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Showing 1-20 of 42 trials
NCT06890312
While the reduced hemorrhagic risk of radial access for percutaneous coronary intervention compared to femoral access is well-established, its main complication remains radial artery occlusion, which can occur in up to 30% of patients. Anticoagulation is the primary preventive measure recommended in clinical practice to reduce the risk of this complication, typically involving heparin injection during the procedure in most centers. However, data on the effect of the timing of heparin injection are limited. The investigators hypothesize that injection of heparin before sheath insertion may reduce the rate of radial artery occlusion compared with injection after sheath insertion.
NCT03632785
Approximately 50% of coronary events occur in previously asymptomatic patients. Thus, the early detection of the individuals at higher risk became an important research target within the current cardiology. The various clinical scores used present a predictive accuracy for ischemic events, evaluated by the ROC curve, which ranges from 0.73 to 0, 79. Therefore, the introduction of new non-invasive techniques for the detection of atherosclerosis aims to allow a more adequate classification of risk. The development of radiological techniques, fundamentally coronary angiotomography of multiple detectors (CAMD) and electron beam computed tomography-EBCT‖, demonstrated that the degree of coronary calcification correlates with endothelial lesion and individual prognosis in the long term. Notably, the calcium score has a weak correlation with the severity of coronary stenosis per se, possibly due to variations in arterial remodeling due to coronary calcification. On the other hand, the CAMD allows the detection of a small magnitude atheromatous disease, not diagnosed clinically, nor by tests provoking ischemia, or even by coronary catheterization. The clinical relevance of the small magnitude atheromatous disease diagnosed by the ACMD and its correlation with plaque vulnerability markers, mainly platelet aggregation, vascular reactivity, and inflammation are still not well determined. This is a case and control study and we will enrolled 90 patients with low and medium risk of cardiovascular event whose cases should present discrete plaques in the CAMD e controls should present none plaque in coronary stenosis Coronary atherosclerotic disease often begins in the transition from childhood to adolescence, progressing slowly and quietly. Its clinical manifestation occurs in the majority of cases from the 4th decade of life. However, it is important to remember that necropsy studies conducted in the 1970s identified the presence of non-obstructive atherosclerotic plaques in the aorta of individuals from the second decade of life. From its first description to the present day, the subject has been deeply studied, providing reliable information on several mechanisms involved in atherogenesis, disease progression and plaque unstabilization, which may occur in a silent manner or lead to a clinical picture of unstable myocardial ischemic syndrome (UMIS). In this period, classic risk factors for coronary artery disease (age, sex, diabetes mellitus, systemic arterial hypertension, hypercholesterolemia and smoking, among others) were described, and risk scores were developed that aid in the individual prediction of the probability of disease manifestation coronary artery disease (CAD). The most widespread of these scores is that developed from the population of Framingham, which was started in the United States of the same name after 1948. Subjects with no evidence of cardiovascular disease were followed prospectively with biannual evaluations. The data obtained allowed the elaboration of an algorithm of prediction of individual risk that is included in the most recent recommendations of evaluation of cardiovascular risk. However, these traditional clinical assessment scores tend to underestimate cardiovascular risk in some populations, especially in women and young individuals. In the global population, the various clinical scores used have a predictive accuracy for ischemic events, as assessed by the ROC (Receiver Operating Characteristic) curve, ranging from 0.73 to 0.79. In this way, the concept of "detection interval" is proposed. Defined by the difference between cases of coronary disease or cardiovascular events detected and the actual total prevalence of atherosclerotic disease in the population, such detection interval opens a new field for the introduction of new non-invasive atherosclerosis investigation techniques. Taking into account that approximately 50% of coronary events occur in previously asymptomatic patients, the early detection of these individuals at greater risk has become an important research target within the current cardiology. More recently, the development of radiologic techniques, fundamentally coronary angiography of multiple detectors (CAMD) and electron beam computed tomography (EBCT), have demonstrated that the degree of coronary calcification correlates with endothelial lesion and individual prognosis in the long term, allowing to refine the clinical classification of a patient's risk for a greater or lesser chance of fatal and non-fatal events. Notably, the calcium score has a weak correlation with the severity of coronary stenosis per se, possibly due to variations in the arterial remodeling due to coronary calcification. On the other hand, calcification of the coronary arteries is known to be associated with lower myocardial blood flow even in the absence of significant stenosis. This means that calcification is not merely a marker of obstructive coronary disease and may predispos
NCT07483619
This study investigated whether virtual reality (VR) can reduce pain and anxiety in patients undergoing coronary angiography. Coronary angiography is a common cardiac procedure performed under local anesthesia while patients remain awake, which can cause significant pain and anxiety. Adult patients scheduled for elective coronary angiography were randomly assigned to two groups: one group watched a nature-themed VR video during the procedure, while the control group received standard care. Pain and anxiety levels were measured before and after the procedure using validated scales. The findings of this study may help healthcare providers offer a simple, non-pharmacological method to improve patient comfort during coronary angiography.
