Abstract
Aim. This study reviews the role of vitamin E in cardiovascular diseases.
Background. Cardiovascular diseases are among the most common health-related problems, and the number of the patients with cardiovascular diseases increases each year. Long-term manifestations of cardiovascular disease bears a lot of cost to the family and society.
Method. This review study was conducted by searching out the related literature in the databases Google Scholar, PubMed, PMC, Springer, and Elsevier, for papers published from 2014 to 2018. Initially, a total of 72 articles were found and the number of articles was reduced to 42 by removing duplicates and articles that were only accessible as abstract. Finally, a review by 21 articles was carried out.
Findings. α-Tocopherol is the most common form of vitamin E in human tissues. Increased oxidative stress is an important mediator of endothelial injury in hypertension pathology, associated with increased oxidant protein production, such as hydrogen peroxide super oxidation, decreased nitric oxide synthesis, and decreased biological capacity of antioxidants. Oxidative stress may lead to endothelial dysfunction, inflammation, hypertrophy, fibrosis, and angiogenesis associated with hypertensive vascular changes. Vitamin E deficiency can provide a constraint for micro ribonucleic acids (miRNAs) networks, and this may lead to the progression of atherosclerosis. Vitamin E deficiency causes adverse effects in cardiovascular systems. However, the effect of its use in the treatment of diseases is still not fully understood.
Discussion. A good amount of Vitamin E should be provided and it should be replaced before the complications occur.

Abstract
Aim. This review study aims to investigate the impact of reducing Door-to-ECG (DTE) time on on morbidity and mortality of patients with chest pain referred to emergency department.
Background. Chest pain is the second most common reason for referral to an emergency unit. According to American Heart Association, all patients with chest pain presenting to the emergency ward should be approached with an ECG within 10 minutes of entrance to the emergency department. This is considered as the first line of diagnostic tests for myocardial infarction.
Method. In this narrative review study, several databases and search engines including SID, Pub Med, Google Scholar, Web of Science and Scopus were used to find the articles published between 2000 and 2018. The keywords used to search articles were “Door to ECG”, “chest pain”, “emergency unit” and “triage”. The articles selected for review were interventional or descriptive in terms of design, in Persian or English, with available full text. The criterion for selecting articles was the similarity of the their subject with the search keywords including Door to ECG (DTE) time and triage and their value in the early diagnosis and treatment of coronary disorders.
Findings. A total of 20 articles were found. After removing the articles that didn’t meet the inclusion criteria, 11 articles related to the subject of the study remained in review. The significant outcomes of timely triage, appropriate time to perform ECG, barriers to access and suggestions for faster treatment by the system especially the role of nurses, were investigated.
Conclusion. The reduction of triage time and Door to ECG (DTE) time as well as the role of the nurse in those cases are associated with a reduction in the morbidity and mortality of cardiac patients.

Abstract
Aim. The aim of this study was to identify the factors affecting the outcomes in people with heart failure.
Background. Heart failure is a complex clinical syndrome. Due to functional and structural problems occurs in the heart failure and its high prevalence and associated financial burden, it is considered a public health problem. Mortality rate and serious complications from the disease are on the rise. Decreased quality of life and frequent hospitalizations are among these complications.
Method. In this review study, a comprehensive search on scientific databases and search engines such as Science Direct, Ovid, PubMed, Google Scholar, Medline was conducted with the keywords heart failure, education, health literacy education, heart failure knowledge, self care, readmission, family support and heart failure outcomes for papers published between 2003 to 2018.
Findings. Heart failure is associated with many problems and several factors affect the patient. Focusing on previous studies on factors influencing the outcomes of heart failure, we can refer to patient health literacy, self-care, heart failure knowledge and patient family support. Education of affected patients has also influenced the outcomes of the disease and frequent hospitalization of patients.
Conclusion. Patient education based on health literacy has effect on heart failure outcomes.