Post-percutaneous Coronary Intervention Patients Research Articles

Depression and its impact on stroke risk and mortality in post-percutaneous coronary intervention patients: a nationwide retrospective cohort study

Abstract Background/Introduction Cardiovascular disease (CVD) remains a leading cause of global mortality, with percutaneous coronary intervention (PCI) being a common therapeutic procedure for managing CVD. While depression is recognized as a risk factor for adverse cardiovascular outcomes post-PCI, its association with stroke risk in this patient group has been less explored. Purpose This study aims to evaluate the association between pre-existing depression and the incidence of stroke, alongside other cardiovascular outcomes and mortality, in patients undergoing PCI. Methods Utilizing the Korean National Health Insurance Service database, a population-based retrospective cohort study was conducted, encompassing individuals who underwent PCI between 2010 and 2017, with a follow-up until 2019. Depression was identified through ICD-10 codes prior to PCI. The primary outcome was acute stroke incidence, with all-cause mortality and revascularization as secondary outcomes. Adjustments were made for sociodemographic, lifestyle factors, and comorbidities. Results Among 164,198 individuals, those with pre-existing depression (17.4% of the cohort) exhibited a 27% increased risk of acute stroke (aHR 1.27, 95% CI 1.20-1.35) and a 25% higher risk of all-cause mortality (aHR 1.25, 95% CI 1.21-1.29) compared to those without. The association was stronger in individuals under 65 years and varied by sex, with males showing a higher risk of mortality. Conclusion(s) Pre-existing depression in patients undergoing PCI is associated with a significantly increased risk of stroke and all-cause mortality, particularly in younger patients. These findings highlight the importance of depression management as part of comprehensive care in post-PCI patients, suggesting potential benefits in reducing stroke risk and improving survival outcomes. Further research is warranted to explore the mechanisms and intervention strategies that could mitigate these risks.Study FlowchartRisk of stroke and all-cause death

Association between reduced risk of gastrointestinal bleeding related to proton pump inhibitor use and subsequent all-cause death in patients with percutaneous coronary intervention

Abstract Background Gastrointestinal bleeding is the leading cause of post-percutaneous coronary intervention (PCI) bleeding complications which are associated with a high risk for subsequent clinical outcomes. The aim of this study was to estimate association between risk of gastrointestinal bleeding events related to proton pump inhibitor (PPI) use and subsequent clinical outcomes in patients with PCI. Methods The Clinical Deep Data Accumulation System (CLIDAS) is a database for inclusive of patient characteristics, medications, laboratory test, physiological test, cardiac catheterization and PCI treatment, all of which were aggregated from electronic medical records in 7 tertiary hospitals in Japan. Data of 6457 patients who underwent PCI between April 2014 and March 2020 and were then followed for 30 days after the index PCI, were analyzed. These patients were divided into two groups based on use of PPI; the PPI group (n=5285; 82%) and the non-PPI group (n=1172; 18%). Clinical outcomes, defined as gastrointestinal bleeding and all-cause death, were assessed using propensity score matching (PSM) and inverse probability of treatment weighting (IPTW) models. Results Among the 6457 PCI patients, 90 (1.7%) in the PPI group and 31 (2.6%) in the non-PPI group experienced gastrointestinal bleeding events. Adjusting for baseline demographics, comorbidities, and anti-thrombotic treatments, the multivariable Cox hazard model suggested a trend towards a lower risk of gastrointestinal bleeding with PPI use (HR, 0.70; 95%CI, 0.46-1.05; p=0.087). The PSM analysis confirmed a significant association between PPI use and a lower risk of gastrointestinal bleeding (HR, 0.13; 95%CI, 0.04-0.43; p=0.001), consistent with IPTW model results (HR, 0.60; 95%CI, 0.38-0.95; p=0.031). Subgroup analysis showed that PPI use was associated with a low risk of all-cause death in patients with acute coronary syndrome (ACS) (HR, 0.58; 95%CI, 0.36-0.93; p=0.024). Causal mediation analysis indicated an indirect effect of PPI on reducing all-cause death through the suppression of gastrointestinal bleeding events. Conclusion These findings suggested that use of PPI against gastrointestinal bleeding complications might reduce the risk of subsequent all-cause death in ACS patients undergoing PCI.

