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Lim Y, Kim MC, Ahn JH, Lee SH, Hyun DY, Cho KH, Sim DS, Hong YJ, Kim JH, Jeong MH, Choi IJ, Choo EH, Lim S, Hwang BH, Park MW, Kim CJ, Park CS, Kim HY, Chang K, Ahn Y. Optimal timing of percutaneous coronary intervention for non-ST elevated myocardial infarction with congestive heart failure. Cardiovasc Revasc Med 2024:S1553-8389(24)00447-0. [PMID: 38679500 DOI: 10.1016/j.carrev.2024.04.295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 03/30/2024] [Accepted: 04/23/2024] [Indexed: 05/01/2024]
Abstract
OBJECTIVES This study investigated the optimal timing for percutaneous coronary intervention (PCI) in patients with NSTEMI complicated by heart failure (HF). METHODS In total, 762 patients with NSTEMI and HF in a multicenter, prospective registry in South Korea were classified according to the Killip classification (Killip class 2, n = 414 and Killip class 3, n = 348) and underwent early (within 24 h) and delayed (after 24 h) PCI. The primary outcome was all-cause mortality which was further analyzed with landmark analysis with two months as a cut-off. Secondary outcomes were cardiovascular death, in-hospital cardiogenic shock (CS), readmission due to HF, and acute myocardial infarction during follow-up. RESULTS Delayed PCI was associated with lower rates of 2-month mortality (6.1 % vs. 15.8 %, p = 0.007) and in-hospital CS (4.3 % vs. 14.1 %, p = 0.003), along with lower risks of 2-month mortality (hazard ratio [HR] = 0.38, 95 % confidence interval [CI] = 0.18-0.83, p = 0.014), in-hospital CS (HR = 0.29, 95 % CI = 0.12-0.71, p = 0.006) in multivariate Cox models of Killip class 3 patients. There was no statistical difference of incidence and risk of all predefined outcomes according to varying timing of PCI in Killip 2 patients. CONCLUSIONS Based on these results, the timing of PCI in patients with NSTEMI complicated by HF should be determined based on HF severity. Delayed PCI should be considered in patients with NSTEMI and more severe HF.
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Affiliation(s)
- Yongwhan Lim
- Department of Cardiovascular Medicine, Chonnam National University Medical School/Hospital, Gwangju, South Korea
| | - Min Chul Kim
- Department of Cardiovascular Medicine, Chonnam National University Medical School/Hospital, Gwangju, South Korea
| | - Joon Ho Ahn
- Department of Cardiovascular Medicine, Chonnam National University Medical School/Hospital, Gwangju, South Korea
| | - Seung Hun Lee
- Department of Cardiovascular Medicine, Chonnam National University Medical School/Hospital, Gwangju, South Korea
| | - Dae Young Hyun
- Department of Cardiovascular Medicine, Chonnam National University Medical School/Hospital, Gwangju, South Korea
| | - Kyung Hoon Cho
- Department of Cardiovascular Medicine, Chonnam National University Medical School/Hospital, Gwangju, South Korea
| | - Doo Sun Sim
- Department of Cardiovascular Medicine, Chonnam National University Medical School/Hospital, Gwangju, South Korea
| | - Young Joon Hong
- Department of Cardiovascular Medicine, Chonnam National University Medical School/Hospital, Gwangju, South Korea
| | - Ju Han Kim
- Department of Cardiovascular Medicine, Chonnam National University Medical School/Hospital, Gwangju, South Korea
| | - Myung Ho Jeong
- Department of Cardiovascular Medicine, Chonnam National University Medical School/Hospital, Gwangju, South Korea
| | - Ik Jun Choi
- Division of Cardiology, Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Eun Ho Choo
- Division of Cardiology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Sungmin Lim
- Division of Cardiology, Department of Internal Medicine, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Byung-Hee Hwang
- Division of Cardiology, Department of Internal Medicine, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Mahn-Won Park
- Division of Cardiology, Department of Internal Medicine, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Chan Joon Kim
- Division of Cardiology, Department of Internal Medicine, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Chul Soo Park
- Division of Cardiology, Department of Internal Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Hee Yeol Kim
- Division of Cardiology, Department of Internal Medicine, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Kiyuk Chang
- Division of Cardiology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Youngkeun Ahn
- Department of Cardiovascular Medicine, Chonnam National University Medical School/Hospital, Gwangju, South Korea.
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Kim MC, Ahn JH, Hyun DY, Lim Y, Lee SH, Oh S, Cho KH, Sim DS, Hong YJ, Kim JH, Jeong MH, Cho JH, Lee SR, Kang DO, Hwang JY, Youn YJ, Jeong YH, Park Y, Kim DB, Choo EH, Kim CJ, Kim W, Rhew JY, Lee JH, Yoo SY, Ahn Y. Timing of fractional flow reserve-guided complete revascularization in patients with ST-segment elevation myocardial infarction with multivessel disease: Rationale and design of the OPTION-STEMI trial. Am Heart J 2024; 273:35-43. [PMID: 38641031 DOI: 10.1016/j.ahj.2024.03.017] [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] [Received: 02/16/2024] [Revised: 03/19/2024] [Accepted: 03/31/2024] [Indexed: 04/21/2024]
Abstract
BACKGROUND Current guidelines recommend complete revascularization (CR) in hemodynamically stable patients with ST-segment elevation myocardial infarction (STEMI) and multivessel coronary artery disease (MVD). With regard to the timing of percutaneous coronary intervention (PCI) for non-infarct-related artery (non-IRA), recent randomized clinical trials have revealed that immediate CR was non-inferior to staged CR. However, the optimal timing of CR remains uncertain. The OPTION-STEMI trial compared immediate CR and in-hospital staged CR guided by fractional flow reserve (FFR) for intermediate stenosis of the non-IRA. METHODS The OPTION-STEMI is a multicenter, investigator-initiated, prospective, open-label, non-inferiority randomized clinical trial. The study included patients with at least 1 non-IRA lesion with ≥50% stenosis by visual estimation. Patients fulfilling the inclusion criteria were randomized into 2 groups at a 1:1 ratio: immediate CR (i.e., PCI for the non-IRA performed during primary angioplasty) or in-hospital staged CR. In the in-hospital staged CR group, PCI for non-IRA lesions was performed on another day during the index hospitalization. Non-IRA lesions with 50%-69% stenosis by visual estimation were evaluated by FFR, whereas those with ≥70% stenosis was revascularized without FFR. The primary endpoint was the composite of all-cause death, non-fatal myocardial infarction, and all unplanned revascularization at 1 year after randomization. Enrolment began in December 2019 and was completed in January 2024. The follow-up for the primary endpoint will be completed in January 2025, and primary results will be available in the middle of 2025. CONCLUSIONS The OPTION-STEMI is a multicenter, non-inferiority, randomized trial that evaluated the timing of in-hospital CR with the aid of FFR in patients with STEMI and MVD. TRIAL REGISTRATION URL: https://www. CLINICALTRIALS gov. Unique identifier: NCT04626882; and URL: https://cris.nih.go.kr. Unique identifier: KCT0004457.
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Affiliation(s)
- Min Chul Kim
- Division of Cardiology, Department of Internal Medicine, Chonnam National University Medical School, Chonnam National University Hospital, Gwangju, Korea
| | - Joon Ho Ahn
- Division of Cardiology, Department of Internal Medicine, Chonnam National University Medical School, Chonnam National University Hospital, Gwangju, Korea
| | - Dae Young Hyun
- Division of Cardiology, Department of Internal Medicine, Chonnam National University Medical School, Chonnam National University Hospital, Gwangju, Korea
| | - Yongwhan Lim
- Division of Cardiology, Department of Internal Medicine, Chonnam National University Medical School, Chonnam National University Hospital, Gwangju, Korea
| | - Seung Hun Lee
- Division of Cardiology, Department of Internal Medicine, Chonnam National University Medical School, Chonnam National University Hospital, Gwangju, Korea
| | - Seok Oh
- Division of Cardiology, Department of Internal Medicine, Chonnam National University Medical School, Chonnam National University Hospital, Gwangju, Korea
| | - Kyung Hoon Cho
- Division of Cardiology, Department of Internal Medicine, Chonnam National University Medical School, Chonnam National University Hospital, Gwangju, Korea
| | - Doo Sun Sim
- Division of Cardiology, Department of Internal Medicine, Chonnam National University Medical School, Chonnam National University Hospital, Gwangju, Korea
| | - Young Joon Hong
- Division of Cardiology, Department of Internal Medicine, Chonnam National University Medical School, Chonnam National University Hospital, Gwangju, Korea
| | - Ju Han Kim
- Division of Cardiology, Department of Internal Medicine, Chonnam National University Medical School, Chonnam National University Hospital, Gwangju, Korea
| | - Myung Ho Jeong
- Division of Cardiology, Department of Internal Medicine, Chonnam National University Medical School, Chonnam National University Hospital, Gwangju, Korea
| | | | - Sang-Rok Lee
- Division of Cardiology, Department of Internal Medicine, Jeonbuk National University Medical School, Jeonbuk National University Hospital, Jeonju, Korea
| | - Dong Oh Kang
- Cardiovascular Center, Department of Internal Medicine, Korea University College of Medicine, Korea University Guro Hospital, Seoul, Korea
| | - Jin-Yong Hwang
- Division of Cardiology, Department of Internal Medicine, Gyeongsang National University College of Medicine, Gyeongsang National University Hospital, Jinju, Korea
| | - Young Jin Youn
- Division of Cardiology, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju Severance Christian Hospital, Wonju, Korea
| | - Young-Hoon Jeong
- CAU Thrombosis and Biomarker Center, Chung-Ang University Gwangmyeong Hospital, Gwangmyeong, Korea and Division of Cardiology, Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea
| | - Yongwhi Park
- Division of Cardiology, Department of Internal Medicine, Gyeongsang National University College of Medicine, Gyeongsang National University Changwon Hospital, Changwon, Korea
| | - Dong-Bin Kim
- Division of Cardiology, Department of Internal Medicine, The Catholic University of Korea, Bucheon St. Mary's Hospital, Bucheon, Korea
| | - Eun-Ho Choo
- Division of Cardiology, Department of Internal Medicine, The Catholic University of Korea, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
| | - Chan Joon Kim
- Division of Cardiology, Department of Internal Medicine, The Catholic University of Korea, Uijeongbu St. Mary's Hospital, Uijeongbu, Korea
| | - Weon Kim
- Division of Cardiology, Department of Internal Medicine, Kyung Hee University College of Medicine, Kyung Hee University Medical Center, Seoul, Korea
| | | | - Jung-Hee Lee
- Division of Cardiology, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju Severance Christian Hospital, Wonju, Korea and Division of Cardiology, Yeungnam University College of Medicine, Yeungnam University Medical Center, Daegu, Korea
| | - Sang-Yong Yoo
- Good Morning Hospital, Pyeongtaek, Korea and Division of Cardiology, Department of Internal Medicine, University of Ulsan College of Medicine, Gangneung Asan Hospital, Gangneung, Korea
| | - Youngkeun Ahn
- Division of Cardiology, Department of Internal Medicine, Chonnam National University Medical School, Chonnam National University Hospital, Gwangju, Korea.
