• Title/Summary/Keyword: Coronary intervention

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Radiation Dose and Estimate of Lifetime Attributable Risk of Cancer from Coronary Angiography and Percutaneous Coronary Intervention (관상동맥조영술과 경피적관상동맥중재술에서 환자 선량과 암 발생 생애귀속위험 평가)

  • Kang, Yeong-Han;Kim, Bu-Sun;Park, Jong-Sam
    • Journal of radiological science and technology
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    • v.33 no.3
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    • pp.213-221
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    • 2010
  • The Purpose of this study was to determine the effective dose to an average patient from Coronary Angiography (CA) and Percutaneous Coronary Intervention (PCI). And to estimate the lifetime attributable risk (LAR) of cancer associated with radiation exposure from CA and PCI. The dose-area product (DAP) values to the patient were recorded from 60 CA and 58 PCI. A Monte Carlo based program PCXMC was used to calculate the effective dose from DAP values for each patient. Lifetime attributable risks were estimated with models developed in the National Academies' Biological Effects of Ionizing Radiation VII report. The mean DAP values was $53.76\;Gy{\cdot}cm^2$ for CA and $165.82\;Gy{\cdot}cm^2$ for PCI. Mean effective dose were 1.28 mSv in CA, 3.94 mSv in PCI. Results of Calculate organ dose, lung doses was 2.17 mSv in CA and 6.71 mSv in PCI. Female breast doses was 5.45 mSv in CA and 16.82 mSv in PCI. LAR estimates for CA varied from 1 in 1,508 for man to 1 in 1,357 for women. In PCI procedure varied from 1 in 553 for man to 1 in 482 for women. DAP can be used as the dose indicator to calculate the organ dose and effective dose of patient based on Monte Carlo simulation. These dose estimates derived from our simulation models suggest that CA and PCI are associated with a nonnegligible LAR of cancer. This risk varies markedly and is considerably greater for women, PCI than for man, CA.

The Prevalence of Cardiovascular Disease Risk Factors and the Framingham Risk Score in Patients Undergoing Percutaneous Intervention Over the Last 17 Years by Gender: Time-trend Analysis From the Mayo Clinic PCI Registry

  • Lee, Moo-Sik;Flammer, Andreas J.;Kim, Hyun-Soo;Hong, Jee-Young;Li, Jing;Lennon, Ryan J.;Lerman, Amir
    • Journal of Preventive Medicine and Public Health
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    • v.47 no.4
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    • pp.216-229
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    • 2014
  • Objectives: This study aims to investigate trends of cardiovascular disease (CVD) risk factor profiles over 17 years in percutaneous coronary intervention (PCI) patients at the Mayo Clinic. Methods: We performed a time-trend analysis within the Mayo Clinic PCI Registry from 1994 to 2010. Results were the incidence and prevalence of CVD risk factors as estimate by the Framingham risk score. Results: Between 1994 and 2010, 25 519 patients underwent a PCI. During the time assessed, the mean age at PCI became older, but the gender distribution did not change. A significant trend towards higher body mass index and more prevalent hypercholesterolemia, hypertension, and diabetes was found over time. The prevalence of current smokers remained unchanged. The prevalence of ever-smokers decreased among males, but increased among females. However, overall CVD risk according to the Framingham risk score (FRS) and 10-year CVD risk significantly decreased. The use of most of medications elevated from 1994 to 2010, except for ${\beta}$-blockers and angiotensin converting enzyme inhibitors decreased after 2007 and 2006 in both baseline and discharge, respectively. Conclusions: Most of the major risk factors improved and the FRS and 10-year CVD risk declined in this population of PCI patients. However, obesity, history of hypercholesterolemia, hypertension, diabetes, and medication use increased substantially. Improvements to blood pressure and lipid profile management because of medication use may have influenced the positive trends.

