Effects of bifid triple viable capsules dissolving at intestines combined with emergency comprehensive nursing on intestinal microorganism and nutritional status of patients with coronary heart disease after percutaneous coronary intervention

Coronary heart disease (CHD) belongs to a kind of heart disease that causes myocardial ischemia, hypoxia and even necrosis because of vascular cavity obstruction, stenosis and (or) coronary spasm caused by coronary artery (coronary artery) atherosclerosis (1). According to guidelines published by the European Society of Cardiology in 2019, CHD can be separated into acute coronary syndromes (ACS) as well as chronic coronary syndromes (CCS) (2). As one of the major cardiovascular diseases affecting the global population and human health, CHD is an important cause of death for residents both abroad and at home (3). The high incidence of CH D is middle-aged and elderly people, some patients may show no significant symptoms, and the typical symptoms of symptomatic patients are chest pain (often feel a sense of contraction and pressure in the precardiac area) (4). At the same time, patients may have nausea, respiratory depression, sweating and other systemic symptoms, with the prolonged course of CHD can cause heart failure, cardiogenic shock, arrhythmia and other complications, therefore, more attention should be paid to this disease (5).

Conservative drug therapy is the most common treatment for patients with CHD (6). Although this kind of drug therapy can achieve a certain maintenance treatment effect, the long-term use of such drugs may have certain side effects, and some severe patients may have acute heart failure due to long-term use, which restricts the efficacy of conservative drug treatment to a certain extent (7). With the progress of cardiac medicine research in recent years, percutaneous coronary intervention (PCI) has been widely applied in clinic (8). PCI means that doctors re-clear the narrow coronary artery cavity with the help of the ever-developing cardiac catheterization technology, so as to restore and promote the myocardial blood supply, which is the cornerstone of the treatment of CHD (9). With the development of science and technology along with the accumulation of experience, PCI technology develops rapidly, and the equipment is updated iteratively (10). The variety of stent selection and the expansion of surgical approaches have promoted the application of PCI in the treatment of CHD patients (11). Nevertheless, postoperative patients need long-term medication, and poor treatment compliance and improper health behavior will affect the prognosis (12). Therefore, auxiliary and effective nursing intervention is needed to promote the prognosis of patients.

Emergency comprehensive nursing intervention belongs to a novel nursing model, which can offer comprehensive and systematic nursing services for patients along with improve nursing quality (13). With the deepening of nursing research, the comprehensive nursing intervention model has been widely applied in clinical practice, and has achieved remarkable results (14).

Intestinal flora is known as the “human microbial organ,” which can effectively regulate the innate and acquired immunity of the body, and the disturbance of intestinal flora can induce lesions of multiple systems or organs (15). Studies have found that due to the large volume load of CHD patients, intestinal flora disturbance promotes the increase of intestinal permeability, accelerates the progression of CHD after excessive toxins enter the blood circulation, and the worse the heart function, the faster the spread of pathogenic bacteria (16). Recent studies have shown that intestinal microbial imbalance can cause adverse cardiovascular events after CHD (17).

Bifid triple viable capsules dissolving at intestines is a new type of microecological preparation, the components of which are: bifidobacterium longiformis, lactobacillus acidophilus and enterococcus faecalis, which can effectively adjust the balance of intestinal flora, inhibit and remove pathogenic bacteria in the intestine, reduce the production of enterotoxin, promote the body’s digestion of nutrients, synthesize vitamins required by the body, stimulate the body’s immunity (18). As reported previously, probiotics can improve lipid profiles in CHD patients (19) and effectively prevents myocardial injury from CHD patients (20). However, the role of bifid triple viable capsules in CHD patients after PCI remains unclear.

In this study, we aimed to explore the impacts of bifid triple viable capsules dissolving at intestines combined with emergency comprehensive nursing on intestinal microorganism and nutritional status of CHD patients after PCI.

The CG adopted emergency routine nursing, vital signs were monitored, oxygen inhalation support, water and electrolyte correction intervention were given to the patients, and the patients’ condition was evaluated and PCI was performed actively with the doctors. The precautions of self-management should be emphasized to patients after PCI.

The SG was given emergency comprehensive nursing, and the specific contents were as follows:

SPSS 24.0 statistical software was adopted for data analysis. Measurement data were expressed as (x ± s), and t-test was adopted for comparison. Count data were expressed as (n, %), and Fisher’s exact test was used for comparison. p < 0.05 meant statistical significance.

CHD is more common in middle-aged and elderly people (24). With the acceleration of the aging process of social population, the proportion of elderly CHD patients increases (25). Analyzing the causes of the disease, it is closely related to the patients’ bad living habits, such as high sugar, high fat diet, long stay up late, smoking, alcoholism and so on (26). PCI is the main method to treat this disease, which can effectively relieve patients’ angina pectoris and improve myocardial blood perfusion (27). However, patients with improper emotional control after surgery will elevate the risk of cardiovascular adverse events along with reduce the quality of life of patients (28). Therefore, how to carry out effective nursing is the key to ensure the effect of PCI surgery and the safety of patients.

The purpose of emergency comprehensive nursing is to obtain better quality of life for patients while treating, so that medical resources can be used reasonably and fully (29). The orderly development of emergency comprehensive nursing requires professional skills, good communication skills and a high sense of responsibility of nursing staff, putting the needs of patients in the first place, and increasing the comfort of patients during hospitalization (30). The connotation of emergency comprehensive nursing is the overall responsibility system of nursing staff, ensuring the safety and comfort of patients, and improving the professional value of nursing staff (31). Previous studies have revealed that emergency comprehensive nursing has more advantages in relieving patients’ negative emotions and speeding up the rehabilitation process than conventional nursing (32).

