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Jang SY, Kim NK, Kim CY, Bae MH, Lee JH, Yang DH, Park HS, Cho Y, Chae SC. IMPACT OF SIMPLE THREE RISK FACTORS (AGE, BODY WEIGHT, AND HISTORY OF STROKE) ON IN-HOSTPIAL BLEEDINGS IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION. J Am Coll Cardiol 2016. [DOI: 10.1016/s0735-1097(16)30486-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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77
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Lee JH, Bae MH, Yang DH, Park HS, Cho Y, Lee WK, Jeong MH, Kim YJ, Cho MC, Kim CJ, Chae SC. Angiotensin II type 1 receptor blockers as a first choice in patients with acute myocardial infarction. Korean J Intern Med 2016; 31:267-76. [PMID: 26701233 PMCID: PMC4773713 DOI: 10.3904/kjim.2014.268] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2014] [Revised: 11/19/2014] [Accepted: 12/17/2014] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND/AIMS Angiotensin II type 1 receptor blockers (ARBs) have not been adequately evaluated in patients without left ventricular (LV) dysfunction or heart failure after acute myocardial infarction (AMI). METHODS Between November 2005 and January 2008, 6,781 patients who were not receiving angiotensin-converting enzyme inhibitors (ACEIs) or ARBs were selected from the Korean AMI Registry. The primary endpoints were 12-month major adverse cardiac events (MACEs) including death and recurrent AMI. RESULTS Seventy percent of the patients were Killip class 1 and had a LV ejection fraction ≥ 40%. The prescription rate of ARBs was 12.2%. For each patient, a propensity score, indicating the likelihood of using ARBs during hospitalization or at discharge, was calculated using a non-parsimonious multivariable logistic regression model, and was used to match the patients 1:4, yielding 715 ARB users versus 2,860 ACEI users. The effect of ARBs on in-hospital mortality and 12-month MACE occurrence was assessed using matched logistic and Cox regression models. Compared with ACEIs, ARBs significantly reduced in-hospital mortality(1.3% vs. 3.3%; hazard ratio [HR], 0.379; 95% confidence interval [CI], 0.190 to0.756; p = 0.006) and 12-month MACE occurrence (4.6% vs. 6.9%; HR, 0.661; 95% CI, 0.457 to 0.956; p = 0.028). However, the benefit of ARBs on 12-month mortality compared with ACEIs was marginal (4.3% vs. 6.2%; HR, 0.684; 95% CI, 0.467 to 1.002; p = 0.051). CONCLUSIONS Our results suggest that ARBs are not inferior to, and may actually be better than ACEIs in Korean patients with AMI.
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Yang YA, Yang DH, Kim HN, Kwon SH, Jang SY, Bae MH, Lee JH, Chae SC. Tachycardia-Induced Right Heart Failure and Severe Tricuspid Regurgitation That Improved with Medication. Chonnam Med J 2015; 51:135-8. [PMID: 26730365 PMCID: PMC4697114 DOI: 10.4068/cmj.2015.51.3.135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Revised: 08/10/2015] [Accepted: 08/17/2015] [Indexed: 11/17/2022] Open
Abstract
Secondary tricuspid regurgitation (TR) primarily develops due to left heart failure or primary pulmonary diseases. Tricuspid annular dilation, which is commonly caused by right ventricular volume and pressure overload followed by right ventricle dilation, is believed to be the main mechanism underlying secondary TR. It is reported that once the tricuspid annulus is dilated, its size cannot spontaneously return to normal, and it may continue to dilate. These reports also suggest the use of an aggressive surgical approach for secondary TR. In the present report, we describe a case of tachycardia-induced severe TR that was completely resolved without the need for surgery.
