were employed to examine the association between dietary scores and PCAD risk. Participants with higher adherence to both the Med-Diet and PDQS had significantly lower odds of PCAD (OR = 0.30, 95% CI: 0.22, 0.40; P for trend < 0.001 for PDQS), with a stronger association observed for the Med-Diet (OR = 0.08, 95% CI: 0.06, 0.10; P for trend < 0.001). Additionally, higher adherence to the Med-Diet (OR = 0.04, 95% CI 0.03, 0.05) and PDQS (OR = 0.21, 95% CI: 0.17, 0.26) was inversely associated with PCAD severity in the fully adjusted model. This study showed a protective association of the Med-Diet and PDQS with reduced risk of PCAD in the Iranian population.

Background Premature coronary artery disease (PCAD) is one of the major health concerns leading to considerable death and disabilities. This study aimed to evaluate the relationship of dietary patterns with risk of PCAD. Methods Iran premature coronary diseases (IPAD) is a case-control study consists of 3159 participants. Obstructive CAD in ≥ 75% of at least one coronary artery or ≥ 50% in the left main artery based on coronary angiography in women under 70 and men under 60 years old was considered PCAD. The habitual dietary intake of participants was collected using a semi-quantitative validated food frequency questionnaire (SFFQ). Principal Component Analysis (PCA) was used to extract dietary patterns. Results Three main dietary patterns including healthy, Western and high-fat, high-sugar were identified. Patients categorized in the last tertile of the healthy dietary pattern had a decreased risk of PCAD (OR = 0.77, 95% CI: 0.64–0.93), while those in the top tertile of Western (OR = 2.38, 95 CI:1.97–2.86) and High-fat simple carbohydrate (HFSC) (OR = 3.10, 95% CI:2.57–3.75) diets had increased risk of PCAD. Conclusions A healthy dietary pattern was significantly related to a decreased risk of PCAD presence, whereas Western and HFSC diets were connected to a higher risk of PCAD.

Background The association of sugar sweetened beverages (SSBs) and coronary artery disease (CAD) has not been well-established in Asians, where SSBs are the leading ultra-processed food product. Objective We aim to examine the association between SSBs and premature CAD (PCAD) in Iranian adults. Design Case-control. Participants A multi-centric study of Iranians including 2006 PCAD and 1131 healthy individuals as control group. Main outcome measures Dietary intakes were assessed using a validated food frequency questionnaire (FFQ). SSBs consist of artificial juice and sugar -sweetened drinks. The PCAD was determined based on the results of angiography and the occlusion percent of vessels. Statistical analysis The odds of PCAD across the quartiles of SSBs were assessed by binary logistic regression. Results The mean (SD) age of participants and SSB consumption was 51.5 years and 46.9 g/d, respectively. In the fully-adjusted model, compared with participants in the first quartile, those in the fourth quartile had higher risk of PCAD (OR = 1.50, 95% CI: 1.12, 2.00; P trend = 0.044). Consistently, SSB consumption was directly associated with the severity of PCAD. The higher SSB consumption, the greater risk for the severe PCAD (OR Q4 vs. Q1 = 1.34, 95% CI: 1.06, 1.68; P  < 0.001). Conclusion This study demonstrated that higher consumption of SSB might be associated with higher risk of PCAD. However, more prospective cohort studies are necessary to confirm this association. Research Snapshot Research question Does Sugar Sweetened Beverages (SSBs) Consumption Increases the Risk of Premature Coronary Artery Disease (PCAD)? Key findings Logistic regression of data from Iran Premature Coronary Artery Disease Study from 3137 individuals from 8 ethnicities of Iran demonstrated that there is a positive association between SSBs and PCAD. However, prospective cohort studies are suggested for further illustration of causal relationships. Research brief Sugar Sweetened Beverages (SSBs) Consumption Was Associated With Increased Risk of Premature Coronary Artery Disease (PCAD): Iran Premature Coronary Artery Disease Study (IPAD).

Background Despite some evidence on individual eating habits in relation to cardiovascular disease, little is known about the combination of common eating habits in relation to premature coronary artery disease (PCAD). Objective We investigated the association between a combined eating habits score (EHS) and PCAD risk. Methods In this case-control study, 2022 patients with PCAD and 1063 healthy control were recruited. Women aged between 18 and 70 and men aged between 18 and 60 years were eligible. PCAD was defined as 75% or more stenosis in a single coronary artery disease or at least 50% in the left main coronary artery. Eating habits were assessed through interview and higher scores represent healthier behaviors. Results Participants in the fourth quartile of EHS had 22% lower risk of PCAD than those in the first quartile (95% CI: 0.61, 0.99; P  = 0.024). Not adding salt at the table (OR = 0.80, 95% CI: 0.66, 0.97; P  = 0.023), low-salt meals (OR = 0.75, 95% CI: 0.57, 0.99; P  = 0.022), and slow eating (OR = 0.42, 95% CI: 0.24, 0.71; P  < 0.001) were associated with lower risk of PCAD while more water drinking (OR = 1.56, 95% CI: 1.07, 2.27; P  = 0.013), and increased meal frequency (OR = 1.85, 95% CI: 1.09, 3.13; P  = 0.025) were linked with increased risk of PCAD. Conclusion Healthy eating behaviors score, particularly low salt intake and slow eating were associated with lower risk of PCAD. However, higher meal frequency and more water drinking were associated with increased risk of PCAD. Well-designed prospective cohort studies are required.

