• Title/Summary/Keyword: 관상동맥 중재술

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Clinical Effectiveness of Acupuncture Related to Improvement in Quality of Life and Problems after Percutaneous Coronary Intervention : A Systematic Review (관상동맥 중재술 후 문제점 및 삶의 질 개선에 관한 침 치료 효과 : 체계적 문헌 고찰)

  • Lee, Ji Sung;Park, Ui Hyun;Kwon, Jung-nam
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.33 no.2
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    • pp.82-88
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    • 2019
  • This systematic review evaluates the clinical effectiveness of acupuncture related to improvement in quality of life and problems after Percutaneous Coronary Intervention(PCI). We searched papers in many databases, including National Discovery for Science Leaders(NDSL), Koreanstudies Information Service System(KISS), Oriental Medicine Advanced Searching Integrated System(OASIS), Research Information Sharing Service(RISS), Public/Publisher MEDLINE(Pubmed), Embase, Cochranelibrary, Chinese Academic Journals(CAJ), Japan Science and Technology Agency(J-STAGE). Initially, 161 studies were found. Of these, 141 studies were excluded following abstract screening. After the remaining 20 papers were scanned, 5 RCTs were selected and analyzed. Among these 5 RCTs, HAMD(Hamilton Rating Scale for Depression) is significantly effective in 1 RCT. In 2 RCTs, LVEF(Left Ventricular Ejection Fraction) is significantly effective. In 2 RCTs, 6MWT(Six-Minute Walk Test) is significantly effective. The review of 5 studies suggests that acupuncture after PCI can be effective in many problems occured after PCI. However, This study couldn't conduct a meta-analysis due to the differences in interventions. Therefore, we hope that systematic reviews with meta-analysis will be published.

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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Health Locus of Control and Compliance of Treatment in Acute Coronary Syndrome Patients after Percutaneous Coronary Intervention (관상동맥중재술을 받은 급성관동맥증후군 환자의 건강통제위 및 치료지시이행)

  • Shin, Su-Jin
    • Korean Journal of Adult Nursing
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    • v.20 no.6
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    • pp.829-838
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    • 2008
  • Purpose: The purpose of this study was to explore the differences of health locus of control and treatment compliance according to general characteristics and severity in acute coronary syndrome(ACS) patients after percutaneous coronary intervention. Methods: This descriptive study was conducted with a convenient sample of 103 ACS patients. The dependent variables were measured by the scales for the Multidimensional Health Locus of Control and the Treatment Compliance. The collected data were analyzed by the Fisher's exact test, Chi-square and t-tests, and ANOVA using the SPSS program. Results: Pre-interventional severity was significantly different between men and women. In terms of internal health locus of control, there was a significant difference according to gender, educational status, economic status, and severity. The level of medication compliance was the lowest among the sub-scales of treatment compliance. Conclusion: These findings suggest that clinical nurses should evaluate the general characteristics and severity of the patients with ACS for providing tailored nursing interventions.

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A Case of Continuous Positive Airway Pressure Therapy in a Patient with Central Sleep Apnea and Heart Failure (중추성 수면 무호흡이 동반된 심부전 환자에서 지속적 상기도 양압술 적용 1례)

  • An, Jee Young;Kim, Shin Bum;Kang, Hyeon Hui
    • Sleep Medicine and Psychophysiology
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    • v.24 no.2
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    • pp.118-123
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    • 2017
  • Central sleep apnea (CSA) is a highly prevalent comorbidity in patients with heart failure and may present in 25 to 40 percent of heart failure patients. Continuous positive airway pressure (CPAP) is the primary therapeutic option and effective in treatment of obstructive sleep apnea (OSA). In heart failure patients with CSA, several trials of CPAP showed a number of positive effects in heart failure treatment. A 58-year-old male visited the hospital because of dyspnea and he was diagnosed as heart failure with ischemic heart disease. He underwent coronary angiography and received percutaneous coronary intervention due to stenosis at the middle of left anterior descending coronary artery. However, dyspnea was not completely improved after treatment with percutaneous coronary intervention. The patient also experienced snoring and sleep apnea which worsened with symptom of dyspnea in the recent year. We suspected CSA and the patient underwent polysomnography to confirm whether sleep apnea was present. During the polysomnography, CSA with Cheyne-Stokes respiration (CSR) was observed and apnea-hypopnea index was 45.9/hr. The patient was treated with CPAP. After CPAP treatment, hypoxemia and CSA were resolved and dyspnea was improved with reducing NYHA class. We report a case successfully treated with clinical improvement by presuming CSA in a patient with heart failure.