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Lee JH, Kim CY, Kim NK, Jang SY, Park SH, Bae MH, Yang DH, Park HS, Cho Y, Chae SC. TCT-256 Prognostic value of ACEF (age, creatinine, ejection fraction) score in patients undergoing percutaneous coronary intervention after acute myocardial infarction. J Am Coll Cardiol 2015. [DOI: 10.1016/j.jacc.2015.08.939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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80
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Kim NK, Kim CY, Kim JH, Jang SY, Bae MH, Lee JH, Yang DH, Park HS, Cho Y, Chae SC. A Hypereosinophilic Syndrome with Cardiac Involvement from Thrombotic Stage to Fibrotic Stage. J Cardiovasc Ultrasound 2015; 23:100-2. [PMID: 26140152 PMCID: PMC4486173 DOI: 10.4250/jcu.2015.23.2.100] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2014] [Revised: 12/11/2014] [Accepted: 05/19/2015] [Indexed: 11/22/2022] Open
Abstract
Cardiac involvement is a major cause of morbidity and mortality in hypereosinophilic syndrome (HES). It is classified into 3 stages by the degree of eosinophils-mediated heart injury; acute necrotic stage, thrombotic stage, and fibrotic stage. Nonetheless, definitive evidence that each patient passes sequentially through these stages is lacking. We present a case of 48-year-old male patient with dyspnea and peripheral edema who underwent valve replacement surgery due to severe mitral regurgitation. After the valve replacement, HES with cardiac involvement in the thrombotic stage was diagnosed. In the follow-up study, the patient progressed into fibrotic stage of HES.
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Park SH, Yang YA, Kim KY, Park SM, Kim HN, Kim JH, Jang SY, Bae MH, Lee JH, Yang DH. Left Ventricular Strain as Predictor of Chronic Aortic Regurgitation. J Cardiovasc Ultrasound 2015; 23:78-85. [PMID: 26140149 PMCID: PMC4486182 DOI: 10.4250/jcu.2015.23.2.78] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Revised: 05/16/2015] [Accepted: 05/19/2015] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND It is not well known about the implication of left ventricular (LV) strain as a predictor for mortality in patients with chronic aortic regurgitation (AR). The purpose of this study was to investigate whether global longitudinal strain measured by two-dimensional speckle-tracking echocardiography could predict long-term outcome in patients with chronic AR. METHODS This is a single center non-randomized retrospective observational study. The patients with chronic AR from January 2002 to December 2012 were retrospectively enrolled. Following patients were excluded; combined other significant valvular disease, previous heart surgery, aortic disease, congenital heart disease, acute AR and young age under 18 years old. Finally, 60 patients were analyzed and the LV global strain rate was measured on apical four chamber image (GS-4CH). RESULTS During 64 months follow-up duration, 16 patients (26.7%) were deceased and 38 patients (63.3%) underwent aortic valve replacement (AVR). Deceased group was older (69 years old vs. 51 years old, p < 0.001) and had lower longitudinal strain (-12.05 ± 3.72% vs. -15.66 ± 4.35%, p = 0.005). Kaplan-Meier survival curve stratified by GS-4CH showed a trend of different event rate (log rank p = 0.001). On multivariate analysis by cox proportional hazard model adjusting for age, sex, body surface area, history of atrial fibrillation, blood urea nitrogen, LV dilatation, LV ejection fraction and AVR, decreased GS-4CH proved to be an independent predictor of mortality in patients with chronic AR (hazard ratio 1.313, 95% confidence interval 1.010-1.706, p = 0.042). CONCLUSION GS-4CH may be a useful predictor of mortality in patient with chronic AR.