The effects of cold therapy on pain related to chest tube removal in patients with coronary artery bypass graft surgery (냉요법 적용이 관상동맥 우회술 환자의 흉관 제거시 통증에 미치는 효과)

  • Jeon, Mi-Kyeong;Kim, Keum-Soon
    • Journal of Korean Critical Care Nursing
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    • v.1 no.1
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    • pp.33-45
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    • 2008
  • Purpose: Patients who underwent a coronary artery bypass graft surgery(CABG) experienced the unpleasant emotions and discomfort when their chest tube was removed. The purpose of this study was to evaluate the effects of cold therapy on pain related to chest tube removal(CTR) in CABG patients. Methods: Fifty adult patients undergoing CABG were recruited in a prospective, double blinded study. Subjects were divided into the experimental group and the control group considering their sex and age. The pretest data were obtained 20 minutes before CTR. Patients in the experimental group, received cold therapy for 10 minutes before CTR. Pain sense and intensity were determined immediately after CTR and at 10 minutes after CTR. Results: The total score of pain sense immediately after CTR of the experimental group was significantly lower than that of the control group(t=-3.703, p=.003). And scores of pain intensity immediately after CTR in the experimental group were significantly lower than that of the control group(t=-3.073, p=.001). But, there was no significant difference in the score of pain intensity 10 minutes after CTR between the experimental and the control group(t=1.759, p=.085). Conclusion: The cold therapy would be recommended as an effective and nonpharmacologic nursing intervention for relieving pain in patients undergoing CTR.

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A Study on Food Intake and Family Support in Patients with Coronary Artery Disease (관상동맥질환자의 식품섭취와 가족지지)

  • Lee, Sun-Ja;Kim, Aee-Lee;Lee, Young-Hee
    • Korean Journal of Adult Nursing
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    • v.21 no.1
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    • pp.1-12
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    • 2009
  • Purpose: This study was to examine the food intake and family support of patients with Coronary Artery Disease(CAD). Methods: 90 hospitalized patients who received CAD medical treatment were randomly selected. The food intake frequency and family support instrument were utilized. Collected data was analyzed by SPSS/WIN 14.0: t-test, $x^2$-test and Pearson's correlation coefficient. Results: The mean score of food intake frequency was 5.65(total mean score 97.50) which was relatively healthy food intake based on the CAD treatment guidelines. Undesirable food intake items were fruit, fish, milk etc. The mean score of family support was 2.44(range: 1 - 4). Food intake showed a significant(p < .001) positive correlation with family support. There was significant difference(p < .05) on family support according to exercise. There was significant difference(p < .05) on LDL level, one of the CAD risk factors, between first admission patients and readmission patients. Conclusion: These findings suggest that nursing intervention education programs should be developed to appropriately care for CHD patients for needed changes.

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The Mediating Effect of the Resilience on the Relationship between Type D Personality and Compliance in Patients with Coronary Artery Disease (관상동맥질환자의 D유형 성격과 치료지시이행의 관계에 미치는 극복력의 매개효과)

  • Cheon, Mi Young;Kang, Jiyeon
    • Korean Journal of Adult Nursing
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    • v.28 no.1
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    • pp.61-70
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    • 2016
  • Purpose: This study aimed to identify the mediating effect of the resilience on the relationship between type D personality and compliance of Coronary Artery Disease (CAD) patients. Methods: The subjects were 236 CAD patients who visited the cardiology outpatient clinics of D University Medical Center in B City in Korea. The type D personality, resilience, and compliance of subjects were measured using structured questionnaires from July to August, 2014. The mediating effect was analyzed by a multiple hierarchical regression. Results: The subjects with type D personality accounted for 30.9% of all study subjects. The resilience and compliance of type D subjects were significantly lower than those of non type D subjects. There was a significant correlation between resilience and compliance. The direct effect of type D personality on compliance was not significant (${\beta}=-.07$, p=.243), while the indirect effect of type D personality on compliance via resilience was significant (${\beta}=.23$, p<.001). Conclusion: On the basis of above results, it can be concluded that the resilience had completely mediating effect on the relation between type D personality and compliance of CAD patients. Further studies need to be done to develop the intervention enhancing resilience of CAD patients with Type D personality.

