• Title, Summary, Keyword: Percutaneous Coronary Intervention

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Factors Influencing Life Satisfaction of Elderly Patients after Percutaneous Coronary Intervention (경피적 관상동맥중재술을 받은 노인의 삶의 만족도 영향 요인)

  • Han, Mi-Na;Kim, Hwasoon;Lee, Young-Whee
    • Journal of Korean Critical Care Nursing
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    • v.9 no.2
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    • pp.24-35
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    • 2016
  • Purpose: This study investigated the degree of stress, depression, mindfulness and life satisfaction of elderly patients who had undergone percutaneous coronary intervention (PCI) and identified factors influencing life satisfaction. Methods: Participants were 106 patients over 60 years who had undergone PCI in a university hospital. Results: The mean scores for stress, depression, mindfulness, and life satisfaction were $9.10{\pm}2.53$, $7.77{\pm}3.32$, $88.57{\pm}8.47$, and $17.40{\pm}5.38$ respectively. There were statistically significant differences in life satisfaction by main source of income (F = 4.74, p = .004) and perceived health status as compared with peer (F = 4.80, p = .010). Depression (p < .001) explained 38 % of the total variance of life satisfaction, and the explanatory power increased to 42 % when mindfulness (p = .035) was added. There were significant correlations among stress, depression, mindfulness and life satisfaction of the patients. Conclusions: Depression and mindfulness were significant influencing factors on subjects' satisfaction in life. To enhance the life satisfaction of the elderly patients after PCI, it is necessary to reduce depression and to develop mindfulness-based interventions.

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Comparison of Health Behavior Change Before and After the Percutaneous Coronary Intervention among Coronary Artery Disease Patients (관상동맥 중재시술을 받은 환자의 시술 전후 건강행태 변화 비교)

  • Lee, Jung-Hun;Lee, Kyeong-Soo;Hwang, Tae-Yoon
    • Journal of agricultural medicine and community health
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    • v.41 no.3
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    • pp.140-151
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    • 2016
  • Objectives: The purpose of this study was to investigate health behaviors of patients before and after percutaneous coronary intervention (PCI). Methods: The subjects of this study were 120 men and women whose age ranged from 40 years to 69 years among the patients who received percutaneous coronary intervention in Y university hospital that was located in Daegu city and who had diagnosed for 3 months or more and less than 2 years. Structured questionnaire was used to conduct self-administered survey from May 15 to October 12 in 2012. Results: Patients's health behavior score was ranged from 46 to 94 points after the PCI intervention. The score was $65.42{\pm}12.99$ points before and significantly increased up to $72.53{\pm}10.18$ points after the PCI intervention (p<.001). According to subcategory of health behavior, significant differences were found in scores of health responsibility (increased interest in health, watching of lecture on health and behavior to be punctual on counseling or medical treatment), diet, smoking, and drinking (p<.001, p=.039, p=<.001). However, no significant change was found in practice efforts such as exercise, eating habits and relaxation for stress management. Conclusions: In conclusion, it is necessary to provide education and counseling that enabling patients to improve smoking, drinking, practicing exercise and healthy eating habits.

Comparison of Vessel Elasticity according to Risk Factors for Coronary Artery Disease, and the Mediating Effects of Treatment Compliance among Patients with Percutaneous Coronary Intervention (관상동맥질환 위험정도와 혈관탄성의 관계에서 치료지시이행의 매개효과: 경피적 관상동맥 중재술 환자 대상)

  • Yeo, Ga Ram;Sung, Kyung Mi
    • Journal of East-West Nursing Research
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    • v.22 no.1
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    • pp.32-40
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    • 2016
  • Purpose: This study aimed to provide basic data for vascular health of patient who underwent percutaneous coronary intervention (PCI) by verifying the mediating effect of compliance in the relationship between risk level of coronary artery disease (CAD) and blood vessel elasticity. Methods: This is a descriptive study with 115 patients, who underwent the PCI a year ago and visited in the cardiology department from January to March, 2015. The risk level of CAD, blood vessel elasticity and the compliance were measured. For data analysis, SPSS/WIN 21.0 and AMOS (IBM) 21.0 were used. Results: There were a positive correlation with blood vessel elasticity score (i.e. inelasticity of the blood vessel wall) (r=.189) and a negative correlation with compliance (r=-.658) in mediating effect of risk level of CAD. There was a negative correlation between compliance and blood vessel elasticity (r=-.482). The direct effect (${\beta}=-.226$), indirect effect (${\beta}=.415$) and total effect (${\beta}=.186$) of mediating effect of risk level of CAD on blood vessel elasticity were significant. Compliance had a partial mediating effect of risk level of CAD on blood vessel elasticity. Conclusion: The results of this study suggest that managing and preventing moderating effect of risk level of CAD on compliance is helpful in restoring blood vessel elasticity.

Factors Associated with Early Adverse Events after Coronary Artery Bypass Grafting Subsequent to Percutaneous Coronary Intervention

