Purpose:To compare the effectiveness of the interventional limb raising management strategy(ILRMS)to elastic bandage compression at radial vascular access sites following coronary angiographies(CAGs)and percutaneous c...Purpose:To compare the effectiveness of the interventional limb raising management strategy(ILRMS)to elastic bandage compression at radial vascular access sites following coronary angiographies(CAGs)and percutaneous coronary interventions(PCIs).Methods:Patients with ischemic coronary heart disease whose condition was stable over three months were enrolled in this clinical study(n=590;aged 25e80).All participants had just undergone CAG and PCI.Patients were randomized into either the ILRMS group(n=360)or standard post-intervention care with an elastic bandage(n=230).Overall comfort and wrist pain was assessed and the degree of index finger swelling and oxygen saturation was measured on the affected arm.All variables were measured prior to postintervention treatment and again at six hours after CAG and PCI.Results:We found that patients receiving ILRMS had significantly lower wrist pain scores and swelling around the index finger compared to the elastic bandage group(p<0.05).Oxygen saturation of the index finger was not statistically significant(p>0.05).We also found that 19.57%of the elastic bandage patients were comfortable,while ILRMS patients were significantly more comfortable(93.06%;p<0.05).Conclusions:We find that ILRMS alleviates swelling and pain of the wrist more effectively than current practices and improves the degree of overall comfort of patients who undergo CAG and PCI.展开更多
Objective:To compare the feasibility and safety between right distal radial artery access and right radial artery access in patients undergoing coronary angiography(CAG)or percutaneous coronary intervention(PCI).Metho...Objective:To compare the feasibility and safety between right distal radial artery access and right radial artery access in patients undergoing coronary angiography(CAG)or percutaneous coronary intervention(PCI).Methods:On the basis of arterial access,113 patients who underwent CAG or PCI in Kunshan Hospital of Traditional Chinese Medicine between January and October 2018 were divided into two groups:a right distal radial artery group(52 patients)and a right radial artery group(61 patients).We collected general information,the number of puncture attempts,access times,postoperative compression time,and complications.Results:The general characteristics,rate of successful radial artery puncture,and rate of successful catheter placement in the two groups were not different.The right radial artery group had fewer puncture attempts(1.26±0.44 times vs.2.19±0.53 times,P=0.001)and a shorter access time(3.23±0.86 min vs.4.77±1.49 min,P=0.001)than the right distal radial artery group.However,the postoperative compression time in the right distal radial artery group was shorter(3.44±0.9 h vs.7.16±1.21 h,P=0.001).Two cases of bleeding,four cases of hematoma,and one case of artery occlusion in the right radial artery group and one case of hematoma in the right distal artery group occurred before discharge.The rate of total complications in the right distal radial artery group was lower than in the right radial artery group(1.93%vs.11.48%,P=0.048).Conclusion:CAG or PCI through the right distal radial artery is feasible and safe.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
Introduction: Cardiac catheterisation plays a fundamental role in the management of acute coronary syndrome. These explorations require heavy, complex and costly equipment and a large team of doctors, nurses and techn...Introduction: Cardiac catheterisation plays a fundamental role in the management of acute coronary syndrome. These explorations require heavy, complex and costly equipment and a large team of doctors, nurses and technicians with highly specialized training. Aims: To describe epidemiological, clinical and coronary angiography aspects of patients with acute coronary syndrome. Patients and Methods: Descriptive study from September 2019 to December 2023 in the Cardiology Department of the Hôpital Mère-Enfant of Bamako. Inclusion criteria were patients admitted for coronary angiography with the diagnosis of acute coronary syndrome. Results: During the study period, 1253 patients underwent coronary angiography, 596 of whom had acute coronary syndrome as an indication, representing a hospital frequency of 47%. Sex-ratio was 2.10. Mean age of patients was 58.5 ± 11.39 years. ST elevation acute coronary syndrome was the most common indication with 63.92% of cases. High blood pressure was the main cardiovascular risk factor with 58.7% of cases, and radial access approach was used in 98% of cases. Coronary angiography was pathological in 91.70% of cases (n = 548). Patients with lesions of anterior interventricular artery were 73.73% of cases. Tritruncal lesions accounted for 40.63% of cases. Conclusion: ST elevation acute coronary syndrome is the most frequent manifestation of acute coronary syndrome. Anterior interventricular artery is most often the culprit lesion for our patients.展开更多
Introduction: Acute coronary syndromes (ACS) are a diagnostic and therapeutic emergency. Objective: Studying the feasibility, difficulties and results of coronary angioplasty in acute coronary syndromes at the Luxembo...Introduction: Acute coronary syndromes (ACS) are a diagnostic and therapeutic emergency. Objective: Studying the feasibility, difficulties and results of coronary angioplasty in acute coronary syndromes at the Luxembourg Mother-Child University Hospital in Bamako. Patients and Methods: Cross-sectional, descriptive study with prospective recruitment over 18 months from September 2020 to February 2022. All patients aged at least 18 years old admitted for SCA and having undergone PCI during the study period were included. Result: We collected 249 patients for SCA, of whom 160 underwent angioplasty, either an angioplasty/SCA ratio of 0.64. The average age of the patients was 59.54 ± 11.62 with extremes of 32 and 92 years. The age group of 45 to 65 years was the most representative. The predominance was male, sex ratio of 2.4. The main cardiovascular risk factors were high blood pressure (58.23%) and diabetes (45.78%). Persistent ST-segment elevation on the electrocardiogram was present in 71.48%. The treatment time was more than 12 hours after the first medical contact in 95.5%. The approach was radial in 96.5% of cases. Coronarography was pathological in 91.16% of our patients. The lesions were tri-truncular in 34.13% with the anterior inter ventricular as culprit artery in 72% of cases. The majority of patients (64%) had undergone angioplasty with implantation of an active stent. Angioplasty was performed successfully in 98% and per procedural mortality was 1.87%. Only 6.45% of ACS with ST elevation benefited from primary angioplasty. Conclusion: Percutaneous coronary intervention is performed routinely in our center with satisfactory results. Difficulties exist, related to the diagnostic delay of ACS and the high cost of angioplasty.展开更多
