Search

Aims We sought to explore the latent classifications of psychosocial adaptation in young and middle-aged patients with acute myocardial infarction (AMI) and analyse the characteristics of different profiles of AMI patients. Methods and results A cross-sectional study was performed in 438 Chinese young and middle-aged patients with AMI. The investigation time was 1 month after discharge. Three different self-report instruments were distributed to the participants, including the Psychosocial Adjustment to Illness Scale, the Perceived Stress Scale, and the Social Support Rating Scale. The seven dimensions of the Psychosocial Adjustment to Illness Scale were then used to perform a latent profile analysis. All participants signed informed consent forms in accordance with the ethical principles of the Declaration of Helsinki. Finally, a total of 411 young and middle-aged AMI patients were enrolled. Three distinct profiles were identified, including the 'well-adapted group' (44.8%), 'highlight in psychological burdens group' (25.5%), and 'poorly adapted group' (29.7%). The influencing factors included stress perception, social support, occupational type, and marital status (P < 0.05). Conclusion The psychosocial adaptation of young and middle-aged AMI patients can be divided into three profiles. Clinical nurses can carry out individualized psychological interventions according to the characteristics of patients in different potential profiles to improve the psychosocial adaptation of patients and the prognosis of their disease. [ABSTRACT FROM AUTHOR]

Aims Publicized adverse events after vaccination against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) raised concern among patients with coronary atherosclerosis disease (CAD). We sought to study the association between SARS-CoV-2 vaccines and long-term clinical outcomes including ischaemic and bleeding events among patients with CAD. Methods and results Inpatients diagnosed with CAD by coronary angiography, without a history of SARS-CoV-2 infection and vaccination, were included between 1 January and 30 April 2021, and underwent follow-up until 31 January 2022. Two doses of inactivated whole-virion SARS-CoV-2 vaccine (CoronaVac, BBIBPCorV, or WIBP-CorV) were available after discharge, and the group was stratified by vaccination. The primary composite outcomes were cardiovascular death, non-fatal myocardial infarction, stent thrombosis, unplanned revascularization, ischaemic stroke, venous thrombo-embolism, or peripheral arterial thrombosis. The bleeding outcomes were Bleeding Academic Research Consortium (BARC) type 3 or 5 bleeding. Cox regression models with vaccination status as a time-dependent covariate were used to calculate the hazard ratio (HR) for the outcomes. A propensity score matching method was used to reduce confounding biases. This prospective cohort study included 2078 individuals with CAD, 1021 (49.1%) were vaccinated. During a median follow-up of 9.1 months, 45 (4.3%) primary composite outcomes occurred in the unvaccinated group, and 33 (3.2%) in the vaccinated group. In Cox regression, the adjusted HR was 1.13 [95% confidence interval (CI) 0.65–1.93]. The adjusted HR for the bleeding outcomes associated with vaccination was 0.81 [95% CI 0.35–1.19]. After matching, the adjusted HR for the primary composite outcomes associated with vaccination was 1.06 [95% CI 0.57–1.99] and for the bleeding outcomes was 0.91 [95% CI 0.35–2.38]. Similar results were found in the seven prespecified subgroups. No grade 3 adverse reactions after vaccination were recorded. Conclusion Our results indicated no evidence of an increased ischaemic or bleeding risk after vaccination with inactivated SARS-CoV-2 vaccine among Chinese patients with CAD, with limited statistical power. [ABSTRACT FROM AUTHOR]

Within this context, Xu I et al i .[9] provide new data from the FAVOR III China trial, which sought to determine whether the peri-procedural use of quantitative flow ratio (QFR) to guide lesion selection for percutaneous coronary intervention (PCI) might improve clinical outcomes, compared with angiography-guidance alone. Accordingly, a greater proportion of lesions with QFR <= 0.80 was treated in the QFR-guided group than in the angiography-guided group [1990 (96.7%) of 2058 lesions vs. 1843 (91.1%) of 2023 lesions]. Keywords: Fractional flow reserve; Quantitative flow ratio; Non-invasive physiological assessment; Percutaneous coronary intervention; Major adverse cardiovascular events EN Fractional flow reserve Quantitative flow ratio Non-invasive physiological assessment Percutaneous coronary intervention Major adverse cardiovascular events e78 e80 3 09/01/22 20220701 NES 220701 Pressure wire-based physiological assessment with fractional flow reserve (FFR) and the instantaneous wave-free ratio (iFR) more accurately identifies flow-limiting lesions than angiographic assessment alone. [Extracted from the article]

Background The China ST-segment elevation myocardial infarction (STEMI) Care Project (CSCAP) was launched in 2011 to address the problems of insufficient reperfusion and long treatment delay in STEMI care in China. Aim To describe the baseline status of STEMI emergency care in Tertiary PCI Hospitals using Phase 1 (CSCAP-1) data. Design CSCAP-1 is a prospective multi-center STEMI registry. Methods and results A total of 4191 patients with symptom onset within 12 or 12–36 h requiring primary percutaneous coronary intervention (PCI), were enrolled from 53 tertiary PCI hospitals in 14 provinces, municipalities, and autonomous regions of China in CSCAP-1. Among them, 49.0% were self-transported to the hospital, 26.5% were transferred to the hospital by calling the emergency medical services directly, and 24.5% were transferred from other hospitals. In patients with symptom onset within 12 h, 83.2% received primary PCI, 5.9% received thrombolysis and 10.9% received conservative medications. The median door-to-balloon time was 115 (85–170) min and the median door-to-needle time for in-hospital thrombolysis was 80 (50–135) min. The overall in-hospital all-cause mortality was 2.4%, while it was 5.3% in the non-reperfusion group and 2.1% in the reperfusion group (P  < 0.001). Conclusion Although a long treatment delay and a high proportion of patients transporting themselves to the hospital were observed, trends were positive with greater adoption of primary PCI and lower in-hospital mortality in tertiary hospitals in China. Our results provided important information for further integrated STEMI network construction in China. [ABSTRACT FROM AUTHOR]

