• Title/Summary/Keyword: Coronary diseases

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Surgical Result of Coronary Artery Bypass Grafting - The Effect of Pre and Intraoperative Procedures (관동맥 우회술의 수술성적-수술전 처치 및 수술수기의 영향에 관한 연구)

  • Kim, Young-Tae;Hong, Jong-Myun;Chae, Hurn
    • Journal of Chest Surgery
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    • v.26 no.2
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    • pp.141-147
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    • 1993
  • A total of 40 patients having a diagnosis of atherosclerotic coronary arterial disease were analysed on the operative outcomes according to variables as follows: 1) preoperative risk factors such as age, sex, CCS (Canadian Cardiovascular Society) functional class, type of angina, number of diseased vessel, presence of left main coronary artery stenosis, previous history of habitual smoking and presence of other medical diseases (diabetes mellitus, essential hypertension), 2) preoperative management such as intravenous infusion of nitroglycerine, preoperative IABP (intra-aortic balloon pump) support and whether the operation was scheduled as emergency or not, 3) intraoperative variables such as infusion method and composition of cardioplegic solutions, number of distal anastomosis, use of internal mammary artery, total cardiopulmonary bypass time and total cross clamp time. Complications included operative death in 12.5%, perioperative myocardial infarction in 25.0% and perioperative arrhythmia in 17.5%. Nineteen perioperative variables were analyzed to identify risk factors for these end points. For operative death, presence of left main coronary artery stenosis (p = 0.056) and cardiopulmonary bypass time (p = 0.029) were significant in the univariate analysis, but presence of left main coronary artery lesion (p = 0.011, $\chi$$^2$= 6.45) and abscence of preoperative of IABP support (p = 0.069, $\chi$$^2$ = 3.30) were independent predictor in multivariate analysis (stepwise linear logistic regression).

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A Comparative Study on Comorbidity Measurements with Lookback Period using Health Insurance Database: Focused on Patients Who Underwent Percutaneous Coronary Intervention (건강보험 청구자료에서 동반질환 보정방법과 관찰기관 비교 연구: 경피적 관상동맥 중재술을 받은 환자를 대상으로)

  • Kim, Kyoung-Hoon;Ahn, Lee-Su
    • Journal of Preventive Medicine and Public Health
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    • v.42 no.4
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    • pp.267-273
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    • 2009
  • Objectives : To compare the performance of three comorbidity measurements (Charlson comorbidity index, Elixhauser s comorbidity and comorbidity selection) with the effect of different comorbidity lookback periods when predicting in-hospital mortality for patients who underwent percutaneous coronary intervention. Methods : This was a retrospective study on patients aged 40 years and older who underwent percutaneous coronary intervention. To distinguish comorbidity from complications, the records of diagnosis were drawn from the National Health Insurance Database excluding diagnosis that admitted to the hospital. C-statistic values were used as measures for in comparing the predictability of comorbidity measures with lookback period, and a bootstrapping procedure with 1,000 replications was done to determine approximate 95% confidence interval. Results : Of the 61,815 patients included in this study, the mean age was 63.3 years (standard deviation: ${\pm}$10.2) and 64.8% of the population was male. Among them, 1,598 2.6%) had died in hospital. While the predictive ability of the Elixhauser's comorbidity and comorbidity selection was better than that of the Charlson comorbidity index, there was no significant difference among the three comorbidity measurements. Although the prevalence of comorbidity increased in 3 years of lookback periods, there was no significant improvement compared to 1 year of a lookback period. Conclusions : In a health outcome study for patients who underwent percutaneous coronary intervention using National Health Insurance Database, the Charlson comorbidity index was easy to apply without significant difference in predictability compared to the other methods. The one year of observation period was adequate to adjust the comorbidity. Further work to select adequate comorbidity measurements and lookback periods on other diseases and procedures are needed.