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
Background: Diabetes mellitus (DM) is independently associated with an increased risk of cardiovascular mortality and morbidity, including coronary artery disease (CAD). CAD is a shared burden disease and the leading ...Background: Diabetes mellitus (DM) is independently associated with an increased risk of cardiovascular mortality and morbidity, including coronary artery disease (CAD). CAD is a shared burden disease and the leading cause of death in developed and developing countries. We aimed to assess the angiographic patterns of coronary arteries in patients with DM in a developing country (Yemen) as the first study. Methods: This study is a cross-sectional, prospective, observational study that includes a total of 250 patients who were admitted for elective diagnostic coronary angiography. Results: 96 (38.4%) patients were diabetics;68% were male;mean age was 57 ± 11 years. The incidence of three-vessel disease was 31.2% of patients. Considering the severity of lumen occlusion, (11.2%) of patients had non-significant lesions, (37.6%) of patients had significant lesions, and (32%) had total occlusive lesions. Lesions were of LAD in 76%, RCA in 60%, and LCX in 52% of the population. Among diabetics, two and 3-vessel diseases (33.3% vs. 20.8% & 50% vs. 19.5%, P = 0.001), left main lesion (10.4% vs. 2.6%, P = 0.012), significant stenosis (41.7% vs. 35.1%, P = 0.032), total occlusion of coronary arteries (43.8% vs. 19.5%, P = 0.032) and type C lesion (66.7% vs. 35.1%, P = 0.010) were more frequent than non-DM patients. Conclusion: The burden of significant and severe coronary lesions is more common among DM, which may be the major cause of morbidity and mortality of DM in developing countries.展开更多
BACKGROUND Cardiovascular disease,particularly myocardial infarction(MI)profound impact on patients'quality of life and places a substantial burden on the healthcare and economy systems.Developments in medical tec...BACKGROUND Cardiovascular disease,particularly myocardial infarction(MI)profound impact on patients'quality of life and places a substantial burden on the healthcare and economy systems.Developments in medical technology have led to the emer-gence of coronary intervention as an essential method for treating MI.AIM To assess the effects of cardiac rehabilitation care on cardiac function recovery and negative emotions in MI after coronary intervention.METHODS This study included a total of 180 patients with MI during the period from June 2022 to July 2023.Selected patients were divided into two groups:An observation group,which receiving cardiac rehabilitation care;a control group,which re-ceiving conventional care.By comparing multiple observation indicators such as cardiac function indicators,blood pressure,exercise tolerance,occurrence of adverse cardiac events,and negative emotion scores between the two groups of patients.All the data were analyzed and compared between two groups.RESULTS There were 44 males and 46 females in the observation group with an average age of 36.26±9.88 yr;there were 43 males and 47 females in the control group,with an average age of 40.87±10.5 yr.After receiving the appropriate postoperative nursing measures,the results of the observation group showed significant improvement in several indicators compared with the control group.Indicators of cardiac function,such as left ventricular end-diastolic internal diameter and left ventricular ejection fraction were significantly better in the observation group than in the control group(P<0.05).Exercise endurance assessment showed that the 6-minute walking test distance was significantly increased in the patients of the observation group(P<0.01).In addition,the incidence of adverse cardiac events was significantly lower in the observation group,and negative mood scores were significantly reduced(P<0.05).CONCLUSION Cardiac rehabilitation care after coronary intervention has a significant positive impact on functional recovery.This emphasizes the importance of cardiac rehabilitation care to improve patient recovery.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
Objective: To analyze the effect of nursing intervention in preventing complications after whole-brain angiography and reducing the risk of neurological dysfunction, infection, and vascular complications. Methods: One...Objective: To analyze the effect of nursing intervention in preventing complications after whole-brain angiography and reducing the risk of neurological dysfunction, infection, and vascular complications. Methods: One hundred patients who underwent whole-brain angiography in our hospital from December 2022 to December 2023 were selected and randomly divided into control and observation groups of 50 cases each. The control group received routine care, and the observation group received systematic care. The psychological status, complication rate, nursing quality, blood pressure, and nursing satisfaction of the two groups of patients were compared. Results: Before the intervention, there was no significant difference in psychological state between the two groups (P > 0.05). After the intervention, the positive effect (PA) and negative effect (NA) exhibited a significant correlation between the two groups (P < 0.05). The observation group had a lower incidence of postoperative complications as compared to the control group (P < 0.05). The nursing quality and satisfaction of the observation group were significantly higher than those of the control group (P < 0.05). There was no significant difference in blood pressure levels between the two groups before surgery (P > 0.05), while during and after surgery, the blood pressure levels of the two groups of patients showed a highly significant correlation (P < 0.05). Conclusion: Nursing intervention exhibited a significant preventive effect after whole-brain angiography. Scientific and reasonable nursing measures can effectively reduce the incidence of complications and improve the surgical safety and recovery of patients.展开更多
