The Effect of Predictive Nursing Intervention on Cardiac Function and Clinical Outcomes in CCU Patients with Acute Myocardial Infarction After Interventional Therapy

Objective:To evaluate the impact of predictive nursing on the care of acute myocardial infarction(AMI)patients in the Coronary Care Unit(CCU)after interventional therapy.Methods:From September 2021 to September 2023,84 AMI patients admitted to the CCU were randomly divided into two groups:the experimental group(42 patients)received predictive nursing,and the reference group(42 patients)received conventional nursing.Cardiac function and clinical outcomes were compared between the groups.Results:Before nursing,there was no difference in cardiac function between the two groups(P>0.05).After nursing,the cardiac function of the experimental group was better than that of the reference group(P<0.05).The clinical outcomes of the experimental group were better than those of the reference group(P<0.05).Before nursing,there was no difference in psychological scores between the two groups(P>0.05).After nursing,the psychological scores of the experimental group were lower than those of the reference group(P<0.05).Conclusion:Predictive nursing can improve the cardiac function and clinical outcomes of AMI patients after interventional therapy and can also regulate patients’negative psychological states.

Effect of Continuous Nursing Intervention on Psychological State and Medication Compliance of Patients with Acute Myocardial Infarction after PCI

Objective:To explore the effect of continuous nursing intervention on psychological status and medication compliance of patients with acute myocardial infarction after PCI operation.Methods:from February 2013 to September 2016,102 patients with acute myocardial infarction treated by PCI were selected and divided into two groups,51 cases in each group according to the different nursing methods.The observation group was added continuous nursing on the basis of routine nursing,while the control group was the usual nursing mode.The mental state of the two groups before and after treatment was evaluated,and the patients were followed up for 6 months after discharge.The compliance of the two groups at 1,3 and June after discharge was statistically analyzed.Results:before nursing,there was no significant difference in the mental state evaluation between the two groups(P>0.05).After nursing,the mental status of the two groups was improved,while the psychological state of the observation group was better than that of the control group(P<0.05).After 6 months'follow-up,there was no significant difference in the compliance rate between the two groups at 1 months after discharge(P>0.05).In 3 and June,the compliance of the patients in the observation group was better than that in the control group(P<0.05).Conclusion:continuous nursing intervention for patients with acute myocardial infarction after PCI can effectively adjust the unhealthy psychological state of patients,improve medication compliance and promote early rehabilitation of patients.

Infuences of Previous Angina Pectoris on Coronary Collateral Circulation and Left Ventricular Function in Patients with Acute Myocardial Infarction

Objective To investigate the influences of previous angina pectoris on coronary collateral circulation and left ventricular function in patients with acute myocardial infarction. Methods 307 patients with a first episode acute myocardial infarction underwent selective coronary angiography and left ventriculography. The relation of previous angina pectoris to coronary collateral circulation, peak creatine kinase and left ventricular function were analyzed. Results ①In the 307 patients, there were 192 (62. 5 % ) with previous angina [PA ( + ) group] and 115 (37. 5 % ) without [PA (-) group]. ②The peak creatine kinase (CK) and CK -MB were significantly higher in PA (-) group than in PA (+) group ( P < 0. 05 for both comparisons) . ③ Collateral circulation to infarct - related artery was more likely to be present in PA ( + ) group than in PA (-) group ( P < 0. 05) . (4) The left ventricular ejection fraction was significantly increased, and the left ventricular wall motion Cortina score decreased, in PA (+) group than in PA (-) group ( P < 0. 01 for both comparisons) . Conclusion In patients with acute myocardial infarction, previous angina pectoris may have beneficial effects on coronary collateral circulation and left ventricular function.

A comparative study on transradial vs transfemoral artery access for primary percutaneous coronary intervention 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.

A randomized trail comparing primary percutaneous coronary intervention with a strategy of short-acting thrombolysis and immediate planned primary percutaneous coronary intervention in acute myocardial infarction

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.