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Kim MC, Lim Y, Lee SH, Shin Y, Ahn JH, Hyun DY, Cho KH, Sim DS, Hong YJ, Kim JH, Jeong MH, Jung YH, Jeong IS, Ahn Y. Early Left Ventricular Unloading or Conventional Approach After Venoarterial Extracorporeal Membrane Oxygenation: The EARLY-UNLOAD Randomized Clinical Trial. Circulation 2023; 148:1570-1581. [PMID: 37850383 DOI: 10.1161/circulationaha.123.066179] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [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: 06/29/2023] [Accepted: 08/29/2023] [Indexed: 10/19/2023]
Abstract
BACKGROUND Although venoarterial extracorporeal membrane oxygenation (VA-ECMO) is beneficial for the treatment of profound cardiogenic shock, peripheral VA-ECMO cannulation can increase left ventricular afterload, thus compromising myocardial recovery. We investigated whether early routine left ventricular unloading can reduce 30-day mortality compared with the conventional approach in patients with cardiogenic shock undergoing VA-ECMO. METHODS This randomized clinical trial involved 116 patients with cardiogenic shock undergoing VA-ECMO from March 2021 to September 2022 at Chonnam National University Hospital, Gwangju, South Korea. The patients were randomly assigned to undergo either early routine left ventricular unloading with transseptal left atrial cannulation within 12 hours after randomization (n=58) or the conventional approach, which permitted rescue transseptal left atrial cannulation in case of an increased left ventricular afterload (n=58). The primary outcome was all-cause mortality within 30 days. RESULTS All 116 randomized patients (mean age, 67.6±13.5 years; 34 [29.3%] women) completed the trial. At 30 days, all-cause death had occurred in 27 (46.6%) patients in the early group and 26 (44.8%) patients in the conventional group (hazard ratio, 1.02 [95% CI, 0.59-1.74]; P=0.942). Crossover to rescue transseptal left atrial cannulation occurred in 29 patients (50%) in the conventional group according to a clear indication. Time to rescue transseptal cannulation in the conventional group was a median of 21.8 (interquartile range, 12.4-52.2) hours after randomization. There were no significant differences in other secondary outcomes between the 2 groups except for a shorter time to disappearance of pulmonary congestion in the early group (median, 3 [interquartile range, 2-6] versus 5 [interquartile range, 3-7] days; P=0.027). CONCLUSIONS Among patients with cardiogenic shock undergoing VA-ECMO, early routine left ventricular unloading with transseptal left atrial cannulation did not reduce 30-day mortality compared with the conventional strategy, which permitted rescue transseptal left atrial cannulation. These findings should be cautiously interpreted until the results of multicenter trials using other unloading modalities become available. REGISTRATION URL: https://www. CLINICALTRIALS gov; Unique identifier: NCT04775472.
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Affiliation(s)
- Min Chul Kim
- Division of Cardiology, Department of Internal Medicine (M.C.K., Y.L., S.H.L., Y.S., J.H.A., D.Y.H., K.H.C., D.S.S., Y.J.H., J.H.K., M.H.K., Y.A.), Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, South Korea
| | - Yongwhan Lim
- Division of Cardiology, Department of Internal Medicine (M.C.K., Y.L., S.H.L., Y.S., J.H.A., D.Y.H., K.H.C., D.S.S., Y.J.H., J.H.K., M.H.K., Y.A.), Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, South Korea
| | - Seung Hun Lee
- Division of Cardiology, Department of Internal Medicine (M.C.K., Y.L., S.H.L., Y.S., J.H.A., D.Y.H., K.H.C., D.S.S., Y.J.H., J.H.K., M.H.K., Y.A.), Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, South Korea
| | - Yoonmin Shin
- Division of Cardiology, Department of Internal Medicine (M.C.K., Y.L., S.H.L., Y.S., J.H.A., D.Y.H., K.H.C., D.S.S., Y.J.H., J.H.K., M.H.K., Y.A.), Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, South Korea
| | - Joon Ho Ahn
- Division of Cardiology, Department of Internal Medicine (M.C.K., Y.L., S.H.L., Y.S., J.H.A., D.Y.H., K.H.C., D.S.S., Y.J.H., J.H.K., M.H.K., Y.A.), Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, South Korea
| | - Dae Young Hyun
- Division of Cardiology, Department of Internal Medicine (M.C.K., Y.L., S.H.L., Y.S., J.H.A., D.Y.H., K.H.C., D.S.S., Y.J.H., J.H.K., M.H.K., Y.A.), Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, South Korea
| | - Kyung Hoon Cho
- Division of Cardiology, Department of Internal Medicine (M.C.K., Y.L., S.H.L., Y.S., J.H.A., D.Y.H., K.H.C., D.S.S., Y.J.H., J.H.K., M.H.K., Y.A.), Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, South Korea
| | - Doo Sun Sim
- Division of Cardiology, Department of Internal Medicine (M.C.K., Y.L., S.H.L., Y.S., J.H.A., D.Y.H., K.H.C., D.S.S., Y.J.H., J.H.K., M.H.K., Y.A.), Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, South Korea
| | - Young Joon Hong
- Division of Cardiology, Department of Internal Medicine (M.C.K., Y.L., S.H.L., Y.S., J.H.A., D.Y.H., K.H.C., D.S.S., Y.J.H., J.H.K., M.H.K., Y.A.), Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, South Korea
| | - Ju Han Kim
- Division of Cardiology, Department of Internal Medicine (M.C.K., Y.L., S.H.L., Y.S., J.H.A., D.Y.H., K.H.C., D.S.S., Y.J.H., J.H.K., M.H.K., Y.A.), Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, South Korea
| | - Myung Ho Jeong
- Division of Cardiology, Department of Internal Medicine (M.C.K., Y.L., S.H.L., Y.S., J.H.A., D.Y.H., K.H.C., D.S.S., Y.J.H., J.H.K., M.H.K., Y.A.), Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, South Korea
| | - Yong Hun Jung
- Department of Emergency Medicine (Y.H.J.), Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, South Korea
| | - In-Seok Jeong
- Department of Thoracic and Cardiovascular Surgery (I.-S.J.), Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, South Korea
| | - Youngkeun Ahn
- Division of Cardiology, Department of Internal Medicine (M.C.K., Y.L., S.H.L., Y.S., J.H.A., D.Y.H., K.H.C., D.S.S., Y.J.H., J.H.K., M.H.K., Y.A.), Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, South Korea
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Ahn JH, Kim MC, Ahn Y, Cho DI, Lim Y, Hyun DY, Lee SH, Cho KH, Cho M, Kim YS, Sim DS, Hong YJ, Kim JH, Jeong MH. Culprit lesion plaque characteristics and angiopoietin like 4 in acute coronary syndrome: A virtual histology-intravascular ultrasound analysis. Int J Cardiol 2023; 388:131164. [PMID: 37429444 DOI: 10.1016/j.ijcard.2023.131164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 04/26/2023] [Revised: 06/20/2023] [Accepted: 07/05/2023] [Indexed: 07/12/2023]
Abstract
BACKGROUND Thin-cap fibroatheroma is a rupture-prone vulnerable plaque that leads to acute coronary syndrome (ACS). However, its underlying mechanisms are not fully understood. Several studies have investigated the clinical association between angiopoietin-like protein 4 (ANGPTL4) and coronary artery disease. Therefore, this study aimed to investigate the correlation of plasma ANGPTL4 in culprit lesion of ACS patients using intravascular ultrasound (IVUS) and virtual-histology IVUS (VH-IVUS). METHODS Fifty patients newly diagnosed with ACS between March to September 2021 were selected. Blood samples for baseline laboratory tests, including ANGPTL4, were collected before percutaneous coronary intervention (PCI), and all pre- and post-PCI IVUS examinations were performed of the culprit lesions. RESULTS Linear regression analysis between plasma ANGPTL4 and grayscale IVUS/VH-IVUS parameters revealed that plasma ANGPTL4 was strongly correlated with the necrotic core (NC) of the minimal lumen site (r = -0.666, p = 0.003) and largest NC site (r = -0.687, p < 0.001), and patients with lower plasma ANGPTL4 levels showed a significantly higher proportion of TFCA. CONCLUSION The present study further demonstrated the protective role of ANGPTL4 in the spectrum of atherosclerotic development in patients with ACS by culprit lesion morphology analysis using IVUS and VH-IVUS.
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Affiliation(s)
- Joon Ho Ahn
- Department of Cardiology, Chonnam National University Hospital, Gwangju, South Korea
| | - Min Chul Kim
- Department of Cardiology, Chonnam National University Hospital, Gwangju, South Korea; Department of Cardiology, Chonnam National University Medical School, Gwangju, South Korea.