Chest pain of unstable angina treated with oriental medicine therapies: A case report (불안전 협심증을 진단받은 환자의 흉통 한방 치험 1례)

  • Kim, Myung-ho;Ahn, Lib;Choi, Dong-jun
    • The Journal of the Society of Stroke on Korean Medicine
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    • v.15 no.1
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    • pp.72-79
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    • 2014
  • A 44-year-old male complained of chest pain. Two years ago he was diagnosed with angina pectoris for stenosis of coronary artery in coronary angiography. Despite of medication, his chest pain aggravated to cardiovascular society classification class III. His electrocardiogram, cardiac enzymes were normal. Accordingly we diagnosed him with unstable angina. And we pattern differentiated him with heart heat syndrome considering his other symptoms. He wanted conservative care instead of coronary artery intervention generally recommended for treating unstable angina. We treated him for 13-days with tongxinluo, modified daochi-san, acupuncture, smoking prohibition which were thought to be effective for treating unstable angina based on experimental, clinical studies. Within the therapeutic period, frequency of chest pain and frequency of taking nitroglycerin were on the decrease.

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Cardiovascular complications after Kawasaki disease and its management (가와사끼병의 심혈관계 합병증 및 치료)

  • Jang, Gi Young
    • Clinical and Experimental Pediatrics
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    • v.51 no.5
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    • pp.462-467
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    • 2008
  • Kawasaki disease is a systemic vasculitis of unknown etiology, usually occurring in infants and young children. Although the etiology of Kawasaki disease remains uncertain, its serious complicationssuch as giant aneurysm formation, coronary arterial stenotic lesions, and thrombotic occlusionhave been proven to cause myocardial ischemia or infarction in patients with Kawasaki disease. To prevent and treat these complications, several modes of therapyincluding long-term anticoagulation, interventional catheterization, and surgical treatmenthave been gradually developed. In this article, we review the cardiovascular complications following Kawasaki disease and the management thereof, which includes thrombolytic therapy, catheter intervention, and coronary artery bypass graft.

Cognitive-behavioral Approach to Patients with Cardiovascular Diseases (심장혈관계 질환 환자들에 대한 인지행동적 접근)

  • Koh, Kyung-Bong
    • Korean Journal of Psychosomatic Medicine
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    • v.3 no.2
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    • pp.185-196
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    • 1995
  • The author reviewed cognitive-behavioral approach to A type behavior pattern and hypertension which are known to be risk factors for coronary heart diseases. Those cognitive distortions frequently found in persons with A type behavior include all-nothing thinking, selective attention, personalization, and attribution of causality. Cognitive-behavioral techniques were also described, which can be applied to management of each characteristic of A type behavior pattern such as time urgency, perfectionism, achievement striving, low self-esteem, excessive work involvement, hostility, and depression. Cognitive-behavioral intervention for hypertension might help the patients to recognize and monitor anger-engendering conflicts, identify characteristic styles of responding, and experiment with alternative ways of managing conflict and anger. Since different features predominate in different individuals, it is necessary to develop treatment plan on the basis of individual characteristics and problems.

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Long-term Clinical Outcomes after Primary Percutaneous Coronary Intervention in Patients with Acute Myocardial Infarction-on the basis of 65 Years (급성 심근경색증 환자에서 일차적 관상동맥 중재술 후 장기적 임상 경과-65세를 기준으로)

