Clinical study of a new nutritional index for predicting long-term prognosis in patients with coronary atherosclerotic heart disease following percutaneous coronary intervention

Background and Objective: Some patients continue to experience major adverse cardiovascular and cerebrovascular events (MACCE) after percutaneous coronary intervention (PCI) in frigid places. Indexes of inflammation and nutrition alone were shown to predict outcomes in patients with PCI. However, the clinical predictive value of mixed indicators is unclear. This study aimed to assess the predictive value of the albumin/neutrophil/lymphocyte ratio (NLR) on the long-term prognosis of patients with coronary heart disease (CHD) following percutaneous coronary intervention (PCI). Methods: A total of 608 post-PCI CHD patients were categorized into low- and high-index groups based on the optimal cut-off values for albumin and NLR. The primary outcome was a composite endpoint comprising all-cause mortality and major adverse cerebrovascular events. The secondary outcome was the comparison of the predictive efficiency of the new nutritional index, albumin/NLR, with that of albumin or NLR alone. Results: Over the five-year follow-up period, 45 patients experienced the composite endpoint. The incidence of endpoint events was significantly higher in the low-index group (12%) compared to the high-index group (4.9%). Receiver operating characteristic (ROC) curve analysis revealed that the albumin/NLR index had a larger area under the curve (AUC: 0.655) than albumin (AUC: 0.621) or NLR (AUC: 0.646), indicating superior predictive efficiency. The prognostic nutritional index had an AUC of 0.644, further supporting the enhanced predictive value of the albumin/NLR index over individual nutritional and inflammatory markers. Conclusion: The albumin/neutrophil/lymphocyte ratio is independently associated with the long-term prognosis of CHD patients post-PCI and demonstrates superior predictive efficiency compared to individual nutritional and inflammatory markers.

Effect of continuous nursing on treatment compliance and side effect management of coronary heart disease

BACKGROUND There are relatively few studies on continuing care of coronary heart disease(CHD),and its research value needs to be further clarified.AIM To investigate the effect of continuous nursing on treatment compliance and side effect management in patients with CHD.METHODS This is a retrospective study with patients from January 2021 to 2023.The study was divided into two groups with 30 participants in each group.Self-rating anxiety scale(SAS)and Self-rating depression scale(SDS)were used to assess patients'anxiety and depression,and medical coping questionnaire was used to assess patients'coping styles.The pelvic floor dysfunction questionnaire(PFDI-20)was used to assess the status of pelvic floor function,including bladder symptoms,intestinal symptoms,and pelvic symptoms.RESULTS SAS score decreased from 57.33±3.01before treatment to 41.33±3.42 after treatment,SDS score decreased from 50.40±1.45 to 39.47±1.57.The decrease of these two indexes was statistically significant(P<0.05).PFDI-20 scores decreased from the mean 16.83±1.72 before treatment to 10.47±1.3the mean after treatment,which was statistically significant(P<0.05).CONCLUSION The results of this study indicate that pioneering research in continuous care of CHD has a positive impact on improving patients'treatment compliance,reducing anxiety and depression levels,and improving coping styles and pelvic floor functional status.

Treatment of Coronary Heart Disease from the Perspective of Liver Controlling Dispersion

The liver is in charge of distributing and regulating the movement of qi throughout the whole body,coordinating the transportation and transformation of the internal organs in the middle part of the body,promoting the biochemical circulation of qi,blood,and body fluids,and regulating emotions.Liver dysfunction can disrupt the transportation and transformation of qi,blood,and body fluids,causing phlegm turbidity,blood stasis,and other unwanted symptoms.Poor regulation of emotion further aggravates the accumulation of pathological substances,resulting in the obstruction of heart vessels,and ultimately coronary heart disease(CHD).Through regulating lipid metabolism,inflammatory reaction,vasoactive substances,platelet function,neuroendocrine,and other factors,liver controlling dispersing qi plays a comprehensive role in the prognosis of atherosclerosis,the primary cause of CHD.Therefore,it is recommended to treat CHD from the perspective of liver-controlling dispersion.