| | - Youngkeun Ahn
- Department of Cardiology, Chonnam National University Hospital, Gwangju, South Korea; Department of Cardiology, Chonnam National University Medical School, Gwangju, South Korea; Cell Regeneration Research Center, Chonnam National University Hospital, Gwangju, Republic of Korea
| | - Dong Im Cho
- Cell Regeneration Research Center, Chonnam National University Hospital, Gwangju, Republic of Korea
| | - Yongwhan Lim
- Department of Cardiology, Chonnam National University Hospital, Gwangju, South Korea
| | - Dae Young Hyun
- Department of Cardiology, Chonnam National University Hospital, Gwangju, South Korea
| | - Seung Hun Lee
- Department of Cardiology, Chonnam National University Hospital, Gwangju, South Korea
| | - Kyung Hoon Cho
- Department of Cardiology, Chonnam National University Hospital, Gwangju, South Korea; Department of Cardiology, Chonnam National University Medical School, Gwangju, South Korea
| | - Meeyoung Cho
- Cell Regeneration Research Center, Chonnam National University Hospital, Gwangju, Republic of Korea
| | - Yong Sook Kim
- Cell Regeneration Research Center, Chonnam National University Hospital, Gwangju, Republic of Korea; Biomedical Research Institute, Chonnam National University Hospital, Gwangju, Republic of Korea
| | - Doo Sun Sim
- Department of Cardiology, Chonnam National University Hospital, Gwangju, South Korea; Department of Cardiology, Chonnam National University Medical School, Gwangju, South Korea
| | - Young Joon Hong
- Department of Cardiology, Chonnam National University Hospital, Gwangju, South Korea; Department of Cardiology, Chonnam National University Medical School, Gwangju, South Korea
| | - Ju Han Kim
- Department of Cardiology, Chonnam National University Hospital, Gwangju, South Korea; Department of Cardiology, Chonnam National University Medical School, Gwangju, South Korea
| | - Myung Ho Jeong
- Department of Cardiology, Chonnam National University Hospital, Gwangju, South Korea; Department of Cardiology, Chonnam National University Medical School, Gwangju, South Korea
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Yim S, Ahn JH, Jeong MH, Ahn Y, Kim JH, Hong YJ, Sim DS, Kim MC, Cho KH, Lee SH, Hyun DY. Impact of sex difference on clinical outcomes in acute myocardial infarction patients with single-vessel and multi-vessel disease: based on Korea Acute Myocardial Infarction Registry-National Institute of Health. Cardiovasc Diagn Ther 2023; 13:660-672. [PMID: 37675088 PMCID: PMC10478015 DOI: 10.21037/cdt-22-536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 04/17/2023] [Indexed: 09/08/2023]
Abstract
Background Several studies have compared clinical outcomes according to sex in patients with acute myocardial infarction (AMI). However, studies evaluating sex differences in clinical outcomes of single-vessel disease (SVD) and multi-vessel disease (MVD) in Korean patients with AMI are lacking. Therefore, this study aimed to analyze sex differences in the clinical characteristics of patients with AMI with SVD and MVD and to evaluate the impact of sex differences on the clinical outcomes in patients with AMI with SVD and MVD. Methods A total of 11,002 AMI patients from November 2011 to June 2015 in the Korea AMI Registry, National Institute of Health, were enrolled. The current study was retrospective observational study. Patients were divided into SVD (n=5,644) and MVD (n=5,358) groups, and clinical impact of sex difference were analyzed by propensity score matching analysis and Cox proportional hazard regression model. Results Women were older and had poor baseline clinical characteristics than men. Propensity score-matched analysis of men and women with SVD and MVD revealed that the adjusted 3-year risk of major adverse cardiac event (MACE) (15.0% vs. 9.4%; hazard ratio, 1.86; 95% confidence interval, 1.10-3.13; P=0.020) was higher in women with SVD aged <65 years. However, the incidence and risk of MACE were similar for men and women with MVD, and those with SVD aged ≥65 years. Conclusions In the present study of Korean patients with AMI, women were older and exhibited a higher prevalence of comorbidities than men. Women with SVD aged <65 years had a significantly higher risk of MACE.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Seung Hun Lee
- Department of Cardiovascular Medicine, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
| | | | - other KAMIR-NIH Investigator
- Department of Cardiovascular Medicine, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
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Kim MC, Lim Y, Lee SH, Shin Y, Ahn JH, Hyun DY, Cho KH, Sim DS, Hong YJ, Kim JH, Jeong MH, Jung YH, Jeong IS, Ahn Y. Early left ventricular unloading after extracorporeal membrane oxygenation: rationale and design of EARLY-UNLOAD trial. ESC Heart Fail 2023. [PMID: 37415397 PMCID: PMC10375154 DOI: 10.1002/ehf2.14450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 05/09/2023] [Accepted: 06/21/2023] [Indexed: 07/08/2023] Open
Abstract
AIMS The clinical benefits of venoarterial extracorporeal membrane oxygenation (VA-ECMO) for profound cardiogenic shock are well known. However, peripheral VA-ECMO increases the left ventricular afterload, thus compromising myocardial recovery. Recent studies have revealed the benefit of left ventricular unloading using various methods applied at different times. The EARLY-UNLOAD trial compares the clinical outcomes of early left ventricular unloading and conventional approach after VA-ECMO. METHODS AND RESULTS The EARLY-UNLOAD trial is a single-centre, open-label, randomized trial that recruited 116 patients with cardiogenic shock undergoing VA-ECMO. Patients meeting the inclusion criteria were randomized in a 1:1 ratio to two groups: routine left ventricular unloading via intracardiac echocardiography-guided transseptal left atrial cannulation within 12 h of VA-ECMO initiation or conventional approach that indicates rescue left ventricular unloading if clinical signs of an increased left ventricular afterload are present. The primary endpoint is the cumulative incidence of all-cause death within 30 days, and patients will be followed-up for 12 months. A key secondary endpoint is a composite measure of all-cause death and rescue transseptal left atrial cannulation in the conventional group (suggestive of VA-ECMO treatment failure) within 30 days. The enrolment of patients was finished in September 2022. CONCLUSIONS The EARLY-UNLOAD trial is the first randomized controlled trial to compare early left ventricular unloading and conventional approach after VA-ECMO using the same unloading modality. The results could impact clinical practice to overcome the haemodynamic issues associated with VA-ECMO.
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Affiliation(s)
- Min Chul Kim
- Department of Internal Medicine, Division of Cardiology, Chonnam National University Medical School, Chonnam National University Hospital, Gwangju, South Korea
| | - Yongwhan Lim
- Department of Internal Medicine, Division of Cardiology, Chonnam National University Medical School, Chonnam National University Hospital, Gwangju, South Korea
| | - Seung Hun Lee
- Department of Internal Medicine, Division of Cardiology, Chonnam National University Medical School, Chonnam National University Hospital, Gwangju, South Korea
| | - Yoonmin Shin
- Department of Internal Medicine, Division of Cardiology, Chonnam National University Medical School, Chonnam National University Hospital, Gwangju, South Korea
| | - Joon Ho Ahn
- Department of Internal Medicine, Division of Cardiology, Chonnam National University Medical School, Chonnam National University Hospital, Gwangju, South Korea
| | - Dae Young Hyun
- Department of Internal Medicine, Division of Cardiology, Chonnam National University Medical School, Chonnam National University Hospital, Gwangju, South Korea
| | - Kyung Hoon Cho
- Department of Internal Medicine, Division of Cardiology, Chonnam National University Medical School, Chonnam National University Hospital, Gwangju, South Korea
| | - Doo Sun Sim
- Department of Internal Medicine, Division of Cardiology, Chonnam National University Medical School, Chonnam National University Hospital, Gwangju, South Korea
| | - Young Joon Hong
- Department of Internal Medicine, Division of Cardiology, Chonnam National University Medical School, Chonnam National University Hospital, Gwangju, South Korea
| | - Ju Han Kim
- Department of Internal Medicine, Division of Cardiology, Chonnam National University Medical School, Chonnam National University Hospital, Gwangju, South Korea
| | - Myung Ho Jeong
- Department of Internal Medicine, Division of Cardiology, Chonnam National University Medical School, Chonnam National University Hospital, Gwangju, South Korea
| | - Yong Hun Jung
- Department of Emergency Medicine, Chonnam National University Medical School, Chonnam National University Hospital, Gwangju, South Korea
| | - In-Seok Jeong
- Department of Thoracic and Cardiovascular Surgery, Chonnam National University Medical School, Chonnam National University Hospital, Gwangju, South Korea
| | - Youngkeun Ahn
- Department of Internal Medicine, Division of Cardiology, Chonnam National University Medical School, Chonnam National University Hospital, Gwangju, South Korea
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Hyung J, Lee JY, Kim JE, Yoon S, Yoo C, Hong YS, Jeong JH, Kim TW, Jeon S, Jun HR, Jung CK, Jang JP, Kim J, Chun SM, Ahn JH. Safety and efficacy of trastuzumab biosimilar plus irinotecan or gemcitabine in patients with previously treated HER2 (ERBB2)-positive non-breast/non-gastric solid tumors: a phase II basket trial with circulating tumor DNA analysis. ESMO Open 2023; 8:101583. [PMID: 37327700 DOI: 10.1016/j.esmoop.2023.101583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 05/15/2023] [Indexed: 06/18/2023] Open
Abstract
BACKGROUND Human epidermal growth factor receptor 2 (HER2) (ERBB2)-directed agents are standard treatments for patients with HER2-positive breast and gastric cancer. Herein, we report the results of an open-label, single-center, phase II basket trial to investigate the efficacy and safety of trastuzumab biosimilar (Samfenet®) plus treatment of physician's choice for patients with previously treated HER2-positive advanced solid tumors, along with biomarker analysis employing circulating tumor DNA (ctDNA) sequencing. METHODS Patients with HER2-positive unresectable or metastatic non-breast, non-gastric solid tumors who failed at least one prior treatment were included in this study conducted at Asan Medical Center, Seoul, Korea. Patients received trastuzumab combined with irinotecan or gemcitabine at the treating physicians' discretion. The primary endpoint was the objective response rate as per RECIST version 1.1. Plasma samples were collected at baseline and at the time of disease progression for ctDNA analysis. RESULTS Twenty-three patients were screened from 31 December 2019 to 17 September 2021, and 20 were enrolled in this study. Their median age was 64 years (30-84 years), and 13 patients (65.0%) were male. The most common primary tumor was hepatobiliary cancer (seven patients, 35.0%), followed by colorectal cancer (six patients, 30.0%). Among 18 patients with an available response evaluation, the objective response rate was 11.1% (95% confidence interval 3.1% to 32.8%). ERBB2 amplification was detected from ctDNA analysis of baseline plasma samples in 85% of patients (n = 17), and the ERBB2 copy number from ctDNA analysis showed a significant correlation with the results from tissue sequencing. Among 16 patients with post-progression ctDNA analysis, 7 (43.8%) developed new alterations. None of the patients discontinued the study due to adverse events. CONCLUSIONS Trastuzumab plus irinotecan or gemcitabine was safe and feasible for patients with previously treated HER2-positive advanced solid tumors with modest efficacy outcomes, and ctDNA analysis was useful for detecting HER2 amplification.
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Affiliation(s)
- J Hyung
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul
| | - J Y Lee
- Department of Medical Science, Asan Medical Institute of Convergence Science and Technology, Asan Medical Center, University of Ulsan College of Medicine, Seoul; Asan Center for Cancer Genome Discovery, Asan Institute for Life Science, Asan Medical Center, Seoul
| | - J E Kim
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul
| | - S Yoon
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul
| | - C Yoo
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul
| | - Y S Hong
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul
| | - J H Jeong
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul
| | - T W Kim
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul
| | - S Jeon
- Department of Medical Science, Asan Medical Institute of Convergence Science and Technology, Asan Medical Center, University of Ulsan College of Medicine, Seoul; Asan Center for Cancer Genome Discovery, Asan Institute for Life Science, Asan Medical Center, Seoul
| | - H R Jun
- Department of Medical Science, Asan Medical Institute of Convergence Science and Technology, Asan Medical Center, University of Ulsan College of Medicine, Seoul; Asan Center for Cancer Genome Discovery, Asan Institute for Life Science, Asan Medical Center, Seoul
| | | | | | - J Kim
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - S M Chun
- Asan Center for Cancer Genome Discovery, Asan Institute for Life Science, Asan Medical Center, Seoul; Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
| | - J H Ahn
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul.
