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A manpower saving approach for patient education
Poster Presentation Sessions / International Journal of Cardiology 163S2 (2013) S1–S30
pool (SUVM/B) were associated with the overestimation. Myocardial SPECT and F-18 FDG PET/CT had a 67.1% identity in determining the latest activation site and 5.2% more viable myocardium was detected by 18F-FDG PET/CT than SPECT. Conclusion: Phase analysis by gated F-18 FDG PET/CT imaging should be cautiously applied in CAD patients with severe LV functional impairment and poor myocardial F-18 FDG uptake in assessing LV mechanical dyssynchrony.
P024 Assessment of right ventricular function in patients with acute myocardial infarction by tissue doppler H. Rashid. Cardiology department, Benha Faculty of Medicine, Benha University, Egypt Purpose: to assess the right ventricular function by using of tricuspid annular motion and tricuspid annular velocity determined by DTI in patients with AMI. Methods: thirty patients were included in this study, and diagnosed as acute myocardial infarction by ECG and cardiac enzymes, and 10 healthy volunteers as a control with matched age and sex. The patients divided into three groups: group I (14 patients) with inferior infarction which subdivided into IA (with RV infarction) and IB (without RV infarction), group II (16 patients) with anterior infarction, while group III included 10 normal healthy individuals. All patients subjected for full history taking, clinical examination, resting ECG, echocardiography to determine tricuspid anterior motion (TAM), LVEF, and RVEF, RV wall motion abnormalities. Tissue doppler was done with detection of tricuspid annulus systolic (Sa) and diastolic (Ea, Aa) velocities. Results: we found that 83% of patients with group IA had RV wall motion abnormalities versus 12% in group IB, but there was significant reduction on LVEF in group II. There was a significant reduction in systolic TAM in group I compared with both group II and group III (p<0.001). There was a significant reduction in group II compared with group III (p<0.05). The reduction was more pronounced in group IA compared to group IB (p<0.001). There was a significant reduction in Sa in group I compared with both group II and group III (p<0.01), also the peak Sa in group IA was highly significant reduced compared to group IB, (p<0.001). There was a significant correlation of Sa with both RVEF (p<0.001) and TAM (p<0.05). Conclusion: TAM by conventional M-mode echo and TAV by DTI can be used for RV function assessments
P025 Effect of amlodipine on platelet inhibition by clopidogrel in patients with ischemic heart disease: a randomized, controlled trial
S17
primary analysis involved the PRU values on day 28. The secondary analyses were percentage of platelet inhibition and poor responder to clopidogrel as defined by PRU >235. Results: Both groups experienced comparable day 28 PRUs (amlodipine: 227±84 vs. control 214±90; mean difference 12.7 and its 95% CI –22 to +47). Percentage of platelet inhibition (amlodipine 33% vs. control 38%, mean difference –4.5%, 95% CI –14% to +5%) and those of poor responder on day 28 (amlodipine 49% vs. control 45%; p=0.76) did not differ significantly. Conclusion: Concomitant amlodipine has no negative impact on clopidogrel-mediated platelet inhibition in patients with ischemic heart disease.
P026 A manpower saving approach for patient education S.Y. Chair, M.Y. Chau, J.W.H. Sit, E.M.L. Wong, A.W.K. Chan, D.Y.P. Leung, O.W.M. Fung, S.P.Y. Pun, D.Y.S. Wong. The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong Background: Cardiac catheterization (CC) is an essential diagnostic procedure for coronary artery disease. Patient education has been proved to be an essential element in patient care. However, it is time consuming for providing education especially during a manpower shortage period. Methods: Patients preparing for the first-time CC were recruited. Usual care included a written pamphlet and brief verbal information regarding the CC. Patients in the intervention group received a 12minute educational DVD regarding CC. Questions will be answered after the DVD. Anxiety and uncertainty levels were measured before the DVD session and within two hours before CC; while patients’ satisfaction and perceived knowledge gain were measured at 20–24 hours after CC. Results: 128 patients completed the study with 83 (64.8%) male and 45 (35.2%) female patients. The mean age was 61.3 years old (SD=11.65). There was a significant difference between the two groups across time on anxiety level (F1,126=26.39, p<0.001) and uncertainty (F1,126=69.06, p<0.001) with the interventional group experienced a significant lower anxiety and uncertainty levels. T-tests showed statistically significant difference between the two groups on satisfaction level (t=3.627, p=0.016) and knowledge gain (t=0.336, p=0.002) favoring the interventional group. Conclusion: Using DVD with pamphlet is a manpower saving way to prepare patients for CC. The approach is effective in reducing patients’ anxiety and uncertainty levels, as well as producing higher satisfaction and knowledge levels.