NCT01001663
Is the FemoSeal® closure device safer and more comfortable than manual compression for femoral artery access closure after coronary angiography?
NCT03142126
The researchers are seeking to study whether or not there is benefit in keeping patients flat after Angioseal for extended periods of time after diagnostic heart catheterization or if a more aggressive approach of early ambulation would be just as safe while improving cost and patient comfort.
NCT04982419
This is a prospective, double-blind, sham-controlled, multicenter, randomized clinical trial is to study the effects of remote ischemic preconditioning on contrast-associated acute kidney injury, functional capacity, and major adverse kidney events in in patients with congestive heart failure undergoing cardiac catheterization and/or percutaneous coronary intervention.
NCT07138430
This study explores the impact of virtual reality (VR) interventions on patient outcomes during coronary angiography procedures. It evaluates the effectiveness of VR in reducing patient anxiety, enhancing comfort, and improving overall satisfaction. The findings suggest that the use of VR as a non-pharmacological support tool can positively influence patients' emotional states, reduce perceived stress levels, and potentially improve cooperation during the procedure. These results highlight the potential of immersive technologies to support patient-centered care in interventional cardiology settings.
NCT07184918
This clinical trial evaluates whether continuing or withholding ACE inhibitors (specifically Ramipril) before coronary angiography affects the risk of contrast-induced nephropathy (CIN). CIN is a known complication of iodinated contrast exposure, particularly in patients with chronic conditions such as hypertension or diabetes. The trial involves 44 adult patients randomized into two groups: one continuing Ramipril and the other withholding it 48 hours before and restarting 72 hours after the procedure. Renal biomarkers including serum creatinine, NGAL, and superoxide dismutase will be assessed to evaluate renal function.
NCT06916351
This randomized controlled experimental study aimed to determine the effects of acupressure applied before the procedure on pain, anxiety and vital signs in patients who applied to Kocaeli City Hospital Angiography Unit and were to undergo planned radial artery coronary angiography.