Antiplatelet Strategy for Patients With Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention: ASystematic Review and Network Meta-Analysis.

Optimal duration and choice of antiplatelet therapy in patients with acute coronary syndrome undergoing percutaneous coronary intervention remain controversial. Digital databases (PubMed, Cochrane, and Embase) were queried to select all randomized controlled trials on a post-percutaneous coronary intervention population with acute coronary syndrome. Dual-antiplatelet therapy (DAPT) with aspirin and clopidogrel for 12 months was compared with 4 major strategies: high-potency, high- to low-potency, low-dose, and short-duration DAPT. A network meta-analysis was performed to compare the safety and efficacy of different antiplatelet strategies. This study was the second updated manuscript under the International Prospective Register of Systematic Reviewregistration (CRD42021286552). Thirty-two randomized controlled trials comprising 103 459 (51 750 experimental, 51 709 control) patients were included. Compared with DAPT with aspirin and clopidogrel for 12 months, high- to low-potency DAPT (risk ratio [RR], 0.69 [95% CI, 0.52-0.92]) and aspirin+prasugrel containing DAPT for 12 months (RR, 0.84 [95% CI, 0.72-0.98]) had a significantly lower, whereas DAPT for 1 month followed by clopidogrel only (RR, 1.59 [95% CI, 1.06-2.39]) had a higher, incidence of major adverse cardiovascular events at 1 year (median follow-up). Prasugrel (RR, 1.35 [95% CI, 1.09-1.66]) and ticagrelor (RR, 1.38 [95% CI, 1.17-1.62]) containing DAPT for 12 months had significantly higher rates, whereas high- to low-potency DAPT (RR, 0.85 [95% CI, 0.63-1.15]) had no significant risk of major bleeding. Aspirin and ticagrelor for 3 months, followed by aspirin and clopidogrel for the remaining duration, can be considered the optimal strategy for treating post-percutaneous coronary intervention patients with acute coronary syndrome because of a significantly reduced risk of major adverse cardiovascular events without increasing the risk of bleeding.

Study on the management effect of chronic disease intelligent information management platform in post percutaneous coronary intervention patients.

In 2019, approximately 330 million individuals in China were affected by cardiovascular diseases, with 11.4 million cases specifically attributed to coronary artery disease (CAD). A national public health report indicated that the mortality rate for CAD ranged from 121.59 to 130.14 per 100,000 individuals in 2019. The treatments for CAD include lifestyle changes, medications, percutaneous coronary intervention (PCI) and coronary artery bypass grafting. To investigate the management effect of a digital health program in patients with coronary artery disease (CAD) after percutaneous coronary intervention (PCI). This retrospective study compares blood pressure, blood glucose, low-density lipoprotein cholesterol (LDL-C), medication adherence, lifestyle modification, and readmission rate between digital health users and traditional follow-up in post-PCI CAD patients. In this study of 698 CAD patients, the 6-month readmission rate of all patients was 27.4%, with digital health users showing lower rates than those in traditional follow-up (22.6% vs. 32.1%, p= 0.005). Digital health users had significantly higher target achievements rates in blood pressure (79.7% vs. 54.7%, p< 0.001), blood glucose (98.9% vs. 82.5%, p< 0.001) and LDL-C level (71.3% vs. 52.7%, p< 0.001) at 6-month post-PCI. The digital health group had more patients adopting lifestyle changes, including quitting smoking, maintaining a healthy diet, and exercising regularly. In risk factor analysis, digital health utilization (OR = 0.60, 95%CI: 0.40-0.90, p= 0.014) and multivessel disease (double: OR = 1.72, 95%CI: 1.09-2.72, p= 0.02; triple: OR = 2.59, 95%CI: 1.61-4.17, p< 0.001) were independent predictors of CAD-related cardiovascular readmissions. Post-PCI patients using digital health platforms exhibited improved blood pressure, glucose, and LDL-C control, greater treatment adherence, enhanced lifestyle changes, and reduced six-month readmission rates versus those with traditional follow-up.