Surgical Management of Multiple Coronary Artery Aneurysms - A case report - (다발성 관상동맥류의 수술적 치료 - 1예 보고 -)

  • Kim, Chang-Young;Park, Kyung-Taek;Kim, Yeon-Soo;Ryoo, Ji-Yoon;Chang, Woo-Ik
    • Journal of Chest Surgery
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    • v.41 no.1
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    • pp.106-109
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    • 2008
  • Multiple coronary aneurysms are rare in adults. The cause may be atherosclerosis, congenital malformations, post-traumatic or post-syphilitic vascular lesions, connective tissue diseases like Marfan and Ehler-Danlos syndromes or Kawasaki disease, all of which cause weakening of the media. Surgical intervention is indicated to prevent rupture, embolization or compression symptoms. The successful management of multiple coronary artery. aneurysms, associated with previous rupture and arrhythmia, originating from proximal potions of ramus intermedius and left circumflex artery are reported.

Prevalence of Clustering of Coronary Risk Factors in Health Checkup Examinees (일부 건강검진 수검자들의 관상동맥질환 위험인자의 군집별 유병률)

  • Kim, Eun-Suk;Kim, Kwang-Hwan;Cho, Young-Chae
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.10 no.3
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    • pp.625-633
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    • 2009
  • This study was conducted to assess the distribution of coronary risk factors(CRF) and evaluate the risk profile of coronary heart disease by the clustering of the CRF in health checkup examinees. The study sample consists of 3,345 adults aged 30s-60s years(1,917 males, 1,428 females), not recognized as taking medicines for or having cardiovascular diseases, who underwent health package check-up at the health examination center of a university-affliated hospital in Daejon City. The proportion of subjects with 1, 2, 3, 4 and or more risk factors were 27.6%, 26.5%, 16.9% and 9.1%, respectively, therefore, the 80.0% of total subjects had at least one more risk factor. From these findings, this study concluded that the prevalence rates of CRF were relatively high. These data provide further evidence that the early intervention for coronary health prevention and promotion in general adult population is necessary at the population level.

Comparison of mean platelet volume levels in coronary artery ectasia and healthy people: systematic review and meta-analysis

  • Moghadam, Reza Heidary;Shahmohammadi, Afshar;Asgari, Nader;Azizi, Koorosh;Mansour, Sahar Mehr;Roozbahani, Mohammad
    • BLOOD RESEARCH
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    • v.53 no.4
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    • pp.269-275
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    • 2018
  • Coronary artery ectasia (CAE) is defined as the dilation of a segment of a coronary vessel to at least 1.5 times the diameter of its normal adjacent segment. Mean platelet volume (MPV) plays a role in acute coronary syndromes, with high MPV correlating to poor prognosis for acute thrombotic events and CAE. Several studies investigated the relationship between MPV and CAE, resulting in conflicting results. These results led us to systematically review all studies investigating the relationship between MPV and ectatic heart diseases by performing a meta-analysis study in order to report a unified result. This meta-analysis study investigated all case-control articles examining the relationship between MPV and CAE. All studies in the following databases published until January 31, 2018, were investigated: Science Direct, Scopus, PubMed, Google Scholar, and Web of Science. Following a quality control evaluation, 14 articles, all of which were published following studies performed in Turkey from 2007 to 2016, met the criteria for study inclusion. After pooling the results from all of the articles, a total standardized mean difference (SMD) value of 0.584 (95% CI, 0.219, 0.95) was obtained using the D+L pooled SMD, indicating a significant difference (P=0.002) between the two groups, with higher MPV values in ectatic patients when comparing to healthy individuals. Therefore, increased MPV levels were significantly related to CAE, suggesting that platelets, with their inflammatory and thrombotic activities, play a role in this disease. Therefore, anti-platelet and anti-inflammatory therapies may be effective in treating CAE.