NCT05340998
All patients who undergo to percutaneous coronary diagnostic or interventional procedures through transradial access (TRA) will be screened for inclusion in this prospective observational study and patients with TRA failure necessitating vascular crossover will be included in the Registry after signing a dedicated written informed consent. A Control group of consecutive patients with radial access and without crossover will be included. Primary end point of the study is the rate of in-hospital vascular complications and major bleeding in crossover vs non crossover groups
NCT06725875
Coronary artery disease (CAD) is the leading cause of mortality and morbidity worldwide. Coronary Angiography (CAG) is an invasive method used in the diagnosis and treatment of CAD. Invasive methods such as coronary angiography cause pain. The sympathetic nervous system is stimulated and vital functions can be affected by the increased stress level of the pain experienced. In the angiography laboratory, patients are awake, aware of everything, and can easily hear the sounds of the monitor and the comments and conversations of the healthcare team. This auditory exposure can further trigger the patient's fear and anxiety and increase their pain. Increased anxiety can lead to an increase in the intensity of perceived pain and a decrease in pain tolerance. In addition to anxiety, catastrophizing such as fear of death can also be a means for disability and complications. In the literature, it is recommended to use nonpharmacological methods together with pharmacological treatment to increase pain tolerance and improve patient comfort and satisfaction in patients affected by invasive procedures. Nonpharmacological methods, unlike pharmacological agents, do not cause any harm to patients. It can help to keep physiological parameters such as blood pressure, respiration and pulse rate at normal levels and to increase comfort and satisfaction with the procedure. Sound therapy, which is a non-pharmacological method, turns the person's attention from negative stimuli to positive and hopeful feelings and can reduce stress, anxiety and pain. Non-pharmacological methods such as white noise therapy and using earplugs that prevent sound permeability can be used to distract the patient's attention from the source of stress and focus on other thoughts. It is suggested that patients exposed to 50 to 55 dB white noise experience pain relief and have an effect on heart rate and oxygen saturation (12). As a result of our literature review, no studies were found where white noise was applied during coronary angiography. This situation reveals the originality of our study. With white noise, the patient can be isolated from ambient sounds during the procedure and the stress experienced can be controlled, the increase in pain intensity and decrease in tolerance that may occur due to stress can be controlled, and the patient's comfort and satisfaction level during the procedure can be increased. We think that the patient's compliance during the procedure can be increased. The noise in the units affects the anxiety levels of the patients. The literature supports that the use of earplugs increases the comfort of the patient. In the study investigating the effect of auditory interventions on pain and comfort, it was determined that the pain level and heart rate were lower and the comfort level was higher in patients using earplugs compared to the control group. More evidence is needed on the effect of earplugs on physiological parameters, pain, comfort and procedure satisfaction of the patients by applying them to different patient groups. As a result of our literature review, no study was found where earplugs were applied during the coronary angiography procedure. This situation reveals another originality of our study. The nurse involved in every step of coronary angiography aims to ensure that the patient benefits from the procedure to a high extent and to increase the quality of the procedure by integrating innovative methods. Nursing practices that increase the quality of the procedure are included in national and international nursing care guidelines. Therefore, in order to implement quality nursing care, it is necessary to increase the number of randomized controlled experimental studies and to increase the level of evidence. The fact that our study was a pre-test post-test randomized controlled double-blind study will increase the level of evidence in this regard. This situation reveals another originality of our study. This study will use a randomized pre-test and post-test control group experimental design. It is planned that a total of 150 patients will participate in the study; 50 in the white noise group, 50 in the earplug group, and 50 in the control group. Data of the study will be collected via ''Personal information form, Numeric Pain Scale (NPS), Numeric Satisfaction Scale (NMS), Numeric Comfort Scale (NKS)''. A web-based randomization system will be used to determine the groups in the study. Pulse rate, respiratory rate, systolic blood pressure (SBP), diastolic blood pressure (DBP) and oxygen saturation values (SpO2) will be evaluated before, during, and after the procedure. Pain, satisfaction, and comfort levels will be evaluated at the end of the procedure. Interventions will be performed by the researcher and the patients will be observed throughout the intervention.
NCT06602128
This randomised controlled trial will be conducted to evaluate the effect of breathing exercise on anxiety, pain and vital signs in patients undergoing coronary angiography before angiography. Hypotheses of the study; H11: The anxiety level of the patients who underwent breathing exercise is lower than the patients in the control group. H12: The pain level of the patients who underwent breathing exercise is lower than the control group H13: The vital signs of the patients who underwent breathing exercises are within normal limits compared to the control group. In the study, there will be an intervention group in which breathing exercise will be applied and a control group in which no intervention will be applied. Data will be collected with the pre-test data collection form half an hour before the angiography procedure in patients in the intervention and control groups. Patients in the intervention group will be given breathing exercises, while patients in the control group will not be subjected to any intervention. After the angioplasty procedure, data will be collected from the intervention and control groups with post-test data collection forms.
