1
|
Kim MC, Ahn Y, Kim MH, Kim SY, Hong TJ, Rhee MY, Kim SH, Hong SJ, Kim H, Kim W, Chae IH, Kang DH, Kim BK, Kim HS. A Randomized, Multicenter, Double-blind, Placebo-Controlled Study to Evaluate the Efficacy and Safety of a Quadruple Combination of Amlodipine, Losartan, Rosuvastatin, and Ezetimibe in Patients with Concomitant Essential Hypertension and Dyslipidemia. Am J Cardiovasc Drugs 2023:10.1007/s40256-023-00590-9. [PMID: 37395974 DOI: 10.1007/s40256-023-00590-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/22/2023] [Indexed: 07/04/2023]
Abstract
BACKGROUND Few data are available regarding the efficacy and safety of a single-pill combination (SPC) consisting of four medications in patients with concomitant hypertension and dyslipidemia. OBJECTIVE We aimed to determine the efficacy and tolerability of a fixed-dose SPC consisting of 5 mg amlodipine, 100 mg losartan, 20 mg rosuvastatin, and 10 mg ezetimibe (A/L/R/E) in patients with concomitant hypertension and dyslipidemia. METHODS This was a 14-week, randomized, multicenter, double-blind, placebo-controlled, phase III clinical trial. In total, 145 patients were randomized to receive A/L/R/E, A/L, or L/R/E. The primary endpoints were the average change in the low-density lipoprotein cholesterol (LDL-C) level in the A/L/R/E and A/L groups and the sitting systolic blood pressure (sitSBP) in the A/L/R/E and L/R/E groups. The numbers of patients with adverse drug reactions (ADRs) were compared as safety variables. RESULTS The average percentage change in the LDL-C level as the least squares mean (LSM) from the baseline LDL-C level at the end of the 8-week treatment was - 59.0% in the A/L/R/E group and 0.2% in the A/L group (LSM difference - 59.2, 95% confidence interval [CI] - 68.1 to - 50.4; p < 0.0001). The average change in the sitSBP as the LSM was - 15.8 mmHg in the A/L/R/E group and -4.7 mmHg in the L/R/E group (LSM difference - 11.1, 95% CI - 16.8 to - 5.4; p = 0.0002). No ADRs occurred in the A/L/R/E group. CONCLUSIONS A/L/R/E as an SPC could be an effective treatment for patients with hypertension and dyslipidemia without significant safety issues. CLINICAL TRIALS REGISTRATION NCT04074551 (registered 30 August 2019).
Collapse
Affiliation(s)
- Min Chul Kim
- Division of Cardiology, Department of Internal Medicine, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Youngkeun Ahn
- Division of Cardiology, Department of Internal Medicine, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Moo Hyun Kim
- Department of Cardiology, Dong-A University Medical School, Pusan, Republic of Korea
| | - Seok-Yeon Kim
- Department of Cardiology, Seoul Medical Center, Seoul, Republic of Korea
| | - Taek Jong Hong
- Division of Cardiology, Department of Internal Medicine, Pusan National University Medical School, Pusan, Republic of Korea
| | - Moo-Yong Rhee
- Cardiovascular Center, Dongguk University Ilsan Hospital, Goyang, Republic of Korea
| | - Sang-Hyun Kim
- Division of Cardiology, Department of Internal Medicine, SMG-SNU Seoul Boramae Hospital, Seoul National University Medical School, Seoul, Republic of Korea
| | - Soon-Jun Hong
- Department of Cardiology, Cardiovascular Center, Korea University College of Medicine, Seoul, Republic of Korea
| | - Hyungseop Kim
- Keimyung University Dongsan Medical Center, Daegu, Republic of Korea
| | - Weon Kim
- Division of Cardiovascular, Department of Internal Medicine, Kyung Hee University Hospital, Kyung Hee University Medical School, Seoul, Republic of Korea
| | - In Ho Chae
- Cardiovascular Center, Seoul National University Bundang Hospital, Seoul National University Hospital, Seongnam, Republic of Korea
| | - Duk-Hyun Kang
- Division of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Byeong-Keuk Kim
- Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hyo-Soo Kim
- Department of Internal Medicine, Cardiovascular Center, Seoul National University Hospital, Seoul National University Medical School, 101, Daehak-ro, Jongro-gu, Seoul, 03080, Republic of Korea.
| |
Collapse
|
2
|
Kim BJ, Cha KS, Cho WH, Kim EJ, Chae IH, Choi SH, Kim MH, Kim SH, Park JB, Park SM. PS-BPC12-2: EFFICACY AND SAFETY OF SINGLE-PILL COMBINATION OF OLOMAX&ACIRC; (OLMESARTAN, AMLODIPINE, AND ROSUVASTATIN) IN HYPERTENSIVE PATIENTS WITH LOW-TO-MODERATE CARDIOVASCULAR RISK. J Hypertens 2023. [DOI: 10.1097/01.hjh.0000916052.82849.30] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
|
3
|
Lee W, Kang SH, Kim SH, Chae IH. Impact of dementia and drug compliance on patients with acute myocardial infarction. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
There has been a worrying rise in the number of people with dementia, especially with many of them also suffering from acute myocardial infarction (AMI), a disease with a high mortality rate.
Purpose
We evaluated the impact of dementia on the mortality of patients with AMI and how drug compliance affects this relationship.
Methods
The data were derived from National Health Insurance Service-Senior. The total number of patients diagnosed with AMI for the first time between 2007 and 2013 was 16,835, among whom 2,021 had dementia. Medication possession ratio (MPR) was used to assess medication adherence.
Results
AMI patients with dementia had unfavorable baseline characteristics; they had significantly higher risk of all-cause mortality (Hazard ratio [HR]: 2.49; 95% confidence interval (CI): 2.34–2.66; P<0.001) and lower MPR (aspirin: 21.9% vs. 42.8%; P<0.001). AMI patients were stratified by presence of dementia and medication adherence, and the survival rate was the highest among those with no dementia and good adherence. followed by those with no dementia and poor adherence, those with dementia and good adherence, and those with dementia and poor adherence. The multivariable analysis revealed that dementia (HR: 1.64; 95% CI: 1.53–1.75; P<0.001) and poor adherence to medication (HR: 1.60; 95% CI: 1.49–1.71; P<0.001) had a significant association with all-cause mortality in AMI patients.
Conclusions
AMI patients with dementia have a higher mortality rate. Patients with dementia have poorer medication adherence than those without, negatively affecting their prognosis.
Funding Acknowledgement
Type of funding sources: None.
Collapse
Affiliation(s)
- W Lee
- Seoul National University Bundang Hospital , Seongnam , Korea (Republic of)
| | - S H Kang
- Seoul National University Bundang Hospital , Seongnam , Korea (Republic of)
| | - S H Kim
- Seoul National University Bundang Hospital , Seongnam , Korea (Republic of)
| | - I H Chae
- Seoul National University Bundang Hospital , Seongnam , Korea (Republic of)
| |
Collapse
|
4
|
Suh JW, Kang H, Kim J, Cho HW, Lee W, Yoon CH, Youn TJ, Chae IH. Prediction of endogenous thrombolytic activity in patients with coronary artery disease. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Endogenous thrombolytic activity (ETA) has been suggested as an essential factor related to the acute coronary syndrome. However, there have been little data regarding clinical characteristics of ETA in East Asians.
Method
As an interim study of the entire cohort (n=2,000), we analyzed a total of 278 patients who underwent percutaneous coronary intervention (PCI) due to coronary artery disease (CAD). Informed consent was obtained from all research subjects. Blood samples of patients were brought before the procedure. The Global Thrombosis Test (GTT, Thromboquest, UK), a novel test for examining ETA, was used. Lysis time (LT), which means the time interval between blood flow occlusion and restart, was used as an indicator for ETA. Clinical, laboratory and angiographic characteristics were obtained. LT=3000 seconds was used as a cut-off value to divide patients into two groups. P value<0.05 was regarded as significant.
Results
LT of Korean CAD patients showed bimodal distribution. Median value was 1695 [IQR: 1099, 5932] and it was higher than previous data from Europeans (Figure 1). Patients with impaired ETA (LT>3000) were older and more diabetic. They showed higher creatinine, aPTT, fibrinogen, D-dimer, c-reactive protein, and proBNP values. Moreover, they had lower hemoglobin and platelet levels. Intracoronary thrombus was more frequently observed in LT>3000 group. In the multivariable regression analysis, hemoglobin (per g/dL, odds ratio 0.766, 95% confidence interval (CI) 0.632–0.928) and fibrinogen level(per 10mg/L, odds ratio 1.054, 95% CI 1.015–1.095) could significantly predict impaired ETA.
Conclusion
East Asian patients showed a right-shifted distribution of ETA compared to that of Europeans. Patients with impaired ETA had different clinical, laboratory and angiographic characteristics from those with intact ETA. Hemoglobin and fibrinogen level were significantly associated with impaired ETA. Further studies are warranted to confirm causal relationship among these factors.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): National Research Foundation, Republic of Korea
Collapse
Affiliation(s)
- J W Suh
- Seoul National University Bundang Hospital, Seongnam, Korea (Republic of)
| | - H Kang
- Seoul National University College of Medicine, Seoul, Korea (Republic of)
| | - J Kim
- Seoul National University College of Medicine, Seoul, Korea (Republic of)
| | - H W Cho
- Seoul National University Bundang Hospital, Seongnam, Korea (Republic of)
| | - W Lee
- Seoul National University Bundang Hospital, Seongnam, Korea (Republic of)
| | - C H Yoon
- Seoul National University Bundang Hospital, Seongnam, Korea (Republic of)
| | - T J Youn
- Seoul National University Bundang Hospital, Seongnam, Korea (Republic of)
| | - I H Chae
- Seoul National University Bundang Hospital, Seongnam, Korea (Republic of)
| |
Collapse
|
5
|
Moon MG, Yoon CH, Lee K, Kang SH, Youn TJ, Chae IH. Evaluation of Heart-type Fatty Acid-binding Protein in Early Diagnosis of Acute Myocardial Infarction. J Korean Med Sci 2021; 36:e61. [PMID: 33650337 PMCID: PMC7921368 DOI: 10.3346/jkms.2021.36.e61] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 12/16/2020] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Although electrocardiography and cardiac troponin play important roles in the diagnosis of acute coronary syndrome (ACS), there remain unmet clinical needs. Heart-type fatty acid-binding protein (H-FABP) has been identified as an early diagnostic marker of acute myocardial infarction (AMI). In this study, we examined the diagnostic and prognostic value of H-FABP in patients suspected with ACS. METHODS We conducted an observational single-center cohort study, including 89 adults aged 30 years or older, who presented to the emergency room (ER) within 24 hours after the onset of chest pain and/or dyspnea. We performed laboratory analysis and point-of-care testing (POCT) for cardiac markers, including H-FABP, troponin I, and creatine kinase-myocardial band. We also evaluated the correlation between cardiac markers and left ventricular (LV) dysfunction and extent of coronary artery disease (CAD). RESULTS In patients presented to ER within 4 hours after symptom onset (n = 49), the diagnostic accuracy of H-FABP for AMI, as quantified by the area under the receiver operating characteristic curve, was higher (0.738; 95% confidence interval [CI], 0.591-0.885) than other cardiac markers. In POCT, the diagnostic accuracy of H-FABP (56%; 95% CI, 45-67) was significantly higher than other cardiac markers. H-FABP was correlated with not extent of CAD but post-AMI LV dysfunction. CONCLUSION H-FABP is a useful cardiac marker for the early diagnosis of AMI and prediction of myocardia injury. Difference in the circulatory release timeline of cardiac markers could explain its utility in early-stage of myocardial injury.
Collapse
Affiliation(s)
- Mi Gil Moon
- Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Chang Hwan Yoon
- Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Internal Medicine, College of Medicine, Seoul National University, Seoul, Korea.
| | - Kyunghoon Lee
- Department of Laboratory Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Laboratory Medicine, College of Medicine, Seoul National University, Seoul, Korea
| | - Si Hyuck Kang
- Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Internal Medicine, College of Medicine, Seoul National University, Seoul, Korea
| | - Tae Jin Youn
- Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Internal Medicine, College of Medicine, Seoul National University, Seoul, Korea
| | - In Ho Chae
- Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Internal Medicine, College of Medicine, Seoul National University, Seoul, Korea
| |
Collapse
|
6
|
Choi W, Kim CH, Hwang IC, Yoon CH, Yoon YE, Chae IH, Cho GY. Three-dimensional myocardial strain for the prediction of clinical events in patients with successfully reperfused ST-segment elevation myocardial infarction. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeaa356.156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background/Introduction
Two-dimensional (2D) myocardial strain analysis can be used to evaluate the prognosis of patients with acute myocardial infarction and has comparable predictive power as conventional echocardiographic parameters such as left ventricular ejection fraction (LV EF). Three-dimensional (3D) myocardial strain analysis is also expected to have similar clinical usefulness and overcome several inherent limitations of 2D strain analysis. However, no large-scale studies have been reported to date.
Purpose
We aimed to clarify the prognostic significance of 3D strain analysis in patients with ST-segment elevation myocardial infarction (STEMI) who are most likely to benefit from 3D strain analysis.
Methods
Patients who underwent successful revascularization for STEMI from June 2011 to April 2017 were retrospectively recruited. In addition to conventional echocardiographic parameters, 3D global area strain (GAS), 3D global longitudinal strain (GLS), as well as 2D GLS were obtained.
To evaluate the clinical outcomes, we constructed a composite outcome consisting of all-cause death or re-hospitalisation due to acute decompensation of heart failure.
Results
From June 2011 to April 2017, 632 patients were retrospectively recruited in our hospital. Of these patients, 545 patients (86.2%) had a reliable 3D strain analysis. The clinical course of each patient was followed up for a maximum of 96 months (median 49.5 months). During follow-up periods, 55 (10.1%) among 545 patients experienced the composite outcome of all-cause death or re-hospitalisation due to acute decompensation of heart failure. Patients with adverse events were older, had more underlying diseases such as obesity, dyslipidemia, previous history of stroke, or chronic kidney disease. (all, p < 0.05) LV EF was significantly lower, while 2D GLS, 3D GLS, and 3D GAS were significantly higher in patients with poor outcomes. (all, p < 0.001) The area under the receiver operating characteristic curve (AUC) values of LV EF, 2D GLS, 3D GLS, and 3D GAS were 0.70, 0.71, 0.67, and 0.65, respectively. (all, p < 0.05) Kaplan-Meier analysis of composite outcomes based on the best cut-off values of each parameter demonstrated similar results. (Figure 1) In the Cox proportional hazard model, the hazard ratios of LV EF, 2D GLS, and 3D GLS were 3.0, 5.5, and 2.0, respectively. (all, p < 0.05) The maximum likelihood-ratio test was performed to evaluate the additional prognostic value of 2D GLS or 3D GLS over the basic prognostic model consisting of baseline clinical characteristics and LV EF, and the likelihood ratio was 15.9 for 2D GLS (p < 0.001) and 1.49 for 3D GLS (p = 0.22).