Effects of Non-Pharmacological Interventions on Major Adverse Cardiac Events in Patients Underwent Percutaneous Coronary Intervention: Systematic Review and Meta-Analysis (경피적 관상동맥 중재술을 시행한 대상자에게 적용한 비약물적 중재가 주요 심혈관 사건에 미치는 효과: 체계적 문헌고찰과 메타분석)

  • Jo, Sojeong;Lee, Haejung;Park, Gaeun
    • Journal of Korean Academy of Nursing
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    • v.54 no.3
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    • pp.311-328
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    • 2024
  • Purpose: In this study a systematic review and meta-analysis investigated the impact of non-pharmacological interventions on major adverse cardiac events (MACE) in patients with coronary artery disease who underwent percutaneous coronary intervention (PCI). Methods: A literature search was performed using PubMed, Cochrane Library, EMBASE, and Cumulative Index to Nursing & Allied Health Literature databases up to November 2023. The risk of bias was assessed using the Cochrane Risk of Bias 2.0 tool. Effect sizes and 95% confidence intervals were calculated using R software (version 4.3.2). Results: Eighteen randomized studies, involving 2,898 participants, were included. Of these, 16 studies with 2,697 participants provided quantitative data. Non-pharmacological interventions (education, exercise, and comprehensive) significantly reduced the risk of angina, heart failure, myocardial infarction, restenosis, cardiovascular-related readmission, and cardiovascular-related death. The subgroup meta-analysis showed that combined interventions were effective in reducing the occurrence of myocardial infarction (MI), and individual and group-based interventions had significant effects on reducing the occurrence of MACE. In interventions lasting seven months or longer, occurrence of decreased by 0.16 times, and mortality related to cardiovascular disease decreased by 0.44 times, showing that interventions lasting seven months or more were more effective in reducing MI and cardiovascular disease-related mortality. Conclusion: Further investigations are required to assess the cost-effectiveness of these interventions in patients undergoing PCI and validate their short- and long-term effects. This systematic review underscores the potential of non-pharmacological interventions in decreasing the incidence of MACE and highlights the importance of continued research in this area (PROSPERO registration number: CRD42023462690).

Meta-analysis on the Blood Lipids as Risk Factors of Coronary Heart Diseases in Koreans (한국인 관상동맥성 심질환의 위험요인으로서 혈청지질에 관한 메타분석)

  • Kim, Ki-Soon;Kim, Yang-Ok;Park, Jong;Park, Jong-Ku;Kim, Chun-Bae;Jee, Sun-Ha;Ryu, So-Yeon
    • Journal of Preventive Medicine and Public Health
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    • v.32 no.4
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    • pp.491-498
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    • 1999
  • Objectives : To determine the relations between seven blood lipids such as total cholesterol(TC), triglyceride(TG), HDL-cholesterol(HDL), LDL-cholesterol(LDL), apolipoprotein A-1(Apo A1), apolipoprotein B(Apo B) and lipoprotein(a)(Lp(A)) and the coronary heart diseases(CHD), the quantitative techniques of meta-analysis were applied to studios of blood lipids and CHD in Koreans. Methods : We searched the Korean and the English literature published from 1980 to August, 1997 by manual search and bibliography review. Information on sample size, study design, participant characteristics(gender, age) and blood lipid levels were abstracted by reviewers using inclusion criteria. Estimates of the effect sizes of blood lipid levels on CHD in Koreans and corresponding 95% confidence intervals were calculated using random-effect models. Results : We identified 16 case-control studies to apply meta-analysis. The overall effect sizes for CHD were 20.3(95% CI: 14.23-20.22) in TC, 24.8(95% CI: 12.6-36.86) in TG, 15.16(95% CI: 3.99-26.33) in LDL, -3.48(95% CI: -5.79 - -1.17) in HDL, -9.78(95% CI: -16.98 - -2.58) in Apo-a1, 17.88(95% CI: 9.72-26.05) in Apo B and 18.95(95% CI: 17.88-20.02) in Lp(a). Conclusions : Our results suggested that seven blood lipids were significantly associated with CHD in Koreans. Well-designed and prospective studies between blood lipids and CMD in Koreans should be peformed.