Impact of continuous care on cardiac function in patients with lung cancer complicated by coronary heart disease

BACKGROUND Despite sharing similar pathogenic factors,cancer and coronary heart disease(CHD)occur in comparable populations at similar ages and possess similar susceptibility factors.Consequently,it is increasingly commonplace for patients to experience the simultaneous occurrence of cancer and CHD,a trend that is steadily rising.AIM To determine the impacts of continuing care on lung cancer patients with CHD following percutaneous coronary intervention(PCI).METHODS There were 94 lung cancer patients with CHD following PCI who were randomly assigned to the intervention group(n=38)and the control group(n=41).In the intervention group,continuing care was provided,while in the control group,routine care was provided.An evaluation of cardiac and pulmonary function,medication compliance,a 6-min walk test,and patient quality of life was performed.RESULTS Differences between the two groups were significant in left ventricular ejection fraction,6-min walk test,oxygen uptake,quality of life and medication compliance(P<0.05).In comparison with the control group,the enhancement in the intervention group was more significant.The intervention group had more patients with high medication compliance than the control group,with a statistically significant difference(P<0.05).CONCLUSION After undergoing PCI,lung patients with CHD could benefit from continued care in terms of cardiac and pulmonary function,medications compliance,and quality of life.

Coronary artery disease and heart failure:Late-breaking trials presented at American Heart Association scientific session 2023

The late-breaking science presented at the 2023 scientific session of the American Heart Association paves the way for future pragmatic trials and provides meaningful information to guide management strategies in coronary artery disease and heart failure(HF).The dapagliflozin in patient with acute myocardial infarction(DAPA-MI)trial showed that dapagliflozin use among patients with acute MI without a history of diabetes mellitus or chronic HF has better cardiometabolic outcomes compared with placebo,with no difference in cardiovascular outcomes.The MINT trial showed that in patients with acute MI and anemia(Hgb<10 g/dL),a liberal transfusion goal(Hgb≥10 g/dL)was not superior to a restrictive strategy(Hgb 7-8 g/dL)with respect to 30-day all-cause death and recurrent MI.The ORBITA-2 trial showed that among patients with stable angina and coronary stenoses causing ischemia on little or no antianginal therapy,percutaneous coronary intervention results in greater improvements in anginal frequency and exercise times compared with a sham procedure.The ARIES-HM3 trial showed that in patients with advanced HF who received a HeartMate 3 levitated left ventricular assist device and were anticoagulated with a vitamin K antagonist,placebo was noninferior to daily aspirin with respect to the composite endpoint of bleeding and thrombotic events at 1 year.The TEAMMATE trial showed that everolimus with low-dose tacrolimus is safe in children and young adults when given≥6 months after cardiac transplantation.Providing patients being treated for HF with reduced ejection fraction(HFrEF)with specific out-of-pocket(OOP)costs for multiple medication options at the time of the clinical encounter may reduce‘contingency planning’and increase the extent to which patients are taking the medications decided upon.The primary outcome,which was cost-informed decisionmaking,defined as the clinician or patient mentioning costs of HFrEF medication,occurred in 49%of encounters with the checklist only control group compared with 68%of encounters in the OOP cost group.

Firebird stent for the treatment of patients with coronary heart disease： short-term clinical outcome

Objective The sirolimus-eluting stent （SES） has dramatically reduced the rate ofrestenosis in comparison to that with the baremetal stent （BMS）.This study aimed to evaluate the short-term efficacy and safety of Firebird stent implantation for patients with coronary heart disease （CHD）. Methods From Apri12006 through July 2007, 155 patients （mean age 58.93±10.27 years ） with CHD were implanted with Firebird stent or Cypher select stent at Daxing Hospital. Patients were followed up for one year. All-cause mortality, major adverse cardiac events （MACE, including cardiac death, myocardial infarction, recurrence of angina pectoris, heart failure, revascularization, and adverse arrhythmia） and stent thrombosis were compared between the 2 groups. Results Of the 155 consecutive patients, 147 patients were revascularized completely. Of these patients, 48 （with 59 lesions） were treated with Firebird stent, 59 patients （with 75 lesions） with Cypher select stent. The demographic characteristics were similar in the 2 groups. All the angiographic and procedural results were not significantly different between the 2 groups. All-cause mortality, myocardial infarction, recurrence of angina pectoris, MACE and stent thrombosis were almost identical between the 2 groups before discharge, at 6 months and at one year .Conclusion The short-term efficacy and safety of Firebird stent are similar to that of the cypher select stent for the treatment of patients with CHD （J Geriatr Cardlo12009; 6：157-161）.

