• 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.

• Korean Journal of Radiology
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• 제22권5호
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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.

• 대한간호학회지
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• 제54권3호
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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).

• 대한방사선기술학회지:방사선기술과학
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• 제33권3호
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• pp.213-221
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• 2010

관상동맥질환의 진단과 치료를 위한 관상동맥조영술(Coronary Angiography, CA)과 경피적관상동맥중재술(Percutaneous Coronary Intervention, PCI) 과정에서 환자에 대한 유효선량을 알아보고, 이 선량으로 인한 암 발생위험을 CA와 PCI를 구분하여 평가해 보고자 하였다. CA를 시행한 환자 60명과 PCI 시술을 받은 환자 58명을 대상으로 DAP(dose-area product)를 측정하였고, 몬테카를로 시뮬레이션(Monte Carlo simulations) 프로그램(PCXMC 1.5)을 이용하여 유효선량과 장기선량을 산출하였다. 암 발생의 생애귀속위험의 평가는 전리방사선 생물학적 효과 위원회의 7차 보고서(BEIR VII)를 활용하였다. 그 결과 대상자의 DAP 값 평균은 CA군에서 $53.76\;Gy{\cdot}cm^2$이었고, PCI군에서는 $165.82\;Gy{\cdot}cm^2$이었다. 유효선량은 CA군에서 평균 1.28 mSv이었고, PCI군에서는 3.94 mSv이었다. 장기선량은 폐에서 CA군 2.17 mSv, PCI군 6.71 mSv이었고, 여성 유방선량은 CA에서 5.45 mSv, PCI에서 16.82 mSv이었다. 암 발생 생애귀속위험은 CA에서 남성은 1,508명 중 1명, 여성은 1,357명 중 1명이었고, PCI에서는 남성 553 중 1명, 여성은 482명 중 1명이었다. DAP 값은 몬테 카를로 시뮬레이션을 기본으로 하여 장기선량과 유효선량을 계산할 수 있는 지표가 되었다. CA와 PCI 과정에서 환자에게 노출되는 방사선량은 무시할 수 없는 암 발생의 생애귀속위험이 된다. 또한 암 발생 위험은 PCI군에서 더 높았고, 남성보다는 여성이 더 높았다.

• 대한물리의학회지
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• 제14권1호
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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.

• 성인간호학회지
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• 제20권3호
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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.

• 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.

• 한국콘텐츠학회논문지
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• 제19권12호
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• pp.279-288
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• 2019

본 연구는 흉통이 발생되어 관상동맥조영술을 실시한 후 재입원한 대상자의 관상동맥중재술 시행 여부에 따른 건강행위와 건강지표의 차이를 종단적으로 비교하고자 수행되었고, 2010년 1월부터 2017년 12월까지 일개병원에서 247명의 흉통발생자의 간호정보조사지와 전자의무기록을 분석한 2차 자료 분석연구이다. 대상자는 관상동맥중재술 비시행자와 시행자로 구분하여 병원 1차 입원 시점과 재입원 시점에서 흡연, 음주, 수면장애등 건강행위와 혈압과 혈중 지질 수치등 건강지표를 측정하였다. 수집된 자료는 SPSS 24.0를 사용하여 분석하였고, 연구 결과, 초기 입원시에는 관상동맥중재술 시행자와 비시행자간 건강행위와 건강지표에는 유의한 차이가 없었으나, 재입원시에는 관상동맥중재술 시행자가 비시행자에 비해 흡연과 지질 수치에 있어서 유의하게 건강한 양상을 나타내었다. 관상동맥중재술 비시행자의 경우 관상동맥협착의 위험이 많은 환자임에도 불구하고 흡연률이 높았고, 전체 대상자중 60%가 퇴원후 6-12개월 사이에 흉통으로 재입원하여, 흉통환자에게 의학적 치료와 더불어 건강행위를 도모하는 지속적인 통합관리가 필요함을 알 수 있었다. 본 연구의 의의는 관상동맥중재술 실시 여부에 따른 건강행위와 건강지표를 종단적으로 비교하여 관상동맥질환자와 위험환자의 건강행위의 중요성을 확인한 것이다.

• 한국산학기술학회논문지
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• 제17권8호
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• pp.226-235
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• 2016

본 논문은 관상동맥중재술 대상자의 신체적 기능상태, 적대성향, 사회적지지의 관계를 규명하여 간호 중재 개발의 기초자료를 제공하고자 하였다. 서울시 2개 상급종합병원에서 관상동맥중재술을 받고 관리를 위해 외래에 내원한 환자 135명을 대상으로 구조화된 설문지를 이용하여 자료를 수집하였다. 신체적 기능상태는 성별(t=5.880, p<.001), 연령(F=23.620, p<.001), 교육정도(F=17.718, p<.001), 직업(t=-6.498, p<.001), 월수입(F=7.237, p<.001), 흡연여부(t=2.327, p=.025)에 따라 유의한 차이를 보였다. 적대성향은 연령(F=6.150, p=.001), 시술 후 경과기간(F=6.141, p=.001), 가족력(t=2.514, p=.013)에 따라 유의한 차이를 보였다. 사회적지지는 연령(F=2.866, p=.039), 교육정도(F=5.136, p=.002)에 따라 유의한 차이를 보였다. 신체적 기능상태는 사회적지지(r=.20, p=.025), 친구지지(r=.22, p=.010)와 각각 통계적으로 유의한 정적 상관관계가 있었으며, 적대성향(r=-.24, p=.005)과 유의한 부적 상관관계가 있는 것으로 나타났다. 적대성향은 친구지지(r=-.17, p=.046)와 유의한 부적 상관관계가 있었다. 따라서 간호사는 관상동맥중재술 대상자의 특성을 고려하고, 신체적 기능상태, 적대성향, 사회적지지를 향상시킬 수 있는 간호중재 개발할 필요가 있다.

• 대한의생명과학회지
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• 제19권1호
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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.