جستجوی مقالات مرتبط با کلیدواژه « angioplasty » در نشریات گروه « پزشکی »

Background & Aims :

One of the concerns of nurses and physicians is the adherence to treatment in patients with heart diseases. In Iran, there are no accurate statistics on the treatment adherence of patients with coronary artery stents, and the risk of cardiovascular diseases (CVDs) in these patients has not been investigated. Therefore, this study aims to determine the relationship between treatment adherence and the risk of CVDs in patients with coronary artery stents.

Materials & Methods:

 This descriptive cross-sectional study was conducted from June to August 2021 in Shahid Madani Hospital in Tabriz, Iran. Participants were 200 patients who underwent coronary angioplasty in the past year and had coronary artery stents. They were selected by a simple random sampling method. To collect data, a demographic form, the treatment adherence questionnaire, and the Framingham risk score (FRS) were used. The collected data were analyzed in SPSS software, version 22 using descriptive statistics, Pearson correlation test, t-test, and one-way analysis of variance.

Results :

The mean age of the patients was 61.6±10.62 years. Most of them were male (60.5%) and married (68%). The overall mean score of treatment adherence was 41.50±8.48, indicating moderate adherence. Patients had poor adherence in domains of dietary regimen and regular physical activity such that most of them used high-fat food (87%) and had the least amount of physical activity per week (92.4%), but they used prescribed medicines on time (70.3%). Based on the FRS, men were twice as likely to have CVDs as women. There was a significant association between treatment adherence and the risk of CVDs, such that the risk of CVDs in the next 10 years among patients decreased with increasing their adherence to treatment (r=-0.25, P<0.001).

Conclusion:

 Given that there is a significant relationship between treatment adherence and the risk of CVDs in patients with coronary artery stents, and considering that these patients have poor adherence to a low-fat diet and regular physical activity, it is recommended that nurses in their patient education programs emphasize adherence to having a low-fat diet and regular physical activity and identify the barriers to achieving it, so that, by increasing patients’ adherence to treatment, the risk of CVDs in the next 10 years can be reduced in these patients.

Coronary heart disease (CHD) is the leading cause of death from cardiovascular disorders. Over the past few decades, coronary angioplasty has become an effective procedure for the treatment of coronary artery disease. Patients undergoing angioplasty experience high levels of anxiety due to poor quality of care resulting from inadequate and unprincipled training of nurses. The aim of this study was to evaluate the effect of an educational program based on the James Brown model on the quality of nursing care during angioplasty.

The current quasi-experimental study (before and after method) investigated 24 nurses working in the angioplasty unit of chamran hospital in Isfahan in 2021. They were selected by the consensus sampling method. The nurses’ group was trained based on the James Brown model. The quality of angioplasty nursing care was measured before the intervention, 3 days and one month after the intervention Using a researcher-made checklist of the quality of angioplasty care. The data were analyzed by the SPSS 16 software at the significance level of p<0.05. Statistical tests such as paired t-test and repeated measure ANOVA were used to analyze the data.

 Based on the results, the mean scores of the nursing care quality equaled 42/52±6/04 before the intervention, 60/46±7/51 three days after the intervention, and 66/07±6/53 one month after the intervention. The results showed significant differences among the mean scores of the angioplasty nursing care quality before training by the James Brown model, as well as three days and one month after the training (p<0.001).

According to the results, The James Brown educational program enhanced the quality of angioplasty nursing care. Therefore, it is suggested that the nurses working in this unit receive specific angioplasty care training through the James Brown model.

In patients with coronary artery disease (CAD), quality of life and functional capacity decline. In CAD patients, studies have shown that high-intensity interval training (HIIT) is superior to conventional moderate to-high intensity continuous training (MICT) for improving functional capacity. Mental health is as important as physical health, but few studies have examined the effects of HIIT on quality of life. The aim of this study was to investigate the effect of high-intensity interval training (HIIT) with short intervals and inactive recovery on cardiorespiratory fitness and health-related quality of life in cardiac patients after angioplasty.

