scholarly journals Effect of Showing Angiograms to Patients After Elective Percutaneous Coronary Intervention on Anxiety and Illness Perception: A Randomized, Blinded, Controlled Clinical Trial

2019 ◽  
Vol 8 ◽  
Author(s):  
Babak Geraiely ◽  
Roya Sattarzadeh Badkoubeh ◽  
Maryam Jalalsafari ◽  
Nazila Shahmansouri ◽  
Anahita Tavousi ◽  
...  

Background: As an invasive modality, a coronary angioplasty may cause a great deal of anxiety in patients and affect their mental health and general well-being. Accordingly, we sought to assess whether showing patients the video of their elective percutaneous coronary intervention (angiogram) could affect their illness perception and anxiety level. Materials and Methods: In this randomized clinical trial, the patients undergoing angioplasty, were randomly divided into two groups of 30 patients. Angiograms were shown only to the intervention group postprocedurally. A checklist comprising demographic data and clinical presentations as well as the Beck anxiety questionnaire and the Brief Illness Perception Questionnaire (BIPQ) was completed for each patient immediately after the intervention and one month later. The differences in the patients’ anxiety level and illness perception were analyzed. Results: In the intervention group, the mean anxiety score before and after watching the angiograms was 34.26 ± 8.1 and 24.4 ± 8.56, respectively. While in the control group, the score before and after angioplasty was 34.46 ± 9.34 and 26.6 ± 9.44, respectively. Thus, watching angiograms led to a significant decrease in the anxiety score in the intervention group, whereas there was no such difference in the control group. There was also a considerable difference in the anxiety score between the two groups. Further, there was a significant decrease in the BIPQ score of the intervention group after watching the angioplasty videos. Conclusion: Educating cardiovascular patients about diagnostic and therapeutic procedures may confer such good outcomes as alleviated anxiety, enhanced satisfaction, and ultimately, fewer anxiety-related complications. [GMJ.2019;8:e1556]

2020 ◽  
Vol 9 (4) ◽  
pp. 188-194
Author(s):  
Maryam Valikhani ◽  
Seyyed Mousa Mahdizadeh ◽  
Ali Eshraghi ◽  
Seyyed Reza Mazloum ◽  
Javad Dehghani

Introduction: Angioplasty is widely used as a selective treatment for acute coronary syndromes. The complications of this procedure often lead to an increase in the length of the patients’ stay and hospital costs. Therefore, this study aimed to determine the effect of using sand and ice bags on hematoma and hemorrhage after percutaneous coronary intervention (PCI). Methods: In this randomized clinical trial, study was completed with participation of 60 patients with femoral angioplasty candidate, referring to Imam Reza hospital in Mashhad, were randomly divided into control and intervention groups. In the control group, a sand bag was placed on the location for up to 4 hours. In the intervention group, the ice bag and the sand bag were used simultaneously for 15 minutes, and then for 45 minutes, with the pressure of the sand bag only. This cycle was repeated four times. Hemorrhage (volume and weight) and hematoma (area and lump) were checked four times. The data were analyzed using SPSS software version 22. Results: The rate of hemorrhage after intervention was significantly reduced in the intervention group compared to the control group. Although the incidence of hematoma in the intervention group decreased from control to 20% to 6.7%, but the statistical test was not significant. Conclusion: According to the results of the present study, the simultaneous sand-ice bag application can reduce post-PCI’ hemorrhage (and hematoma rate, though insignificantly) through compression and vasoconstriction.


2019 ◽  
Vol 7 (4) ◽  
pp. 118-121
Author(s):  
Haleh Bodagh ◽  
Zahra Esfahani ◽  
Naser Aslanabadi ◽  
Bita Amiri ◽  
Ali Heidari Sarvestani

Introduction : Allopurinol could decrease the undesirable effects of free radicals and then prevent contrast induced nephropathy (CIN). Therefore, it may be useful for reducing the ischemia-reperfusion induced nephropathy and inhibiting nitric oxide synthesis produced in CIN. This study was performed aimeing to determine the effect of allopurinol in the prevention of CIN in patients undergoing angioplasty. Methods: In this randomized clinical trial, 100 patients (50 cases as the intervention group receiving allopurinol 300 mg one day and one hour before angiography and 50 cases as the control group) were evaluated. CIN was considered if the serum creatinine (SCr) value was increased 25% in relation to its basic value. Additionally, the prevalence of CIN was evaluated. Results: The case and control groups had CIN 38% and 12%, respectively (P = 0.003). Hyperuricemia was significant indicator of higher CIN rate in the control group (37.5% versus 7.1%) (P = 0.044). Conclusion: Finally, the administration of allopurinol before procedure might prevent CIN following elective percutaneous coronary intervention (PCI) and decrease the rate of CIN.