Change of Serum Levels of C-Reactive Protein After Coronary Angioplasty and Its Effects on Clinical Restenosis (협심증 환자에서 관동맥중재술에 따른 C-reactive Protein의 변화 및 임상경과)

  • Park, Jong-Seon;Hong, Gu-Ru;Lee, Chae-Hoon;Shin, Dong-Gu;Kim, Young-Jo;Shim, Bong-Sup
    • Journal of Yeungnam Medical Science
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    • v.18 no.2
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    • pp.215-225
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    • 2001
  • Background: There are many evidences that inflammation is an important determinant of the development of atherosclerosis and one of the systemic markers of inflammation, C-reactive protein(CRP), is associated with extent of coronary artery disease and risk of coronary events. We assessed the time response of CRP response after coronary angioplasty and it's influence on the clinical restenosis in angina patients. Materials and Methods: Patients included 36 angina patients undergoing single vessel angioplasty. Levels of CRP were measured before and 12, 24, 48, and 72 hours after angioplasty. Clinical restenosis was assessed at 6 months after procedure. Results: Baseline CRP level was $0.30{\pm}0.01$ mg/dL in stable and $0.46{\pm}0.28$ mg/dL in unstable angina patients(p<0.05). After angioplasty, CRP level was increased with peak at 24 hour and persisted to 72 hours after angioplasty. At 24 hour after angioplasty, the magnitude of CRP change was $0.32{\pm}0.31$ mg/dL in stable and $0.79{\pm}0.73$ mg/dL in unstable angina patient(p<0.05). The change of CRP level was not associated with troponin-T after angioplasty. In unstable angina patients, clinical restenosis was developed in 8% of patients with low baseline CRP levels and in 50% of those with high baseline CRP levels more than 0.6 mg/dL(p<0.05). Conclusion: In unstable angina patients, inflammatory response is more increased than stable angina patients, and increased inflammatory response effects on the restenosis after coronary angioplasty.

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Impacts of Diastolic Function on Clinical Outcomes in Young Patients with Acute Myocardial Infarction (젊은 급성 심근경색증 환자에서 좌심실 이완 기능 및 충만압이 관상동맥중재술 후 임상 경과에 미치는 영향)