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Lee JH, Bae MH, Yang DH, Park HS, Cho Y, Jeong MH, Kim YJ, Kim KS, Hur SH, Seong IW, Cho MC, Kim CJ, Chae SC. Contemporary Trends of Optimal Evidence-Based Medical Therapy at Discharge for Patients Surviving Acute Myocardial Infarction From the Korea Acute Myocardial Infarction Registry. Clin Cardiol 2015; 38:350-6. [PMID: 25962712 DOI: 10.1002/clc.22396] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2014] [Revised: 01/12/2015] [Accepted: 01/25/2015] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Temporal trends of evidence-based optimal medical therapy (OMT) at discharge after acute myocardial infarction (AMI) have not been investigated in recent years. HYPOTHESIS OMT should have been increased in AMI and gap between guidelines and practices in its use should have been narrowed. METHODS We examined discharge medications of 17,578 post-MI patients who had no documented contraindications to antiplatelet agents, β-blockers, angiotensin-converting enzyme inhibitors, or statins across a 6-year period (divided into subperiods of November 2005 to December 2006 [period 1], 2007 [period 2], 2008 [period 3], 2009 [period 4], 2010 [period 5], and January to June 2011 [period 6]) in the Korean AMI Registry. OMT was defined as use of all 4 indicated medications. RESULTS Marked increases in OMT (48.6% to 63.2%) were seen irrespective of age and sex, mainly attributed to marked increases in the use of β-blockers (70.3% to 83.7%) and statins (76.9% to 82.6%) from period 1 to period 6. The gap in use of OMT between men and women narrowed over time between the first and second 3 periods, but not between the young and the elderly. Advanced age (odds ratio [OR]: 0.88, P = 0.04) was independently associated with underuse of OMT. Adjusted ORs for OMT from period 1 to period 6 were as follows: 1, 1.14 (P = 0.024), 1.21 (P = 0.001), 1.40 (P < 0.001), 1.47 (P < 0.001), and 1.69 (P < 0.001), respectively. CONCLUSIONS Despite gradual increase in OMT over time, the gap between guidelines and practices in use of OMT continues to exist.
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Lee JH, Bae MH, Yang DH, Park HS, Cho Y, Jeong MH, Kim YJ, Kim KS, Hur SH, Seong IW, Cho MC, Kim CJ, Chae SC. Prognostic value of the age, creatinine, and ejection fraction score for 1-year mortality in 30-day survivors who underwent percutaneous coronary intervention after acute myocardial infarction. Am J Cardiol 2015; 115:1167-73. [PMID: 25772739 DOI: 10.1016/j.amjcard.2015.02.001] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2014] [Revised: 02/04/2015] [Accepted: 02/04/2015] [Indexed: 12/22/2022]
Abstract
Few simple and effective tools are available for determining the prognosis of 30-day survivors after acute myocardial infarction. We aimed to assess whether the simple age, creatinine, and ejection fraction (ACEF) score could predict 1-year mortality of 12,000 post-myocardial infarction 30-day survivors who underwent percutaneous coronary intervention. The ACEF score was computed as follows: (age/ejection fraction)+1, if the serum creatinine was >2 mg/dl. Accuracy was defined through receiver-operating characteristics analysis and area under the curve (AUC) evaluation. Twelve risk factors were selected and ranked according to their AUC value. Age, ejection fraction, and serum creatinine levels indicated the best AUC value. The ACEF score was significantly higher in the nonsurvivors (1.95±0.82 vs 1.28±0.50; p<0.001) and was an independent predictor of 1-year mortality (adjusted hazard ratio 2.26; p<0.001). The best accuracy was achieved by a prediction model including 12 risk factors (AUC=0.80), but this did not significantly differ compared with the AUC (0.79) of the ACEF score (p=ns). Adjusted hazard ratios for 1-year mortality were 1 (reference), 3.11 (p<0.001), and 10.38 (p<0.001) for the ACEFLOW (ACEF score<1.0), ACEFMID (ACEF score 1.0 to 1.39), and ACEFHIGH (ACEF score≥1.4) groups, respectively. The ACEF score may be a novel valid model to stratify the 1-year mortality risk in 30-day survivors who underwent percutaneous coronary intervention after acute myocardial infarction.