Conclusion(s)
3D strain could be reliably measured in the majority of the patients and had a significant prognostic value. However, the predictive power of the 3D strain was lower than that of the 2D strain. The clinical implications of 3D strain indices should be investigated further.
Abstract Figure.
Collapse
Affiliation(s)
- W Choi
- Seoul National University Bundang Hospital, Seongnam, Korea (Republic of)
| | - CH Kim
- Sejong General Hospital, Bucheon, Korea (Republic of)
| | - IC Hwang
- Seoul National University Bundang Hospital, Seongnam, Korea (Republic of)
| | - CH Yoon
- Seoul National University Bundang Hospital, Seongnam, Korea (Republic of)
| | - YE Yoon
- Seoul National University Bundang Hospital, Seongnam, Korea (Republic of)
| | - IH Chae
- Seoul National University Bundang Hospital, Seongnam, Korea (Republic of)
| | - GY Cho
- Seoul National University Bundang Hospital, Seongnam, Korea (Republic of)
| |
Collapse
|
7
|
Lim C, Won H, Ko YG, Lee SJ, Ahn CM, Min PK, Lee JH, Yoon CH, Yu CW, Lee SW, Lee SR, Choi SH, Chae IH, Choi D. Association between Body Mass Index and Clinical Outcomes of Peripheral Artery Disease after Endovascular Therapy: Data from K-VIS ELLA Registry. Korean Circ J 2021; 51:696-707. [PMID: 34327883 PMCID: PMC8326216 DOI: 10.4070/kcj.2021.0040] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 04/28/2021] [Accepted: 06/09/2021] [Indexed: 12/12/2022] Open
Abstract
We investigated the association between body mass index and clinical outcomes of peripheral artery disease (PAD) after endovascular therapy (EVT). A total of 2914 PAD patients undergoing EVT were participated according to body mass index groups. Underweight was significantly associated with increased risk of major adverse cardiovascular events (MACE) (adjusted hazard ratio [HR], 1.540; 95% confidence interval [CI], 1.091–2.173) and major adverse limb events (MALE) (adjusted HR, 1.523; 95% CI, 1.066–2.177) compared with normal weight. Plus, overweight was associated with lower risk of MACE and not with MALE. However, obesity showed no significant association with MACE or MALE. Background and Objectives Few studies have investigated the obesity paradox in clinical outcomes of peripheral artery disease (PAD). We investigated the association between body mass index (BMI) and clinical outcomes in PAD patients undergoing endovascular therapy (EVT). Methods Patients (n=2,914) from the retrospective Korean Vascular Intervention Society Endovascular Therapy in Lower Limb Artery Disease registry were categorized according to BMI: underweight (<18.5 kg/m2, n=204), normal weight (18.5–25 kg/m2, n=1,818), overweight (25–30 kg/m2, n=766), or obese (≥30 kg/m2, n=126). Groups were compared for major adverse cardiovascular events (MACE) and major adverse limb events (MALE). Results The underweight and obese groups were older and had more frequent critical limb ischemia and infrapopliteal artery disease than the normal or overweight groups (all p<0.001). Hypertension and diabetes were more frequent and current smoking was less frequent in the overweight and obese groups than the underweight or normal weight groups (all p <0.001). The underweight group showed the higher rates of MACE and MALE at 3 years (17.2%, 15.7%) compared with the normal weight (10.8%, 11.7%), overweight (8.4%, 10.7%), or obese groups (8.7%, 14.3%) (log-rank p<0.001, p=0.015). In contrast, the risk of MACE was lower in the overweight than the normal weight group (adjusted hazard ratio, 0.706; 95% CI, 0.537–0.928). Conclusions In PAD patients undergoing EVT, underweight was an independent predictor for MACE and MALE, whereas MACE risk was lower for overweight than normal weight patients. Trial Registration ClinicalTrials.gov Identifier: NCT02748226
Collapse
Affiliation(s)
- Chewan Lim
- Division of Cardiology, Department of Internal Medicine, Myongji Hospital, Hanyang University College of Medicine, Goyang, Korea
| | - Hoyoun Won
- Cardiovascular & Arrhythmia Center, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea
| | - Young Guk Ko
- Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea.
| | - Seung Jun Lee
- Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Chul Min Ahn
- Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Pil Ki Min
- Division of Cardiology, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Jae Hwan Lee
- Division of Cardiology, Department of Internal Medicine, Chungnam National University Hospital, Daejeon, Korea
| | - Chang Hwan Yoon
- Division of Cardiology, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Cheol Woong Yu
- Division of Cardiology, Department of Internal Medicine, Korea University Anam Hospital, Seoul, Korea
| | - Seung Whan Lee
- Division of Cardiology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sang Rok Lee
- Division of Cardiology, Department of Internal Medicine, Chonbuk National University Hospital, Jeonju, Korea
| | - Seung Hyuk Choi
- Division of Cardiology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - In Ho Chae
- Division of Cardiology, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Donghoon Choi
- Division of Cardiology, Department of Internal Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Korea
| | | |
Collapse
|
8
|
Choi W, Kim SH, Lee W, Kang SH, Yoon CH, Youn TJ, Chae IH. Comparison of Continuous ECG Monitoring by Wearable Patch Device and Conventional Telemonitoring Device. J Korean Med Sci 2020; 35:e363. [PMID: 33200590 PMCID: PMC7669461 DOI: 10.3346/jkms.2020.35.e363] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 09/01/2020] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Detection of arrhythmias is crucial for the treatment of cardiovascular diseases. However, conventional devices do not provide sufficient diagnostic accuracy while patients should suffer from bothersome diagnostic process. We sought to evaluate diagnostic capability and safety of the new adhesive electrocardiogram (ECG) monitoring device in patients who need ECG monitoring during admission. METHODS We enrolled 10 patients who admitted to Seoul National University Bundang Hospital and required continuous ECG monitoring between October 31, 2019 and December 18, 2019. New adhesive ECG monitoring device and conventional ECG monitoring device were simultaneously applied to the patients and maintained for 48 hours. From each patient, 48 pairs of ECG signal were collected and analyzed by two cardiologists independently. Discrepancy of diagnosis and frequency of noise or signal loss were compared between the two devices. RESULTS From analyzable ECG data, discrepancy of arrhythmia diagnosis was not observed between the two devices. Noise rate was higher in conventional ECG monitoring device (2.5% vs. 17.3%, P < 0.001) and signal loss was not observed in new adhesive device while there was 9.4% of signal losses in conventional Holter recorder group. The new device was well-tolerated among 48 hours of monitoring period and no adverse event was observed. CONCLUSION A newer adhesive ECG monitoring device demonstrated similar diagnostic accuracy compared to conventional ECG monitoring device.
Collapse
Affiliation(s)
- Wonsuk Choi
- Cardiovascular Center, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Sun Hwa Kim
- Cardiovascular Center, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Wonjae Lee
- Cardiovascular Center, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Si Hyuck Kang
- Cardiovascular Center, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Chang Hwan Yoon
- Cardiovascular Center, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
| | - Tae Jin Youn
- Cardiovascular Center, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - In Ho Chae
- Cardiovascular Center, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| |
Collapse
|
9
|
Lee KY, Lee BK, Kim WJ, Kang SH, Park TK, Kim SY, Suh JW, Yoon CH, Yang DH, Ryu SK, Kim SH, Lee SY, Chae IH. Consensus Statement on Coronary Intervention during the Coronavirus Disease 2019 (COVID-19) Pandemic: from the Korean Society of Interventional Cardiology (KSIC). Korean Circ J 2020; 50:974-983. [PMID: 33118332 PMCID: PMC7596212 DOI: 10.4070/kcj.2020.0283] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 08/24/2020] [Accepted: 09/08/2020] [Indexed: 01/30/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) is a highly contagious disease caused by the novel virus severe acute respiratory syndrome coronavirus-2. The first case developed in December, 2019 in Wuhan, China; several months later, COVID-19 has become pandemic, and there is no end in sight. This disaster is also causing serious health problems in the area of cardiovascular intervention. In response, the Korean Society of Interventional Cardiology formed a COVID-19 task force to develop practice guidelines. This special article introduces clinical practice guidelines to prevent secondary transmission of COVID-19 within facilities; the guidelines were developed to protect patients and healthcare workers from this highly contagious virus. We hope these guidelines help healthcare workers and cardiovascular disease patients around the world cope with the COVID-19 pandemic.
Collapse
Affiliation(s)
- Kwan Yong Lee
- Department of Cardiology, Incheon St. Mary's Hospital, The Catholic University of Korea, Incheon, Korea
| | - Bong Ki Lee
- Division of Cardiology, Department of Internal Medicine, Kangwon National University Hospital, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Won Jang Kim
- Department of Cardiology, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea
| | - Se Hun Kang
- Department of Cardiology, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea
| | - Taek Kyu Park
- Division of Cardiology, Department of Medicine, Heart Vascular and Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Song Yi Kim
- Division of Cardiology, Department of Internal Medicine, Jeju National University Hospital, Jeju National University School of Medicine, Jeju, Korea
| | - Jung Won Suh
- Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Chang Hwan Yoon
- Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Dong Heon Yang
- Division of Cardiology, Department of Internal Medicine, School of Medicine, Kyungpook National University Hospital, Daegu, Korea
| | - Sung Kee Ryu
- Division of cardiology, Nowon Eulji Medical Center, Eulji University, Seoul, Korea
| | - Sang Hyun Kim
- Division of Cardiology, Seoul Boramae Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Sung Yun Lee
- Cardiac and Vascular Center, Inje University Ilsan Paik Hospital, Goyang, Korea
| | - In Ho Chae
- Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam, Korea.
| | | |
Collapse
|
10
|
Jeong S, Kang SH, Yoon CH, Youn TJ, Chae IH, Kim SH. 1272Physical activity and mortality with and without cardiovascular disease. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background/Introduction
Physical activity has been shown to reduce mortality in a dose-response fashion. Current guidelines recommend 500 to 1,000 MET-min per week of regular physical activity. However, evidence is limited regarding the specific dose-response relationship in patients with cardiovascular disease.
Purpose
Our aim was to compare the impact of physical activity on mortality in primary versus secondary cardiovascular prevention.
Methods
We analyzed 441,798 individuals with complete information on physical activity levels between 2009 and 2015 were extracted from a population-based cohort (National Health Insurance Service-National Health Screening cohort). Physical activity measured by self-report questionnaires. A rating of 2.9, 4.0, and 7.0 METs were assigned for light-intensity, moderate-intensity, and vigorous-intensity activities, respectively. Physical activity-related energy expenditure (MET-min/week) was calculated by summing the product of frequency, intensity, and duration. The level of physical activity was classified into 0, 0 to 499, 500 to 999, 1,000 to 1,499, and ≥1,500 MET-min/week. Study participants were stratified by the presence of cardiovascular disease, defined as prior myocardial infarction, ischemic heart disease, prior stroke, and/or chronic heart failure. The main study outcome was all-cause mortality. The median follow-up duration was 5.9 years.
Results
Individuals with cardiovascular disease had lower physical activity levels and a higher risk of mortality than those without cardiovascular disease. There was an inverse relationship between the physical activity level and the mortality risk in both groups. The benefit in the secondary prevention group was shown to be greater than that in the primary prevention group: every 500 MET-min/week increase in physical activity resulted in a 14% and 7% risk reduction in mortality in the secondary and primary prevention groups, respectively (interaction P<0.001). In addition, while individuals without cardiovascular disease benefited the most between 0 and 500 MET-min/week of physical activity, the benefit in those with cardiovascular disease continued above 500 to 1,000 MET-min/week. The adjusted mortality risk of individuals with cardiovascular disease who performed a high level of physical activity (≥1,000 MET-min/week) was shown to be comparable to or lower than that of their counterparts without cardiovascular disease.
Adjusted risk of mortality
Conclusion
Individuals with cardiovascular disease may benefit from physical activity to a greater extent than do healthy subjects without cardiovascular disease. Clinicians should encourage patients with cardiovascular disease to maintain a physically active lifestyle as much as possible.
Collapse
Affiliation(s)
- S Jeong
- Seoul national university bundang hospital, SungNam, Korea (Republic of)
| | - S H Kang
- Seoul national university bundang hospital, SungNam, Korea (Republic of)
| | - C H Yoon
- Seoul national university bundang hospital, SungNam, Korea (Republic of)
| | - T J Youn
- Seoul national university bundang hospital, SungNam, Korea (Republic of)
| | - I H Chae
- Seoul national university bundang hospital, SungNam, Korea (Republic of)
| | - S H Kim
- Seoul national university bundang hospital, SungNam, Korea (Republic of)
| |
Collapse
|
11
|
Hudec M, Ijsselmuiden A, Trillo R, Gwon HC, Marques da Costa J, Chae IH, Burgos JM, Jeong MH, Mayurathan G, Charng MJ, Wang YC, Maskon O, Merkely B, Serra A, Theotonio R, Khokhlov A, Mateev H, Huang CY, Mar P. TCT-279 Safety and Efficacy of Sirolimus-Eluting Stent System in All-Comers Real-World Population With Coronary Artery Stenosis: The MILES-Global Study. J Am Coll Cardiol 2019. [DOI: 10.1016/j.jacc.2019.08.352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
12
|
Park JJ, Kim SH, Kim MA, Chae IH, Choi DJ, Yoon CH. Effect of Hyperglycemia on Myocardial Perfusion in Diabetic Porcine Models and Humans. J Korean Med Sci 2019; 34:e202. [PMID: 31347313 PMCID: PMC6660319 DOI: 10.3346/jkms.2019.34.e202] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2019] [Accepted: 07/03/2019] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Diabetes mellitus (DM) causes macro- and microvasculopathy, but data on cardiac microvascular changes in large animals are scarce. We sought to determine the effect of DM on macro- and microvascular changes in diabetic pigs and humans. METHODS Eight domestic pigs (4 with type I diabetes and 4 controls) underwent coronary angiography with optical coherence tomography (OCT; at baseline and 1 and 2 months), coronary computed tomography angiography, cardiac magnet resonance (CMR) imaging, and histologic examination. RESULTS The diabetic pigs had more irregular capillaries with acellular capillaries and a smaller capillary diameter (11.7 ± 0.33 μm vs. 13.5 ± 0.53 μm; P < 0.001) than those of the control pigs. The OCT showed no significant epicardial stenosis in either group; however diabetic pigs had a greater intima-media thickness. CMR results showed that diabetic pigs had a lower relative upslope at rest (31.3 ± 5.9 vs. 37.9 ± 8.1; P = 0.011) and during stress (18.0 ± 3.0 vs. 21.6 ± 2.8; P = 0.007) than the control pigs, implying decreased myocardial perfusion. Among the 79 patients with ST elevation myocardial infarction, 25 had diabetes and they had lower myocardial perfusion on CMR as well. CONCLUSION DM causes microvascular remodeling and a decrease in myocardial perfusion in large animals at a very early stage of the disease course. Early and effective interventions are necessary to interrupt the progression of vascular complications in diabetic patients.
