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ANALYSIS OF KEY INDICATORS OF PATIENTS' CONDITION DURING CORONARY ARTERY STENTING

Journal: Art of Medicine (Vol.4, No. 3)

Publication Date:

Authors : ;

Page : 66-73

Keywords : coronary artery stenting; analgosedation; concomitant pathology; urgent and planned hospitalization;

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Abstract

According to WHO, 17.9 million people died from cardiovascular diseases in 2016, which is 31% of all deaths. As of 2017, according to the Ministry of Health of Ukraine, there are more than 9 million people with coronary artery disease (CAD). In 2018, more than 45,000 patients were hospitalized for myocardial infarction (MI) in our country, of which more than 6% died within the first day after hospitalization. Minimally invasive techniques have become one of the main methods of diagnosis and treatment of CAD and have long been included in international treatment protocols. According to the Stent4Life initiative group, as of 2016, the number of percutaneous coronary interventions per-formed in patients with myocardial infarction reached 7,427 procedures. In just three years between 2014 and 2017, the number of endovascular interventions on heart arteries in Ukraine has doubled. In 2017-18, during a retrospective research con-ducted in the Heart Institute of the Ministry of Health of Ukraine, we analyzed the medical records of 73 patients (58 men and 15 women) aged 35-83 years. Of these, 29 patients (39.73%) were hospitalized on a planned basis, and 44 patients (60.27%) were urgently admitted. For the research, we selected patients with vari-ous clinical forms of CAD: acute coronary syndrome (myocardial infarction, unstable angina) and chronic coronary syndromes (stable angina of various functional classes, asymptomatic atherosclerosis of the coronary arteries). All patients underwent coronary angiography and stenting of the coronary arteries in a planned and urgent manner. Surgery was performed under routine sedation (Ramsey sedation level II-III) with diazepam and/or fentanyl and / or morphine. All patients hospitalized in a planned and urgent manner were performed a standard set of diagnostic laboratory tests: CBC, glucose, creatinine, urea, electro-lytes, coagulogram, blood gas analysis. Troponin I levels were also determined in all patients hospitalized for acute coronary syndrome. The aim of the research was to analyze the key indicators of patients' condition during coronary artery stenting under routine sedation. During the research, the structure of the re-searched group was analyzed by age, gender, forms of CAD, complications, comorbidities, history of the dis-ease, laboratory results and the amount of intervention. Statistical analysis of the obtained data was per-formed using the licensed statistical software package StatPlus 6 and MS Excel. We found that the majority of patients were men aged 59.93±0.84 years and overweight. The majority of hospitalized patients were overweight (41.10% of patients) and obese to varying degrees (36.98 %). The average body weight was 85.40 ± 14.80 kg, the average body mass index was 28.93 ± 4.98. Planned hospitalized patients mostly suffered from stable coronary artery disease angina, FC III (21.92%), among urgent patients, the main cause of surgical intervention was STEMI (38.36%). 64 patients were also diagnosed with hypertension of various stages and degrees (87.67%). Nine patients (13.71%) had diabetes, including 1.37% who were first diagnosed. Atrial fibrillation was present in 12.33% of patients. In the majority of patients (94.52%) the course of coronary heart disease was accompanied by the development of clinical signs of heart failure. For intraoperative sedation, fentanyl was mainly used in the group of patients who were hospitalized urgently, and fentanyl and diazepam were used in the subgroup of planned hospitalization.

Last modified: 2020-12-17 01:33:38