Objective:To explore the impact of a continuous precision nursing model on patients’Knowledge,Attitudes,and Practices(KAP)and cardiac function during the nursing process of patients undergoing percutaneous coronary a...Objective:To explore the impact of a continuous precision nursing model on patients’Knowledge,Attitudes,and Practices(KAP)and cardiac function during the nursing process of patients undergoing percutaneous coronary angiography and stent implantation.Methods:Ninety patients who underwent percutaneous coronary angiography and stent implantation in our hospital from April 2022 to April 2023 were selected and randomly divided into the control group(45 cases),in which routine nursing support was carried out during the treatment process,and the observation group(45 cases),in which continuous precision nursing model was carried out during the treatment process.Comparisons were made between the two groups of patients on their KAP,cardiac function,and quality of life during recovery.Results:There was no difference in the left ventricular ejection fraction(LVEF),cardiac output(CO),and cardiac index(CI)levels before intervention.After the intervention,the levels of cardiac function in the observation group were higher than those of the control group(P<0.05).There was no difference in the Exercise of Self-Care Agency(ESCA)self-care ability scale scores before the intervention.After the intervention,the observation group had higher ESCA scores than the control group(P<0.05).Conclusion:Implementation of a continuous precision nursing model in the care of patients undergoing percutaneous coronary angiography and stent implantation improved the patient’s cardiac function,and KAP,and promoted recovery.展开更多
Coronary artery abnormalities are the most important complications in children with Kawasaki disease(KD).Two-dimensional transthoracic echocardiography currently is the standard of care for initial evaluation and foll...Coronary artery abnormalities are the most important complications in children with Kawasaki disease(KD).Two-dimensional transthoracic echocardiography currently is the standard of care for initial evaluation and follow-up of children with KD.However,it has inherent limitations with regard to evaluation of mid and distal coronary arteries and,left circumflex artery and the poor acoustic window in older children often makes evaluation difficult in this age group.Catheter angiography(CA)is invasive,has high radiation exposure and fails to demonstrate abnormalities beyond lumen.The limitations of echocardiography and CA necessitate the use of an imaging modality that overcomes these problems.In recent years advances in computed tomography technology have enabled explicit evaluation of coronary arteries along their entire course including major branches with optimal and acceptable radiation exposure in children.Computed tomography coronary angiography(CTCA)can be performed during acute as well as convalescent phases of KD.It is likely that CTCA may soon be considered the reference standard imaging modality for evaluation of coronary arteries in children with KD.展开更多
[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 under...[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.展开更多
BACKGROUND Ischemic colitis(IC)is common,rising in incidence and associated with high mortality.Its presentation,disease behavior and severity vary widely,and there is significant heterogeneity in therapeutic strategi...BACKGROUND Ischemic colitis(IC)is common,rising in incidence and associated with high mortality.Its presentation,disease behavior and severity vary widely,and there is significant heterogeneity in therapeutic strategies and prognosis.The common causes of IC include thromboembolism,hemodynamic insufficiency,iatrogenic factors and drug-induced.However,contrast-induced IC,especially isolated right colon ischemia is rarely reported.CASE SUMMARY A 52-year-old man was admitted to the hospital due to intermittent chest distress accompanied by palpitation.Coronary angiography was performed using 60 mL of the iodinated contrast agent iohexol(Omnipaque 300),and revealed moderate stenosis of the left anterior descending artery and right coronary artery.At 3 h post-procedure,he complained of epigastric pain without fever,diarrhea and vomiting.Vital signs remained normal.An iodixanol-enhanced abdominal computed tomography(CT)scan revealed thickening,edema of the ascending and right transverse colonic wall and inflammatory exudate,without thrombus in mesenteric arteries and veins.Following 4 days of treatment with antibiotic and supportive management,the patient had a quick and excellent recovery with disappearance of abdominal pain,normalization of leucocyte count and a significant decrease in C reactive protein.There was no recurrence of abdominal pain during the patient's two-year follow-up.CONCLUSION This case emphasizes that contrast-induced IC should be considered in the differential diagnosis of unexplained abdominal pain after a cardiovascular interventional procedure with the administration of contrast media.Timely imaging evaluation by CT and early diagnosis help to improve the prognosis of IC.展开更多