Collapse
Affiliation(s)
- Jin Joo Park
- Division of Cardiology, Department of Internal Medicine, Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Sun Hwa Kim
- Division of Cardiology, Department of Internal Medicine, Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Myung A Kim
- Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea
| | - In Ho Chae
- Division of Cardiology, Department of Internal Medicine, Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Dong Ju Choi
- Division of Cardiology, Department of Internal Medicine, Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Chang Hwan Yoon
- Division of Cardiology, Department of Internal Medicine, Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam, Korea.
| |
Collapse
|
13
|
Hong YJ, Jeong MH, Bae JH, Oh SK, Rha SW, Hur SH, Lee SY, Kim SW, Cha KS, Chae IH, Ahn TH, Kim KS. Efficacy and safety of pitavastatins in patients with acute myocardial infarction: Livalo in Acute Myocardial Infarction Study (LAMIS) II. Korean J Intern Med 2017; 32:656-667. [PMID: 28618772 PMCID: PMC5511934 DOI: 10.3904/kjim.2016.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Revised: 02/12/2016] [Accepted: 11/10/2016] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND/AIMS We evaluated the efficacy and safety and influence on glucose tolerance by different doses of pitavastatins in acute myocardial infarction (AMI) patients. METHODS Consecutive 1,101 AMI patients who were enrolled in Livalo in Acute Myocardial Infarction Study (LAMIS)-II were randomly assigned to receive either 2 mg of pitavastatin or 4 mg of pitavastatin orally per day. Primary efficacy endpoint was composite of cardiac death, nonfatal myocardial infarction, target-lesion revascularization, and hospitalization for unstable angina, heart failure or arrhythmic events at 12-month. RESULTS There was no significant difference in primary efficacy endpoint between 2 mg and 4 mg groups (9.07% vs. 9.13%, p = 0.976). The degree of the reduction of low density lipoprotein cholesterol (LDL-C) was significantly greater in 4 mg group compared to 2 mg group from baseline to follow-up (-42.05 ± 32.73 mg/dL vs. -34.23 ± 31.66 mg/dL, p = 0.002). Fasting plasma glucose level was reduced significantly in both groups (-20.16 ± 54.49 mg/dL in 4 mg group and -24.45 ± 63.88 mg/dL in 2 mg group, p < 0.001 and p < 0.001, respectively) and there was no significant change of glycated hemoglobin in two groups from baseline to follow-up (-0.13% ± 1.21% in 4 mg group and -0.04% ± 1.10% in 2 mg group, p = 0.256 and p = 0.671, respectively). CONCLUSIONS Although LDL-C was reduced more significantly by using 4 mg of pitavastatin compared to 2 mg of pitavastatin, the event rate was comparable without adverse effects on glucose tolerance in both groups in AMI patients who were enrolled in LAMIS-II.
Collapse
Affiliation(s)
- Young Joon Hong
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Korea
| | - Myung Ho Jeong
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Korea
- Correspondence to Myung Ho Jeong, M.D. Department of Cardiology, Chonnam National University Hospital, 42 Jebong-ro, Dong-gu, Gwangju 61469, Korea Tel: +82-62-220-6243 Fax: +82-62-228-7174 E-mail:
| | - Jang Ho Bae
- Department of Cardiology, Konyang University Hospital, Daejeon, Korea
| | - Seok Kyu Oh
- Department of Cardiology, Wonkwang University Hospital, Iksan, Korea
| | - Seung Woon Rha
- Department of Cardiology, Korea University Guro Hospital, Seoul, Korea
| | - Seung Ho Hur
- Department of Cardiology, Keimyung University Dongsan Medical Center, Daegu, Korea
| | - Sung Yun Lee
- Department of Cardiology, Inje University Ilsan Paik Hospital, Goyang, Korea
| | - Sang Wook Kim
- Department of Cardiology, Chung-Ang University Hospital, Seoul, Korea
| | - Kwang Soo Cha
- Department of Cardiology, Pusan National University Hospital, Busan, Korea
| | - In Ho Chae
- Department of Cardiology, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Tae Hoon Ahn
- Department of Cardiology, Gachon University Gil Medical Center, Incheon, Korea
| | - Kee Sik Kim
- Department of Cardiology, Daegu Catholic University Medical Center, Daegu, Korea
| |
Collapse
|
14
|
Chae IH, Yoon CH, Park JJ, Oh IY, Suh JW, Cho YS, Youn TJ, Choi DJ. Comparison of Drug-Eluting Balloon Followed by Bare Metal Stent with Drug-Eluting Stent for Treatment of de Novo Lesions: Randomized, Controlled, Single-Center Clinical Trial. J Korean Med Sci 2017; 32:933-941. [PMID: 28480650 PMCID: PMC5426232 DOI: 10.3346/jkms.2017.32.6.933] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Accepted: 03/19/2017] [Indexed: 01/03/2023] Open
Abstract
The combined use of a drug-eluting balloon (DEB) and a bare metal stent (BMS) for the treatment of de novo non-small vessel coronary artery diseases (CAD) remains to be evaluated. We investigated the efficacy of a sequential treatment using a DEB together with a BMS implantation in comparison to a zotarolimus-eluting stent (ZES). This study was a prospective, randomized, open-label study. We designed it to demonstrate the non-inferiority of a sequential treatment using a DEB first followed by a BMS (DEB + BMS) compared with the use of a ZES. The primary endpoint was in-segment late loss (LL) at 9 months measured by quantitative coronary angiography (QCA). A total of 180 patients were enrolled in the study. The 9-month follow-up angiography was performed in 72 patients with DEB + BMS and 74 patients with ZES. When comparing the DEB + BMS results with the ZES ones, LL was 0.50 ± 0.46 mm in DEB + BMS patients vs. 0.21 ± 0.44 mm in ZES patients (P < 0.001). The mean difference of the LL was 0.31 mm, which was larger than the prespecified non-inferiority margin of 0.19 mm, and the 2-sided 95% confidence interval was 0.15-0.48. The clinical outcomes were not significantly different. In conclusion, the DEB + BMS strategy is inferior to the ZES one in terms of the LL result at 9 months. The DEB strategy for de novo coronary artery lesions needs to be improved for it to become an alternative treatment option.
Collapse
Affiliation(s)
- In Ho Chae
- Department of Internal Medicine, Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Chang Hwan Yoon
- Department of Internal Medicine, Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam, Korea.
| | - Jin Joo Park
- Department of Internal Medicine, Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Il Young Oh
- Department of Internal Medicine, Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Jung Won Suh
- Department of Internal Medicine, Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Young Seok Cho
- Department of Internal Medicine, Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Tae Jin Youn
- Department of Internal Medicine, Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Dong Ju Choi
- Department of Internal Medicine, Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam, Korea
| |
Collapse
|
15
|
Ahn JM, Cho MS, Kang SH, Park DW, Shin ES, Koo BK, Nam CW, Doh JH, Kim JH, Chae IH, Yoon J, Her SH, Seung KB, Chung WY, Yoo SY, Lee JB, si wan choi, Park K, Hong T, Lee SY, Lee PH, Kang SJ, Lee SW, Kim YH, Lee CW, Park SW, Park SJ. TCT-534 Fractional Flow Reserve and Cardiac Events In Coronary Artery Disease: Data From Prospective Registry. J Am Coll Cardiol 2016. [DOI: 10.1016/j.jacc.2016.09.671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
16
|
Rhee TM, Lee JM, Hahn JY, Hwang D, Park J, Woo (KW) Park K, Kim HL, Kim SH, Chae IH, Doh JH, JEON KIHYUN, Choi YJ, Park JS, Choi SH, Gwon HC, Koo BK, Alfonso F, Kim HS. TCT-395 Comparison of Clinical Outcomes after Treatment of In-Stent Restenosis Using Drug-Eluting Balloon versus Newer Generation Drug-Eluting Stents: Patient-Level Pooled Analysis of Korean Multicenter In-Stent Restenosis Registry. J Am Coll Cardiol 2016. [DOI: 10.1016/j.jacc.2016.09.530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
17
|
Kim JY, Jeong MH, Choi YW, Ahn YK, Chae SC, Hur SH, Hong TJ, Kim YJ, Seong IW, Chae IH, Cho MC, Yoon JH, Seung KB. Temporal trends and in-hospital outcomes of primary percutaneous coronary intervention in nonagenarians with ST-segment elevation myocardial infarction. Korean J Intern Med 2015; 30:821-8. [PMID: 26552457 PMCID: PMC4642011 DOI: 10.3904/kjim.2015.30.6.821] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2014] [Revised: 10/13/2014] [Accepted: 11/13/2014] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND/AIMS Data regarding the outcomes of primary percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI) in nonagenarians are very limited. The aim of the present study was to evaluate the temporal trends and in-hospital outcomes of primary PCI in nonagenarian STEMI patients. METHODS We retrospectively reviewed data from the Korea Acute Myocardial Infarction Registry (KAMIR) from November 2005 to January 2008, and from the Korea Working Group on Myocardial Infarction (KorMI) from February 2008 to May 2010. RESULTS During this period, the proportion of nonagenarians among STEMI patients more than doubled (0.59% in KAMIR vs. 1.35% in KorMI), and the rate of use of primary PCI also increased (from 62.5% in KAMIR to 81.0% in KorMI). We identified 84 eligible study patients for which the overall in-hospital mortality rate was 21.4% (25.0% in KAMIR vs. 20.3% in KorMI, p = 0.919). Multivariate analysis identified two independent predictors of in-hospital mortality, namely a final Thrombolysis in Myocardial Infarction (TIMI) flow < 3 (odds ratio [OR], 13.7; 95% confidence interval [CI], 3.2 to 59.0; p < 0.001) and cardiogenic shock during hospitalization (OR, 6.7; 95% CI, 1.5 to 30.3; p = 0.013). CONCLUSIONS The number of nonagenarian STEMI patients who have undergone primary PCI has increased. Although a final TIMI flow < 3 and cardiogenic shock are independent predictors of in-hospital mortality, primary PCI can be performed with a high success rate and an acceptable in-hospital mortality rate.
Collapse
Affiliation(s)
- Joon Young Kim
- Department of Cardiovascular Medicine, Yeocheon Chonnam Hospital, Yeosu, Korea
| | - Myung Ho Jeong
- Department of Cardiovascular Medicine, Chonnam National University Hospital, Gwangju, Korea
- Correspondence to Myung Ho Jeong, M.D. Department of Cardiovascular Medicine, Chonnam National University Hospital, 42 Jebong- ro, Dong-gu, Gwangju 61469, Korea Tel: +82-62-220-6243 Fax: +82-62-228-7174 E-mail:
| | - Yong Woo Choi
- Department of Cardiovascular Medicine, Yeocheon Chonnam Hospital, Yeosu, Korea
| | - Yong Keun Ahn
- Department of Cardiovascular Medicine, Chonnam National University Hospital, Gwangju, Korea
| | - Shung Chull Chae
- Department of Cardiovascular Medicine, Kyungpook National University Hospital, Daegu, Korea
| | - Seung Ho Hur
- Department of Cardiovascular Medicine, Keimyung University Dongsan Medical Center, Daegu, Korea
| | - Taek Jong Hong
- Department of Cardiovascular Medicine, Pusan National University Hospital, Busan, Korea
| | - Young Jo Kim
- Department of Cardiovascular Medicine, Yeungnam University Medical Center, Daegu, Korea
| | - In Whan Seong
- Department of Cardiovascular Medicine, Chungnam National University Hospital, Daejeon, Korea
| | - In Ho Chae
- Department of Cardiovascular Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Myeong Chan Cho
- Department of Cardiovascular Medicine, Chungbuk National University Hospital, Cheongju, Korea
| | - Jung Han Yoon
- Department of Cardiovascular Medicine, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Ki Bae Seung
- Department of Cardiovascular Medicine, College of Medicine, Seoul St. Mary’s Hospital, The Catholic University of Korea, Seoul, Korea
| | | |
Collapse
|
18
|
Chen KY, Rha SW, Wang L, Li YJ, Li GP, Choi CU, Park CG, Seo HS, Oh DJ, Jeong MH, Ahn YK, Hong TJ, Kim YJ, Chae SC, Hur SH, Seong IW, Chae JK, Cho MC, Bae JH, Choi DH, Jang YS, Chae IH, Kim HS, Kim CJ, Yoon JH, Ahn TH, Chung WS, Seung KB, Park SJ. One-year clinical outcomes of everolimus- versus sirolimus-eluting stents in patients with acute myocardial infarction. Int J Cardiol 2014; 176:583-8. [PMID: 25305704 DOI: 10.1016/j.ijcard.2014.08.049] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2013] [Revised: 06/02/2014] [Accepted: 08/09/2014] [Indexed: 10/24/2022]
Abstract
BACKGROUND In contrast to many studies comparing everolimus-eluting stent (EES) with paclitaxel-eluting stent (PES), data directly comparing EES with sirolimus-eluting stent (SES) are limited, especially in patients with acute myocardial infarction (AMI). METHODS This study includes 2911 AMI patients treated with SES (n=1264) or EES (n=1701) in Korea Acute Myocardial Infarction Registry (KAMIR). Propensity score matching was applied to adjust for baseline imbalance in clinical and angiographic characteristics, yielding a total of 2400 well-matched patients (1200 receiving SES and 1200 receiving EES). One-year clinical outcomes were compared between the two propensity score matched groups. RESULTS Baseline clinical and angiographic characteristics were similar between the two propensity score matched groups. One-year clinical outcomes of the propensity score matched cohort were comparable between the EES versus the SES groups including the rates of cardiac death (4.8% vs. 4.8%, P=1.000), recurrent myocardial infarction (1.4% vs. 1.7%, P=0.619), target lesion revascularization (1.4% vs. 1.6%, P=0.737), target lesion failure (7.0% vs. 7.3%, P=0.752), and probable or definite stent thrombosis (0.5% vs. 0.9%, P=0.224) except for a trend toward lower incidence of target vessel revascularization (1.9% vs. 3.0%, P=0.087) and a lower rate of total major adverse cardiac events (9.3% vs. 11.9%, P=0.034) in the EES group. CONCLUSIONS The present propensity score matched analysis performed in a large-scale, prospective, multicenter registry suggests that the second-generation drug-eluting stent EES has at least comparable or even better safety and efficacy profiles as compared with SES in the setting of AMI.
