Management of patients after primary percutaneous coronary intervention for myocardial infarction

Dalal, Fatima; Dalal, Hasnain M; Voukalis, Christos; Gandhi, Manish

doi:10.1136/bmj.j3237

Cited by 12 publications

(3 citation statements)

References 51 publications

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“…This means that patients must wait at their local hospital before being transported to the PCI centre. These patients therefore experience more complex clinical pathways and are discharged sooner from hospital as compared to STEMI patients [41]. This is also consistent with the finding that patients who stayed in hospital for a longer period or were transported to another hospital before discharge experienced greater continuity of care.…”

Section: Health Service Factors Associated With Perceived Continuity supporting

confidence: 79%

Continuity of care and its associations with self-reported health, clinical characteristics and follow-up services after percutaneous coronary intervention

Valaker

Fridlund

Wentzel‐Larsen

et al. 2020

BMC Health Serv Res

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Aims: Complexity of care in patients with coronary artery disease is increasing, due to ageing, improved treatment, and more specialised care. Patients receive care from various healthcare providers in many settings. Still, few studies have evaluated continuity of care across primary and secondary care levels for patients after percutaneous coronary intervention (PCI). This study aimed to determine multifaceted aspects of continuity of care and associations with socio-demographic characteristics, self-reported health, clinical characteristics and follow-up services for patients after PCI. Methods: This multi-centre prospective cohort study collected data at baseline and two-month follow-up from medical records, national registries and patient self-reports. Univariable and hierarchical regressions were performed using the Heart Continuity of Care Questionnaire total score as the dependent variable. Results: In total, 1695 patients were included at baseline, and 1318 (78%) completed the two-month follow-up. Patients stated not being adequately informed about lifestyle changes, medication and follow-up care. Those experiencing poorer health status after PCI scored significantly worse on continuity of care. Patients with STsegment elevation myocardial infarction scored significantly better on informational and management continuity than those with other cardiac diagnoses. The regression analyses showed significantly better continuity (P ≤ 0.034) in patients who were male, received written information from hospital, were transferred to another hospital before discharge, received follow-up from their general practitioner or had sufficient consultation time after discharge from hospital. Conclusion: Risk factors for sub-optimal continuity were identified. These factors are important to patients, healthcare providers and policy makers. Action should be taken to educate patients, reconcile discharge plans and organise post-discharge services. Designing pathways with an interdisciplinary approach and shared responsibility between healthcare settings is recommended.

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Section: Health Service Factors Associated With Perceived Continuity supporting

confidence: 79%

Continuity of care and its associations with self-reported health, clinical characteristics and follow-up services after percutaneous coronary intervention

Valaker

Fridlund

Wentzel‐Larsen

et al. 2020

BMC Health Serv Res

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“…In CAD treatment, the adoption of PCI and drug‐eluting stents presents great effect on unchoking the stenosis of coronary artery, preventing vessel wall recoil, and inhibiting neointimal growth of the targeted lesion, while the treatment efficacy has been frequently reported to be attenuated by occurrence of RASP and restenosis, which becomes one of the major clinical challenges for CAD treatment . Although the exact mechanism of RASP in CAD patients is unclear, it is currently accepted that rupture of plaques and the subsequent injury response facilitate the accretion of the vascular wall and contribute to RASP .…”

Section: Discussionmentioning

confidence: 99%

Comprehensive analysis of predictive factors for rapid angiographic stenotic progression and restenosis risk in coronary artery disease patients underwent percutaneous coronary intervention with drug‐eluting stents implantation

2018

Clinical Laboratory Analysis

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“…At present, MI treatment can only relieve the symptoms but cannot solve the problem of myocardial cell loss from the root. 3) As a result, the incidence and mortality of heart failure after MI continue to rise. 4) Studies have confirmed that cardiomyocyte apoptosis is an important cause of ventricular remodeling, cardiac insufficiency, and arrhythmia after MI, 5,6) and myocardial angiogenesis is a key process for ventricular remodeling after MI.…”

mentioning

confidence: 99%

MiR-134-5p Regulates Myocardial Apoptosis and Angiogenesis by Directly Targeting KDM2A After Myocardial Infarction

et al. 2020

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MiR-134-5p was found to have potential diagnostic value for myocardial infarction (MI), but its biological role in MI has not been reported. In this study, MI mouse model was established. Quantitative real-time PCR (qRT-PCR) and western blot were used to measure the expression of miR-134-5p, lysine demethylase 2A (KDM2A), and vascular endothelial growth factor (VEGF). Dual-Luciferase reporter (DLR) assay was used to explore the relationship between miR-134-5p and KDM2A. The influence of miR-134-5p on cardiomyocytes apoptosis was detected using methyl thiazolyl tetrazolium (MTT) assay. The results revealed that miR-134-5p was highly expressed in infarction tissues of MI mice. Knockdown of miR-134-5p inhibited hypoxia/reoxygenation (H/R)-induced cardiomyocyte apoptosis. In addition, KDM2A was the target gene of miR-134-5p and negatively regulated by miR-134-5p. The promotion effect on the protein level of KDM2A and VEGF induced by miR-134-5p inhibitor can be reversed by shKDM2A in cardiomyocytes. Further, silencing of miR-134-5p promoted myocardial angiogenesis and inhibited myocardial apoptosis via upregulating KDM2A in MI mice. Taken together, our research revealed that knockdown of miR-134-5p increased KDM2A expression, thereby suppressing myocardial apoptosis and promoting myocardial angiogenesis.

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Management of patients after primary percutaneous coronary intervention for myocardial infarction

Cited by 12 publications

References 51 publications

Continuity of care and its associations with self-reported health, clinical characteristics and follow-up services after percutaneous coronary intervention

Continuity of care and its associations with self-reported health, clinical characteristics and follow-up services after percutaneous coronary intervention

Comprehensive analysis of predictive factors for rapid angiographic stenotic progression and restenosis risk in coronary artery disease patients underwent percutaneous coronary intervention with drug‐eluting stents implantation

MiR-134-5p Regulates Myocardial Apoptosis and Angiogenesis by Directly Targeting KDM2A After Myocardial Infarction

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