2008 ◽  
Vol 7 (4) ◽  
pp. 307-313 ◽  
Author(s):  
Maria Bäck ◽  
Bertil Wennerblom ◽  
Susanna Wittboldt ◽  
Åsa Cider

Background: The aim of this study was to evaluate the effects of high frequency exercise for patients before and after an elective percutaneous coronary intervention (PCI), with special reference to maximal aerobic capacity, muscle function, health related quality of life (HRQoL), waist–hip ratio (WHR) and restenosis. Methods: A randomised, controlled study was performed in Sweden between 2004 and 2006 in thirty-seven patients (five women) with stable coronary artery disease (CAD), age 63.6 ± 6.9 years, randomised to either high frequency exercise or control group. The patients in the training group performed three endurance resistance exercises and trained on a cycle ergometer 30 min, 5 times a week for 8 months at 70% of VO2max. Results: Patients in the training group significantly improved their maximal aerobic capacity (15 (9–46) vs. 8 (0–18)% p ≤ 0.05), shoulder flexion ( p ≤ 0.01), shoulder abduction ( p ≤ 0.01) and heel-lift ( p ≤ 0.05) compared to the control group. There were no significant differences between the groups in HRQoL, WHR and restenosis. Conclusion: High frequency exercise in patients treated with PCI seems to improve maximal aerobic capacity and muscle function, which may reduce the risks of further progression of atherosclerosis. However, further larger studies are needed to fully investigate the effects of exercise in patients with PCI.


2019 ◽  
Vol 9 (2) ◽  
pp. 307-313 ◽  
Author(s):  
Farzaneh Foroughinia ◽  
Mahtabalsadat Mirjalili ◽  
Ehsan Mirzaei ◽  
Alireza Oboodi

Purpose: Contrast-induced nephropathy (CIN) is the third cause of hospital-acquired renal failure and is associated with significant morbidity and mortality. Several studies have revealed the protective role of omega-3 in prevention and treatment of some kidney injuries. This study was conducted to examine the effect of omega-3 supplementation on the markers of renal function and to evaluate its potential in the prevention of CIN in patients undergoing elective percutaneous coronary intervention (PCI). Methods: In this double-blind, randomized clinical trial, 85 eligible patients scheduled for PCI was randomly divided into omega-3 (a single 3750 mg dose of omega-3 as well as routine hydration therapy within 12 hours before PCI) or control (placebo plus routine hydration therapy) groups. Serum creatinine (SCr) and cystatin C levels were measured at baseline and 24 hours after PCI. Results: Our results indicated that post- PCI cystatin C levels were significantly decreased in the omega-3 group compared to the control group (P < 0.001). Although less upward manner was seen in the level of 24-hour creatinine in the omega-3 group, it did not reach the significance level (P = 0.008). Conclusion: The positive effect of omega-3 on cystatin C levels showed that it may have a protective role in the prevention of CIN in post-PCI patients with normal kidney function. However, to better assess this effect, it is highly recommended to design future studies with higher doses and longer duration of therapy with omega-3 plus long-term follow up.


2009 ◽  
Vol 4 (2) ◽  
pp. 19-23
Author(s):  
Md Razib Ahsan ◽  
Md Abu Siddique ◽  
KMHS Sirajul Haque ◽  
Syed Ali Ahsan ◽  
Md Khurshed Ahmed ◽  
...  

Appearance of serum creatine kinase MB fraction (CK-MB), reflecting the periprocedural myonecrosis, after successful percutaneous coronary intervention (PCI) is associated with future cardiac adverse events. The intracoronary adenosine on the incidence of myonecrosis after elective PCI was assessed. In this prospective, case control study with a total of 60 patients, 30 cases pretreated with 50 micro grams bolus intracoronary adenosine before advancement of guidewire and 30 controls not pretreated was studied during elective PCI. Both groups received statin and loading dose of Clopidogrel. Myonecrosis was assessed by CK-MB level after PCI. Post procedural myonecrosis occurred in 16.7 % (n=5) in case group and 36.7 % (n=11) in control group (OR=1.818; 95% CI 0.841; P=0.080). The result is not statistically significant but shows that the incidence of myonecrosis was reduced from 36.7% to 16.7%. Intracoronary adenosine reduces the incidence of myonecrosis after elective PCI. Keywords: Adenosine; Creatine kinase MB fraction; Intracoronary; Myonecrosis; Percutaneous coronary intervention; Periprocedural.   doi:10.3329/uhj.v4i2.2068 University Heart Journal Vol. 4 No. 2 July 2008 p19-23