NCT06572670
This study was planned to examine the effects of progressive relaxation exercise on anxiety, comfort, pain and physiological parameters in patients undergoing coronary angiography. The data of the study will be collected using the Descriptive Characteristics Questionnaire Form, State and Trait Anxiety Inventory, Perianesthesia Comfort Questionnaire, Visual Analog Scale (VAS), Vital Signs Follow-up Form, Complication Follow-up Form and Progressive Relaxation Exercise Application Guidelines.
NCT04691037
The investigator aims to prospectively enroll patients who were referred for coronary computed tomography angiography (CCTA) for the assessment of stable chest pain (SCP) suspected of obstructive coronary artery disease (CAD). All patients underwent CCTA according to established guidelines and local institutional protocols. The imaging data were evaluated using different image post-processing software to comprehensively analyse anatomical, functional and histological information of coronary. This study will determine if CCTA-based imaging evaluation can provide more informaton to improve clinical management for SCP, including fewer MACE and better decision-making of downstream investigations and therapeutic interventions.
NCT06035783
In calcified lesions, optimal stent placement and expansion may prove to be challenging. Lesion preparation is necessary to facilitate optimal stenting in calcified lesions, for which orbital atherectomy can used. Therefore the aim of this study is to: 1. Show that orbital atherectomy effectuates optimal stent expansion 2. Investigate the mechanics of lesion preparation when using orbital atherectomy Patients presenting with a significant and severely calcified lesion in need of orbital atherectomy will undergo optical coherence tomography guided orbital atherectomy and stent placement.
NCT05982366
The distal transradial approach (dTRA) via the anatomical snuffbox is hypothesized to be more beneficial than the conventional transradial access (cTRA) in patients undergoing coronary procedures. This prospective single-center randomized trial was designed to investigate the safety, efficacy, and various ultrasound parameters of dTRA.
NCT04194606
The objective of the study is to determine that a coronary angiography (CAG) or percutaneous coronary intervention (PCI) via a distal puncture of the radial artery (distal transradial access, dTRA) leads to a lower rate of radial artery occlusion (RAO) while also showing that it has a similar success rate when compared to the traditional proximal (proximal transradial access, pTRA) puncture site.
NCT03375411
This is a First In Man study with the aim to know the safety and effectiveness of a novel bare metal stent (INC-1) in the treatment of de novo coronary lesions in patients with stable coronary angina and unique coronary lessions.
NCT05546216
In addition to pharmacological methods, non-pharmacological methods are also used to control back pain and anxiety. The aim of the study is to determine the effect of 30 degrees raised supine position and back support applied to patients undergoing coronary angiography from the femoral artery on back pain, anxiety and patient comfort. This research was planned as a pretest-posttest randomized, controlled, experimental study in order to determine the effect of the elevated supine position and back support application applied to patients undergoing coronary angiography with femoral artery access on back pain, anxiety and comfort levels of patients. Research Kahramanmaraş Sütçü İmam University SUAH Hospital Cardiology intensive care unit September 2021 - September The sample of the research was determined by power analysis. According to the calculation made, the sample; With an effect size of 0.90, a margin of error of 0.05, a confidence interval of 0.95, and a power of 0.95, it was calculated that there should be 35 people in each group to represent the universe. "Patient Information Form", "Numeric Pain Intensity Scale VAS", "State- The necessary information of the patient will be collected with the "Trait Anxiety Scale" and the "Immobilization comfort scale". After the information of the patient whose hemodynamics is provided, the experimental group will be given a 30 degrees Elevated Supine Position and the back area will be supported with a 36x33x10 sized silicone gel pad that prevents sweating, and the measurements will be repeated at the 2nd and 4th hours after the CAG procedure. The patients in the control group will have the same measurements at the 0th hour, 2nd hour and 4th hour after the femoral angiography procedure. During this period, the patients will remain in the straight supine position without back support, which is routinely applied in the clinic.
NCT04801901
Prospective randomized non-blinded study to determine degree of vessel trauma and adverse remodeling of the proximal forearm radial artery following distal radial artery access (dTRA) for cardiac catheterization compared to standard forearm transradial access (fTRA).