Evidence-based optimization of integrated traditional Chinese and Western medicine therapies for prevention and treatment of coronary heart disease： design and implementation

As a chronic disease that seriously endangers public health, the number of coronary heart disease （CHD） patients in China has increased in recent years. There is great potentiality to integrate traditional Chinese and Western medicine therapies to prevent and treat CHD in clinical practice. However, most of the current integrated therapies still lack sufficient high-quality evidence, and the key links in how to apply are unclear. It is urgent to optimize them through evidence-based research to further improve the effectiveness. Therefore, we propose strategies to conduct evidence-based optimization of integrated traditional Chinese and Western medicine therapies in prevention and treatment of progressive cardiovascular diseases. These are integrated clinical trial design, attention to the key links of taking effect, combination of clinical and basic research. Based on the strategies, we started the national key research and development project ＂Evidence-based optimization research of TCM therapies in prevention and treatment of CHD （angina pectoris - myocardial infarction - heart failure）＂, which is expected to be a new paradigm in the field.

Effect of nursing intervention based on Maslow's hierarchy of needs in patients with coronary heart disease interventional surgery

BACKGROUND It is very important to provide effective nursing programs to regulate the physical and mental state of patients and to improve treatment compliance after interventional surgery for coronary heart disease(CHD).AIM To explore the effect of a nursing intervention based on Maslow’s hierarchy of needs theory on patients with CHD undergoing percutaneous coronary intervention.METHODS Ninety-four patients with CHD undergoing interventional surgery in our hospital from January 2020 to February 2021 were randomly divided into a research group(n=47)and a control group(n=47).The control group received routine nursing,and the research group received a nursing intervention based on Maslow’s hierarchy of needs theory.The scores of self-efficacy,negative emotion[depression(SDS),anxiety(SAS)],intervention compliance(standardized medication,moderate exercise,healthy diet,and regular review),and nursing satisfaction were calculated before and after intervention for the two groups.RESULTS Before intervention,there was no significant difference in the scores of disease general management self-efficacy,disease management self-efficacy,and total self-efficacy between the two groups(P=0.795,0.479,and 0.659,respectively).After intervention,these three scores in the research group were higher than those in the control group(P<0.001).Before intervention,there was no significant difference in the scores of SAS and SDS between the two groups(P=0.149 and 0.347,respectively).After intervention,the scores of SAS and SDS in the research group were lower than those in the control group(P<0.001).The standardized drug use rate(97.87%),moderate exercise rate(97.87%),healthy diet rate(95.74%),and regular reexamination rate(97.87%)in the research group were higher than those in the control group(85.11%,82.98%,80.85%,and 87.23%,respectively)(P=0.027,0.014,0.025,and 0.049,respectively).Nursing job satisfaction in the research group(93.62%)was higher than that in the control group(78.72%)(P=0.036).CONCLUSION A nursing program based on Maslow’s hierarchy of needs theory can effectively alleviate negative emotion,enhance self-efficacy and intervention compliance,and ensure that the patients are highly satisfied with the nursing work.

Optimal scheme of Shengmai Injection in the treatment of angina pectoris of coronary heart disease based on Louvain algorithm: A real world study

