Purpose: Coronary artery calcification (CAC) is utilized as an important tool for global risk assessment of cardiovascular events in individuals with intermediate risk. Ecto phosphodiesterase/nucleotide phosphohydrolase-1(ENPP1) converts extracellular nucleotides into inorganic pyrophosphate and it is a key regulator of tissue calcification that adjusts calcification in tissues like vascular smooth muscle cells. The main purpose of this clinical study was to find out the correlation between ENPP1 serum concentration and CAC in human for the first time.Methods: In this study 83 patients (16 diabetic patients and 67 non-diabetic patients) with coronary artery disease who fulfilled inclusion and exclusion criteria, entered the study. For all patients a questionnaire consisting demographic data and traditional cardiovascular risk factors were completed. Computed tomography (CT)-Angiography was carried out to determine coronary artery calcium score and enzyme-linked immunosorbent assay (ELISA) method was used for measuring ENPP1 serum concentrations.Results: There was a reverse significant correlation between ENPP1 serum concentration and total CAC score and also CAC of right coronary artery (RCA) (P<0.05) in non-diabetic patients.Conclusion: On the basis of our results, ENPP1 serum concentration may be a suitable biomarker for coronary artery disease at least in non-diabetic patients. However, more studies with higher sample size are necessary for its confirmation.

BACKGROUND: Many patients who are candidates for a pacemaker are also at the same time risk factors for coronary artery disease such as high blood pressure, hypertension, diabetes, and hyperlipidemia, and therefore the probability of having coronary artery disease is significant. Effective diagnostic measures can be taken to prove the factors affecting the incidence of CAD in patients undergoing pacemakers at high-risk, including angiography. Therefore, it can prevent complications during and after pacemaker implantation, which leads to an increase in the quality of treatment in patients requiring pacemaker implantation. AIM: Therefore, the purpose of this study was to determine the predictive factors of significant coronary artery disease in patients with pacemaker implantation to identify patients in need of coronary angiography at the time of pacemaker implantation. METHODS: This retrospective study was carried out to examine the patients' files that were placed at the heart of Imam Reza Hospital during the period between March 2017 and September 2017. Demographic data, risk factors, echocardiography findings, and angiography, were collected and then recorded using a checklist. Statistical analysis was performed using SPSS software version 22 and Chi-square, and Mann-Whitney tests were used for determining significates variables. RESULTS: A group of 102 patients who had undergone a permanent cardiac pacemaker insertion due to an atrioventricular (AV) Block were included in the study, and also coronary anatomy was determined coronary angiography. Based on the results, 13.7% of patients with cardiac pacemaker had obstructive coronary artery disease (stenosis > 70%). Factors affecting coronary artery stenosis on angiography include gender, chest pain, history of myocardial infarction, angioplasty, diabetes, smoking, history of aspirin intake, calcium blocker and Plavix, high hematocrit, ST elevation and ST depression in the ECG, and severe mitral regurgitation. CONCLUSION: It seems that in most patients requiring permanent pacemaker insertion because of the atrioventricular (AV) Block, angiography does not change the patient's fate, and so can be ignored. However, in patients who have several risk factors from the listed above, coronary angiography is recommended during admission.

Background: Shortage of rehabilitation services as well as personal and financial problems prevents patients from participating in cardiac rehabilitation programs. Participation in these programs alleviates patients' perceived inadequacy, improves their quality of life, and prolongs their survival. Thus, there is a clear need to educate cardiac patients and guide them toward patient-centered and home-based rehabilitation programs. Objectives: The present study was undertaken to examine the effect of phase III cardiac rehabilitation on the quality of life of patients who had undergone coronary artery bypass graft Methods: This quasi-experimental study was done on forty 35 to 75 year-old patients, who were in phase III cardiac rehabilitation after bypass surgery. Patients were selected purposively and were allocated to a control and an experimental group randomly, 20 patients in each group. The groups did not differ significantly regarding patients' age, body mass index, and the duration of cardiac problems. A demographic questionnaire and the short form 36 quality of life questionnaire were used for gathering data both before and one month after the study intervention. A cardiac rehabilitation educational program was implemented for the patients in the experimental group with six 1.5-hour sessions in three subsequent weeks. Patients in the control group also received the same education in four sessions, which were held after the posttest. The data were entered in the SPSS (v. 15.0) software and were analyzed by running repeated measure analysis of variance (ANOVA), the paired-and the independent-sample t, the one-way ANOVA, and the Tukey's post-hoc statistical tests. The level of significance was set at 0.05.