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Li T, Lu FH, Zhao Q. Impact of specialized nursing outpatient case management on post-coronary artery bypass grafting patients. World J Clin Cases 2024; 12:3035-3044. [DOI: 10.12998/wjcc.v12.i17.3035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 04/23/2024] [Accepted: 05/14/2024] [Indexed: 06/04/2024] Open
Abstract
BACKGROUND Some patients with coronary atherosclerotic heart disease experience major adverse cardiac events (MACE) and require readmission after Coronary Artery Bypass Grafting (CABG) surgery. This is often attributed to patients' unhealthy lifestyles and dietary habits, inadequate understanding of the disease, and poor disease management compliance. Thus, searching for more targeted nursing intervention models that can enhance patients' self-management abilities and reduce the risk of readmission after CABG surgery is significant.
AIM To observe the impact of specialized nursing outpatient case management on patients after CABG surgery.
METHODS A total of 103 patients who underwent CABG surgery in our hospital between April 2021 and April 2022 comprised the study sample. The patients were divided into two groups using an odd-even number grouping method. The control group received routine nursing care, while the case management group received specialized nursing outpatient case management. The differences in psychological status, adherence to medical treatment, self-care ability, knowledge mastery, quality of life scores, and the occurrence rate of MACE were compared between the two groups.
RESULTS After the intervention, the case management group had lower scores on the self-rating depression scale and self-rating anxiety scale and lower MACE rate, as well as higher scores for adherence to a healthy diet, medication adherence, good lifestyle habits, regular exercise, and timely follow-up, higher scores on the Coronary Heart Disease Self-Management Scale, higher scores for managing adverse habits, symptoms, emotional cognition, emergency response, disease knowledge, general lifestyle, and treatment adherence, higher scores for understanding coronary heart disease, recognizing the importance of medication adherence, understanding self-care points after CABG surgery, and being aware of post-CABG precautions, higher scores for physical well-being, disease condition, general health, social-psychological well-being, and work-related aspects (P < 0.05).
CONCLUSION Specialized nursing outpatient case management can enhance patient adherence to medical treatment, knowledge mastery, psychological well-being, and overall quality of life in patients after CABG surgery.
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Affiliation(s)
- Tong Li
- Department of Outpatient, Comprehensive Medical Service Center, The First Affiliated Hospital of Air Force University of Military Medicine, Xi’an 710032, Shaanxi Province, China
| | - Fang-Hui Lu
- Department of Outpatient, Comprehensive Medical Service Center, The First Affiliated Hospital of Air Force University of Military Medicine, Xi’an 710032, Shaanxi Province, China
| | - Qing Zhao
- Department of Outpatient, Comprehensive Medical Service Center, The First Affiliated Hospital of Air Force University of Military Medicine, Xi’an 710032, Shaanxi Province, China
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HU SS. Community-based prevention and treatment of cardiovascular diseases. J Geriatr Cardiol 2024; 21:315-322. [PMID: 38665283 PMCID: PMC11040059 DOI: 10.26599/1671-5411.2024.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2024] Open
Abstract
The Annual Report on Cardiovascular Health and Diseases in China (2022) intricate landscape of cardiovascular health in China. This is the third section of the report with a specific focus on community-based prevention and treatment of cardiovascular diseases (CVD). This section of the report underscores the importance of initiatives outlined in the "Healthy China 2030 Plan," emphasizing the comprehensive prevention and control strategy for chronic diseases. A key aspect of this plan involves the establishment of national demonstration areas aimed at comprehensive prevention and control of chronic diseases. By 2020, 488 such areas had been set up across China, surpassing the initial target and covering a significant proportion of counties and districts. The report highlights the successful implementation of these strategies in Lishan district, Anshan city, where demonstration areas for comprehensive prevention and control of chronic diseases were launched in 2013. Over the course of seven years, the number of healthy units increased substantially, leading to improvements in managing risk factors for CVD among residents. Significant reductions in prevalence rates of overweight, obesity, smoking, passive smoking, and drinking were observed, along with the development of healthier behaviors among residents. Similarly, Qiaokou district in Wuhan City, designated as a national demonstration area in 2014, implemented comprehensive public health promotion initiatives. Notably, special clinics for hypertension intervention were established, contributing to an increase in self-reported rates of hypertension, a slight decrease in prevalence, and a remarkable improvement in the control rate among treated patients. Overall, these efforts underscore the effectiveness of community-based approaches in driving positive health outcomes and advancing the comprehensive prevention and control of chronic diseases, particularly cardiovascular diseases, in China.