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Hyun DY, Han X, Oh S, Ahn JH, Lee SH, Cho KH, Kim MC, Sim DS, Hong YJ, Kim JH, Ahn Y, Jeong MH. Long-term clinical outcomes in patients with acute myocardial infarction complicated by cardiogenic shock according to the application and initiation time of extracorporeal membrane oxygenation in South Korea. Cardiol J 2022; 30:713-724. [PMID: 36342031 PMCID: PMC10635714 DOI: 10.5603/cj.a2022.0101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 09/18/2022] [Accepted: 09/29/2022] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Limited data are available regarding the proper application time and long-term outcomes of extracorporeal membrane oxygenation (ECMO) in patients with cardiogenic shock. This cohort study appraised the clinical outcomes according to ECMO application without or before cardiopulmonary resuscitation (CPR) in patients with acute myocardial infarction (AMI) combined with cardiogenic shock. METHODS Between 2011 and 2015, a total of 13,104 patients with AMI were enrolled in a nationwide AMI registry. Eligible patients with cardiogenic shock, who underwent percutaneous coronary intervention, with a 3-year clinical follow-up, were analyzed. The 949 included patients were divided into two groups: no ECMO (n = 845) and ECMO application (n = 104). The ECMO group was further divided into ECMO without or before CPR (n = 11) and ECMO after CPR (n = 93). RESULTS Significant differences were noted in major adverse cardiac events (MACEs) between the no ECMO and ECMO application groups during the 3-year follow-up (41.5% vs. 80.8%; p < 0.001). However, the ECMO without or before CPR group showed similar outcomes to the no ECMO group in 3-year MACEs (63.6% vs. 41.5%; p = 0.055). MACEs during 3 years of follow-up were significantly lower in the ECMO without or before CPR group than in the ECMO after CPR group (63.6% vs. 82.8%; p = 0.005). CONCLUSIONS A significantly lower risk of major cardiac events in ECMO without or before CPR suggests that early application of ECMO can be a reasonable strategy to improve outcomes in patients with AMI complicated by cardiogenic shock.
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Affiliation(s)
- Dae Young Hyun
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Republic of Korea.
| | - Xiongyi Han
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Republic of Korea
| | - Seok Oh
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Republic of Korea
| | - Joon Ho Ahn
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Republic of Korea
| | - Seung Hun Lee
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Republic of Korea
| | - Kyung Hoon Cho
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Republic of Korea
| | - Min Chul Kim
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Republic of Korea
- Department of Cardiology, Chonnam National University Medical School, Hwasun, Republic of Korea
| | - Doo Sun Sim
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Republic of Korea
- Department of Cardiology, Chonnam National University Medical School, Hwasun, Republic of Korea
| | - Young Joon Hong
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Republic of Korea
- Department of Cardiology, Chonnam National University Medical School, Hwasun, Republic of Korea
| | - Ju Han Kim
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Republic of Korea
- Department of Cardiology, Chonnam National University Medical School, Hwasun, Republic of Korea
| | - Youngkeun Ahn
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Republic of Korea
- Department of Cardiology, Chonnam National University Medical School, Hwasun, Republic of Korea
| | - Myung Ho Jeong
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Republic of Korea
- Department of Cardiology, Chonnam National University Medical School, Hwasun, Republic of Korea
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Song HG, Ahn JH, Koh JS, Bae JS, Park YW, Hwang SJ, Hwang JY, Jeong YH. Prognostic implication of residual inflammatory risk according to disease status in patients treated with percutaneous coronary intervention. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1289] [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
Compared with stable angina, acute myocardial infarction (AMI) phenotype is related with the elevated inflammatory activity. However, time-dependent change of inflammatory level and its prognostic implication has not been fully understood according to the disease entity.
Methods
We enrolled total 4,263 patients who underwent percutaneous coronary intervention (PCI) with serial measurement of high-sensitivity C-reactive protein (hsCRP) at on-admission and 1-month post-PCI. The risks of MACE (a composite of death, MI or stroke), and major bleeding were evaluated up to 4 years after procedure.
Results
Compared with the non-AMI group (n=1,887), the AMI group (n=2,376) showed the significant decrease of hs-CRP during 1 month (∇0.5 vs. ∇0.1 mg/L; P<0.001). However, 1-month hs-CRP value still was higher in the AMI group than in the non-AMI group (median: 1.0 vs. 0.9 mg/L; P=0.001). During 1-month follow-up, high vs. low inflammatory risk (upper vs. lower tertile of hs-CRP) was significantly associated with increased rate of MACE in the AMI group (HR: 7.66; 95% CI: 2.29–25.59; P<0.001), but not in the non-AMI group (HR: 0.74; 95% CI: 0.12–4.40; P=0.736). From 1-month to 4-years, patients with high inflammatory risk showed the greater rate of MACE compared to those with low inflammatory risk, in both the AMI (HR: 2.40; 95% CI: 1.73–3.45; P<0.001) and non-AMI (HR: 2.67; 95% CI: 1.80–3.94; P<0.001) groups.
Conclusion
In PCI-treated patients, patients presented with AMI showed the greater values of inflammatory activity and its prognostic implication during the early phase, but combined inflammatory risk appeared similar across the disease entity during the late phase. This result may support that clinical benefit of post-PCI anti-inflammatory treatment would be constant regardless of the disease entity during the stabilized phase.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- H G Song
- Department of Cardiology, Heart-Brain Hospital, Chung-Ang University Gwang-Myeong Medical Center , Gwang-Myeong , Korea (Republic of)
| | - J H Ahn
- Cardiovascular Center, Gyeongsang National University Changwon Hospital , Changwon , Korea (Republic of)
| | - J S Koh
- Cardiovascular Center, Gyeongsang National University Hospital , Jin-Ju , Korea (Republic of)
| | - J S Bae
- Cardiovascular Center, Gyeongsang National University Changwon Hospital , Changwon , Korea (Republic of)
| | - Y W Park
- Cardiovascular Center, Gyeongsang National University Changwon Hospital , Changwon , Korea (Republic of)
| | - S J Hwang
- Cardiovascular Center, Gyeongsang National University Hospital , Jin-Ju , Korea (Republic of)
| | - J Y Hwang
- Cardiovascular Center, Gyeongsang National University Hospital , Jin-Ju , Korea (Republic of)
| | - Y H Jeong
- Department of Cardiology, Heart-Brain Hospital, Chung-Ang University Gwang-Myeong Medical Center , Gwang-Myeong , Korea (Republic of)
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Sung KIM J, Lee SH, Jeong MH, Ahn Y, Hong YJ, Sim DS, Kim MC, Cho KH, Hyun DY, Ahn JH, Kim JH, Oh S, Lim Y, Shin Y. TCT-24 Ticagrelor Versus Prasugrel in Acute Myocardial Infarction for East Asians. J Am Coll Cardiol 2022. [DOI: 10.1016/j.jacc.2022.08.035] [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: 11/30/2022]
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Lee SH, Jeong MH, Ahn JH, Hyun DY, Cho KH, Kim MC, Sim DS, Hong YJ, Kim JH, Ahn Y, Hwang JY, Kim W, Park JS, Yoon CH, Hur SH, Lee SR, Cha KS, Investigators OBOTKAMIR(KAMIRNIH. Predictors of recurrent acute myocardial infarction despite successful percutaneous coronary intervention. Korean J Intern Med 2022; 37:777-785. [PMID: 35811366 PMCID: PMC9271730 DOI: 10.3904/kjim.2021.427] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 09/13/2021] [Accepted: 02/07/2022] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND/AIMS Recurrent acute myocardial infarction (AMI) is an adverse cardiac event in patients with a first AMI. The predictors of recurrent AMI after the first AMI in patients who underwent successful percutaneous coronary intervention (PCI) have not been elucidated. METHODS We analyzed the data collected from 9,869 patients (63.2 ± 12.4 years, men:women = 7,446:2,423) who were enrolled in the Korea Acute Myocardial Infarction Registry-National Institute of Health between November 2011 and October 2015, had suffered their first AMI and had received successful PCI during the index hospitalization. Multivariable logistic regression analysis was performed to identify the independent predictors of recurrent AMI following the first AMI. RESULTS The cumulative incidence of recurrent AMI after successful PCI was 3.6% (359/9,869). According to the multivariable logistic regression analysis, the significant predictive factors for recurrent AMI were diabetes mellitus, renal dysfunction, atypical chest pain, and multivessel disease. CONCLUSION In this Korean prospective cohort study, the independent predictors of recurrent AMI after successful PCI for the first AMI were diabetes mellitus, renal dysfunction, atypical chest pain, and multivessel disease.