This study is a randomized clinical trial (RCT). twenty-four available male patients with hypertension and CAD after angioplasty were randomly divided into 2 equal groups of 12 subjects, including an experimental group and a control group. The experimental group performed a HIIT protocol with short intervals and inactive recovery for eight weeks, with three sessions per week (30 seconds of activity and 30 seconds of rest), while the control group received no treatment. Research instruments, including the Storer-Davis test, the Bruce test, and the SF-36 questionnaire, were administered to patients in the two groups before and after the test. Data were analyzed using ANCOVA and  T-test for paired samples.

After 8 weeks of HIIT with short intervals and inactive recovery, the results of the study indicate a significant increase in VO2peak (P=0.002) and improvement in all areas of patients’ quality of life (P ≤ 0.05).

The results indicate that HIIT with short intervals and inactive recovery has the potential to improve VO2peak and all domains of quality of life in cardiac patients after PCI.

Coronary angiography is an elective method to confirm or rule out coronary artery disease and to decide on the treatment plan but it is an invasive method and it has some complications. The most important and common complication was hematoma. It could be the cause of mortality and morbidity. The present study was conducted with the aim of investigating the time of hematoma occurrence after angioplasty and investigating the effect of various factors (for example age, sex, BMI, BP, hematocrit, anticoagulant agent, etc.) on the occurrence of hematoma.

This was a prospective cohort study from March 2022 to March 2023 in Mazandaran heart center. The study population was patients who underwent angioplasty through the femoral artery. If the ACT is less than 150-180, sheet removal was done by applying pressure with the hand on the proximal puncture site for 15-20 minutes and ensuring sufficient hemostasis. Then, the ultrasound of the puncture site was performed before pulling the sheet/one hour and six hours after pulling the sheet, and after collecting the data, the data were analyzed to study the effect of BMI, BP, sex, hematocrit, hemoglobin, age, time of sheet removal, anticoagulant agent, etc. on prevalence of hematoma and it size.

200 patients were examined, of which 44(22%) had hematoma. Women had hematoma more than men (P<0.05). BMI and blood pressure in patients with hematoma decreased and increased, respectively (P<0.05). Older age, female gender, lower hematocrit, and longer duration of sheet retention were effective factors in increasing hematoma size (P<0.05). In the logistic regression model, with increasing BMI, the chance of hematoma occurrence decreased (P=0.029, OR=0.831).

Controlling blood pressure and preventing of decreasing the hematocrit, reduces the incidence of hematoma in patients after angiography. Also, preventing hematocrit drop and removal of sheet at the appropriate time, can prevent of increasing in size of hematoma. There is some difference between nursing report and sonography finding. Nursing report overestimated the hematoma size.

Percutaneous coronary intervention (PCI) is a reperfusion strategy to increase survival and ejection fraction in patients with ST-elevation myocardial infarction (STEMI). Therefore, the aim of the present study was to determine and evaluate the ejection fraction in patients with acute myocardial infarction undergoing percutaneous coronary intervention.

This is a cross-sectional descriptive study that was conducted on 176 patients in Golestan and Imam Khomeini hospitals in Ahvaz in 2022. Patients who underwent angioplasty in the first 12 hours (without receiving fibrinolytic drug) and patients who underwent angioplasty within 12-24 hours after referral (after receiving fibrinolytic drug), 40 days after treatment, all Patients were reevaluated. Patients were compared based on the type of lesion, the number of involved vessels, the type of involved vessel and the location of the lesion in terms of the increase in ejection fraction. Descriptive statistics were used to present quantitative data in the form of mean ± standard deviation and for qualitative variables in the form of percentages, tables and graphs. Chi-square test was used to compare frequency in two groups. T-test was used to compare the mean in two groups. Odds ratio was calculated to compare two groups of case and control in terms of the frequency of each genotype. The collected data were analyzed using Chi-square and t-test.