The Age Factor in Cardiac Rehabilitation

Coronary artery disease (CAD) is a major global cause of death, and its risk increases with age. This study investigates the relationship between age, patient characteristics, and rehabilitation outcomes in the cardiac rehabilitation (CR) of CAD. A cross-sectional study analyzed 60 medical records of post-coronary artery bypass graft (CABG) or post-percutaneous coronary intervention (PCI) patients who underwent a 6-week CR program after a graded exercise test using the Modified Bruce Protocol. The CR consists of 90% male participants, with an average age of 59.25 ± 6.69 years and an overweight body mass index. CR increases metabolic equivalents in all subjects, while age has a weakly significant negative correlation with the result of CR, so it can be concluded that CR is advantageous for older post-CABG or post-PCI patients.

Critical appraisal and assessment of bias among studies evaluating risk prediction models for in-hospital and 30-day mortality after percutaneous coronary intervention: a systematic review

ObjectiveWe systematically assessed prediction models for the risk of in-hospital and 30-day mortality in post-percutaneous coronary intervention (PCI) patients.DesignSystematic review and narrative synthesis.Data sourcesSearched PubMed, Web of Science, Embase, Cochrane...

Predictive value of the inconsistency between the residual and post-PCI QFR for prognosis in PCI patients.

To investigate the prognostic value of the consistency between the residual quantitative flow ratio (QFR) and postpercutaneous coronary intervention (PCI) QFR in patients undergoing revascularization. This was a single-center, retrospective, observational study. All enrolled patients were divided into five groups according to the ΔQFR (defined as the value of the post-PCI QFR minus the residual QFR): (1) Overanticipated group; (2) Slightly overanticipated group; (3) Consistent group; (4) Slightly underanticipated group; and (5) Underanticipated group. The primary outcome was the 5-year target vessel failure (TVF). A total of 1373 patients were included in the final analysis. The pre-PCI QFR and post-PCI QFR were significantly different among the five groups. TVF within 5 years occurred in 189 patients in all the groups. The incidence of TVF was significantly greater in the underanticipated group than in the consistent group (P = 0.008), whereas no significant differences were found when comparing the underanticipated group with the other three groups. Restricted cubic spline regression analysis showed that the risk of TVF was nonlinearly related to the ΔQFR. A multivariate Cox regression model revealed that a ΔQFR≤ -0.1 was an independent risk factor for TVF. The consistency between the residual QFR and post-PCI QFR may be associated with the long-term prognosis of patients. Patients whose post-PCI QFR is significantly lower than the residual QFR may be at greater risk of TVF. An aggressive PCI strategy for lesions is anticipated to have less functional benefit and may not result in a better clinical outcome.

Physical activity levels and predictors in patients following percutaneous coronary intervention: a cross-sectional study

Abstract 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-reported 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 participants took part 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 participation 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.

Post-menopause women show increased levels in risk prediction scores with age as dependent variable

Abstract Background Men and women differ in outcome after percutaneous coronary intervention (PCI). However, frequently used scores for ischemic risk prediction in patients with cardiovascular disease do not include sex related factors. In this study, we aimed to analyze sex related differences in risk score prediction in patients after PCI in dependence from age-determined menopause. Methods In this mono-center analysis, we compared frequently used risk prediction scores for post PCI patients (GRACE [Global Registry of Acute Coronary Events], PRECISE-DAPT [PREdicting bleeding Complications In patients undergoing Stent implantation and subsEquent Dual Antiplatelet Therapy], NCDR-mortality and PARIS [Patterns of Non-Adherence to Anti-Platelet Regimen in Stented Patients]-thrombotic score) in male versus female post PCI patients in dependence from menopause (age determined) and age itself. Three-year follow-up was conducted to assess the incidence of MACCE (major adverse cerebro- and cardiovascular events) including all-cause mortality, myocardial infarction and stroke. Receiver operating characteristic (ROC) analysis was conducted to analyze predictive capacity of each score. Results 1,001 patients post PCI were included (38% chronic coronary syndrome [CCS], 61% acute coronary syndrome [ACS]). Out of these, 765 were male and 306 were female. Women were slightly older (68.1±11.5 vs. 73.3±11.3 years, p&amp;lt;0.0001). Male and female patients did not differ in achieved levels of risk score below the age of 55. In contrast, in the subgroups &amp;gt;55 years, GRACE, PD-DAPT and NCDR Mortality scores were higher in woman compared to men (GRACE – 120.5±27.89 vs. 128.5±29.97, p&amp;lt;0.0001; PD-DAPT – 26.46±13.13 vs. 30.66±12.76, p&amp;lt;0.001; NCDR Mortality – 345.79±18.33 vs. 40.8±20.62, p&amp;lt;0.0001). Interestingly, PARIS thrombotic score was reduced (4.02±2.28 vs. 3.6±2.3, p=0.027). After Propensity score matching for age, GRACE, PD-DAPT and NCDR Mortality did no longer differ whereby PARIS thrombotic was reduced in female patients in this analysis as well. ROC revealed a moderate predictive capacity for MACCE for all scores in this post PCI cohort with a numerically higher predictive capacity for women (GRACEAUC – 0.625 vs. 0.662; PD-DAPTAUC 0.589 vs. 0.660, NCDR-mortalityAUC 0.625 vs. 0.667; PARIS-thromboticAUC 0.594 vs. 0.638). Conclusion In this single center analysis of post PCI patients with ACS and CCS, we could reveal that the GRACE, PD-DAPT and NCDR-mortality risk scores show higher values in post-menopause women compared to men whereby the PARIS-thrombotic score was reduced. We revealed age as major driver for this discrepancy. Moreover, women showed a numerically higher predictive accuracy for the occurrence of MACCE in line with the demonstrated worse outcome after PCI in several cohorts.