Gender differences in clinical outcomes of acute myocardial infarction undergoing percutaneous coronary intervention: insights from the KAMIR-NIH Registry

Background There are numerous but conflicting data regarding gender differences in outcomes following percutaneous coronary intervention(PCI). Furthermore, gender differences in clinical outcomes with acute myocardial infarction(AMI) following PCI in Asian population remain uncertain because of the under-representation of Asian in previous trials. Methods A total of 13,104 AMI patients from Korea Acute Myocardial Infarction Registry-National Institute of Health(KAMIR-NIH) between November 2011 and December 2015 were classified into male(n = 8021, 75.9%) and female(n = 2547, 24.1%). We compared the demographic, clinical and angiographic characteristics, 30-days and 1-year major adverse cardiac and cerebrovascular events(MACCE) in women with those in men after AMI by using propensity score(PS) matching. Results Compared with men, women were older, had more comorbidities and more often presented with non-ST segment elevation myocardial infarction(NSTEMI) and reduced left ventricular systolic function. Over the median follow-up of 363 days, gender differences in both 30-days and 1-year MACCE as well as thrombolysis in myocardial infarction minor bleeding risk were not observed in the PS matched population(30-days MACCE: 5.3% vs. 4.7%, log-rank P = 0.494, HR = 1.126, 95% CI: 0.800-1.585;1-year MACCE: 9.3% vs. 9.0%, log-rank P = 0.803, HR = 1.032, 95% CI: 0.802-1.328;TIMI minor bleeding: 4.9% vs. 3.9%, log-rank P = 0.215, HR = 1.255, 95% CI: 0.869-1.814). Conclusions Among Korean AMI population undergoing contemporary PCI, women, as compared with men, had different clinical and angiographic characteristics but showed similar 30-days and 1-year clinical outcomes. The risk of bleeding after PCI was comparable between men and women during one-year follow up.

Effectiveness and feasibility of transradial approaches for primary percutaneous coronary intervention in patients with acute myocardial infarction

Objective： To evaluate the efficacy and feasibility of the transradial approach for primary percutaneous coronary intervention （PCI） in patients with acute myocardial infarction（AMI）. Methods： 195 patients with acute myocardial infarction were randomly divided into two groups according to the different PCI operation pathways. 105 cases were assigned to the transfemoral artery group and 90 cases to the transradial artery group. We analyzed the data from the two groups, including the achievement ratio of paracentesis, cannulation time, the time from local anesthesia to the first time balloon inflation, the time of the total procedure, achievement ratio of PCI, incidence rate of vascular complications, total duration of hospitalization, and the six-month follow-up results in both groups. Results： Our results showed that the achier ement ratio of arteriopuncture, cannulafion time and the time from local anesthesia to the first time balloon inflation in the transradial and transfemoral groups were 98.9% vs. 100%, 3.15 ± 1.56min vs. 2.86 ± 0.97 min, and 18.56 ± 4.37 min vs. 17.75 ± 3.21 min, respectively. These differences between the two groups were not statistically significant. The total operating time was 29.75 ± 4.38 rain for the transradial group and 27.89 ± 3.95 min（P 〈 0.05） for the transfemoral group. The operation achievement ratio in the transradial group was 96.7%, and 96.2% in the transfemoral group. The incidence of puncture point complications was 2.2% in the transradial group and 11.4% in the transfemoral group, and this difference was significant. The duration of hospitalization was 10.56 ± 2.85 days for the transradial group and 13.78 ± 3.15 days（P 〈 0.05） for the transfemoral group. At the six-month follow-up, the rate of survival without cardiac event was 86.1% vs. 86.4% respectively in the transradial and transfemoral groups（P 〉 0.05）. Conclusion： The transradial approach was as effective as the transfemoral approach, and there were fewer puncture point complications as well as a shorter span of hospitalization in the transradial group. PCI via the transradial approach is safe, effective and feasible in patients with AMI.

