BACKGROUND Frailty is a common condition in elderly patients who receive percutaneous coronary intervention(PCI).However,how frailty affects clinical outcomes in this group is unclear.AIM To assess the link between fr...BACKGROUND Frailty is a common condition in elderly patients who receive percutaneous coronary intervention(PCI).However,how frailty affects clinical outcomes in this group is unclear.AIM To assess the link between frailty and the outcomes,such as in-hospital complic-ations,post-procedural complications,and mortality,in elderly patients post-PCI.METHODS The PubMed/MEDLINE,EMBASE,Cochrane Library,and Web of Science databases were screened for publications up to August 2023.The primary outcomes assessed were in-hospital and all-cause mortality,major adverse cardiovascular events(MACEs),and major bleeding.The Newcastle-Ottawa Scale was used for quality assessment.RESULTS Twenty-one studies with 739693 elderly patients undergoing PCI were included.Frailty was consistently associated with adverse outcomes.Frail patients had significantly higher risks of in-hospital mortality[risk ratio:3.45,95%confidence interval(95%CI):1.90-6.25],all-cause mortality[hazard ratio(HR):2.08,95%CI:1.78-2.43],MACEs(HR:2.92,95%CI:1.85-4.60),and major bleeding(HR:4.60,95%CI:2.89-7.32)compared to non-frail patients.CONCLUSION Frailty is a pivotal determinant in the prediction of risk of mortality,development of MACEs,and major bleeding in elderly individuals undergoing percutaneous coronary intervention.展开更多
Wang and Liu's systematic review of frailty among elderly patients undergoing percutaneous coronary intervention(PCI)revealed that patients with frailty have significantly higher risks of all-cause and in-hospital...Wang and Liu's systematic review of frailty among elderly patients undergoing percutaneous coronary intervention(PCI)revealed that patients with frailty have significantly higher risks of all-cause and in-hospital death,major undesirable cardiovascular events,and major haemorrhage.Frailty is associated with adverse events,prolonged hospital stays,increased complications,and elevated mortality risk due to diminished physiological reserves.Integrating frailty into risk assessment tools is crucial,and gait speed has emerged as a key predictor of frailty.Recognizing the impact of frailty leads to personalized and informed decisionmaking,and frailty assessments should be performed.This holistic approach can inform tailored interventions,thereby optimizing outcomes for this vulnerable population undergoing PCI.展开更多
BACKGROUND Myocardial infarction,particularly ST-segment elevation myocardial infarction(STEMI),is a key global mortality cause.Our study investigated predictors of mortality in 96 STEMI patients undergoing primary pe...BACKGROUND Myocardial infarction,particularly ST-segment elevation myocardial infarction(STEMI),is a key global mortality cause.Our study investigated predictors of mortality in 96 STEMI patients undergoing primary percutaneous coronary intervention at Erbil Cardiac Center.Multiple factors were identified influencing in-hospital mortality.Significantly,time from symptom onset to hospital arrival emerged as a decisive factor.Consequently,our study hypothesis is:"Reducing time from symptom onset to hospital arrival significantly improves STEMI prognosis."AIM To determine the key factors influencing mortality rates in STEMI patients.METHODS We studied 96 consecutive STEMI patients undergoing primary percutaneous coronary intervention(PPCI)at the Erbil Cardiac Center.Their clinical histories were compiled,and coronary evaluations were performed via angiography on admission.Data included comorbid conditions,onset of cardiogenic shock,complications during PPCI,and more.Post-discharge,one-month follow-up assessments were completed.Statistical significance was set at P<0.05.RESULTS Our results unearthed several significant findings.The in-hospital and 30-d mortality rates among the 96 STEMI patients were 11.2%and 2.3%respectively.On the investigation of independent predictors of in-hospital mortality,we identified atypical presentation,onset of cardiogenic shock,presence of chronic kidney disease,Thrombolysis In Myocardial Infarction grades 0/1/2,triple vessel disease,ventricular tachycardia/ventricular fibrillation,coronary dissection,and the no-reflow phenomenon.Specifically,the recorded average time from symptom onset to hospital arrival amongst patients who did not survive was significantly longer(6.92±3.86 h)compared to those who survived(3.61±1.67 h),P<0.001.These findings underscore the critical role of timely intervention in improving the survival outcomes of STEMI patients.CONCLUSION Our results affirm that early hospital arrival after symptom onset significantly improves survival rates in STEMI patients,highlighting the critical need for prompt intervention.展开更多
