• Journal of Preventive Medicine and Public Health
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• 제52권1호
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• pp.21-29
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• 2019

Objectives: The Regional Cardiocerebrovascular Center (RCCVC) Project designated local teaching hospitals as RCCVCs, in order to improve patient outcomes of acute cardiocerebrovascular emergencies by founding a regional system that can adequately transfer and manage patients within 3 hours. We investigated the effects of RCCVC establishment on treatment volume and 30-day mortality. Methods: We constructed a panel dataset by extracting all acute myocardial infarction cases that occurred from 2007 to 2016 from the Health Insurance Review and Assessment Service claims data, a national and representative source. We then used a panel fixed-effect model to estimate the impacts of RCCVC establishment on patient outcomes. Results: We found that the number of cases of acute myocardial infarction that were treated increased chronologically, but when the time effect and other related covariates were controlled for, RCCVCs only significantly increased the number of treatment cases of female in large catchment areas. There was no statistically significant impact on 30-day mortality. Conclusions: The establishment of RCCVCs increased the number of treatment cases of female, without increasing the mortality rate. Therefore, the RCCVCs might have prevented potential untreated deaths by increasing the preparedness and capacity of hospitals to treat acute myocardial infarction patients.

• Journal of Chest Surgery
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• 제37권4호
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• pp.369-372
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• 2004

인공판막 혈전에 의한 관상동맥 폐쇄 후 발생하는 급성심근경색은 드물지만 치명적인 질환으로 환자들의 생존율을 높이기 위해서는 빠른 진단과 적절한 치료가 중요하다 본원에서는 기계승모판막 혈전에 의한 좌전하행지의 폐쇄로 급성심근경색이 발생한 환자 1예에서 중재시술 및 항혈전요법 후 승모판 재치환술을 성공적으로 시행하였기에 증례 보고하는 바이다.

• 보험의학회지
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• 제32권2호
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• pp.33-38
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• 2013

Coronary artery diseases are very important agenda in the insurance medicine. Insurance medicine is defined as using medical knowledge for insurance administration such as underwriting, claims, and customer satisfaction. This review article contains review of coronary artery disease in terms of insurance medicine. Estimation of extra-risks for acute myocardial infarction are MR of 349% and EDR of 41‰. In medical underwriting, individual life applicants can be assessed by Framingham's CHD risk assessment model. In claims, medical claims review is a useful method of consulting for claims staffs. Several diagnostic criteria of acute myocardial infarction are introduced in time. The universal definition of myocardial infarction by ESC/ACCF/WHF was demonstrated the most valuable predictor of 10-year mortality. Contents for State-Of-The-Art of the coronary artery disease are current antithrombotics. There are many novel anti-thrombotic agents such as ticagrelol, dabigatran, rivaroxaban, and pegnivacogin.

• Journal of Periodontal and Implant Science
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• 제35권1호
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• pp.111-121
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• 2005

Coronary heart disease is the leading cause of mortality in adult population. Whereas the association between periodontal disease and coronary heart disease (CHD) are controversial, recent studies reported the association between periodontal disease and acute myocardial infarction or prognosis of CHD. This study was aimed to investigate the relationship between periodontal disease and angiographically defined CHD, and acute myocardial infarction, and the prognosis of treated CHD. Patients under the age of 60 who had undergone the diagnostic coronary angiography were enrolled in this study, Subjects were classified as positive CHD (+CHD, n=37) with coronary artery stenosis more than 50% in at least one of major epicardial arteries, and negative CHD (-CHD, n=20) without stenosis. After recording the number of missing teeth, periodontal disease status was measured by means of plaque index (PI), gingival index (GI), bleeding on probing (BOP), probing depth (PD), and clinical attachment level (CAL), Positive CHD subjects were classified into acute myocardial infarction group (AMI), and non-AMI with angina pectoris and old myocardial infarction. Six months postoperatively, positive CHD subjects were followed and had undergone the coronary angiography again. Even though there was no significant difference in the periodontal parameters and status between positive CHD and negative CHD, some periodontal parameters, such as mean probing depth and proportion of sites with probing depth greater than 4mm or 6mm were significantly different between AMI and Non-AMI(p<0.05). There was no significant difference in the periodontal parameters according to in angiographically follow-up status. These results indicate that periodontal disease may be associated with the occurrence of acute myocardial infarction.

• 대한핵의학회지
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• 제27권1호
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• pp.65-70
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• 1993

Among 64 patients with acute myocardial infarction who underwent coronary angiogrphy, 7 patients (10.9%) showed normal coronary artery. Six patients were men and 1 patient was female. The mean age of patients were $31.1{\pm}3.9$ years. Among the risk factors of coronary heart disease, smoking was most probable factor in patients with acute myocardial infarction with normal coronary angiography. $^{99m}Tc$-MIBI heart SPECT performed 5 of 7 patients and showed that it could be used in diagnosis, localization, extent of infarct area in patients with acute myocardial infarction with normal coronary angiograpy. But follow up $^{99m}Tc$-MIBI heart SPECT study will be needed to define the ability of myocardial viability in this patients.

