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Objectives: This study aims to evaluate the knowledge and proficiency of nurses in managing thrombolytic therapy for myocardial infarction. Methodology: A cross-sectional research design was adopted and conducted in a public teaching hospital from May 2020 to September 2020. Registered professional nurses (n=52) working in the emergency department (ED) and cardiac care unit (CCU) were invited to participate. A structured, pre-validated questionnaire was used for data collection. The study received approval from the institutional review board and ethics committee. Data were analyzed using SPSS version 25.0. Results: Fifty ED nurses participated in the study, predominantly male, aged = 34 years, with = 3 years of experience. The overall knowledge score of nurses regarding thrombolytic therapy was 71%, while the practice score was 79%. The lowest level of knowledge was related to contraindications (65%) and treatment protocols (66%), while the highest was for therapy considerations (85.2%). The lowest task performance (47.8%) was observed in the pre - administration phase. There was a negative correlation (r = -0.226) between knowledge and practice. Knowledge levels were higher among male nurses, while task performance was better among those with cardiac certification. Conclusion: The study revealed that while nurses had a favorable level of knowledge about thrombolytic therapy, their practical implementation was poor. This gap highlights the need for targeted educational programs and the establishment of efficient documentation systems to enhance clinical practice. [ABSTRACT FROM AUTHOR]

Heart disease is the leading cause of death in many countries around the world and is linked to numerous complications. In addition to conventional pharmacological treatments, complementary and alternative medicines like massage and dry cupping are employed to help manage the disease and its symptoms. This study aimed to compare the effects of massage and dry cupping on dysrhythmia in patients with heart diseases. This randomized parallel controlled clinical trial study was conducted in two critical care units of Shafa hospital in Kerman, southeastern Iran, in 2019–2020. A total of 90 eligible patients were allocated into three groups: massage (n = 30), dry cupping (n = 30), and control (n = 30) using a stratified block randomization method. In the massage group, the head and face were massaged for three consecutive nights, while the dry cupping group received dry cupping between the fifth cervical vertebra and the second thoracic vertebra for the same duration. Each intervention session lasted 15 min. Data collection tools included a socio-demographic and clinical characteristics questionnaire, a form for hemodynamic parameters (systolic blood pressure, diastolic blood pressure, heart rate, respiratory rate, and peripheral oxygen saturation), and a form for assessing dysrhythmia using electrocardiogram readings. Dysrhythmia in the participants was evaluated after each session. The results within each group indicated a statistically significant difference in the prevalence of dysrhythmia in the dry cupping group after the intervention (P < 0.05), but this difference was not statistically significant in the massage and control groups. However, when comparing between the groups, no significant difference was found among the three groups. Additionally, there was no significant difference in the type of dysrhythmia between the groups (P > 0.05). While there was no difference in the type of dysrhythmia between the three groups, the additional reduction of dysrhythmia in the dry cupping group could hold clinical significance. Further studies are recommended to validate or refute the findings of the present study. [ABSTRACT FROM AUTHOR]

Abstract Aim This study aimed to explore the barriers to the implementation of patient‐centred care (PCC) in the cardiac care unit (CCU) from the perspectives of patients, nurses, physicians and nursing managers. Design This study was performed with a descriptive qualitative study approach. Methods In this study, the data were collected through face‐to‐face in‐depth semi‐structured interviews with 10 cardiac care nurses, one assistant nurse, two cardiologists, seven patients admitted to the CCU and nine nursing managers and analysed by Graneheim and Lundman content analysis method. Results After analysing the data, eight subcategories and three main categories were extracted. The main categories included challenges related to: organization, healthcare providers and patients. This study demonstrated the barriers to the implementation of PCC in the CCU. Insights into these barriers can guide interventions aimed at improving the quality of PCC in the CCU, which in turn can lead to improved disease outcomes.

Aim: This study aimed to explore the barriers to the implementation of patient‐centred care (PCC) in the cardiac care unit (CCU) from the perspectives of patients, nurses, physicians and nursing managers. Design: This study was performed with a descriptive qualitative study approach. Methods: In this study, the data were collected through face‐to‐face in‐depth semi‐structured interviews with 10 cardiac care nurses, one assistant nurse, two cardiologists, seven patients admitted to the CCU and nine nursing managers and analysed by Graneheim and Lundman content analysis method. Results: After analysing the data, eight subcategories and three main categories were extracted. The main categories included challenges related to: organization, healthcare providers and patients. This study demonstrated the barriers to the implementation of PCC in the CCU. Insights into these barriers can guide interventions aimed at improving the quality of PCC in the CCU, which in turn can lead to improved disease outcomes. [ABSTRACT FROM AUTHOR]

Introduction: Activities of daily living (ADL) refer to the ability to perform the essential self-care activities that are necessary to have a life without dependency. Development of chronic diseases such as heart disease, as age progresses, can affect ADL. Facilitating the return of patients to the ADL and determining the level of care is one of the responsibilities of nurses. Therefore, using Barthel and Katz indexes, this study aimed to assess ADL dependency after discharge from cardiac care unit (CCU). Methods: In this descriptive cross-sectional study, 180 patients were selected by the available sampling method. Data were analyzed before and after admission to the CCU using SPSS software version 13. Results: The mean score of the Barthel and Katz indexes, before admission to the CCU, was 92.96 and 5.37, respectively, which changed to 82.85 and 4.57 post-cardiac care unit (P-CCU). Accordingly, ADL dependency increased after discharge from CCU. Conclusion: After discharge from the CCU (in P-CCU), patients do not return to the same level of activities before hospitalization, and the functional status and ability of patients to perform daily activities decrease.

