• Korean Circulation Journal
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• 제48권11호
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• pp.1000-1001
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• 2018

• Journal of Chest Surgery
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• 제50권4호
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• pp.247-254
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• 2017

Background: Hybrid coronary revascularization (HCR) was developed to combine the advantages of coronary artery bypass graft (CABG) with percutaneous coronary intervention (PCI). However, it is still controversial whether it is more optimal to perform CABG or PCI first. The purpose of this study was to compare the clinical outcomes of these 2 approaches. Methods: Eighty patients who underwent HCR from May 2010 to December 2015 were enrolled in this retrospective analysis. The CABG-first group comprised 12 patients and the PCI-first group comprised 68 patients. Outcomes of interest included in-hospital perioperative factors, major adverse cardiac and cerebrovascular events (MACCEs), and the incidence of repeated revascularization, especially for the target vessel lesion. Results: No significant difference was found in the amount of postoperative bleeding (p=0.239). The incidence of MACCEs was similar between the CABG-first and PCI-first groups (1 of 12 [8.3%] vs. 5 of 68 [7.4%], p>0.999). Repeated revascularization was performed on 3 patients (25%) in the CABG-first and 9 patients (13.2%) in the PCI-first group (p=0.376). Conclusion: There were no significant differences in postoperative and medium-term outcomes between the CABG-first and PCI-first groups. Based on these results, it can be inferred that it is safe to opt for either CABG or PCI as the primary procedure in 2-stage HCR.

• 대한간호학회지
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• 제47권6호
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• pp.756-769
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• 2017

Purpose: To identify the effects of a smart program for the patients who underwent percutaneous coronary intervention (SP-PCI) on coronary disease-related knowledge, health behaviors, and quality of life. Methods: A nonequivalent control group with a non-synchronized design was utilized and 48 participants (experimental=22, control=26) were recruited from a university hospital in Gyeongsang area from May to December, 2016. The 12-week SP-PCI consisted of self-study of health information using smart phone applications (1/week), walking exercise (>5/week) using smart band, feedback using Kakao talk (2/week), and telephone counseling (1/week). Patients in the control group received usual care from their primary health care providers and a brief health education with basic self-management brochure after the PCI. Data were analyzed using the SPSS 21.0 program through descriptive statistics, $x^2$ test, and t-test. Results: After the 12-week SP-PCI, the experimental group showed higher levels of coronary disease-related knowledge (t=2.43, p=.019), heart-related health behaviors (t=5.96, p<.001), regular exercise (Z=-4.47, p<.001), and quality of life-MCS (t=3.04, p=.004) and showed lower levels of stress (Z=-3.53, p<.001) and sodium intake (t=-4.43, p<.001) than those in the control group. There were no significant group differences in medication adherence and food intake in total energy, lipids, and cholesterol. Conclusion: The suggested SP-PCI provided easy access and cost-effective intervention for patients after PCI and improved their knowledge of the disease, performance of health behaviors, and quality of life. Further study with a wider population is needed to evaluate the effects of SP-PCI on disease recurrence and quality of life for patients after PCI.

• 보건행정학회지
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• 제28권2호
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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.

• 보건의료산업학회지
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• 제9권4호
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• pp.105-117
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• 2015

Objectives : The aim of this study was to investigate the relationship among uncertainty, self-care agency and physiological index in acute myocardial infarction (AMI) patients who underwent primary percutaneous coronary intervention. Methods : A total of 196 patients who were admitted C National University Hospital from Oct 2014 to Jun 2015 participated in the study. Data were collected with a questionnaire, and the blood pressure, HgA1C, and lipid profile levels of the patients were acquired. Results : The mean age was 69.2 (${\pm}13.0$) years, and 74 % of the patients were men. The mean score for uncertainty in illness was 48.7 (${\pm}8.8$). The mean score for self-care agency was 73.3 (${\pm}13.4$). Self-care agency showed a negative correlation with uncertainty (r=-.579, p<.001), age (r=-.732, p<.001), systolic blood pressure (r=-.265, p=.001) and HgA1C (r=-.293, p<.001). Conclusions : The results of this study can be used to develop a nursing program that prevents AMI and to improve the clinical prognosis of AMI patients.

• 한국임상약학회지
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• 제26권3호
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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.

