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Outpatient percutaneous coronary intervention

Alexis L Beatty, Jacob A Doll, David W Schopfer, Charles Maynard, Mary E Plomondon, Hui Shen, Mary A Whooley
Background Cardiac rehabilitation (CR) is strongly recommended after percutaneous coronary intervention (PCI), but it is underused. We sought to evaluate CR participation variation after PCI and its association with mortality among veterans. Methods and Results Patients undergoing PCI between 2007 and 2011 were identified in the Veterans Affairs Clinical Assessment, Reporting, and Tracking database and followed up until January 25, 2017. We excluded patients who died within 30 days of PCI and calculated the percentage participating in ≥1 outpatient CR visits within 12 months after PCI...
October 2, 2018: Journal of the American Heart Association
Lila M Martin, James L Januzzi, Ryan W Thompson, Timothy G Ferris, Jagmeet P Singh, Vijeta Bhambhani, Jason H Wasfy
Background Medicare's Hospital Readmissions Reduction Program assesses financial penalties to hospitals based on risk-standardized readmission rates after specific episodes of care, including acute myocardial infarction. Detailed information about the type of patients included in the penalty is unknown. Methods and Results Starting with administrative data from Medicare, we conducted physician-adjudicated chart reviews of all patients considered 30-day readmissions after acute myocardial infarction from July 2012 to June 2015...
August 21, 2018: Journal of the American Heart Association
Ghulam Abbas Shaikh, Ameema Asad, Syed Saadan Ahmed
Anomalies pertaining to the coronary vasculature are rare and generally asymptomatic, however, they can pose life-threatening risks in the form of sudden cardiac arrests or myocardial ischemia. We present a rare anomaly of a supradominant left circumflex artery (LCX) and a rudimentary left anterior descending artery (LAD). The patient presented in our outpatient department (OPD) with complaints of occasional chest pain and dyspnea on exertion. An exercise tolerance test (ETT) was carried out, which was inconclusive and an electrocardiogram (EKG) revealed a sinus rhythm with a nonspecific ST segment...
August 23, 2018: Curēus
Aleksandr Shek, Rano Alieva, Ravshanbek Kurbanov, Shavkat Hoshimov, Ulugbek Nizamov, Guzal Abdullaeva, Aleksandr Nagay
BACKGROUND AND AIMS: We aimed to assess the disease burden and to study the molecular genetic characteristics of heterozygous familial hypercholesterolemia (HeFH) patients within the Uzbek population to develop a program of early disease detection and effective treatment measures. METHODS: 201 patients were included in the study, of whom 57 with chronic stable coronary artery disease (SCAD) and HeFH, and 144 with SCAD without HeFH belonging to the control group, and divided into two subgroups: A, statin free before the study (n = 63) and B (n = 81), who took statin outpatiently...
October 2018: Atherosclerosis
Jiaying Fang, Bin Huang, Duanmin Xu, Jilin Li, William W Au
BACKGROUND: Medical care for the Chinese population has been focused on first-line activities, that is, therapy, but with little follow-up on treated patients. However, efficacy of therapy is highly dependent upon post-therapy recovery. For coronary heart disease (CHD), home-based cardiac telerehabilitation (HBCTR) is an alternative to hospital-based or center-based cardiac rehabilitation, and is an innovative approach to enhance recovery, but the approach is seldom used in China. Our preliminary survey in Shantou, China, indicated that most CHD patients showed a positive attitude toward the HBCTR technology...
September 7, 2018: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
Kamran Zafar, Nirav Patil
The clinical characteristics and outcomes among patients with inpatient-onset non-ST-segment-elevation acute coronary syndrome have not been fully investigated. Therefore, we conducted a retrospective single-center analysis of patients who were ≥18 years old and diagnosed with acute coronary syndrome at our hospital during 2014. We performed logistic regression analysis to evaluate outcomes and made adjustments for age, race, family history of premature coronary artery disease, and comorbidities. Our search through 31,274 hospital discharge records identified 683 cases of acute coronary syndrome: 32 were inpatient-onset and 651 were outpatient-onset...
June 2018: Texas Heart Institute Journal
Kibum Kim, Todd A Lee, Daniel R Touchette, Robert J DiDomenico, Amer K Ardati, Surrey M Walton
BACKGROUND: In patients with acute coronary syndrome (ACS) treated with percutaneous coronary intervention (PCI), newer antiplatelet agents prasugrel and ticagrelor have lower rates of cardiovascular events when compared with clopidogrel. However, it is unclear whether there are differences in economic outcomes when comparing these agents in ACS-PCI patients. OBJECTIVE: To assess aggregated costs and medical resource utilization among ACS-PCI patients prescribed prasugrel, ticagrelor, or generic clopidogrel, using a large commercial insurance claims database...