Risk factors of acute myocardial infarction following primary percutaneous coronary intervention among elderly patients

Background and Objective Large randomized controlled trials have demonstrated that percutaneous coronary intervention （PCI） with the routine use of drug-eluting stents is safe and effective, however, the patients older than 75 years undergoing PCI are at increased risk for major adverse cardiac events, so that the patients are usually excluded from this trial. The aim of the present study was to assess the early clinical outcome and risk factors in old patients with acute ST elevation myocardial infarction （STEMI） following primary PCI. Methods We analyzed the outcome after stenting in 136 patients older than 60 years in our coronary care unit with acute STEMI, and the patients were further classified in 2 age groups： patients≥75 years and 〈75 years. Results Though the older group had a higher prevalence of adverse baseline characteristics and lower final TIMI flow than those of the younger, the procedural success had no difference between two groups. The main adverse clinical events （MACE） for the old group was a little higher comparing with the younger in 12-month following up. Conclusions Our study suggest that drug-eluting stent implantation in elderly patients with acute ST elevation myocardial infarction has high initial procedural success rates despite having more severe baseline risk characteristics, and to shorten the time form symptom onset to PCI and improve final TIMI flow strategy may decrease MACE among old patients following PCI（J Geriatr Cardio12009; 6：67-70）.

Clinical and procedural predictors of no-ref low in patients with acute myocardial infarction after primary percutaneous coronary intervention

BACKGROUND: The treatment of acute myocardial infarction(AMI) is thought to restore antegrade blood flow in the infarct-related artery(IRA) and minimize ischemic damage to the myocardium as soon as possible. The present study aimed to identify possible clinical predictors for no-refl ow in patients with AMI after primary percutaneous coronary intervention(PCI).METHODS: A total of 312 consecutive patients with AMI who had been treated from January 2008 to December 2010 at the Cardiology Department of East Hospital, Tongji University School of Medicine were enrolled in this study. Inclusion criteria were:(i) patients underwent successfully primary PCI within 12 hours after the appearance of symptoms; or(ii) patients with ischemic chest pain for more than 12 hours after a successful primary PCI within 24 hours after appearance of symptoms. Exculsion criteria were:(i) coronary artery spasm;(ii) diameter stenosis of the culprit lesion was ≤50% and coronary blood f low was normal;(iii) patients with severe left main coronary or multivessel disease, who had to require emergency revascularization. According to thrombolysis in myocardial infarction(TIMI), the patients were divided into a reflow group and a no-reflow group. The clinical data, angiography f indings and surgical data were compared between the two groups. Univariate and multivariate logistic regressions were used to determine the predictors for no-ref low.RESULTS: Fifty-four(17.3%) of the patients developed NR phenomenon after primary PCI. Univariate analysis showed that age, time from onset to reperfusion, systolic blood pressure(SBP) on admission, Killip class of myocardial infarction, intra-aortic balloon pump(IABP) use before primary PCI, TIMI flow grade before primary PCI, type of occlusion, thrombus burden on baseline angiography, target lesion length, reference luminal diameter and method of reperfusion were correlated with no-reflow(P<0.05 for all). Multiple logistic regression analysis identified that age >65 years [OR=1.470, 95% confi dence interval(CI) 1.460–1.490, P=0.007], long time from onset to reperfusion >6 hours(OR=1.270, 95%CI 1.160–1.400, P=0.001), low SBP on admission <100 mmHg(OR=1.910, 95%CI 1.018–3.896, P=0.004), IABP use before PCI(OR= 1.949, 95%CI 1.168–3.253, P=0.011), low(≤1) TIMI fl ow grade before primary PCI(OR=1.100, 95%CI 1.080–1.250, P<0.001), high thrombus burden(OR=1.600, 95%CI 1.470–2.760, P=0.030), and long target lesion(OR=1.948, 95%CI 1.908–1.990, P=0.019) on angiography were independent predictors of no-refl ow.CONCLUSION: The occurrence of no-refl ow after primary PCI for acute myocardial infarction can predict clinical, angiographic and procedural features.