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Alcohol Consumption and the Coronary Heart Disease-Related Risk Factors in Korean Adults;the Third Korea National Health and Nutrition Examination Survey (KNHANES III), 2005 (한국인에서 알코올 섭취가 관상동맥질환 관련 위험요인에 미치는 영향;국민건강영양조사 제3기 (2005년))

  • Park, Sung-Hee;Kang, Young-Hee;Park, Hyun-Young
    • Journal of Nutrition and Health
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    • v.41 no.3
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    • pp.232-241
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    • 2008
  • Moderate alcohol consumption has been known to be associated with reduced risk for coronary heart disease (CHD). We assessed the association between alcohol consumption and CHD-related risk factors [hypertension, diabetes mellitus (DM) , high total cholesterol, high triglyceride (TG), low HDL-cholesterol (HDL-C), and high LDL-cholesterol (LDL-C)] in Korean. After excluding those with extreme intake values, the number of final subjects included in the analysis was 4,662 Korean adults aged over 20 years (1,961 men, 2,701 women) who participate in the 2005 Korean National Health and Nutrition Examination Survey. The subjects were divided into four or five groups; none-alcohol consumption group, moderate alcohol consumption group (<15 or 15.0-29.9 g/d), heavy alcohol consumption group (30-69.9 g/d or ${\geq}$ 70 g/d in men, ${\geq}$ 30 g/d in women). Odds ratios (ORs) were estimated from logistic regression adjusting for potential covariates. Alcohol consumption was inversely associated with low HDL-C in both men and women. However, heavy alcohol intake (${\geq}$ 70 g/d) significantly increased risk for hypertension, DM, and hypertriglyceridemia in men. The frequency of alcohol intake was also associated with CHD risk. The risk for low HDLC was decreased with alcohol consumption (${\geq}$ 1 times/wk), but frequent alcohol intake (${\geq}$ 4 times/wk) increased the risk for hypertension. This study revealed that moderate alcohol consumption has protective effect on CHD-related risk factors in Korean population.

The Application of Ryodoraku in the U-health Care System (유헬스케어(U-health Care)에서 양도락의 활용 방안)

  • Song, Ho-Sueb
    • Journal of Acupuncture Research
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    • v.27 no.6
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    • pp.115-122
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    • 2010
  • Objectives : The purpose of this study was to propose the utilization plan of Ryodoraku in the U-health care systems. Methods : Computerized literature searches were performed for Ryodoraku related articles using the following databases: KISS, RISS, DBPIA, NDSL from 1990 to Oct 2010. Search terms were '양도락' or 'Ryodoraku' or 'U-health'. Due to Ryodoraku coming from Japan, additional literature review(articles published by 2008) on Japanese journal of Ryodoraku medicine was done for compensation. Results : 1. Introduction of U-health : As rapid progress of population aging and strong interest in health, the demand for the traditional Korean medical service is increasing. Until now healthcare service has provided post treatment by face-to-face manner. But according to related researches, proactive treatment is resulted to be more effective for preventing diseases. Particularly, the existing healthcare services have limitations in preventing and managing chronic geriatric degenrative diseases such as metabolic syndrome, CVA, coronary heart diseases, parkinson's diseases, degenerative joint disease, spondylosis, etc., because the cause of the above is complex and even related to life habit. As the advent of ubiquitous technology, patients with the chronic geriatric degenrative diseases can improve life habit such as poor eating habits and physical inactivity without the constraints of time and space through u-healthcare service. Therefor, lots of researches for u-healthcare service focus on providing the personalized healthcare service for preventing and managing that. To cope with this situations, The concept of u-healthcare service should be adopted in the traditional korean medicine and diagnostic devices suitable for it should be also devised and developed based on traditonal korean medine. 2. Review of existing Ryodoraku related articles for applying to U-health : articles investigating feasibility applying Ryodoraku to meridian diagnosis and raising problems of it, articles providing recent research trends of Ryodoraku, Ryodoraku related articles considering usefulness for U-health, and articles confirming the repeatability and reproducity of Ryodoraku were included. Based on the review of the above Ryodoraku related articles, several application of Ryodoraku in the U-health care system. Conclusions : To make preparations for the increasing need of traditional Korean medicine due to rising morbidity rate of chronic geriatric degenerative diseases, it is necessary to appropriately apply Ryodoraku to the U-health care system. The application of Ryodoraku is as follows. 1. To use Ryodoraku additionally to the established diagnostic device of metabolic syndrome, CVA, coronary heart diseases, parkinson's diseases, degenerative joint disease, spondylosis. 2. To apply Ryodoraku to the symptoms or diseases having a tendency to be diagnosed by correlation between the affected meridian and the lesion such as headache, nuchal pain, shoulder pain, low back pain, sciatica, HNP, etc. 3. To secure the repeatability and reproducity of Ryodoraku. 4. To devise and develop Ryodoraku appliance in order to overcome the known drawbacks and to improve error of measurement.

