• Title/Summary/Keyword: PCI: Percutaneous Coronary Intervention

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CT Angiography-Derived RECHARGE Score Predicts Successful Percutaneous Coronary Intervention in Patients with Chronic Total Occlusion

  • Jiahui Li;Rui Wang;Christian Tesche;U. Joseph Schoepf;Jonathan T. Pannell;Yi He;Rongchong Huang;Yalei Chen;Jianan Li;Xiantao Song
    • Korean Journal of Radiology
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    • v.22 no.5
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    • pp.697-705
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    • 2021
  • Objective: To investigate the feasibility and the accuracy of the coronary CT angiography (CCTA)-derived Registry of Crossboss and Hybrid procedures in France, the Netherlands, Belgium and United Kingdom (RECHARGE) score (RECHARGECCTA) for the prediction of procedural success and 30-minutes guidewire crossing in percutaneous coronary intervention (PCI) for chronic total occlusion (CTO). Materials and Methods: One hundred and twenty-four consecutive patients (mean age, 54 years; 79% male) with 131 CTO lesions who underwent CCTA before catheter angiography (CA) with CTO-PCI were retrospectively enrolled in this study. The RECHARGECCTA scores were calculated and compared with RECHARGECA and other CTA-based prediction scores, including Multicenter CTO Registry of Japan (J-CTO), CT Registry of CTO Revascularisation (CT-RECTOR), and Korean Multicenter CTO CT Registry (KCCT) scores. Results: The procedural success rate of the CTO-PCI procedures was 72%, and 61% of cases achieved the 30-minutes wire crossing. No significant difference was observed between the RECHARGECCTA score and the RECHARGECA score for procedural success (median 2 vs. median 2, p = 0.084). However, the RECHARGECCTA score was higher than the RECHARGECA score for the 30-minutes wire crossing (median 2 vs. median 1.5, p = 0.001). The areas under the curve (AUCs) of the RECHARGECCTA and RECHARGECA scores for predicting procedural success showed no statistical significance (0.718 vs. 0.757, p = 0.655). The sensitivity, specificity, positive predictive value, and the negative predictive value of the RECHARGECCTA scores of ≤ 2 for predictive procedural success were 78%, 60%, 43%, and 87%, respectively. The RECHARGECCTA score showed a discriminative performance that was comparable to those of the other CTA-based prediction scores (AUC = 0.718 vs. 0.665-0.717, all p > 0.05). Conclusion: The non-invasive RECHARGECCTA score performs better than the invasive determination for the prediction of the 30-minutes wire crossing of CTO-PCI. However, the RECHARGECCTA score may not replace other CTA-based prediction scores for predicting CTO-PCI success.

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.

Effect of Cardiopulmonary Physiotherapy on Patients With Percutaneous Coronary Intervention - Systematic Review and Meta-Analysis (경피적 관상동맥 중재술을 받은 환자를 대상으로 심장호흡물리치료에 대한 효과 - 체계적 고찰과 메타분석)

  • Kang, Na-yoon;Park, Beom-seok;Kim, Min-hee
    • Journal of the Korean Society of Physical Medicine
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    • v.14 no.1
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    • pp.63-73
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    • 2019
  • PURPOSE: This study examined the effects of cardiopulmonary physiotherapy on the cardiopulmonary function, metabolism, inflammatory markers, and quality of life in patients with coronary artery disease who underwent percutaneous coronary intervention (PCI). METHODS: Electronic bibliographic databases of a regional information sharing system (RISS) and PubMed were searched to identify studies with randomized and non-randomized controlled trials. As the final outcome, 320 publications were identified and 18 studies met the inclusion and exclusion criteria. All studies were assessed for the quality of study using Cochrane's risk of bias. RESULTS: Sixteen studies met the inclusion criteria, in which meta-analysis had been conducted to examine the effectiveness of cardiopulmonary physiotherapy on the cardiopulmonary function, metabolism, inflammatory markers, and quality of life in patients undergoing PCI. Meta-analysis based on a random effect model showed that the cardiopulmonary physiotherapy was beneficial in improving the cardiopulmonary function, metabolism, inflammatory markers, and quality of life. In particular, there was a significant effect on the peak oxygen uptake (effect size 5.30%; 95% confidence interval 3.62~6.97). Cardiopulmonary physiotherapy for a during period of 6 weeks or more was effective in significantly improving the cardiopulmonary function and metabolism function in a subgroup analysis, but cardiopulmonary physiotherapy for less than 6 weeks was not effective. CONCLUSION: Cardiopulmonary physiotherapy has positive effects on the cardiopulmonary function, metabolism, inflammatory markers, and quality of life in patients undergoing PCI.