Background: Sustained arrhythmias are frequently encountered in cardiac care units (CCU), but their types and outcomes in Africa are unknown. Studies from high-income countries suggest arrhythmias are associated with worse outcomes. Objectives: To determine the types and proportion of cardiac arrhythmias among patients admitted to the CCU at Moi Teaching and Referral Hospital (MTRH), and to compare 30-day outcomes between patients with and without arrhythmias at the time of CCU admission. Methods: We conducted a prospective study of a cohort of all patients admitted to MTRH-CCU between March and December 2021. They were stratified on the presence or absence of arrhythmia at the time of CCU admission, irrespective of whether it was the primary indication for CCU care or not. Clinical characteristics were collected using a structured questionnaire. Participants were followed up for 30 days. The primary outcome of interest was 30-day all-cause mortality. Secondary outcomes were 30-day all-cause readmission and length of hospital stay. The 30-day outcomes were compared between the patients with and without arrhythmia, with a p value < 0.05 being considered statistically significant. Results: We enrolled 160 participants. The median age was 46 years (IQR 31, 68), and 95 (59.4%) were female. Seventy (43.8%) had a diagnosis of arrhythmia at admission, of whom 62 (88.6%) had supraventricular tachyarrhythmias, five (7.1%) had ventricular tachyarrhythmias, and three (4.3%) had bradyarrhythmia. Atrial fibrillation was the most common supraventricular tachyarrhythmia (82.3%). There was no statistically significant difference in the primary outcome of 30-day mortality between those who had arrhythmia at admission versus those without: 32.9% versus 30.0%, respectively (p = 0.64). Conclusion: Supraventricular tachyarrhythmias were common in critically hospitalized cardiac patients in Western Kenya, with atrial fibrillation being the most common. Thirty-day all-cause mortality did not differ significantly between the group admitted with a diagnosis of arrhythmia and those without.

This paper summarized the practice and experience of shift rotation in the general ward, CCU and catheterization unit of cardiology. The practice of shift rotation included rotation background of rotation, setting up of a team of clinical teachers, establishing the teaching program, training before shift rotation and related assessment. Nurses were trained in professional skills, and implementation of shift rotation had relieved pressure on nursing human resources. (本文主要对心内科普通病房、CCU和导管室3个护理单元实施轮转的相关经验进行总结, 主要包括轮转的背景、带教老师的确定、教学内容的制定、轮转前的培训以及相关考核等, 通过实施轮转, 护士的业务能力明显提高, 缓解了科室人力资源紧张的情况。)

Introduction: Due to the complexity of the situation and rapid changes in patients' clinical status in intensive care units, it is necessary to teach decision-making skills to nurses, alongside critical thinking. The aim of this study was to evaluate critical thinking training by using critical thinking cards on clinical decision-making of nurses in cardiac care units (CCU). Methods: In this quasi-experimental study, 74 CCU nurses from the selected hospitals affiliated to Ahvaz and Dezful Universities of Medical Sciences were selected based on the inclusion criteria and were assigned to either the intervention or the control group by using permuted block randomization. The data were entered into SPSS V22 and analyzed. Results: There was no statistically significant difference between the demographic characteristics of the two groups (P < 0.05). The mean total score of nurses' clinical decision-making before training sessions in the intervention group was calculated to be 141.59 ± 10.76, which was lower compared to a score of 148.56 ± 10.95 in the control group (P = 0.011). Therefore, covariance analysis was used to modify the results. The mean total score of nurses' clinical decision-making after the training in the intervention group was calculated as 163.82 ± 8.83, indicating a significant increase compared to a score of 154.50 ± 11.25 in the control group (P < 0.001). Conclusion: The findings of the present study show that the education of critical thinking by using the critical card tool leads to improved clinical decision-making in CCU nurses.

Introduction: Activities of daily living (ADL) refer to the ability to perform the essential selfcare activities that are necessary to have a life without dependency. Development of chronic diseases such as heart disease, as age progresses, can affect ADL. Facilitating the return of patients to the ADL and determining the level of care is one of the responsibilities of nurses. Therefore, using Barthel and Katz indexes, this study aimed to assess ADL dependency after discharge from cardiac care unit (CCU). Methods: In this descriptive cross-sectional study, 180 patients were selected by the available sampling method. Data were analyzed before and after admission to the CCU using SPSS software version 13. Results: The mean score of the Barthel and Katz indexes, before admission to the CCU, was 92.96 and 5.37, respectively, which changed to 82.85 and 4.57 post-cardiac care unit (P-CCU). Accordingly, ADL dependency increased after discharge from CCU. Conclusion: After discharge from the CCU (in P-CCU), patients do not return to the same level of activities before hospitalization, and the functional status and ability of patients to perform daily activities decrease. [ABSTRACT FROM AUTHOR]

Patients admitted to the cardiac care unit (CCU) are prone to functional degradation and disability due to prolonged hospitalization and cardiovascular diseases. The aim of this study was to assess the activities of daily living (ADLs) after discharge from CCU. This descriptive cross-sectional study was performed on 180 subjects selected through convenience sampling from the patients admitted to the post-CCU of the hospitals affiliated to the three major medical universities of Tehran, Iran. The ADLs were evaluated by the Barthel index and the data were analyzed by the Wilcoxon test using SPSS version 19. P < 0.05 was considered significant. Bathing had the highest dependence level (21.1%) and disability in this activity increased from 12.8% to 33.9% after discharge. The lowest dependence was found for feeding (2.8%) anddependence augmented after admission, compared to before (92.96±16.02 and 82.85±22.22, respectively). The findings of this study could be applied in empowering the caregivers and designing home care plans for the patients after discharge from the CCU.

Background: Multimedia interventions may play an important role in improving patient care and reducing the time constraints of patient-clinician encounters. The "MyStay Cardiac" multimedia resource is an innovative program designed to be accessed by adult patients undergoing cardiac surgery., Objective: The purpose of this study was to evaluate the uptake of the MyStay Cardiac both during and following the COVID-19 pandemic., Methods: A prospective observational study design was used that involved the evaluation of program usage data available from the digital interface of the multimedia program. Data on usage patterns were analyzed for a 30-month period between August 2020 and January 2023. Usage patterns were compared during and following the lifting of COVID-19 pandemic restrictions. Uptake of the MyStay Cardiac was measured via the type and extent of user activity data captured by the web-based information system., Results: Intensive care unit recovery information was the most accessed information, being viewed in approximately 7 of 10 usage sessions. Ward recovery (n=124/343, 36.2%), goal (n=114/343, 33.2%), and exercise (n=102/343, 29.7%) information were routinely accessed. Most sessions involved users exclusively viewing text-based information (n=210/343, 61.2%). However, in over one-third of sessions (n=132/342, 38.5%), users accessed video information. Most usage sessions occurred during the COVID-19 restriction phase of the study (August 2020-December 2021). Sessions in which video (P=.02, phi=0.124) and audio (P=.006, phi=0.161) media were accessed were significantly more likely to occur in the restriction phase compared to the postrestriction phase., Conclusions: This study found that the use of digital multimedia resources to support patient education was well received and integrated into their practice by cardiac nurses working in acute care during the COVID-19 pandemic. There was a pattern for greater usage of the MyStay Cardiac during the COVID-19 pandemic when access to the health service for nonfrontline, essential workers was limited., (©Anastasia Hutchinson, Damien Khaw, Annika Malmstrom-Zinkel, Natalie Winter, Chantelle Dowling, Mari Botti, Joanne McDonall. Originally published in JMIR Nursing (https://nursing.jmir.org), 18.07.2024.)