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Shin J, Park JB, Kim KI, Kim JH, Yang DH, Pyun WB, Kim YG, Kim GH, Chae SC. 2013 Korean Society of Hypertension guidelines for the management of hypertension: part III-hypertension in special situations. Clin Hypertens 2015; 21:3. [PMID: 26893917 PMCID: PMC4750807 DOI: 10.1186/s40885-014-0014-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Accepted: 12/23/2014] [Indexed: 12/11/2022] Open
Abstract
Different treatment strategies are suggested for special situations. Hypertension is common in the elderly and frequently accompanied by or complicates other clinical conditions such as metabolic syndrome, coronary artery disease, heart failure, stroke, diabetes mellitus and chronic kidney disease.
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Shin J, Park JB, Kim KI, Kim JH, Yang DH, Pyun WB, Kim YG, Kim GH, Chae SC. 2013 Korean Society of Hypertension guidelines for the management of hypertension. Part II-treatments of hypertension. Clin Hypertens 2015; 21:2. [PMID: 26893916 PMCID: PMC4745141 DOI: 10.1186/s40885-014-0013-2] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Accepted: 12/23/2014] [Indexed: 02/07/2023] Open
Abstract
Treatment strategies are provided in accordance with the level of global cardiovascular risk, from lifestyle modification in the lower risk group to more comprehensive treatment in the higher risk group. Considering the common trend of combination drug regimen, the choice of the first drug is suggested more liberally according to the physician's discretion.
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Shin J, Park JB, Kim KI, Kim JH, Yang DH, Pyun WB, Kim YG, Kim GH, Chae SC. 2013 Korean Society of Hypertension guidelines for the management of hypertension: part I-epidemiology and diagnosis of hypertension. Clin Hypertens 2015; 21:1. [PMID: 26893915 PMCID: PMC4745140 DOI: 10.1186/s40885-014-0012-3] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Accepted: 12/23/2014] [Indexed: 01/01/2023] Open
Abstract
The standardized techniques of blood pressure measurement in the clinic are emphasized and the indications for ambulatory and/or home blood pressure monitoring are specified more broadly. The epidemiologic findings specific to Korean population related to blood pressure are reviewed. Cardiovascular risk of hypertensive patients are stratified based upon the data of a Korean population cohort study.
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Jang SY, Cho Y, Kim JH, Park SH, Bae MH, Lee JH, Yang DH, Park HS, Chae SC. PROGNOSTIC VALUE OF THE EPINEPHRINE TEST FOLLOWING THORACOSCOPIC LEFT CARDIAC SYMPATHETIC DENERVATION IN PATIENTS WITH INHERITED ARRHYTHMIA SYNDROME. J Am Coll Cardiol 2015. [DOI: 10.1016/s0735-1097(15)60438-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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88
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Park KT, Ahn SG, Jo SH, Park S, Kang HJ, Kim KI, Kim KH, Yang DH, Kim SH, Han KH, Lee IK. Dyslipidemia and Lipid-Lowering in Patients with High Risk of Cardiovascular Diseases and Their Cardiovascular Outcomes in Korea (ENSURE study): Secondary Prevention in Chronic Stable Angina. J Lipid Atheroscler 2015. [DOI: 10.12997/jla.2015.4.1.27] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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Kim M, Cha SI, Choi KJ, Shin KM, Lim JK, Yoo SS, Lee J, Lee SY, Kim CH, Park JY, Yang DH. Prognostic value of serum growth differentiation factor-15 in patients with chronic obstructive pulmonary disease exacerbation. Tuberc Respir Dis (Seoul) 2014; 77:243-50. [PMID: 25580140 PMCID: PMC4286781 DOI: 10.4046/trd.2014.77.6.243] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Revised: 08/01/2014] [Accepted: 09/16/2014] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Information regarding prognostic value of growth differentiation factor 15 (GDF-15) and heart-type fatty acid-binding protein (H-FABP) in patients with chronic obstructive pulmonary disease (COPD) exacerbation