The most frequent type of lesion diagnosed in patients was type B (61.4%) and the most common vessel involved in patients was the left anterior descending coronary artery (60.2%). The most frequent area involved in the studied patients was diagnosed as anterior (56.8%). There was no significant difference in the increase of jump fraction between the two groups (p=0.2). A marked difference was seen between the ejection fraction, 40 days after treatment based on the involved area (p<0.001), so that at the beginning of the heart attack and before angioplasty, the highest and lowest amount of ejection fraction was observed in patients with involvement, respectively. It was in the posterior region (46.2±5.9) and anterior region (32.2±6.4), after angioplasty regardless of the time, the increase in the second ejection fraction (40 days after myocardial infarction) in patients with obstruction The anterior artery was observed. Correspondingly, the highest rate of ejection fraction was seen in patients with involvement of the right coronary artery (45.7±7) and the lowest amount of ejection fraction was seen in the involvement of the left anterior descending coronary artery (32.4±6.4) (p<0.001). No difference was seen between patients in terms of lesion type (p=0.2). The number of involved vessels had no effect on EF level after treatment (p=0.9) and no significant relationship was observed between the effect of risk factors and EF level (p<0.05).

Based on the results of the present study, the left anterior descending coronary artery and the anterior region were the most involved areas in ST-segment elevation myocardial infarction patients, which led to a further decrease in the ejection fraction. Furthermore, after angioplasty, a greater increase in the second ejection fraction was observed (40 days after a heart attack).

Complaints of low back pain and fatigue caused by prolonged lying on the back are complications of angioplasty. The aim of this study was to evaluate the effect of acupressure on severity of low back pain and fatigue in patients after coronary artery angioplasty through femoral artery.

A simple randomized controlled clinical trial was carried out in three groups of patients (n= 75); experimental group, pseudo-intervention group, and control group. The study was performed in Sari Fatemeh Al-Zahra Hospital affiliated with Mazandaran University Medical Sciences, 2021. In experimental group, acupressure was applied to four points, including ST36, GV26, SI3, and BL60, each for two minutes, at two, four, six, and eight hours after angioplasty. In pseudo-intervention group, all measures performed in the experimental group were done without putting pressure. The control group received no intervention. The severity of low back pain was measured using Visual Analogue Scale and the severity of fatigue was measured using Visual Analog Fatigue Scale before and after the intervention. Data were analyzed applying descriptive and inferential statistics.

Severity of back pain significantly decreased in experimental group after four hours (P=0.001), six hours (P<0.001), and eight hours (P=0.01) following angioplasty compared with other groups. Also, in this group, severity of fatigue significantly decreased after four hours (P<0.001) and six hours (P<0.001) following angioplasty when compared to other two groups.

Acupressure was effective in reducing the severity of low back pain and fatigue in patients undergoing angioplasty. Therefore, this method can be introduced as an easy, non-invasive and helpful method in reducing the severity of low back pain and fatigue in these patients.

Coronary artery disease is the leading cause of death and disability. Therefore, the prevention and management of this health condition are vitally important. The present study aimed to determine the effect of educational intervention based on Pender's health promotion model on health-promoting behaviors in patients undergoing coronary angioplasty.

This is a randomized control trial study, in which a total of 96 patients undergoing coronary angioplasty in Farshchian Heart Center in Hamadan in 2020 were allocated into two groups of intervention and control. The intervention group, in addition to the routine training in the control group, received 3 training sessions based on the Pender model. The Health-Promoting Lifestyle Profile II (HPLP II) was completed in both groups. Descriptive and analytical statistical tests and SPSS software version 16 were used to analyze the data.

The result showed that in both intervention and control groups, there was a statistically significant difference in the mean scores of the domains of health responsibility, physical activity, nutrition, spiritual growth, interpersonal relations, and stress management after the intervention (p<.001). Furthermore, in the control group, no statistically significant difference was found (p>0.05). But this difference was shown to be statistically significant in all domains in the intervention group (p<.001).

Based upon the results of the present study, the patient education based on Pender's health promotion model has a positive effect on health-promoting behaviors in patients undergoing coronary angioplasty, as this educational approach can be appropriate for improving the state of health in these patients.