Background: Anxiety can negatively affect patients' prognosis in cardiovascular disease. Aromatherapy helps reduce anxiety level in chronic diseases. However, the effectiveness of aromatherapy on anxiety and haemodynamic variables remains uncertain.Objective: To evaluate the evidence for the effectiveness of aromatherapy on anxiety and haemodynamic variables in patients with cardiovascular disease.Design: A systematic review and meta-analysis.Review Methods: The CINAHL COMPLETE, Cochrane Central, Web of Science, Pubmed, Scopus, Science Direct, Ovid and ProQuest databases were searched. The study was conducted in line with the Cochrane and PRISMA guideline. Examination for bias in the included studies was conducted with the Cochrane bias guideline. Heterogeneity and publication bias were evaluated.Results: Twelve studies published from 2012 to 2020 were included in the meta-analysis. Lavender aromatherapy inhalation was used the most for anxiety in patients. Aromatherapy had a highly significant effect on anxiety, systolic blood pressure and heart rate, a moderate effect on breathing rate and a non-significant effect on diastolic blood pressure. The Cochrane GRADE approach was used to assess the rating of the certainty of evidence. A high level of evidence was found for the effect of aromatherapy on heart rate, a moderate level for the effect of aromatherapy on anxiety and breathing rate and a low level for the effects of aromatherapy on blood pressure and lavender on anxiety.Conclusion: It was found that aromatherapy reduced anxiety, systolic blood pressure, heart rate and breathing rate in patients with cardiovascular disease. This study provides information to researchers and health professionals about the effectiveness of aromatherapy on decreasing anxiety and haemodynamic variables in patients with cardiovascular disease. Also, the study can contribute to planning studies which are better designed, conducted and reported. [ABSTRACT FROM AUTHOR]

Introduction: Due to the complexity of the situation and rapid changes in patients' clinical status in intensive care units, it is necessary to teach decision-making skills to nurses, alongside critical thinking. The aim of this study was to evaluate critical thinking training by using critical thinking cards on clinical decision-making of nurses in cardiac care units (CCU). Methods: In this quasi-experimental study, 74 CCU nurses from the selected hospitals affiliated to Ahvaz and Dezful Universities of Medical Sciences were selected based on the inclusion criteria and were assigned to either the intervention or the control group by using permuted block randomization. The data were entered into SPSS V22 and analyzed. Results: There was no statistically significant difference between the demographic characteristics of the two groups (P < 0.05). The mean total score of nurses' clinical decision-making before training sessions in the intervention group was calculated to be 141.59 ± 10.76, which was lower compared to a score of 148.56 ± 10.95 in the control group (P = 0.011). Therefore, covariance analysis was used to modify the results. The mean total score of nurses' clinical decision-making after the training in the intervention group was calculated as 163.82 ± 8.83, indicating a significant increase compared to a score of 154.50 ± 11.25 in the control group (P < 0.001). Conclusion: The findings of the present study show that the education of critical thinking by using the critical card tool leads to improved clinical decision-making in CCU nurses. [ABSTRACT FROM AUTHOR]

Introduction and purpose: Cardiovascular diseases with an increasing trend are among the leading causes of death in developed countries. Therefore, epidemiological indices in mortality are recently highlighted. In this regard, the present study aimed to determine the epidemiology of mortality and morbidity caused by cardiovascular diseases in patients admitted to the cardiac care units of Hamadan educational-medical hospitals, Hamadan, Iran, within 2017. Methods: This was a retrospective, descriptive cross-sectional study. The data were collected from expired patients' records which were kept for one year after their deaths in the cardiac care unit of Besat and Farshchian heart centers in Hamadan, Iran, using a census method and a researcher-made checklist. The collected data were analyzed in SPSS (version 21) using descriptive statistics. Results: Out of the 3,446 patients admitted to the cardiac care unit, 191 patients died with the highest mortality incidences occurring in the sixth decade of life among married, urban, low-educated and low-income women with a history of hypertension and lipid disorders who did not smoke, had no family history of heart disease and diabetes. Based on the obtained results, the most prevalent underlying and cardiovascular diseases were reported as respiratory disorders (24.6%) (47) and myocardial infarction (34.6%) (66), respectively. Conclusion: Various risk factors increase the odds of developing cardiovascular diseases. Therefore, it seems necessary to focus on education and promotion of community awareness in various ways, such as social media, in order to prevent these diseases.

Introduction: This study aimed to determine the effect of warm footbath before bedtime on the quality of sleep on patients with acute Coronary Syndrome in Cardiac Care Unit. Methods: This study was conducted on 120 patients admitted to CCU at Mazandaran Heart Center and randomly divided into two groups of intervention and control. In the intervention group, warm footbath was performed after the second night in hospital before bed time by 41 C water for 20 minutes for three consecutive nights; in contrast, the control group did not receive anything of this sort. The next day, St Mary's Hospital Sleep Questionnaire was completed to evaluate sleep quality. Then, the obtained data were analyzed using SPSS software and Friedman, Wilcoxon exact statistical tests. Results: The quality of sleep in the first night of hospitalization was different from the third night after the intervention in both groups and the improvement process of sleep quality was observed in both groups. Most patients had moderate impairments (23-36), which had not changed during the intervention. In intervention groups, 8 patients had severe sleep disorders (greater than 37), which declined to 1 after three nights of intervention. While, in the control group this number fell from 10 patients with severe sleep disorders to 5. Warm footbath had a great positive impact on patients suffering from severe sleep disorders (P

Abstract Background This study aimed at developing and validating a scoring model to stratify critically ill patients after cardiac surgery based on risk for dysphagia, a common but often neglected complication. Methods Data were prospectively collected and analyzed from January 2016 to June 2017 from 395 consecutive post cardiac surgery patients at the cardiac care unit (CCU) at a single center; 103 (26.1%) developed dysphagia. Univariate and multivariate logistic analyses were used to identify independent predictors for dysphagia. The survival nomogram was developed on the basis of a multivariable Cox model, which allowed us to obtain survival probability estimations. The predictive performance of the nomogram was verified for discrimination and calibration. Areas under receiver operating characteristic curve analysis were used to illustrate and evaluate the diagnostic performance of the novel model. Results The final novel scoring model, named SSG-OD, consists of three independent factors: gastric intubation (OR = 1.024, 95% CI 1.015–1.033), sedative drug use duration (OR = 1.031, 95% CI 1.001–1.063) and stroke or not (OR = 6.182, 95% CI 3.028–12.617). SSG-OD identified patients at risk for dysphagia with sensitivity of 68.5% and specificity of 89.0% (OR = 0.833, 95% CI: 0.782–0.884). The positive and negative likelihood ratios were 6.22 and 0.35. Conclusions The novel SSG-OD scoring system to risk stratify CCU patients for dysphagia is an easy-to-use bedside prognostication aid with good predictive performance and the potential to reduce aspiration incidence and accelerate recovery.

