• 제목/요약/키워드: Coronary intervention

검색결과 231건 처리시간 0.02초

경피적 관상동맥중재술 후 재협착 예방에 대한 한약의 효과 : 무작위배정 대조군 임상연구에 대한 체계적 문헌고찰 및 메타분석 (Effect of Herbal Medicines on Preventing Restenosis After Percutaneous Coronary Intervention: A Systematic Review and Meta-analysis of Randomized Controlled Trials)

  • 허나연;안수빈;김홍준;장인수
    • 대한한방내과학회지
    • /
    • 제44권3호
    • /
    • pp.387-401
    • /
    • 2023
  • Objective: This study was conducted to investigate the preventive effect of herbal medicines on restenosis after percutaneous coronary intervention (PCI) by reviewing randomized controlled trials (RCTs). Methods: RCTs were searched for herbal medicine treatment after PCI using eight online databases (PubMed, CNKI, Wanfang, J-STAGE, OASIS, ScienceON, KTKP, and KISS). Studies that confirmed restenosis through coronary angiography at follow-up were selected according to the inclusion and exclusion criteria. The primary outcome was the restenosis rate, and the secondary outcome was the angina recurrence rate. Data were extracted from the final selected studies according to the research methodology and then analyzed with Review Manager 5.4.1. Study quality was assessed using Cochrane's risk-of-bias (RoB) tool. Results: Of the 252 papers obtained through the primary search, nine studies that met the selection criteria were finally selected. In these nine studies, herbal medicine combined with western medicine was used for the experimental group, and western medicine treatment was used alone for the control group. The meta-analysis result revealed that the restenosis rate and angina recurrence rate were significantly lower in the experimental group than in the control group (RR=0.34, 95% CI: 0.22-0.53, p<0.00001, I2=0% and RR=0.47, 95% CI: 0.29-0.78, p=0.004, I2=0%, respectively). Furthermore, the quality of studies assessed by Cochrane's RoB was low. Conclusions: This study showed that the combined treatment of herbal medicine and western medicine was effective in preventing restenosis and angina after PCI. As the number of papers included in this study was small, a large number of high-quality clinical studies should be considered in the future.

다혈관 관상동맥류가 동반된 불안정성 협심증 환자에서의 관상동맥 우회로술 (CABG for Treating Unstable Angina with Multivessel Coronary Artery Aneurysms - A case report-)

  • 김진식;지현근;정진우;김준석;신제균;송명근
    • Journal of Chest Surgery
    • /
    • 제43권6호
    • /
    • pp.743-746
    • /
    • 2010
  • 관상동맥류는 비교적 드문 질환으로 내과적 또는 수술적 치료방법에 대해서는 논란이 있다. 관상동맥류의 원인으로는 동맥경화증, 가와사키병, 염증성 혈관질환, 결체조직질환 및 선천선 기형 등이 있다. 본원에서는 50세 남자환자가 관상동맥 조영술 시행 결과 다혈관 관상동맥류를 진단받고 관상동맥 우회로술을 시행하였기에 문헌고찰과 함께 보고하는 바이다.

Results of Extracorporeal Membrane Oxygenation (ECMO) Support before Coronary Reperfusion in Cardiogenic Shock with Acute Myocardial Infarction

  • Chung, Eui-Suk;Lim, Cheong;Lee, Hae-Young;Choi, Jin-Ho;Lee, Jeong-Sang;Park, Kay-Hyun
    • Journal of Chest Surgery
    • /
    • 제44권4호
    • /
    • pp.273-278
    • /
    • 2011
  • Despite aggressive treatment, the mortality rate of cardiogenic shock with acute myocardial infarction (AMI) is high. We performed extracorporeal membrane oxygenation (ECMO) prior to coronary reperfusion, and evaluated the early clinical results and risk factors. Materials and Methods: From May 2006 to November 2009, we reviewed the medical records of 20 patients in cardiogenic shock with AMI (mean age $67.7{\pm}11.7$ yrs, M : F 14 : 6). After initially performing ECMO using the CAPIOX emergency bypass system ($EBS^{(R)}$Terumo, Tokyo, Japan), patients underwent coronary reperfusion (coronary artery bypass grafting, 13; percutaneous coronary intervention, 7). Results: All patients were in a cardiogenic shock state, cardiopulmonary resuscitations (CPR) were performed for fourteen patients (mean CPR time $20.8{\pm}26.0$ min). The mean time from vascular access to the initiation of ECMO was $17.2{\pm}9.4$ min and mean support time was $3.8{\pm}4.0$ days. Fourteen patients were able to be weaned from ECMO and ten patients were discharged (mean admission duration $50.1{\pm}31.6$ days). Patients survived on average $476.6{\pm}374.6$ days of follow-up. Longer CPR and support time, increased cardiac enzyme, lower ejection fraction, lower albumin, and major complications were the risk factors of mortality (p<0.05). Conclusion: The early application of ECMO prior to coronary reperfusion and control of risk factors allowed for good clinical results in cardiogenic shock with AMI.