Possibility of Involvement of Porphyromonas gingivalis in Coronary Heart Disease

  • Lee, Jin-Yong;Park, Byung-Lae;Yun, Hyun-Kyung;Park, Eun-Ah;Shin, Eun-Ah;Jue, Seong-Suk;Shin, Je-Won
    • The Journal of the Korean Society for Microbiology
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    • v.35 no.3
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    • pp.203-214
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    • 2000
  • Porphyromonas gingivalis has been implicated in periodontal diseases. Accumulating evidence suggests that cardiovascular disease is the most prevalent medical problem in patients with periodontal diseases. In order to check the possibility that P. gingivalis is involved in coronary heart disease, the present study was performed to observe P. gingivalis adherence and invasion of human coronary artery endothelial cells (HCAEC) and production of cytokines and growth factors by HCAEC upon P. gingivalis infection. $^3H$-labeled P. gingivalis 381 was incubated with HCAEC for 90 min. The radioactivity of the washed HCAEC was a measure of the absorbed (adhering and invading) P. gingivalis. The absorption radioactivity of the HCAEC infected by P. gingivalis was determined to be 59.58% of the input bacterial cells. In contrast, the absorption radioactivity of the cells infected by S. gordonii Challis which was employed as a control was negligible (0.59%). DPG3, a P. gingivalis mutant defective of fimbriae, appeared to be impaired to some extent in capability of adherence/invasion as compared to that of the parental strain 381, showing 43.04% of the absorption radioactivity. The absorption radioactivity of the HCAEC infected by P. gingivalis 381 in the presence of excessive fimbriae at the concentrations of $50\;{\mu}g$ and $100\;{\mu}g/ml$ was 57.27 and 45.44%, respectively. Invasion of HCAEC by P. gingivalis 381 was observed by an antibiotic (metronidazole) protection assay and transmission electron microscopy (TEM). In the antibiotic protection assay, invasion by the bacterium was measured to be 0.73, 1.09, and 1.51% of the input bacterial cells after incubation for 30, 60, and 90 min, respectively. Invasion by DPG3 was shown to be 0.16% after 90-min incubation. In comparison of invasion efficiency at 90 min of the incubation, the invasion efficiency of DPG3 was 0.37% while that of its parental strain 381 was 2.54%. The immunoblot analysis revealed fimbriae of P. gingivalis did not interact with the surface of HCAEC. These results suggest that fimbriae are not the major contribution to the adherence of P. gingivalis to HCAEC but may be important in the invasion of HCAEC by the bacterium. The presence of cytochalasin D ($1\;{\mu}g/ml$) and staurosporine ($1\;{\mu}M$) reduced the invasion of HCAEC by P. gingivalis 381 by 78.86 and 53.76%, respectively, indicating that cytoskeletal rearrangement and protein kinase of HCAEC are essential for the invasion. Infection of P. gingivalis induced HCAEC to increase the production of TNF-${\alpha}$. by 60.6%. At 90 min of the incubation, the HCAEC infected with P. gingivalis cells was apparently atypical in the shape, showing loss of the nuclear membrane and subcellular organelles. The overall results suggest that P. gingivalis may cause coronary heart disease by adhering to and invading endothelial cells, and subsequently damaging the cells.

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