Objective: An intra-aortic balloon pump (IABP) is a mechanical support device that is used in addition to pharmacological treatment of the failing heart in intensive cardiac care unit (ICCU) patients. In the literature, there are limited data regarding the clinical characteristics and in-hospital outcomes of acute coronary syndrome patients in Turkey who had an IABP inserted during their ICCU stay. This study is an analysis of the clinical characteristics and outcomes of these acute coronary syndrome patients. Methods: The data of patients who were admitted to the ICCU between September 2014 and March 2017 were analyzed retrospectively. The data were retrieved from the ICCU electronic database of the clinic. A total of 142 patients treated with IABP were evaluated in the study. All of the patients were in cardiogenic shock following percutaneous coronary intervention, at the time of IABP insertion. Results: The mean age of the patients was 63.0+-9.7 years and 66.2% were male. In-hospital mortality rate of the study population was 54.9%. The patients were divided into 2 groups, consisting of survivors and non-survivors of their hospitalization period. Multivariate analysis after adjustment for the parameters in univariate analysis revealed that ejection fraction, Thrombolysis in Myocardial Infarction flow score of ≤2 after the intervention, chronic renal failure, and serum lactate and glucose levels were independent predictors of in-hospital mortality. Conclusion: The mortality rate remains high despite IABP support in patients with acute coronary syndrome. Patients who are identified as having a greater risk of mortality according to admission parameters should be further treated with other mechanical circulatory support devices.

Meeting the spiritual needs of patients with cardiovascular diseases has a significant effect on their speed of recovery and spiritual health, especially in coronary care units (CCUs). The present study was conducted to investigate the effect of spiritual care based on the sound heart model on the spiritual health of patients with acute myocardial infarction (AMI) admitted to the CCU of Chamran Hospital in Isfahan, Iran, in 2016. This clinical trial was conducted on 92 patients with AMI selected by convenience sampling and randomly assigned to the intervention (n = 46) and control (n = 46) groups. The spiritual care program based on the sound heart model was regularly carried out for the intervention group over 3 days at 5–8 PM during their hospital stay, and continued for 1 month at home after discharge from the hospital, and the control group only received routine nursing interventions. The patients completed Paloutzian and Ellison's Spiritual Well-Being Scale at baseline and a month after the intervention. Data were ultimately analyzed using Fisher's exact test, Mann–Whitney's test, the Chi-square test, and the t test. The spiritual care program was able to improve the mean scores of religious health (7.8), existential health (9.3) and the total score of spiritual health (17.1) in the intervention group, while these scores reduced to 0.9, 3.4 and 4.2 in the control group. A significant difference was found between the intervention and control groups in terms of the spiritual health score (P < 0.001). The present findings confirmed the effect of spiritual care based on the sound heart model on promoting spiritual health in patients with AMI. Its application as a holistic care approach is therefore recommended for improving the signs and dimensions of spiritual health in patients with coronary artery disease, especially MI. [ABSTRACT FROM AUTHOR]

The activities of the nurse performing duties at a haemodynamic facility is characterized by the need to be able to field a high degree of specialisation. It is absolutely essential that he/she has bases of knowledge and skills also in the field of intensive care and cardiac resuscitation that are adequate for the high complexity of the diseases and procedures that are treated . Method : Quantitative design with descriptive study was carried out with assessment approach and it was conducted on nurses in cardiac care unit of pediatric hospital in Sulaimani city/Kurdistan region from 1st July 2017-1st May 2018. Non-probability sampling was performed, a purposive sample of (35) nurses, all males and females . Data were shown and tabled in frequencies and percentage, and mean of scores was calculated from ordinal data in five level ( 5, 4, 3, 2, 1 ) . In the present study the highest mean of score indicates the highest level of practice regarding nursing management. The P-value at 0.05 level indicates the degree of significance. Independent T- test and ANOVA have been utilized to find out the significant relationship of nursing care management with socio-demographic characteristics, and nurse’s skill and experiences. Result : socio-demographic profile of participants presented. Out of 35 participants studied 21 (60%) were from age group 20 – 30 years, with mean age of 30.4 years. Majority of participants studied 77.1 % were female . Majority of the nurses were graduated for institute 16 (45.7%) and 10 (28.6%) were hold university certificate . According to working experience and skills. Out of 35 participants studied, only 19 (54.29%) attended training session regarding Pediatric Intensive Care Unit (PICU). Around 74.29% of participants were not familiar with PICU drugs . Around 74.29% of participants were not familiar with PICU drugs however, 88.6% of participants were familiar to PICU doses. 80% of the total participants did not attend the periodic educational program and conference/symposium. 97.14% of the participants did not study the books regarding CHD. The right to practice in manner that is suitable for fulfilling the obligations was reported as never by 48.6% of nurses . Regarding perception of ethical practice in work environment major participants 88.6% reported sometime. [ABSTRACT FROM AUTHOR]

Objective: To investigate the effects of Acknowledge, Introduce, Duration, Explanation, and Thank you (AIDET) communication program on satisfaction among patients and families at cardiac care unit, Bangkok Heart Hospital. Material and Methods: This study was done using pre-post study design. A patients and families satisfaction report was collected by the Quality Information Management Department, Bangkok Hospital. Data were collected precommunication program implementation from January to December of 2014 and post AIDET communication program implementation from January-December of 2015 with a telephone structured interview guideline. Data were analyzed using descriptive statistics using percentage and comparing two proportions using Test of two proportion. Results: A total of 882 respondents were accepted to provide their information. After the communication program implementation, patients and families satisfaction raised from 46.1-54.8% to 56.4-62.2% and was higher than those before the program implementation. Conclusion: This communication program could be an effective intervention to increase patients and families satisfaction. Health care providers could employ this communication program to improve communication behavior in which to improve quality of care.