The Effect of Hand Massage on Discomfort in Patients Following Percutaneous Coronary Intervention (손마사지가 경피적관상동맥중재술 환자의 불편감에 미치는 효과)

  • Kim, Yeo-Jin;Chung, Seung-Hee;Suh, In-Sun
    • Korean Journal of Adult Nursing
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    • v.20 no.3
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    • pp.452-460
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    • 2008
  • Purpose: This study assessed the effectiveness of hand massage on reducing discomfort of patients undergoing percutaneous coronary intervention(PCI). Methods: The sample consisted of 62 patients admitted to an university affiliated hospital. The 30 patients in experimental group received hand massage developed by Snyder(1995) for 5 minutes on both hands and 32 patients in control group received the usual nursing intervention only. The outcome variable of discomfort was measured 10 minutes before and after the hand massage using Questionnaire and VAS. The data were collected from Feb. 5th to May 17th in 2007, and analysed through Chi-square, and t-test with SPSS WIN 12.0. Results: The level of discomfort measured with the questionnaire was decreased in experimental group, but increased in control group. This discomfort changes in two groups were significantly different(t=4.43, p<.001). The level of discomfort measured with VAS was also decreased in experimental group, but increased in control group. The changes were significant, too(t=5.62, p<.001). Conclusion: It was clear that hand massage could be a useful nursing intervention in reducing the discomfort of patients undergoing PCI.

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Updates in the Management of Coronary Artery Disease (관동맥질환 치료의 최신 지견)

  • Yang, Dong-Heon;Chae, Shung-Chull
    • The Korean Journal of Nuclear Medicine
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    • v.39 no.2
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    • pp.87-93
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    • 2005
  • Coronary artery disease (CAD) has been increasing during the last decade and is the one of major causes of death. The management of patients with coronary artery disease has evolved considerably. There are two main strategies in the management of CAD, complementary, not competitive, each other; the pharmacologic therapy to prevent and treat CAD and the percutaneous coronary Intervention (PCI) to restore coronary flow. Antiplatelet drugs and cholesterol lowering drugs have central roles in pharmacotherapy. Drug eluting stent (DES) bring about revolutional changes in PCI. In the management of patients with 57 segment elevation acute myocardial infarction (AMI), there has been a debate on the better strategy for the restoration of coronary flow. Thrombolytic therapy is widely available and easy to administer, whereas primary PCI is less available and more complex, but mote complete. Recently published evidences in the pharmacologic therapy including antiplatelet and stalin, and PCI including DES and reperfusion therapy in patients with ST segment elevation AMI were reviewed.

Comparison of Health Behaviors and Health Indices According to Percutaneous Coronary Intervention in Patients with Chest Pain -Analysis of Nursing Information Chart and Electronic Medical Record- (흉통환자의 관상동맥중재술 시행 여부에 따른 건강행위 및 건강지표 비교 - 간호정보조사지와 전자의무기록 분석-)

  • Kweon, Mi-Soo;Lee, Sook-Jeong
    • The Journal of the Korea Contents Association
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    • v.19 no.12
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    • pp.279-288
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    • 2019
  • The purpose of this study was to compare the health behaviors and health indices according to whether a percutaneous coronary intervention(PCI) was performed due to chest pain. This is a secondary data analysis study of nursing information questionnaires and electronic medical records of 247 chest pain patients in a hospital from January 2010 to December 2017. The participants were divided into non-PCI and PCI groups, and the health behaviors, blood pressure, and blood lipid levels were collected at the first hospital admission and re-admission. Collected data were analyzed using SPSS 24.0. As a result of the study, smoking and lipid levels were significantly healthier than the participants in PCI group during re-hospitalization. Non-PCI group had a high risk of smoking despite the high risk of coronary artery stenosis. It was found that continuous integrated management to promote health behavior is needed. The significance of this study was to identify the importance of health behavior in patients with the risk of cardiovascular disease.

Functional Status, Hostility, and Social Support in Patients with Percutaneous Coronary Intervention (관상동맥중재술 대상자의 신체적 기능상태, 적대성향, 사회적지지에 관한 연구)

  • Kim, Jiyoung;Kim, Oksoo
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.8
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    • pp.226-235
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    • 2016
  • The purpose of this study was to determine the relationships among the functional status, hostility, and social support in patients with percutaneous coronary intervention (PCI). The subjects were comprised of 135 patients who had received PCI from two general hospitals in Seoul, Korea. The functional status differed significantly according to gender (t=5.880, p<0.001), age (F=23.620, p<0.001), education (F=17.718, p<0.001), occupation (t=-6.498, p<0.001), monthly income (F=7.237, p<0.001), and smoking (t=2.327, p=0.025). The hostility differed significantly according to age (F=6.150, p=0.001), period after PCI (F=6.141, p=0.001), and family history (t=2.514, p=0.013). Differences were observed in the scores for social support according to age (F=2.866, p=0.039) and education (F=5.136, p=0.002). Significant positive correlations were found among functional status and social support (r=.20, p=0.025), friends support (r=.22, p=0.010) and a significant negative correlation between functional status and hostility (r=-.24, p=0.005). A significant negative correlation was found between hostility and friends support (r=-.17, p=0.046). Nurses should consider the characteristics of patients who have undergone PCI and develop nursing intervention programs to improve their functional status, hostility, and social support.