Background: The study of the development and evaluation of self-management intervention among patients with acute myocardial infarction (AMI) undergoing percutaneous coronary intervention (PCI) is lacking, especially in China. Aim: To examine the effects of a nurse-led individualized self-management program (NISMP) on health behaviors, control of cardiac risk factors, and health-related quality of life (HRQoL) among patients with AMI undergoing PCI. Methods: The quasi-experimental design included a convenience sample of 112 participants recruited from a tertiary hospital in China. The participants were assigned to the control group (n = 56) or the intervention group (n = 56). The intervention group underwent the NISMP, which includes six group-based education sessions, a face-to-face individual consultation, and 12-month telephone follow-ups. Data were collected at baseline and at the end of the 12-month program using the Health Promotion Lifestyle Profile, the Risk Factors Assessment Form, and the Short Form 36-item Health Survey. Results: The baseline sociodemographic and clinical characteristics of the two groups were comparable (p > 0.05). After the 12-month intervention, the health behaviors and HRQoL of the participants in the intervention group had significantly improved (p < 0.05 for both) compared to those of the control group. Compared to the control group, the participants in the intervention group also reported significantly better control of cardiac risk factors including smoking (χ2 = 4.709, p = 0.030), low-density lipoprotein (χ2 = 4.160, p = 0.041), body mass index (χ2 = 3.886, p = 0.049) and exercise (χ2 = 10.096, p = 0.001). Conclusion: The NISMP demonstrated positive effects on health behaviors, control of cardiac risk factors, and HRQoL among Chinese patients with AMI undergoing PCI. [ABSTRACT FROM AUTHOR]

Introduction: Periodic population surveys of smoking behavior can inform development of effective tobacco control strategies. We investigated smoking patterns, cessation, and knowledge about smoking hazards in China.Methods: A nationally representative cross-sectional survey recruited 176 318 people aged ≥18 years across 31 provinces of China in 2013-2014, using multi-stage stratified cluster sampling methods. The smoking patterns, cessation, and knowledge about smoking hazards were analyzed, overall and in population subgroups, adjusting for sample selection weight and post-stratification factors.Results: Among men, 60.7% were ever-smokers, with proportions of regular, occasional and former smokers being 46.3%, 5.5%, and 8.8% respectively. Among women, only 2.8% had ever smoked. The prevalence of ever smoking in men was higher in rural than urban areas (63.2% vs. 57.6%) and varied from 39.5% to 67.4% across 31 provinces. Among male regular smokers, the mean daily number of cigarettes smoked was 17.8, with mean age at first starting to smoke daily being 20.1 years. Among current smokers, one-third (32.6% men, 32.1% women) had tried to quit before and 36.8% (36.8% men, 35.5% women) intended to quit in the future. Of the Chinese adults, 75.9% recognized that smoking was hazardous, with the proportions believing that smoking could cause lung cancer, heart attack or stroke being 67.0%, 33.2%, and 29.5%, respectively and with 26.0% reporting that smoking could cause all these conditions.Conclusion: Among Chinese adults, the smoking prevalence remained high in men but was low in women. In both men and women, knowledge about smoking hazards was poor.Implications: This study showed that tobacco smoking remained highly prevalent among adult men in China in 2013-2014. Moreover, men born in recent decades were more likely to start smoking at younger ages and to smoke more cigarettes than those born in previous generations. There was a large regional variation in male smoking prevalence, with the least economically developed regions having higher prevalence. In contrast, few women in China smoked, especially among those born in recent decades. The contrasting smoking patterns in men and women is likely to result in an increasingly large gender disparity in life expectancy in the coming decades. [ABSTRACT FROM AUTHOR]

Objective Although quality indicators for the care of patients having acute myocardial infarction have been described for other countries, there are none specifically tailored to the Chinese health-care system. The study objective was to develop quality indicators for acute myocardial infarction in China, which measure and improve the quality of care for this patient population, and which could be reported on performance reports. Design A modified Delphi process regarding association with seven dimensions (evidence-based, usefulness, interpretable, validity, prevention, feasibility and overall assessment) on a 5-point scale. Participants A 17-member multidisciplinary expert panel was assembled, including 6 thoracic and cardiovascular surgeons and 11 cardiovascular internists. Main outcome measure Indicators with an arithmetic mean score of >4 in the overall assessment group were considered for the discussion round with the panelists. Results A total of 60 quality indicators were examined. There were 33 quality indicators with scores >4. This list was distilled to 23 indicators related to quality of care. These selected indicators consisted of 5 outcome variables, 15 process of care variables and 3 structure variables. Conclusions This set of consensus quality indicators can be used as a standard list to be monitored by providers of acute myocardial infarction care in an effort to continuously evaluate and improve their performance. [ABSTRACT FROM PUBLISHER]