Background: Chest pain is a common complaint and encompasses a broad differential diagnosis that includes several life-threatening causes. Objective: The study aimed to assess nurses knowledge regarding chest pain management and respiratory maintains in Cardiac Care Unit. Methodology: A quantitative design (a descriptive study) was carried out to assess nurses knowledge regarding chest pain management and respiratory maintains in cardiac care unit. A non-probability (purposive) sample of (44) nurses who work in CCU unit at Azady teaching Hospital and Kirkuk general Hospital in Kirkuk city. the tools of data collection consisted of (25) items which divided to three parts. Part one, Nurses demographic characteristics, Part two deal with chest pain and part three is the respiratory maintains assessment. The data were collected through the utilization of constructed questionnaire, interview technique. The data were analyzed throught descriptive statistical analysis and inferential statistical analysis. Results: A total of 44 nurses participate in the study, the study shows that (61.4%) of the samples age were (20-30) years old, (63.6%) were male. (68.2%) of them Graduate B.Sc. of Nursing, and (45.5%) of the sample has 1-5 years' experience in Cardiac Care Unit. The relative sufficiency for the chest pain assessment was (69.1) while the relative sufficiency for the maintains repiratory was (87.8). Conclusions: Based on the result, the study concluded that most of the samples were between (20-30) yearts, male, Graduate B.Sc. of Nursing, has 1-5 years' experience in Cardiac Care Unit. According to the grand mean of scores, the nurses has moderate knowledge regarding chest pain management while they have high knowledge regarding respiratory maintains. [ABSTRACT FROM AUTHOR]

Introduction: This study aimed to determine the effect of warm footbath before bedtime on the quality of sleep on patients with acute Coronary Syndrome in Cardiac Care Unit. Methods: This study was conducted on 120 patients admitted to CCU at Mazandaran Heart Center and randomly divided into two groups of intervention and control. In the intervention group, warm footbath was performed after the second night in hospital before bed time by 41 C water for 20 minutes for three consecutive nights; in contrast, the control group did not receive anything of this sort. The next day, St Mary's Hospital Sleep Questionnaire was completed to evaluate sleep quality. Then, the obtained data were analyzed using SPSS software and Friedman, Wilcoxon exact statistical tests. Results: The quality of sleep in the first night of hospitalization was different from the third night after the intervention in both groups and the improvement process of sleep quality was observed in both groups. Most patients had moderate impairments (23-36), which had not changed during the intervention. In intervention groups, 8 patients had severe sleep disorders (greater than 37), which declined to 1 after three nights of intervention. While, in the control group this number fell from 10 patients with severe sleep disorders to 5. Warm footbath had a great positive impact on patients suffering from severe sleep disorders (P<0.05). Conclusion: Although warm footbath did not improve the quality of sleep in all patients, it reduced the number of patients who had severe sleep disturbances. [ABSTRACT FROM AUTHOR]

Introduction: Discharges against medical advice (DAMA) is a common problem of hospitals that could lead increasing the complications and readmission. For this, the aim of this study is to investigate the frequency and effective factors of DAMA in patients with cardiovascular disease in hospital cardiac care units (CCU) of East Azerbaijan, Iran. Methods: This cross-sectional study was performed, in 2013, in Tabriz University of Medical Sciences, Iran. Required information was extracted using valid and reliable forms of medical records of 2000 patients admitted to 20 CCU in 17 hospitals of East Azerbaijan, by two trained interviewers. Data analysis was performed using descriptive statistics (frequency, mean, percentage, etc.), chi-square test, and linear regression model using the SPSS software. The tests were considered a statistically significant level of 0.05%. Results: The results showed that 272 patients (13.6%) were DAMA from the hospital. The frequency of DAMA was in men more than women. The most frequency of discharge has occurred in the range of 40-80 years old. Results of linear regression showed that there was a significant correlation between DAMA and type of insurance, history of myocardial infarction (MI), comorbid disease, cause of hospitalization, location of hospital, and staying < 48 hours (P < 0.050). Conclusion: In this study, the rate of DAMA was relatively high compared with similar studies and it is considered as a concern problem that should study the reasons and its effective factors and plan effective interventions to reduce them.

Background:Urinary tract infection patient Urinary Tract Infection ( UTI ) one of commonest types of patient admitted to CCU ( cardiac care unit ) of other medical wards this is occur directly from contact to infected hand or material or during catheterization. Objective:To evaluation common bacterial cause UTI in patients admitted Cardiac Care Unite to show the antimicrobial agent and bacteria resistant and production the biofilm. Patients and Methods: Collection of samples from urine aseptically for culture.Isolation and identification of uropathogens using biochemical tests and testing ability of these bacterial isolation for virulence production and testing the antimicrobial susceptibility test. Results: It is A total of 135 catheter samples were collected from patient (135) catheter samples from patients in CCU at Baqubah General Teaching Hospital for the period from 1st November 2016 to 1st March 2017 frommales and female, and the samples and cultured on the medium blood agar and MacConkey agar. Then growing bacterial farms subjected to microscopic and biochemical tests for the diagnosis of bacteria. Escherichia coli with a ratio 31.8%, and (20)isolations of Proteus mirabilis with a ratio 18.2%, 16 isolates of Klebsiella pneumonia, (14) isolations of Pseudomonas aeruginosa with a ratio 12.7% .The Antimicrobial sensitivity is investigated for (9) antibiotics from different groups including; The results show a high resistance to most of the antibiotics under study, and resistance all isolates ware of Aztreonam,Cefotaxime, Co-Trimoxazol with ratio 95%, Naldixic acid with ratio 100%, Tetracycline 75%, Gentamycin 70% and Antimicrobial sensitivity to antibiotics to Amikacin 45% followed by Ciproflaxcin 50% and tobramycin 80% . All kinds of bacteria were produced in biofilm in the ELISA method with a ratio 100%,while Congo red with a ratio 50%. Conclusion: It was observed that multiple antibiotic resistance was common among local isolates of the bacteria under study and Biofilms are important in protecting the bacteria inside the catheter from antibiotics. [ABSTRACT FROM AUTHOR]