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Affiliation(s)
- Sheng-Shou HU
- Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Wen M, Chen Y, Yu J, Li J, Wen X, OuYang X, He P. Effects of a PRECEDE-PROCEED Model-Based Intervention on Fatigue in Patients With Coronary Heart Disease: A Randomized Controlled Trial. West J Nurs Res 2024; 46:68-80. [PMID: 38146221 DOI: 10.1177/01939459231215727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2023]
Abstract
OBJECTIVE This research aimed to determine how a 12-week PRECEDE-PROCEED model-based intervention affected fatigue in patients with coronary heart disease. METHODS This cluster randomized controlled trial recruited participants diagnosed with coronary heart disease at 2 community health centers in China. Participants in the control group (n = 36) received routine health education, whereas those in the intervention group (n = 38) were given a 12-week PRECEDE-PROCEED model-based intervention and routine health education. The intervention consisted of 6 training sessions on coronary heart disease, fatigue, fatigue management, self-management skills and social support. A primary outcome (fatigue) and 4 secondary outcomes (knowledge of fatigue, self-management, quality of life and body mass index) were assessed using the Fatigue Scale-14, Fatigue Cognitive Questionnaire for Patients with Coronary Heart Disease, Coronary Artery Disease Self-Management Scale, Chinese Cardiovascular Questionnaire of Quality of Life, and electronic weighing scale, respectively. Data were collected 3 times over 12 weeks. RESULTS Compared with the control group, the intervention group showed a statistically significant improvement in the level of fatigue (8.72 vs 7.06, P < .001), knowledge of fatigue (P < .001), self-management skills (P < .001), and quality of life (P < .001). However, there was no significant difference in body mass index between the 2 groups (P = .504). CONCLUSIONS The findings suggest that a well-designed intervention based on the PRECEDE-PROCEED model could alleviate fatigue symptoms and increase knowledge of fatigue, self-management skills and quality of life in patients with coronary heart disease.
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Affiliation(s)
- Min Wen
- School of Nursing, Hengyang Medical School, University of South China, Hengyang, China
- School of Nursing, Yueyang Vocational Technical College, Yueyang, China
| | - Yeshi Chen
- School of Nursing, Hengyang Medical School, University of South China, Hengyang, China
| | - Juping Yu
- Faculty of Life Sciences and Education, University of South Wales, Pontypridd, UK
| | - Junyi Li
- School of Nursing, Hengyang Medical School, University of South China, Hengyang, China
| | - Xiaohui Wen
- School of Nursing, Hengyang Medical School, University of South China, Hengyang, China
| | - Xinping OuYang
- Medical College, Hunan Normal University, Changsha, China
| | - Pingping He
- School of Nursing, Hengyang Medical School, University of South China, Hengyang, China
- Medical College, Hunan Normal University, Changsha, China
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Cho SJ, Kim SR, Cho KH, Shin NM, Oh WO. Effect of a Hospital-To-Home Transitional Intervention Based on an Interaction Model of Client Health Behavior for Adult Patients with Stroke. J Community Health Nurs 2023; 40:273-288. [PMID: 37431105 DOI: 10.1080/07370016.2023.2227154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/12/2023]
Abstract
To develop and identify the effectiveness of a hospital-to-home transitional intervention based on an interaction model of client health behavior in adult patients with stroke. A non-equivalent control group pretest-posttest. Thirty-eight patients participated (18=intervention, 20=control); the intervention group received 12 weeks of the intervention. The intervention influenced anxiety, disease severity, health behavior adherence, patient satisfaction, and quality of life in adult patients with stroke. Transitional programs have potential to improve the health behaviors of subjects, and community health nurses can assist in the implementation of these programs. Health behaviors and quality of life scores were significantly higher in the intervention group than in the control group; these findings support the need for continuity of nursing care during the transitional period for patients with stroke. Given the challenges faced by adult stroke patients after stroke, community nurses should pay attention to patients' transitional experiences.