Objective:To explore the optimal scheme of Shengmai Injection combined with other drugs for clinical doctors.Methods:Based on the large-scale data warehouse established by the institute of Clinical Basic Medicine,Chinese Academy of Traditional Chinese Medicine,the hospital information system of 22 large-scale tertiary hospitals in China was collected and 1751 patients with angina pectoris who were treated with Shengmai Injection were selected.Louvain algorithm and complex network analysis are used to build the model to summarize the rule of Shengmai Injection in the treatment of angina pectoris of coronary heart disease.Results:On the basis of Shengmai Injection,according to the symptom treatment of angina pectoris of coronary heart disease,nitrates or Suxiao Jiuxin Pill was used to dilate coronary artery;for the treatment of risk factors of angina pectoris,a combination of"insulin+acarbose+bisoprolol+nifedipine+captopril+estazolam"was used to control blood glucose and blood pressure;"Ganmao Qingre Granule+levofloxacin"to treat upper respiratory tract infection and other medication regimens were used as well.For the complications of angina pectoris of coronary heart disease,"furosemide+spironolactone+potassium chloride+magnesium sulfate"was used to reduce edema and“isosorbide nitrate+metoprolol+Shenmai injection+Wenxin Granule"was used to improve symptom of heart failure of qi and yin deficiency type.Conclusion:The therapeutic regimen of Shengmai Injection combined with traditional chinese medicine and western medicine is basically consistent with the current guidelines,but more clinical studies are still needed to explore more effective combination therapy.

General awareness of symptoms of myocardial infarction and the need for urgent treatment:A cross-sectional,street survey in Chennai,Tamil Nadu

Objective:To investigate the golden-time-awareness of and the necessary actions in response to acute myocardial infarction among the general public.Methods:This study was conducted with the use of a descriptive research design and convenience sampling.A sample of 800 subjects,using self-structured knowledge questionnaires,was selected for data collection and analysis.The study was conducted at Dr.M.G.R.Educational and Research Institute,India,from February to November 2022.Awareness of myocardial infarction symptoms and intervention timeline(the golden time)was investigated.A multivariate logistic regression analysis was performed to identify the demographic factors affecting the recognition of the golden time of acute myocardial infarction.Results:A total of 800 subjects were included.Among the subjects,367(45.8%)were male,433(54.2%)were female,and 443(55.3%)participants failed to recognize the golden time.Our multivariate logistic regression analysis showed that people with a bachelor’s degree(OR=0.41,95%CI:0.23-0.74,P=0.03)and a high school level diploma(OR=0.55,95%CI:0.31-0.97,P=0.03)are more likely to know about myocardial infarction(golden time)than illiterate people.Additionally,people who are employed(OR=0.59,95%CI:0.41-0.85,P=0.05)are more likely to know about myocardial infarction(golden time)than those who are not.Conclusions:The majority of people in the awareness group realize that taking myocardial infarction patients to the hospital would be the best course of action.The unawareness of the ideal treatment window for myocardial infarction may cause a delay in seeking medical attention,which can lead to an increase in mortality and morbidity.

Application of Medical Failure Mode and Effect Analysis in Preoperative Preparation for Coronary Intervention

[Objectives]To explore application effect of healthcare failure mode and effect analysis(HFMEA)in preoperative management of coronary intervention.[Methods]The preoperative management process of 455 patients who underwent coronary intervention surgery from January to March in 2022 was sorted out,and the failure modes and causes in the preoperative management were analyzed.The priority risk value was calculated,and the top 6 failure modes were found out.Improvement measures were formulated according to the causes of failure modes.Two months after the implementation of the procedure,470 patients who underwent coronary intervention surgery from May to July in 2022 were selected as the intervention group,and the optimized preoperative preparation procedure by HFMEA was adopted.The decrease of risk priority number(RPN)and RPN value of two high-risk failure modes,as well as changes in the rate of the time of taking dual-antiplatelet drugs reaching the standard,the rate of passing the dress code,the rate of timely signing of informed consent,and the rate of filling in the handover form of preoperative preparation were analyzed.[Results]The rate of the time of taking dual-antiplatelet drugs reaching the standard,the rate of passing the dress code,the rate of timely signing of informed consent,and the rate of filling in the handover form of preoperative preparation in experimental groups were higher than those of the control group,and the difference was statistically significant(P<0.05).[Conclusions]Applying HFMEA to the management of preoperative preparation process for coronary intervention can effectively improve the timeliness and qualification rate of preoperative preparation for coronary intervention,and provide guarantee for the safe and smooth implementation of coronary intervention.