August 2018: Journal of Managed Care & Specialty Pharmacy
Fen Cao, Baojian Zhang, Xinyi Li, Shu Duan
To explore the effect and difference of percutaneous coronary intervention (PCI) and medical therapy on quality of life and cognitive function in patients with coronary heart disease (CHD), and to investigate the relationship between quality of life and cognitive function.
 Methods: A total of 320 patients with CHD, who underwent coronary angiography and PCI (PCI group, n=160), or underwent coronary angiography and medical therapy (drug therapy group, n=160), were selected. The quality of life was assessed by using the Health Survey Form SF-36 (SF-36) and the Seattle Angina Questionnaire (SAQ), and the cognitive function was assessed by using the Mini-Mental State Examination (MMSE)...
May 28, 2018: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
Wenjian Xie, Qian Yin, Mengran Zhang, Shengnan Li, Shaoliang Chen
To investigate the potential correlation between miR-223 level in leukocytes and platelet responses to clopidogrel in patients with coronary artery disease.
 Methods: A cohort of 188 outpatients, who conducted percutaneous coronary intervention (PCI) and received dual antiplatelet therapy, were recruited. The patient's electronic health data were collected, and their blood samples were obtained for measurement of adenosine diphosphate (ADP)-induced whole-blood platelet aggregation. Extreme cases of platelet responses to clopidogrel (ultra- vs...
April 28, 2018: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
B Acar, E Gucuk Ipek, S Unal, C Yayla, M Karanfil, C Burak, M Kara, F Bayraktar, M S Kuyumcu, S Aydogdu
INTRODUCTION: Lifestyle modification is an important component of the secondary prevention strategies; and a healthy diet is one of the cornerstones in management of the coronary heart disease. We aimed to investigate the dietary habits of the patients with history of coronary revascularization, characteristics of the ones with good adherence by using alternate MedDiet questionnaire. METHODS: We included outpatients who had a history of coronary revascularization at least 6 months prior to enrollment...
June 2018: Revista Clínica Española
Mariusz Gasior, Marek Gierlotka, Łukasz Pyka, Tomasz Zdrojewski, Bogdan Wojtyniak, Krzysztof Chlebus, Piotr Rozentryt, Jacek Niedziela, Piotr Jankowski, Jadwiga Nessler, Grzegorz Opolski, Piotr Hoffman, Ewa Jankowska, Lech Polonski, Piotr Ponikowski
Background The proportion of patients discharged after myocardial infarction with left ventricular systolic dysfunction remains high and the prognosis is unfavourable. The aim of this study was to analyse the temporal trends in the treatment and outcomes of a nationwide cohort of patients. Methods and results Data from the Polish Registry of Acute Coronary Syndromes and Acute Myocardial Infarction in Poland Registry were combined to achieve complete information on inhospital course, treatment and outcomes. An all-comer population of patients discharged with left ventricular ejection fraction of 40% or less formed the sample population ( n = 28,080)...
June 2018: European Journal of Preventive Cardiology
Jasveen J Kandhai-Ragunath, Carine J M Doggen, Liefke C van der Heijden, Marlies M Kok, Paolo Zocca, Bjorn de Wagenaar, Cees Doelman, Harald T Jørstad, Ron J G Peters, Clemens von Birgelen
Knowledge about the changes in endothelial function after ST-elevation myocardial infarction (STEMI) is of substantial interest, but serial data are scarce. The aim of the present study was to noninvasively evaluate whether endothelial function, as assessed shortly after primary percutaneous coronary intervention (PPCI) for STEMI, may improve until 12-month follow-up. This prospective observational cohort study was performed in patients in the RESPONSE randomized trial who participated in a substudy and underwent noninvasive assessment of endothelial function at 1 (baseline), 6, and 12-month follow-up after treatment of a STEMI by PPCI...
September 2018: Heart and Vessels
Hee Sun Kim, Hyun Kyung Kim, Kyung Ok Kang, Yi Sik Kim
AIM: This study aimed to identify health-related quality of life (HRQoL) and its determinants in outpatients with acute coronary syndrome (ACS) after percutaneous coronary intervention. METHODS: A cross-sectional design was used and a total of 124 Korean participants was enrolled. The HRQoL (physical limitations, treatment satisfaction, and disease perception), symptom experience (frequency, severity, and distress), physiological (left ventricular ejection fraction and lipids), psychological (depression and anxiety), and situational (social support) factors were measured, selected on the basis of the theory of unpleasant symptoms...
March 7, 2018: Japan Journal of Nursing Science: JJNS
K A Volodina, R M Linchak, E E Achkasov, E N Alaeva, O V Bulgakova, S N Puzin, N A Buvalin
Echocardiographic parameters were assessed in patients with non-ST segment elevation acute coronary syndrome, who underwent emergency percutaneous coronary intervention followed by various outpatient physical cardiac rehabilitation programs. The patients underwent physical rehabilitation for 3 months under conditions of diagnostic centre in the rehabilitation unit according to the standard program including in treadmill or bicycle exercise in the exercise therapy room or with Nordic walking in the main training block...
