An advanced nurse-led clinic for patients following percutaneous coronary intervention

2020 ◽  
Vol 15 (10) ◽  
pp. 1-11
Author(s):  
Shirley Ingram ◽  
Mary B Quirke ◽  
Bryan Loo
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Nurse Practitioners ◽  
Hospital Setting ◽  
Coronary Intervention ◽  
Clinical Nurse Specialists ◽  
Patient Profile ◽  
Coronary Syndrome ◽  
Percutaneous Coronary ◽  
Chronic Coronary Heart Disease ◽  
Nursing Roles

Percutaneous coronary intervention (PCI) is internationally recognised as the preferred initial treatment for acute coronary syndrome and as a treatment option for chronic coronary heart disease. The use of PCI has led to shorter inpatient stays. However, reduced length of stay can mean less opportunity for patient education. Once discharged from hospital, timely outpatient review encompassing symptom reassessment, advanced physical assessment, medication and cardiovascular risk management is a key component of patient care. In an Irish acute hospital setting, cardiology clinical nurse specialists and advanced nurse practitioners have established an advanced nurse-led post-PCI clinic. This article describes the post-PCI clinic and provides an overview of the patient profile and outcomes over a 2-year period, with an emphasis on advanced nursing roles and patient symptoms.

The ESC ACCA EAPCI EORP acute coronary syndrome ST-elevation myocardial infarction registry

2019 ◽  
Vol 6 (2) ◽  
pp. 100-104 ◽  
Author(s):  
Uwe Zeymer ◽  
Peter Ludman ◽  
Nicolas Danchin ◽  
Petr Kala ◽  
Aldo P Maggioni ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Coronary Intervention ◽  
Reperfusion Therapy ◽  
St Elevation Myocardial Infarction ◽  
Patient Profile ◽  
Coronary Syndrome ◽  
Percutaneous Coronary ◽  
St Elevation ◽  
Stemi Guidelines

Abstract Aims  The Acute Cardiac Care Association (ACCA)–European Association of Percutaneous Coronary Intervention (EAPCI) Registry on ST-elevation myocardial infarction (STEMI) of the EurObservational programme (EORP) of the European Society of Cardiology (ESC) registry aimed to determine the current state of the use of reperfusion therapy in ESC member and ESC affiliated countries and the adherence to ESC STEMI guidelines in patients with STEMI. Methods and results  Between 1 January 2015 and 31 March 2018, a total of 11 462 patients admitted with an initial diagnosis of STEMI according to the 2012 ESC STEMI guidelines were enrolled. Individual patient data were collected across 196 centres and 29 countries. Among the centres, there were 136 percutaneous coronary intervention centres and 91 with cardiac surgery on-site. The majority of centres (129/196) were part of a STEMI network. The main objective of this study was to describe the demographic, clinical, and angiographic characteristics of patients with STEMI. Other objectives include to assess management patterns and in particular the current use of reperfusion therapies and to evaluate how recommendations of most recent STEMI European guidelines regarding reperfusion therapies and adjunctive pharmacological and non-pharmacological treatments are adopted in clinical practice and how their application can impact on patients’ outcomes. Patients will be followed for 1 year after admission. Conclusion  The ESC ACCA-EAPCI EORP ACS STEMI registry is an international registry of care and outcomes of patients hospitalized with STEMI. It will provide insights into the contemporary patient profile, management patterns, and 1-year outcome of patients with STEMI.

scholarly journals Differing effects of beta-blockers on long-term clinical outcomes following percutaneous coronary intervention between patients with mid-range and reduced left ventricular ejection fraction

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jun Shitara ◽  
Ryo Naito ◽  
Takatoshi Kasai ◽  
Hirohisa Endo ◽  
Hideki Wada ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Ejection Fraction ◽  
Clinical Outcomes ◽  
Beta Blockers ◽  
Coronary Intervention ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Coronary Syndrome ◽  
Percutaneous Coronary

Abstract Background The aim of this study was to determine the difference in effects of beta-blockers on long-term clinical outcomes between ischemic heart disease (IHD) patients with mid-range ejection fraction (mrEF) and those with reduced ejection fraction (rEF). Methods Data were assessed of 3508 consecutive IHD patients who underwent percutaneous coronary intervention (PCI) between 1997 and 2011. Among them, 316 patients with mrEF (EF = 40–49%) and 201 patients with rEF (EF < 40%) were identified. They were assigned to groups according to users and non-users of beta-blockers and effects of beta-blockers were assessed between mrEF and rEF patients, separately. The primary outcome was a composite of all-cause death and non-fatal acute coronary syndrome. Results The median follow-up period was 5.5 years in mrEF patients and 4.3 years in rEF patients. Cumulative event-free survival was significantly lower in the group with beta-blockers than in the group without beta-blockers in rEF (p = 0.003), whereas no difference was observed in mrEF (p = 0.137) between those with and without beta-blockers. In the multivariate analysis, use of beta-blockers was associated with reduction in clinical outcomes in patients with rEF (hazard ratio (HR), 0.59; 95% confidence interval (CI), 0.36–0.97; p = 0.036), whereas no association was observed among those with mrEF (HR 0.74; 95% CI 0.49–1.10; p = 0.137). Conclusions Our observational study showed that use of beta-blockers was not associated with long-term clinical outcomes in IHD patients with mrEF, whereas a significant association was observed in those with rEF.

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