The aging of the population has caused an increase in the number of elderly people who receive treatment for cardiovascular disease. The prevalence of coronary artery disease is higher in the elderly, and on the other hand, complications after cardiac events are worse in the elderly. The most common cause of death in the elderly is cardiovascular disease. Rapid restoration of blood flow can lead to myocardial survival, preservation of cardiac function, and prolongation of the patient's life, and many clinical trial studies have been conducted to investigate the effect of Thrombolytics, and their results showed that Thrombolytics preserve ventricular function. Primary coronary angioplasty was defined as the primary revascularization strategy for acute myocardial infarction without or with prior thrombolytic therapy. In the last two decades, it has been shown that the complications of coronary artery syndrome have decreased with the development of therapeutic strategies such as revascularization, medical treatment, and risk factors in follow-up after discharge. Data from many cardiovascular centers have shown that angioplasty not only leads to a significant reduction in mortality but also in coronary ischemic events. Elderly people who have concurrent diseases such as lung diseases, kidney diseases, and cerebrovascular accidents and suffer from coronary accidents accept angioplasty with caution. This is even though in symptomatic patients with chronic coronary disease, revascularization leads to the resolution of symptoms and improvement of the patient's life expectancy. Despite the effects of coronary artery disease on the quality of life, morbidity, and mortality of the elderly, in the majority of cardiovascular studies, the elderly 75 years and older were significantly less expressed and directly due to advanced age, and complex co-morbidities, and significant physical and cognitive disabilities., fatigue, living in a nursing home, and decline in daily functioning were excluded from the study. Therefore, recent guidelines cannot provide evidence-based recommendations for the diagnosis and treatment of coronary diseases in the elderly. Choosing the correct treatment strategy for the elderly with acute coronary artery disease is due to the importance of the burden of care from the economic, social, and family points of view. Also, few studies are comparing the effect of medical treatment with revascularization in the elderly 75 years and older. The aim of the study is to determine whether elderly people benefit from primary angioplasty compared to medical treatment alone and the side effects of each of these treatments in the elderly.

The present study is a prospective cohort type, which was approved by the ethical code IR.TUMS.MEDICINE.REC.1397.934 in the ethical code commission of the Faculty of Medicine of Tehran University of Medical Sciences and 97 samples were taken in 9 months from June 2018 to the end of March. were collected and then for 24 hours and 30 days after the treatment (medical/angioplasty), the elderly (mostly 60 years old) with acute coronary artery disease were followed up in terms of the effectiveness and side effects of the treatments. All elderly people diagnosed with acute coronary syndrome hospitalized in two teaching hospitals of Tehran University of Medical Sciences were included in the study and evaluated in two groups. The first group of the interventional treatment group: was patients who were diagnosed with acute coronary syndrome and were treated with angioplasty from the beginning, and the second group, the optimal medical treatment group: patients who were treated with standard medical treatment from the beginning (including Thrombolytics, oral beta blockers, intravenous nitrates, antiplatelet Duals such as aspirin and Clopidogrel, intravenous anticoagulants such as heparin or enoxaparin, statin and angiotensin-converting enzyme inhibitors or angiotensin receptor blockers 2) were included according to the latest guidelines. In this prospective cohort study, all patients aged 60 years and older with the acute coronary syndrome were collected by face-to-face interview and case evaluation from two teaching hospitals, Tehran University of Medical Sciences from 2018, and they were divided into two primary and medical angioplasty groups in terms of complications., mortality and efficacy of 24 hours and 30 days were compared.

Out of 120 patients with an average age of 71.2±8.2 years, 52 and 68 patients received primary angioplasty and medical treatment, respectively. The majority of patients in the primary angioplasty group were male (57.7%) and female (57.4%) in the medical group (p=0.07). In the first 24 hours, comparing the two groups with the logistic regression method, atrial fibrillation was significantly 11 times higher in the medical group (p=0.016) and improvement of angina in the primary angioplasty group was 3.8 times higher (p=0.04). The 30-day mortality rate was significantly higher in the medical group (p=0.006).