Percutaneous approach to treatment of coronary disease in a patient with uremic cardiomyopathy

Uremic cardiomyopathy is chronic ischemic left ventricular dysfunction characterized by heart failure, myocardial ischemia, hypotension in dialysis and arrhythmia. This nosologic entity represents a leading cause of morbidity and mortality among patients with endstage renal disease receiving long-term hemodialysis. It is intuitive that revascularization in the presence of coronary artery disease in these patients represents an effective option for improving their prognosis. Although the surgical option seems to be followed by the best clinical outcome, some patients refuse this option and others are not good candidates for surgery. The present report describes the case of a patient affected by uremic cardiomyopathy and severe coronary artery disease in whom revascularization with percutaneous coronary angioplasty was followed by a significant improvement in quality of life.

Review of Medical Treatment of Stable Ischemic Heart Disease

Medical treatment is the initial treatment strategy and is the cornerstone of management in patients with stable ischemic heart disease (IHD). Many patients are not suitable for percutaneous or surgical revascularization because of unfavourable anatomy, or the presence of co-morbidities. In addition, many patients have recurrence of angina following revascularization due to restenosis or incomplete revascularization. Furthermore, randomized clinical trials comparing optimal medical treatment to revascularization have not clearly shown that myocardial revascularization is superior to optimal medical treatment. Traditional drugs for angina treatment include b-blockers, calcium channel blockers and nitrates. Newer drugs are available with different mechanisms of action and with equal efficacy that do not cause significant hemodynamic deterioration. The availability of these newer drugs expands the therapeutic potential of medical treatment to even a wider population with stable IHD. Revascularization in patients with stable ischemic heart disease has never been shown to reduce hard endpoints (death or myocardial infarction) in randomized clinical trials.

Comparison of clinical outcomes of Chinese men and women after coronary stenting for coronary artery disease:a multi-center retrospective analysis of 4,334 patients

The outcome differences between Chinese male and female patients within one-year follow-up after percutaneous coronary intervention（PCI） with stent remain unclear.The present study was aimed to compare clinical outcomes in such two populations.From May 1999 to December 2009,4,334 patients with acute myocardial infarction（MI）,unstable angina,stable angina,or silent ischemia,who underwent PCI,were registered at our centers.Among these,3,089 were men and 1,245 were women.We compared these groups with respect to the primary outcomes of MI and secondary outcomes including a composite of major adverse cardiac events（MACE） including cardiac death,MI,target lesion revascularization,target vessel revascularization（TVR）,stent thrombosis（ST）,definite ST and probable ST at one-year follow-up.Chinese male patients had a higher MACE rate（13%vs.10.7%,P =0.039）,mainly led by TVR（9.09%vs.6.98%,P=0.024） at one year,which was significantly different than female patients.Chinese male and female patients showed a significant difference on MACEs.However,there was no significant difference with respect to MI between these groups.

Risk Factors and Intervention Status of Cardiovascular Disease in Elderly Patients with Coronary Heart Disease

To analyze the correlation between coronary heart disease and the possible risk factors such as age, gender, hypertension, dyslipidemia, smoking, diabetes, uric acid and plasma fibrinogen, to screen the main risk factors of coronary heart disease in the elderly and evaluate the intervention status of coronary heart disease in the elderly. In the unchangeable risk factors, age is still the main risk factor of coronary heart disease;in terms of gender, the onset age of female coronary heart disease is later than that of male, but the complications and mortality rate are higher than that of male, and the risk factors are more than that of male. The first level prevention needs doctors and patients to establish a mutual trust relationship, and actively intervene to reduce the total risk of cardiovascular disease. Drug compliance management should be strengthened in secondary prevention.

The changes of Hs-CRP and WBC count after percutaneous coronary intervention in different types of coronary heart diseases

