Nonischemic Chest Pain Following Successful Percutaneous Coronary Intervention at a Regional Referral Centre in Southern Ontario

McGillion, Michael; Arthur, Heather M.; Natarajan, Madhu K.; Cook, Allison; Gunn, Elizabeth; Watt‐Watson, Judy; Thorpe, Kevin E.; Cosman, Tammy

doi:10.1016/j.cjca.2011.10.017

Cited by 10 publications

(13 citation statements)

References 64 publications

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“…A bidirectional link between depression and revascularization has also been reported by several studies [11][12][13]19]. Higher baseline depression scores were found to be significant risk factors for chest pain of nonischemic origin after successful PCI [19].…”

Section: Discussionmentioning

confidence: 77%

“…Depressed patients with coronary disease have been shown to have more severe angina symptoms and fatigue compared with nondepressed patients [27,28]. They also have the tendency to amplify bodily sensations, have increased rates of panic disorders and physician visits, and have more severe concerns about the cause of their symptoms [19,29]. We believe that these effects of depression on symptom awareness and reporting lead to earlier referral to repeat angiography after the primary procedure, increasing the potential odds of repeat revascularization.…”

Section: Discussionmentioning

confidence: 90%

“…Higher baseline depression scores were found to be significant risk factors for chest pain of nonischemic origin after successful PCI [19]. In a cohort study involving 198 patients with stable coronary disease undergoing elective angiography, the depression status at angiography was related to the need for revascularization and the total healthcare costs over the 5 years of followup [13].…”

Section: Discussionmentioning

confidence: 99%

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Association of depression with adverse cardiovascular events after percutaneous coronary intervention

Wang

Guo

Tian

et al. 2013

Coronary Artery Disease

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Section: Discussionmentioning

confidence: 77%

Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 99%

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Association of depression with adverse cardiovascular events after percutaneous coronary intervention

Wang

Guo

Tian

et al. 2013

Coronary Artery Disease

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“…Strategies previously developed will be applied [3,6]; RAs will screen preoperative surgical patient lists daily. Anesthesia, CaVS, and medicine services will contact the RAs for all CaVS admissions through emergency and new consultations.…”

Section: Methodsmentioning

confidence: 99%

Technology-Enabled Remote Monitoring and Self-Management — Vision for Patient Empowerment Following Cardiac and Vascular Surgery: User Testing and Randomized Controlled Trial Protocol

McGillion¹,

Yost²,

Turner³

et al. 2016

JMIR Res Protoc

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BackgroundTens of thousands of cardiac and vascular surgeries (CaVS) are performed on seniors in Canada and the United Kingdom each year to improve survival, relieve disease symptoms, and improve health-related quality of life (HRQL). However, chronic postsurgical pain (CPSP), undetected or delayed detection of hemodynamic compromise, complications, and related poor functional status are major problems for substantial numbers of patients during the recovery process. To tackle this problem, we aim to refine and test the effectiveness of an eHealth-enabled service delivery intervention, TecHnology-Enabled remote monitoring and Self-MAnagemenT—VIsion for patient EmpoWerment following Cardiac and VasculaR surgery (THE SMArTVIEW, CoVeRed), which combines remote monitoring, education, and self-management training to optimize recovery outcomes and experience of seniors undergoing CaVS in Canada and the United Kingdom.ObjectiveOur objectives are to (1) refine SMArTVIEW via high-fidelity user testing and (2) examine the effectiveness of SMArTVIEW via a randomized controlled trial (RCT).MethodsCaVS patients and clinicians will engage in two cycles of focus groups and usability testing at each site; feedback will be elicited about expectations and experience of SMArTVIEW, in context. The data will be used to refine the SMArTVIEW eHealth delivery program. Upon transfer to the surgical ward (ie, post-intensive care unit [ICU]), 256 CaVS patients will be reassessed postoperatively and randomly allocated via an interactive Web randomization system to the intervention group or usual care. The SMArTVIEW intervention will run from surgical ward day 2 until 8 weeks following surgery. Outcome assessments will occur on postoperative day 30; at week 8; and at 3, 6, 9, and 12 months. The primary outcome is worst postop pain intensity upon movement in the previous 24 hours (Brief Pain Inventory-Short Form), averaged across the previous 14 days. Secondary outcomes include a composite of postoperative complications related to hemodynamic compromise—death, myocardial infarction, and nonfatal stroke— all-cause mortality and surgical site infections, functional status (Medical Outcomes Study Short Form-12), depressive symptoms (Geriatric Depression Scale), health service utilization-related costs (health service utilization data from the Institute for Clinical Evaluative Sciences data repository), and patient-level cost of recovery (Ambulatory Home Care Record). A linear mixed model will be used to assess the effects of the intervention on the primary outcome, with an a priori contrast of weekly average worst pain intensity upon movement to evaluate the primary endpoint of pain at 8 weeks postoperation. We will also examine the incremental cost of the intervention compared to usual care using a regression model to estimate the difference in expected health care costs between groups.ResultsStudy start-up is underway and usability testing is scheduled to begin in the fall of 2016.ConclusionsGiven our experience, dedicated industry partners, an...