These results indicate that we overestimate the risks associated with revascularization in the elderly and deprive people of useful treatments. With increasing age, despite the significant reduction of hospital and short-term mortality by about 5 times, increasing the rate of angina recovery and fewer complications in angioplasty, this treatment method is less often chosen in elderly patients, and elderly people are less likely to choose this method due to their age. They are denied treatment. There are sufficient reasons for the elderly and very elderly with good tolerance to angioplasty. The success rate of immediate angioplasty and the survival rate without complications are similar to young patients, so old age is not a contraindication for angioplasty. Also, old age is not an independent risk factor for poor prognosis. In addition, complete revascularization in very elderly patients may improve prognosis and reduce the incidence of cardiac events. This study included limitations. Collecting samples from two different hospitals, one of these hospitals was not able to perform angioplasty in patients with angioplasty indication due to the lack of an angiography department, and the patients were forced to undergo medical treatment, which also led to a decrease in the number of The samples included in the angioplasty group and the bias in the selection of patients with real indications for medical treatment. On the other hand, it also leads to an increase in complications. The low sample size and the age of the patients included in the study were among the limitations of this study.

Patients' adherence to treatment is one of the behaviors that can reduce the negative effects and severity of coronary artery disease.This study aimed todetermine the effect of educational program based on information, motivation, and behavioral skills model on adherence to treatment of patients after coronary angioplasty.

This experimental study was performed on 80 patients who underwent angioplasty at least 9 months ago. Participants were selected by convenience sampling method from among the eligible patients referred to the specialized heart clinic of Razi Hospital in Birjand in 2020. The patients were randomly divided into two groups of 40, experimental and control using a table of random numbers. The experimental group was trained in 6 sessions of 60-90 minutes based on information, motivation, and behavioral skills model. The control group received routine care. Then, the study instrument was completed for all participants immediately and one month after the intervention. Data were analyzed in SPSS software version 16 using descriptive and inferential statistical methods.

There was a significant difference between the mean score of adherence to treatment at the time immediately (4.01±0.22) and one month after the intervention (3.93±0.25) compared to the time before the intervention (3.66±0.39) in the experimental group (p <0.001). The mean score of components of trust in treatment, adaptability, integration of treatment with life, and commitment to treatment significantly increased in the experimental group immediately and one month after intervention (p < 0.05). Also, the components of willingness to participate in treatment and stick to the treatment showed a significant increase in the experimental group after the intervention (p < 0.05).

An educational program based on information, motivation, and behavioral skills model can be considered by nurses, physicians, and relevant managers to promote the concept of adherence to treatment in patients after angioplasty.

 Postoperative anxiety, such as coronary artery bypass graft surgery, is one of the most common stressors in this group of patients, which can endanger their physical and mental health. This study aimed to compare the effect of aromatherapy with geranium and lemon essential oil on situational anxiety and physiological indices of patients after coronary angioplasty.

 In this placebo-controlled randomized clinical trial study, 150 patients undergoing coronary angioplasty were selected by convenience sampling method and obtained their informed written consent. They were randomly divided into three groups: geranium essential oil, lemon essential oil, and the control group. The patients’ anxiety was measured using a situational anxiety questionnaire before and after the intervention. Also, the physiological indices of patients were measured before and after the intervention. Data analysis was performed at descriptive and inferential levels (analysis of covariance and the Kruskal-Wallis test) in SPSS version 22.

The effect of aromatherapy with geranium essential oil on reducing anxiety (35.94±8.64) in patients was significantly greater than aromatherapy with lemon essential oil (44.16±8.72) and almond oil (41.14±5.08) (P<0.001). There was no significant difference between the effect of aromatherapy with almond oil (41.14±5.08) and lemon essential oil (44.16±8.72) in reducing patients’ anxiety (P = 0.241). Also, the effect of aromatherapy with geranium essential oil on reducing pulse rate and systolic blood pressure was significantly greater than aromatherapy with lemon essential oil (P <0.001).

 According to the results of the present study on the effect of aromatherapy on anxiety in patients after angioplasty, it is recommended to use aromatherapy as a complementary and low-risk treatment to reduce anxiety in this group of patients.