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Affiliation(s)
- Sang Hun Lee
- Department of Cardiology, Chonnam National University Hospital, Gwangju,
Korea
| | - Myung Ho Jeong
- Department of Cardiology, Chonnam National University Hospital, Gwangju,
Korea
- Department of Cardiology, Chonnam National University Medical School, Gwangju,
Korea
| | - Joon Ho Ahn
- Department of Cardiology, Chonnam National University Hospital, Gwangju,
Korea
| | - Dae Young Hyun
- Department of Cardiology, Chonnam National University Hospital, Gwangju,
Korea
| | - Kyung Hoon Cho
- Department of Cardiology, Chonnam National University Hospital, Gwangju,
Korea
| | - Min Chul Kim
- Department of Cardiology, Chonnam National University Hospital, Gwangju,
Korea
- Department of Cardiology, Chonnam National University Medical School, Gwangju,
Korea
| | - Doo Sun Sim
- Department of Cardiology, Chonnam National University Hospital, Gwangju,
Korea
- Department of Cardiology, Chonnam National University Medical School, Gwangju,
Korea
| | - Young Joon Hong
- Department of Cardiology, Chonnam National University Hospital, Gwangju,
Korea
- Department of Cardiology, Chonnam National University Medical School, Gwangju,
Korea
| | - Ju Han Kim
- Department of Cardiology, Chonnam National University Hospital, Gwangju,
Korea
- Department of Cardiology, Chonnam National University Medical School, Gwangju,
Korea
| | - Youngkeun Ahn
- Department of Cardiology, Chonnam National University Hospital, Gwangju,
Korea
- Department of Cardiology, Chonnam National University Medical School, Gwangju,
Korea
| | - Jin Yong Hwang
- Department of Cardiology, Gyeongsang National University College of Medicine, Jinju,
Korea
| | - Weon Kim
- Department of Cardiology, Kyung Hee University Hospital, Seoul,
Korea
| | - Jong Seon Park
- Department of Cardiology, Yeungnam University Medical Center, Daegu,
Korea
| | - Chang-Hwan Yoon
- Department of Cardiology, Seoul National University Bundang Hospital, Seongnam,
Korea
| | - Seung Ho Hur
- Department of Cardiology, Keimyung University Dongsan Hospital, Daegu,
Korea
| | - Sang Rok Lee
- Department of Cardiology, Jeonbuk National University Hospital, Jeonju,
Korea
| | - Kwang Soo Cha
- Department of Cardiology, Pusan National University Hospital, Busan,
Korea
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12
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Shin AY, Jekarl DW, Kim HW, Ha JH, Ahn JH, Kim JS. Early line-probe assay using DNA specimens in patients with pulmonary TB. Int J Tuberc Lung Dis 2022; 26:509-515. [PMID: 35650694 DOI: 10.5588/ijtld.21.0381] [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] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND: We investigated the feasibility of early line-probe assay (LPA) using remnant DNA of Mycobacterium tuberculosis from polymerase chain reaction (PCR) test.METHODS: M. tuberculosis DNA specimens with cycle threshold (Ct) values reported and collected from patients with known results for both LPA with culture isolates and phenotype drug susceptibility testing (pDST) were selected. The diagnostic performance of DNA-based LPA according to the Ct value was investigated.RESULTS: A total of 143 respiratory specimens were included. For isoniazid resistance, the accuracy in subgroups with Ct value <25, 25-29 and ≥29 was respectively 96.8%, 65.7% and 13.3%. For rifampicin resistance, accuracy in subgroups with Ct values <29 and ≥29 was respectively 87.8% and 13.3%. When compared to the pDST results, sensitivity, specificity, positive predictive value and negative predictive value in specimens with Ct values <25 was respectively 1.00 (95% CI 0.69-1.00), 0.95 (95% CI 0.76-1.00), 0.91 (95% CI 0.59-1.00) and 1.00 (95% CI 0.83-1.00) for isoniazid resistance. For rifampicin resistance, corresponding values in subgroups with Ct values <29 were respectively 0.89 (95% CI 0.52-1.00), 0.98 (95% CI 0.91-1.00), 0.80 (95% CI 0.50-0.94) and 0.99 (95% CI 0.92-1.00).CONCLUSIONS: DNA-based early LPA with remnant DNA from respiratory samples was feasible and accurate when the Ct values were low.
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Affiliation(s)
- A Y Shin
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Incheon St Mary´s Hospital, Republic of Korea
| | - D W Jekarl
- Department of Laboratory Medicine, Seoul St Mary´s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - H W Kim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Incheon St Mary´s Hospital, Republic of Korea
| | - J H Ha
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Incheon St Mary´s Hospital, Republic of Korea
| | - J H Ahn
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Incheon St Mary´s Hospital, Republic of Korea
| | - J S Kim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Incheon St Mary´s Hospital, Republic of Korea
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Kim DK, Ahn JH, Lee KH, Kang S, Kim SS, Na JO, Park SD, Ahn KT, Lee J, Jung IH, Seo J, Choi WG. Ambulatory blood pressure response to S‐amlodipine in Korean adult patients with uncontrolled essential hypertension: A prospective, observational study. J Clin Hypertens (Greenwich) 2022; 24:350-357. [PMID: 35188327 PMCID: PMC8925000 DOI: 10.1111/jch.14442] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 01/19/2022] [Accepted: 01/29/2022] [Indexed: 11/30/2022]
Abstract
Although amlodipine is recommended as the first‐line therapy for the treatment of hypertension, its use is limited by its potential side effects. S‐amlodipine is expected to be able to minimize side effects of amlodipine with a similar antihypertensive effect by removing the malicious R‐chiral form. However, sustainable blood pressure control with S‐amlodipine has not been well established yet. The purpose of the current study was to evaluate ambulatory blood pressure (ABP) profiles before and after a 12‐week treatment of S‐amlodipine. Patients received once‐daily S‐amlodipine 2.5 or 5 mg. ABP during 24 hr and office blood pressure were measured at baseline and after the 12‐week treatment. Primary endpoints were changes of systolic and diastolic 24 hr ABP. After 12‐week S‐amlodipine treatment, mean systolic ABP (‐15.1 ± 16.2 mmHg, p < .001) and diastolic ABP (‐8.9 ± 9.8 mmHg, p < .001) were decreased significantly. Both daytime and night‐time mean systolic BP and diastolic BP were also significantly decreased after the 12‐week treatment. Global trough‐to‐peak ratio and smoothness index after 12‐week S‐amlodipine treatment were .75 and .79 for SBP and .65 and .61 for DBP, respectively. Age ≥65 years (hazard ratio [HR]: 3.13; 95% confidence interval [CI]: 1.67–14.3) and nonalcohol drinking (HR: 3.09; 95% CI: 1.34–7.17) were independent clinical factors for target ABP achievement. Adverse drug reactions (ADR) were developed in 16 (6.4%) patients, including two (.8%) cases of peripheral edema. In conclusion, this study demonstrated the efficacy and safety of S‐amlodipine in patients with uncontrolled essential hypertension.
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Affiliation(s)
- Dong Kyun Kim
- Department of Cardiology Chonnam National University Hospital Gwangju South Korea
| | - Joon Ho Ahn
- Department of Cardiology Chonnam National University Hospital Gwangju South Korea
- Department of Internal Medicine Chonnam National University Medical School Gwangju South Korea
| | - Ki Hong Lee
- Department of Cardiology Chonnam National University Hospital Gwangju South Korea
- Department of Internal Medicine Chonnam National University Medical School Gwangju South Korea
| | - Si‐Hyuck Kang
- Cardiovascular Center Department of Internal Medicine Seoul National University Bundang Hospital Seongnam South Korea
| | - Sung Soo Kim
- Department of Cardiology Chosun University Hospital Gwangju South Korea
| | - Jin Oh Na
- Department of Cardiology Korea University Guro Hospital Seoul South Korea
| | - Sang Don Park
- Department of Cardiology Inha University Hospital Incheon South Korea
| | - Kye Taek Ahn
- Department of Cardiology Chungnam National University Hospital Daejeon South Korea
| | - Jung‐Hee Lee
- Department of Cardiology Yeungnam University Medical Center Daegu South Korea
| | - In Hyun Jung
- Department of Cardiology Inje University Sanggye Paik Hospital Seoul South Korea
| | - Jongkwon Seo
- Department of Cardiology Inje University Sanggye Paik Hospital Seoul South Korea
| | - Woong Gil Choi
- Department of Internal Medicine Konkuk University School of Medicine Chungju South Korea
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14
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Han X, Jeong MH, Bai L, Ahn JH, Hyun DY, Cho KH, Kim MC, Sim DS, Hong YJ, Kim JH, Ahn Y. Long-term clinical outcomes of type 1 vs. type 2 myocardial infarction in patients who underwent angiography: data from the Korea acute myocardial infarction-national institute of health registry. Cardiovasc Diagn Ther 2022; 12:55-66. [PMID: 35282670 PMCID: PMC8898687 DOI: 10.21037/cdt-21-434] [Citation(s) in RCA: 1] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 10/25/2021] [Indexed: 09/15/2023]
Abstract
BACKGROUND In the cause of increase the clinical research observational evidence on type 2 myocardial infraction (T2MI), the study compared the characteristics of T2MI and T1MI with respect to major adverse cardiac events (MACE) and mortality as long-term outcomes from a large, nationwide, prospective Korean cohort registry. METHODS From 13,105 consecutively enrolled individuals in the Korea Acute Myocardial Infarction-National Institute of Health (KAMIR-NIH) registry between October 2011 and December 2015, 11,053 acute myocardial infarction (AMI) patients were divided into the T1MI (n=10,545) and T2MI (n=508) groups. All patients completed ≥3 years of follow-up. RESULTS The Kaplan-Meier curve analysis and Cox proportional hazard regression models showed that the cumulative rate of MACE was similar between the 2 groups (11.4% vs. 13.4%, log-rank P=0.185) at 3 years. However, the T2MI group showed higher rates of all-cause death [12.6% vs. 9.4%, log-rank P=0.019; hazard ratio (HR), 1.42; 95% CI: 1.08-1.85; P=0.012] and non-cardiac death (3.5% vs. 5.3%, log-rank P=0.043; HR, 1.55; 95% CI: 1.01-2.37; P=0.043) than the T1MI group. Male sex (HR 1.540; 95% CI: 1.218-1.947, P<0.001), old age (≥65 years; HR, 3.546; 95% CI: 2.645-4.753, P<0.001), low hemoglobin level (<12 g/dL; HR, 2.335; 95% CI: 1.841-2.961, P<0.001), high heart rate (>100 beats/min; HR, 1.852; 95% CI: 1.436-2.388, P<0.001), low glomerular filtration rate (GFR) (<60 mL/min/1.73 m2; HR, 2.373; 95% CI: 1.874-3.005, P<0.001), high body mass index (>25 kg/m2; HR, 0.644; 95% CI: 0.514-0.805, P<0.001), and low left ventricular ejection fraction (LVEF) (<40%; HR, 1.487; 95% CI: 1.095-2.020, P=0.011) were the independent predictors for 3-year non-cardiac mortality. CONCLUSIONS Although the 2 groups did not differ in MACE, the total mortality rate was higher in T2MI than in T1MI, especially non-cardiac mortality. The independent predictors for non-cardiac mortality were male sex, old age, anemia, low GFR, tachycardia, obesity, and low LVEF.