  • Cho, Eun Young;Jeong, Myung Ho;Yoon, Hyun Ju;Kim, Yong Cheol;Sohn, Seok-Joon;Kim, Min Chul;Sim, Doo Sun;Hong, Young Joon;Kim, Ju Han;Ahn, Youngkeun;Cho, Jae Young;Kim, Kye Hun;Park, Jong Chun
    • The Korean Journal of Medicine
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    • v.93 no.6
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    • pp.538-547
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    • 2018
  • Background/Aims: The impact of left ventricular (LV) diastolic function and filling pressure on clinical outcomes in young patients with acute myocardial infarction (AMI) has been poorly studied. Therefore, the aim of this study was to investigate the impact of LV diastolic function and LV filling pressure on major adverse cardiac events (MACEs) in young patients with AMI. Methods: A total of 200 young patients (males < 45 year, females < 55 year) with AMI were divided into two groups according to the diastolic function; normal (n = 46, $39.5{\pm}5.3$ years) versus abnormal (n = 154, $43.5{\pm}5.1$ years). Results: Despite regional wall motion abnormalities, normal LV diastolic function was not uncommon in young AMI patients (23.0%). During the 40 months of clinical follow-up, MACEs developed in 26 patients (13.0%); 14 re-percutaneous coronary intervention (7.0%), 8 recurrent MI (4.0%), and 4 deaths (2.0%). MACEs did not differ between the normal and abnormal diastolic function group (13.6% vs. 10.9%, p = 0.810), but MACEs were significantly higher in the high LV filling pressure group than the normal LV filling pressure group (36.8% vs. 10.5%, p < 0.001). On multivariate analysis, high LV filling pressure was an independent predictor of MACEs (hazard ratio 3.022, 95% confidence interval 1.200-7.612, p = 0.019). Conclusions: This study suggested that measurement of the LV filling pressure (E/e' ratio) would be useful in the risk stratification of young patients with AMI. However, it would be necessary to monitor this category of patient more carefully.

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.

Transformation of Adult Mesenchymal Stem Cells into Cardiomyocytes with 5-azacytidine: Isolated from the Adipose Tissues of Rat (성체 백서의 지방조직에서 추출한 중간엽 줄기세포의 5-azacytidine을 이용한 심근세포 분화 유도)

  • Choe Ju-Won;Kim Yong-In;Oh Tae-Yun;Cho Dai-Yoon;Sohn Dong-Suep;Lee Tae-Jin
    • Journal of Chest Surgery
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    • v.39 no.7 s.264
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    • pp.511-519
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    • 2006
  • Background: Loss of cardiomyocytes in the myocardial infarction leads to regional contractile dysfunction, and necrotized cardiomyocytes in infracted ventricular tissues are progressively replaced by fibroblasts forming scar tissue. Although cardiomyoplasty, or implantation of ventricular assist device or artificial heart was tried in refractory heart failure, the cardiac transplantation was the only therapeutic modality because these other therapeutic strategies were not permanent. Cell transplantation is tried instead of cardiac transplantation, especially bone marrow is the most popular donated organ. But because bone marrow aspiration procedure is invasive and painful, and it had the fewer amounts of cellular population, the adipose tissue is recommended for harvesting of mesenchymal stem cells. Material and Method: After adipose tissues were extracted from abdominal subcutaneous adipose tissue and intra-abdominal adipose tissue individually, the cellular components were obtained by same method. These cellular components were tried to transformation with the various titers of 5-azacytidine to descript the appropriate concentration of 5-azacytidine and possibility of transformation ability of adipose tissue. Group 1 is abdominal subcutaneous adipose tissue and Group 2 is intra-abdominal adipose tissue-retroperitoneal adipose tissue and omentum. Cellular components were extracted by collagenase and $NH_4Cl$ et al, and these components were cultured by non-induction media - DMEM media containing 10% FBS and inducted by none, $3{\mu}mol/L,\;6{\mu}mol/L,\;and\;9{\mu}mol/L$ 5-azacytidine after the 1st and 2nd subculture. After 4 weeks incubation, tile cell blocks were made, immunostaining was done with the antibodies of CD34, heavy myosin chain, troponin T, and SMA. Result: Immunostaining of the transformed cells for troponin T was positive in the $6{\mu}mol/L\;&\;9{\mu}mol/L$ 5-azacytidine of Group 1 & 2, but CD34 and heavy myosin chain antibodies were negative and SMA antibody was positive in the $3{\mu}mol/L\;&\;6{\mu}mol/L$ 5-azacytidne of Group 2. Conclusion: These observations confirm that adult mesenchymal stem cells isolated from the abdominal subcutaneous adipose tissues and intra-abdominal adipose tissues can be chemically transformed into cardiomyocytes. This can potentially be a source of autologous cells for myocardial repair.