Appropriate ischemic criteria for type 4a myocardial infarction: insights from the ALPHEUS trial

Abstract Background Different troponin thresholds have been proposed to define periprocedural myocardial injury based on post percutaneous coronary intervention (PCI) troponin increase only, whereas the definition of type 4a myocardial infarction (MI) needs the association of post procedural troponin and one ischemic criterion. These criteria which evolved from the 3rd to the 4th Universal Definition of Myocardial Infarction (UDMI) are frequently under-reported in studies on periprocedural MI. Purpose We aimed to describe rates of type 4a MI additional diagnostic criteria among the ranges of post PCI troponin elevation in the randomized ALPHEUS trial which compared ticagrelor to clopidogrel in high-risk elective PCI patients. Methods 1698 patients with normal pre-PCI troponin values and centralized core laboratory angiogram analyzes were divided into 4 groups according to maximal post PCI troponin elevations (≤ 1x upper reference limit (URL) for group 1; &amp;gt; 1xURL and ≤ 5xURL for group 2; &amp;gt; 5xURL and &amp;lt; 35xURL for group 3 and ≥ 35xURL for group 4). The type 4a MI additional criteria (ischaemic imaging changes, ischaemic ECG changes, chest pain and angiographic complications) as defined by the 3rd and 4th UDMI were reported and the different angiographic complications were detailed for each group. Results The most prevalent additional ischemic criterion was the presence of angiographic complications detected by the core laboratory. The rate of angiographic complications increased in a stepwise manner with higher post PCI troponin elevation (Figure). Interestingly, we found a similar rate of angiographic complications in patients without any increase in post PCI troponin and troponin elevations below the 5xURL threshold (8.4% and 9.9% respectively). Most angiographic complications were related to transient main branch dissection and/or thrombosis, and transient or permanent side branch occlusions (Table). ECG changes and chest pain ischemic criteria also increased in a stepwise manner and were rarely found below the 5-fold threshold increase, although they might be underreported. Conclusion When using a core laboratory, angiographic complications are found even in patients with no or minor troponin elevation. Above the 5 xURL threshold the rates of angiographic complications are 2 to 3-fold more frequent, and ECG changes and chest pain ischaemic criteria are likely to be present. Our findings support the use of angiographic core laboratory in clinical trial using periprocedural MI as an endpoint; similarly, chest pain -which disappeared from the 4th UDMI- should be reconsidered as a diagnostic ischemic criterion.

