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Background&Objective: The main cause of the cardiovascular disease is atherosclerosis of coronary artery. One of theraputic methods of the disease is coronary artery bypass graft (CABG). One of the main complicatons of CABG is bleeding after grafting. Different methods and proposed for preventing or reducting the bleeding. The aim of this study is to evaluate the effects of tranexamic acid (TA) on reduction of bleeding after grafting.

Materials&Methods: This study was a randomized clinical trial. 100 patients conditated to CBG divided into 2 groups randomizely (50 for control and 50 for subject). TA was injected to subject group twice with the same dosage of 15 mg/kg: first during the operation and second after ending the cardiopulmunary pomp and neutralizing the theraputic effect of heparin by protamin. The same method was used for the control group, except normal saline was used instead of TA variations such as bleeding rate, PT, aPTT were tested after CABG. The extracted data was analysed by SPSS software.

Results: The range of ages was 28 to 75 years and the control and subject groups were distributed normally from age viewpoint. Bleeding rate after grafting in subject group was 335±45 ml and in control group was 490±81 ml. in case and control platelet count and hematocrit groups, were significant differences (P<0.05).

Conclusion: Using TA during and after CABG is suggested to control bleeding.

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Background & Objective: The atherosclerosis of left anterior descending (LAD) coronary artery because of subtending more than 50% of left ventricular myocardial mass, has long been the focus of concern regarding appropriate treatment. This study aimed to evaluate efficacy of Percutaneous Transluminal Coronary Angioplasty (PTCA) with stenting for treatment of proximal LAD disease. Materials & Methods: In this descriptive study, 75 patients with isolated proximal LAD atherosclerotic lesion treated with PTCA and stenting were followed up for 9 months. The stenosis of all patients was documented by coronary angiography prior to enrollment. Exercise tolerance testing (ETT) by Bruce protocol was performed before angioplasty and at the end of follow up period as well. Results: There were 44 (58.7%) males, and 31 (41.3%) females. The mean age of patients was 59.4 (range, 39 to 83 yrs). Clinical outcomes of 73 (97.3%) patients were satisfactory. Only two patients developed re-stenosis during the follow up period. The first patient developed myocardial infarction at the 3rd day of her admission, and the second one had an abnormal ETT after 9 months. Percutaneous coronary revascularization with stenting was performed, and both of them were discharged without any problem. Conclusion: This study demostrated that the nine months prognosis of patients with isolated stenosis of proximal LAD coronary artery that treated by PTCA and stenting was acceptable. This treatment improves clinical status and results in lower hospital adverse event rates and in appropriate clinical outcome.

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Background and Objective: The silent brain infarctions are common in first-ever stroke. Some recent studies show the possible role of silent brain infarction in ischemic stroke. The aim of this study was to evaluate the frequency of silent brain infarction in acute first-ever ischemic stroke and its association with stroke risk factors. Materials and Methods: This descriptive - analytical study was carried out on 203 (94 males, 109 females) patients with acute first-ever ischemic stroke in Shafa hospital in Kerman, Iran during 2010. The diagnosis of ischemic stroke was made by physical examination and was confirmed by MRI and CT Scan. A questionnaire containing demographic information and risk factors including hypertension, diabetes, hyperlipidemia, cigarette smoking, ischemic and non-ischemic heart disease for stroke as well as presence of silent stroke was completed for each patient. Data were analyzed using SPSS-16 and logistic regression test. Results: The mean age of patients was 62.56±17.35 years. Among our patients history of hypertension, hyperlipidemia, cigarette smoking, diabetes, history of ischemic heart disease, history of other cardiac disease and silent stroke were observed in 66 (32.5%), 26 (12.8%), 16 (7.9%), 40 (19.7%), 27 (13.3%), 16 (7.9%) and 31 (15.3%), respectively. The probability of silent stroke among patient with hyperlipidemia, was 3.7 times more than those without hyperlipidemia (95%CI: 1.556-12.780, P<0.05). There was no significant correlation between silent stroke and the above risk factors. Conclusion: Silent stroke was found in 15% of patients with ischemic stroke. Control of hyperlipidemia can have a vital role in the prevention of silent stroke.