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The purpose of this paper is to docoment a randomized controlled trial, with follow‐up at three and six months, to determine the impact of a coronary risk factor modification program for employees.

Intervention participants received a 12‐week health promotion program involving exercise, education seminars, nutritional analysis and smoking cessation counselling. Outcome measures included differences in coronary risk factors of control and intervention participants between baseline and three and six‐month follow‐up visits.

The participants included 566 individuals employed in the Halifax area, Nova Scotia, Canada. They were between 19 and 66 years old with at least two modifiable coronary risk factors. There were statistically significant differences at three months in coronary risk score improvement, smoking cessation, physical activity level increases, body mass index reductions and serum cholesterol. At six months, improvements remained significant except for cholesterol. Reduction in blood pressure was not significantly different. Intervention participants compared to control participants showed significant differences in both cardiac and stroke risk at three and six‐month visits.

This study demonstrates that employees had a significant coronary disease risk reduction as a result of a relatively short health promotion intervention. Benefits three months post‐intervention were not sustained to the same extent as during the intervention. This underscores the need for long‐term commitment with lifestyle changes and raises the issue of the need for a comprehensive approach that also addresses environmental factors.

This paper contributes to the current research base on this topic as there are few well‐designed studies to reduce coronary risk factors for employees.

Coronary artery disease (CAD) is reported as one of the most common sources of death all over the world. The presence of stenosis (plaque) in the coronary arteries results in the restriction of blood supply, leading to myocardial infarction. The current study investigates the influence of multi stenosis on hemodynamic properties in a patient-specific left coronary artery.

A three-dimensional model of the patient-specific left coronary artery was reconstructed based on computed tomography (CT) scan images using MIMICS-20 software. The diseased model of the left coronary artery was investigated, having the narrowing of 90% and 70% of area stenosis (AS) at the left anterior descending (LAD) and left circumflex (LCX), respectively.

The results indicate that the upstream region of stenosis experiences very high pressure for 90% AS during the systolic period of the cardiac cycle. The pressure drops maximum as the flow travels into the stenotic zone, and the high flow velocities were observed across the 90% AS. The higher wall shear stresses occur at the stenosis region, and it increases with the increase in the flow rate. It is found that the maximum wall shear stress across 90% AS is at the highest risk for rupture. A recirculation region immediately after the stenosis results in the further development of stenosis.

The current study provides evidence that there is a strong effect of multi-stenosis on the blood flow in the left coronary artery.

Coronary artery disease (CAD) is developed by an insufficient supply of oxygen-rich blood to the myocardium. Recent studies have shown that increased oxidative stress has implicated in the pathogenesis of coronary atherosclerosis. Anxiety and CAD have a mutual relationship, as the effect of long-lasting anxiety on atherosclerosis and CAD is well known. The purpose of this study is to investigate the relationship between dietary / serum total antioxidant capacity and CAD.

A total of 160 male patients were enrolled in this cross-sectional study. Diagnosis and analysis of angiograms were performed visually by a cardiologist. The subjects were categorized into CAD− (coronary artery obstruction <75 per cent) and CAD+ (coronary artery obstruction ≥ 75 per cent) groups. Anthropometric indices, blood pressure, blood sugar and lipid profile and physical activity (PA) were assessed. Information about anxiety was obtained by Spielberger questionnaire. Dietary total antioxidant capacity (TAC) was obtained by using a semi-quantitative food frequency questionnaire and an oxygen radical absorbance capacity of selected foods.

Mean of dietary TAC was significantly lower in CAD+ than CAD− group (P < 0.001). However, there was not any significant differences about serum TAC (P = 0.28). The mean of body mass index (BMI) (P = 0.04) and triglyceride (TG) level (P = 0.03) and the frequency of smoking (P = 0.03) were significantly higher in the CAD+ than the CAD− group. There was no significant relationship between CAD with apparent (P = 0.33) and hidden anxiety level (P = 0.16). Confounding factors such as smoking and medications were adjusted.

This study had certain limitations. Being a single center cross-sectional design does not permit analysis of causal relationships; the sample size was geographically limited. The authors could not exclude the medication of patients, which could affect the total antioxidant capacity levels. Measurement error in self-reported dietary consumption may results misclassification of exposure.

A diet high in total antioxidant capacity is inversely associated with CAD. Serum TAC does not vary between men with and without CAD when confounders including age, BMI, TG, smoking, SBP, DBP, energy intake, PA, HDL-C, LDL-C, T-C, FBS, family history of CAD, education and anxiety are taken into consideration.

High consumption of vegetables and fruits may play a major role in the prevention of CAD.

The study was approved by the ethics committee of Isfahan University of Medical Sciences (No:394888).

Coronary artery disease is one of the most common cardiovascular disorders in the world, and it can be deadly. Traditional diagnostic approaches are based on angiography, which is an interventional procedure having side effects such as contrast nephropathy or radio exposure as well as significant expenses. The purpose of this paper is to propose a novel artificial intelligence (AI) approach for the diagnosis of coronary artery disease as an effective alternative to traditional diagnostic methods.