Collapse
Affiliation(s)
- Kang-Yin Chen
- Cardiovascular Center, Korea University Guro Hospital, 80, Guro-dong, Guro-gu, Seoul 152-703, Republic of Korea
| | - Seung-Woon Rha
- Cardiovascular Center, Korea University Guro Hospital, 80, Guro-dong, Guro-gu, Seoul 152-703, Republic of Korea.
| | - Lin Wang
- Cardiovascular Center, Korea University Guro Hospital, 80, Guro-dong, Guro-gu, Seoul 152-703, Republic of Korea
| | - Yong-Jian Li
- Cardiovascular Center, Korea University Guro Hospital, 80, Guro-dong, Guro-gu, Seoul 152-703, Republic of Korea
| | - Guang-Ping Li
- Cardiovascular Center, Korea University Guro Hospital, 80, Guro-dong, Guro-gu, Seoul 152-703, Republic of Korea
| | - Cheol Ung Choi
- Cardiovascular Center, Korea University Guro Hospital, 80, Guro-dong, Guro-gu, Seoul 152-703, Republic of Korea
| | - Chang Gyu Park
- Cardiovascular Center, Korea University Guro Hospital, 80, Guro-dong, Guro-gu, Seoul 152-703, Republic of Korea
| | - Hong Seog Seo
- Cardiovascular Center, Korea University Guro Hospital, 80, Guro-dong, Guro-gu, Seoul 152-703, Republic of Korea
| | - Dong Joo Oh
- Cardiovascular Center, Korea University Guro Hospital, 80, Guro-dong, Guro-gu, Seoul 152-703, Republic of Korea
| | - Myung Ho Jeong
- Cardiovascular Center, Korea University Guro Hospital, 80, Guro-dong, Guro-gu, Seoul 152-703, Republic of Korea
| | - Young Keun Ahn
- Cardiovascular Center, Korea University Guro Hospital, 80, Guro-dong, Guro-gu, Seoul 152-703, Republic of Korea
| | - Taek Jong Hong
- Cardiovascular Center, Korea University Guro Hospital, 80, Guro-dong, Guro-gu, Seoul 152-703, Republic of Korea
| | - Young Jo Kim
- Cardiovascular Center, Korea University Guro Hospital, 80, Guro-dong, Guro-gu, Seoul 152-703, Republic of Korea
| | - Shung Chull Chae
- Cardiovascular Center, Korea University Guro Hospital, 80, Guro-dong, Guro-gu, Seoul 152-703, Republic of Korea
| | - Seung Ho Hur
- Cardiovascular Center, Korea University Guro Hospital, 80, Guro-dong, Guro-gu, Seoul 152-703, Republic of Korea
| | - In Whan Seong
- Cardiovascular Center, Korea University Guro Hospital, 80, Guro-dong, Guro-gu, Seoul 152-703, Republic of Korea
| | - Jei Keon Chae
- Cardiovascular Center, Korea University Guro Hospital, 80, Guro-dong, Guro-gu, Seoul 152-703, Republic of Korea
| | - Myeong Chan Cho
- Cardiovascular Center, Korea University Guro Hospital, 80, Guro-dong, Guro-gu, Seoul 152-703, Republic of Korea
| | - Jang Ho Bae
- Cardiovascular Center, Korea University Guro Hospital, 80, Guro-dong, Guro-gu, Seoul 152-703, Republic of Korea
| | - Dong Hoon Choi
- Cardiovascular Center, Korea University Guro Hospital, 80, Guro-dong, Guro-gu, Seoul 152-703, Republic of Korea
| | - Yang Soo Jang
- Cardiovascular Center, Korea University Guro Hospital, 80, Guro-dong, Guro-gu, Seoul 152-703, Republic of Korea
| | - In Ho Chae
- Cardiovascular Center, Korea University Guro Hospital, 80, Guro-dong, Guro-gu, Seoul 152-703, Republic of Korea
| | - Hyo Soo Kim
- Cardiovascular Center, Korea University Guro Hospital, 80, Guro-dong, Guro-gu, Seoul 152-703, Republic of Korea
| | - Chong Jin Kim
- Cardiovascular Center, Korea University Guro Hospital, 80, Guro-dong, Guro-gu, Seoul 152-703, Republic of Korea
| | - Jung Han Yoon
- Cardiovascular Center, Korea University Guro Hospital, 80, Guro-dong, Guro-gu, Seoul 152-703, Republic of Korea
| | - Tae Hoon Ahn
- Cardiovascular Center, Korea University Guro Hospital, 80, Guro-dong, Guro-gu, Seoul 152-703, Republic of Korea
| | - Wook Sung Chung
- Cardiovascular Center, Korea University Guro Hospital, 80, Guro-dong, Guro-gu, Seoul 152-703, Republic of Korea
| | - Ki Bae Seung
- Cardiovascular Center, Korea University Guro Hospital, 80, Guro-dong, Guro-gu, Seoul 152-703, Republic of Korea
| | - Seung Jung Park
- Cardiovascular Center, Korea University Guro Hospital, 80, Guro-dong, Guro-gu, Seoul 152-703, Republic of Korea
| | | |
Collapse
|
19
|
Jeong HC, Jeong MH, Ahn Y, Chae SC, Hur SH, Hong TJ, Kim YJ, Seong IW, Chae JK, Rhew JY, Chae IH, Cho MC, Bae JH, Rha SW, Kim CJ, Choi D, Jang YS, Yoon J, Chung WS, Cho JG, Seung KB, Park SJ. Comparative assessment of angiotensin II type 1 receptor blockers in the treatment of acute myocardial infarction: surmountable vs. insurmountable antagonist. Int J Cardiol 2013; 170:291-7. [PMID: 24239100 DOI: 10.1016/j.ijcard.2013.07.146] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2012] [Revised: 06/23/2013] [Accepted: 07/15/2013] [Indexed: 11/19/2022]
Abstract
BACKGROUND The mechanisms of antagonism vary between the angiotensin II type 1 receptor blockers (ARBs): insurmountable antagonism and surmountable antagonism. Recent retrospective observational studies suggest that ARBs may not have equivalent benefits in various clinical situations. The aim of this study was to compare the effect of two categories of ARBs on the long-term clinical outcomes of patients with acute myocardial infarction (AMI). METHODS We analyzed the large-scale, prospective, observational Korea Acute Myocardial Infarction Registry study, which enrolled 2740 AMI patients. They divided by the prescription of surmountable ARBs or insurmountable ARBs at discharge. Primary outcome was major adverse cardiac events (MACEs), defined as a composite of cardiac death, nonfatal MI, and re-percutaneous coronary intervention, coronary artery bypass graft surgery. RESULTS In the overall population, the MACEs rate in 1 year was significantly higher in the surmountable ARB group (14.3% vs. 11.2%, p=0.025), which was mainly due to increased cardiac death (3.3% vs. 1.9%, p=0.031). Matching by propensity-score showed consistent results (MACEs rate: 14.9% vs. 11.4%, p=0.037). In subgroup analysis, the insurmountable ARB treatment significantly reduced the incidence of MACEs in patients with left ventricular ejection fraction greater than 40%, with a low killip class, with ST segment elevation MI, and with normal renal function. CONCLUSIONS In our study, insurmountable ARBs were more effective on long-term clinical outcomes than surmountable ARBs in patients with AMI.
Collapse
Affiliation(s)
- Hae Chang Jeong
- Chonnam National University Hospital, Gwangju, Republic of Korea.
| | - Myung Ho Jeong
- Chonnam National University Hospital, Gwangju, Republic of Korea
| | - Youngkeun Ahn
- Chonnam National University Hospital, Gwangju, Republic of Korea
| | | | - Seung Ho Hur
- Keimyung University Dongsan Medical Center, Daegu, Republic of Korea
| | | | | | - In Whan Seong
- Chungnam National Univ. Hosp., Daejon, Republic of Korea
| | - Jei Keon Chae
- Chunbuk National Univ. Hosp., Jeonju, Republic of Korea
| | - Jay Young Rhew
- Jeonju Presbyterian Medical Center, Jeonju, Republic of Korea
| | - In Ho Chae
- Seoul National University Bundang Hospital, Republic of South Korea
| | - Myeong Chan Cho
- Chungbuk National University Hospital, Cheongju, Republic of Korea
| | - Jang Ho Bae
- Konyang University, Daejon, Republic of Korea
| | - Seung Woon Rha
- Korea University Guro Hospital, Seoul, Republic of Korea
| | | | - Donghoon Choi
- Yonsei University Hospital, Seoul, Republic of Korea
| | - Yang Soo Jang
- Yonsei University Hospital, Seoul, Republic of Korea
| | - Junghan Yoon
- Wonju University Hospital, Wonju, Republic of Korea
| | | | - Jeong Gwan Cho
- Chonnam National University Hospital, Gwangju, Republic of Korea
| | - Ki Bae Seung
- Catholic University Hospital, Seoul, Republic of Korea
| | | |
Collapse
|
20
|
Yamanaka F, Jeong MH, Saito S, Ahn Y, Chae SC, Hur SH, Hong TJ, Kim YJ, Seong IW, Chae JK, Rhew JY, Chae IH, Cho MC, Bae JH, Rha SW, Kim CJ, Choi D, Jang YS, Yoon J, Chung WS, Cho JG, Seung KB, Park SJ. Comparison of clinical outcomes between octogenarians and non-octogenarians with acute myocardial infarction in the drug-eluting stent era: analysis of the Korean Acute Myocardial Infarction Registry. J Cardiol 2013; 62:210-6. [PMID: 23731919 DOI: 10.1016/j.jjcc.2013.04.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2012] [Revised: 11/18/2012] [Accepted: 04/13/2013] [Indexed: 12/23/2022]
Abstract
BACKGROUND AND PURPOSE Octogenarians (age ≥ 80 years) with coronary artery disease constitute a high-risk group. However, octogenarian patients with acute myocardial infarction (AMI) in the drug-eluting stents (DES) era have not been widely reported. We aimed to identify clinical outcomes in octogenarian compared with non-octogenarian AMI patients. METHODS AND SUBJECTS We retrospectively analyzed 9877 patients who underwent percutaneous coronary intervention (PCI) with drug-eluting stents (DES) and who were enrolled in the Korean Acute Myocardial Infarction Registry (KAMIR). They were divided into 2 groups, octogenarians (n=1494) and non-octogenarians (n=8383), in order to compare the incidence of 1-year all-cause death and 1-year major adverse cardiac events (MACE), where MACE included all-cause death, recurrent myocardial infarction, target vessel revascularization (TVR), target lesion revascularization (TLR), and coronary artery bypass grafting (CABG). RESULTS The clinical status was significantly inferior in octogenarians compared to non-octogenarians: Killip class ≥ II (34.8% vs. 22.5%, p<0.001), multivessel disease (65.8% vs. 53.7%, p<0.001). Rates of 1-year all-cause death were significantly higher in octogenarians than in non-octogenarians (22.3% vs. 6.5%, p<0.001). However, the rates of 1-year recurrent myocardial infarction (1.3% vs. 0.9%, p=0.68), TLR (2.4% vs. 3.1%, p=0.69), TVR (3.6% vs. 4.3%, p=0.96), and CABG (0.9% vs. 0.9%, p=0.76) did not differ significantly between the 2 groups. CONCLUSIONS Octogenarian AMI patients have higher rates of mortality and MACE even in the DES era. According to KAMIR subgroup analysis, the TLR/TVR rates in octogenarians were comparable to those in non-octogenarian AMI patients.
Collapse
Affiliation(s)
- Futoshi Yamanaka
- Chonnam National University Hospital, Gwangju, Republic of Korea; Shonan Kamakura Hospital, Japan
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
21
|
Kim JY, Jeong MH, Moon JH, Ahn YK, Chae SC, Hur SH, Hong TJ, Kim YJ, Seong IW, Chae IH, Cho MC, Jang YS, Yoon JH, Seung KB, Park SJ. Impact of Clopidogrel loading dose in patients with chronic kidney disease undergoing primary percutaneous coronary intervention for ST-segment elevation myocardial infarction. Am J Cardiol 2012; 110:1598-606. [PMID: 22935526 DOI: 10.1016/j.amjcard.2012.07.025] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2012] [Revised: 07/27/2012] [Accepted: 07/27/2012] [Indexed: 11/29/2022]
Abstract
The optimal loading dose of clopidogrel in patients with chronic kidney disease who undergo primary percutaneous coronary intervention for ST-segment elevation myocardial infarction has not been investigated. The aim of this study was to assess the impact of clopidogrel loading dose on clinical outcomes in this setting. A total of 1,457 patients with CKD (estimated glomerular filtration rate <60 ml/min/1.73 m(2)) were evaluated according to clopidogrel loading dose: 600 mg (n = 861) versus 300 mg (n = 596). In-hospital complications, including major bleeding and clinical outcomes at 1 and 12 months, were compared between the 2 groups. The in-hospital major bleeding rate was similar (0.8% vs 0.2%, p = 0.09). Also, there were no differences in major adverse cardiac event rates, including death, recurrent myocardial infarction, target lesion revascularization, and stent thrombosis, at 1 month (15.6% vs 16.4%, p = 0.70) and 12 months (19.0% vs 21.3%, p = 0.32). On multivariate analysis, a 600-mg loading dose of clopidogrel was not an independent predictor of 1-month (odds ratio 1.13, 95% confidence interval 0.49 to 2.57, p = 0.78) and 12-month (odds ratio 0.89, 95% confidence interval 0.52 to 1.51, p = 0.66) major adverse cardiac events. After propensity score-matched analysis, these results were unchanged. In conclusion, a 600-mg loading dose of clopidogrel was not effective in reducing 1- and 12-month major adverse cardiac events in patients with chronic kidney disease who underwent primary percutaneous coronary intervention for ST-segment elevation myocardial infarction, but this dose did not increase the in-hospital major bleeding rate.