• 보건행정학회지
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• 제13권4호
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• pp.115-130
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• 2003

Reperfusion delay in patients with acute myocardial infarction leads to increased morbidity and mortality. We sought to measure the rates of reperfusion delay and to identify factors associated with reperfusion delay after arrival to hospitals. We included 360 patients who had acute myocardial infarction with ST-elevation or left bundle branch block on electrocardiogram and received reperfusion therapy from the three participating academic medical centers from 1997 to 2000. Through retrospective chart review, we collected data about time to reperfusion therapy, patient and hospital factors potentially associated with reperfusion delay. Factors independently associated with reperfusion delay were determined by logistic regression analysis. Median door­to­needle time was 60.0 minutes, and median door­to­balloon time was 102.5 minutes. According to recommendation of the American College of Cardiology/American Heart Association Guidelines, 226 out of 264(85.6％) of thrombolytic patients and 43 out of 96(44.8％) percutaneous transluminal coronary angioplasty(PTCA) patients experienced reperfusion delay. The significant factors associated with delay were type of reperfusion therapy, patient factors including hypertension and delayed symptom onset to presentation(>4 hours), and hospital factors including nocturnal presentation(6pm∼8am), weekend, and an individual hospital. A significant proportion of patients experienced reperfusion delay. The identified predictors of reperfusion delay may help design a hospital system to reduce the delay in reperfusion therapy

• Bulletin of the Korean Chemical Society
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• 제35권1호
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• pp.158-164
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• 2014

Substance P and neuropeptide Y were discovered as early diagnostic biomarkers of acute myocardial infarction in Korean patients and confirmed using enzyme-linked immunosorbent assay (ELISA). We screened 12 peptides from the sera of Korean acute myocardial infarction (AMI) patients and detected 3 peptides (neuropeptide Y, substance P, and N-terminal pro-B-type natriuretic peptide) to be elevated from patients' sera by liquid chromatography mass/mass spectrometry. The elevated concentration of 3 peptides was confirmed by ELISA. The screening results revealed the substance P, neuropeptide Y, and pro-B-type natriuretic peptide (47-76) concentrations were higher in patients' sera than in healthy controls. The sensitivity and specificity of substance P for AMI diagnostic marker were 80% and 83%, respectively, and those of neuropeptide Y were 87% and 90%, respectively compared to healthy controls. These results suggest that substance P and neuropeptide Y could be used as early diagnostic biomarkers in patients with AMI.

• 대한간호학회지
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• 제33권6호
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• pp.693-704
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• 2003

Purpose: The purpose of this study was to determine whether a relaxing music was effective in reducing stress response of patients admitted to a coronary care unit with the diagnosis of acute myocardial infarction. Method: The research design was the chosen convenience sample of a randomized control group pre-posttest quasi-experimental design. Forty patients, 20 for an experimental group and another 20 for control group. The study was to provide the patients three different kinds of relaxing music. The experimental group listened to relaxing music for a 20-minute one time a day for 3days. The control group was just provided with a 20-minute period of rest. Test for hypothesis was done by repeated measured ANOV A. Result: The experimental group which received relaxing music showed a significantly lower level of electrodermal response, myocardial oxygen consumption and respiration rate, and a higher level of peripheral skin temperature than the control group. The experimental group which received relaxing music showed a significant reduction in state anxiety than the control group. Conclusion: The results showed that relaxing music is an effective nursing intervention for reducing physiologic and psychologic stress response of the patients with acute myocardial infarction in a critical intensive care unit.

• 국제물리치료학회지
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• 제7권2호
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• pp.999-1005
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• 2016

The purpose of this study was to investigate the effects of low-intensity cardiac rehabilitation exercise on the cardiac function and the degree of fibrosis in an older white rat model. This study used male Sprague-Dawley white rats that were 50 weeks old. After the acute myocardial infarction induction, Twenty of the rats were randomly allocated into an experimental group and a control group, and each of the groups consisted of 8 rats. In the experimental group, the exercise was conducted for six weeks, 30 minutes a day, five days a week, using a Rotarod treadmill for animals. The degree of myocardial fibrosis was significantly repressed in the experimental group($13.69{\pm}1.90%$) and in the control group($15.67{\pm}1.54%$)(p<0.05). However, fractional shortening and ejection fraction did not show a significant difference. The results of this study suggest that cardiac rehabilitation with low intensity treadmill exercise repress the myocardial fibrosis.

• Journal of Chest Surgery
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• 제28권1호
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• pp.69-72
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• 1995

A 69-year-old patient with rupture of anterolateral papillary muscle following non-Q-wave myocardial infarction is described. Transesophageal echocardiography was useful in making the diagnosis. Mitral valve replacement was performed 22 days after the onset of acute myocardial infarction. The patient was discharged in his good condition and coronary angiography is scheduled.