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 revie...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.展开更多
Objective: To examine physical activity(PA) of post-percutaneous coronary intervention(PCI) patients and explore the demographic, clinical, and social psychological characteristics associated with PA levels. Methods: ...Objective: To examine physical activity(PA) of post-percutaneous coronary intervention(PCI) patients and explore the demographic, clinical, and social psychological characteristics associated with PA levels. Methods: A total of 246 post-PCI patients from the Peking University Third Hospital in Beijing, China, were included in this crosssectional study through convenience sampling. Data were collected from a self-repor ted questionnaire. PA was categorized into low, moderate, or high levels. The ordinal multinomial logistic regression model was used to estimate the relationship among demographic, medical, and psychosocial characteristics. Results: The overall prevalence of low, moderate, and high PA was 20%, 70%, and 10%, respectively. For the domain-specific PA patterns, most par ticipants took par t in leisure-time PA(84.5%);walking was the most common PA. Increased motivation and selfefficacy, lower monthly income, and unemployment were predictors of high PA. Conclusions: PA levels in post-PCI patients was not optimal, and leisure-time PA had the highest par ticipation rate. Analyses of influencing factors can provide medical staff and health workers information to focus on high-risk groups and introduce more tailored interventions. Future studies can explore more regions, and ecological models can be introduced to study more influencing factors.展开更多
Objective This study was to evaluate the efficacy and safety of a short acting reduced dose fibrinolytic regimen to promote early infarct related artery (IRA) patency for acyute myocardial infarction (AMI) patients re...Objective This study was to evaluate the efficacy and safety of a short acting reduced dose fibrinolytic regimen to promote early infarct related artery (IRA) patency for acyute myocardial infarction (AMI) patients referred for percutaneous coronary intervention (PCI).Methods Following aspirin and heparin, 166 patients were randomized to a 50 mg bolus of recombinant tissue type plasminogen activator(rt PA) or to a same volume sodium chloride injection followed by immediate primary PCI. The end points included patency rates on catheterization laboratory (cath lab) arrival, revascularization results when PCI was performed, complication rates, left ventricular function and restored patency rate following PCI. Results Patency on cath lab arrival was 64% with rt PA (34% TIMI 3,30% TIMI 2), while 31% of placebo (13% TIMI 3, 18% TIMI 2). There was no difference in the restored TIMI 3 rates of IRA between the two groups (85% vs 87%). No difference were observed in stroke or major bleeding. Left ventricular function was similar in both groups (52±9% vs 50±8%), but left ventricular ejection fraction fraction (LVEF) was higher with patent IRA (TIMI 3) on cath lab arrival than that of others (56±12% vs 48±10%).Conclusions Strategy thrombolytic regimens were compatible with subsequent PCI lead to more frequenc early recanalization (before cath lab arrival), which facilitates greater left ventricular function preservation with no augmentation of adverse events.展开更多