is limited. The aim of this study was to investigate whether serum levels of GDF-15 and H-FABP predict an adverse outcome for COPD exacerbation. METHODS Clinical variables, including serum GDF-15 and H-FABP levels were compared in prospectively enrolled patients with COPD exacerbation that did or did not experience an adverse outcome. An adverse outcome included 30-day mortality and need for endotracheal intubation or inotropic support. RESULTS Ninety-seven patients were included and allocated into an adverse outcome (n=10) or a control (n=87) group. Frequencies of mental change and PaCO2>37 mm Hg were significantly higher in the adverse outcome group (mental change: 30% vs. 6%, p=0.034 and PaCO2>37 mm Hg: 80% vs. 22%, p<0.001, respectively). Serum GDF-15 elevation (>1,600 pg/mL) was more common in the adverse outcome group (80% vs. 43%, p=0.041). However, serum H-FABP level and frequency of serum H-FABP elevation (>755 pg/mL) did not differ between the two groups. Multivariate analysis showed that an elevated serum GDF-15 and PaCO2>37 mm Hg were significant predictors of an adverse outcome (odds ratio [OR], 25.8; 95% confidence interval [CI], 2.7-243.8; p=0.005 and OR, 11.8; 95% CI, 1.2-115.3; p=0.034, respectively). CONCLUSION Elevated serum GDF-15 level and PaCO2>37 mm Hg were found to predict an adverse outcome independently in patients with COPD exacerbation, suggesting the possibility that serum GDF-15 could be used as a prognostic biomarker of COPD exacerbation.
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Park SM, Lee J, Seong SJ, Park JG, Gwon MR, Lim MS, Lee HW, Yoon YR, Yang DH, Kwon KI, Han S. Population pharmacokinetic and pharmacodynamic modeling of transformed binary effect data of triflusal in healthy Korean male volunteers: a randomized, open-label, multiple dose, crossover study. BMC Pharmacol Toxicol 2014; 15:75. [PMID: 25534747 PMCID: PMC4416384 DOI: 10.1186/2050-6511-15-75] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2014] [Accepted: 12/12/2014] [Indexed: 11/10/2022] Open
Abstract
Background Triflusal is a drug that inhibits platelet aggregation. In this study we investigated the dose-exposure-response relationship of a triflusal formulation by population pharmacokinetic (PK) and pharmacodynamic (PD) modeling of its main active metabolite, hydroxy-4-(trifluoromethyl) benzoic acid (HTB). Methods This study was a randomized, open-label, multiple-dose, two-period, two-treatment, comparative crossover design. All volunteers received a single oral loading dose of 900 mg of triflusal on Day 1, followed by a dose of 600 mg/day from Day 2 to 9. Using data from 34 healthy volunteers, 476 HTB plasma concentration data points and 340 platelet aggregation data points were used to construct PK and PD models respectively using NONMEM (version 6.2). As the PD endpoint was qualitative, we implemented binary analysis of ‘inhibition’ and ‘non-inhibition’ rather than using the actual value of the test. The final PK-PD model was evaluated using a visual predictive check (VPC) and bootstrap. Results The time-concentration profile of HTB over the entire dosing period was described by a one-compartment model with a first-order formation rate constant for HTB. Weight was selected as a covariate for clearance and volume of triflusal, respectively. The structure and the population estimates for triflusal PK were as follows: oral clearance (CL/F) = 0.2 · (weight/71.65)0.845 L/h, oral volume of distribution (V/F) = 8.3 · (weight/71.65) L, and kf = 0.341 h-1. A sigmoid relationship between triflusal concentration and the probability of significant inhibition with shape factor was chosen as the final PD model. No time delay between concentration and response was identified. The final structure between predicted concentration and the probability of inhibition of platelet aggregation (IPA) relationship was as follows: Probability of . Thus, we concluded this relationship is more like quantal concentration-response relationship. The current dosing regimen was considered to be efficacious based on the EC50 estimate of 84.9 μg/mL obtained in this study. Conclusions A PK and binary probability PD model of triflusal was successfully developed for Korean healthy volunteers. The model may be used to further prediction inhibition of platelet aggregation by triflusal. Trial registration Clinical Research Information Service (CRIS), KCT0001299 (Registered December 5, 2014)