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Affiliation(s)
- Xiongyi Han
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Republic of Korea
- Department of Cardiology, Yanbian University Hospital, Yanji, China
| | - Myung Ho Jeong
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Republic of Korea
| | - Liyan Bai
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Republic of Korea
- Department of Cardiology, Yanbian University Hospital, Yanji, China
| | - Joon Ho Ahn
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Republic of Korea
| | - Dae Young Hyun
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Republic of Korea
| | - Kyung Hoon Cho
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Republic of Korea
| | - Min Chul Kim
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Republic of Korea
| | - Doo Sun Sim
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Republic of Korea
| | - Young Joon Hong
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Republic of Korea
| | - Ju Han Kim
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Republic of Korea
| | - Youngkeun Ahn
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Republic of Korea
| | - other KAMIR-NIH Registry Investigators
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Republic of Korea
- Department of Cardiology, Yanbian University Hospital, Yanji, China
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15
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Oh S, Kim JS, Ahn Y, Ahn JH, Hyun DY, Lee SH, Cho KH, Kim MC, Sim DS, Hong YJ, Kim JH, Jeong MH. Different outcomes between iso-osmolar and low-osmolar contrast media in acute myocardial infarction with renal impairment. Cardiol J 2021; 30:790-798. [PMID: 34931692 PMCID: PMC10635715 DOI: 10.5603/cj.a2021.0171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 11/09/2021] [Accepted: 12/03/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The selection of appropriate contrast media (CM) remains an important issue in terms of renal preservation in patients with acute myocardial infarction (AMI) and renal impairment scheduled for percutaneous coronary intervention (PCI). We compared the clinical outcomes of patients with AMI and renal impairment, depending on the CM type (iso-osmolar CM [IOCM] vs. low-osmolar CM [LOCM]) that was used during PCI. METHODS From the Convergent Registry of Catholic and Chonnam University for Acute Myocardial Infarction, 3174 post-PCI patients with AMI and renal impairment were subdivided into two groups (IOCM [n = 2101] and LOCM [n = 1073]). RESULTS Regarding in-hospital clinical outcomes, the IOCM group had a higher peak creatinine (Cr) level and lower "Cr differential" than the LOCM group. A higher proportion of dialysis was noted in the IOCM group. In 30-day clinical outcomes, the IOCM group showed higher incidence of new-onset heart failure (HF) but lower incidence of revascularization than the LOCM group. The differences in in-hospital and 30-day clinical outcomes were attenuated after inverse probability of treatment weighting, except for new-onset HF. All other variables in 30-day clinical outcomes, including all-cause death, non-fatal myocardial infarction, cerebrovascular accidents, stent thrombosis, and any dialysis events, were similar between the two groups. CONCLUSIONS IOCM use did not prevent future incidence of dialysis compared to LOCM use in AMI patients with renal impairment.
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Affiliation(s)
- Seok Oh
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Korea
| | - Ji Sung Kim
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Korea
| | - Youngkeun Ahn
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Korea.
- Department of Cardiology, Chonnam National University Medical School, Gwangju, Korea.
| | - Joon Ho Ahn
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Korea
| | - Dae Young Hyun
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Korea
| | - Seung Hun Lee
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Korea
| | - Kyung Hoon Cho
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Korea
| | - Min Chul Kim
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Korea
- Department of Cardiology, Chonnam National University Medical School, Gwangju, Korea
| | - Doo Sun Sim
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Korea
- Department of Cardiology, Chonnam National University Medical School, Gwangju, Korea
| | - Young Joon Hong
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Korea
- Department of Cardiology, Chonnam National University Medical School, Gwangju, Korea
| | - Ju Han Kim
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Korea
- Department of Cardiology, Chonnam National University Medical School, Gwangju, Korea
| | - Myung Ho Jeong
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Korea
- Department of Cardiology, Chonnam National University Medical School, Gwangju, Korea
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16
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Ahn JH, Ahn Y, Jeong MH, Kim JH, Hong YJ, Sim DS, Kim MC, Cho KH, Hyun DY, Lee SH, Kim HS, Gwon HC, Seong IW, Hur SH, Oh SK. Optimal low-density lipoprotein cholesterol target level in Korean acute myocardial infarction patients (<70 mg/dL vs. <55 mg/dL): Based on Korea acute myocardial infarction registry-National Institute of Health. Int J Cardiol 2021; 351:15-22. [PMID: 34921900 DOI: 10.1016/j.ijcard.2021.12.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 04/16/2021] [Revised: 11/06/2021] [Accepted: 12/13/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Current treatment guidelines for acute myocardial infarction (AMI) recommend lowering low density lipoprotein cholesterol (LDL-C). However, previous clinical studies among East Asian AMI patients failed to prove its clinical efficacy of lipid lowering therapy based on Western target LDL-C level. Thus, the purpose of this study is directly to compare the clinical outcomes of target LDL-C < 70 mg/dL and < 55 mg/dL and identify optimal target LDL-C level and in Korean AMI patients. METHODS AND RESULTS A total of 2198 AMI patients in Korea AMI Registry - National Institute of Health were enrolled. Patients were initially divided into LDL-C non-target group (n = 1115) and target group (n = 1083). Successful achievement of follow up target LDL-C was defined as <70 mg/dL and ≥ 50% reduction from baseline. Target group patients were additionally divided to <70 mg/dL group (n = 698) and <55 mg/dL group (n = 385). Propensity score matching analysis was done in non-target vs. target group and <70 mg/dL vs. <55 mg/dL group. In the matched population, the risk of 3 years major adverse cardiac event (MACE) (13.0% vs 9.8%, HR: 0.73; 95% CI: 0.56-0.96; p = 0.025) was higher in non-target group patients. However, the risk of MACE was similar in <70 mg/dL and < 55 mg/dL group patients (10.0% vs 8.1%, HR: 0.75, 95% CI: 0.46-1.22; p = 0.247). CONCLUSION In the present study, target LDL-C level of <70 mg/dL and ≥ 50% reduction from baseline level was associated with better clinical outcomes in Korean AMI patients. However, further lowering target LDL-C level of <55 mg/dL showed no additional benefits.
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Affiliation(s)
- Joon Ho Ahn
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Republic of Korea
| | - Youngkeun Ahn
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Republic of Korea.
| | - Myung Ho Jeong
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Republic of Korea
| | - Ju Han Kim
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Republic of Korea
| | - Young Joon Hong
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Republic of Korea
| | - Doo Sun Sim
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Republic of Korea
| | - Min Chul Kim
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Republic of Korea
| | - Kyung Hoon Cho
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Republic of Korea
| | - Dae Yong Hyun
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Republic of Korea
| | - Seung Hun Lee
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Republic of Korea
| | - Hyo-Soo Kim
- Department of Cardiology, Seoul National University Hospital, Seoul, Republic of Korea
| | - Hyeon Cheol Gwon
- Department of Cardiology, Sungkyunkwan University Samsung Medical Center, Seoul, Republic of Korea
| | - In Whan Seong
- Department of Cardiology, Chungnam National University Hospital, Daejeon, Republic of Korea
| | - Seung-Ho Hur
- Department of Cardiology, Keimyung University Dongsan Medical Center, Daegu, Republic of Korea
| | - Seok Kyu Oh
- Department of Cardiology, Wonkwang University Hospital, Iksan, Republic of Korea
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Kang MG, Kim KH, Park HW, Koh JS, Park JR, Park YH, Hwang SJ, Jeong YH, Kwak CH, Ahn JH, Song HN, Hwang JY. Impact of active and stable cancer on survival in patients undergoing percutaneous coronary intervention. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2858] [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
With advances in treatment of ischemic heart disease and cancer treatment, use of percutaneous coronary intervention (PCI) in cancer survivors and patients with active cancer (AC) is expanding.
Objectives
The purpose of this study was to determine the impact of cancer on survival and major cardiovascular events (MACE) in a long-term, single-center cohort of patients treated with PCI.
Methods
Patients treated with PCI between January 2010 and December 2017 were grouped as follows: controls (patients without cancer), stable cancer (SC), and AC. AC was included patients with cancer diagnosed within the past 6 months, patients who had cancer-related therapy within the past 6 months, active metastatic disease, or active recurrence of the cancer. The primary endpoints were 5-year survival and a secondary endpoint was 5-year MACE.
Results
A total of 6,743 patients (age 66±12 years, 68.4% men) treated with PCI were included: 6,404 (95.0%) controls, 245 (3.6%) SC, and 94 (1.4%) AC. Predominant malignancies were gastrointestinal (37.4%), lung (22.7%), and genitourinary cancer (14.7%). No differences were observed between patients with AC, SC and controls regarding 5-year MACE (total MACE, 33.2% vs. 28.1% vs. 17.5%, p=0.072; cardiac death, 13.6% vs. 9.1% vs. 6.7%, p=0.066; non-fatal myocardial infarction, 2.9% vs. 7.5% vs. 7.8%, p=0.820; revascularization, 17.9% vs. 17.6% vs. 11.6%, p=0.794, respectively). Patients with AC and SC had reduced 5-year survival compared with controls (62.0% vs. 81.5% vs. 89.8%, p<0.001) (Figure). AC was associated with a 1.76 (95% CI 1.22 to 2.54, p=0.002) fold increased risk of all-cause 5-year mortality in multivariable adjusted models.