2019 ◽  
Vol 26 (10) ◽  
pp. 627-637
Author(s):  
Hui Liu ◽  
Wei Wang ◽  
Haojia Chen ◽  
Zhi Li ◽  
Shushuang Feng ◽  
...  

Background Pre-hospital identification of acute ST-elevation myocardial infarction and activation of the catheterization laboratory can reduce first medical contact to wire-crossing times. We conducted a study on providing 24-hour tele-electrocardiography services via the WeChat group application, aiming to reduce the time taken for diagnosis and treatment of ST-elevation myocardial infarction. Methods A controlled before and after study was conducted on 140 ST-elevation myocardial infarction patients who were initially seen in non-percutaneous coronary intervention-capable hospital and transferred for primary percutaneous coronary intervention at our percutaneous coronary intervention centre from 1 February to 31 October 2018. The WeChat group had 70 patients with pre-hospital electrocardiography transmission via WeChat and the control group had 70 patients who did not transfer pre-hospital electrocardiography. The reperfusion time of the two groups was compared to evaluate the effect of the WeChat group intervention. Results In the WeChat group versus the control group, the median symptom onset to first medical contact time was similar (129 vs 150 min, p > 0.05), but the median first medical contact to wire, door to wire and first medical contact to catheterization laboratory activity were significantly shorter (132 vs 171 minutes, p < 0.001; 60 vs 95 minutes, p < 0.001; 29 vs 74 minutes, p < 0.001, respectively). Conclusions Pre-hospital electrocardiography transfer via a WeChat group resulted in earlier reperfusion of ST-elevation myocardial infarction patients who were transferred from the non-percutaneous coronary intervention centre.


2018 ◽  
Vol 9 (7) ◽  
pp. 758-763 ◽  
Author(s):  
Arshad A Khan ◽  
Allan J Davies ◽  
Nicholas J Whitehead ◽  
Michael McGee ◽  
Mohammed S Al-Omary ◽  
...  

Introduction: Elevated left ventricular end diastolic pressure (LVEDP) is an independent predictor of mortality and heart failure in patients with ST-segment elevation myocardial infarction (STEMI). Whether lowering elevated LVEDP improves outcomes remains unknown. Methods: This non-randomized, single blinded study with prospective enrolment and sequential group allocation recruited patients undergoing primary percutaneous coronary intervention for STEMI with LVEDP ⩾ 20 mmHg measured immediately after primary percutaneous coronary intervention. The intervention arm ( n=10) received furosemide 40 mg intravenous bolus plus escalating doses of glyceryl trinitrate (100 µg per min to a maximum of 1000 µg) during simultaneous measurement of LVEDP. The control group ( n=10) received corresponding normal saline boluses with simultaneous measurement of LVEDP (10 readings over 10 min). Efficacy endpoints were final LVEDP achieved, and the dose of glyceryl trinitrate needed to reduce LVEDP by ⩾ 20%. Safety endpoint was symptomatic hypotension (systolic blood pressure < 90 mmHg). Results: From 1 April 2017 to 23 August 2017 we enrolled 20 patients (age: 64±9 years, males: 60%, n=12, anterior STEMI: 65%, n=13). The mean LVEDP for the whole cohort ( n=20) was 29±4 mmHg (intervention group: 28±3 mmHg vs. control group: 31±5 mmHg; p=0.1). The LVEDP dropped from 28±3 to 16±2 mmHg in the glyceryl trinitrate + furosemide group ( p <0.01) but remained unchanged in the control group. The median dose of glyceryl trinitrate required to produce ⩾ 20% reduction in LVEDP in the intervention group was 200 µg (range: 100–800). One patient experienced asymptomatic decline in systolic blood pressure to below 90 mmHg. There was no correlation between LVEDP and left ventricular ejection fraction. Conclusion: The administration of glyceryl trinitrate plus furosemide in patients with elevated LVEDP following primary percutaneous coronary intervention for STEMI safely reduces LVEDP.


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