Aged ; Angioplasty, Balloon, Coronary ; Coronary Angiography ; Coronary Artery Disease ; diagnosis ; therapy ; Coronary Vessel Anomalies ; diagnosis ; therapy ; Female ; Humans

Atherosclerosis ; diagnosis ; therapy ; Coronary Disease ; diagnosis ; therapy ; Humans ; Medicine, Chinese Traditional

OBJECTIVETo establish and screen the primitive entry pool of scale for patient-reported outcomes of coronary heart disease angina (CHDA).

METHODSUnder the guidance of Chinese medical theory, the original entry pool was preliminarily established in referring the international scale development methods and the characteristics of angina pectoris, which was screened by focus group discussions, semi-open questionnaires investigation, and expert's interviews.

RESULTSThirty-six entries were screened out from the 41 entries of initially established entry pool, in which 14 entries dealt with physiological domain, 8 with psychological domain, 4 with independent domain, 3 with social relations domain, 6 with social environment domain and 1 for overall assessment.

CONCLUSIONSThe preliminary entries screened out have covered all the 5 commonly concerned domains of CHD-AP, could reflect the connotation of the disease more comprehensively. And it has good content validity due to its popular language, which is easily to be understood, comprehended and responded.

Angina Pectoris ; diagnosis ; therapy ; Coronary Disease ; diagnosis ; therapy ; Humans ; Integrative Medicine ; Treatment Outcome

No abstract available.
Aged ; Angina Pectoris/diagnosis/etiology ; Coronary Angiography ; Coronary Artery Disease/*complications/diagnosis/therapy ; Coronary Stenosis/*complications/diagnosis/therapy ; Coronary Vessel Anomalies/*complications/diagnosis ; Humans ; Male ; Percutaneous Coronary Intervention/instrumentation ; Stents ; Treatment Outcome

OBJECTIVETo investigate the impact of depression on clinical outcome of patients undergoing revascularization.

METHODSSelf-rating depression scale (SDS) assessment was made before and after coronary artery bypass grafting (CABG, n = 345) and percutaneous coronary intervention (PCI, n = 308) procedure. Patients were divided into depression and non-depression group. All patients were followed up for 12 months after procedure for the occurrence of rehospitalization and major adverse cardiovascular events (MACE) including all-cause mortality, nonfatal myocardial infarction or target lesion revascularization.

RESULTSDepression was present in 40.9% (n = 141) of patients after CABG, which was significantly higher than before procedure (24.3%, P < 0.01). The MACE rate was significantly higher in patients with post-procedure depression [8.5% (12/141)] than in patients without depression [2.9% (6/204), P < 0.05] and the incidences of target lesion revascularization and rehospitalization were also significantly higher in depression patients than in non-depression patients during the 12 months follow-up (all P < 0.05). Depression was present in 36.4% (n = 112) of patients after PCI, which was significantly higher than that before procedure (28.6%, P < 0.05). The MACE rate [8.0% (9/112) vs. 2.0% (4/196)] and rehospitalization rate [12.5% (14/112) vs. 4.6% (9/196)] were significantly higher in depression patients than in patients without depression during the 12 months follow-up (P < 0.05). There was no significant difference on SDS score between the PCI and CABG before the procedure. However, after the procedure, the SDS score for patients undergoing CABG was significantly higher than in patients undergoing PCI (48.9 ± 9.8 vs. 45.7 ± 10.5 P = 0.01). The level of serum IL-6 was significantly higher in depression patients than in patients without depression (P < 0.05).

CONCLUSIONPrevalence of depression is high in patients treated with revascularization procedures and is linked with poor post-procedure prognosis.