The main pathological feature of CHD is atherosclerosis, in which metabolic abnormalities and inflammatory reactions play an important role, among which intestinal flora is a new target discovered in recent years (33). Studies have found that intestinal flora controls the absorption and metabolism of nutrients through proteolytic pathways and glycolysis pathways, and participates in the occurrence and development of cardiovascular, cerebrovascular, kidney and other diseases (34). Other studies have confirmed through animal experiments that the number of lactobacillus increases and the number of bacteroides decreases in the CHD group, and the progression of CHD can be delayed after the mice in the CHD group are administrated with bacteroides (35).

Bifid triple viable capsules dissolving at intestines are a combination of bifidobacterium longiformis, lactobacillus acidophilus, and enterococcus faecalis (36). Lactobacillus and bifidobacterium are microorganisms in the body that are beneficial to host health, which can improve intestinal function and regulate immune function (37). At the same time, they have biological barrier and nutritional effects on human health. After intestinal flora is disturbed, the metabolic components of bile acids in the body are changed, and the induced dyslipidemia can promote atherosclerosis and then increase the risk of major adverse cardiovascular events (38). Lactobacillus and bifidobacterium can produce a hydrolase combining bile acid, which can promote the liver to synthesize bile acid with cholesterol as raw material, accelerate the speed of cholesterol transformation, and achieve the effect of lipid lowering (39). When the blood lipid gradually improves to the normal state, the internal environment of the body on which the intestinal microbial colonies depend tends to be suitable for the survival and colonization of beneficial bacteria, improve the growth, reproduction and metabolism level of beneficial bacteria, hinder the adhesion of pathogenic bacteria, improve the level of intestinal microbes, and reduce the occurrence of major adverse cardiovascular events (40).

In our study, the results indicated that after intervention, the LVEF and blood pressure in the SG presented higher than the CG, the time of lying in bed and hospital stay in the SG presented shorter than the CG, and the incidence of complications in the SG presented lower than the CG, suggesting that bifid triple viable capsules dissolving at intestines combined with emergency comprehensive nursing could reduce the impact of PCI on the cardiovascular function of patients, promote the postoperative recovery along with reduce the risk of complications of CHD patients, which was in accordance with former studies (41, 42).

Besides, our study indicated that after intervention, the SAS as well as SDS scores in the SG presented lower when comparing with the CG, the GQOLI-74 scores in the SG presented higher than the CG, the GSES score in the SG presented higher when comparing with the CG, and the nursing satisfaction in the SG presented higher when comparing with the CG. All these results implied that bifid triple viable capsules dissolving at intestines combined with emergency comprehensive nursing could reduce the negative emotions, promote the quality of life and self-efficacy along with elevate the nursing satisfaction of CHD patients. Consistently, Zhang et al. have indicated that comprehensive nursing can improve the pregnancy outcomes as well as has positive significance in reducing negative emotions of patients with polycystic ovary syndrome (43). Yang et al. have pointed that comprehensive intervention can elevate the life quality of elderly patients with Alzheimer Disease (44). Jalal Moludi et al. have indicated that probiotic supplementation in patients with PCI post-myocardial infarction has beneficial effects on depressive symptoms (45).

In addition, our study indicated that after intervention, the improvements of lactobacillus, bifidobacterium and escherichia coli in the SG were more significant than the CG, Hb, ALB, TRF, and PA levels were elevated in 2 groups, and those in the SG were higher than the CG, and the improvements of TG, TC, LDL-C and HDL-C in the SG were more significant than the CG, suggesting that bifid triple viable capsules dissolving at intestines combined with emergency comprehensive nursing could improve the intestinal microbiome status, enhance the nutritional status and improve the blood lipid levels of CHD patients after PCI, which was in line with previous studies (46, 47).

In conclusion, our study demonstrates that bifid triple viable capsules dissolving at intestines combined with emergency comprehensive nursing can improve the cardiovascular function, decrease the risk of complications, promote the self-efficacy and quality of life, improve the intestinal microorganism and nutritional status and improve the blood lipid levels of CHD patients after PCI.

This study demonstrated that the combination of bifid triple viable capsules dissolving at intestines with emergency comprehensive nursing significantly improves cardiovascular function, shortens recovery time, enhances self-efficacy, and promotes the quality of life in coronary heart disease patients’ post-percutaneous coronary intervention. Additionally, the intervention effectively restores intestinal microbiota balance, optimizes nutritional status, and improves lipid profiles, offering a novel approach to enhancing the outcomes of PCI patients.

The author(s) declare that no financial support was received for the research and/or publication of this article.

The datasets presented in this study can be found in online repositories. The names of the repository/repositories and accession number(s) can be found in the article/supplementary material.

The studies involving humans were approved by ethics committee of Xuanwu Hospital Capital Medical University. The studies were conducted in accordance with the local legislation and institutional requirements. The participants provided their written informed consent to participate in this study.

MZ: Writing – review & editing, Writing – original draft. ZL: Writing – original draft, Writing – review & editing.

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

The authors declare that no Gen AI was used in the creation of this manuscript.

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