Collapse
|
22
|
Hong YJ, Jeong MH, Ahn Y, Kim SW, Bae JH, Hur SH, Ahn TH, Rha SW, Kim KS, Chae IH, Kim JH, Yun KH, Oh SK. Effect of pitavastatin treatment on changes of plaque volume and composition according to the reduction of high-sensitivity C-reactive protein levels. J Cardiol 2012; 60:277-82. [DOI: 10.1016/j.jjcc.2012.04.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2012] [Revised: 03/15/2012] [Accepted: 04/11/2012] [Indexed: 11/30/2022]
|
23
|
Cho JR, Shin S, Kim JS, Ko YG, Hong MK, Jang Y, Seung KB, Park HS, Tahk SJ, Lim DS, Jeon DW, Chae IH, Kim DK, Yoon J, Jeong MH, Choi D. Clinical characteristics of acute aortic syndrome in korean patients: from the korean multi-center registry of acute aortic syndrome. Korean Circ J 2012; 42:528-37. [PMID: 22977448 PMCID: PMC3438262 DOI: 10.4070/kcj.2012.42.8.528] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2011] [Revised: 12/20/2011] [Accepted: 02/25/2012] [Indexed: 11/22/2022] Open
Abstract
Background and Objectives Acute aortic syndrome (AAS) is a heterogeneous group of disorders that often present with severe chest or back pain. It includes acute aortic dissection (AD), intramural hematoma (IMH), dissecting aneurysm, and penetrating aortic ulcer (PAU). The clinical picture of AAS and its prognosis have not been studied in a large number of Korean patients. Therefore, we organized a multi-center registry to identify the clinical characteristics and treatment patterns, as well as long-term outcomes in Korean patients with AAS. Subjects and Methods Five-hundred twenty-eight patients, who had been diagnosed with AAS, were enrolled into this registry from 10 centers. On a retrospective basis, we collected demographic, laboratory, imaging data, as well as follow-up clinical outcomes by reviewing medical records from individual centers. All the data were collected in core lab and analyzed in detail. Results The mean patient age was 60.1±14.5 years; the male-to-female ratio was M : F=297 : 231. The prevalent risk factors for AAS included hypertension (361, 68.4%) and diabetes (52, 11.1%). The components of AAS that are included in this study are acute AD (446, 84.5%), IMH (57, 10.7%), and PAU (11, 2.1%). By type of AAS, patients diagnosed with Stanford A were 45.6% of enrolled patients, whereas those with Stanford B were 54.4% of enrolled patients. Among nearly half of the patients were treated with medicine (55.7%) alone, whereas 40.0% underwent surgery and 4.3% underwent endovascular treatment. Overall, the in-hospital event rate was 21.2% and the in-hospital death rate was 8.1%. The mean follow-up duration was 42.8 months and there showed 22.9% of total event and 10.1% of death during this period. Conclusion By organizing a multi-center registry of AAS, we could identify the characteristics of AAS in real-world Korean patients. Further, prospective study is warranted with a larger number of patients.
Collapse
Affiliation(s)
- Jung Rae Cho
- Cardiology Division, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
24
|
Kim U, Park JS, Kang SW, Kim YM, Park WJ, Lee SH, Hong GR, Shin DG, Kim YJ, Jeong MH, Chae SC, Hur SH, Song IW, Hong TJ, Chae IH, Cho MC, Jang Y, Yoon J, Seung KB, Park SJ. Outcomes according to presentation with versus without cardiogenic shock in patients with left main coronary artery stenosis and acute myocardial infarction. Am J Cardiol 2012; 110:36-9. [PMID: 22481010 DOI: 10.1016/j.amjcard.2012.02.044] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2011] [Revised: 02/23/2012] [Accepted: 02/23/2012] [Indexed: 11/19/2022]
Abstract
This study is aimed at evaluating 1-year clinical outcomes and their predictors in patients with unprotected left main coronary artery (ULMCA)-related acute myocardial infarction (AMI). In total 248 patients diagnosed with AMI involving the ULMCA as the culprit vessel and registered in the Korean Acute Myocardial Infarction database were enrolled in this study. Patients were divided according to the absence (shock-, n = 206) or presence (shock+, n = 42) of cardiogenic shock at initial presentation. Independent risk factors of in-hospital cardiac death associated with ULMCA-related AMI were elucidated by multivariate regression analysis. In-hospital mortality rates were 8.7% in the shock- group and 47.6% in the shock+ group (p = 0.001). During 1-year follow-up after discharge, major adverse cardiac events developed in 16.3% of patients in the shock- group and 18.2% of patients in the shock+ group (p = 0.828); cardiac death, MI, and ischemia-driven target vessel revascularization were similar between the 2 groups at 1 year. On multivariate analysis, initial shock presentation (odds ratio 8.9, confidence interval 4.1 to 19.2, p = 0.004) and left ventricular ejection fraction <30% (odds ratio 7.6, confidence interval 2.7 to 21.1, p = 0.001) were independent risk factors of in-hospital cardiac death associated with ULMCA-related AMI. In conclusion, almost 1/2 of patients with ULMCA-related AMI presenting with cardiogenic shock had a fatal in-hospital outcome compared to <10% of those without cardiogenic shock; however, clinical outcomes after survival of the in-hospital period were not different between these groups.
Collapse
Affiliation(s)
- Ung Kim
- Yeungnam University Medical Center, Deagu, Korea
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
25
|
Jeong HC, Jeong JM, Jeong MH, Ahn Y, Chae SC, Hur SH, Hong TJ, Kim YJ, Seong IW, Chae JK, Rhew JY, Chae IH, Cho MC, Bae JH, Rha SW, Kim CJ, Choi D, Jang YS, Yoon J, Chung WS, Cho JG, Seung KB, Park SJ. Effect of single or dual blockade of renin-angiotensin system in acute myocardial infarction patients according to renal function. Int J Cardiol 2012; 157:408-11. [PMID: 22513185 DOI: 10.1016/j.ijcard.2012.03.141] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2012] [Accepted: 03/15/2012] [Indexed: 11/27/2022]
|
26
|
Hong YJ, Jeong MH, Ahn Y, Kim SW, Bae JH, Hur SH, Ahn TH, Rha SW, Kim KS, Chae IH, Kim JH, Yun KH, Oh SK. AS-078 Effect of Pitavastatin Treatment on Changes of Plaque Volume and Composition According to the Reduction of High-Sensitivity C-Reactive Protein Levels: Virtual Histology-Intravascular Ultrasound Analysis (From the LivaloÒ [Pitavastatin] in Acute Myocardial Infarction Study [LAMIS]). Am J Cardiol 2012. [DOI: 10.1016/j.amjcard.2012.01.090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
|
27
|
Yamanaka F, Jeong MH, Ahn Y, Chae SC, Hur SH, Hong TJ, Kim YJ, Seong IW, Chae JK, Rhew JY, Chae IH, Cho MC, Bae JH, Rha SW, Kim CJ, Choi D, Jang YS, Yoon J, Chung WS, Cho JG, Seung KB. COMPARISON OF CLINICAL OUTCOMES BETWEEN OCTOGENARIAN AND NON-OCTOGENARIAN ACUTE MYOCARDIAL INFARCTION PATIENTS. J Am Coll Cardiol 2012. [DOI: 10.1016/s0735-1097(12)60016-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
28
|
Jo HS, Park JS, Sohn JW, Yoon JC, Sohn CW, Lee SH, Hong GR, Shin DG, Kim YJ, Jeong MH, Chae SC, Hur SH, Hong TJ, Seong IW, Chae JK, Rhew JY, Chae IH, Cho MC, Bae JH, Rha SW, Kim CJ, Choi DH, Jang YS, Yoon JH, Chung WS, Seung KB, Park SJ. Culprit-Lesion-Only Versus Multivessel Revascularization Using Drug-Eluting Stents in Patients With ST-Segment Elevation Myocardial Infarction: A Korean Acute Myocardial Infarction Registry-Based Analysis. Korean Circ J 2011; 41:718-25. [PMID: 22259602 PMCID: PMC3257455 DOI: 10.4070/kcj.2011.41.12.718] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2011] [Revised: 03/16/2011] [Accepted: 06/20/2011] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND AND OBJECTIVES In patients with ST-segment elevation myocardial infarction (STEMI) and multivessel disease, complete revascularization (CR) for non-culprit lesions is not routinely recommended. The aim of this study was to compare the clinical outcomes of multivessel compared with infarct-related artery (IRA)-only revascularization in patients undergoing primary percutaneous coronary intervention (PCI) for STEMI. SUBJECTS AND METHODS From the Korean Acute Myocardial Infarction Registry (KAMIR) database, 1,094 STEMI patients with multivessel disease who underwent primary PCI with drug-eluting stents were enrolled in this study. The patients were divided into two groups: culprit-vessel-only revascularization (COR, n=827) group; multivessel revascularization, including non-IRA (MVR, n=267) group. The primary endpoint of this study included major adverse cardiac events (MACEs), such as death, myocardial infarction, or target or nontarget lesion revascularization at one year. RESULTS There was no difference in clinical characteristics between the two groups. During the one-year follow-up, 102 (15.2%) patients in the COR group and 32 (14.2%) in the MVR group experienced at least one MACE (p=0.330). There were no differences between the two groups in terms of rates of death, myocardial infarction, or revascularization (2.1% vs. 2.0%, 0.7% vs. 0.8%, and 11.7% vs. 10.1%, respectively; p=0.822, 0.910, and 0.301, respectively). The MACE rate was higher in the incompletely revascularized patients than in the completely revascularized patients (15% vs. 9.5%, p=0.039), and the difference was attributable to a higher rate of nontarget vessel revascularization (8.6% vs. 1.8%, p=0.002). CONCLUSION Although multivessel angioplasty during primary PCI for STEMI did not reduce the MACE rate compared with culprit-vessel-only PCI, CR was associated with a lower rate of repeat revascularization after multivessel PCI.
Collapse
Affiliation(s)
- Hyun Su Jo
- Division of Cardiology, Department of Internal Medicine, Yeungnam University Hospital, Daegu, Korea
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
29
|
Suh SY, Rha SW, Ahn TH, Shin EK, Choi CU, Oh DJ, Bae JH, Hur SH, Yun KH, Oh SK, Kim JH, Kim SW, Chae IH, Kim KS, Hong YJ, Jeong MH. Long-term safety and efficacy of Pitavastatin in patients with acute myocardial infarction (from the Livalo Acute Myocardial Infarction Study [LAMIS]). Am J Cardiol 2011; 108:1530-5. [PMID: 21890083 DOI: 10.1016/j.amjcard.2011.07.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2011] [Revised: 07/12/2011] [Accepted: 07/12/2011] [Indexed: 11/15/2022]
Abstract
Pitavastatin is a potent lipophilic statin and may play an important role in acute myocardial infarction (AMI) but there have been limited data on the safety and efficacy of pitavastatin in AMI. This study consisted of 1,039 consecutive patients with AMI (74.0% men, mean age 61.4 ± 12.6 years) who presented in 10 major percutaneous coronary intervention centers in Korea from February 2007 through September 2009. Pitavastatin 2 mg/day was routinely administered in patients with AMI from time of presentation. We investigated changes of lipid profiles, biochemical markers, adverse events, and clinical outcomes up to 12 months. During the study 318 events overall occurred in 220 patients (21.2%) who reported ≥1 treatment emergent adverse event, although 20 events in 14 patients (1.4%) were treatment-related adverse events. Low-density lipoprotein (LDL) cholesterol percent change was -25.6% and LDL cholesterol target attainment was 70.5% at 12-month follow-up. Levels of creatinine phosphokinase, serum glutamic oxaloacetic transaminase, glutamic pyruvic transaminase, and high-sensitivity C-reactive protein decreased significantly during the first 1 month of pitavastatin treatment and were sustained to 12-month follow-up. Major adverse cardiac events occurred in 66 patients (7.3%). All-cause deaths occurred in 32 patients (3.5%) including 19 (2.1%) cardiac deaths and recurrent MIs occurred in 14 (1.6%) and target lesion revascularizations in 42 (4.7%). In conclusion, administration of pitavastatin 2 mg/day in patients with AMI showed 70.5% LDL cholesterol target attainment with good tolerance and was associated with favorable clinical outcomes up to 12 months.
Collapse
Affiliation(s)
- Soon Yong Suh
- Gachon University of Medicine and Science, Gil Hospital, Incheon, Korea
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
30
|
Lee MG, Jeong MH, Ahn Y, Cho JG, Park JC, Kang JC, Chae SC, Hur SH, Hong TJ, Kim YJ, Seong IW, Chae JK, Rhew JY, Chae IH, Cho MC, Bae JH, Rha SW, Kim CJ, Choi D, Jang YS, Yoon J, Chung WS, Seung KB, Park SJ. Comparison of paclitaxel-, sirolimus-, and zotarolimus-eluting stents in patients with acute ST-segment elevation myocardial infarction and metabolic syndrome. Circ J 2011; 75:2120-7. [PMID: 21757819 DOI: 10.1253/circj.cj-11-0263] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND The purpose of the present study was to compare the efficacy and safety of paclitaxel-eluting stent (PES), sirolimus-eluting stent (SES), and zotarolimus-eluting stent (ZES) in primary percutaneous coronary intervention (PCI) for acute ST-segment elevation myocardial infarction (STEMI) with metabolic syndrome (MS). METHODS AND RESULTS Using data from Korea Acute Myocardial Infarction Registry (KAMIR; November 2005-December 2007), a total of 1,768 MS patients with STEMI who underwent primary PCI were enrolled: The PES group was 634, SES group, 906, and ZES group, 228. The primary endpoint was major adverse cardiac event (all-cause death, re-myocardial infarction, target lesion revascularization) during 12 months follow-up. At 12 months, the cumulative incidence of primary endpoint in the PES, SES, and ZES groups was 10.9%, 9.1%, and 11.0%, respectively (P=0.086). Incidence of death, recurrent myocardial infarction, or target lesion revascularization did not differ among the 3 groups. There were 7 episodes of acute (0.3% in PES group, 0.4% in SES group, and 0.4% in ZES group, respectively, P=0.773) and 18 episodes of cumulative stent thrombosis including late stent thrombosis (0.9% in PES group, 1.0% in SES group, and 1.3% in ZES group, respectively, P=0.448). CONCLUSIONS Implantation of SES, PES, and ZES in MS patients with STEMI undergoing primary PCI provided comparable clinical outcomes in patients enrolled in KAMIR.