Expected eligibility for PCSK9i therapy in secondary prevention, ESC/EAS guidelines vs Irish reimbursement criteria in post PCI patients

Abstract Introduction Reimbursement of proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9i) in Ireland is determined by the national center for pharmacoeconomics (NCPE) managed access protocol. To be eligible for a PCSK9i, patients must have had a myocardial infarction or CABG, LDL of &amp;gt;3.5mmol/L, be treated with a high dose statin and ezetimibe. In contrast, the 2019 ESC/EAS dyslipidemias guidelines recommend that patients at ‘very high risk’ with an LDL-C of &amp;gt;1.4mmol/L on a maximally tolerated dose of a statin and ezetimibe, be considered for PCSK9i. In this study, we aimed to define the proportion of patients who are potentially suitable for a PCSK9i at follow-up outpatient post-percutaneous coronary intervention (PCI). Method We retrospectively analysed data on patients who had PCI in University Hospital Limerick (UHL) between January 2016 to December 2019, with follow-up complete lipid profiles at baseline and at 6 - 8 weeks during outpatient review. We sought to compare the potential PCSK9i eligible population in our cohort based on guideline recommendations vs Irish reimbursement criteria. We performed a hierarchal analysis of patients on high dose statin therapy with an LDL-C &amp;gt;1.4mmol/L at follow-up, who could potentially be eligible for a PCSK9i based on expected LDL-C. Expected LDL-C in these patients was calculated based on a 25% reduction in LDL-C with the addition of ezetimibe. Results Our analysis includes 1817 patients, with baseline characteristics; mean age 63.65years, 78.26% male, 40.01% smokers, 20.09% Diabetes Mellitus. 844 (46.45%) patients had a history of MI making them eligible for a PCSK9i based on NCPE clinical criteria. 12 patients (0.66%) in this group were on a high dose statin, and would have an expected LDL-C of &amp;gt;3.5mmol/L with the addition of ezetimibe, therefore making them eligible for a PCSK9i as per NCPE MAP criteria. In contrast to the NCPE MAP criteria all 1817 patients were deemed eligible for a PCSK9i based on ESC/EAS clinical criteria of "very high risk". 1275 patients (70.17%) had an LDL-C level &amp;gt;1.4mmol/L, 6 - 8 weeks post PCI despite high dose statin therapy. Only a minority of patients in this cohort were on ezetimibe, 57/1817 (3.14%). The addition of ezetimibe to patients with an LDL-C &amp;gt;1.4mmol/L, would result in 784 (43.14%) potentially being eligible for a PCSK9i based on current ESC guidelines, results are summarized in figure 1. Discussion Our data highlights the discrepancy between current ESC/EAS guidelines and reimbursement criteria for PCSK9i in Ireland. Based on expected attainable LDL-C minimal patients with coronary artery disease are eligible for reimbursement of a PCSK9i in Ireland for secondary prevention. Our findings also highlight that the majority of patients with established coronary disease do not meet their LDL-C goal at early follow-up. The addition of ezetimibe, would still result in over 40% of our cohort still having a significant lipid burden.

An assessment of platelet response to ticagrelor in post-percutaneous coronary intervention patients using light transmission platelet aggregometry (LTA)

Background: Low on-treatment platelet reactivity (LTPR) or High on-treatment platelet reactivity (HTPR) with P2Y12 inhibitors is associated with bleeding (LTPR) or ischemic events (HTPR) in patients on dual antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI). Objective: Mapping of Indonesian patients’ platelet response secondary to ticagrelor and thus identifying either LTPR or HTPR. Method: During May – June 2019, 20 post-PCI patients on aspirin–ticagrelor combination were included. Light transmission aggregometry (LTA) for monitoring platelet function was used. Ticagrelor’s LTA &lt;40% is LTPR while &gt;70% is HTPR. Result: Patients were mostly male (18 patients) and aged between 40-73 years old with a history of diabetes and/or hypertension and smoking. About eight patients (40%) were LTPR and one (5%) patient was HTPR. Conclusion: A personalised DAPT strategy for preventing bleeding events, a de-escalation, might be valuable for Indonesian patients.

Serum Globulin to Albumin Ratio as a Novel Predictor of Adverse Clinical Outcomes in Coronary Artery Disease Patients Who Underwent PCI.