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Objective The is study examined the effects of geranium aroma on anxiety among patients with AMI. Methods This randomized, triple-blind, placebo-controlled clinical trial recruited 80 patients with AMI through convenience sampling. The patients were allocated to geranium and placebo groups (n = 40 each) using stratified block randomization. On the second day of admission three drops of geranium essential oil and placebo were poured on absorbing patches attached inside the oxygen masks of the geranium and placebo groups, respectively. The patients were asked to inhale the aroma for 20 min a day on two consecutive days. Results all stages of the intervention, the two groups had a significant difference in anxiety scores, i.e. geranium aroma caused significantly greater reductions in the anxiety scores (P < 0.001). Conclusion Inhalation aromatherapy with geranium essential oil is recommended as an easy-to-use, intervention to reduce anxiety among patients with AMI. [ABSTRACT FROM AUTHOR]

Background and objectives Environmental noises may create physiological and psychological disorders in patients hospitalized in the CCU. Therefore, this study was conducted to investigate the effects of nature sounds on physiological indicators among patients in the CCU. Materials & methods This randomized clinical trial was conducted on 93 patients hospitalized in the cardiac care units of three teaching hospitals in 2016. The patients were selected using the convenient method with three randomized blocks. The patients were assigned into three groups as nature sounds, silence that received a set of headphones without playing sounds, and control groups. In addition to routine care, the patients in the intervention group listened to nature sounds for 30 min using a set of headphones for two days. The patients in the control group only received routine care. In addition to routine care, the patients in the silence group used a set of headphones for 30 min to block noises and no sound was played for them. Physiological indicators such as heartbeat rate, systolic and diastolic blood pressures, respiration rate, and arterial O 2 saturation were assessed using monitoring devices. Descriptive and inferential statistics were used for data analysis via the SPSS software. Findings Nature sounds and silence had no statistically significant effects on physiological indicators. However, a statistically significant difference was reported in the heart rate in the nature sound group before and after the intervention in the first day of the intervention (P = 0.046). In the second day of the intervention, there were statistically significant differences in the diastolic blood pressure in the nature sounds group (P = 0.028), heart rate (P = 0.001) and diastolic blood pressure (P = 0.013) in the silence group, and heart rate (P = 0.014) in the control group before and after the intervention. Conclusion Listening to nature sounds or the use of headphones blocked environmental noises and could influence mean arterial pressure. Future studies can examine the effects of this intervention implemented for a longer term using nature sounds by patients. [ABSTRACT FROM AUTHOR]

Background: Several theoretical models have been proposed to evaluate and explain the acceptance of ICT. In health technology acceptance, previous studies have confirmed the use of TAM and UTAUT. However, these models still have limitations in their predictive power, and future technology adoption research should develop more robust theoretical models. Objective: We attempted to investigate a new model, proposed by Safdari et al, to use a computerized physician order entry system and propose it for future studies in the same clinical settings if appropriate in the research setting. Material and Methods: In this descriptive-analytic study, model dimensions were derived from Safari's research and were evaluated by a researcher-made questionnaire. The data collected by 200 questionnaires from cardiac care units of four teaching hospitals of Shiraz University of Medical Sciences. The model tests were done by LISREL software in Absolute, Comparative and Adjusted fit indicators. Results: Most of the fit indices were completely within the acceptable or close to the acceptable range. The model's appropriate design with the technology application environment has made the model fit successfully. Conclusion: According to the model successful fitting, the model proposed by Safdari et al. has the capacity to be used in the feasibility of mobile technology adoption in health care environments. Note that every mobile heath technology may require the investigation of other factors that researchers should be consider, according to the characteristics and intended environment for use. [ABSTRACT FROM AUTHOR]

Background: Sustained arrhythmias are frequently encountered in cardiac care units (CCU), but their types and outcomes in Africa are unknown. Studies from high-income countries suggest arrhythmias are associated with worse outcomes., Objectives: To determine the types and proportion of cardiac arrhythmias among patients admitted to the CCU at Moi Teaching and Referral Hospital (MTRH), and to compare 30-day outcomes between patients with and without arrhythmias at the time of CCU admission., Methods: We conducted a prospective study of a cohort of all patients admitted to MTRH-CCU between March and December 2021. They were stratified on the presence or absence of arrhythmia at the time of CCU admission, irrespective of whether it was the primary indication for CCU care or not. Clinical characteristics were collected using a structured questionnaire. Participants were followed up for 30 days. The primary outcome of interest was 30-day all-cause mortality. Secondary outcomes were 30-day all-cause readmission and length of hospital stay. The 30-day outcomes were compared between the patients with and without arrhythmia, with a p value < 0.05 being considered statistically significant., Results: We enrolled 160 participants. The median age was 46 years (IQR 31, 68), and 95 (59.4%) were female. Seventy (43.8%) had a diagnosis of arrhythmia at admission, of whom 62 (88.6%) had supraventricular tachyarrhythmias, five (7.1%) had ventricular tachyarrhythmias, and three (4.3%) had bradyarrhythmia. Atrial fibrillation was the most common supraventricular tachyarrhythmia (82.3%). There was no statistically significant difference in the primary outcome of 30-day mortality between those who had arrhythmia at admission versus those without: 32.9% versus 30.0%, respectively ( p = 0.64)., Conclusion: Supraventricular tachyarrhythmias were common in critically hospitalized cardiac patients in Western Kenya, with atrial fibrillation being the most common. Thirty-day all-cause mortality did not differ significantly between the group admitted with a diagnosis of arrhythmia and those without., Competing Interests: The authors have no competing interests to declare., (Copyright: © 2023 The Author(s).)

Introduction: Cardiovascular diseases are among the most prevalent chronic diseases leading to high degrees of mortality and morbidity worldwide and in Iran. The aim of the current study was to determine and develop appropriate indicators for evaluating provided service quality for cardiovascular patients admitted to Cardiac Care Units (CCU) in Iran. Methods: In order to determine the indicators for evaluating provided service quality, a four-stage process including reviewing systematic review articles in premier bibliographic databases, interview, performing two rounds of Delphi technique, and holding experts panel by attendance of experts in different fields was adopted. Finally, after recognizing relevant indicators in resources, these indicators were finalized during various stages using ideas of 27 experts in different fields. Results: Among 2800 found articles in the text reviewing phase, 21 articles, which had completely mentioned relevant indicators, were studied and 48 related indicators were extracted. After two interviews with a cardiologist and an epidemiologist, 32 items of the indicators were omitted and replaced by 27 indicators coping with the conditions of Iranian hospitals. Finally, 43 indicators were added into the Delphi phase and after 2 rounds of Delphi with 18 specialists, 7 cases were excluded due to their low scores of applicability. In the experts’ panel stage, 6 items were also omitted and 10 new indicators were developed to replace them. Eventually, 40 indicators were finalized. Conclusion: In this study, some proper indicators for evaluating provided service quality for CCU admissions in Iran were determined. Considering the informative richness of these indicators, they can be used by managers, policy makers, health service providers, and also insurance agencies in order to improve the quality of services, decisions, and policies.