Collapse
Affiliation(s)
- Min Goo Lee
- Chonnam National University Hospital, Gwangju, Korea
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
31
|
Kim JY, Jeong MH, Ahn YK, Moon JH, Chae SC, Hur SH, Hong TJ, Kim YJ, Seong IW, Chae IH, Cho MC, Kim CJ, Jang YS, Yoon J, Seung KB, Park SJ. Decreased Glomerular Filtration Rate is an Independent Predictor of In-Hospital Mortality in Patients With ST-Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention. Korean Circ J 2011; 41:184-90. [PMID: 21607168 PMCID: PMC3098410 DOI: 10.4070/kcj.2011.41.4.184] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2010] [Revised: 07/09/2010] [Accepted: 07/23/2010] [Indexed: 11/20/2022] Open
Abstract
Background and Objectives Patients with renal dysfunction (RD) experience worse prognosis after myocardial infarction (MI). The aim of the present study was to investigate the impact of admission estimated glomerular filtration rate (eGFR) on clinical outcomes of patients undergoing primary percutaneous coronary intervention (PCI) for ST-segment elevation MI (STEMI). Subjects and Methods We retrospectively evaluated 4,542 eligible patients from the Korea Acute Myocardial Infarction Registry (KAMIR). Patients were divided into three groups according to eGFR (mL/min/1.73 m2): normal renal function (RF) group (eGFR ≥60, n=3,515), moderate RD group (eGFR between 30 to 59, n=894) and severe RD group (eGFR <30, n=133). Baseline characteristics, angiographic and procedural results, and in-hospital outcomes between the three groups were compared. Results Age, gender, Killip class ≥3, hypertension, diabetes, congestive heart failure, peak creatine kinase-MB, high sensitivity C-reactive protein, B-type natriuretic peptide, left ventricle ejection fraction, multivessel disease, infarct-related artery and rate of successful PCI were significantly different between the 3 groups (p<0.05). With decline in RF, in-hospital complications developed with an increasing frequency (14.1% vs. 31.8% vs. 45.5%, p<0.0001). In-hospital mortality rate was significantly higher in the moderate and severe RD groups as compared to the normal RF group (2.3% vs. 13.9% vs. 25.6%, p<0.0001). Using multivariate logistic regression analysis, adjusted odds ratio for in-hospital mortality was 2.67 {95% confidence interval (CI) 1.44-4.93, p=0.002} in the moderate RD group, and 4.09 (95% CI 1.48-11.28, p=0.006) in the severe RD group as compared to the normal RF group. Conclusion Decreased admission eGFR was associated with worse clinical courses and it was an independent predictor of in-hospital mortality in STEMI patients undergoing primary PCI.
Collapse
|
32
|
Lee MG, Jeong MH, Ahn Y, Chae SC, Hur SH, Hong TJ, Kim YJ, Seong IW, Chae JK, Rhew JY, Chae IH, Cho MC, Bae JH, Rha SW, Chung WS, Kim CJ, Choi D, Jang YS, Yoon J, Seung KB, Park SJ. AS-194 Comparison of Paclitaxel-, Sirolimus-, and Zotarolimus-Eluting Stents in Patients with Acute ST-Segment Elevation Myocardial Infarction Accompanied with Metabolic Syndrome. Am J Cardiol 2011. [DOI: 10.1016/j.amjcard.2011.02.172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
33
|
Choi CU, Rha SW, Oh DJ, Poddar KL, Na JO, Kim JW, Lim HE, Kim EJ, Park CG, Seo HS, Hong TJ, Park JS, Kim YJ, Hur SH, Seong IW, Chae JK, Cho MC, Bae JH, Choi DH, Jang YS, Chae IH, Kim HS, Kim CJ, Yoon JH, Ahn TH, Tahk SJ, Chung WS, Seung KB, Chae SC, Park SJ, Ahn YK, Jeong MH. Standard versus high loading doses of clopidogrel in Asian ST-segment elevation myocardial infarction patients undergoing percutaneous coronary intervention: insights from the Korea Acute Myocardial Infarction Registry. Am Heart J 2011; 161:373-382.e1-3. [PMID: 21315222 DOI: 10.1016/j.ahj.2010.10.031] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2010] [Accepted: 10/18/2010] [Indexed: 10/18/2022]
Abstract
BACKGROUND The optimal loading dose of clopidogrel in Asian patients with ST-segment elevation myocardial infarction (STEMI) has not been fully investigated. We compared bleeding, vascular complications, and midterm outcomes of a 300-mg versus a 600-mg loading dose of clopidogrel in a large series of Korean patients with STEMI undergoing primary percutaneous coronary intervention (PCI). METHODS A total of 2,664 STEMI patients (age 61.96 ± 11.91 years, men 70.4%) who underwent primary PCI were enrolled in this study. The patients were divided into a standard loading dose group (300 mg; n = 1,447 patients) and a high loading dose group (600 mg; n = 1,217 patients). Bleeding and vascular complications, and in-hospital and clinical outcomes up to 12 months were compared between the 2 groups. RESULTS In-hospital bleeding and vascular complications were similar between the 2 groups. There were no differences in bleeding and vascular complications and in 1- and 12-month clinical outcomes, including mortality, myocardial infarction, repeated PCI, and major adverse cardiac events, between the 2 groups. These findings were consistent even after the propensity score-matched analysis. CONCLUSIONS The standard loading dose of clopidogrel may be as safe and similarly effective as the high loading dose in Asian STEMI patients undergoing primary PCI.
Collapse
|
34
|
Choi SG, Jeong MH, Ahn Y, Cho JG, Kang JC, Chae SC, Hur SH, Hong TJ, Kim YJ, Seong IW, Chae JK, Rhew JY, Chae IH, Cho MC, Bae JH, Rha SW, Kim CJ, Choi D, Jang YS, Yoon J, Chung WS, Seung KB, Park SJ. Relationship between obesity and N-terminal brain natriuretic Peptide level as a prognostic value after acute myocardial infarction. Korean Circ J 2010; 40:558-64. [PMID: 21217932 PMCID: PMC3008826 DOI: 10.4070/kcj.2010.40.11.558] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2010] [Revised: 03/09/2010] [Accepted: 04/13/2010] [Indexed: 12/22/2022] Open
Abstract
Background and Objectives Recently, the prognostic value of N-terminal brain natriuretic peptide (NT-proBNP) in acute coronary syndrome has been demonstrated in many studies. However, NT-proBNP levels are influenced by various factors such as sex, age, renal function, heart failure severity, and obesity. NT-proBNP concentrations tend to decrease with higher body mass index (BMI). The aim of this study was to examine the influence of obesity on NT-proBNP as a predictive prognostic factor in acute myocardial infarction (AMI) patients. Subjects and Methods Using data from the Korea Acute Myocardial Infarction Registry (January 2005 to September 2008), 2,736 AMI patients were included in this study. These patients were divided into men (n=1,972, 70%) and women (n=764, 30%), and were grouped according to their BMIs. Major adverse cardiac events (MACE) during 1 year clinical follow-up were evaluated. Results NT-proBNP was significantly higher in lower BMI (p<0.001). Mean NT-proBNP levels of each obesity group were 2,393±4,022 pg/mL in the lean group (n=875), 1,506±3,074 pg/mL in the overweight group (n=724) and 1,100±1,137 pg/mL in the obese group (n=1,137) (p<0.01). NT-proBNP was an independent prognostic factor of AMI in obese patients by multivariative analysis of independent risk factors of MACE (p=0.01). Conclusion NT-proBNP is lower in obese AMI patients than in non-obese AMI patients, but NT-proBNP is still of independent prognostic value in obese AMI patients.
Collapse
Affiliation(s)
- Seon Gyu Choi
- Department of Internal Medicine, Yeosu Chonnam Hospital, Yeosu, Korea
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
35
|
Cho JS, Her SH, Baek JY, Park MW, Kim HD, Jeong MH, Ahn YK, Chae SC, Hur SH, Hong TJ, Kim YJ, Seong IW, Chae JK, Rhew JY, Chae IH, Cho MC, Bae JH, Rha SW, Kim CJ, Choi D, Jang YS, Yoon J, Chung WS, Cho JG, Seung KB, Park SJ. Clinical benefit of low molecular weight heparin for ST-segment elevation myocardial infarction patients undergoing primary percutaneous coronary intervention with glycoprotein IIb/IIIa inhibitor. J Korean Med Sci 2010; 25:1601-8. [PMID: 21060749 PMCID: PMC2966997 DOI: 10.3346/jkms.2010.25.11.1601] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2010] [Accepted: 06/16/2010] [Indexed: 11/20/2022] Open
Abstract
The efficacy of low molecular weight heparin (LMWH) with low dose unfractionated heparin (UFH) during percutaneous coronary intervention (PCI) with or without glycoprotein (Gp) IIb/IIIa inhibitor compared to UFH with or without Gp IIb/IIIa inhibitor has not been elucidated. Between October 2005 and July 2007, 2,535 patients with ST elevation acute myocardial infarction (STEMI) undergoing PCI in the Korean Acute Myocardial Infarction Registry (KAMIR) were assigned to either of two groups: a group with Gp IIb/IIIa inhibitor (n=476) or a group without Gp IIb/IIIa inhibitor (n=2,059). These groups were further subdivided according to the use of LMWH with low dose UFH (n=219) or UFH alone (n=257). The primary end points were cardiac death or myocardial infarction during the 30 days after the registration. The primary end point occurred in 4.1% (9/219) of patients managed with LMWH during PCI and Gp IIb/IIIa inhibitor and 10.8% (28/257) of patients managed with UFH and Gp IIb/IIIa inhibitor (odds ratio [OR], 0.290; 95% confidence interval [CI], 0.132-0.634; P=0.006). Thrombolysis In Myocardial Infarction (TIMI) with major bleeding was observed in LMHW and UFH with Gp IIb/IIIa inhibitor (1/219 [0.5%] vs 1/257 [0.4%], P=1.00). For patients with STEMI managed with a primary PCI and Gp IIb/IIIa inhibitor, LMWH is more beneficial than UFH.
Collapse
Affiliation(s)
- Jung Sun Cho
- Cardiovascular Center, Seoul St. Mary's Hospital, Seoul, Korea
| | - Sung-Ho Her
- Cardiovascular Center, Seoul St. Mary's Hospital, Seoul, Korea
| | - Ju Yeal Baek
- Cardiovascular Center, Seoul St. Mary's Hospital, Seoul, Korea
| | - Mahn-Won Park
- Cardiovascular Center, Seoul St. Mary's Hospital, Seoul, Korea
| | - Hyoung Doo Kim
- Cardiovascular Center, Seoul St. Mary's Hospital, Seoul, Korea
| | - Myung Ho Jeong
- Cardiovascular Center, Chonnam National University Hospital, Gwangju, Korea
| | - Young keun Ahn
- Cardiovascular Center, Chonnam National University Hospital, Gwangju, Korea
| | - Shung Chull Chae
- Cardiovascular Center, Kyungpook National University, Daegu, Korea
| | - Seung Ho Hur
- Cardiovascular Center, Keimyung University Dongsan Medical Center, Daegu, Korea
| | - Taek Jong Hong
- Cardiovascular Center, Pusan National University Hospital, Busan, Korea
| | - Young Jo Kim
- Cardiovascular Center, Yeungnam University Hostpial, Daegu, Korea
| | - In Whan Seong
- Cardiovascular Center, Chungnam National University Hostpial, Daejon, Korea
| | - Jei Keon Chae
- Cardiovascular Center, Chonbuk National University Hospital, Jeonju, Korea
| | - Jay Young Rhew
- Cardiovascular Center, Jeonju Presbyterian Medical Center, Jeonju, Korea
| | - In Ho Chae
- Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Myeong Chan Cho
- Cardiovascular Center, Chungbuk National University, Cheongju, Korea
| | - Jang Ho Bae
- Cardiovascular Center, Konyang University, Daejon, Korea
| | - Seung Woon Rha
- Cardiovascular Center, Korea University Guro Hospital, Seoul, Korea
| | - Chong Jim Kim
- Cardiovascular Center, Kyunghee University Hospital, Seoul, Korea
| | - Donghoon Choi
- Cardiovascular Center, Yonsei University Hospital, Seoul, Korea
| | - Yang Soo Jang
- Cardiovascular Center, Yonsei University Hospital, Seoul, Korea
| | - Junghan Yoon
- Cardiovascular Center, Wonju University Hospital, Wonju, Korea
| | - Wook Sung Chung
- Cardiovascular Center, Seoul St. Mary's Hospital, Seoul, Korea
| | - Jeong Gwan Cho
- Cardiovascular Center, Chonnam National University Hospital, Gwangju, Korea
| | - Ki Bae Seung
- Cardiovascular Center, Seoul St. Mary's Hospital, Seoul, Korea
| | - Seung Jung Park
- Cardiovascular Center, Ulsan University Asan Medical Center, Seoul, Korea
| | | |
Collapse
|
36
|
Lee MG, Jeong MH, Ahn Y, Chae SC, Hur SH, Hong TJ, Kim YJ, Seong IW, Chae JK, Rhew JY, Chae IH, Cho MC, Bae JH, Rha SW, Kim CJ, Choi D, Jang YS, Yoon J, Chung WS, Cho JG, Seung KB, Park SJ. Impact of the metabolic syndrome on the clinical outcome of patients with acute ST-elevation myocardial infarction. J Korean Med Sci 2010; 25:1456-61. [PMID: 20890426 PMCID: PMC2946655 DOI: 10.3346/jkms.2010.25.10.1456] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2009] [Accepted: 04/12/2010] [Indexed: 11/30/2022] Open
Abstract
We sought to determine the prevalence of metabolic syndrome (MS) in patients with acute myocardial infarction and its effect on clinical outcomes. Employing data from the Korea Acute Myocardial Infarction Registry, a total of 1,990 patients suffered from acute ST-elevation myocardial infarction (STEMI) between November 2005 and December 2006 were categorized according to the National Cholesterol Education Program-Adult Treatment Panel III criteria of MS. Primary study outcomes included major adverse cardiac events (MACE) during one-year follow-up. Patients were grouped based on existence of MS: group I: MS (n=1,182, 777 men, 62.8±12.3 yr); group II: Non-MS (n=808, 675 men, 64.2±13.1 yr). Group I showed lower left ventricular ejection fraction (LVEF) (P=0.005). There were no differences between two groups in the coronary angiographic findings except for multivessel involvement (P=0.01). The incidence of in-hospital death was higher in group I than in group II (P=0.047), but the rates of composite MACE during one-year clinical follow-up showed no significant differences. Multivariate analysis showed that low LVEF, old age, MS, low high density lipoprotein cholesterol and multivessel involvement were associated with high in-hospital death rate. In conclusion, MS is an important predictor for in-hospital death in patients with STEMI.