Objective:To evaluate the impact of hyperuricemia on the occurrence of contrast agentrelated acute kidney injury after percutaneous coronary intervention.Methods:Retrieve PubMed,Embase,Cochrane Library,Web of Science,...Objective:To evaluate the impact of hyperuricemia on the occurrence of contrast agentrelated acute kidney injury after percutaneous coronary intervention.Methods:Retrieve PubMed,Embase,Cochrane Library,Web of Science,CNKI,Wanfang,and VIP databases,and publish articles on the correlation between hyperuricemia and contrast agent-related acute kidney damage after percutaneous coronary intervention from the establishment of the database to August 162023.Two researchers independently conducted literature screening and data extraction to evaluate the bias risk of inclusion in the study,and conducted metaanalysis using Review Manager 5.4 software.Results:A total of 12 articles were included,including 11676 patients.The meta-analysis results showed that compared with patients without hyperuricemia,patients with hyperuricemia had a higher risk of developing PC-AKI,with an incidence rate of 22.3%.Hyperuricemia was a risk factor for the occurrence of PCAKI(OR=2.03,95%CI:1.58-2.61);Patients with hyperuricemia have a higher risk of death after PC-AKI,with a mortality rate of 7.5%.Hyperuricemia is a risk factor for early death in PC-AKI patients(OR=2.33,95%CI:1.81-3.00);The probability of CRRT treatment after PCAKI in patients with hyperuricemia is higher,at 3.14%.Hyperuricemia is an influencing factor for CRRT treatment in PC-AKI patients(OR=7,95%CI:2.83-17.30).Conclusion:Existing research evidence suggests that the presence of hyperuricemia is an independent risk factor for the occurrence of PC-AKI,and it significantly increases the hospital mortality rate and the risk of renal replacement therapy in PC-AKI patients.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
BACKGROUND There is evolving role of computed tomography coronary angiography(CTCA)in non-invasive evaluation of coronary artery abnormalities in children with Kawasaki disease(KD).Despite this,there is lack of data o...BACKGROUND There is evolving role of computed tomography coronary angiography(CTCA)in non-invasive evaluation of coronary artery abnormalities in children with Kawasaki disease(KD).Despite this,there is lack of data on radiation dose in this group of children undergoing CTCA.AIM To audit the radiation dose of CTCA in children with KD.METHODS Study(December 2013-February 2018)was performed on dual source CT scanner using adaptive prospective electrocardiography-triggering.The dose length product(DLP in milligray-centimeters-mGy.cm)was recorded.Effective radiation dose(millisieverts-mSv)was calculated by applying appropriate age adjusted conversion factors as per recommendations of International Commission on Radiological Protection.Radiation dose was compared across the groups(0-1,1-5,5-10,and>10 years).RESULTS Eighty-five children(71 boys,14 girls)with KD underwent CTCA.The median age was 5 years(range,2 mo-11 years).Median DLP and effective dose was 21 mGy.cm,interquartile ranges(IQR)=15(13,28)and 0.83 mSv,IQR=0.33(0.68,1.01)respectively.Mean DLP increased significantly across the age groups.Mean effective dose in infants(0.63 mSv)was significantly lower than the other age groups(1-5 years 0.85 mSv,5-10 years 1.04 mSv,and>10 years 1.38 mSv)(P<0.05).There was no significant difference in the effective dose between the other groups of children.All the CTCA studies were of diagnostic quality.No child required a repeat examination.CONCLUSION CTCA is feasible with submillisievert radiation dose in most children with KD.Thus,CTCA has the potential to be an important adjunctive imaging modality in children with KD.展开更多
Background: The severity of coronary lesions in patients with coronary artery disease (CAD) has important prognostic and therapeutic consequences. Clinical symptoms not always reflect the disease severity and this stu...Background: The severity of coronary lesions in patients with coronary artery disease (CAD) has important prognostic and therapeutic consequences. Clinical symptoms not always reflect the disease severity and this study aimed to evaluate coronary lesions in the Algerian population where these data are scarce. Methods: It was a prospective cross-sectional study conducted in consecutive patients with an age ≥20 years who underwent clinically-indicated coronary angiography in our center. The objective of the study was to determine the prevalence of severe coronary lesions assessed with the Gensini score. The predictive factors of severity were evaluated in a multivariate analysis. Results: A total of 507 patients were included (male, 79.7%;mean age, 58.8 years). Coronary angiography was prescribed most frequently for ST-segment elevation myocardial infarction (STMI) (46.9%) and non-STMI (38.1%). The prevalence of severe coronary lesions was 69.6% (95% CI 65.5 - 73.5). In multivariate analysis, the independent predictive factors of severe coronary lesions were male sex (odds ratio [OR] 2.00;p = 0.0141), diabetes (OR 1.92;p = 0.0070), left ventricular dysfunction (OR 1.81;p = 0.0059), age (OR 1.72;p = 0.0297) and no lipid-lowering treatment (OR, 0.47;p = 0.0388). Conclusions: Severe coronary lesions were present in two out three patients in this cohort of Algerian patients undergoing coronary angiography. Independent predictive factors of severe coronary lesions were male sex, diabetes, age, left ventricular dysfunction and no lipid-lowering treatment. It is important to identify these at-risk patients, as they should be explored at an asymptomatic stage before a cardiovascular event and receive prompt treatment with angioplasty or surgery.展开更多
Objective:To assess the feasibility of coronary angiography by transradial approach with 4F catheter.Methods:The procedural details,picture quality,local complication were recorded for coronary by transradial approach...Objective:To assess the feasibility of coronary angiography by transradial approach with 4F catheter.Methods:The procedural details,picture quality,local complication were recorded for coronary by transradial approach with 4F catheter in 138 patients.Results:The success rate of angiography was 97.7%;fluoroscopy time was(5.05±3.23)minutes,total procedural time was(20.51±3.37)minutes;the incidence of dislodgement,excessive engagement of either coronary artery was 7.8%,9.4%,repectively;the angiographic scores for left anterior descending,circumflex and right coronary arteries were(2.87±0.40),(2.88±0.39),(2.90±0.35),respectively.The spasm complication occurred 4.3% in radial artery and 1.5% in coronary artery.There were no occlusion of radial artery during follow up.Conclusion:4F catheter could be the first chosen in some selecting patients for its nice maneuverability,fine images and fewer vascular complications.展开更多
基金This work was supported by the National Natural Science Foundation of China(GrantNos.81170279,81370408,81370409)the Social Development Projects of Jiangsu Province(WS074,LJ201116,Q201308)the Projects from Social Development of Zhenjiang(SS2012002,SH2013023,SH2013024).
