The Relationship between Type of Cardiovascular Procedure and the Incidence of post-procedure Complications among Adults Treated for Cardiac Disease
Background
In the contemporary clinical practices, the programs of cardiac stenting constitute a primary approach through which modifiable risk factors are tackled in the setting of the secondary intervention of the diagnosis of cardiovascular disease. Nevertheless, there has been a broader agreement concerning the fact that the CVD’s primary prevention is a worthwhile and effective approach to improving wellness among the CVD patients (Artero et al., 2012). Additionally, there have also been scientific and technical advances in the area of coronary revascularization that have brought about new fields of evidence and the unique challenges having uncertainty, with respect to the current multi-vessel CAD’s optimal management. In spite of the improvements for the past ten years, data from the national and global surveys has revealed that a reasonable number of patients cannot effectively control their elevated blood pressure. It has been argued that one of the leading risk factors for international disease burden is the high blood pressure resulting from the coronary artery disease (Nakanishi et al. 2012; Kashiwagi et al., 2013). This research seeks to provide the current body of the evidence which demonstrates the efficacy of the people’s health and wellness programs based on the goals of the Healthy People 2020. McManus et al. (2014) have argued that it is possible to make comparisons between self-monitoring with self-titration of antihypertensive medication and those with usual care resulting in the lower systolic blood pressure over one year. This situation is prevalent among patients who have hypertension at high risk of cardiovascular disease. The key health concern of this program has been to improve the lives of the people around the world by reduction of the deaths rates caused by cardiovascular diseases among others. Additionally, this paper will be important as it will present a discussion of the vital aspects to consider in the implementation and development of the wellness and health initiatives, with a primary goal of reducing the rates as well as the prevalence of cardiovascular disease and also preventing the diagnosis of CV.
Analysis of Quantitative Articles
Many studies have been conducted concerning CVD based on the cardiovascular procedures that seek to improve the wellness of the adults suffering from this disease. Firstly, Lee et al. (2016) studied the complications of cardiac characterization in the structural heart disease (SHD). This study utilized a blend of quantitative and qualitative research methods. The qualitative research design was important as it provided the background information concerning the cardiac stenting involving the cardiac characterization complications in SHD. On the other hand, quantitative design was helpful in the provision of the statistical data where the 2071 cardiac characterization were conducted at the Seoul National University Children’s Hospital, and these data was used in the research analysis. This data indicates that the study used random sampling where the participants were picked randomly in the hospital setting and found to have cardiac complications in the SHD. The data obtained was obtained from the inferential statistics because it was a portion of the entire population of the hospital patients. In this case, the results were that the overall complication accounted for 16. 2 percent, while severe complication and mortality rates were 1.15 percent and 0.19 percent respectively. The limitation of this retrospective research was that there were losses of the minor data since there was no inclusion of gastroinstentinal complications in the prior studies. It was concluded that the increased complexity of cardiac characterization in SHD due to the rise in the incidence of therapeutic characterization in many advanced centers today has called for the efforts of prevention.
McManus et al. (2014) sought to examine the impact of medication self-titration and self-monitoring in comparison with the usual care on the systolic blood pressure among the individuals suffering from CVD, chronic kidney disease, and diabetes. The design employed by the researchers involved the quantitative research where the data was obtained from the primary care trials for statistical analysis. The sampling strategy used was the unblended randomized clinical trials where 552 patients aged over 35 years with the coronary heart disease, chronic kidney disease or stroke were used. Also, the baseline blood pressure for such patients was more than 130/80 mm Hg under treatment at 59 UK primary care practices, between March 2011 and January 2013. The data gathered was from the inferential statistics because it was part of the entire population of the primary care. This study made a conclusion that lower systolic blood pressure recorded for one year was realized among the patients who had hypertension at high risk of CVD, self-monitoring and self-titration of antihypertensive medication in comparison with the usual care. The limitation encountered in this article is the issue of generalization of the findings concerning the research problem.
Gu et al. (2016) investigated an issue of the rise in the prevalence of depression and anxiety symptoms in patients suffering from coronary heart disease prior to and after the intervention treatment of percutaneous coronary in the context of cardiac stenting. The design used comprised a mixture of the qualitative and quantitative methods. While the qualitative approach provided the description of the variables examined in this study, the quantitative method offered the statistical data and analysis. The sampling strategy involved a randomized selection of 170 patients with CHD treated for PCI between September 2013 and February 2014 at the hospital known as the Second Hospital of Hebei Medical University. Inferential statistics was utilized in the collection of the data regarding the incidences of CHD. It was concluded that there was a significant rise in the persistence of the symptoms of depression, anxiety, and comorbid depression and anxiety a day before and after the treatment of PCI (Gu et al., 2016). On the other hand, there was a decline in the incidence of the psychological problems as time advanced resulting from PCI. One of the limitations of this study is that HADS that are not standardized are broadly utilized by physicians in general hospitals in the assessment of the suspected depression or anxiety disorder, which may lead to positive results which are fault.