P027 Is it safe to keep patients in bed for only two hours after femoral cardiac catheterization?
A.Y.W. Li 1 , F.H. Ng 1 , F.K.L. Chan 2 , P. Tunggal 1 , K. Chan 1 , Y.K. Lau 1 . 1 Department of Medicine and Geriatrics, Ruttonjee Hospital, Hong Kong, China; 2 Department of Medicine & Therapeutics, The Chinese University of Hong Kong, China
S.Y. Chair, W.K.W. So, S.P.Y. Pun, E.M.L. Wong, J.W.H. Sit, O.W.M. Fung, D.Y.S. Wong, C.W.H. Chan, A.W.K. Chan. The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong
Objective: Amlodipine inhibits CYP450 enzyme and has the potential to reduce clopidogrel bioactivation in vivo. Reports in previous retrospective studies described greater platelet reactivity in patients on amlodipine. The aim of this study is to evaluate the treatment effect of clopidogrel in patients on amlodipine versus not on calciumchannel blockers. Methods: Ninety-eight patients on clopidogrel for ischemic heart disease were recruited consecutively and randomized to take either amlodipine or drugs with inert CYP450 effect as control. The authors quantified the P2Y12 reaction unit (PRU) of platelets with VerifyNow assay using whole blood obtained at baseline and on day 28. The
Background: After trans-femoral diagnostic cardiac catheterization, bed rest and immobilization of the affected leg are recommended to prevent vascular complications. Objective: To review the effects of different lengths of bed rest after trans-femoral diagnostic cardiac catheterization. Design: Systematic review of randomized and quasi-randomized controlled trials Methods: Ten literature databases, reference lists of relevant articles and conference proceedings were searched. Key organizations and researchers in the field were also approached. All randomized and quasi-randomized controlled trials that compared the effects of dif-
pool (SUVM/B) were associated with the overestimation. Myocardial SPECT and F-18 FDG PET/CT had a 67.1% identity in determining the latest activation site and 5.2% more viable myocardium was detected by 18F-FDG PET/CT than SPECT. Conclusion: Phase analysis by gated F-18 FDG PET/CT imaging should be cautiously applied in CAD patients with severe LV functional impairment and poor myocardial F-18 FDG uptake in assessing LV mechanical dyssynchrony.
P024 Assessment of right ventricular function in patients with acute myocardial infarction by tissue doppler H. Rashid. Cardiology department, Benha Faculty of Medicine, Benha University, Egypt Purpose: to assess the right ventricular function by using of tricuspid annular motion and tricuspid annular velocity determined by DTI in patients with AMI. Methods: thirty patients were included in this study, and diagnosed as acute myocardial infarction by ECG and cardiac enzymes, and 10 healthy volunteers as a control with matched age and sex. The patients divided into three groups: group I (14 patients) with inferior infarction which subdivided into IA (with RV infarction) and IB (without RV infarction), group II (16 patients) with anterior infarction, while group III included 10 normal healthy individuals. All patients subjected for full history taking, clinical examination, resting ECG, echocardiography to determine tricuspid anterior motion (TAM), LVEF, and RVEF, RV wall motion abnormalities. Tissue doppler was done with detection of tricuspid annulus systolic (Sa) and diastolic (Ea, Aa) velocities. Results: we found that 83% of patients with group IA had RV wall motion abnormalities versus 12% in group IB, but there was significant reduction on LVEF in group II. There was a significant reduction in systolic TAM in group I compared with both group II and group III (p<0.001). There was a significant reduction in group II compared with group III (p<0.05). The reduction was more pronounced in group IA compared to group IB (p<0.001). There was a significant reduction in Sa in group I compared with both group II and group III (p<0.01), also the peak Sa in group IA was highly significant reduced compared to group IB, (p<0.001). There was a significant correlation of Sa with both RVEF (p<0.001) and TAM (p<0.05). Conclusion: TAM by conventional M-mode echo and TAV by DTI can be used for RV function assessments
P025 Effect of amlodipine on platelet inhibition by clopidogrel in patients with ischemic heart disease: a randomized, controlled trial
S17
primary analysis involved the PRU values on day 28. The secondary analyses were percentage of platelet inhibition and poor responder to clopidogrel as defined by PRU >235. Results: Both groups experienced comparable day 28 PRUs (amlodipine: 227±84 vs. control 214±90; mean difference 12.7 and its 95% CI –22 to +47). Percentage of platelet inhibition (amlodipine 33% vs. control 38%, mean difference –4.5%, 95% CI –14% to +5%) and those of poor responder on day 28 (amlodipine 49% vs. control 45%; p=0.76) did not differ significantly. Conclusion: Concomitant amlodipine has no negative impact on clopidogrel-mediated platelet inhibition in patients with ischemic heart disease.