文摘Purpose:To compare the effectiveness of the interventional limb raising management strategy(ILRMS)to elastic bandage compression at radial vascular access sites following coronary angiographies(CAGs)and percutaneous coronary interventions(PCIs).Methods:Patients with ischemic coronary heart disease whose condition was stable over three months were enrolled in this clinical study(n=590;aged 25e80).All participants had just undergone CAG and PCI.Patients were randomized into either the ILRMS group(n=360)or standard post-intervention care with an elastic bandage(n=230).Overall comfort and wrist pain was assessed and the degree of index finger swelling and oxygen saturation was measured on the affected arm.All variables were measured prior to postintervention treatment and again at six hours after CAG and PCI.Results:We found that patients receiving ILRMS had significantly lower wrist pain scores and swelling around the index finger compared to the elastic bandage group(p<0.05).Oxygen saturation of the index finger was not statistically significant(p>0.05).We also found that 19.57%of the elastic bandage patients were comfortable,while ILRMS patients were significantly more comfortable(93.06%;p<0.05).Conclusions:We find that ILRMS alleviates swelling and pain of the wrist more effectively than current practices and improves the degree of overall comfort of patients who undergo CAG and PCI.
文摘Objective:To compare the feasibility and safety between right distal radial artery access and right radial artery access in patients undergoing coronary angiography(CAG)or percutaneous coronary intervention(PCI).Methods:On the basis of arterial access,113 patients who underwent CAG or PCI in Kunshan Hospital of Traditional Chinese Medicine between January and October 2018 were divided into two groups:a right distal radial artery group(52 patients)and a right radial artery group(61 patients).We collected general information,the number of puncture attempts,access times,postoperative compression time,and complications.Results:The general characteristics,rate of successful radial artery puncture,and rate of successful catheter placement in the two groups were not different.The right radial artery group had fewer puncture attempts(1.26±0.44 times vs.2.19±0.53 times,P=0.001)and a shorter access time(3.23±0.86 min vs.4.77±1.49 min,P=0.001)than the right distal radial artery group.However,the postoperative compression time in the right distal radial artery group was shorter(3.44±0.9 h vs.7.16±1.21 h,P=0.001).Two cases of bleeding,four cases of hematoma,and one case of artery occlusion in the right radial artery group and one case of hematoma in the right distal artery group occurred before discharge.The rate of total complications in the right distal radial artery group was lower than in the right radial artery group(1.93%vs.11.48%,P=0.048).Conclusion:CAG or PCI through the right distal radial artery is feasible and safe.
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Introduction: Cardiac catheterisation plays a fundamental role in the management of acute coronary syndrome. These explorations require heavy, complex and costly equipment and a large team of doctors, nurses and technicians with highly specialized training. Aims: To describe epidemiological, clinical and coronary angiography aspects of patients with acute coronary syndrome. Patients and Methods: Descriptive study from September 2019 to December 2023 in the Cardiology Department of the Hôpital Mère-Enfant of Bamako. Inclusion criteria were patients admitted for coronary angiography with the diagnosis of acute coronary syndrome. Results: During the study period, 1253 patients underwent coronary angiography, 596 of whom had acute coronary syndrome as an indication, representing a hospital frequency of 47%. Sex-ratio was 2.10. Mean age of patients was 58.5 ± 11.39 years. ST elevation acute coronary syndrome was the most common indication with 63.92% of cases. High blood pressure was the main cardiovascular risk factor with 58.7% of cases, and radial access approach was used in 98% of cases. Coronary angiography was pathological in 91.70% of cases (n = 548). Patients with lesions of anterior interventricular artery were 73.73% of cases. Tritruncal lesions accounted for 40.63% of cases. Conclusion: ST elevation acute coronary syndrome is the most frequent manifestation of acute coronary syndrome. Anterior interventricular artery is most often the culprit lesion for our patients.
