Journal des maladies coronariennes

Paradoxical coronary artery embolism and spontaneous coronary artery dissection are rare causes of acute myocardial infarction in young females. These unusual etiologies for myocardial infarction should be considered in young female patients presenting with chest pain and at a low risk profile, by Bayesian analysis, for coronary atherosclerosis.

We present a case of a 21-year - old female of a paradoxical embolism causing ST elevation myocardial infarction in a patient with markedly elevated Lipoprotein (a) levels and an atrial septal defect. Chest pain, abnormal ECG, and elevated troponins led to coronary angiography demonstrating a clot in the obtuse marginal branch of the circumflex coronary artery. Echocardiography revealed an unknown atrial septal defect with bidirectional shunting. The question we address is whether closure of the atrial septal defect is appropriate to prevent a recurrence of a paradoxical embolism.

Aims: to increase the awareness about cardiovascular diseases risk among diabetic patients in KAMC-Jeddah.
Method: Observational cross-sectional study assessed DM patients for their knowledge on of diet, physical activity complication of DM, whether they received any educational sessions using a questionnaire. This was followed by education.
Result: The study included 132 participants; we found that 41% of the sample was obese and 34% overweight. (15.9%) developed cardiovascular diseases. Less than 5% of DM patients with cardiac disease indicated they had education. In the end, 95.5% of participants reported they had learned from the interview and it was educational for them.
Conclusion: There was a clear lack of information on the disease, complications and method of prevention. In addition, one to one education was informative and helpful to the patient

Objective: The main goal of the study was to find out the effects of body weight and physical activity on heart disease aged from 30 to above 80 years residing in and around Khulna district of Bangladesh, during September, 2017 to February, 2018.
Methods and Results: Data were collected by questionnaires on the basis of sex, age, BMI, physical activity, family history, food preferences, and Total cholesterol test. A total number of 240 patients were selected randomly for collection of data who were diagnosis by heart disease. Among them male were 188 and 52 were female. Data were analyzed statistically. 78 % males were found more vulnerable to HD than 22 % females because their food intake pattern, nutritional status, physical activity and life style. This study also indicates that increased body weight and sedentary life style related factors, including poor dietary habits, excess saturated and trans fat, high salt intake, and low-level physical activity may be important as well and family history of cardiac diseases are influential risk factors for HD.
Conclusion: So, we have concluded that increasing body weight, physical inactivity, unhealthy eating habits, poor lifestyle has an effect with HD.

Objective: The purpose of this study was to examine the association between Type D personality and repeated episodes of coronary artery spasm.
Design: Using a quasi-experimental design, with 44 coronary artery spasm patients, Type D and non-Type D personality patients were compared. Demographic, clinical, and psychological data was collected. Hypothesis testing, correlation matrix, single regression, multiple regression, and logistic regression analysis were used to examine the relationship between Type D personality and repeated episodes of coronary artery spasm while adjusting for demographic, clinical, and psychological factors.
Main outcome measures: This study assessed the impact of Type D personality on repeated episodes of coronary artery spasm.
Results: The probability of experiencing repeated episodes of coronary artery spasm requiring medical attention was greater among patients who had a Type D personality, d=.27, p =.022, 95% CI [.0385548, .506900], z=2.28. Patients who had a Type D personality were more likely to experience anxiety and depression disorder. Smoking was a predictor of coronary artery spasm among patients who had a Type D personality; (F(1,19) = 5.47, p = .033).
Conclusions: Type D personality is a predictor of coronary artery spasm and a risk factor for repeated episodes of coronary artery spasm requiring medical attention.

Background: Dimethylarginine aminodehydrolase (DDAH1) and alanine glyoxylate aminotransferase2 (AGXT2) are two enzymes that contribute in the asymmetric dimethylarginine (ADMA) and symmetric dimethylarginine (SDMA) metabolism. ADMA and SDMA are two known endogenous arginine derivatives reported to affect the production and bioavailability of eNOS-derived nitric oxide (NO) and consequently healthy blood vessels. The major aims of the current study were to investigate the association of the genetic variants of AGXT2 rs37369, AGXT2 rs16899974 and DDAH1 rs997251 SNPs with the incidence of coronary artery disease (CAD) in the Egyptian population and to correlate these variants with the serum levels of ADMA and SDMA.
Methods: The study included 150 subjects; 100 CAD patients and 50 healthy controls. Genotyping was performed by qPCR while the ADMA and SDMA concentrations were assayed by ELISA.
Results: Both serum ADMA and SDMA concentrations were significantly higher in CAD patients compared to controls (both p<0.0001). Genotype distributions for all studied SNPs were significantly different between CAD patients and controls. Carriers of AGXT2 rs37369-T allele (CT+TT genotypes) and AGXT2 rs16899974-A allele (CA+AA genotypes) had 2.4 and 2.08 fold higher risk of having CAD than CC genotype in both SNPs p=0.0050 and 0.0192, respectively). DDAH1 rs997251 TC+CC genotypes were associated with 2.3 fold higher risk of CAD than TT genotype (p=0.0063). Moreover, the AGXT2 rs37369 TT genotype, AGXT2 rs16899974 AA genotype and DDAH1 rs997251 CC genotype were associated with the highest serum ADMA and SDMA concentrations.
Conclusion: AGXT2 rs37369-T, AGXT2 rs16899974-A, and DDAH1 rs997251-C alleles represent independent risk factors for CAD in the Egyptians.