• 근관절건강학회지
• /
• 제30권3호
• /
• pp.254-262
• /
• 2023

Purpose: This study was to determine the effect of Individualized education-counseling program on the performance of Health behavior and Cardiovascular risk after discharge inpatients with percutaneous coronary intervention. Methods: This study is a quasi-experimental study of the non-equivalence control group and the subjects of this study were patients who underwent percutaneous coronary intervention for coronary artery disease and had no complications due to severe arrhythmia or heart failure. The purpose of the study was explained to the subjects who met the selection conditions, and written consent was obtained, and 50 randomized experimental groups and 50 control groups were selected and assigned. Results: Compared to the control group, health behaviors were significantly higher after 1 week (F=33.63, p<.001) and 12 weeks (F=23.63, p<.001). The cardiovascular risk score based on Framingham risk score differed significantly depending on the measurement period (F=26.18, p<.001), there was no significant difference in the interaction between the two groups and the measurement period (F=0.72, p=.469). Conclusion: It was confirmed that the Individualized education counseling program provided to patients with Percutaneous coronary intervention was effective in increasing the subject's health behavior, but not in lowering the cardiovascular risk.

• The Korean journal of internal medicine
• /
• 제39권1호
• /
• pp.77-85
• /
• 2024

Background/Aims: There may be many predictors of anticoagulation-related gastrointestinal bleeding (GIB), but until now, systematic reviews and assessments of the certainty of the evidence have not been published. We conducted a systematic review to identify all risk factors for anticoagulant-associated GIB to inform risk prediction in the management of anticoagulation-related GIB. Methods: A systematic review and meta-analysis were conducted to search PubMed, EMBASE, Web of Science, and Cochrane Library databases (from inception through January 21, 2022) using the following search terms: anticoagulants, heparin, warfarin, dabigatran, rivaroxaban, apixaban, DOACs, gastrointestinal hemorrhage, risk factors. According to inclusion and exclusion criteria, studies of risk factors for anticoagulation-related GIB were identified. Risk factors for anticoagulant-associated GIB were used as the outcome index of this review. Results: We included 34 studies in our analysis. For anticoagulant-associated GIB, moderate-certainty evidence showed a probable association with older age, kidney disease, concomitant use of aspirin, concomitant use of the antiplatelet agent, heart failure, myocardial infarction, hematochezia, renal failure, coronary artery disease, helicobacter pylori infection, social risk factors, alcohol use, smoking, anemia, history of sleep apnea, chronic obstructive pulmonary disease, international normalized ratio (INR), obesity et al. Some of these factors are not included in current GIB risk prediction models. such as anemia, co-administration of gemfibrozil, co-administration of verapamil or diltiazem, INR, heart failure, myocardial infarction, etc. Conclusions: The study found that anemia, co-administration of gemfibrozil, co-administration of verapamil or diltiazem, INR, heart failure, myocardial infarction et al. were associated with anticoagulation-related GIB, and these factors were not in the existing prediction models. This study informs risk prediction for anticoagulant-associated GIB, it also informs guidelines for GIB prevention and future research.

• Journal of Korean Biological Nursing Science
• /
• 제9권1호
• /
• pp.5-31
• /
• 2007

Purpose: The purpose of this study was to explore the knowledge and learning needs on cardiac rehabilitation of coronary artery bypass graft(CABG) patients. Method: The subjects consisted of 100 CABG patients at A hospital in Seoul. Data were collected by the two different kind of questionnaires which measure knowledge and learning needs on cardiac rehabilitation of CABG patients. The subjects responded the questionnaire on knowledge before CABG and that on learning needs before their discharge. Result: The mean score of knowledge on cardiac rehabilitation was 68.54. Knowledge on risk factor, nature of disease, diet, daily activity, medication, post operative care were great in order. The mean score of learning needs on cardiac rehabilitation was 4.28. Learning needs on diet, medication, nature of disease, post operative care, daily activity, risk factor were great in order. There were significant differences in knowledge according to occupation, economic status and family history(p=.021, p=.017, p=.023). There was a positive correlation between knowledge and learning needs(r=.3009, p=.002). Conclusion: Level of knowledge on cardiac rehabilitation of CABG patients is low and knowledge on postoperative care is the lowest, and learning needs are great in ail categories.