March 2018: Bulletin of Experimental Biology and Medicine
Kaneshka Masdjedi, Joost Daemen, Roberto Diletti, Jeroen Wilschut, Elisabeth Utens, Peter P de Jaegere, Miguel E Lemmert, Arie-Pieter Kappetein, Felix Zijlstra, Ron van Domburg, Nicolas M Van Mieghem
BACKGROUND AND AIMS: Significant left main (LM) stem disease is potentially life-threatening and mandates revascularization. This study aimed to assess how patients rate the importance of particular features of coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI), how this determines their preference for a particular treatment strategy, and whether particular personality characteristics influence this preference. METHODS AND RESULTS: In total, 1145 patients who visited the outpatient clinic of the Erasmus Medical Center for stable coronary artery disease were asked to complete a case vignette-questionnaire on a hypothetical significant LM stenosis amenable to PCI or CABG...
August 2018: Journal of Cardiology
Ching-Yu Julius Chen, Tzu-Ching Yang, Christopher Chang, Shao-Chun Lu, Po-Yuan Chang
BACKGROUND: Homocysteine has been long considered a risk factor for atherosclerosis. However, cardiovascular events cannot be reduced through homocysteine lowering by B vitamin supplements. Although several association studies have reported an elevation of serum homocysteine levels in cardiovascular diseases, the relationship of homocysteine with ST-segment elevation myocardial infarction (STEMI) is not well established. METHODS: We prospectively enrolled STEMI patients who were consecutively admitted to an intensive care unit following coronary intervention in a single medical center in Taiwan...
February 13, 2018: BMC Cardiovascular Disorders
Yan Wu, Hua Yu, Hai-Qin Tang, Yong Su, Tian-Lu Shi, Sheng Liu, Quan Xia, Du-Juan Xu
BACKGROUNDS: Clopidogrel is widely used in Coronary Heart Disease (CHD) patients undergoing percutaneous coronary intervention (PCI) to prevent thrombotic events. However, clopidogrel response variability (CRV) may affect the patients' clinical outcomes. The current data have shown that genetic factors play an important role in CRV. The aim of this research is to investigate the association of pregnane X receptor (PXR, also called NR1I2) genetic polymorphisms with the clinical efficacy of clopidogrel in patients undergoing PCI...
May 5, 2018: Gene
Frank H Lawler, Frank R Wilson, G Keith Smith, Lynn V Mitchell
Background: Healthcare reimbursement, which has traditionally been based on the quantity of services delivered, is currently moving toward value-based reimbursement-a system that addresses the quantity, quality, and cost of services. One such arrangement has been the evolution of bundled payments for a specific procedure or for an episode of care, paid prospectively or through post-hoc reconciliation. Objective: To evaluate the impact of instituting bundled payments that incorporate facility charges, physician fees, and all ancillary charges by the State of Oklahoma HealthChoice public employee insurance plan...
December 2017: American Health & Drug Benefits
Mahshid Givi, Nizal Sarrafzadegan, Mohammad Garakyaraghi, Ghasem Yadegarfar, Masoumeh Sadeghi, Alireza Khosravi, Amir Hossein Azhari, Mohammad Reza Samienasab, Davood Shafie, Mohammad Saadatnia, Hamidreza Roohafza, Navid Paydari, Azam Soleimani, Mohsen Hosseinzadeh, Seyed Abdulah Ahmadi, Leila Dehghani, Jamshid Najafian, Elham Andalib, Javad Shahabi, Mohammad Reza Sabri
BACKGROUND: Our aim was to create and establish a database called "Persian Registry Of cardioVascular diseasE (PROVE)" in order to be used for future research and in addition, as a tool to develop national guidelines for diagnosis, treatment, and prevention of cardiovascular disease (CVD). In this paper, the design and methodology of the PROVE pilot study will be discussed, launched in Isfahan, Iran, in 2015-2016. METHODS: Through establishing PROVE, patients' data were collected from hospitals and outpatient clinics prospectively or retrospectively and followed up for a maximum of three years based on the type of CVDs...
September 2017: ARYA Atherosclerosis
Tannaz Shoja, Craig Basman, Suresh Jain, Aditya Mangla, Zoran Lasic
Spontaneous coronary artery dissection (SCAD) is a rare entity that can cause acute myocardial infarction and sudden cardiac death (SCD) which often goes unrecognized. We report a case of SCAD in a young postpartum female who presented with sudden cardiac arrest. The patient was managed medically and found to have fibromuscular dysplasia (FMD). After being stabilized in the critical care unit, coronary angiography was performed which showed dissection of the left main artery, intramural hematoma, and the culprit lesion...
December 2017: Cardiology Research
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