제4형 이중 좌전하행 관상동맥: 드문 선천성 관상동맥 기형에 대한 증례 보고 (Type 4 Dual Left Anterior Descending Artery: A Case Report of a Rare Congenital Coronary Anomaly)

  • 장선웅;김기환;이병훈
    • 대한영상의학회지
    • /
    • 제85권2호
    • /
    • pp.428-433
    • /
    • 2024
  • 이중 좌전하행 관상 동맥은 일반 인구에서 약 1%의 유병률을 보이는 드문 선천성 기형이다. 지금까지 이중 좌전하행 관상동맥 기형은 10가지 유형으로 보고되었다. 그중 제4형 이중 좌전하행 관상동맥은 가장 희귀한 유형 중 하나이다. 이중 좌전하행 관상동맥에 대한 지식과 인식은 정확한 진단과 관상동맥 우회 수술 및 경피적 관상동맥 중재술을 계획하는 데 중요하다. 저자들은 수개월 동안 소화불량과 발한을 주소로 내원하였고 짧은 좌전하행 관상동맥의 주요 대각분지에 약 50%-70% 협착이 있었던, 제4형 이중 좌전하행 관상동맥 기형을 가진 59세 남성의 증례를 보고하고자 한다.

관상동맥질환자의 금연변화단계와 관련된 요인 및 장애요인에 대한 전향적 연구 (Prospective Study on the Relating Factors to the Stages of Change in Smoking Cessation and Barriers in Coronary Artery Disease Patients*)

  • 김화순
    • 대한간호학회지
    • /
    • 제35권1호
    • /
    • pp.27-36
    • /
    • 2005
  • Purpose: The main purpose of this study was to investigate that the stages of change in smoking cessation behavior among coronary artery disease patients for six months progressed following the stages of change suggested by the transtheoretical model. Method: Subjects for this descriptive survey were 59 coronary disease patients who were smoking or who had stopped smoking for less than six months. Result: In the baseline, the distribution of the subjects’ stages of change was as follows: pre-contemplation stage 25.4%, contemplation stage 25.4%, preparation stage 22%, and action stage 27.1%. After six months, more subjects in the contemplation(33.3%) and preparation stages(30.8%) progressed to the action stage than those of the pre-contemplation stage(0%). Eighty-one percent of the subjects in the action stage at baseline progressed to the maintenance stage. The relationship between the numbers of smoking cessation attempts for six months and stages of change at baseline was significant(p=.001). However, the relationships between self-efficacy and nicotine dependence at baseline and progression in stages of change after six months were not significant. Conclusion: Progression in the stages of change for six months among subjects corresponded to the stages of change suggested by the transtheoretical model. Hence, future development and evaluation of intervention programs should be tailored individually considering each patient's stage of change.

급성관상동맥증후군 남성 환자의 흡연과 스트레스에 영향을 미치는 요인 (Predicting Factors of Smoking and Emotional Stress among Male Patients with Acute Coronary Syndrome)

  • 김은영;황선영
    • 성인간호학회지
    • /
    • 제23권1호
    • /
    • pp.100-109
    • /
    • 2011
  • Purpose: This study was conducted to identify the factors that predict a current smoking behavior and higher emotional stress among male patients with acute coronary syndrome (ACS). Methods: The study was approved by an institutional review board from a university hospital, 2010. A face to face interview using questionnaires was performed with 185 first-time ACS male patients who were undertaken a percutaneous coronary intervention at a cardiovascular care unit. Data were analyzed using SPSS/WIN 15.0. Results: About 54% of the study subjects were currently smoking. The current smokers had dyslipidemia and reported bad eating habits compared to the non-smokers. The current smokers were younger, living alone, and reported lower perceived benefit on smoking cessation than the non-smokers, and 15% of them did not consider quitting (precontemplation stage). Smoking status was not significantly related to emotional stress. Logistic regression analysis revealed that being employed including professional or labor increased the odds of current smoking four or three times compared to the non-employed or retired. Low income or dyslipidemia also increased the likelihood of current smoking 2.8 and 2.1 times, respectively. Blue collar workers or heavy drinkers had 2.9 and 2.8 times more risks of having higher level of stress. Conclusion: An occupational background and health habits should be considered to develop an effective educational strategy for smoking cessation and stress reduction among male patients with ACS.