文摘Introduction: Acute coronary syndromes (ACS) are a diagnostic and therapeutic emergency. Objective: Studying the feasibility, difficulties and results of coronary angioplasty in acute coronary syndromes at the Luxembourg Mother-Child University Hospital in Bamako. Patients and Methods: Cross-sectional, descriptive study with prospective recruitment over 18 months from September 2020 to February 2022. All patients aged at least 18 years old admitted for SCA and having undergone PCI during the study period were included. Result: We collected 249 patients for SCA, of whom 160 underwent angioplasty, either an angioplasty/SCA ratio of 0.64. The average age of the patients was 59.54 ± 11.62 with extremes of 32 and 92 years. The age group of 45 to 65 years was the most representative. The predominance was male, sex ratio of 2.4. The main cardiovascular risk factors were high blood pressure (58.23%) and diabetes (45.78%). Persistent ST-segment elevation on the electrocardiogram was present in 71.48%. The treatment time was more than 12 hours after the first medical contact in 95.5%. The approach was radial in 96.5% of cases. Coronarography was pathological in 91.16% of our patients. The lesions were tri-truncular in 34.13% with the anterior inter ventricular as culprit artery in 72% of cases. The majority of patients (64%) had undergone angioplasty with implantation of an active stent. Angioplasty was performed successfully in 98% and per procedural mortality was 1.87%. Only 6.45% of ACS with ST elevation benefited from primary angioplasty. Conclusion: Percutaneous coronary intervention is performed routinely in our center with satisfactory results. Difficulties exist, related to the diagnostic delay of ACS and the high cost of angioplasty.
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Background: Diabetes mellitus (DM) is independently associated with an increased risk of cardiovascular mortality and morbidity, including coronary artery disease (CAD). CAD is a shared burden disease and the leading cause of death in developed and developing countries. We aimed to assess the angiographic patterns of coronary arteries in patients with DM in a developing country (Yemen) as the first study. Methods: This study is a cross-sectional, prospective, observational study that includes a total of 250 patients who were admitted for elective diagnostic coronary angiography. Results: 96 (38.4%) patients were diabetics;68% were male;mean age was 57 ± 11 years. The incidence of three-vessel disease was 31.2% of patients. Considering the severity of lumen occlusion, (11.2%) of patients had non-significant lesions, (37.6%) of patients had significant lesions, and (32%) had total occlusive lesions. Lesions were of LAD in 76%, RCA in 60%, and LCX in 52% of the population. Among diabetics, two and 3-vessel diseases (33.3% vs. 20.8% & 50% vs. 19.5%, P = 0.001), left main lesion (10.4% vs. 2.6%, P = 0.012), significant stenosis (41.7% vs. 35.1%, P = 0.032), total occlusion of coronary arteries (43.8% vs. 19.5%, P = 0.032) and type C lesion (66.7% vs. 35.1%, P = 0.010) were more frequent than non-DM patients. Conclusion: The burden of significant and severe coronary lesions is more common among DM, which may be the major cause of morbidity and mortality of DM in developing countries.
文摘BACKGROUND Cardiovascular disease,particularly myocardial infarction(MI)profound impact on patients'quality of life and places a substantial burden on the healthcare and economy systems.Developments in medical technology have led to the emer-gence of coronary intervention as an essential method for treating MI.AIM To assess the effects of cardiac rehabilitation care on cardiac function recovery and negative emotions in MI after coronary intervention.METHODS This study included a total of 180 patients with MI during the period from June 2022 to July 2023.Selected patients were divided into two groups:An observation group,which receiving cardiac rehabilitation care;a control group,which re-ceiving conventional care.By comparing multiple observation indicators such as cardiac function indicators,blood pressure,exercise tolerance,occurrence of adverse cardiac events,and negative emotion scores between the two groups of patients.All the data were analyzed and compared between two groups.RESULTS There were 44 males and 46 females in the observation group with an average age of 36.26±9.88 yr;there were 43 males and 47 females in the control group,with an average age of 40.87±10.5 yr.After receiving the appropriate postoperative nursing measures,the results of the observation group showed significant improvement in several indicators compared with the control group.Indicators of cardiac function,such as left ventricular end-diastolic internal diameter and left ventricular ejection fraction were significantly better in the observation group than in the control group(P<0.05).Exercise endurance assessment showed that the 6-minute walking test distance was significantly increased in the patients of the observation group(P<0.01).In addition,the incidence of adverse cardiac events was significantly lower in the observation group,and negative mood scores were significantly reduced(P<0.05).CONCLUSION Cardiac rehabilitation care after coronary intervention has a significant positive impact on functional recovery.This emphasizes the importance of cardiac rehabilitation care to improve patient recovery.
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.