Objective Comparative study on the feasibility,safety and outcome of transradial artery and transfemoral artery access for primary percutaneous coronary intervention (PCI) in patients with acute myocardial infarction(...Objective Comparative study on the feasibility,safety and outcome of transradial artery and transfemoral artery access for primary percutaneous coronary intervention (PCI) in patients with acute myocardial infarction(AMI).Methods Two hundred and eight patients with AMI episoded within 12 hours, male 159, female 49, age 58.9 ±11.9 (34～88)years, were randomly divided into transradial artery access for primary PCI (TRA pPCI) group of 106 cases and transfemoral artery access for PCI (TFA pPCI) group of 102 cases during Sept, 2000 to Aug, 2002. The protocols of the manipulation duration and the effect for TRA pPCI and TFA pPCI procedures were respectively compared, including the time of transradial artery puncture and the rate of puncture success at first time ; the time of guiding catheter engaging into target coronary ostium; the rate of patence in infarct related artery (IRA); total duration of manipulation and the successful rate.The incidence of complications such as bleeding, vessel injury,thrombi and embolism as well as the average stay of hospitalization between two groups was compared. The status and the incidance of vessel spasm were observed and the effect of medicine administration to prevent from and relieve the vascular spasm was evaluated. The time of Allen’s test before and after TRA pPCI , the inner diameter and the peak of blood velocity of the right and left radial artery were investigated with color Doppler vessel echography as well as the complications of radial artery were followed up 1 month after TRA pPCI procedure. Results Two cases in every TRA pPCI and TFA pPCI groups were crossed over each other because procedure of the transradial or transfemoral access was failure. One handred and six vessels (48 vessels in LAD,22 vessels in LCX and 36 vessels in RCA) associated with 28 vessels of total occlusion in TRA pPCI group and 102 vessels (51 vessels in LAD,18 veesles in LCX and 33 vessels in RCA) with 24 vessels in total occlusion in TFA pPCI group were angioplasticized . The successful rates of the first time puncture in access artery, the re patence IRA and pPCI were similar in TRA pPCI and TFA pPCI groups ( 93.4% vs 96.1% ;100% vs 100%; 96.2% vs 97.1% , P >0.05 ). There were no significant diffierence in the average time of puncture time of access artery ,engaging in target vessels of guiding catheters and the total procedure of PCI between the two groups ( 1.3 ±0.3s vs 1.2 ±0.3s ; 6.0 ±1.6min vs 5.8 ±0.9min ; 49.2 ±24.1min vs 46.5 ± 26.4min , P >0.05 ). The access artery complications such as bleeding ,hematoma and embolism as well the veneous thrombosis in TFA pPCI group were much more than those in TRA pPCI group(p< 0.01 ). Although slight artery spasm of 4.7% cases in TRA pPCI group was happened during the procedure of PCI , the procedure had being continued after administration of medicine to release the spasm. The time of Allen’s test ,diameter and the systolic velocity of blood in daul radial arteries were no significant change before and after pPCI.Conclusions The duration and effect by TRA pPCI for AMI with stable hemodynamics was similar to TFA pPCI. The complications such as of bleeding,vessel injury, thrombi and embolism by TRA pPCI were few, and it was unnecessary to discontinue the anticoagulation medicine. TRA pPCI might be selected as a access vessel for pPCI in AMI patients with stable hemodynamics.展开更多
文摘BACKGROUND Frailty is a common condition in elderly patients who receive percutaneous coronary intervention(PCI).However,how frailty affects clinical outcomes in this group is unclear.AIM To assess the link between frailty and the outcomes,such as in-hospital complic-ations,post-procedural complications,and mortality,in elderly patients post-PCI.METHODS The PubMed/MEDLINE,EMBASE,Cochrane Library,and Web of Science databases were screened for publications up to August 2023.The primary outcomes assessed were in-hospital and all-cause mortality,major adverse cardiovascular events(MACEs),and major bleeding.The Newcastle-Ottawa Scale was used for quality assessment.RESULTS Twenty-one studies with 739693 elderly patients undergoing PCI were included.Frailty was consistently associated with adverse outcomes.Frail patients had significantly higher risks of in-hospital mortality[risk ratio:3.45,95%confidence interval(95%CI):1.90-6.25],all-cause mortality[hazard ratio(HR):2.08,95%CI:1.78-2.43],MACEs(HR:2.92,95%CI:1.85-4.60),and major bleeding(HR:4.60,95%CI:2.89-7.32)compared to non-frail patients.CONCLUSION Frailty is a pivotal determinant in the prediction of risk of mortality,development of MACEs,and major bleeding in elderly individuals undergoing percutaneous coronary intervention.