The Effects of Exercise-based Cardiac Rehabilitation Phase II on Pro- and Anti-inflammatory Markers in Patients with Acute Coronary Syndrome

  • Kim, Al-Chan;Oh, Jae-Keun;Shin, Kyung-Ah;Kim, Young-Joo
    • Biomedical Science Letters
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    • v.19 no.1
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    • pp.61-69
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    • 2013
  • The aim of this study was to evaluate the effect of exercise-based cardiac rehabilitation on pro- and anti-inflammatory markers in patients with acute coronary syndrome (ACS). ACS patients who underwent percutaneous coronary intervention (PCI) and took medicine during phase II of rehabilitation were recruited for study. Subjects were divided into two groups; exercise group (EX, n=21) and a non-exercise group (non-EX, n=13). Supervised exercise program in hospital consisted of treadmill and bicycle exercise was performed three times per week for 6 weeks. Patients of EX received individual counseling, including knowledge of heart disease, risk factor modification, and physical training. Cardiopulmonary fitness, body composition, and biochemical blood factors were analyzed before and after experiment. There was no significant difference in serum levels of hs-CRP and TGF-${\beta}1$ between groups, and between time intervals. But there was a significant decrease in serum levels of IL-18 (P<.001). And there was a significant increase in ratio of IL-18 to IL-10 (P<.01) and serum levels of IL-10 (P<.001). After cardiac rehabilitation, there was significant increase in exercise duration (P<.001), maximal oxygen uptake ($VO_{2peak}$; P<.001) and decrease in submaximal rate-pressure product (sRPP; P<.05) in EX. In conclusion, exercise-based cardiac rehabilitation during phase II in patients with ACS after PCI decreased serum IL-18 (pro-inflammatory) content and ratio of IL-18 to IL-10 in serum (highly related with disease recurrence), and increased serum IL-10 (anti-inflammatory) content. In addition, it led to improved cardiopulmonary fitness.

Effect of Triple Compared to Dual Antiplatelet Therapy After Drug-Eluting Stent Implantation in Percutaneous Coronary Intervention (관상동맥 약물 용출 스텐트 삽입 후 항혈소판제제 3제요법과 2제요법의 임상적 효과 비교)

  • Ye, Kyong-Nam;Kim, Jeong-Tae;Lee, Suk-Hyang
    • Korean Journal of Clinical Pharmacy
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    • v.22 no.2
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    • pp.113-122
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    • 2012
  • ACC/AHA/SCAI Guideline recommends for administration dual antiplatelet therapy after drug-eluting stent (DES) to prevent restenosis and stent thrombosis in patients with percutaneous coronary intervention (PCI). Recently triple antiplatelet therapy including cilostazol is known to reduce restenosis and stent thrombosis significantly after DES implantation. However, there is lack of data providing the efficacy of triple antiplatelet therapy. The purpose of this study is to evaluate the clinical effects of the triple therapy after DES implantation compared with the dual therapy. This retrospective study collected data from medical charts of 251 patients who received DES implantation between Jul 2006 and Jun 2008. They received either dual antiplatelet therapy (N = 154 clopidogrel and aspirin; Dual group) or triple antiplatelet therapy (N = 97 cliostazol, clopidogrel and aspirin; Triple group). Major adverse cardiac event rates (MACE, included total death, myocardial infarction, target lesion revascularization) at 12 months, 24 months, stent thrombosis, rates of bleeding complications and adverse drug reactions were compared between these two groups. Compared with the dual group, the triple group had a similar incidence of the MACE rates at 24months (12.3% vs. 12.4%, p = 0.99). There is no difference in overall stent thrombosis between two groups (Dual group 2.6% vs. Triple group 4.1%, p = 0.5). Subgroup analysis showed that diabetic patients got more benefit in reducing MACE rates but, there is no statistical difference. Bleeding complications and adverse drug effects were not different significantly. As compared with dual antiplatelet therapy, triple antiplatelet therapy did not reduce the 12-months, 24-months MACE rates and stent thrombosis. Bleeding complications and adverse drug effects were not different.

Case Report of Korean Medical Treatment of Chest Pain After Percutaneous Coronary Intervention (경피적관상동맥중재술을 시행한 후 발생한 흉통(胸痛)에 대한 한방치료 1례)

  • Min, Seon-woo;Kim, Hak-kyeom;Moon, Ji-seong;Kim, Ye-seul;Park, Ji-yoon;Jeong, Ji-cheon
    • The Journal of Internal Korean Medicine
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    • v.42 no.2
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    • pp.184-196
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    • 2021
  • Objectives: This case report presents the effects of Korean medical treatment in a patient with chest pain after percutaneous coronary intervention (PCI). Methods: An 80-year-old woman was treated with Korean herbal medicine, acupuncture, and cupping therapy. Chest pain, sore tongue, and headache were assessed daily using a numeric rating scale (NRS). Results: After 15 days of treatment, chest pain disappeared, as reflected by an NRS change from 9 to 0, and headache was relieved (NRS decreased from 9 to 2). On the eighth day of treatment, the sore tongue was also relieved, as reflected by an NRS change from 9 to 0. Conclusion: These results show that chest pain after PCI can be relieved with Korean medical treatment, and it is expected that major adverse cardiac events (MACEs) may be prevented with Korean medical treatment. However, additional well-designed studies are required to confirm these findings.