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“…For example, in a descriptive-cross-sectional study, MacKenzie and Neibert examined ACS symptoms in women with and without DM [42]. [43] in the EXPLORE study reported that their ACS sample (n = 110) post percutaneous coronary intervention (PCI), described cardiac pain with an admixture of neuropathic and nociceptive descriptors for pain at three and six months post PCI [43]. Results of the current study may be related to the inclusion criteria of an ACS sample that was composed of patients with either UA or NSTEMI.…”

Section: Discussionmentioning

confidence: 99%

Nociceptive and Neuropathic Pain Qualities in Men and Women with Acute Coronary Syndromes: A Complex Pain Presentation

O’Keefe-McCarthy¹,

McGillion²,

Victor³

et al. 2017

OJN

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Background: Cardiac pain arising from acute coronary syndrome (ACS) is a multi-factorial phenomenon. Historically, episodes of cardiac pain have been captured using a one-dimensional numeric pain rating scale. Lacking in clinical practice are acute pain assessments that employ a comprehensive evaluation of an emergent ACS episode. Aim: To examine the sensory-discriminative, motivational-affective and cognitive-evaluative dimensions of ACS-related pain. Methods: A descriptive-correlational, repeated-measure design was used to collect data on 121 ACS patients of their cardiac pain intensity. The (numeric rating scale-NRS 0-10 scale) measured chest pain "Now" and "Worst pain in the previous 2 hours over 8 hours" and the McGill Pain Questionnaire Short-Form (MPQ-SF) measured pain at 4 hours. Results: Mean age was 67.6 ± 13, 50% were male, 60% had unstable angina and 40% had Non-ST-elevation myocardial infarction. Cardiac pain intensity scores remained in the mild range from 1.1 ± 2.2 to 2.4 ± 2.7. MPQ-SF: 66% described pain as distressing and 26% reported pain was horrible or excruciating. Participants described ACS pain quality as acute injury (nociceptive pain: heavy, cramping, stabbing), as nerve damage (neuropathic: gnawing, hot-burning, shooting) and as a mixture of acute and chronic pain qualities (aching, tender and throbbing).

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Nonischemic Chest Pain Following Successful Percutaneous Coronary Intervention at a Regional Referral Centre in Southern Ontario

Cited by 10 publications

References 64 publications

Association of depression with adverse cardiovascular events after percutaneous coronary intervention

Association of depression with adverse cardiovascular events after percutaneous coronary intervention

Technology-Enabled Remote Monitoring and Self-Management — Vision for Patient Empowerment Following Cardiac and Vascular Surgery: User Testing and Randomized Controlled Trial Protocol

Nociceptive and Neuropathic Pain Qualities in Men and Women with Acute Coronary Syndromes: A Complex Pain Presentation

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