Conclusions
Cumulative incidence of 5-year survival was discriminated by concurrent status of cancer following PCI. Individualized decision making is needed in the routine practice of PCI regarding concurrent cancer-specific treatment and prognosis.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- M G Kang
- Gyeongsang National University Hospital, Jinju, Korea (Republic of)
| | - K H Kim
- Gyeongsang National University Hospital, Cardiology, Jinju, Korea (Republic of)
| | - H W Park
- Gyeongsang National University Hospital, Cardiology, Jinju, Korea (Republic of)
| | - J S Koh
- Gyeongsang National University Hospital, Cardiology, Jinju, Korea (Republic of)
| | - J R Park
- Gyeongsang National University Hospital, Cardiology, Jinju, Korea (Republic of)
| | - Y H Park
- Gyeongsang National University Changwon Hospital, Changwon, Korea (Republic of)
| | - S J Hwang
- Gyeongsang National University Hospital, Cardiology, Jinju, Korea (Republic of)
| | - Y H Jeong
- Gyeongsang National University Changwon Hospital, Changwon, Korea (Republic of)
| | - C H Kwak
- Gyeongsang National University Changwon Hospital, Changwon, Korea (Republic of)
| | - J H Ahn
- Gyeongsang National University Changwon Hospital, Changwon, Korea (Republic of)
| | - H N Song
- Gyeongsang National University Hospital, Jinju, Korea (Republic of)
| | - J Y Hwang
- Gyeongsang National University Hospital, Cardiology, Jinju, Korea (Republic of)
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Kim MC, Jeong IS, Ahn JH, Hyun DY, Kim D, Lee K, Ahn Y, Jeong MH. Bi-Caval Dual Lumen Catheter for Pediatric Patients Undergoing Venovenous Extracorporeal Membrane Oxygenation. Chonnam Med J 2021; 57:219-220. [PMID: 34621643 PMCID: PMC8485090 DOI: 10.4068/cmj.2021.57.3.219] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 03/28/2021] [Accepted: 03/29/2021] [Indexed: 11/06/2022] Open
Affiliation(s)
- Min Chul Kim
- Division of Cardiology, Department of Internal Medicine, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
| | - In-Seok Jeong
- Department of Thoracic and Cardiovascular Surgery, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
| | - Joon Ho Ahn
- Division of Cardiology, Department of Internal Medicine, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
| | - Dae Young Hyun
- Division of Cardiology, Department of Internal Medicine, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
| | - Dowan Kim
- Department of Thoracic and Cardiovascular Surgery, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
| | - Kyoseon Lee
- Department of Thoracic and Cardiovascular Surgery, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
| | - Youngkeun Ahn
- Division of Cardiology, Department of Internal Medicine, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
| | - Myung Ho Jeong
- Division of Cardiology, Department of Internal Medicine, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
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19
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Kim MC, Oh S, Ahn Y, Moon K, Ahn JH, Hyun DY, Cho KH, Sim DS, Hong YJ, Kim JH, Jeong MH, Cho JG, Park JC. The change in high-sensitivity troponin-T as a risk factor for significant coronary stenosis in patients with acute coronary syndrome. Korean J Intern Med 2021; 36:608-616. [PMID: 33395738 PMCID: PMC8137410 DOI: 10.3904/kjim.2020.090] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 03/09/2020] [Accepted: 04/26/2020] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND/AIMS High-sensitivity cardiac troponin (hs-TnT) assays detect very low levels of cardiac troponin. This study examined the interval change between initial and subsequent hs-TnT levels and evaluated its ability to predict significant coronary stenosis. METHODS The study analyzed 163 patients who presented with acute coronary syndrome (ACS) and underwent coronary angiography (CAG) between April 2014 and May 2018. The 0 and 3-hour hs-TnT were checked. The patients were subdivided into positive (n = 32) and negative (n = 131) interval change groups. The presence of significant coronary artery stenosis on CAG in the two groups was compared. RESULTS The positive interval change group was older and had higher 0 and 3-hour hs-TnT and blood glucose levels than the negative interval change group. Significant coronary stenosis was more common in the positive interval change group than in the negative interval change group (68.8% vs. 23.7%, p = 0.001). However, vasospasm was more common in the negative interval change group (6.3% vs. 31.3%, p = 0.003). The positive interval change group had higher rates of bifurcation lesions and received more percutaneous coronary intervention. In multivariate analysis, age, interval change of serial hs-TnT and diabetes mellitus were independent predictors of significant coronary artery stenosis. CONCLUSION This study identified a relationship between the serial change in cardiac biomarkers and the presence of significant coronary stenosis in patients with ACS. Serial hs-TnT change was associated with real angiographic stenosis in patients with ACS.
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Affiliation(s)
- Min Chul Kim
- Division of Cardiology, Department of Internal Medicine, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
| | - Seok Oh
- Division of Cardiology, Department of Internal Medicine, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
| | - Youngkeun Ahn
- Division of Cardiology, Department of Internal Medicine, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
| | - Keumyi Moon
- Division of Cardiology, Department of Internal Medicine, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
| | - Joon Ho Ahn
- Division of Cardiology, Department of Internal Medicine, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
| | - Dae Young Hyun
- Division of Cardiology, Department of Internal Medicine, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
| | - Kyung Hoon Cho
- Division of Cardiology, Department of Internal Medicine, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
| | - Doo Sun Sim
- Division of Cardiology, Department of Internal Medicine, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
| | - Young Joon Hong
- Division of Cardiology, Department of Internal Medicine, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
| | - Ju Han Kim
- Division of Cardiology, Department of Internal Medicine, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
| | - Myung Ho Jeong
- Division of Cardiology, Department of Internal Medicine, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
| | - Jeong Gwan Cho
- Division of Cardiology, Department of Internal Medicine, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
| | - Jong Chun Park
- Division of Cardiology, Department of Internal Medicine, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
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20
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Han X, Bai L, Jeong MH, Ahn JH, Hyun DY, Cho KH, Kim MC, Sim DS, Hong YJ, Kim JH, Ahn Y. Higher Long-Term Mortality in Patients with Non-ST-Elevation Myocardial Infarction than ST-Elevation Myocardial Infarction after Discharge. Yonsei Med J 2021; 62:400-408. [PMID: 33908210 PMCID: PMC8084695 DOI: 10.3349/ymj.2021.62.5.400] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 03/04/2021] [Accepted: 03/09/2021] [Indexed: 01/25/2023] Open
Abstract
PURPOSE This study aimed to compare mortality rates after discharge between the patients with non-ST-elevation myocardial infarction (NSTEMI) and those with ST-elevation myocardial infarction (STEMI), and identify each mortality risk factors in these two types of myocardial infarction. MATERIALS AND METHODS Between 2011 and 2015, 13105 consecutive patients were enrolled in the Korea Acute Myocardial Infarction-National Institute of Health registry (KAMIR-NIH); 12271 patients with acute myocardial infarction met the inclusion criteria and were further stratified into the STEMI (n=5828) and NSTEMI (n=6443) groups. The occurrence of mortality and cardiac mortality at 3 years were compared between groups, and the factors associated with mortality for NSTEMI and STEMI were evaluated. RESULTS The comparison between these two groups and long-term follow-up outcomes showed that the cumulative rates of all-cause and cardiac mortality were higher in the NSTEMI group than in the STEMI group [all-cause mortality: 10.9% vs. 5.8%; hazards ratio (HR), 0.464; 95% confidence interval (CI), 0.359-0.600, p<0.001; cardiac mortality: 6.6% vs. 3.5%, HR, 0.474; 95% CI, 0.344-0.654, p<0.001, respectively). In the NSTEMI group, low left ventricular ejection fraction (LVEF; <40%), no percutaneous coronary intervention (PCI), old age (≥65 years), and low hemoglobin level (<12 g/dL) were identified as risk factors for 3-year mortality. In the STEMI group, old age, low glomerular filtration rate (<60 mL/min/1.73 m²), low LVEF, high heart rate (>100 beats/min), no PCI, and low hemoglobin level were identified as the risk factors for 3-year mortality. CONCLUSION The NSTEMI group had higher mortality compared to the STEMI group during the 3-year clinical follow-up after discharge. Low LVEF and no PCI were the main risk factors for mortality in the NSTEMI group. In contrast, old age and renal dysfunction were the risk factors for long-term mortality in the STEMI group.
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Affiliation(s)
- Xiongyi Han
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Korea
- Department of Cardiology, Yanbian University Hospital, Yanji, China
| | - Liyan Bai
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Korea
- Department of Cardiology, Yanbian University Hospital, Yanji, China
| | - Myung Ho Jeong
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Korea.
| | - Joon Ho Ahn
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Korea
| | - Dae Young Hyun
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Korea
| | - Kyung Hoon Cho
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Korea
| | - Min Chul Kim
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Korea
| | - Doo Sun Sim
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Korea
| | - Young Joon Hong
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Korea
| | - Ju Han Kim
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Korea
| | - Youngkeun Ahn
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Korea
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21
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Cho KH, Han X, Ahn JH, Hyun DY, Kim MC, Sim DS, Hong YJ, Kim JH, Ahn Y, Hwang JY, Oh SK, Cha KS, Choi CU, Hwang KK, Gwon HC, Jeong MH. Long-Term Outcomes of Patients With Late Presentation of ST-Segment Elevation Myocardial Infarction. J Am Coll Cardiol 2021; 77:1859-1870. [PMID: 33858622 DOI: 10.1016/j.jacc.2021.02.041] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [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: 11/23/2020] [Revised: 01/26/2021] [Accepted: 02/18/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Real-world data on baseline characteristics, clinical practice, and outcomes of late presentation (12 to 48 h of symptom onset) in patients with ST-segment elevation myocardial infarction (STEMI) are limited. OBJECTIVES This study aimed to investigate real-world features of STEMI late presenters in the contemporary percutaneous coronary intervention (PCI) era. METHODS Of 13,707 patients from the Korea Acute Myocardial Infarction Registry-National Institutes of Health database, 5,826 consecutive patients diagnosed with STEMI within 48 h of symptom onset during 2011 to 2015 were categorized as late (12 to 48 h; n = 624) or early (<12 h; n = 5,202) presenters. Coprimary outcomes were 180-day and 3-year all-cause mortality. RESULTS Late presenters had remarkably worse clinical outcomes than early presenters (180-day mortality: 10.7% vs. 6.8%; 3-year mortality: 16.2% vs. 10.6%; both log-rank p < 0.001), whereas presentation at ≥12 h of symptom onset was not independently associated with increased mortality after STEMI. The use of invasive interventional procedures abruptly decreased from the first (<12 h) to the second (12 to 24 h) 12-h interval of symptom-to-door time ("no primary PCI strategy" increased from 4.9% to 12.4%, and "no PCI" from 2.3% to 6.6%; both p < 0.001). Mortality rates abruptly increased from the first to the second 12-h interval of symptom-to-door time (from 6.8% to 11.2% for 180-day mortality; from 10.6% to 17.3% for 3-year mortality; all p < 0.05). CONCLUSIONS Data from a nationwide prospective Korean registry reveal that inverse steep differences in the use of invasive interventional procedures and mortality rates were found between early and late presenters after STEMI. A multidisciplinary approach is required in identifying late presenters of STEMI who can benefit from invasive interventional procedures until further studied.
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Affiliation(s)
- Kyung Hoon Cho
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Republic of Korea
| | - Xiongyi Han
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Republic of Korea
| | - Joon Ho Ahn
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Republic of Korea
| | - Dae Young Hyun
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Republic of Korea
| | - Min Chul Kim
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Republic of Korea; Department of Cardiology, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Doo Sun Sim
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Republic of Korea; Department of Cardiology, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Young Joon Hong
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Republic of Korea; Department of Cardiology, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Ju Han Kim
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Republic of Korea; Department of Cardiology, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Youngkeun Ahn
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Republic of Korea; Department of Cardiology, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Jin Yong Hwang
- Department of Cardiology, Gyeongsang National University, School of Medicine, Jinju, Republic of Korea
| | - Seok Kyu Oh
- Department of Cardiology, Wonkwang University Hospital, Iksan, Republic of Korea
| | - Kwang Soo Cha
- Department of Cardiology, Pusan National University Hospital, Busan, Republic of Korea
| | - Cheol Ung Choi
- Department of Cardiology, Korea University Guro Hospital, Seoul, Republic of Korea
| | - Kyung-Kuk Hwang
- Department of Cardiology, Chungbuk National University Hospital, Cheongju, Republic of Korea
| | - Hyeon Cheol Gwon
- Department of Cardiology, Seoul Samsung Medical Center, Seoul, Republic of Korea
| | - Myung Ho Jeong
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Republic of Korea; Department of Cardiology, Chonnam National University Medical School, Gwangju, Republic of Korea.