금연변화단계에 따른 관상동맥질환자들의 흡연관련 특성과 심리적 특성 (Features Related to Smoking and Psychological Characteristics of Coronary Artery Patients Associated with the Stage of Change in Smoking Cessation)

  • 김화순
    • 성인간호학회지
    • /
    • 제17권4호
    • /
    • pp.592-601
    • /
    • 2005
  • Purpose: The purpose of this study was to investigate differences in smoking related characteristics and psychological features of coronary artery patients by the stages of change in smoking cessation behaviors. Method: Subjects for this survey were 97 patients who were smoking when doctors diagnosed them to have coronary artery diseases. Result: Subjects were distributed 21.6% in precontemplation stage, 24.7% in contemplation stage, 17.5% in preparation stage, 19.6% in action stage, and 16.5% in maintenance stage respectively. The numbers of previous attempts to quit smoking of subjects in precontemplation stage(mean=3.00, SD=3.71) and contemplation stage(mean=2.63, SD=2.32) were significantly lower than that of subjects in preparation stage(mean=5.82, SD=6.20). Benefit scores of subjects in maintenance stage were significantly greater than those of subjects in precontemplation stage. Self-efficacy, barriers, seriousness, and nicotine dependency were not significantly different by the stages of change. Number of signs and symptoms related to smoking which subjects were experiencing were not significant by the stages of change too. Conclusion: Future intervention programs for smoking cessation should be focused on the strategies to enhance the realization of health benefits that patients might acquire from smoking cessation.

  • PDF

관상동맥질환 위험요인, 자율성 지지 및 건강행위 이행이 관상동맥질환자의 재발에 미치는 영향 (Impact of Risk Factors, Autonomy Support and Health Behavior Compliance on the Relapse in Patients with Coronary Artery Disease)

  • 박애란;소향숙;송지은
    • 성인간호학회지
    • /
    • 제29권1호
    • /
    • pp.32-40
    • /
    • 2017
  • Purpose: The purpose of this secondary data analysis was to identify factors influencing a relapse among patients with coronary artery disease (CAD). Methods: Of 250 participants enrolled in the original study 75 were selected as there was no relapse for more than one year following the initial treatment and 54 were selected because there was a relapse. Data were analyzed using ${\chi}^2$ test, t-test or F test to determine if there were any significant differences in the study variables relative to the status of relapse. Predictors were calculated by logistic regression. Results: Autonomy supported by healthcare providers was the significant predictor for relapse in patients with CAD. Patients with low autonomy supported by healthcare providers was 3.91 times more likely to relapse than patients with high autonomy supported. Patients with diabetes were at greater risk of recurrence. Conclusion: Secondary prevention of CAD is a major task for patients with CAD. Behavioral strategies for cardiovascular risk reduction are essential and autonomy supported by healthcare providers should be included in their strategies.

금연 자기효능감 증진 프로그램이 흡연 급성관상동맥증후군 환자에게 미치는 효과 (Effects of the Smoking Cessation Self-efficacy Improvement Program on Smoking Patients after Acute Coronary Syndrome)

  • 윤경순;조숙희
    • 근관절건강학회지
    • /
    • 제24권1호
    • /
    • pp.37-46
    • /
    • 2017
  • Purpose: The purpose of this study was to examine the effects of the program to improve on smoking patients' after acute coronary syndrome (ACS) smoking cessation rate, smoking cessation related self-efficacy, carbone monoxide (CO), nicotine dependence, and pain sense. Methods: This study used a non-equivalent control group pretest-posttest design. The participants of this study were 60 ACS patients: experimental group (30), control group (30), who received percutaneous coronary intervention. The study lasted from Aug 16, 2016 to Jan 13, 2017. Smoking cessation rate, smoking cessation related self-efficacy, CO, nicotine dependence, and pain sense were measured using the structured questionnaires and CO monitor Results: An examination of the effects of this program revealed the experimental group to have a significant increase in smoking cessation rate, smoking cessation related self-efficacy than the control group, and a significant decrease in CO, nicotine dependence and pain sense than in the control group. Conclusion: The findings indicate that this smoking cessation self-efficacy improvement program is effective for hospitalized patients after ACS.