Objective： To investigate the regulation of High sensitive C-reactive protein（Hs-CRP） and WBC count in patients with coronary heart disease（CHD） by percutaneous transluminal intervention（PCI） and to discuss the mechanism of inflammatory reaction after coronary stenting. Methods：127 patients who received successful percutaneous transluminal coronary stenting, were divided into groups of stable angina（SAP）, unstable angina（UAP）, and acute myocardial infarction（AMI） according to their clinical types. Another 41 stable angina patients with more than 70% of coronary artery tenosis who did not receive PCI served as control. Serum Hs-CRP levels and WBC count were determined before intervention, 3 days and 7 days post PCI and the data were analyzed statistically by t-test. Results： There showed no difference in clinical baseline characteristics between groups. The serum Hs-CRP level and WBC count was gradually raised in the UAP and AMI group（how about SAP group, andhad no difference in CAG group and SAP group）. After PCI serum HsCRP levels and WBC counts were significantly higher in the SAP group than in the coronary angiography group（CAG） at 3 days and had no difference at 7 days. In the UAP and AMI group, the serum Hs-CRP level at 3 days and 7 days declined obviously, however serum WBC count did not decrease apparently. Conclusion： The serum Hs-CRP level and WBC count elevate transiently after PCI. There are different inflammatory reactions in different types of coronary heart diseases after coronary stenting procedure.

Proteomics analysis of coronary atherosclerotic heart disease with different Traditional Chinese Medicine syndrome types before and after percutaneous coronary intervention

OBJECTIVE: To investigate the underlying protein molecular mechanisms of "Qi stagnation and blood stasis syndrome"(QS) and "Qi deficiency and blood stasis syndrome"(QD), as two subtypes of coronary artery disease(CAD) in Traditional Chinese Medicine(TCM),following percutaneous coronary intervention(PCI).METHODS: In this study, a total of 227 CAD patients with QS and 211 CAD patients with QD were enrolled;all participants underwent PCI. Label-free quantification proteomics were employed to analyze the changes in serum in two subtypes of CAD patients before and 6 months after PCI, aiming to elucidate the intervention mechanism of PCI in treating CAD characterized by two different TCM syndromes.RESULTS: Biochemical analysis revealed significant changes in tumor necrosis factor-α, high density lipoprotein cholesterol, blood stasis clinical symptoms observation, and Gensini levels in both patient groups post-PCI;Proteomic analysis identified 79 and 95 differentially expressed proteins in the QS and QD patient groups, respectively, compared to their control groups.complement C8 alpha chain, complement factor H,apolipoprotein H, apolipoprotein B, plasminogen,carbonic anhydrase 2, and complement factor Ⅰ were altered in both comparison groups. Furthermore,enrichment analysis demonstrated that cell adhesion and connectivity-related processes underwent changes in QS patients post-PCI, whereas lipid metabolism-related pathways, including the peroxisome proliferator-activated receptor signaling pathway and extracellular matrix receptor interaction, underwent changes in the QD group.The protein-protein interaction network analysis further enriched 52 node proteins, including apolipoprotein B,lipoprotein(a), complement C5, apolipoprotein A4,complement C8 alpha chain, complement C8 beta chain,complement C8 gamma chain, apolipoprotein H,apolipoprotein A-Ⅱ, albumin, complement C4-B,apolipoprotein C3, among others. The functional network of these proteins is posited to contribute to the pathophysiology of CAD characterized by TCM syndromes.CONCLUSION: The current quantitative proteomic study has preliminarily identified biomarkers of CAD in different TCM subtypes treated with PCI, potentially laying the groundwork for understanding the protein profiles associated with the treatment of various TCM subtypes of CAD.

Feasibility of percutaneous coronary intervention via transulnar artery approachin selective patients with coronary heart disease