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Kim JH, Lee JH, Jang SY, Park SH, Bae MH, Yang DH, Park HS, Cho Y, Chae SC. Prognostic value of early acute kidney injury after primary percutaneous coronary intervention in patients with ST-segment elevation myocardial infarction. Am J Cardiol 2014; 114:1174-8. [PMID: 25159240 DOI: 10.1016/j.amjcard.2014.07.039] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2014] [Revised: 07/09/2014] [Accepted: 07/09/2014] [Indexed: 01/18/2023]
Abstract
The pattern and prognostic impact of "early" acute kidney injury (AKI) after primary percutaneous coronary intervention (PCI) in patients with ST-segment elevation myocardial infarction have not been well established. From November 2005 to November 2011, 971 post-myocardial infarction patients who underwent primary PCI were analyzed. Early AKI was defined using absolute change in serum creatinine (SCr; SCr <24 hours after primary PCI minus admission SCr) as follows: no early AKI (SCr change <0.3 mg/dl), mild early AKI (SCr change 0.3 to <0.5 mg/dl), moderate early AKI (SCr change 0.5 to <1.0 mg/dl), and severe early AKI (SCr change ≥1.0 mg/dl). One-year major adverse cardiac events were defined as death, nonfatal myocardial infarction, and revascularizations. Overall, 9.6% had early AKI, including 5.7% with mild, 2.5% with moderate, and 1.4% with severe early AKI. Diabetes mellitus (odds ratio 1.84, p = 0.042), the left ventricular ejection fraction (odds ratio 0.97, p = 0.042), and hemoglobin levels (odds ratio 0.84, p = 0.039) were independently associated with early AKI. Early AKI (adjusted hazard ratio 2.80, p = 0.005) was an independent predictor of 1-year major adverse cardiac events. The adjusted hazard ratios of 1-year major adverse cardiac events from the lowest (reference) to the highest quartile of early AKI were as follows: 1, 2.87 (p = 0.012), 3.22 (p = 0.021), and 5.83 (p = 0.004), respectively. In conclusion, early dynamic change in renal function after primary PCI can sensitively predict worse outcomes.
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Jang SY, Bae MH, Kim JH, Park SH, Lee JH, Yang DH, Park HS, Cho Y, Chae SC. Predictors and clinical implications of minimal ST-segment elevation in patients with ST-segment elevation myocardial infarction. Cardiology 2014; 128:273-81. [PMID: 24903255 DOI: 10.1159/000362438] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2014] [Accepted: 03/25/2014] [Indexed: 01/30/2023]
Abstract
OBJECTIVES Some patients with suspected ST-segment elevation (STE) myocardial infarction (STEMI) show STE that does not fulfill the current criteria for STEMI. The purpose of this study was to investigate the characteristics and prognoses of patients with minimal STEMI. METHODS Between November 2007 and December 2011, 546 patients who underwent primary percutaneous coronary intervention (PCI) for STEMI were enrolled. RESULTS The minimal STE group had a higher proportion of women (30.2 vs. 21.0%, p = 0.031), better pre-PCI antegrade flow (Thrombolysis in Myocardial Infarction flow 2-3, 30.2 vs. 18.8%, p = 0.006) and better collateralization (Rentrop score 2-3, 27.4 vs. 18.1%, p = 0.024) compared to the definite STE group. Multivariate analysis showed that each of them were independent predictors for minimal STE. However, 1-year mortality of the minimal STE group did not differ from that of the definite STE group (7.1 vs. 9.3%, log-rank p = 0.315). CONCLUSIONS Female gender, good collateral flow and good pre-PCI antegrade flow were independent predictors for minimal STE in patients with STEMI. However, minimal STE was not related to a good prognosis in patients with STEMI.