Coronary heart disease is one of the main causes of Mortality. Many biological indicators have been used to predict the prognosis of patients with coronary heart disease. The ratio of serum globulin to albumin (GAR) has been used to predict the prognosis of patients with various cancers. It has been proven that GAR is related to the prognosis of patients with stroke. However, GAR's role in cardiovascular disease remains unclear. Our purpose was to investigate the predictive value of GAR on clinical outcomes in post-percutaneous coronary intervention (PCI) patients with coronary artery disease (CAD). From Dec. 2016 to Oct. 2021, a total of 14,994 patients undergoing PCI patients admitted to the First Affiliated Hospital of Xinjiang Medical University were divided into high GAR group (GAR 0.76, n = 4087) and low GAR group (GAR 0.76, n = 10,907). The incidence of adverse outcomes including all-cause mortality (ACM), cardiovascular mortality (CM), major adverse cardiovascular events (MACE) and major adverse cardiovascular and cerebrovascular events (MACCE) was compared between the two groups. Multivariate Cox regression was used to adjust for the effects of confounding factors, while hazard ratios (HRs) and 95% confidence intervals (95% CI) were calculated. Median follow-up time was 24 months. Compared with the low GAR group, the high GAR group had significantly higher incidence of ACM (6.5% vs. 1.7%, p 0.001); CM (4.9% vs. 1.2%, p 0.001), MACE (10.5% vs. 6.7%, p 0.001), and MACCE (11.3% vs. 7.5%, p 0.001). Cox regression analysis showed the patients in the high GAR group had a 1.62-fold increased risk for ACM (HR = 2.622, 95% CI: 2.130-3.228, p 0.01), a 1.782-fold increased risk for CM (HR = 2.782, 95% CI: 2.180-3.550, p 0.01). There was a 37.2% increased risk for MACE (HR = 1.372, 95% CI: 1.204-1.564, p 0.01), and 32.4% increased risk for MACCE (HR = 1.324, 95% CI: 1.169-1.500, p 0.01), compared to the patients in the low GAR group. The present study suggested that post-PCI CAD patients with higher GAR presented significantly increased mortality and adverse events GAR level at admission may 296 be considered as part of risk stratification when PCI is possible in patients with coronary heart disease. The detailed information of the PRACTICE study has been registered on http://Clinicaltrials.gov (Identifier: NCT05174143).

Hubungan Dukungan Keluarga Dengan Kualitas Hidup Pasien Pasca-Percutaneous Coronary Intervention (PCI) Di Klinik Jantung RSUD Raden Mattaher Jambi Tahun 2023

Heart attacks are caused by a blockage that keeps blood from flowing to the heart and to the brain, resulting in further complications such as failure of the heart muscle to get oxygen supply which results in a person's death. Therefore, patients with heart disease require Percutaneous Coronary Intervention to deal with their treatment. PCI is also known as cardiac angioplasty or percutaneous coronary intervention. PCI installation in patients with heart disease can affect physical activity so that patients really need family support. Family support will increase self-confidence and motivation to face problems and increase the standard of living to improve the patient's quality of life. This type of research uses a quantitative technique with a cross sectional approach. Sampling was carried out by purposive sampling technique with a total sample of 54 people.The results showed that the majority of respondents had good family support, with all dimensions of family support having a good percentage which showed a significant good percentage (100.00%), and had a very good quality of life (75.93%) , with those who have a good quality of life (24.07%). There is a significant relationship between family support and the quality of life of post-percutaneous coronary intervention (PCI) patients in the cardiac clinic room of Raden Mattaher Hospital, Jambi, with the Sig. (2-tailed) is 0.032 less than α (0.05). In addition to the analysis significance value, a correlation coefficient (cc) value of 0.293* was also obtained.The relationship between family support and quality of life of post-percutaneous coronary intervention (PCI) patients in the cardiac clinic room at Raden Mattaher Hospital Jambi in 2023 resulted in a relationship that was sufficient or strong enough and led to a positive relationship, that is, better family support.

Is It Really Safe to Discontinue Antiplatelet Therapy 12 Months After Percutaneous Coronary Intervention in Patients with Atrial Fibrillation?