Severe pneumonia and acute myocardial infarction complicated with pericarditis after percutaneous coronary intervention:A case report

BACKGROUND Cases of severe pneumonia complicated with acute myocardial infarction(AMI)with good prognosis after percutaneous coronary intervention(PCI)are rare,especially those with postoperative pericarditis and intestinal obstruction.CASE SUMMARY A 53-year-old male patient was admitted to the emergency department of our hospital because of paroxysmal chest tightness for 4 d,aggravated with chest pain for 12 h.The symptoms,electrocardiography,biochemical parameters,echocardiography and chest computed tomography confirmed the diagnosis of severe pneumonia complicated with AMI.The patient was treated with antiplatelet aggregation,anticoagulation,lipid regulation,vasodilation,anti-infective agents and direct PCI.The patient was discharged after 3 wk of treatment.Follow-up showed that the patient was asymptomatic without recurrence.CONCLUSION For patients with severe pneumonia complicated with AMI,PCI and antibiotic therapy is a life-saving strategy.

Randomized controlled trials on Roy adaptation model nursing in patients with acute myocardial infarction in china: a systematic review

Objective:This study was to evaluate the quality of the randomized controlled trials on Roy adaptation model nursing in individuals suffering from acute myocardial infarction in China.Methods:We systematically searched the Cnki,Wanfang and Vipdatabases,to get randomized controlled trials on Roy adaptation model nursing in individuals suffering from acute myocardial infarction.The search period was from inception to October 2020.According to the Cochrane risk bias assessment tool,the quality of the studies included was appraised.Results:A total of 55 studies were retrieved,and 11 were eventually included in the study.Among the studies included,the first study was published in 2008.The overall quality of the 11 studies included was relatively low.Conclusions:The overall quality of the randomized controlled trials on Roy adaptation model nursing in individuals suffering from acute myocardial infarction was not high,which would hinder the evidence transformation as well as clinical practice.

Application Analysis of Cardiac Rehabilitation Nursing in Patients with Acute Myocardial Infarction

Objective: Application analysis of cardiac rehabilitation in patients with acute myocardial infarction. Methods: A total of 102 patients with acute myocardial infarction admitted to our hospital from January 2020 to January 2022 were retrospectively selected as the observation objects. According to the nursing measures taken, they were divided into a control group and an observation group, with 51 cases in each group. A total of 51 patients in the control group received routine nursing, while 51 patients in the observation group were guided to actively participate in the cardiac rehabilitation nursing plan. The hospitalization conditions and effects of the two groups were compared. Results: The cardiac function index, bed time, hospitalization time, anxiety score and depression score of the observation group were significantly better than those of the control group, and the differences were statistically significant (P Conclusion: The application of cardiac rehabilitation nursing in patients with acute myocardial infarction has a good effect. The patients’ cardiac function recovers faster, they feel more comfortable, and they also reduce the time of hospitalization and bed rest, which is conducive to improving the psychological and anxiety state of patients and improving the quality of life.

Reducing Readmission Rates in Heart Failure and Acute Myocardial Infarction by Pharmacy Intervention

Background： Hospital readmissions are common, costly and largely preventable. Objectives： To evaluate the impact of a pharmacy-led medication discharge and post discharge counseling program on 30 day readmission rates for HF （heart failure） and AMI （acute myocardial infarction）. Methods： Three month prospective, quality improvement, pilot study with I-IF and AMI patients who received pre-discharge and post-discharge medication counseling from December 2013 to February 2014 whose 30 day readmission rates were compared to readmission rates from the previous fiscal year.Results： Fifty-one patients were included in the study. Primary endpoint of30-day readmission rates showed a 33.9% decrease for AMI and a 50.1% decrease for HF in readmission rates compared to the previous fiscal year, with a potential annual savings of $458,800. The study also identified 25.5% of patients having at least one medication error that was identified through medication reconciliation. Conclusions： Pharmacy provided medication reconciliation and medication discharge counseling reduced readmission rates as well as decreased medication errors. There is also a potential for significant health cost savings.