  • Lee, Han-Ol;Jang, Seong-Joo;Kim, In-Soo;Han, Jae-Bok;Park, Soo-Hwan;Kim, Jeong-Hun;Jang, Young-Ill
    • The Journal of the Korea Contents Association
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    • v.14 no.5
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    • pp.251-261
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    • 2014
  • Primary percutaneous coronary intervention (PCI) has been found to be superior, in terms of hospital mortality and long-term outcome, compared with thrombolytic therapy in patients with acute myocardial infarction (AMI). However, the clinical benefits of primary PCI have not been precisely evaluated in elderly patients.1,974 patients (Group I: n=1,018, $age{\geq}65years$, $73.8{\pm}5.99years$; Group II: n=956, age<65years, $52.8{\pm}7.96years$) who underwent primary PCI for AMI at Chonnam National University Hospital between 2006 and 2010 were analyzed according to their clinical, angiographic characteristics for hospital and one-year survival. Group I had a higher percentage of women, diabetes mellitus, hypertension, multi-vessel disease and lower prevalence of current smoking, hyperlipidemia, familial history than Group II. Culprit lesions were at the left anterior descending artery, left circumflex artery, right coronary artery and left main artery in 42.8% vs. 45.0%, 34.1% vs. 29.6%, 14.6% vs 14.6, 2.7% vs. 1.6%, respectively (p=0.007). Stent diameter was smaller in group I ($3.17{\pm}0.39$ vs. $3.29{\pm}0.42mm$, p=0.001). In-hospital mortality was higher in group I (8.4 vs. 1.9%, p<0.001). There were significant differences in the rates of major adverse cardiac events between the two groups during one-year clinical follow-up (20.1 vs.14.0%, p<0.001). On multiple logistic regression analysis, systolic blood pressure<100mmHg, serum $creatinine{\geq}1.3mg/dL$, Killip class> I, multivessel disease, left ventricular ejection fraction <40% and cerebro vascular disease were independent predictors of one-year motality in patients over 65 years after PCI.

Beta Blockers or Calcium Channel Blockers as Primary Antianginal Drug after Percutaneous Coronary Intervention: Prescription Pattern and its association with Clinical Outcome (관상동맥중재술 전후 주요 항협심증 약제로서의 베타차단제와 칼슘채널차단제: 처방패턴 및 임상결과에 미치는 영향)

  • Noh, Sun Young;Jo, Yun Hee;Cho, Yoon Sook;Hahn, Hyeon Joo;Lee, Hae-Young;Lee, Ju-Yeun
    • Korean Journal of Clinical Pharmacy
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    • v.26 no.3
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    • pp.213-219
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    • 2016
  • Objective: Although guideline recommends beta blockers (BBs) as first line antianginal agent and calcium channel blockers (CCBs) as alternatives after percutaneous coronary intervention (PCI), the prescription patterns in real practice are not in accordance with the guideline. We aimed to investigate the prescribing patterns of primary antianginal drug and relating factors in patients who underwent PCI. Methods: Patients who have undergone PCI without myocardial infarction (MI) from November 2012 to June 2014 and followed up at least one year in a tertiary teaching hospital were included. Prescribing patterns of primary antianginal drug before, at the time of, and one year after PCI were described. Factors affecting drug selection, and their relationship with incidence of clinical outcomes defined as MI and repeated PCI, unscheduled admission or visit related with heart problem were analyzed with multivariate logistic regression. Results: A total of 506 patients were included and as primary antianginal drugs, BB, CCB, and both were prescribed in 32.2%, 24.5%, and 17.8% of patients, respectively. Also, neither BB nor CCB was prescribed at the time of PCI in 25.5% of patients. Compared with BB, CCBs were more likely prescribed in patients who had hypertension (Odds Ratio, OR 2.18, 95% confidence interval, CI 1.16-4.07), use of same class before PCI (OR 7.18, 3.37-15.2) and concomitant angiotensin receptor blocker (ARB) use (OR, 1.92, 95% CI 1.10-3.33). Incidence of clinical outcomes were not significantly greater in patients who prescribed CCB compared with BB at the time of PCI (aOR 1.32, CI 0.65-2.68). Conclusion: This study demonstrated that half of the patients who underwent PCI were prescribed BB. CCB were favored in patients with hypertension, use of same class before PCI, and concomitant ARB use. Significant difference in clinical outcome was not observed between BB and CCB selection as primary antianginal drug.