  • Kamal, Yasser Ali;Mubarak, Yasser Shaban;Alshorbagy, Ashraf Ali
    • The Korean Journal of Thoracic and Cardiovascular Surgery
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    • v.49 no.3
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    • pp.171-176
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    • 2016
  • Background: A previous percutaneous coronary intervention (PCI) may affect the outcomes of patients who undergo coronary artery bypass grafting (CABG). The objective of this study was to compare the early in-hospital postoperative outcomes between patients who underwent CABG with or without previous PCI. Methods: The present study included 160 patients who underwent isolated elective on-pump CABG at the department of cardiothoracic surgery, Minia University Hospital from January 2010 to December 2014. Patients who previously underwent PCI (n=38) were compared to patients who did not (n=122). Preoperative, operative, and early in-hospital postoperative data were analyzed. The end points of the study were in-hospital mortality and postoperative major adverse events. Results: Non-significant differences were found between the study groups regarding preoperative demographic data, risk factors, left ventricular ejection fraction, New York Heart Association class, EuroSCORE, the presence of left main disease, reoperation for bleeding, postoperative acute myocardial infarction, a neurological deficit, need for renal dialysis, hospital stay, and in-hospital mortality. The average time from PCI to CABG was $13.9{\pm}5.4$ years. The previous PCI group exhibited a significantly larger proportion of patients who experienced in-hospital major adverse events (15.8% vs. 2.5%, p=0.002). On multivariate analysis, only previous PCI was found to be a significant predictor of major adverse events (odds ratio, 0.16; 95% confidence interval, 0.03 to 0.71; p=0.01). Conclusion: Previous PCI was found to have a significant effect on the incidence of early major adverse events after CABG. Further large-scale and long-term studies are recommended.

Postinfarct Ventricular Septal Defect after Coronary Covered Stent Implantation

  • Chon, Soon-Ho;Kim, Young-Hak;Kim, Hyuck;Chung, Won-Sang;Kang, Jeong-Ho;Shin, Kyung-Wook
    • The Korean Journal of Thoracic and Cardiovascular Surgery
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    • v.45 no.1
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    • pp.45-48
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    • 2012
  • We report a case of a postinfarction ventricular septal defect caused by an acute recurrent occlusion after the implantation of a covered stent, which was performed as a rescue procedure for the ruptured left anterior descending artery during a percutaneous coronary intervention. Although the emergent implantation of a covered stent for the ruptured coronary arteries such as the left main coronary artery or the origins of the left anterior descending artery can be performed during a percutaneous coronary intervention, and a coronary bypass surgery should be considered in order to decrease the risk of complete occlusion, thus providing a superior long term patency.

Successful transradial intervention via a radial recurrent artery branch from the radioulnar alpha loop using a sheathless guiding catheter

  • Yoon, Shin-Eui;Park, Sangwook;Ahn, Sung Gyun
    • Yeungnam University Journal of Medicine
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    • v.35 no.1
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    • pp.94-98
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    • 2018
  • The radial artery is generally the preferred access route in coronary angiography and coronary intervention. However, small size, spasm, and anatomical variations concerning the radial artery are major limitations of transradial coronary intervention (TRI). We describe a successful case involving a patient with coronary artery disease who underwent TRI via a well-developed radial recurrent artery branch from the radioulnar alpha loop using a sheathless guiding catheter.

Diagnosis and management of acute coronary syndrome (급성 관상동맥증후군의 진단과 치료)

  • Jeon, Doo Soo
    • Journal of the Korean Medical Association
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    • v.60 no.7
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    • pp.568-576
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    • 2017
  • Acute coronary syndrome (ACS) is characterized by the rapid progression of coronary thrombosis and myocardial ischemia associated with the erosion or rupture of vulnerable atherosclerotic plaques. High-sensitivity cardiac troponin assay-based diagnostic algorithms enable rapid diagnosis within a few hours for patients in whom ACS is suspected. Prompt restoration of blood flow in the occluded artery is the top priority in patients with ST-elevation myocardial infarction, and the recommended first medical contact-to-percutaneous coronary intervention time is within 120 minutes. Since patients with non-ST elevation ACS are heterogeneous in their clinical profiles and severity of myocardial ischemia, the treatment strategy for non-ST elevation ACS is based on risk stratification at presentation. An early invasive strategy is indicated for patient at high risk of cardiac events, whereas an ischemia-guided approach is indicated for stabilized patient with lower risk score. Appropriate antithrombotic medication is critically important in the management of ACS. Dual antiplatelet treatment (DAPT) including aspirin and newer P2Y12 inhibitors should be maintained. Generally, at least 12 months of DAPT is recommended in ACS patients; however, the optimal duration of DAPT depends on weighing the benefits of preventing ischemic events versus the risk of bleeding in individual patient.

The Association of Hospital Volume of Percutaneous Coronary Intervention with Cardiac Mortality

  • Kim, Jae-Hyun;Kim, Jang-Mook;Park, Eun-Cheol
    • Health Policy and Management
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    • v.28 no.2
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    • pp.168-177
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    • 2018
  • Background: This study investigates the potential volume and outcome association of coronary heart disease (CHD) patients who have undergone percutaneous coronary intervention (PCI) using a large and representative sample. Methods: We used a National Health Insurance Service-Cohort Sample Database from 2002 to 2013 released by the Korean National Health Insurance Service. A total of 8,908 subjects were analyzed. The primary analysis was based on Cox proportional hazards models to examine our hypothesis. Results: After adjusting for confounders, the hazard ratio of thirty-day and 1-year mortality in hospitals with a low volume of CHD patients with PCI was 2.8 and 2.2 times higher (p=0.00) compared to hospitals with a high volume of CHD patients with PCI, respectively. Thirty-day and 1-year mortality of CHD patients with PCI in low-volume hospitals admitted through the emergency room were 3.101 (p=0.00) and 2.8 times higher (p=0.01) than those in high-volume hospitals, respectively. Only 30-day mortality in low-volume hospitals of angina pectoris and myocardial infarction patients with PCI was 5.3 and 2.4 times those in high-volume hospitals with PCI, respectively. Conclusion: Mortality was significantly lower when PCI was performed in a high-volume hospital than in a low-volume hospital. Among patients admitted through the emergency room and diagnosed with angina pectoris, total PCI volume (low vs. high) was associated with significantly greater cardiac mortality risk of CHD patients. Thus, There is a need for better strategic approaches from both clinical and health policy standpoints for treatment of CHD patients.