Background & Aim: Poor sleep quality is a common problem among patients hospitalized in the CCUs. This study aimed to determine the effect of environmental factors modification strategies on quality of sleep among patients admitted to CCU. Methods & Materials: This was a quasi-experimental study with a single-blinded design. Sixty patients admitted to the CCU of Shariati hospital were divided into two experiment and control groups. Sleep quality was measured in the first day of admission and three days later using the Pittsburgh sleep quality index in both groups. In the intervention group, we implemented a modified work environment between the two measurements. Data were analyzed using the Chi-squared and t-test in the SPSS v.18. Results: Findings showed a significant decrease in sleep quality in the control group after hospitalization, compared with the intervention group (P

Background & Aim: Poor sleep quality is a common problem among patients hospitalized in the CCUs. This study aimed to determine the effect of environmental factors modification strategies on quality of sleep among patients admitted to CCU.Methods & Materials: This was a quasi-experimental study with a single-blinded design. Sixty patients admitted to the CCU of Shariati hospital were divided into two experiment and control groups. Sleep quality was measured in the first day of admission and three days later using the Pittsburgh sleep quality index in both groups. In the intervention group, we implemented a modified work environment between the two measurements. Data were analyzed using the Chi-squared and t-test in the SPSS v.18.Results: Findings showed a significant decrease in sleep quality in the control group after hospitalization, compared with the intervention group (P

Children with congenital heart disease often have medical and surgical complexity and prolonged and complicated recovery time in the intensive care unit. Limited data are published describing sleep duration, timing, and quality in this population. This study was performed to describe sleep and activity patterns of children with congenital heart disease in the immediate post-operative period. This was a secondary analysis of an observational trial of children (0-18 years) who underwent cardiac surgery and had accelerometer data. The primary outcome was the daytime activity ratio estimate (DARE), defined as the proportion of activity that occurred during the daytime hours. Secondary outcomes were sleep quality, including sleep fragmentation index and sleep duration. In total, 130 subjects with 794 hospital days of sleep data were included. Median age was 2.9 years (IQR 0.6-9.9). 83 (63.8%) were males, and 51 (39%) had cyanotic lesions. 35 subjects (26.9%) underwent single ventricle repairs. Average nighttime activity levels were higher than normal in all subjects with an average DARE of 61.1% (±5), normal 75%. Variables independently associated with DARE were total daily sleep time (p=0.005) and total benzodiazepine dose in mcg/kg (p=0.006). Almost half of the subjects had inadequate total sleep time (60, 46%). There was a significant decrease in total sleep time and proportion of subjects with adequate sleep duration in the lower age categories. For every year increase in age, the odds of adequate sleep increased by 27%, p<0.001. Children post cardiac surgery have higher than normal levels of nighttime activity and almost half do not meet the recommended daily hours of sleep. Infants under 1 year of age may be at a higher risk of inadequate sleep. Exposure to benzodiazepines may also affect the balance between daytime and nighttime sleep patterns after cardiac surgery. • Limited sleep data exist about children with congenital heart disease after cardiac surgery • Almost half of children do not get adequate daily sleep during recovery from cardiac surgery • Up to 40% of daily activity occurs at night in children after cardiac surgery • Children under one year old are at higher risk for sleep-wake cycle disruption [ABSTRACT FROM AUTHOR]

Cardiac nursing has changed significantly in recent years and many roles that were traditionally undertaken by medical staff have been adopted by nurses. In addition, the medical treatment that patients with an acute coronary syndrome (ACS) receive has become significantly more invasive and complex with the availability of new drugs and treatment options. This makes cardiac nursing an exciting area to work in with considerable scope for professional development. Furthermore, advances in patient safety methodology are changing service delivery. The role of the cardiac nurse remains central to the provision of good care and to ensuring that it remains safe, effective and patient-centred. This is the second of a two-part article on the role of the coronary care unit nurse in the management of patients with an ACS and describes their recovery and discharge. [ABSTRACT FROM AUTHOR]

Cardiac nursing has changed significantly in recent years, and many roles that were traditionally undertaken by medical staff have been adopted by nurses. In addition, the medical treatment that patients with an acute coronary syndrome (ACS) receive has become significantly more invasive and complex with the availability of new drugs and treatment options. This makes cardiac nursing an exciting area to work in, with considerable scope for professional development. Furthermore, advances in patient safety methodology are changing service delivery. The role of the cardiac nurse remains central to the provision of good care, and ensuring that it remains safe, effective and patient-centred. This is the first of a two-part article on the role of the coronary care unit (CCU) nurse in the management of ACS patients and describes the initial management. [ABSTRACT FROM AUTHOR]

Objective: To develop and prospectively evaluate a web-based tool that forecasts the daily bed need for admissions from the cardiac catheterization laboratory using routinely available clinical data within electronic medical records (EMRs).Methods: The forecast model was derived using a 13-month retrospective cohort of 6384 catheterization patients. Predictor variables such as demographics, scheduled procedures, and clinical indicators mined from free-text notes were input to a multivariable logistic regression model that predicted the probability of inpatient admission. The model was embedded into a web-based application connected to the local EMR system and used to support bed management decisions. After implementation, the tool was prospectively evaluated for accuracy on a 13-month test cohort of 7029 catheterization patients.Results: The forecast model predicted admission with an area under the receiver operating characteristic curve of 0.722. Daily aggregate forecasts were accurate to within one bed for 70.3% of days and within three beds for 97.5% of days during the prospective evaluation period. The web-based application housing the forecast model was used by cardiology providers in practice to estimate daily admissions from the catheterization laboratory.Discussion: The forecast model identified older age, male gender, invasive procedures, coronary artery bypass grafts, and a history of congestive heart failure as qualities indicating a patient was at increased risk for admission. Diagnostic procedures and less acute clinical indicators decreased patients' risk of admission. Despite the site-specific limitations of the model, these findings were supported by the literature.Conclusion: Data-driven predictive analytics may be used to accurately forecast daily demand for inpatient beds for cardiac catheterization patients. Connecting these analytics to EMR data sources has the potential to provide advanced operational decision support. [ABSTRACT FROM AUTHOR]