• Journal of Computing Science and Engineering
• /
• 제8권2호
• /
• pp.87-93
• /
• 2014

Coronary artery disease (CAD) is currently a prevalent disease from which many people suffer. Early detection and treatment could reduce the risk of heart attack. Currently, the golden standard for the diagnosis of CAD is angiography, which is an invasive procedure. In this article, we propose an algorithm that uses data mining techniques, a fuzzy expert system, and the imperialist competitive algorithm (ICA), to make CAD diagnosis by a non-invasive procedure. The ICA is used to adjust the fuzzy membership functions. The proposed method has been evaluated with the Cleveland and Hungarian datasets. The advantage of this method, compared with others, is the interpretability. The accuracy of the proposed method is 94.92% by 11 rules, and the average length of 4. To compare the colonial competitive algorithm with other metaheuristic algorithms, the proposed method has been implemented with the particle swarm optimization (PSO) algorithm. The results indicate that the colonial competition algorithm is more efficient than the PSO algorithm.

• 한국산학기술학회논문지
• /
• 제10권3호
• /
• pp.625-633
• /
• 2009

본 연구는 건강검진 수검자들에 대한 관상동맥질환 위험인자의 유병률을 파악하고자 대전광역시에 있는 C 대학교병원 건강검진센터에서 종합건강검진을 받았던 30세 이상의 일반성인 3,345명을 연구대상으로 하였다. 연구결과, 관상동맥질환 위험인자의 군집별 유병률을 보면, 위험인자를 1개 갖고 있는 사람이 27.6%, 2개 갖고 있는 사람이 26.5%, 3개 갖고 있는 사람이 16.9%등의 순이었으며, 적어도 1개 이상 관상동맥질환 위험인자를 갖고 있는 사람이 80.0%나 되는 것으로 나타났다. 따라서 관상동맥질환 발생 위험을 줄이기 위한 위험인자의 군집별 위험군에 근거한 차별화 된 건강증진프로그램의 개발과 보급이 필요하다고 본다.

• 대한핵의학회지
• /
• 제25권2호
• /
• pp.177-185
• /
• 1991

Dipyridamole thallium imaging is one of the most widely accepted means of evaluating patients with suspected or known coronay artery disease. The results of thallium imaging help diagnose coronary artery disesse (CAD), determine the hemodynamic significance of coronary stenosis, evaluate viability of myocardium, assess the outcome of therapeutic interventions and stratify patients according to their risk for luther cardiac events. An increased lung thallium uptake and transient LV dilation has been reported as poor prognostic indicator and associated with extensive and severe coronary artery disease. We quantitated lung/heart uptake ratio (l/HUR) and transient left ventricular dilation ratio in 44 patients and 17 controls undertaking dipyridamole thallium-201 scintigraphy. The results are as follows: 1) The lung/heart uptake ratio was high in patients with CAD and which became higher according to increasing number of diseased vessel. The L/HUR of patients with low LVEF (<35%) was lower than those with normal LVEF. 2) Transient left ventricular dilation ratio of CAD patients had no close relation between numbers of diseased vessels and was not higher than normals. But transient left ventricular dilation ratio of patients with myocardial infartion was higher than normals. We concluded that lung/heart uptake ratio seems to be sensitive marker for severity of CAD and myocardial function, but transient left ventricular dilation ratio alone is not sufficient to be a marker for severe and extensive CAD.