The prevalence of AF in patients with coronary artery disease is high. The guidelines from many professional groups, including the European Society of Cardiology, American College of Cardiology/American Heart Association and Heart Rhythm Society, recommend a maximum duration of 12 months of combination single antiplatelet and anticoagulation therapy in patients who undergo percutaneous coronary intervention and who have concurrent AF, followed by anticoagulation alone beyond 1 year. However, the evidence that anticoagulation alone without antiplatelet therapy adequately reduces the well-documented attritional risk of stent thrombosis after coronary stent implantation is relatively sparse, particularly given that very late stent thrombosis (>1 year from stent implantation) is the commonest type. By contrast, the elevated risk of bleeding from combined anticoagulation and antiplatelet therapy is clinically important. The aim of this review is to assess the evidence for long-term anticoagulation alone without antiplatelet therapy 1 year post-percutaneous coronary intervention in patients with AF.

The Feasibility and Effects of Smartphone-Based Application on Cardiac Rehabilitation for Patients After Percutaneous Coronary Intervention: A Randomized Controlled Trial.

Cardiac rehabilitation (CR) referral and participation are generally found to be underused worldwide. The data in Asian regions suggest significant underutilization compared with western countries. To promote the continuity and effects of CR, this study aimed at supporting self-care and improving CR effects in phase II CR with mobile health application for Macao patients who have undergone percutaneous coronary intervention. The study was a randomized controlled trial conducted between January 2018 and June 2020 in a nongovernmental Hospital. Social cognitive theory was applied in the intervention for an experimental group. Measurements including anxiety and depression level, medication adherence, exercise capacity, physical activity level, cardiovascular risk modification, self-efficacy, quality of life, use of healthcare resources, mHealth CR utility, and satisfaction were analyzed. One hundred forty eligible patients were recruited, and 110 patients completed the study. Significant interventional effects of the experimental group were found on the reduction of total cholesterol, low-density lipoprotein, sitting time, anxiety level, and total anxiety and depression level ( P < .05). In addition, significant improvement on the 6-minute walk test, regular exercise performance, self-efficacy of cardiac exercise and diet, and quality of life were found as interventional effects in the experimental group ( P < .05). The feasibility of intervention was achieved in a satisfactory level. This theoretically grounded mobile health CR study was a unique program tailor-made to meet the care needs of patients post percutaneous coronary intervention. It was feasible and effective to support CR effects and adherence and would inform further design of clinical practice and public policies.

Prognostic value of coronary computed tomography angiography compared to radionuclide myocardial perfusion imaging in patients With coronary stents.

The aim of this study is to compare the prognostic value of coronary computed tomography angiography (CCTA) with single-photon emission computed tomography (SPECT) in predicting cardiovascular events in patients with stents. Retrospective analysis. University Hospital, London, Ontario Canada. Between January 2007 and December 2018, 119 patients post-percutaneous coronary intervention (PCI) who were referred for hybrid imaging with CTA and 2-day rest/stress SPECT were enrolled. Patients were followed for any major adverse cardiovascular event (MACE) including: All-cause mortality, Non-fatal myocardial infarction (MI), Unplanned revascularization, Cerebrovascular accident and hospitalization for arrhythmia or heart failure. We define hard cardiac events (HCE) as: cardiac death, non-fatal MI or unplanned revascularization. We used two cut-off values to define obstructive lesions with CCTA ≥50% and ≥70% in any coronary segment. SPECT scan defined as abnormal in the presence of >5% reversible myocardial perfusion defect. During the follow-up period of 7.2 ± 3.4 years. 45/119 (37.8%) patients experienced 57 MACE: Ten deaths (2 cardiac deaths and 8 of non-cardiac deaths), 29 acute coronary syndrome including non-fatal MI (25 required revascularization), 7 hospitalizations for heart failure, 6 cerebrovascular accidents and 5 new atrial fibrillation. 31 HCEs were reported. Cox regression analysis showed that obstructive coronary stenosis (≥50% and ≥70%) and abnormal SPECT were associated of MACE (p = 0.037, 0.018 and 0.026), respectively. In contrast, HCEs were significantly associated with obstructive coronary stenosis of ≥50% and ≥70% with p = 0.004 and p = 0.007, respectively. In contrast, abnormal SPECT was a nonsignificant predictor of HCEs (p = 0.062). Obstructive coronary artery stenosis on CCTA can predict MACE and HCE. However, abnormal SPECT can only predict MACE but not HCE in patients post-PCI with a follow-up period of approximately 7 years.