• 대한한방내과학회지
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• 제44권3호
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• pp.387-401
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• 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.

• Journal of Yeungnam Medical Science
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• 제34권2호
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• pp.191-199
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• 2017

Background: This study was conducted to provide a comparison between the clinical outcomes of primary percutaneous coronary intervention (PCI) and that of fibrinolysis followed by routine invasive treatment in ST elevation myocardial infarction (STEMI). Methods: A total of 184 consecutive STEMI patients who underwent primary PCI or fibrinolysis followed by a routine invasive therapy were enrolled from 2004 to 2011, and their major adverse cardiovascular events (MACEs) were compared. Results: Among the 184 patients, 146 patients received primary PCI and 38 patients received fibrinolysis. The baseline clinical characteristics were similar between both groups, except for triglyceride level ($68.1{\pm}66.62$ vs. $141.6{\pm}154.3mg/dL$, p=0.007) and high density lipoprotein level ($44.6{\pm}10.3$ vs. $39.5{\pm}8.1mg/dL$, p=0.005). The initial creatine kinase-MB level was higher in the primary PCI group ($71.5{\pm}114.2$ vs. $35.9{\pm}59.9ng/mL$, p=0.010). The proportion of pre-thrombolysis in MI 0 to 2 flow lesions (92.9% vs. 73.0%, p<0.001) was higher and glycoprotein IIb/IIIa inhibitors were administered more frequently in the primary PCI group. There was no difference in the 12-month clinical outcomes, including all-cause mortality (9.9% vs. 8.8%, p=0.896), cardiac death (7.8% vs. 5.9%, p=0.845), non-fatal MI (1.4% vs. 2.9%, p=0.539), target lesion revascularization (5.7% vs. 2.9%, p=0.517), and stroke (0% vs. 0%). The MACEs free survival rate was similar for both groups (odds ratio, 0.792; 95% confidence interval, 0.317-1.980; p=0.618). The clinical outcome of thrombolysis was not inferior, even when compared with primary PCI performed within 90 minutes. Conclusion: Early fibrinolysis with optimal antiplatelet and antithrombotic therapy followed by appropriate invasive procedure would be a comparable alternative to treatment of MI, especially in cases of shorter-symptom-to-door time.

• 한국콘텐츠학회논문지
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• 제14권5호
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• pp.251-261
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• 2014

본 연구는 일차적인 경피적 관상동맥 중재술(percutaneous coronary intervention, PCI)를 시술 받은 65세 이상의 고령 환자들에서 임상적 특성, 관상동맥 병변 및 중재술의 특성, 병원 내 및 1년 사망률과 주요심장사건(major adverse cardiac events, MACE)의 발생에 대해 알아보고자 하였다. 2006년 1월 1일부터 2010년 12월 30일까지 모 대학병원 심혈관센터에서 급성 심근경색증으로 진단받고 흉통 발생 12시간 이내 관상동맥 조영술 및 일차적 PCI를 시행 받은 환자 1,974예를 대상으로 하였고, 65세 이상의 I군(1,018예, 연령 $73.8{\pm}5.99$세, 남자 : 여자 = 574 : 821)과 65세 이하의 II군(956예, 연령 $52.8{\pm}7.96$세, 남자 : 여자 = 444 : 135)으로 나누어 분석하였다. 심혈관질환의 위험인자는 I군에서 더 높았고, 흡연력, 고지혈증, 가족력은 II군에서 높았다. PCI 표적 병변은 I군에서 좌주관지(2.7 vs. 1.6%, p=0.007)가 유의하게 많았으며, 다혈관병변(54.5 vs. 41.0%, p<0.001)도 I군에서 많았다. 병원 내 사망(8.4 vs. 1.9%)과 MACE(20.1 vs. 14.0%)는 I군에서 많이 관찰되었다(p<0.001). 로지스틱 다중회귀분석 결과 65세 이상 고령 환자에서 1년 사망률에 영향을 미치는 독립적인 인자는 내원 시 혈중 creatinine 1.3 mg/dL 이상, 뇌혈관 질환, 수축기 혈압<100 mmHg, Killip class II 이상, 다혈관 질환, 그리고 좌심실 구혈률 <40%로 나타났다.

• 대한핵의학회지
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• 제39권2호
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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.