In this study, a novel ensemble AI approach based on optimization and classification is proposed. The proposed ensemble structure consists of three stages: feature selection, classification and combining. In the first stage, important features for each classification method are identified using the binary particle swarm optimization algorithm (BPSO). In the second stage, individual classification methods are used. In the final stage, the prediction results obtained from the individual methods are combined in an optimized way using the particle swarm optimization (PSO) algorithm to achieve better predictions.

The proposed method has been tested using an up-to-date real dataset collected at Basaksehir Çam and Sakura City Hospital. The data of disease prediction are unbalanced. Hence, the proposed ensemble approach improves majorly the F-measure and ROC area which are more prominent measures in case of unbalanced classification. The comparison shows that the proposed approach improves the F-measure and ROC area results of the individual classification methods around 14.5% in average and diagnoses with an accuracy rate of 96%.

This study presents a low-cost and low-risk AI-based approach for diagnosing heart disease compared to traditional diagnostic methods. Most of the existing research studies focus on base classification methods. In this study, we mainly investigate an effective ensemble method that uses optimization approaches for feature selection and combining stages for the medical diagnostic domain. Furthermore, the approaches in the literature are commonly tested on open-access dataset in heart disease diagnoses, whereas we apply our approach on a real and up-to-date dataset.

A learning algorithm called CLILP2 (Cover Learning Using Integer Linear Programming) is applied to medical data to generate rules to recognize patients with coronary artery disease. The algorithm partitions a data set into subsets using features which best describe and distinguish a particular subset from all other subsets. These features are used to form the rules which can be used as the knowledge base of a diagnostic expert system. Results from the application of the algorithm to coronary artery stenosis data are compared with the results obtained from the existing expert system.

In May 2014, a new reform in the health sector of Iran was implemented called “health evolution plan.” In the first phase of this reform, the government reduced out-of-pocket payments for service delivery by paying subsidies to the services and after that a revision was done to the medical services values book to improve equity and increase motivation of health professions. One of the affected services in this reform was coronary artery bypass surgery. The purpose of this paper is to show the effects of HEP on costs of coronary artery bypass surgery.

A before-after study was done for this purpose and 167 patients’ total costs and out-of-pocket payments were calculated for the years 2013 (before) and 2014 (after) the reform in three private hospitals of Rasht city, Iran. Econometrics models were estimated after adjustment of confounding variables.

The results of this study showed that surgery costs increased significantly from $1,643.3 to 2,119.5. Nursing and other costs increased significantly from $290.3 to 414.2 and anesthetize costs increased from $619.2 to 947.01. The results of regression model showed that total costs increased $3,008.6 after adjustment of confounders (p-value=0.037). However, no significant changes were found for out-of-pocket payments and out-of-pocket percentage.

The study findings revealed that HTP was not successful enough in financial protection in the private sector.

The Walsall clinic for survivors of myocardial infarction is described. Coronary heart disease is a major health issue in Walsall. The starting point for the project was the publication of the Scandinavian Simvastatin Survival Study (4S) in 1994, which showed the benefit of cholesterol treatment in these patients. Although the new clinic was established primarily to implement a 4S‐based regime, the cholesterol regime has been modified in the light of newer evidence, and the service broadened to encompass cardiological assessment and the use of other forms of secondary prevention. Several factors have contributed to the success of the service, including support from the Health Authority, patient involvement, partnership with Primary Care and the use of information technology. The latter has integrated routine clinical record keeping and correspondence with complete prospective audit data accumulation and measurement of performance against evidence‐based standards. These principles are of potential value in other clinical effectiveness initiatives.

This study aims to determine the relationship between body mass index (BMI) and Global Registry of Acute Coronary Events (GRACE) risk score in patients diagnosed with acute coronary syndrome (ACS) and to evaluate the results in this context.

This was a prospective cohort study of ACS patients admitted to a cardiac care unit in high specialization hospital's cardiology service. The study included 140 men aged >35 years who were diagnosed with ACS.

The mean age of the individuals participating in the study was 61.4 ± 10.9 years old. The mean BMI of the individuals was 25.3 ± 6.6 kg/m², and the mean value of the waist/hip ratio was 0.85 ± 0.01. Individuals were divided into four quarters according to the GRACE score. It was determined that individuals with the highest GRACE score were very underweight or morbidly obese according to their BMI values (p = 0.04).

It has been observed that there is a U-shaped relationship between the GRACE score and the BMI in individuals diagnosed with ACS. The risk of death of ACS patients with very high or very low BMI values was found to be close to each other. Although there is a relationship between BMI and GRACE score, it is concluded that it is insufficient to determine the risk in coronary disease alone, and body fat distribution should be examined together with BMI.

A new report from the National Heart Forum argues that coronary heart disease could lose its position as the leading single cause of death in the UK if only knowledge we have now can be turned into effective policy action. Tackling health inequalities, largely due to relative poverty, must begin in childhood. National nutrition policies are needed to lower average blood cholesterol levels and unhealthy weight gain. Healthy choices in food and lifestyle must be available to all, not just the better off. Government strategies to tackle smoking must be matched by similar strategies for nutrition and physical activity. A failure to act, particularly to raise nutritional standards across the board, could result in an alternative scenario of huge and costly increases in the number of coronary care patients.