Collapse
Affiliation(s)
- Min Goo Lee
- The Heart Center of Chonnam National University Hospital, Gwangju, Korea
| | - Myung Ho Jeong
- The Heart Center of Chonnam National University Hospital, Gwangju, Korea
| | - Youngkeun Ahn
- The Heart Center of Chonnam National University Hospital, Gwangju, Korea
| | | | - Seung Ho Hur
- Keimyung University Dongsan Medical Center, Daegu, Korea
| | | | | | - In Whan Seong
- Chungnam National University Hospital, Daejon, Korea
| | | | | | - In Ho Chae
- Seoul National University Bundang Hospital, Seongnam, Korea
| | | | | | | | | | | | | | - Junghan Yoon
- Yonsei University Wonju Christian Hospital, Wonju, Korea
| | - Wook Sung Chung
- Catholic University of Korea St. Mary's Hospital, Seoul, Korea
| | - Jeong Gwan Cho
- The Heart Center of Chonnam National University Hospital, Gwangju, Korea
| | - Ki Bae Seung
- Catholic University of Korea St. Mary's Hospital, Seoul, Korea
| | | |
Collapse
|
37
|
Cho WR, Hong YJ, Jeong MH, Ahn YG, Ahn TH, Bae JH, Hur SH, Rha SW, Kim KS, Chae IH, Kim JH, Yun KH, Kim SW. AS-74: Impact of Low-Density Lipoprotein Cholesterol and High-Sensitivity C-Reactive Protein Goal Achievement on Cardiac Events in Patients with Acute Myocardial Infarction. Am J Cardiol 2010. [DOI: 10.1016/j.amjcard.2010.01.112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
38
|
Jeong HC, Ahn Y, Jeong MH, Chae SC, Hur SH, Hong TJ, Kim YJ, Seong IW, Chae JK, Rhew JY, Chae IH, Cho MC, Bae JH, Rha SW, Kim CJ, Choi D, Jang YS, Yoon J, Chung WS, Cho JG, Seung KB, Park SJ. Long-Term clinical outcomes according to initial management and thrombolysis in myocardial infarction risk score in patients with acute non-ST-segment elevation myocardial infarction. Yonsei Med J 2010; 51:58-68. [PMID: 20046515 PMCID: PMC2799982 DOI: 10.3349/ymj.2010.51.1.58] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2009] [Revised: 05/03/2009] [Accepted: 05/06/2009] [Indexed: 11/27/2022] Open
Abstract
PURPOSE There is still debate about the timing of revascularization in patients with acute non-ST-segment elevation myocardial infarction (NSTEMI). We analyzed the long-term clinical outcomes of the timing of revascularization in patients with acute NSTEMI obtained from the Korea Acute Myocardial Infarction Registry (KAMIR). MATERIALS AND METHODS 2,845 patients with acute NSTEMI (65.6 +/- 12.5 years, 1,836 males) who were enrolled in KAMIR were included in the present study. The therapeutic strategy of NSTEMI was categorized into early invasive (within 48 hours, 65.8 +/- 12.6 years, 856 males) and late invasive treatment (65.3 +/- 12.1 years, 979 males). The initial- and long-term clinical outcomes were compared between two groups according to the level of Thrombolysis In Myocardial Infarction (TIMI) risk score. RESULTS There were significant differences in-hospital mortality and the incidence of major adverse cardiac events during one-year clinical follow-up between two groups (2.1% vs. 4.8%, p < 0.001, 10.0% vs. 13.5%, p = 0.004, respectively). According to the TIMI risk score, there was no significant difference of long-term clinical outcomes in patients with low to moderate TIMI risk score, but significant difference in patients with high TIMI risk score (>or= 5 points). CONCLUSIONS The old age, high Killip class, low ejection fraction, high TIMI risk score, and late invasive treatment strategy are the independent predictors for the long-term clinical outcomes in patients with NSTEMI.
Collapse
Affiliation(s)
- Hae Chang Jeong
- Department of Internal Medicine, Chonnam National University Hospital, Gwangju, Korea
| | - Youngkeun Ahn
- Department of Internal Medicine, Chonnam National University Hospital, Gwangju, Korea
| | - Myung Ho Jeong
- Department of Internal Medicine, Chonnam National University Hospital, Gwangju, Korea
| | - Shung Chull Chae
- Department of Internal Medicine, Kyungpook National University, Daegu, Korea
| | - Seung Ho Hur
- Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, Korea
| | - Taek Jong Hong
- Department of Internal Medicine, Pusan National University Hospital, Busan, Korea
| | - Young Jo Kim
- Department of Internal Medicine, Yeungnam University Hospital, Daegu, Korea
| | - In Whan Seong
- Department of Internal Medicine, Chungnam National University Hospital, Daejeon, Korea
| | - Jei Keon Chae
- Department of Internal Medicine, Chonbuk National University Hospital, Jeonju, Korea
| | - Jay Young Rhew
- Department of Internal Medicine, Jeonju Presbyterian Medical Center, Jeonju, Korea
| | - In Ho Chae
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Myeong Chan Cho
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Jang Ho Bae
- Department of Internal Medicine, National University, Cheongju, Korea
| | - Seung Woon Rha
- Department of Internal Medicine, Konyang University, Daejeon, Korea
| | - Chong Jin Kim
- Department of Internal Medicine, Korea University Guro Hospital, Seoul, Korea
| | - Donghoon Choi
- Department of Internal Medicine, Kyung Hee University Hospital, Seoul, Korea
| | - Yang Soo Jang
- Department of Internal Medicine, Kyung Hee University Hospital, Seoul, Korea
| | - Junghan Yoon
- Department of Internal Medicine, Yonsei University Wonju Hospital, Wonju, Korea
| | - Wook Sung Chung
- Department of Internal Medicine, Wonju University Hospital, Wonju, Korea
| | - Jeong Gwan Cho
- Department of Internal Medicine, Chonnam National University Hospital, Gwangju, Korea
| | - Ki Bae Seung
- Department of Internal Medicine, Catholic University Hospital, Seoul, Korea
| | - Seung Jung Park
- Department of Internal Medicine, Asan Medical Center, Seoul, Korea
| | | |
Collapse
|
39
|
Kang DG, Jeong MH, Ahn Y, Chae SC, Hur SH, Hong TJ, Kim YJ, Seong IW, Chae JK, Rhew JY, Chae IH, Cho MC, Bae JH, Rha SW, Kim CJ, Jang YS, Yoon J, Seung KB, Park SJ. Clinical effects of hypertension on the mortality of patients with acute myocardial infarction. J Korean Med Sci 2009; 24:800-6. [PMID: 19794974 PMCID: PMC2752759 DOI: 10.3346/jkms.2009.24.5.800] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2008] [Accepted: 11/22/2008] [Indexed: 11/20/2022] Open
Abstract
The incidence of ischemic heart disease has been increased rapidly in Korea. However, the clinical effects of antecedent hypertension on acute myocardial infarction have not been identified. We assessed the relationship between antecedent hypertension and clinical outcomes in 7,784 patients with acute myocardial infarction in the Korea Acute Myocardial Infarction Registry during one-year follow-up. Diabetes mellitus, hyperlipidemia, cerebrovascular disease, heart failure, and peripheral artery disease were more prevalent in hypertensives (n=3,775) than nonhypertensives (n=4,009). During hospitalization, hypertensive patients suffered from acute renal failure, shock, and cerebrovascular event more frequently than in nonhypertensives. During follow-up of one-year, the incidence of major adverse cardiac events was higher in hypertensives. In multi-variate adjustment, old age, Killip class > or =III, left ventricular ejection fraction <45%, systolic blood pressure <90 mmHg on admission, post procedural TIMI flow grade < or =2, female sex, and history of hypertension were independent predictors for in-hospital mortality. However antecedent hypertension was not significantly associated with one-year mortality. Hypertension at the time of acute myocardial infarction is associated with an increased rate of in-hospital mortality.
Collapse
Affiliation(s)
| | | | | | | | - Seung Ho Hur
- Keimyung University Dongsan Medical Center, Daegu, Korea
| | | | | | - In Whan Seong
- Chungnam National University Hospital, Daejeon, Korea
| | | | | | - In Ho Chae
- Seoul National University Bundang Hospital, Seongam, Korea
| | | | | | | | | | | | | | - Ki Bae Seung
- Catholic University of Seoul St. Mary's Hospital, Seoul, Korea
| | | | | |
Collapse
|
40
|
Lee MG, Jeong MH, Ahn Y, Chae SC, Hur SH, Hong TJ, Kim YJ, Seong IW, Chae JK, Rhew JY, Chae IH, Cho MC, Bae JH, Rha SW, Kim CJ, Choi D, Jang YS, Yoon J, Chung WS, Cho JG, Seung KB, Park SJ. Comparison of clinical outcomes following acute myocardial infarctions in hypertensive patients with or without diabetes. Korean Circ J 2009; 39:243-50. [PMID: 19949630 PMCID: PMC2771834 DOI: 10.4070/kcj.2009.39.6.243] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2008] [Revised: 01/16/2009] [Accepted: 02/17/2009] [Indexed: 01/19/2023] Open
Abstract
Background and Objectives It is thought that patients with diabetes mellitus (DM) have a poor prognosis after an acute myocardial infarction (AMI), but the effect of diabetes on the outcomes of hypertensive patients with AMIs has not been elucidated in the Korean population. The aim of this study was to investigate the effects of diabetes on long-term clinical outcomes following AMIs in patients with hypertension. Subjects and Methods Using data from the Korea Acute Myocardial Infarction Registry (November 2005 to December 2006), 2,233 hypertensive patients with AMIs were grouped as follows based on the presence of DM: group I, diabetic hypertension (n=892, 544 men, mean age=66.2±10.9 years); and group II, non-diabetic hypertension (n=1341, 938 men, mean age=63.9±12.8 years). The primary study outcomes included in-hospital death and major adverse cardiac events (MACE; cardiac death, myocardial infarction (MI), repeat percutaneous coronary intervention, and coronary artery bypass surgery) at the 1 year follow-up. Results Hypertensive patients with DM were older and more likely to be women. The diabetic group had lower blood pressure (p<0.001), a lower left ventricular ejection fraction (p<0.001), a more severe degree of heart failure (p<0.001), a longer duration of coronary care unit admission (p<0.001), and a higher incidence of hyperlipidemia (p=0.007). The N-terminal pro-brain natriuretic peptide level (4602.5±8710.6 pg/mL vs. 2320.8±5837.9 pg/mL, p<0.001) was higher and the creatinine clearance (62.4±29.9 mL/min vs. 73.0±40.8 mL/min, p<0.001) was lower in the diabetic group than the non-diabetic group. Coronary angiographic findings revealed more frequent involvement of the left main stem (p=0.002) and multiple vessels (p<0.001) in the diabetic group. The rate of in-hospital death was higher in the diabetic group (p<0.001). During follow-up, the rates of composite MACE at 1 month, 6 months, and 12 months were higher in the diabetic group (p<0.001). Conclusion In hypertensive patients with AMI, DM was associated with worse clinical and angiographic features, with a higher risk of development of severe heart failure, and an increased risk of MACE on long-term clinical follow-up.
Collapse
Affiliation(s)
- Min Goo Lee
- Korea Acute Myocardial Infarction Registry Investigators of Korean Society of Cardiology, Korea
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
41
|
Chen KY, Rha SW, Li YJ, Poddar KL, Jin Z, Minami Y, Wang L, Kim EJ, Park CG, Seo HS, Oh DJ, Jeong MH, Ahn YK, Hong TJ, Kim YJ, Hur SH, Seong IW, Chae JK, Cho MC, Bae JH, Choi DH, Jang YS, Chae IH, Kim CJ, Yoon JH, Chung WS, Seung KB, Park SJ. Triple Versus Dual Antiplatelet Therapy in Patients With Acute ST-Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention. Circulation 2009; 119:3207-14. [PMID: 19528339 DOI: 10.1161/circulationaha.108.822791] [Citation(s) in RCA: 160] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background—
Whether triple antiplatelet therapy is superior or similar to dual antiplatelet therapy in patients with acute ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention in the era of drug-eluting stents remains unclear.
Methods and Results—
A total of 4203 ST-segment elevation myocardial infarction patients who underwent primary percutaneous coronary intervention with drug-eluting stents were analyzed retrospectively in the Korean Acute Myocardial Infarction Registry (KAMIR). They received either dual (aspirin plus clopidogrel; dual group; n=2569) or triple (aspirin plus clopidogrel plus cilostazol; triple group; n=1634) antiplatelet therapy. The triple group received additional cilostazol at least for 1 month. Various major adverse cardiac events at 8 months were compared between these 2 groups. Compared with the dual group, the triple group had a similar incidence of major bleeding events but a significantly lower incidence of in-hospital mortality. Clinical outcomes at 8 months showed that the triple group had significantly lower incidences of cardiac death (adjusted odds ratio, 0.52; 95% confidence interval, 0.32 to 0.84;
P
=0.007), total death (adjusted odds ratio, 0.60; 95% confidence interval, 0.41 to 0.89;
P
=0.010), and total major adverse cardiac events (adjusted odds ratio, 0.74; 95% confidence interval, 0.58 to 0.95;
P
=0.019) than the dual group. Subgroup analysis showed that older (>65 years old), female, and diabetic patients got more benefits from triple antiplatelet therapy than their counterparts who received dual antiplatelet therapy.
Conclusions—
Triple antiplatelet therapy seems to be superior to dual antiplatelet therapy in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention with drug-eluting stents. These results may provide the rationale for the use of triple antiplatelet therapy in these patients.