Aged ; Angioplasty, Balloon, Coronary ; Coronary Artery Bypass ; Coronary Disease ; diagnosis ; psychology ; therapy ; Coronary Stenosis ; Depression ; etiology ; Female ; Humans ; Male ; Middle Aged ; Prognosis ; Treatment Outcome

No abstract is available.
Angioplasty, Transluminal, Percutaneous Coronary/*adverse effects/methods ; Coronary Disease/diagnosis/*therapy ; Human ; Incidence ; Prognosis ; Recurrence ; Risk Assessment

Coronary Artery Disease ; diagnosis ; therapy ; Humans ; Tomography, Optical Coherence ; methods ; Treatment Outcome

When invasively assessing coronary artery disease, the primary goal should be to determine whether the disease is causing a patient's symptoms and whether it is likely to cause future cardiac events. The presence of myocardial ischemia is our best gauge of whether a lesion is responsible for symptoms and likely to result in a future cardiac event. In the catheterization laboratory, fractional flow reserve (FFR) measured with a coronary pressure wire is the reference standard for identifying ischemia-producing lesions. Its spatial resolution is unsurpassed with it not only being vessel-specific, but also lesion-specific. There is now a wealth of data supporting the accuracy of measuring FFR to identify ischemia-producing lesions. FFR-guided percutaneous coronary intervention of these lesions results in improved outcomes and saves resources. Non-hemodynamically significant lesions can be safely managed medically with a low rate of subsequent cardiac events.
*Cardiac Catheterization ; Coronary Artery Disease/complications/*diagnosis/physiopathology/therapy ; *Coronary Circulation ; Fractional Flow Reserve, Myocardial ; *Hemodynamics ; Humans ; Patient Selection ; Percutaneous Coronary Intervention ; Predictive Value of Tests ; Treatment Outcome

A hypothesis of " blood-stasis and toxin causing catastrophe engender acute cardiovascular event (ACE)" was put forward according to TCM cognition on blood-stasis and toxin, in combining with the up to date concept of atherosclerosis and coronary heart disease, and together with our clinical practical experiences. The etiology, pathogenesis, evolving law, initial characteristics, clinical manifestation, therapeutic methods, prescriptions and their compatibility, as well as the well-suited time for applying TCM intervention were discussed. The authors stressed that it is of great significance for further reducing the morbidity of ACE and improving the effect of integrative medicine for preventing and treating cardiovascular thrombotic disease.
Acute Disease ; therapy ; Cardiovascular Diseases ; diagnosis ; drug therapy ; etiology ; Coronary Thrombosis ; complications ; Drugs, Chinese Herbal ; administration & dosage ; Humans

OBJECTIVETo carry out expert survey for traditional Chinese medicine (TCM) syndrome characteristics of different clinical types of coronary artery disease (CAD).

METHODSBy using Delphi method, we carried out two rounds of nationwide expert surveys for modern TCM characteristics of syndrome elements and syndrome types of CAD.

RESULTSBased on expert consensus, qi deficiency, blood stasis, phlegm turbidity, qi deficiency blood stasis, and intermingled phlegm and blood stasis are common TCM syndromes for different clinical types of CAD. Of them, qi stagnation, blood stasis, phlegm turbidity, heat accumulation, cold coagulation, yang deficiency, deficiency of both qi and yang were more often seen in patients with unstable angina than in those with stable angina. Qi deficiency, yin deficiency, and deficiency of both qi and yin were less seen. We could see more excess syndrome and less deficiency syndrome (such as qi deficiency, yin deficiency, etc.) in acute ST-segment elevation myocardial infarction (STEMI) than acute non-ST-segment elevation myocardial infarction (NSTEMI). Qi deficiency, blood stasis, water retention, yang deficiency, phlegm turbidity, yin deficiency, Xin-qi deficiency, and qi deficiency blood stasis induced water retention are the most common TCM syndrome types of CAD heart failure (HF). Blood deficiency, yin deficiency, heat accumulation, deficiency of both Xin and Pi, deficiency of both qi and blood, deficiency of both qi and yin, yin deficiency and fire hyperactivity were more often seen in CAD arrhythmias.

CONCLUSIONSTCM syndrome distributions of different clinical types of CAD have common laws and individual characteristics. Results based on the expert consensus supplied evidence and support for clinical diagnosis and treatment of CAD.

Angina Pectoris ; Angina, Unstable ; China ; Coronary Artery Disease ; diagnosis ; therapy ; Coronary Disease ; diagnosis ; Data Collection ; Heart Failure ; diagnosis ; Humans ; Medicine, Chinese Traditional ; methods ; Qi ; Syndrome ; Yang Deficiency ; diagnosis ; Yin Deficiency ; diagnosis