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Jang SY, Choi WS, Bae MH, Lee JH, Yang DH, Park HS, Cho Y, Chae SC. PREDICTORS AND CLINICAL IMPLICATIONS OF MINIMAL ST-SEGMENT ELEVATION IN PATIENTS WITH ST-SEGMENT ELEVATION MYOCARDIAL INFARCTION. J Am Coll Cardiol 2014. [DOI: 10.1016/s0735-1097(14)60077-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Jang SY, Lee JH, Kim JH, Park SH, Bae MH, Yang DH, Park HS, Cho Y, Chae SC. TCTAP A-044 Prognostic Value of N-terminal Pro-brain Natriuretic Peptide in Patients Undergoing Percutaneous Coronary Intervention with Left Main Coronary Artery Disease. J Am Coll Cardiol 2014. [DOI: 10.1016/j.jacc.2014.02.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Park SH, Yang DH, Lee JH, Bae MH, Jang SY, Kim JH, Park HS, Cho Y, Chae SC. PROCALCITONIN AS PREDICTOR OF SHORT TERM MORTALITY IN PATIENT WITH ACUTE HEART FAILURE. J Am Coll Cardiol 2014. [DOI: 10.1016/s0735-1097(14)60792-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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96
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Bae MH, Lee JH, Yang DH, Park HS, Cho Y, Chae SC. White blood cell, hemoglobin and platelet distribution width as short-term prognostic markers in patients with acute myocardial infarction. J Korean Med Sci 2014; 29:519-26. [PMID: 24753699 PMCID: PMC3991795 DOI: 10.3346/jkms.2014.29.4.519] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2013] [Accepted: 02/11/2014] [Indexed: 11/20/2022] Open
Abstract
The aim of this study was to assess the prognostic value of combined use of white blood cell (WBC), hemoglobin (Hb), and platelet distribution width (PDW) in patients with acute myocardial infarction (AMI). This study included 1,332 consecutive patients with AMI. Patients were categorized into complete blood cell (CBC) group 0 (n=346, 26.0%), 1 (n=622, 46.7%), 2 (n=324, 24.3%), and 3 (n=40, 3.0%) according to the sum of the value defined by the cut-off levels of WBC (1, ≥ 14.5 × 10(3)/µL; 0, <14.5 × 10(3)/µL), Hb (1, <12.7 g/dL; 0, ≥ 12.7 g/dL), and PDW (1, ≥ 51.2%; 0: <51.2%). In-hospital death occurred in 59 (4.4%) patients. Patients who died during index hospitalization had higher WBC and PDW and lower Hb. The patients could be stratified for in-hospital mortality according to CBC group; 1.2%, 2.7%, 9.0%, and 22.5% in CBC groups 0, 1, 2, and 3 (P<0.001), respectively. In multivariate logistic regression analysis, CBC group ≥ 2 (odds ratio, 3.604; 95% confidence interval, 1.040-14.484, P=0.043) was an independent predictor for in-hospital death. The prognostic impact of the combined use of CBC markers remained significant over 12 months. In conclusions, combination of WBC, Hb, and PDW, a cheap and simple hematologic marker, is useful in early risk stratification of patients with AMI.