Developing and Implementing a Hospital‑based Family-centered Health Approach for Patients Undergoing Percutaneous Coronary Intervention: A Randomized Controlled Trial

Objectives: This study aimed to assess the effectiveness of a family-centered health program in promoting healthier lifestyles and improving self-care behavior among patients who had undergone percutaneous coronary intervention. We hypothesized that the family-centered health program would significantly enhance self-care and health-promoting lifestyle in this patient population. The current study was conducted to investigate the effectiveness of the family-centered health program on healthpromoting lifestyle and self-care behavior in post-percutaneous coronary intervention patients. Materials and Methods: A randomized controlled clinical trial was conducted from October 2021 to March 2022 at the Shaheed Rajaie Cardiovascular, Medical &amp; Research Center in Tehran. The study population included patients aged 40 to 65 who had undergone percutaneous coronary intervention. Sixty eligible participants were selected through purposive sampling and randomly assigned to either an experimental group that underwent the family-centered health program (n=30) or a control group (n=30). Data were collected using a demographic information questionnaire, Walker’s health-promoting lifestyle questionnaire (1987), and Miller’s self-care behavior questionnaire (1982) at three time points: baseline, postintervention, and three-month follow-up. The intervention’s effectiveness was assessed using variance analysis with repeated measurements in SPSS-21 software. Results: Preliminary analyses revealed no significant differences between the groups in self-care, health-promoting lifestyle, or blood pressures, indicating the two groups were homogeneous at baseline. However, post-test comparisons revealed significant differences, suggesting the family-centered health program was effective (P &lt; 0.001). Conclusions: Given the demonstrated effectiveness of the family-centered health program, prioritizing such interventions could significantly improve secondary prevention outcomes in patients surviving coronary heart disease.

The Prevalence, Outcomes, and Predictors of Persistent Significant Secondary Mitral Regurgitation in Post-Percutaneous Coronary Intervention Patients

The Prevalence, Outcomes, and Predictors of Persistent Significant Secondary Mitral Regurgitation in Post-Percutaneous Coronary Intervention Patients

Studi Kualitatif Strategi Koping Perawatan Diri Pada Pasien Post Percutaneous Coronary Intervention (PCI)

&lt;div&gt;&lt;strong&gt;&lt;em&gt;Background&lt;/em&gt;&lt;/strong&gt;&lt;em&gt;:&lt;/em&gt; &lt;em&gt;Coronary Heart Disease is a disease of the coronary arteries that are in charge of supplying blood supply to the heart muscles so that it can cause a heart attack. Prevention In order to prevent the recurrence of heart attacks in patients with coronary heart disease, they need to carry out massive self-care with the existence of coping strategies that can act as individual responses to the stressors they face. The purpose of this study was to explore how self-care coping strategies in post-Percutaneous Coronary Intervention (PCI) patients. &lt;strong&gt;Methods: &lt;/strong&gt;This study used a phenomenologcal approachwith a qualitative design, and then the data were analyze used The collaizi method. Research informants were taken using purposive sampling technique, totaling 7 people who did re-control at the Cardiology Polyclinic of RSUD Dr. Achmad Mochtar Bukittinggi. Data were collected through in-depth interviews and field notes. &lt;strong&gt;Results&lt;/strong&gt;: The results of this study identified two themes, namely: problem-focused coping strategy and emotion-focused coping strategy. It can be concluded that the form of coping strategies carried out by post-Percutaneous Coronary Intervention (PCI) patients at RSUD Dr. Achmad Mochtar Bukittinggi varies and the Problem Focused Coping strategy is the main strategy used. There are also participants who use Emotion-Focused Coping strategies. &lt;strong&gt;Conclusion&lt;/strong&gt;: It is recommended that the results of this study can add and provide input as well as reference material for health workers, especially nurses, in providing nursing interventions in the management of chronic diseases during treatment.&lt;/em&gt;&lt;/div&gt;&lt;div&gt;&lt;em&gt;&lt;br /&gt;&lt;/em&gt;&lt;/div&gt;&lt;div&gt;&lt;p&gt;&lt;strong&gt;Keywords: &lt;/strong&gt;&lt;em&gt;Coping Strategies, Self Care, Coronary Heart Disease, Percutaneous Coronary Intervention (PCI)&lt;/em&gt;&lt;/p&gt;&lt;/div&gt;