Objective To probe the clinic feasibility of percutaneous coronary intervention(PCI) via transulnar artery approach (PCI TRU).Methods Fourty patients with unstable ischemic manifestation(male 34,female 6;age 59.3 ±9.10 years)whose radial artery of right hand was thin with a weak pulse that was not suitable to transradial artery PCI while whose ulnar artery was thick with a strong pulse based on their larger diameter in ulnar artery as compared with those in radial artery ( 3.30 ±0.22mm vs 2.43 ±0.33 mm, P <0.05 ) by the investigation of vessel echography,but revesered Allen’s test for radial and ulnar artery was positive,were selected as the subjects for PCI TRU. The radio of ulnar artery versus radial artery was 1.35:1.00 and the time of Allen’s test in ulnar artery side was shorter than that in radial artery side ( 2.70 ±0.36 s vs 4.68 ±0.52s , P <0.05 ) before PCI. The efficiency of PCI TRU was evaluated. The time of manipulative duration for each procedure of PCI TRU was recorded. The time of Allen’s test, luminal diameter (mm) , cross area of vessel lumin (mm 2), blood velocity (Vs max), blood resistance (RI) in ulnar artery and radial artery and the level of blood oxygen in finger (PaO 2、SatO 2) were measured and recorded , respectively , as well were compared quantitatively before and after 1 month of procedure . Results Fourty eight lesion segments of 42 vessels in all patients were angioplasticized successfully via TRU by 6F guiding catheter including 23 segments of type B1 , 14 segments of type B2 and 11 segments of type C. PCI TRU in all of 40 patients was performed successfully. Fourty eight stents were implanted including 2 lesions of intrastent restenosis angioplasticized with cutting balloon technique before re stenting . The average time of manipulative duration of guiding catheters engaging in osicum of target coronary, crossing the vessel lesions of guidewire, dilatation and implantation of stents,and under X ray fluoroscopy were 4.30 ±0.59 min , 2.52 ±0.40min , 2.66 ±0.40 min ,and 25.9 ±0.49 min , respectively, and the total time of the whole procedure was 56.6 ±14.8 min . When the ulnar introducer was taken off, the access site in ulnar artery was suppressed by tourniquet with no bleeding in the access site and no limitation of physical activation under maintaining infusion of heparin immediately after procedure . There was no significant change in the diameter of ulnar artery and the time of Allen’s test after 1 month of PCI procedure as compared with those before procedure ( 3.22 ±0.48mm vs 3.26 ±0.22 mm , P >0.05 ; 2.96 ±0.98 s vs 2.72 ±0.47 s , P >0.05 ). No significant change was found in the parameters of blood velocity , cross area of vessel lumin, blood resistance and the level of blood oxygen in finger after 1 month of PCI procedure. The average total hospital stay was 5.21 ±0.43 days. Following up 1 month, no complications such as occlusion of ulnar artery, abnormal sensitivity and movement disability were found in right hands in all patients.Conclusions The ulnar artery might be selected as one approach of antebrachial artery for PCI in the patients with coronary heart disease whose radial artery was difficulty as access vessels of PCI, while reversed Allen’s test for radial and ulnar artery are positive and the luminal diameter of ulnar artery was larger than that of radial artery.

Research Progress on the Depression Status and Nursing Intervention in Patients after Percutaneous Coronary Intervention

Percutaneous coronary intervention(PCI)is an effective treatment method for myocardial ischemic necrosis.Postoperative depression caused by PCI stress will adversely affect the prognosis of patients.This article reviews the current status and influencing factors of postoperative depression after PCI and summarizes the corresponding nursing interventions,to provide a literature reference to implement effective nursing interventions for depressed patients after clinical PCI.

Effect of exercise rehabilitation combined with trimetazidine on endothelial function, inflammatory response and blood lipid metabolism in patients with coronary heart disease after PCI

Objective:To study the effect of exercise rehabilitation combined with trimetazidine on endothelial function, inflammatory response and blood lipid metabolism in patients with coronary heart disease after percutaneous coronary intervention (PCI).Methods: The patients with stable angina pectoris who received PCI in our hospital between July 2015 and November 2017 were chosen and randomly divided into the observation group who received postoperative exercise rehabilitation combined with trimetazidine and the control group who received conventional intervention combined with trimetazidine. The reactive hyperemia index (RHI) as well as serum contents of endothelial markers, inflammatory cytokines and blood lipid indexes were determined before intervention and after intervention for 3 months.Results:After intervention for 3 months, the RHI levels as well as serum NO, HDL-C and Omentin-1 contents of both groups significantly increased while serum ET-1, vWF, M-CSF, IL-6, IL-8, RANTES, LDL-C and Chemerin contents significantly decreased;the RHI level as well as serum NO, HDL-C and Omentin-1 contents of the observation group was significantly higher than those of the control group while serum ET-1, vWF, M-CSF, IL-6, IL-8, RANTES, LDL-C and Chemerin contents were significantly lower than those of the control group.Conclusion:Exercise rehabilitation combined with trimetazidine can improve the endothelial function, inhibit the inflammatory response and regulate the blood lipid metabolism in patients with coronary heart disease after PCI.