Aim: This study was conducted to examine the effect of self-management program on major advers cardiac complications of coronary angioplasty in patients referred to Tohid Hospital in Sanandaj, Iran, in 2018. Background: Coronary artery disease is the leading cause of death in people over 35 years of age in Iran. Coronary angioplasty is one of the most successful treatment techniques in people with coronary artery disease with some unwanted cardiac complications. Reducing these complications is one of the important goals of health care systems. Method: This was a quasi-experimental study that was conducted on 101 people with coronary artery disease undergoing angioplasty. The samples were selected by convenience sampling method based on inclusion criteria, and then randomly assigned to the experimental (n=51) and control (n=50) group. Data collection tools included a demographic information questionnaire and a checklist of coronary angioplasty complications. The intervention was implemented in sessions of 45 to 60 minutes duration three times per week in the presence of a family member and a copy was handed in. This intervention was continued for six months in the experimental group. During intervention period, the patient’, s condition and the implementation of the self-management program were followed up by phone. The control group received only routine care and the experimental group received both routine care and self-management program. Cardiac complications were assessed in the first, third and sixth months following intervention. Data were analyzed in SPSS version 21 using Chi-square, t-test and generalized estimation equations. Findings: The groups were homogenous in terms of age, gender, marital status, level of education, place of residence, employment status, body mass index, number of children, history of hyperlipidemia, history of diabetes, history of hypertension, history of alcohol consumption, history of heart attack, and type of artery involved. Generalized estimation equations showed that after intervention, the rate of complications of target vessel revascularization (P=0. 04), second coronary angioplasty, (P=0. 005) and coronary artery bypass graft surgery (P=0. 003) were significantly different between the control and experimental groups. However, there were no statistically significant difference between groups in terms of recurrent angina complications (P=0. 066), myocardial infarction (P=0. 069) and death (P=0. 019). Conclusion: The implementation of self-management program can reduce complications after coronary artery angioplasty. It is recommended for nurses to apply self-management programs and follow-up after discharge for this group of patients.

Background: Mean platelet volume (MPV) has been introduced as a simple and accurate method for assessing platelet function, which can be used as a prognostic marker for cardiovascular events. We investigated whether pre-procedural MPV could predict major adverse cardiac events (MACE) in candidates for elective percutaneous coronary intervention (PCI). Methods: In this large retrospective cohort, we reviewed the clinical and follow-up data of 4199 candidates (mean age = 59. 9 ± 10. 3 years; female patients = 1440 [34. 3%]) for elective PCI due to unstable angina (UA) or non-ST segment elevation myocardial infarction (NSTEMI). The primary endpoint of the study was the incidence of MACE defined as in-hospital mortality, cardiac death, nonfatal MI, target lesion revascularization (TLR) or target vessel revascularization (TVR). Based on the MPV level tertiles, patients were categorized into three groups for further comparison. Results: Higher MPV was significantly associated with older age (P < 0. 001), hypertension (P < 0. 001), diabetes mellitus (P = 0. 003), history of previous CABG (P < 0. 001) and lower levels of serum triglyceride (P < 0. 001). The frequency of 1-year MACE was 176 (4. 1%) with no significant difference between the MPV tertile groups. The highest MPV tertile could significantly predict MACE in the univariable model (hazard ratio = 1. 51, 95% confidence interval: 1. 05– 2. 17; P = 0. 026). In the adjusted model, the highest MPV tertile was a borderline predictor for MACE (hazard ratio = 1. 62, 95% CI: 0. 98– 2. 68; P = 0. 057). Conclusion: High MPV was associated with cardiovascular risk factors and older age while high MPV was a borderline independent predictor for 1-year MACE in the candidates for elective PCI.

Background: We aimed to recognize the predictors of long-term major adverse cardiac events (MACE) in the elderly candidates for elective percutaneous coronary intervention (PCI) at our center. Methods: In this retrospective cohort study, we reviewed the data of the elderly (age ≥ 65 years) candidates for elective PCI who met our study criteria, at Tehran heart center between 2004 and 2013. Demographic, anthropometric, clinical, angiographic, procedural and follow-up data of the enrolled patients were retrieved from the angiography/PCI databank of our center. The study characteristics of the patients with or without MACE were compared in a univariable Cox-regression analysis. A multivariable Cox-regression model was applied using variables selected from the univariable model to determine the predictors of MACE. Results: We reviewed the data of 2772 patients (mean age = 70. 8± 4. 7 years, male sex=1726 patients [62. 3%]) from which 393 patients (14. 4%) developed MACE. In the multivariable regression model, female sex was a protective factor for MACE (hazard ratio [HR] = 0. 701; P = 0. 001), while presence of diabetes mellitus (HR = 1. 333; P=0. 007), family history of coronary artery disease (CAD) (HR = 1. 489; P = 0. 003) and plain balloon angioplasty (HR = 1. 810; P = 0. 010) were independent risk factors for MACE. Conclusion: PCI is a safe and effective method of revascularization in the elderly patients, and some clinical and procedural factors can predict MACE in this group of patients.

Background: The aim of the present study was to develop a scoring system for predicting 1-year major adverse cardiac events (MACE), including mortality, target vessel or target lesion revascularization, coronary artery bypass graft surgery, and non-fatal myocardial infarction after percutaneous coronary intervention (PCI).Methods: The data were extracted from a single center PCI registry. The score was created based on the clinical, procedural, and laboratory characteristics of 8206 patients who underwent PCI between April 2004 and October 2009. Consecutive patients undergoing PCI between November 2009 and February 2011 (n=2875) were included as a validation data set.Results: Diabetes mellitus, increase in the creatinine level, decrease in the left ventricular ejection fraction, presentation with the acute coronary syndrome, number of diseased vessels, primary PCI, PCI on the left anterior descending artery and saphenous vein graft, and stent type and diameter were identified as the predictors of the outcome and used to develop the score (R²=0.795). The models had adequate goodness of fit (Hosmer-Lemeshow statistic; p value=0.601) and acceptable ability of discrimination (c-statistics=0.63). The score categorized the individual patients as low-, moderate-, and high-risk for the occurrence of MACE. The validation of the model indicated a good agreement between the observed and expected risks.Conclusion: An individual risk-scoring system based on both clinical and procedural variables can be used conveniently to predict 1-year MACE after PCI. Risk classification based on this score can assist physicians in decision-making and postprocedural health care.