文摘Wang and Liu's systematic review of frailty among elderly patients undergoing percutaneous coronary intervention(PCI)revealed that patients with frailty have significantly higher risks of all-cause and in-hospital death,major undesirable cardiovascular events,and major haemorrhage.Frailty is associated with adverse events,prolonged hospital stays,increased complications,and elevated mortality risk due to diminished physiological reserves.Integrating frailty into risk assessment tools is crucial,and gait speed has emerged as a key predictor of frailty.Recognizing the impact of frailty leads to personalized and informed decisionmaking,and frailty assessments should be performed.This holistic approach can inform tailored interventions,thereby optimizing outcomes for this vulnerable population undergoing PCI.
文摘BACKGROUND Myocardial infarction,particularly ST-segment elevation myocardial infarction(STEMI),is a key global mortality cause.Our study investigated predictors of mortality in 96 STEMI patients undergoing primary percutaneous coronary intervention at Erbil Cardiac Center.Multiple factors were identified influencing in-hospital mortality.Significantly,time from symptom onset to hospital arrival emerged as a decisive factor.Consequently,our study hypothesis is:"Reducing time from symptom onset to hospital arrival significantly improves STEMI prognosis."AIM To determine the key factors influencing mortality rates in STEMI patients.METHODS We studied 96 consecutive STEMI patients undergoing primary percutaneous coronary intervention(PPCI)at the Erbil Cardiac Center.Their clinical histories were compiled,and coronary evaluations were performed via angiography on admission.Data included comorbid conditions,onset of cardiogenic shock,complications during PPCI,and more.Post-discharge,one-month follow-up assessments were completed.Statistical significance was set at P<0.05.RESULTS Our results unearthed several significant findings.The in-hospital and 30-d mortality rates among the 96 STEMI patients were 11.2%and 2.3%respectively.On the investigation of independent predictors of in-hospital mortality,we identified atypical presentation,onset of cardiogenic shock,presence of chronic kidney disease,Thrombolysis In Myocardial Infarction grades 0/1/2,triple vessel disease,ventricular tachycardia/ventricular fibrillation,coronary dissection,and the no-reflow phenomenon.Specifically,the recorded average time from symptom onset to hospital arrival amongst patients who did not survive was significantly longer(6.92±3.86 h)compared to those who survived(3.61±1.67 h),P<0.001.These findings underscore the critical role of timely intervention in improving the survival outcomes of STEMI patients.CONCLUSION Our results affirm that early hospital arrival after symptom onset significantly improves survival rates in STEMI patients,highlighting the critical need for prompt intervention.
基金Xianyang City Key R&D Plan Project(No.:L 2022ZDYFSF004)。
文摘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.
文摘Objective: To examine physical activity(PA) of post-percutaneous coronary intervention(PCI) patients and explore the demographic, clinical, and social psychological characteristics associated with PA levels. Methods: A total of 246 post-PCI patients from the Peking University Third Hospital in Beijing, China, were included in this crosssectional study through convenience sampling. Data were collected from a self-repor ted questionnaire. PA was categorized into low, moderate, or high levels. The ordinal multinomial logistic regression model was used to estimate the relationship among demographic, medical, and psychosocial characteristics. Results: The overall prevalence of low, moderate, and high PA was 20%, 70%, and 10%, respectively. For the domain-specific PA patterns, most par ticipants took par t in leisure-time PA(84.5%);walking was the most common PA. Increased motivation and selfefficacy, lower monthly income, and unemployment were predictors of high PA. Conclusions: PA levels in post-PCI patients was not optimal, and leisure-time PA had the highest par ticipation rate. Analyses of influencing factors can provide medical staff and health workers information to focus on high-risk groups and introduce more tailored interventions. Future studies can explore more regions, and ecological models can be introduced to study more influencing factors.