• 정신신체의학
• /
• 제3권2호
• /
• pp.185-196
• /
• 1995

The author reviewed cognitive-behavioral approach to A type behavior pattern and hypertension which are known to be risk factors for coronary heart diseases. Those cognitive distortions frequently found in persons with A type behavior include all-nothing thinking, selective attention, personalization, and attribution of causality. Cognitive-behavioral techniques were also described, which can be applied to management of each characteristic of A type behavior pattern such as time urgency, perfectionism, achievement striving, low self-esteem, excessive work involvement, hostility, and depression. Cognitive-behavioral intervention for hypertension might help the patients to recognize and monitor anger-engendering conflicts, identify characteristic styles of responding, and experiment with alternative ways of managing conflict and anger. Since different features predominate in different individuals, it is necessary to develop treatment plan on the basis of individual characteristics and problems.

• 보건행정학회지
• /
• 제28권2호
• /
• pp.168-177
• /
• 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.

• 대한간호학회지
• /
• 제38권1호
• /
• pp.19-28
• /
• 2008

Purpose: The purpose of this paper was to examine the relationship between type D personality and cardiovascular disease, and to suggest future research directions. Method: A literature search was conducted from the following nine databases: 1) MEDLINE, 2) CINAHL, 3) Pubmed Unrestricted, 4) PsycINFO, 5) KISS, 6) RICHIS, 7) RISS4U, and 8) Nanet. The combinations of the words, "type D personality", "personality", "heart", "cardiovascular", and "coronary" were used for keyword searches to find relevant articles. Twenty eight studies were identified. Result: Type D personality has been associated with increased morbidity and mortality in patients with established cardiovascular disease. Type D patients are also at increased risk for impaired quality of life, and seem to benefit less from medical and invasive treatment. Conclusion: There is substantial evidence for a relationship between type D personality and clinical outcomes related to cardiovascular disease. Randomized clinical trials are needed to further evaluate the value of controlling type D personality to improve survival and reduce morbidity in patients with cardiovascular disease. Accumulating evidence from this analysis indicates the urgent need to adopt a personality approach in order to optimize the identification of patients at risk for stress related cardiac events.

• Journal of Yeungnam Medical Science
• /
• 제13권2호
• /
• pp.225-233
• /
• 1996

허혈성 심질환의 치료로서 시행되는 관동맥우회술은 최근 국내에서도 보편적으로 시행되고 있는데 1992년부터 1996까지 영남대학교 의과대학 흉부외과학교실에서 시행한 63례의 관동맥우회술을 대상으로 수술성적 및 술전 위험인자들이 술후 합병증에 미치는 영향을 조사하여 다음과 같은 결론을 얻었다. 환자의 성별 및 연령을 보면 총 63례의 환자 중 남자가 44례, 여자가 19례였으며 연령 분포는 36세에서 71세까지 평균 $58.3{\pm}8.6$세였으며 50대와 60대에서 대부분을 차지하였다. 원위문합수는 환자당 평균 3.5개의 원위부 문합을 하였으며 수술사망은 6례였으며 술후 합병증으로 부정맥이 7례, 창상감염이 5례, 술후 출혈이 4례, 술중 및 술후 심근경색이 4례, 뇌졸증이 4례, 그리고 위장관 및 신장 합병증이 5례에서 발생하였다. 술후 합병증 발생의 요소를 분석해 본 결과 술전 관동맥질환 발생의 위험인자 중 흡연환자에서 합병증의 발생빈도가 유의하게 증가하였으며(p<0.05) 술전 위험인자로 정맥으로 Nitroglycerin의 투여가 필요했던 경우와 대동맥 차단시간이 2시간 이상인 경우 합병증의 발생빈도가 유의하게 증가하였으며(p<0.05) 특히 65세 이상의 고령 환자의 경우 수술사망율이 유의하게 증가하였다(p<0.05). 이상의 결과로 흡연, 65세 이상의 고령, 술전 정맥으로 Nitroglycerin의 투여가 필요했던 경우 그리고 이식혈관의 수가 많아 대동맥 차단시간이 긴 경우 술중 및 술후 관리에 더욱 섬세한 주의가 필요함을 알 수 있었다.