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Affiliation(s)
- Su-Jin Cho
- Research Institute of Nursing Science, Pusan National University, Yangsan, Republic of Korea
| | - Sung Reul Kim
- College of Nursing, Korea University Nursing Research Institute, Korea University, Seoul, Republic of Korea
| | - Kyung-Hee Cho
- Department of Neurology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Nah-Mee Shin
- College of Nursing, Korea University Nursing Research Institute, Korea University, Seoul, Republic of Korea
| | - Won-Oak Oh
- College of Nursing, Korea University Nursing Research Institute, Korea University, Seoul, Republic of Korea
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Mattisson M, Börjeson S, Lindberg M, Årestedt K. Psychometric evaluation of the Telenursing Interaction and Satisfaction Scale. Scand J Caring Sci 2023; 37:687-697. [PMID: 36718016 DOI: 10.1111/scs.13149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 01/05/2023] [Accepted: 01/14/2023] [Indexed: 02/01/2023]
Abstract
AIMS AND OBJECTIVES Interaction between caller and telenurse in telenursing is important for caller satisfaction and subsequent compliance. Despite this, satisfaction measures with focus on interaction in telenursing are scarce and rarely anchored in nursing theory. The aim was to evaluate the psychometric properties of the Telenursing Interaction and Satisfaction Scale (TISS) with focus on data quality, factor structure, convergent validity, and reliability. METHODOLOGICAL DESIGN AND JUSTIFICATION This psychometric study was based on cross-sectional data. RESEARCH METHODS, INSTRUMENTS, AND/OR INTERVENTIONS Callers to the National Medical Advisory Service in Sweden (n = 616) completed the 60-item Telenursing Interaction and Satisfaction Questionnaire based on Cox's Interaction Model of Client Health Behavior. Twenty-five of these items were selected to form the TISS in four subscales according to the model. Data quality was evaluated in terms of missing data patterns and score distributions. The factor structure was evaluated with confirmatory factor analysis for ordinal data, convergent validity with Spearman correlations, internal consistency with ordinal alpha, scale reliability with composite reliability coefficients, and test-retest reliability with intraclass correlations. RESULTS The amount of missing data was acceptable and equally distributed. Data deviated significantly from a normal distribution. All response options were endorsed. The factor analysis confirmed the hypothesised four-factor structure; factor loadings ranged from 0.56 to 0.97 and factor correlations were high (0.88-0.96). Internal consistency (ordinal alpha = 0.82-0.97), scale reliability (0.88-0.99), and test-retest reliability (ICC = 0.77-0.86) were satisfactory for all scales. STUDY LIMITATIONS The study design did not allow drop-out analysis. CONCLUSIONS The TISS showed satisfactory psychometric properties in the study sample. It provides a measure that enables quantitative measurement of caller satisfaction with interaction in telenursing.
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Affiliation(s)
- Marie Mattisson
- Department of Health, Medicine and Caring Sciences (HMV), Linköping University, Linköping, Sweden
| | - Sussanne Börjeson
- Department of Health, Medicine and Caring Sciences (HMV), Linköping University, Linköping, Sweden
| | - Malou Lindberg
- 1177 Medical Advisory Service and Department of Health, Medicine and Caring services (HMV), Linköping University, Linköping, Sweden
| | - Kristofer Årestedt
- Faculty of Health and Life Sciences, Linnaeus University, Kalmar, Sweden
- Department of Research, Region Kalmar County, Kalmar, Sweden
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Lizcano-Álvarez Á, Carretero-Julián L, Talavera-Saez A, Cristóbal-Zárate B, Cid-Expósito MG, Alameda-Cuesta A. Intensive nurse-led follow-up in primary care to improve self-management and compliance behaviour after myocardial infarction. Nurs Open 2023. [PMID: 37084014 DOI: 10.1002/nop2.1758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 01/15/2023] [Accepted: 03/24/2023] [Indexed: 04/22/2023] Open
Abstract
AIMS AND OBJECTIVES To assess the effects of intensive follow-up by primary care nurses on cardiovascular disease self-management and compliance behaviours after myocardial infarction. BACKGROUND Although cardiovascular disease prevention and cardiac rehabilitation take place in hospital settings, a nurse-led approach is necessary in primary care during the first few months after a myocardial infarction. Therefore, it is important to assess self-management of cardiovascular disease and levels of compliance with the prescribed diet, physical activity, and medication. DESIGN The study used a multicentre, quasi-experimental, pre-post design without a control group. METHODS Patients with acute coronary syndrome from 40 healthcare facilities were included in the study. A total of 212 patients participated in a programme including 11 interventions during the first 12-18 months after myocardial infarction. The following Nursing Outcomes Classification (NOC) outcomes were assessed at baseline and at the end of the intervention: Self-management: Cardiac Disease (1617) and Compliance Behaviour: Prescribed Diet (1622), Compliance Behaviour: Prescribed Activity (1632), and Compliance Behaviour: Prescribed Medication (1623). Marjory Gordon's functional health patterns and a self-care notebook were used in each intervention. Pre-post intervention means were compared using Student's t-tests for related samples. The results of the study are reported in compliance with the TREND Statement. RESULTS A total of 132 patients completed the intervention. The indicators for each NOC outcome and the variations in