The Developing Trend of Cardiovacular Drug Coated Balloon Catheter (심장혈관용 약물코팅풍선카테터의 개발 동향)

  • Park, Junghun;Jo, Won-Il;Byeon, Dae-Heung;Kang, So Young;Nam, Choong-hyun;Seo, Kyoung-Woo;Park, Jun-Kyu
    • Applied Chemistry for Engineering
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    • v.33 no.5
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    • pp.545-550
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    • 2022
  • As a result of the rapid entry into an aging society and westernized eating habits, the number of heart disease patients caused by angina pectoris, myocardial infarction, and high blood pressure has increased by more than 100,000 over five years. Heart disease has consistently ranked second in the cause of death in Korea over the past eight years, and medical expenses consumed annually reach 6 trillion won. While various treatments are being proposed for more patients, drug-coated balloon catheters have been developed and gradually commercialized to solve the disadvantages of stent implantation such as restenosis and increased risk of bleeding due to long-term double antiplatelet medication. In Korea, it began to use a drug-coated balloon catheter with the first release of it called "SeQuent Please (Bibrown Korea)" in 2010. Its demand increased gradually as insurance benefits were applied in 2012. Drug-coated balloon angioplasty is increasing in use not only in Korea but also around the world, especially in the Asia-Pacific region, including Japan. Until now, the demand for domestic products is increasing, and if the efficiency in vivo and clinical trials is proven in the future, it is expected to be an effective procedure compared to high-risk stent implantation.

Comparison of Efficacy of Overlapped Versus Long Eluting Stent in Acute Myocardial Infarction Patients with Diffuse Long Lesion (미만성 긴 병변이 있는 급성심근경색환자에서 긴 단일 용출 스텐트 시술과 중첩 스텐트 시술의 효과 비교)

  • Kim, Won Hyo;Kim, In Soo;Kong, Chang gi;Han, Jae Bok
    • Journal of the Korean Society of Radiology
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    • v.14 no.3
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    • pp.319-336
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    • 2020
  • The purpose of this study was to compare the outcomes of two interventional methods, overlapping drug-eluting stents (DES) and long DES, for long-term clinical outcomes in patients with acute myocardial infarction (AMI). A total of 438 patients with AMI (65.9±11.0 years, 306 males) from June 2008 to March 2019 who had diffuse long coronary artery lesion, more than 30mm were divided into two groups; group I (overlapped DES group; n=140) and group II (long DES group; n=298). We compared the incidences of major adverse cardiac events [MACEs; cardiac death, myocardial infaction (MI), target lesion revascularization (TLR) and stent thrombosis (ST)] during 12 months between the two groups. Everolimus-eluting stent was more commonly used in group II than in group I (28.1% vs. 51.8% p<0.001). Mean lesion diameter was slightly longer in group II (3.1±0.3mm vs. 3.2±0.3mm, p=0.042), and prevalence of ACC/AHA lesion type C was higher in group I (41.7% vs. 25.4%, p<0.001). Incidences of MACEs during 12 months were higher in group I than group II (18.5% vs. 14.4%, p=0.034). The rates of cardiac death (2.1% vs. 4.4%, p=0.667), MI (5.0% vs. 2.7%, p=0.260) and stent thrombosis rate (0.7% vs. 1.7%, p=0.669) were similar between the two groups. However, TLR rate was higher in group I (10.7% vs. 5.6%, p=0.041). In multivariate logistic regression analysis, presence of diabetes mellitus [Hazard ratio (HR) 2.383, 95% confidence interval (CI) 1.332-4.260, p=0.003] and use of paclitaxel-eluting stent (HR) 2.367, 95% CI 1.371-4.086, p=0.002) were independent predictors of 12-month MACEs, without significant differences in prevalence between the two groups. In AMI patients with diffuse long lesion, TLR rate was higher in the overlapped DES group during 12-month follow-up. Presence of diabetes and use of paclitaxel-eluting stent were independent predictors of MACEs.