Background Emerging acute kidney injury biomarkers, including neutrophil gelatinase-associated lipocalin (NGAL), have a high potential for predicting worsening renal function. Acute exacerbation of renal dysfunction has a great impact on the outcomes of cardiovascular patients in critical conditions. This study aimed to evaluate whether plasma NGAL can predict the mortality and major adverse cardiovascular events (MACEs) after discharge from the cardiac care unit (CCU). Methods Patients who were admitted to the CCU of the Tokyo University Hospital were prospectively enrolled (101 patients). Blood and urinary markers, including the blood NGAL, brain natriuretic peptide, creatinine, cystatin C, urinary albumin, N -acetyl-β- d -glucosaminidase, and L-type fatty acid-binding protein, were measured at CCU discharge. The primary outcome was MACEs until at least 6 months after CCU discharge. Results Thirty-five patients experienced MACEs (35%). Multivariate logistic analysis revealed that the plasma NGAL, length of CCU stay, and existence of diabetes and heart failure were independent predicting factors for MACEs. Patients with the highest NGAL at discharge (>75th percentile) showed a significantly higher risk of MACEs than those with the lowest NGAL (<25th percentile) (log-rank test; hazard ratio, 5.15; 95% confidence interval 1.84–18.20; p < 0.01). Conclusion Plasma NGAL at CCU discharge is a significant prognostic indicator of outcomes at 6 months in critically ill cardiac patients treated in a CCU. [ABSTRACT FROM AUTHOR]

Sublingual Nitroglycerin (SLNTG) is administered to patients with coronary artery disease (CAD) to provide immediate chest pain relief and to avoid myocardial ischemia. A retrospective analysis of 47 patients in cardiac care unit with recurrent CAD, however, revealed that only 14.89% knew how to take SLNTG appropriately. The aim of the proposal was to improve the accuracy of administering SLNTG for patients, and the following interventions were introduced: hold educational seminars to clarify the significance of medication instructions by ICU nurses, design diversified instruction aids, select appropriate instruction methods and aids tailored to individual patient's needs, and place the conditions of instruction under quality control monitoring. After the project was done, the accuracy of taking SLNTG in patients with CAD increased from 14.89% to 95% and the issue with incomplete verbal content was improved. These strategies are applicable to nurses not only provides more systematically instruction, but also clarify the concept of great timing to implement SLNTG instruction. Therefore, it is suggested to standardize SLNTG nursing instruction, popularizing various instruction aids, establishing a case management system to counsel the process of taking SLNTG, and provide follow-up care to discharged patients to enhance self-management and disease coping. [ABSTRACT FROM AUTHOR]

Introduction: Cardiovascular diseases are among the most prevalent chronic diseases leading to high degrees of mortality and morbidity worldwide and in Iran. The aim of the current study was to determine and develop appropriate indicators for evaluating provided service quality for cardiovascular patients admitted to Cardiac Care Units (CCU) in Iran. Methods: In order to determine the indicators for evaluating provided service quality, a four-stage process including reviewing systematic review articles in premier bibliographic databases, interview, performing two rounds of Delphi technique, and holding experts panel by attendance of experts in different fields was adopted. Finally, after recognizing relevant indicators in resources, these indicators were finalized during various stages using ideas of 27 experts in different fields. Results: Among 2800 found articles in the text reviewing phase, 21 articles, which had completely mentioned relevant indicators, were studied and 48 related indicators were extracted. After two interviews with a cardiologist and an epidemiologist, 32 items of the indicators were omitted and replaced by 27 indicators coping with the conditions of Iranian hospitals. Finally, 43 indicators were added into the Delphi phase and after 2 rounds of Delphi with 18 specialists, 7 cases were excluded due to their low scores of applicability. In the experts' panel stage, 6 items were also omitted and 10 new indicators were developed to replace them. Eventually, 40 indicators were finalized. Conclusion: In this study, some proper indicators for evaluating provided service quality for CCU admissions in Iran were determined. Considering the informative richness of these indicators, they can be used by managers, policy makers, health service providers, and also insurance agencies in order to improve the quality of services, decisions, and policies. [ABSTRACT FROM AUTHOR]

The article discusses a study that evaluated the performance of the Cardiac Care Units (CCU) of hospitals in Isfahan, Iran. Topics covered include measures used in the existing health audit system and several quantified ratios, the measurement of price and technical efficiencies and the derivation of the efficient production function, and the score of Isfahan hospitals' CCU based on the checklist.

Abstract: Aims: The conventional 12-lead electrocardiogram (cECG) derived from 10 electrodes using a cardiograph is the gold standard for diagnosing myocardial ischemia. This study tested the hypothesis that a new 5-electrode 12-lead vector-based ECG (EASI; Philips Medical Systems, formerly Hewlett Packard Co, Boeblingen, Germany) patient monitoring system is equivalent to cECG in diagnosing acute coronary syndromes (ACSs). Methods: Electrocardiograms (EASI and cECG) were obtained in 203 patients with chest pain on admission and 4 to 8 hours later. Both types of ECGs were graded as ST-elevation myocardial infarction if at least 1 of the 2 consecutive recordings showed ST elevation more than 0.2 mV, as ACS if one or both showed ST elevation less than 0.2 mV, T-wave inversion, or ST depression. Otherwise, the ECG was graded negative. Results: Final diagnosis was identical in 177 patients (87%; 95% confidence interval [CI], 82%-91%; κ = 0.81; SE = 0.035). ST-elevation myocardial infarction was correctly identified or excluded by EASI with a specificity of 94% (95% CI, 89%-97%) and a sensitivity of 93% (95% CI, 86%-97%; using cECG as the gold standard). Of 118 patients with enzyme elevations, an almost identical number (72 [61% by EASI] and 73 [62% by cECG]) had ST elevations. Both techniques were equivalent in predicting subsequent enzyme elevation (identical, 108/143; 75% of ACS and ST-elevation myocardial infarction ECGs by EASI and cECG). Thus, both ECG methods had exactly the same specificity of 59% (95% CI, 48%-69%) and sensitivity of 91% (95% CI, 85%-96%) for detecting myocardial injury. Conclusion: EASI is equivalent to cECG for the diagnosis of myocardial ischemia. [Copyright &y& Elsevier]