Thrombus aspiration during primary percutaneous coronary intervention for acute myocardial infarction:A review of clinical evidence and guidelines

Acute ST segment elevation myocardial infarction(STEMI) is characterized by complete thrombotic occlusion of a major coronary artery. Early recanalization of the infarct-related artery is most efficiently delivered by primary percutaneous coronary intervention(PPCI),however this does not always restore normal myocardial perfusion,mainly due to distal embolization of the thrombus and microvascular obstruction. Early evidence for manual thrombus aspiration during PPCI was promising and this was once considered an important aspect of the procedure,especially in patients with a high thrombus burden. However,a large body of evidence from recent major randomized controlled trials(notably TASTE and TOTAL) does not support the routine use of manual thrombus aspiration in patients with STEMI undergoing PPCI.

Correlation between intracoronary thrombus components and coronary blood flow after percutaneous coronary intervention for acute myocardial infarction at different onset time

BACKGROUND Acute myocardial infarction(AMI)is a leading cause of mortality.Early reperfusion to restore blood flow is crucial to successful treatment.In the current reperfusion regimen,an increasing number of patients have benefited from direct percutaneous coronary intervention(PCI).In order to understand whether there is a correlation between the components of coronary thrombosis and the absence of reflow or slow blood flow after coronary stent implantation in direct PCI,we collected data on direct PCI cases in our hospital between January 2016 and November 2018.AIM To investigate the correlation between intracoronary thrombus components and coronary blood flow after stent implantation in direct PCI in AMI.METHODS We enrolled 154 patients(85 male and 69 female,aged 36–81 years)with direct PCI who underwent thrombus catheter aspiration within<3,3–6 or 6–12 h of onset of AMI between January 2016 and November 2018.The thrombus was removed for pathological examination under a microscope.The patients of the three groups according to the onset time of AMI were further divided into those with a white or red thrombus.The thrombolysis in myocardial infarction(TIMI)blood flow after stent implantation was recorded based on digital subtraction angiography during PCI.The number of patients with no-reflow and slow blood flow in each group was counted.Statistical analysis was performed based on data such as onset time,TIMI blood flow.RESULTS There were significant differences in thrombus components between the patients with acute ST-segment elevation myocardial infarction and non-ST-segment elevation myocardial infarction(P<0.01).In the group with PCI<3 h after onset of AMI,there was no significant difference in the incidence of no-reflow and slow-flow between the white and red thrombus groups.In the groups with PCI 3-6 and 6-12 h after onset of AMI,there was a significant difference in the incidence of no-reflow and slow-flow between the white and red thrombus groups(P<0.01).There was a significant correlation between the onset time of AMI and the occurrences of no-reflow and slow blood flow during PCI(P<0.01).CONCLUSION In direct PCI,the onset time of AMI and color of coronary thrombus are often used to predict whether there will be no reflow or slow blood flow after stent implantation.

Percutaneous coronary intervention for acute myocardial infarction in a patient with dextrocardia

Situs inversus with dextrocardia is a rare congenital anomaly.There are limited published case reports of successful percutaneous coronary intervention(PCI) in these patients who have atherosclerotic coronary artery disease,especially when presenting with acute myocardial infarction.PCI is technically difficult be-cause of mirror image dextrocardia.We hereby de-scribe a 48-yr-old female,who had acute inferior wall myocardial infarction and underwent successful emer-gency primary coronary angioplasty and stenting of a proximally occluded right coronary artery.Technical details about PCI are discussed.

Ultrasound-guided fascia iliaca compartment block combined with general anesthesia for amputation in an acute myocardial infarction patient after percutaneous coronary intervention: A case report

BACKGROUND Fascia iliaca compartment block is a technique that blocks three nerves,similar to a 3-in-1 nerve block.This block provides analgesia for patients undergoing lower limb surgery,and is a simple technique that is easy to implement.Here,we report a case of fascia iliaca compartment block in a patient with myocardial infarction who underwent emergency middle thigh amputation.CASE SUMMARY A 78-year-old female patient weighing 38 kg with gangrene and occlusive peripheral atherosclerosis of the right leg underwent an emergency middle thigh amputation.The patient had a history of hypertension,coronary heart disease,cerebral infarction,anterior wall myocardial infarction,and had recently undergone percutaneous coronary intervention consisting of coronary angiography and right coronary artery stent implantation.Considering the patient's condition,an ultrasound-guided fascia iliaca compartment block combined with general anesthesia was implemented for amputation.The fascia iliaca compartment block provided analgesia for the operation,and reduced the dosage of general anesthetics.It also alleviated adverse cardiovascular effects caused by pain stress,and ensured the safety of the patient during the perioperative period.This block also provided postoperative analgesia.The patient had a good prognosis,and was subsequently discharged from hospital.CONCLUSION Fascia iliaca compartment block provides surgical analgesia.It also alleviates adverse cardiovascular effects,and ensures patient safety during the perioperative period.