Background Coronary artery disease (CAD) is recognized as the leading cause of death worldwide. This study analyses CAD risk factors using an artificial neural network (ANN) to predict CAD. Methods The research data were obtained from a multi-center study, namely the Iran-premature coronary artery disease (I-PAD). The current study used the medical records of 415 patients with CAD hospitalized in Razi Hospital, Birjand, Iran, between May 2016 and June 2019. A total of 43 variables that affect CAD were selected, and the relevant data was extracted. Once the data were cleaned and normalized, they were imported into SPSS (V26) for analysis. The present study used the ANN technique. Results The study revealed that 48% of the study population had a history of CAD, including 9.4% with premature CAD and 38.8% with CAD. The variables of age, sex, occupation, smoking, opium use, pesticide exposure, anxiety, sexual activity, and high fasting blood sugar were found to be significantly different among the three groups of CAD, premature CAD, and non-CAD individuals. The neural network achieved success with five hidden fitted layers and an accuracy of 81% in non-CAD diagnosis, 79% in premature diagnosis, and 78% in CAD diagnosis. Anxiety, acceptance, eduction and gender were the four most important factors in the ANN model. Conclusions The current study shows that anxiety is a high-prevalence risk factor for CAD in the hospitalized population. There is a need to implement measures to increase awareness about the psychological factors that can be managed in individuals at high risk for future CAD.

The cardioprotective effects of nuts are well established. However, the positive impacts of nuts in preventing CVD at a younger age, a condition known as premature coronary artery disease (PCAD), is still debated. Therefore, we aim to determine the association between nuts and PCAD occurrence and its severity in different Iranian ethnicities. This case-control study was conducted within the framework of the Iran-premature coronary artery disease (I-PAD) study, an ongoing multi-centric study on Iranian patients of different ethnicities. This multi-centric case-control study was conducted in among 3253 persons under the age of 70 years in women and 60 years in men from different ethnicities in Iran. Information on nut consumption was collected using a validated FFQ. Subjects were selected from among the candidates for angiography. Cases were those whose coronary angiography showed stenosis of more than 75 % in at least one vessel or more than 50 % of the left main artery, while the control group participants had normal angiography results. In the crude model, compared to the first quartile, the highest quartile of nut consumption was significantly associated with a lower risk of PCAD (OR = 0·26, 95 % CI (0·21, 0·32); = 0·001). In the top quartile of nut intake, a substantial decrease in PCAD was observed after controlling for putative confounders (OR = 0·32; 95 % CI (0·24, 0·43); = 0·001). Additionally, a 75 % decrease in the risk of severe PCAD was observed in the participants in the highest quartile of nut intake. A significant inverse association was observed between nut intake and the risk and severity of PCAD in the Iranian population. Large-scale clinical trials are required to confirm these findings.

Embolic events are rare presentation of myxoma, which is one of the most prevalent benign cardiac tumors. Here we report the case of a 53-year-old man with presentation of acute anterior infarction and occlusion of the left anterior descending artery in association with left atrial myxoma. Intracoronary aspiration thrombectomy along with frequent balloon inflation was failed to recover distal coronary blood flow.

Fars is considered to be the largest ethnic group in Iran, estimated to comprise between 50% and 70% of the population, followed by Azari, as the second largest ethnic group (15% to 24%), Kurd from 7% to 10%, Gilak from 3% to 6%, Arab from 2% to 4%, Lor from 3% to 5%, and Turkman, Bakhtiari, Qashghaei, and Balouch each with 2%.13 Iran-premature coronary artery disease (I-PAD) study aims to investigate the frequency of premature CAD and its risk factors according to different ethnicities in Iran, so the results can be a gateway to some preventive and treatment strategies. Previous history of documented coronary artery disease such as coronary artery bypass surgery, balloon angioplasty, or percutaneous coronary intervention (PCI) was considered as exclusion criterion. Interviewers in hospitals completed our questionnaires that included questions on demographics like age, sex, ethnicity, religion, education, income, marriage status, and lifestyle behaviors such as any type of smoking, alcohol or drug use, and nutrition via Food Frequency Questionnaire (FFQ), physical activity by International Physical activity Questionnaire (IPAQ), anxiety level through Hospital Anxiety and Depression Scale (HADS), sleep disorders using the Pittsburgh Sleep Quality Index (PSQI), personal and family history of illnesses and used medications. Blood samples were taken to measure triglyceride (TG), total cholesterol, high-density lipoprotein cholesterol (HDL-c), low-density lipoprotein cholesterol (LDLc), and fasting blood sugar (FBS).

Background: Hypertension (HTN) is a major cause of noncommunicable diseases. In this study, we report the prevalence rate of HTN in Birjand population. Methods: This cross-sectional study was conducted on 1286 individuals in Birjand in 2014. Individuals with systolic blood pressure (SBP) ≥140 mmHg and/or diastolic blood pressure (DBP) ≥90 mmHg were considered as hypertensive. Data were analyzed using Chi-square test, independent t-test, and one-way ANOVA.P < 0.05 was considered as statistically significant. Results: Among the 1286 participants, 659 were women (51.2%). Prevalence of HTN was 20.1% (10.3% systolic HTN and 6.9% diastolic HTN). Prevalence self-reported HTN was 12.3%. SBP and DBP means were higher in men (P < 0.001). Mean scores of SBP and DBP increased by aging and body mass index (P < 0.001). Diabetic individuals had higher SBP scores (P < 0.001). Dyslipidemic patients had greater SBP and DBP (P < 0.001). Conclusions: Prevalence of HTN in our study is high. About one-fifth of the participants had HTN. In addition, BP is higher in men, elderly, and diabetic individual. Therefore, it is necessary to control BP regularly in different groups in society.