Yoshimura et al. (2015) utilized descriptive statistic in the evaluation of the accuracy of the newly developed quantitative approach by use of computed topography angiography (CTA) that is 64 multi-sliced in the detection of the coronary in-stent restenosis (ISR). The sampling strategy involved CTA performance on 45 patients who went through the implantation of stent (79 lesions), where the evaluation of the accuracy to diagnose ISR was performed by making comparison with the invasive coronary angiography (ICA). The authors make conclusions that the ISR evaluation by use of SRI is greater than the visual estimation of CTA. This study had two main limitations. The first one was that the new technique did not attain the statistical significance during the diagnosis of sensitivity, NPV, PPV, and ISR as opposed to the visual evaluation (Yoshimura et al., 2015). The second limitation is that there was no consideration of the materials and structure of stent since the artifacts resulting from the thickness of strut did not have an influence on the results, and thus the two situations need to be handled in the future research.
Artero et al. (2012) analyzed the relationship between ideal cardiovascular health and disease-specific death using descriptive statistics. The quantitative research design was used where the statistical data was used for the research analysis. The strategy of sampling that the researchers utilized comprised data resulting from the Aerobics Center Longitudinal Study from October 1947 to March 1999. This study sought to estimate the ideal cardiovascular health prevalence among the 11,993 people and also to investigate the relationship it has with the deaths from all forms of causes, cancer and CVD. It was concluded that the prevalence of the ideal CVD was very low in a cohort of middle-aged women and men from 1987 to 1999 (Artero et al., 2012). The limitations of this study were that majority of the participants were white, middle to upper socioeconomic status, and well educated. There was also was lack of sufficient data concerning the sugar-sweetened beverages among the components of diets and yet another cause of cardiovascular health issues.
Summary of Statistical Results
The articles studied have presented several results concerning the effectiveness of the wellness and health program in addressing cardiovascular problems among the adults. Most of the studies have used descriptive statistics in the presentation of the results. Firstly, Lee et al. (2016) presented the results that the severe complication, the mortality rates, and the overall complication were 1.15 percent, 0.19 percent, and 16.2 percent respectively. In this case, the aspects which brought about a significant increase in the severe and overall complications risk included the use of anticoagulant prior to the procedure, where the p=0.012 when the odd ratio (OR) = 1.83 and p=0001 when OR is 6.45. Secondly, Yoshimura et al. (2015) offered the findings that the qualitative evaluation when applying stent restenosis index (SRI) for the positive predictive value, sensitivity, accuracy, specificity, and negative predictive value were was 64 percent, 82 percent, 91 percent, 93 percent, and 97 percent. In comparison with the qualitative evaluation data, the visual evaluation showed 35 percent, 78 percent, 76 percent, 75 percent, and 95 percent respectively. Gu et al. (2016) provided the results that a significant rise in the persistence of the symptoms of depression, anxiety, and comorbid depression and anxiety a day before and after the treatment of PCI was realized. In a similar vein, a decline in the incidence of the psychological problems as time advanced resulting from PCI was observed. Additionally McManus et al. (2014) found out that there was a lower systolic blood pressure recorded for 12 months among the patients with hypertension at high risk of CVD, self-monitoring and self-titration of antihypertensive medication whose comparison was made with the usual care. The results by Artero et al. (2012) were that only 29 individuals, accounting for 0.2 percent had 7 ideal metrics in the whole cohort. Also, examination year, alcohol intake, parental history of CVD, and sex examination resulted in 55 percent lower risk of death because of CVD among the participants who fulfilled 3 or 4 ideal metrics. Those with 5 to 7 ideal metrics were 63 percent lower in comparison with those who fulfilled 0 to 2 ideal metrics (whose confidence interval was 95 percent and hazard ratio was 0.37).
Based on the results above, it is evident that wellness and health programs play a critical role in improving the lives of the adults with cardiac health issues. The results provide a relationship between the cardiovascular procedures in relation to the cardiac stent and the condition of the post-procedure complications for the adults who are treated for the cardiac disease. Though there seems to be no consensus concerning the management of the cardiac diseases such as the coronary artery diseases, and thus, there is a necessity of considering the intense risk factors modification of the secondary and primary prevention (Sun & Almutairi, 2010). Additionally, an important and yet a less captured aspect is the economic impact associated with the treatment for the wellness of the cardiac disease (Ferreira et al., 2016).
Summary of Interventions
Since I work in an open heart recovery unit, the interventions provided in most of the studies align my practice-based problem and research-based interventions. Most importantly, the studies have revealed how cardiac disease have increasingly caused high rates of deaths in the world and thus need wellness and health programs as clinical interventions. Such interventions would lead to the improvement of the quality of life of people. The studies have identified the cardiovascular diseases which include coronary artery diseases and heart failures among others have contributed to high rates of mortality and morbidity. Because of this issue, there is a growing need for the cardiovascular procedures in relation to the cardiac stent to reduce post-procedure complications among the people who require cardiac disease treatment. In some studies, authors have suggested the selection of the patients for therapeutic characterization with care and improved management and methods in the course of pre-procedural period for the reduction of complications in the cardiac stent. Further findings indicate it is possible to reduce the deaths resulting from cardiovascular diseases can be addressed by primordial prevention. Other studies have provided treatment alternatives such as risk modification for cardiac health issues to improve the patients’ health and wellness. In conclusion, all these wellness and health interventions have focused on the reduction of morbidity and mortality rates among the adults caused by cardiovascular diseases. In effect, there would be improved quality of life among the people in line with the goals of the Healthy People 2020.
References
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