scores before and after the intensive follow-up showed a statistically significant improvement (p-value = 0.000). Compliance Behaviour: Prescribed Diet (pre = 3.7; post = 4.1); Compliance Behaviour: Prescribed Activity (pre = 3.9; post = 4.3); Compliance Behaviour: Prescribed Medication (pre = 3.9; post = 4.7). CONCLUSION Intensive, immediate follow-up after myocardial infarction improves compliance behaviours and self-management of heart disease. A combined self-care and family care approach should be encouraged to empower post-myocardial infarction patients. To facilitate patients' self-efficacy, the use of health education tools such as a cardiovascular self-care notebook can also be helpful. RELEVANCE TO CLINICAL PRACTICE This study highlights the benefits of intensive, protocolised, comprehensive patient follow-up in primary care during the first few months after an acute myocardial infarction (AMI). Primary care nurses train patients in cardiovascular self-care. PATIENT OR PUBLIC CONTRIBUTION Patients were not involved in either the design or the carrying out of the study. However, at the end of the study, they participated in an evaluation process about the utility of the research study and their satisfaction with it. This process was carried out using an ad hoc survey consisting of 10 questions assessing the nursing care and follow-up inputs that were received.
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Affiliation(s)
- Ángel Lizcano-Álvarez
- Department of Nursing and Stomatology, Faculty of Health Sciences, Rey Juan Carlos University, Madrid, Spain
- Nursing Research Group Cardiovascular Care, Society of Family and Community Nursing (SEMAP), Madrid, Spain
| | - Laura Carretero-Julián
- Nursing Research Group Cardiovascular Care, Society of Family and Community Nursing (SEMAP), Madrid, Spain
- Department of Nursing, Faculty of Nursing, Physiotherapy and Podiatry, Complutense University, Madrid, Spain
| | - Ana Talavera-Saez
- Nursing Research Group Cardiovascular Care, Society of Family and Community Nursing (SEMAP), Madrid, Spain
- Primary Care Assistance Management, Luengo Rodriguez Healthcare Centre, Madrid Health Service, Spain
| | - Beatriz Cristóbal-Zárate
- Primary Care Assistance Management, Presentación Sabio Healthcare Centre, Madrid Health Service, Spain
| | - María-Gema Cid-Expósito
- Department of Nursing and Stomatology, Faculty of Health Sciences, Rey Juan Carlos University, Madrid, Spain
| | - Almudena Alameda-Cuesta
- Department of Nursing and Stomatology, Faculty of Health Sciences, Rey Juan Carlos University, Madrid, Spain
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Gok Metin Z, Izgu N, Gulbahar Eren M, Eroglu H. Theory-based nursing interventions in adults with coronary heart disease: A systematic review and meta-analysis of randomized controlled trials. J Nurs Scholarsh 2023; 55:439-463. [PMID: 36411501 DOI: 10.1111/jnu.12839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 10/08/2022] [Accepted: 10/18/2022] [Indexed: 11/23/2022]
Abstract
PURPOSE This systematic review and meta-analysis aimed to synthesize the outcomes of theory-based nursing interventions for coronary heart disease management. DESIGN AND METHODS Web of Science, Scopus, Science Direct, and PubMed databases were electronically searched from January 2013 to August 2021. The Preferred Reporting Item for Systematic Reviews and Meta-analyses statement guidelines was followed for this meta-analysis. Randomized controlled trials on patients with coronary heart disease, using a theory-based nursing intervention were eligible. Methodological quality was examined by two authors using the Modified Jadad Scale. Based on the heterogeneity test, the results were analyzed using a pool of data with 95% confidence intervals, p-values, and fixed or random-effect models (PROSPERO registration number X). FINDINGS A total of 1030 studies were initially retrieved, and 8 randomized controlled trials were eventually included in the meta-analysis after screening. The big majority (81.3%) of participants were males, and the mean age was 54.8 (SD = 8.7) years. This meta-analysis found theory-based nursing interventions had no significant effect on blood lipid profile, blood pressure, and healthy lifestyle. However, these interventions significantly reduced fasting blood glucose, and body mass index and improved the physical and psychological domains of quality of life. CONCLUSIONS The evidence from this meta-analysis reveals that theory-based nursing interventions have a positive effect on fasting blood glucose, body mass index, and quality of life. However, their effects on blood lipid profile, blood pressure, and a healthy lifestyle are inconclusive. The results of this metanalysis are largely based on a few trials and were limited in terms of the number of outcomes. Conducting well-designed randomized controlled trials with adequate power is needed to make a firm conclusion on the influence of theory-based nursing interventions on patient outcomes in the CHD population. CLINICAL RELEVANCE Considering the high mortality and morbidity of coronary heart disease, nurses may play a significant role in coronary heart disease management by providing interventions that are based on a certain theoretical framework. This meta-analysis provides insights into the implementation of theory-based nursing interventions in heart attack survivors or those newly diagnosed with coronary heart disease led by nurses and lasting longer than 6 months in coronary heart disease. In addition, future studies should consider enhancing the content of training programs for a healthy lifestyle within the theory-based nursing interventions and compare the effects of these interventions on acute and chronic coronary syndromes.