文摘Objective This study was to evaluate the efficacy and safety of a short acting reduced dose fibrinolytic regimen to promote early infarct related artery (IRA) patency for acyute myocardial infarction (AMI) patients referred for percutaneous coronary intervention (PCI).Methods Following aspirin and heparin, 166 patients were randomized to a 50 mg bolus of recombinant tissue type plasminogen activator(rt PA) or to a same volume sodium chloride injection followed by immediate primary PCI. The end points included patency rates on catheterization laboratory (cath lab) arrival, revascularization results when PCI was performed, complication rates, left ventricular function and restored patency rate following PCI. Results Patency on cath lab arrival was 64% with rt PA (34% TIMI 3,30% TIMI 2), while 31% of placebo (13% TIMI 3, 18% TIMI 2). There was no difference in the restored TIMI 3 rates of IRA between the two groups (85% vs 87%). No difference were observed in stroke or major bleeding. Left ventricular function was similar in both groups (52±9% vs 50±8%), but left ventricular ejection fraction fraction (LVEF) was higher with patent IRA (TIMI 3) on cath lab arrival than that of others (56±12% vs 48±10%).Conclusions Strategy thrombolytic regimens were compatible with subsequent PCI lead to more frequenc early recanalization (before cath lab arrival), which facilitates greater left ventricular function preservation with no augmentation of adverse events.
文摘Objective Comparative study on the feasibility,safety and outcome of transradial artery and transfemoral artery access for primary percutaneous coronary intervention (PCI) in patients with acute myocardial infarction(AMI).Methods Two hundred and eight patients with AMI episoded within 12 hours, male 159, female 49, age 58.9 ±11.9 (34～88)years, were randomly divided into transradial artery access for primary PCI (TRA pPCI) group of 106 cases and transfemoral artery access for PCI (TFA pPCI) group of 102 cases during Sept, 2000 to Aug, 2002. The protocols of the manipulation duration and the effect for TRA pPCI and TFA pPCI procedures were respectively compared, including the time of transradial artery puncture and the rate of puncture success at first time ; the time of guiding catheter engaging into target coronary ostium; the rate of patence in infarct related artery (IRA); total duration of manipulation and the successful rate.The incidence of complications such as bleeding, vessel injury,thrombi and embolism as well as the average stay of hospitalization between two groups was compared. The status and the incidance of vessel spasm were observed and the effect of medicine administration to prevent from and relieve the vascular spasm was evaluated. The time of Allen’s test before and after TRA pPCI , the inner diameter and the peak of blood velocity of the right and left radial artery were investigated with color Doppler vessel echography as well as the complications of radial artery were followed up 1 month after TRA pPCI procedure. Results Two cases in every TRA pPCI and TFA pPCI groups were crossed over each other because procedure of the transradial or transfemoral access was failure. One handred and six vessels (48 vessels in LAD,22 vessels in LCX and 36 vessels in RCA) associated with 28 vessels of total occlusion in TRA pPCI group and 102 vessels (51 vessels in LAD,18 veesles in LCX and 33 vessels in RCA) with 24 vessels in total occlusion in TFA pPCI group were angioplasticized . The successful rates of the first time puncture in access artery, the re patence IRA and pPCI were similar in TRA pPCI and TFA pPCI groups ( 93.4% vs 96.1% ;100% vs 100%; 96.2% vs 97.1% , P >0.05 ). There were no significant diffierence in the average time of puncture time of access artery ,engaging in target vessels of guiding catheters and the total procedure of PCI between the two groups ( 1.3 ±0.3s vs 1.2 ±0.3s ; 6.0 ±1.6min vs 5.8 ±0.9min ; 49.2 ±24.1min vs 46.5 ± 26.4min , P >0.05 ). The access artery complications such as bleeding ,hematoma and embolism as well the veneous thrombosis in TFA pPCI group were much more than those in TRA pPCI group(p< 0.01 ). Although slight artery spasm of 4.7% cases in TRA pPCI group was happened during the procedure of PCI , the procedure had being continued after administration of medicine to release the spasm. The time of Allen’s test ,diameter and the systolic velocity of blood in daul radial arteries were no significant change before and after pPCI.Conclusions The duration and effect by TRA pPCI for AMI with stable hemodynamics was similar to TFA pPCI. The complications such as of bleeding,vessel injury, thrombi and embolism by TRA pPCI were few, and it was unnecessary to discontinue the anticoagulation medicine. TRA pPCI might be selected as a access vessel for pPCI in AMI patients with stable hemodynamics.