The Effectiveness or Efficacy of Modified Nursing Interventions Classification (NIC) in Reducing the Severity of Depression among Patients with Myocardial Infarction

Background: Post myocardial infarction depression is common and puts a negative effect on recovery. Modified Nursing interventions effectively reduce the frequency and severity of depression in such patients. Objective: The study aimed to determine the effectiveness of Modified Nursing Interventions Classification (NIC) in reducing the severity of depression among patients with Myocardial Infarction. Methods: Sixty-eight stable patients with myocardial infarction (>1 month history) having mild to moderate depression in accordance to Patient Health Questionnaire-9 (PHQ-9) [with a score of 5 to 14] were enrolled. Patients were assorted into interventional and control group. Modified Nursing Intervention was offered in Interventional Group. The frequency and effectiveness of Modified Nursing Intervention among the groups were determined and compared. Results: Both moderate and mild level depression was decreased in Intervention Group as compare to Control Group. Baseline mean depression PHQ-9 score was 2.35 point statistically significantly higher in the Control Group than Interventional Group (Conclusion: Modified Nursing intervention is effective in reducing the frequency and severity of depression compared to routine care in patients with Myocardial infarction.

Application of Evidence-based Nursing in Elderly Patients with Arrhythmia after Acute Myocardial Infarction

Objective: To investigate the effect of evidence-based nursing intervention in elderly patients with arrhythmia after acute myocardial infarction. Methods: 146 elderly patients with arrhythmia after acute myocardial infarction treated in our hospital from February 2016 to March 2017 were selected as research objects. According to the random number method, patients were divided into control group (73 cases, traditional nursing) and observation group (73 cases, evidence-based nursing intervention). The clinical effects and nursing satisfaction of the two groups were compared. Results: The hospital stay, average bed rest time, hospitalization cost, and incidence of arrhythmia complications in the observation group were significantly lower than those in the control group. The difference was statistically significant (P<0.05). After nursing, the four grades of heart function and satisfaction of nursing in the observation group were significantly higher than those in the control group. The difference was statistically significant (P<0.05). Conclusions: In elderly patients with arrhythmia after acute myocardial infarction, evidence-based nursing intervention was adopted. The patient's health has been greatly improved and the doctor-patient relationship has been significantly improved. This method is worth promoting.

Non-invasive ventilation improves hemorheology status in hypoxemic patients with acute myocardial infarction after PCI

Background Hypoxemia sometimes occurs in the emergency room in the patients with acute myocardial infarction （AMI） after percutaneous coronary intervention （PCI）, even in those with administration of conventional high-flow oxygen inhalation. The objective of the present study was to evaluate the effectiveness of non-invasive ventilation （NIV） in improving blood oxygen content and hemorheology in patients with AMI and hypoxemia. Methods This prospective study enrolled 50 consecutive eligible patients with AMI （aged 72.3 ± 9.5 years）, who had undergone PCI and been administered high-flow oxygen but still had hypoxemia. Blood was taken before NIV and at 0.5, 1, and 2 h after NIV. Blood gases, hemorheological variables including erythrocyte deformability, erythrocyte aggregation, erythrocyte osmotic fragility, membrane fluidity, and oxidative stress level were measured. Results Blood PaO2 increased to normal by 1 h after NIV. Assessed hemorheological variables had all improved and plasma malondialdehyde concentration decreased significantly after 2 h of NIV. Conclusions Our data suggest that NIV can help to improve blood oxygen content, hemorheological status, and minimize plasma lipid peroxidation injury in hypoxemic patients with AMI who have undergone PCI.