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Affiliation(s)
- Zehra Gok Metin
- Internal Medical Nursing Department, Faculty of Nursing, Hacettepe University, Ankara, Turkey
| | - Nur Izgu
- Internal Medicine Nursing Department, Faculty of Nursing, Hacettepe University, Ankara, Turkey
| | - Merve Gulbahar Eren
- Internal Medicine Nursing Department, Faculty of Health Science, Sakarya University, Sakarya, Turkey
| | - Hacer Eroglu
- Cardiovascular Surgery Clinic, Ankara Training and Research Hospital, Ankara, Turkey
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Xu L, Fu T, Wang Y, Ji N. Diagnostic value of peripheral blood miR-296 combined with vascular endothelial growth factor B on the degree of coronary artery stenosis in patients with coronary heart disease. JOURNAL OF CLINICAL ULTRASOUND : JCU 2023; 51:520-529. [PMID: 36852944 DOI: 10.1002/jcu.23433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 12/20/2022] [Accepted: 12/27/2022] [Indexed: 06/18/2023]
Abstract
OBJECTIVE Coronary heart disease (CHD) is a disorder resulting from organic and functional coronary artery stenosis (CAS), thus causing reduced oxygenated blood in the heart. miRNAs are useful biomarkers in the diagnosis of atherosclerosis, CHD, and acute coronary syndrome. Vascular endothelial growth factor (VEGF) is closely related to CHD. This study explored the correlation of miR-296 and VEGF-B expression levels in peripheral blood with CAS degree in CHD patients. METHODS Totally 220 CHD patients were enrolled and classified into mild-(71 cases)/moderate-(81 cases)/severe-CAS (68 cases) groups, with another 80 healthy cases as controls. The serum miR-296 and VEGF-B expression levels were detected using reverse transcription quantitative polymerase chain reaction. The correlation between miR-296 and CAS-related indexes was assessed via Pearson analysis. The binding relationship of miR-296 and VEGF-B was first predicted and their correlation was further analyzed via the Pearson method. The clinical diagnostic efficacy of miR-296 or VEGF-B on CAS degree was evaluated by the receiver operating characteristic curve. RESULTS Serum miR-296 was downregulated in CHD patients and was the lowest in patients with severe-CAS. miR-296 was negatively-correlated with high-sensitivity C-reactive protein, brain natriuretic peptide, and cardiac troponin I. miR-296 targeted VEGF-B. VEGF-B was upregulated in CHD patients and inversely-related to miR-296. Low expression of miR-296 and high expression of VEGF-B both had high clinical diagnostic values on CAS degree in CHD patients. miR-296 combined with VEGF-B increased the diagnostic value on CAS. CONCLUSION Low expression of miR-296 combined with high expression of its target VEGF-B predicts CAS degree in CHD patients.
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Affiliation(s)
- Lei Xu
- Department of Cardiology, Yiwu Central Hospital, Affiliated Hospital of Wenzhou Medical University, Zhejiang, China
| | - Ting Fu
- Department of Cardiology, Yiwu Central Hospital, Affiliated Hospital of Wenzhou Medical University, Zhejiang, China
| | - Yu Wang
- Department of Cardiology, Yiwu Central Hospital, Affiliated Hospital of Wenzhou Medical University, Zhejiang, China
| | - Ningning Ji
- Department of Cardiology, Yiwu Central Hospital, Affiliated Hospital of Wenzhou Medical University, Zhejiang, China
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