P026 A manpower saving approach for patient education S.Y. Chair, M.Y. Chau, J.W.H. Sit, E.M.L. Wong, A.W.K. Chan, D.Y.P. Leung, O.W.M. Fung, S.P.Y. Pun, D.Y.S. Wong. The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong Background: Cardiac catheterization (CC) is an essential diagnostic procedure for coronary artery disease. Patient education has been proved to be an essential element in patient care. However, it is time consuming for providing education especially during a manpower shortage period. Methods: Patients preparing for the first-time CC were recruited. Usual care included a written pamphlet and brief verbal information regarding the CC. Patients in the intervention group received a 12minute educational DVD regarding CC. Questions will be answered after the DVD. Anxiety and uncertainty levels were measured before the DVD session and within two hours before CC; while patients’ satisfaction and perceived knowledge gain were measured at 20–24 hours after CC. Results: 128 patients completed the study with 83 (64.8%) male and 45 (35.2%) female patients. The mean age was 61.3 years old (SD=11.65). There was a significant difference between the two groups across time on anxiety level (F1,126=26.39, p<0.001) and uncertainty (F1,126=69.06, p<0.001) with the interventional group experienced a significant lower anxiety and uncertainty levels. T-tests showed statistically significant difference between the two groups on satisfaction level (t=3.627, p=0.016) and knowledge gain (t=0.336, p=0.002) favoring the interventional group. Conclusion: Using DVD with pamphlet is a manpower saving way to prepare patients for CC. The approach is effective in reducing patients’ anxiety and uncertainty levels, as well as producing higher satisfaction and knowledge levels.
P027 Is it safe to keep patients in bed for only two hours after femoral cardiac catheterization?
A.Y.W. Li 1 , F.H. Ng 1 , F.K.L. Chan 2 , P. Tunggal 1 , K. Chan 1 , Y.K. Lau 1 . 1 Department of Medicine and Geriatrics, Ruttonjee Hospital, Hong Kong, China; 2 Department of Medicine & Therapeutics, The Chinese University of Hong Kong, China
S.Y. Chair, W.K.W. So, S.P.Y. Pun, E.M.L. Wong, J.W.H. Sit, O.W.M. Fung, D.Y.S. Wong, C.W.H. Chan, A.W.K. Chan. The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong
Objective: Amlodipine inhibits CYP450 enzyme and has the potential to reduce clopidogrel bioactivation in vivo. Reports in previous retrospective studies described greater platelet reactivity in patients on amlodipine. The aim of this study is to evaluate the treatment effect of clopidogrel in patients on amlodipine versus not on calciumchannel blockers. Methods: Ninety-eight patients on clopidogrel for ischemic heart disease were recruited consecutively and randomized to take either amlodipine or drugs with inert CYP450 effect as control. The authors quantified the P2Y12 reaction unit (PRU) of platelets with VerifyNow assay using whole blood obtained at baseline and on day 28. The
Background: After trans-femoral diagnostic cardiac catheterization, bed rest and immobilization of the affected leg are recommended to prevent vascular complications. Objective: To review the effects of different lengths of bed rest after trans-femoral diagnostic cardiac catheterization. Design: Systematic review of randomized and quasi-randomized controlled trials Methods: Ten literature databases, reference lists of relevant articles and conference proceedings were searched. Key organizations and researchers in the field were also approached. All randomized and quasi-randomized controlled trials that compared the effects of dif-