Collapse
Affiliation(s)
- Kang-Yin Chen
- From the Korea University Guro Hospital, Seoul, Korea
| | | | - Yong-Jian Li
- From the Korea University Guro Hospital, Seoul, Korea
| | | | - Zhe Jin
- From the Korea University Guro Hospital, Seoul, Korea
| | | | - Lin Wang
- From the Korea University Guro Hospital, Seoul, Korea
| | - Eung Ju Kim
- From the Korea University Guro Hospital, Seoul, Korea
| | | | - Hong Seog Seo
- From the Korea University Guro Hospital, Seoul, Korea
| | - Dong Joo Oh
- From the Korea University Guro Hospital, Seoul, Korea
| | | | | | | | - Young Jo Kim
- From the Korea University Guro Hospital, Seoul, Korea
| | - Seung Ho Hur
- From the Korea University Guro Hospital, Seoul, Korea
| | - In Whan Seong
- From the Korea University Guro Hospital, Seoul, Korea
| | - Jei Keon Chae
- From the Korea University Guro Hospital, Seoul, Korea
| | | | - Jang Ho Bae
- From the Korea University Guro Hospital, Seoul, Korea
| | | | - Yang Soo Jang
- From the Korea University Guro Hospital, Seoul, Korea
| | - In Ho Chae
- From the Korea University Guro Hospital, Seoul, Korea
| | - Chong Jin Kim
- From the Korea University Guro Hospital, Seoul, Korea
| | - Jung Han Yoon
- From the Korea University Guro Hospital, Seoul, Korea
| | | | - Ki Bae Seung
- From the Korea University Guro Hospital, Seoul, Korea
| | | |
Collapse
|
42
|
Hong YJ, Jeong MH, Ahn Y, Jeong HC, Chull Chae S, Hur SH, Hong TJ, Kim YJ, Seong IW, Chae JK, Rhew JY, Chae IH, Cho MC, Bae JH, Rha SW, Kim CJ, Choi D, Jang YS, Yoon J, Chung WS, Cho JG, Seung KB, Park SJ. AS-65: Effects of Statins on 1-Year Cardiac Mortality after Drug-Eluting Stent Implantation in Diabetic Acute Myocardial Infarction Patients. Am J Cardiol 2009. [DOI: 10.1016/j.amjcard.2009.01.113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
43
|
Kang DK, Jeong MH, Ahn Y, Chae SC, Kim JH, Hur SH, Hong TJ, Kim YJ, Seong IW, Chae JK, Rhew JY, Chae IH, Cho MC, Bae JH, Rha SW, Kim CJ, Jang YS, Yoon J, Seung KB, Park SJ. AS-227: Clinical Effects of Hypertension on the Mortality of Patients with Acute Myocardial Infarction. Am J Cardiol 2009. [DOI: 10.1016/j.amjcard.2009.01.279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
44
|
Lee MG, Jeong MH, Ahn Y, Chae SC, Hur SH, Hong TJ, Kim YJ, Chae JK, Rhew JY, Chae IH, Seong IW, Cho MC, Bae JH, Rha SW, Kim CJ, Choi DH, Jang YS, Yoon J, Chung WS, Seung KB, Park SJ. AS-92: Effect of Metabolic Syndrome on the Long-Term Clinical Outcome of Patients with Acute Myocardial Infarction. Am J Cardiol 2009. [DOI: 10.1016/j.amjcard.2009.01.140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
45
|
Cho JY, Jeong MH, Ahn Y, Chae SC, Hur SH, Seong IW, Kim JH, Hong TJ, Koo BK, Chae JK, Choi D, Yoon J, Bae JH, Rha SW, Rhew JY, Kim DI, Kim KS, Kim BO, Oh SK, Chae IH, Lee MY, Cho MC, Jung KT, Kim CJ, Kim YJ. AS-82: Hyperglycemic Patients without Diabetes Mellitus Have Worse Outcomes than Normoglycemic Patients after Non-ST-Segment Elevation Myocardial Infarction. Am J Cardiol 2009. [DOI: 10.1016/j.amjcard.2009.01.130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
46
|
Cho JY, Jeong MH, Ahn Y, Chae SC, Seong IH, Kim YJ, Yoon J, Rhew JY, Chae JK, Chae IH, Lee NH, Hwang JY, Cho MC, Kim KS, Kim CJ, Chung WS, Rha SW, Jang YS, Seung KB, Park SJ. Predictive Factors of Major Adverse Cardiac Events and Clinical Outcomes of Acute Myocardial Infarction in Young Korean Patients. Korean Circ J 2008. [DOI: 10.4070/kcj.2008.38.3.161] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Affiliation(s)
- Jae Yeong Cho
- Korea Acute Myocardial Infarction Registry of the Korean Society of Cardiology, Gwangju, Korea
| | - Myung Ho Jeong
- Korea Acute Myocardial Infarction Registry of the Korean Society of Cardiology, Gwangju, Korea
| | - Youngkeun Ahn
- Korea Acute Myocardial Infarction Registry of the Korean Society of Cardiology, Gwangju, Korea
| | - Shung Chull Chae
- Korea Acute Myocardial Infarction Registry of the Korean Society of Cardiology, Gwangju, Korea
| | - In Hwan Seong
- Korea Acute Myocardial Infarction Registry of the Korean Society of Cardiology, Gwangju, Korea
| | - Young Jo Kim
- Korea Acute Myocardial Infarction Registry of the Korean Society of Cardiology, Gwangju, Korea
| | - Junghan Yoon
- Korea Acute Myocardial Infarction Registry of the Korean Society of Cardiology, Gwangju, Korea
| | - Jay Young Rhew
- Korea Acute Myocardial Infarction Registry of the Korean Society of Cardiology, Gwangju, Korea
| | - Jei Keon Chae
- Korea Acute Myocardial Infarction Registry of the Korean Society of Cardiology, Gwangju, Korea
| | - In Ho Chae
- Korea Acute Myocardial Infarction Registry of the Korean Society of Cardiology, Gwangju, Korea
| | - Nae Hee Lee
- Korea Acute Myocardial Infarction Registry of the Korean Society of Cardiology, Gwangju, Korea
| | - Jin Yong Hwang
- Korea Acute Myocardial Infarction Registry of the Korean Society of Cardiology, Gwangju, Korea
| | - Myeong Chan Cho
- Korea Acute Myocardial Infarction Registry of the Korean Society of Cardiology, Gwangju, Korea
| | - Kee Sik Kim
- Korea Acute Myocardial Infarction Registry of the Korean Society of Cardiology, Gwangju, Korea
| | - Chong Jin Kim
- Korea Acute Myocardial Infarction Registry of the Korean Society of Cardiology, Gwangju, Korea
| | - Wook Sung Chung
- Korea Acute Myocardial Infarction Registry of the Korean Society of Cardiology, Gwangju, Korea
| | - Seung Woon Rha
- Korea Acute Myocardial Infarction Registry of the Korean Society of Cardiology, Gwangju, Korea
| | - Yang Soo Jang
- Korea Acute Myocardial Infarction Registry of the Korean Society of Cardiology, Gwangju, Korea
| | - Ki Bae Seung
- Korea Acute Myocardial Infarction Registry of the Korean Society of Cardiology, Gwangju, Korea
| | - Seung Jung Park
- Korea Acute Myocardial Infarction Registry of the Korean Society of Cardiology, Gwangju, Korea
| | | |
Collapse
|
47
|
Jeong HC, Ahn YK, Jeong MH, Chae SC, Kim JH, Seong IW, Kim YJ, Hur SH, Choi DH, Hong TJ, Yoon JH, Rhew JY, Chae JK, Kim DI, Chae IH, Koo BK, Kim BO, Lee NH, Hwang JY, Oh SK, Cho MC, Kim KS, Jeong KT, Lee MY, Kim CJ, Chung WS, Korea Acute Myocardial Infarction Registry Investigators. Intensive Pharmacologic Treatment in Patients With Acute Non ST-Segment Elevation Myocardial Infarction Who Did Not Undergo Percutaneous Coronary Intervention. Circ J 2008; 72:1403-9. [DOI: 10.1253/circj.cj-08-0048] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
| | | | | | | | - Jong Hyun Kim
- Heart Center of Chonnam National University Hospital
| | - In Whan Seong
- Heart Center of Chonnam National University Hospital
| | - Young Jo Kim
- Heart Center of Chonnam National University Hospital
| | - Seung Ho Hur
- Heart Center of Chonnam National University Hospital
| | | | | | - Jung Han Yoon
- Heart Center of Chonnam National University Hospital
| | | | - Jei Keon Chae
- Heart Center of Chonnam National University Hospital
| | - Doo Il Kim
- Heart Center of Chonnam National University Hospital
| | - In Ho Chae
- Heart Center of Chonnam National University Hospital
| | - Bon Kwon Koo
- Heart Center of Chonnam National University Hospital
| | - Byung Ok Kim
- Heart Center of Chonnam National University Hospital
| | - Nae Hee Lee
- Heart Center of Chonnam National University Hospital
| | | | - Seok Kyu Oh
- Heart Center of Chonnam National University Hospital
| | | | - Kee Sik Kim
- Heart Center of Chonnam National University Hospital
| | | | | | - Chong Jin Kim
- Heart Center of Chonnam National University Hospital
| | | | | |
Collapse
|
48
|
Suh JW, Koo BK, Jo SH, Kang HJ, Cho YS, Youn TJ, Chung WY, Chae IH, Choi DJ, Kim HS, Oh BH, Park YB. Optimal Dosage and Method of Administration of Adenosine for Measuring the Coronary Flow Reserve and the Fractional Flow Reserve in Koreans. Korean Circ J 2006. [DOI: 10.4070/kcj.2006.36.4.300] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Affiliation(s)
- Jung Won Suh
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Cardiovascular Center, Seoul National University Hospital, Seoul, Korea
| | - Bon Kwon Koo
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Cardiovascular Center, Seoul National University Hospital, Seoul, Korea
| | - Sang Ho Jo
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Cardiovascular Center, Seoul National University Hospital, Seoul, Korea
| | - Hyun Jae Kang
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Cardiovascular Center, Seoul National University Hospital, Seoul, Korea
| | - Young Seok Cho
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Cardiovascular Center, Bundang Seoul National University Hospital, Seoul, Korea
| | - Tae Jin Youn
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Cardiovascular Center, Bundang Seoul National University Hospital, Seoul, Korea
| | - Woo Young Chung
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Cardiovascular Center, Bundang Seoul National University Hospital, Seoul, Korea
| | - In Ho Chae
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Cardiovascular Center, Bundang Seoul National University Hospital, Seoul, Korea
| | - Dong Ju Choi
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Cardiovascular Center, Bundang Seoul National University Hospital, Seoul, Korea
| | - Hyo Soo Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Cardiovascular Center, Seoul National University Hospital, Seoul, Korea
| | - Byung Hee Oh
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Cardiovascular Center, Seoul National University Hospital, Seoul, Korea
| | - Young Bae Park
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Cardiovascular Center, Seoul National University Hospital, Seoul, Korea
| |
Collapse
|
49
|
Kim JS, Lee WS, Kyung HD, Chang HJ, Cho YS, Youn TJ, Chung WY, Chae IH, Choi DJ. Cardiovascular Response during Thermal Stress: Comparison with Whole-Body Immersion and Half-Body Immersion. Korean Circ J 2004. [DOI: 10.4070/kcj.2004.34.12.1202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Affiliation(s)
- Jung Sun Kim
- Department of Cardiology, Armed Forces Capital Hospital, Sungnam, Korea
| | - Wang Soo Lee
- Department of Cardiology, Armed Forces Capital Hospital, Sungnam, Korea
| | - Hee Doo Kyung
- Department of Cardiology, Armed Forces Capital Hospital, Sungnam, Korea
| | - Hyuk Jae Chang
- Department of Cardiology, Armed Forces Capital Hospital, Sungnam, Korea
| | - Young Seok Cho
- Department of Cardiology, Armed Forces Capital Hospital, Sungnam, Korea
| | - Tae Jin Youn
- Department of Cardiology, Armed Forces Capital Hospital, Sungnam, Korea
| | - Woo Young Chung
- Department of Cardiology, Armed Forces Capital Hospital, Sungnam, Korea
| | - In Ho Chae
- Department of Cardiology, Armed Forces Capital Hospital, Sungnam, Korea
| | - Dong Joo Choi
- Department of Cardiology, Armed Forces Capital Hospital, Sungnam, Korea
| |
Collapse
|
50
|
Park JS, Bae JW, Koo BK, Yeon TJ, Kim HS, Sohn DW, Oh BH, Park YB, Choi YS, Chae IH, Choi DJ, Choi D, Jang Y, Shim WH, Cho SY, Kim K, Kim D, Cho M, Lee MM. Risk Factors of No-Reflow Phenomenon after Primary Percutaneous Coronary Intervention with Stent Implantation. Korean Circ J 2004. [DOI: 10.4070/kcj.2004.34.4.368] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Affiliation(s)
- Jin Shik Park
- Cardiovascular Center, Seoul National University Hospital, Seoul, Korea
| | - Jang Whan Bae
- Cardiovascular Center, Seoul National University Hospital, Seoul, Korea
| | - Bon Kwon Koo
- Cardiovascular Center, Seoul National University Hospital, Seoul, Korea
| | - Tae Jin Yeon
- Cardiovascular Center, Seoul National University Hospital, Seoul, Korea
| | - Hyo Soo Kim
- Cardiovascular Center, Seoul National University Hospital, Seoul, Korea
| | - Dae Won Sohn
- Cardiovascular Center, Seoul National University Hospital, Seoul, Korea
| | - Byung Hee Oh
- Cardiovascular Center, Seoul National University Hospital, Seoul, Korea
| | - Young Bae Park
- Cardiovascular Center, Seoul National University Hospital, Seoul, Korea
| | - Yun Shik Choi
- Cardiovascular Center, Seoul National University Hospital, Seoul, Korea
| | - In Ho Chae
- Cardiovascular Center, Seoul National University Hospital, Seoul, Korea
| | - Dong Joo Choi
- Cardiovascular Center, Seoul National University Hospital, Seoul, Korea
| | - Donghoon Choi
- Cardiovascular Center, Seoul National University Hospital, Seoul, Korea
| | - Yangsoo Jang
- Cardiovascular Center, Seoul National University Hospital, Seoul, Korea
| | - Won Heum Shim
- Cardiovascular Center, Seoul National University Hospital, Seoul, Korea
| | - Seung Yun Cho
- Cardiovascular Center, Seoul National University Hospital, Seoul, Korea
| | - Kiseok Kim
- Cardiovascular Center, Seoul National University Hospital, Seoul, Korea
| | - Dongwoon Kim
- Cardiovascular Center, Seoul National University Hospital, Seoul, Korea
| | - Myeongchan Cho
- Cardiovascular Center, Seoul National University Hospital, Seoul, Korea
| | - Myoung Mook Lee
- Cardiovascular Center, Seoul National University Hospital, Seoul, Korea
| |
Collapse
|