文摘Objective: To analyze the effect of nursing intervention in preventing complications after whole-brain angiography and reducing the risk of neurological dysfunction, infection, and vascular complications. Methods: One hundred patients who underwent whole-brain angiography in our hospital from December 2022 to December 2023 were selected and randomly divided into control and observation groups of 50 cases each. The control group received routine care, and the observation group received systematic care. The psychological status, complication rate, nursing quality, blood pressure, and nursing satisfaction of the two groups of patients were compared. Results: Before the intervention, there was no significant difference in psychological state between the two groups (P > 0.05). After the intervention, the positive effect (PA) and negative effect (NA) exhibited a significant correlation between the two groups (P < 0.05). The observation group had a lower incidence of postoperative complications as compared to the control group (P < 0.05). The nursing quality and satisfaction of the observation group were significantly higher than those of the control group (P < 0.05). There was no significant difference in blood pressure levels between the two groups before surgery (P > 0.05), while during and after surgery, the blood pressure levels of the two groups of patients showed a highly significant correlation (P < 0.05). Conclusion: Nursing intervention exhibited a significant preventive effect after whole-brain angiography. Scientific and reasonable nursing measures can effectively reduce the incidence of complications and improve the surgical safety and recovery of patients.
文摘Objective:To explore the impact of a continuous precision nursing model on patients’Knowledge,Attitudes,and Practices(KAP)and cardiac function during the nursing process of patients undergoing percutaneous coronary angiography and stent implantation.Methods:Ninety patients who underwent percutaneous coronary angiography and stent implantation in our hospital from April 2022 to April 2023 were selected and randomly divided into the control group(45 cases),in which routine nursing support was carried out during the treatment process,and the observation group(45 cases),in which continuous precision nursing model was carried out during the treatment process.Comparisons were made between the two groups of patients on their KAP,cardiac function,and quality of life during recovery.Results:There was no difference in the left ventricular ejection fraction(LVEF),cardiac output(CO),and cardiac index(CI)levels before intervention.After the intervention,the levels of cardiac function in the observation group were higher than those of the control group(P<0.05).There was no difference in the Exercise of Self-Care Agency(ESCA)self-care ability scale scores before the intervention.After the intervention,the observation group had higher ESCA scores than the control group(P<0.05).Conclusion:Implementation of a continuous precision nursing model in the care of patients undergoing percutaneous coronary angiography and stent implantation improved the patient’s cardiac function,and KAP,and promoted recovery.
文摘Coronary artery abnormalities are the most important complications in children with Kawasaki disease(KD).Two-dimensional transthoracic echocardiography currently is the standard of care for initial evaluation and follow-up of children with KD.However,it has inherent limitations with regard to evaluation of mid and distal coronary arteries and,left circumflex artery and the poor acoustic window in older children often makes evaluation difficult in this age group.Catheter angiography(CA)is invasive,has high radiation exposure and fails to demonstrate abnormalities beyond lumen.The limitations of echocardiography and CA necessitate the use of an imaging modality that overcomes these problems.In recent years advances in computed tomography technology have enabled explicit evaluation of coronary arteries along their entire course including major branches with optimal and acceptable radiation exposure in children.Computed tomography coronary angiography(CTCA)can be performed during acute as well as convalescent phases of KD.It is likely that CTCA may soon be considered the reference standard imaging modality for evaluation of coronary arteries in children with KD.
文摘[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.
基金Supported by National Key R&D Program of China,No.2021ZD0111000Beijing Key Clinical Subject Program,No.2018-204.
文摘BACKGROUND Ischemic colitis(IC)is common,rising in incidence and associated with high mortality.Its presentation,disease behavior and severity vary widely,and there is significant heterogeneity in therapeutic strategies and prognosis.The common causes of IC include thromboembolism,hemodynamic insufficiency,iatrogenic factors and drug-induced.However,contrast-induced IC,especially isolated right colon ischemia is rarely reported.CASE SUMMARY A 52-year-old man was admitted to the hospital due to intermittent chest distress accompanied by palpitation.Coronary angiography was performed using 60 mL of the iodinated contrast agent iohexol(Omnipaque 300),and revealed moderate stenosis of the left anterior descending artery and right coronary artery.At 3 h post-procedure,he complained of epigastric pain without fever,diarrhea and vomiting.Vital signs remained normal.An iodixanol-enhanced abdominal computed tomography(CT)scan revealed thickening,edema of the ascending and right transverse colonic wall and inflammatory exudate,without thrombus in mesenteric arteries and veins.Following 4 days of treatment with antibiotic and supportive management,the patient had a quick and excellent recovery with disappearance of abdominal pain,normalization of leucocyte count and a significant decrease in C reactive protein.There was no recurrence of abdominal pain during the patient's two-year follow-up.CONCLUSION This case emphasizes that contrast-induced IC should be considered in the differential diagnosis of unexplained abdominal pain after a cardiovascular interventional procedure with the administration of contrast media.Timely imaging evaluation by CT and early diagnosis help to improve the prognosis of IC.