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Bae MH, Lee JH, Yang DH, Park HS, Cho Y, Chae SC. Usefulness of Surgical Parameters as Predictors of Postoperative Cardiac Events in Patients Undergoing Non-Cardiac Surgery. Circ J 2014; 78:718-23. [DOI: 10.1253/circj.cj-13-1208] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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98
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Song JH, Cheon SS, Bae MH, Lee JH, Yang DH, Park HS, Cho Y, Chae SC. Cardiovascular beriberi: rare cause of reversible pulmonary hypertension. Yeungnam Univ J Med 2014. [DOI: 10.12701/yujm.2014.31.1.38] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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99
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Cha KS, Cho KI, Seo JS, Choi JH, Park YH, Yang DH, Hong GR, Kim DS. Effects of inhaled iloprost on exercise capacity, quality of life, and cardiac function in patients with pulmonary arterial hypertension secondary to congenital heart disease (the Eisenmenger syndrome) (from the EIGER Study). Am J Cardiol 2013; 112:1834-9. [PMID: 24012036 DOI: 10.1016/j.amjcard.2013.08.003] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2013] [Revised: 08/01/2013] [Accepted: 08/01/2013] [Indexed: 02/08/2023]
Abstract
There are limited data on the effect of iloprost therapy in patients with Eisenmenger syndrome (ES). The aim of our study was to evaluate the effect of inhaled iloprost therapy on exercise capacity, quality of life (QoL), cardiac function, and hemodynamics in patients with ES. Eighteen consecutive patients with ES and exertional dyspnea according to the World Health Organization functional class III or IV were prospectively recruited. Exercise capacity was assessed by a 6-minute walk test, and QoL was measured on a 12-Item Short-Form Health Survey. Echocardiographic measurements included peak systolic and mean pulmonary arterial pressures, pulmonary vascular resistance, and myocardial performance index of the right ventricle (RV). All patients underwent comprehensive evaluation at baseline and after 24 weeks of treatment. Of the 18 patients with ES, 13 were included for analysis. After 24 weeks of iloprost therapy, 6-minute walk test distance significantly increased (289.1 ± 76.9 to 369.5 ± 93.4 m, p = 0.032) in addition to concomitant improvements in the 12-Item Short-Form Health Survey physical and mental component summaries (20.6 ± 19.3 to 52.6 ± 28.0, p <0.05; 33.9 ± 19.7 to 54.9 ± 21.3, p <0.05, respectively). RV myocardial performance index improved significantly after treatment (0.80 ± 0.31 to 0.59 ± 0.12, p = 0.042). Pulmonary arterial pressure and pulmonary vascular resistance did not improve with iloprost therapy. This study showed that 24 weeks of inhaled iloprost therapy in patients with ES led to significant improvements in exercise capacity, QoL, and RV function. These results likely explain the symptomatic relief reported by patients with ES receiving iloprost therapy.
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Hwang JH, Kam S, Shin JY, Kim JY, Lee KE, Kwon GH, Chun BY, Chae SC, Yang DH, Park HS, Hwang TY. Incidence of metabolic syndrome and relative importance of five components as a predictor of metabolic syndrome: 5-year follow-up study in Korea. J Korean Med Sci 2013; 28:1768-73. [PMID: 24339707 PMCID: PMC3857373 DOI: 10.3346/jkms.2013.28.12.1768] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2013] [Accepted: 10/08/2013] [Indexed: 11/20/2022] Open
Abstract
The aim of this study was to describe the incidence of metabolic syndrome and to identify five components as metabolic syndrome predictors. The final study included 1,095 subjects enrolled in a rural part of Daegu Metropolitan City, Korea for a cohort study in 2003. Of these, 762 (69.6%) subjects had participated in the repeat survey. During the five-year follow-up, incidence density was significantly higher for women than for men (men, 30.0/1,000 person-years; women, 46.4/1,000 person-years). In both men and women, incidence of metabolic syndrome showed a significant increase with increasing number of metabolic syndrome components at baseline. Compared with individuals presenting none of components at baseline, relative risks were increased 1.22 (men; 95% CI, 0.43-3.51), 2.21 (women; 95% CI, 0.98-4.97) times more for individuals with one component of metabolic syndrome and 5.30 (men; 95% CI, 2.31-12.13), 5.53 (women; 95% CI, 2.78-11.01) times more for those who had two components. In multivariate analysis, the most powerful risk factor for metabolic syndrome was abdominal obesity in men and low HDL-cholesterol in women (adjusted relative risk, 3.28, 2.53, respectively). Consequently, finding a high risk group for metabolic syndrome according to gender and prevention of metabolic syndrome through lifestyle modification are essential.
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