基金Key Research and Development Program of the Ministry of Science and Technology(No.2018YFC1704304)。
文摘Objective:To evaluate the impact of hyperuricemia on the occurrence of contrast agentrelated acute kidney injury after percutaneous coronary intervention.Methods:Retrieve PubMed,Embase,Cochrane Library,Web of Science,CNKI,Wanfang,and VIP databases,and publish articles on the correlation between hyperuricemia and contrast agent-related acute kidney damage after percutaneous coronary intervention from the establishment of the database to August 162023.Two researchers independently conducted literature screening and data extraction to evaluate the bias risk of inclusion in the study,and conducted metaanalysis using Review Manager 5.4 software.Results:A total of 12 articles were included,including 11676 patients.The meta-analysis results showed that compared with patients without hyperuricemia,patients with hyperuricemia had a higher risk of developing PC-AKI,with an incidence rate of 22.3%.Hyperuricemia was a risk factor for the occurrence of PCAKI(OR=2.03,95%CI:1.58-2.61);Patients with hyperuricemia have a higher risk of death after PC-AKI,with a mortality rate of 7.5%.Hyperuricemia is a risk factor for early death in PC-AKI patients(OR=2.33,95%CI:1.81-3.00);The probability of CRRT treatment after PCAKI in patients with hyperuricemia is higher,at 3.14%.Hyperuricemia is an influencing factor for CRRT treatment in PC-AKI patients(OR=7,95%CI:2.83-17.30).Conclusion:Existing research evidence suggests that the presence of hyperuricemia is an independent risk factor for the occurrence of PC-AKI,and it significantly increases the hospital mortality rate and the risk of renal replacement therapy in PC-AKI patients.
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BACKGROUND There is evolving role of computed tomography coronary angiography(CTCA)in non-invasive evaluation of coronary artery abnormalities in children with Kawasaki disease(KD).Despite this,there is lack of data on radiation dose in this group of children undergoing CTCA.AIM To audit the radiation dose of CTCA in children with KD.METHODS Study(December 2013-February 2018)was performed on dual source CT scanner using adaptive prospective electrocardiography-triggering.The dose length product(DLP in milligray-centimeters-mGy.cm)was recorded.Effective radiation dose(millisieverts-mSv)was calculated by applying appropriate age adjusted conversion factors as per recommendations of International Commission on Radiological Protection.Radiation dose was compared across the groups(0-1,1-5,5-10,and>10 years).RESULTS Eighty-five children(71 boys,14 girls)with KD underwent CTCA.The median age was 5 years(range,2 mo-11 years).Median DLP and effective dose was 21 mGy.cm,interquartile ranges(IQR)=15(13,28)and 0.83 mSv,IQR=0.33(0.68,1.01)respectively.Mean DLP increased significantly across the age groups.Mean effective dose in infants(0.63 mSv)was significantly lower than the other age groups(1-5 years 0.85 mSv,5-10 years 1.04 mSv,and>10 years 1.38 mSv)(P<0.05).There was no significant difference in the effective dose between the other groups of children.All the CTCA studies were of diagnostic quality.No child required a repeat examination.CONCLUSION CTCA is feasible with submillisievert radiation dose in most children with KD.Thus,CTCA has the potential to be an important adjunctive imaging modality in children with KD.
文摘Background: The severity of coronary lesions in patients with coronary artery disease (CAD) has important prognostic and therapeutic consequences. Clinical symptoms not always reflect the disease severity and this study aimed to evaluate coronary lesions in the Algerian population where these data are scarce. Methods: It was a prospective cross-sectional study conducted in consecutive patients with an age ≥20 years who underwent clinically-indicated coronary angiography in our center. The objective of the study was to determine the prevalence of severe coronary lesions assessed with the Gensini score. The predictive factors of severity were evaluated in a multivariate analysis. Results: A total of 507 patients were included (male, 79.7%;mean age, 58.8 years). Coronary angiography was prescribed most frequently for ST-segment elevation myocardial infarction (STMI) (46.9%) and non-STMI (38.1%). The prevalence of severe coronary lesions was 69.6% (95% CI 65.5 - 73.5). In multivariate analysis, the independent predictive factors of severe coronary lesions were male sex (odds ratio [OR] 2.00;p = 0.0141), diabetes (OR 1.92;p = 0.0070), left ventricular dysfunction (OR 1.81;p = 0.0059), age (OR 1.72;p = 0.0297) and no lipid-lowering treatment (OR, 0.47;p = 0.0388). Conclusions: Severe coronary lesions were present in two out three patients in this cohort of Algerian patients undergoing coronary angiography. Independent predictive factors of severe coronary lesions were male sex, diabetes, age, left ventricular dysfunction and no lipid-lowering treatment. It is important to identify these at-risk patients, as they should be explored at an asymptomatic stage before a cardiovascular event and receive prompt treatment with angioplasty or surgery.
文摘Objective:To assess the feasibility of coronary angiography by transradial approach with 4F catheter.Methods:The procedural details,picture quality,local complication were recorded for coronary by transradial approach with 4F catheter in 138 patients.Results:The success rate of angiography was 97.7%;fluoroscopy time was(5.05±3.23)minutes,total procedural time was(20.51±3.37)minutes;the incidence of dislodgement,excessive engagement of either coronary artery was 7.8%,9.4%,repectively;the angiographic scores for left anterior descending,circumflex and right coronary arteries were(2.87±0.40),(2.88±0.39),(2.90±0.35),respectively.The spasm complication occurred 4.3% in radial artery and 1.5% in coronary artery.There were no occlusion of radial artery during follow up.Conclusion:4F catheter could be the first chosen in some selecting patients for its nice maneuverability,fine images and fewer vascular complications.