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Ahn JH, Hyun JY, Jeong MH, Kim JH, Hong YJ, Sim DS, Kim MC, Park HS, Kim DI, Hur SH, Oh SK, Ahn Y. Comparative effect of angiotensin converting enzyme inhibitor versus angiotensin ii type i receptor blocker in acute myocardial infarction with non-obstructive coronary arteries; from the Korea Acute Myocardial Infarction Registry - National Institute of Health. Cardiol J 2020; 28:738-745. [PMID: 33001422 DOI: 10.5603/cj.a2020.0130] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 07/21/2020] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Selecting angiotensin converting enzyme inhibitor (ACEI) or angiotensin II type I receptor blocker (ARB) in patients diagnosed as acute myocardial infarction (AMI) with non-obstructive coronary arteries (MINOCA) is not established. The purpose of this study is to compare the clinical effect of ACEI vs. ARB in MINOCA patients. METHODS AND RESULTS A total of 273 patients between November 2011 to June 2015, diagnosed with MINOCA who were registered in the Korea Acute Myocardial Infarction Registry - National Institute of Health were enrolled. Patients were divided into ACEI (n = 112) and ARB groups (n = 161). The primary endpoint was cumulative incidence of major adverse cardiac events (MACE) defined as cardiac death, recurrent MI, any new revascularization during 2 years clinical follow-up. Secondary endpoint was heart failure requiring re-hospitalization. Propensity score matching analysis was done. The incidence of primary endpoint was similar (10.4% vs. 15.6%, HR: 0.65; 95% CI: 0.29-1.47; p = 0.301) among both groups. However, the incidence of recurrent MI was significantly lower in ACEI group compared to ARB group (2.1% vs. 10.4%, HR: 0.18, 95% CI: 0.04-0.86; p = 0.031). CONCLUSIONS In the present study, the risk and incidence of MACE was similar between ACEI and ARB therapy in MINOCA patients. However, ACEI significantly reduced the risk of recurrent MI. Further larger scale multi-center randomized clinical trials are needed to clarify the proper use of renin-angiotensin-aldosterone system blocker in these patients.
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Affiliation(s)
- Joon Ho Ahn
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Korea
| | - Ju Yong Hyun
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Korea
| | - Myung Ho Jeong
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Korea
| | - Ju Han Kim
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Korea
| | - Young Joon Hong
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Korea
| | - Doo Sun Sim
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Korea
| | - Min Chul Kim
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Korea
| | - Hun-Sik Park
- Department of Cardiology, Kyungpuk National University Hospital, Daegu, Korea
| | - Doo-Il Kim
- Department of Cardiology, Inje University Haeundae Paik Hospital, Busan, Korea
| | - Seung-Ho Hur
- Department of Cardiology, Keimyung University Dongsan Hospital, Daegu, Korea
| | - Seok Kyu Oh
- Department of Cardiology, Wonkwang University Hospital, Iksan, Korea
| | - Youngkeun Ahn
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Korea.
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Ahn JH, Ahn Y, Jeong MH, Kim JH, Hong YJ, Sim DS, Kim MC, Hwang JY, Yoon JH, Seong IW, Hur SH, Oh SK. Ticagrelor versus clopidogrel in acute myocardial infarction patients with multivessel disease; From Korea Acute Myocardial Infarction Registry-National Institute of Health. J Cardiol 2020; 75:478-484. [DOI: 10.1016/j.jjcc.2019.11.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 10/24/2019] [Accepted: 11/17/2019] [Indexed: 01/23/2023]
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Kim YJ, Jeong YJ, Kim SH, Kim YJ, Lee SY, Kim TY, Choi MS, Ahn JH. Preparedness for COVID-19 infection prevention in Korea: a single-centre experience. J Hosp Infect 2020; 105:370-372. [PMID: 32302723 PMCID: PMC7194524 DOI: 10.1016/j.jhin.2020.04.018] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 04/09/2020] [Indexed: 11/25/2022]
Affiliation(s)
- Y J Kim
- Division of Infectious Disease, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, South Korea; Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, South Korea; Infection Control Team, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, South Korea.
| | - Y J Jeong
- Division of Infectious Disease, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, South Korea; Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, South Korea; Infection Control Team, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, South Korea
| | - S H Kim
- Division of Infectious Disease, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, South Korea; Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, South Korea; Infection Control Team, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, South Korea
| | - Y J Kim
- Infection Control Team, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, South Korea
| | - S Y Lee
- Infection Control Team, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, South Korea
| | - T Y Kim
- Infection Control Team, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, South Korea
| | - M S Choi
- Infection Control Team, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, South Korea
| | - J H Ahn
- Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, South Korea; Division of Pulmonology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, South Korea
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Ahn JH, Hwang H, Lee KH. 2094 Single-Port Laparoscopic Hysterectomy without Uterine Manipulator in Early Cervical Cancer. J Minim Invasive Gynecol 2019. [DOI: 10.1016/j.jmig.2019.09.081] [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: 11/15/2022]
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Jang JY, Ahn JH, Bae JS, Kang MG, Kim K, Park HW, Koh JS, Park Y, Hwang SJ, Kwak CH, Hwang JY, Jeong YH. P3637Relationship between serial measurements of NT-proBNP and cardiovascular events in patients with acute coronary syndrome. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0494] [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
Increased level of natriuretic peptides has been known as an important predictors of adverse cardiovascular (CV) outcomes in patients with acute coronary syndrome (ACS). We sought to evaluate clinical implication of N-terminal pro-brain natriuretic peptide (NT-proBNP) measured at initial and follow-up periods.
Methods
Serial NT-proBNP levels (on-admission and one-month post-PCI) were measured in ACS patients undergoing PCI (n=2,290). High NT-proBNP levels were determined according to the predefined age-specific criteria. Patients were stratified into 4 groups according to NT-proBNP levels (on-admission & one-month): (1) normal-normal group (n=1234, 53.9%); (2) high–normal group (n=257, 11.2%); (3) normal-high group (n=376, 16.4%); and (4) high-high group (n=423, 18.5%). Clinical events were defined as all-cause death and MACE (a composite of CV death, non-fatal MI, and ischemic stroke).
Results
With a median follow-up of 35.9 (IQR: 16.8, 54.5) months, all-cause death and MACE were occurred in 4.1% and 7.2%, respectively. NT-proBNP on-admission vs. at one-month did not differ significantly (median 391.6 [IQR: 143.9, 1402.3] vs. median 619.1 [IQR 240.1, 1616.1]; p=0.622), but the prevalence of high NT-proBNP was increased over time (25.3% to 34.9%; p<0.001). The rates of all-cause death and MACE significantly increased only in the high-high group compared with other groups (log-rank test, all p values <0.001, Figure). After adjustment, the high-high group remained significantly risky in terms with the occurrence of all-cause death (HR, 2.99; 95% CI, 1.65 to 5.41; p<0.001) and MACE (HR, 1.96; 95% CI, 1.28 to 3.01; p=0.002).
Figure 1
Conclusion
Serial measurements of NT-proBNP at on-admission and follow-up can help to stratify the risks of all-cause death and adverse CV events following PCI in ACS patients. About two-fifths of patients having high NT-proBNP level during hospitalization can be classified into the low-risk group for all-cause death and adverse CV events.
Acknowledgement/Funding
None
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Affiliation(s)
- J Y Jang
- Gyeongsang National University Changwon Hospital, Internal Medicine, Changwon, Korea (Republic of)
| | - J H Ahn
- Gyeongsang National University Changwon Hospital, Internal Medicine, Changwon, Korea (Republic of)
| | - J S Bae
- Gyeongsang National University Changwon Hospital, Internal Medicine, Changwon, Korea (Republic of)
| | - M G Kang
- Gyeongsang National University Hospital, Internal Medicine, Jinju, Korea (Republic of)
| | - K Kim
- Gyeongsang National University Hospital, Internal Medicine, Jinju, Korea (Republic of)
| | - H W Park
- Gyeongsang National University Hospital, Internal Medicine, Jinju, Korea (Republic of)
| | - J S Koh
- Gyeongsang National University Hospital, Internal Medicine, Jinju, Korea (Republic of)
| | - Y Park
- Gyeongsang National University Changwon Hospital, Internal Medicine, Changwon, Korea (Republic of)
| | - S J Hwang
- Gyeongsang National University Hospital, Internal Medicine, Jinju, Korea (Republic of)
| | - C H Kwak
- Gyeongsang National University Changwon Hospital, Internal Medicine, Changwon, Korea (Republic of)
| | - J Y Hwang
- Gyeongsang National University Hospital, Internal Medicine, Jinju, Korea (Republic of)
| | - Y H Jeong
- Gyeongsang National University Changwon Hospital, Internal Medicine, Changwon, Korea (Republic of)
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Jeong HC, Ahn JH, Kim MC, Sim DS, Park KH, Hong YJ, Kim JH, Jeong MH, Seung KB, Chang K, Ahn Y. A score for decision making during percutaneous coronary intervention in acute myocardial infarction patients with multivessel disease. Korean J Intern Med 2019; 34:324-334. [PMID: 29551055 PMCID: PMC6406104 DOI: 10.3904/kjim.2017.169] [Citation(s) in RCA: 2] [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: 04/29/2017] [Accepted: 09/08/2017] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND/AIMS The optimal percutaneous coronary intervention (PCI) strategy in patients with acute myocardial infarction (AMI) with multivessel disease (MVD) is uncertain. This study was designed to develop a novel and simple tool for assessing an individualized and optimized PCI strategy in AMI patients with MVD. METHODS In total, 5,025 patients with AMI from nine centers at two universities were enrolled in the prospective Convergent Registry of Catholic and Chonnam University for Acute Myocardial Infarction (COREA-AMI) registry from January 2004 through December 2009. From among them, we selected 2,630 patients with MVD who were treated by culprit-only or multivessel (MV) PCI. We investigated major adverse cardiac events (MACEs) during a 1-year clinical follow-up. Using a subgroup analysis, we extracted variables for use in the culprit only versus multivessel revascularization (CONVERSE) score, which showed a preference for MV PCI rather than culprit-only PCI for treating MVD. RESULTS The CONVERSE score was constructed using eight independent variables (1 point for each variable): age > 65 years, hypertension, diabetes mellitus, high Killip class (III or IV), low left ventricular ejection fraction (≤ 50%), low creatinine clearance (≤ 60 mL/min), high level of high-sensitivity C-reactive protein (≥ 2.0 mg/L), and left anterior descending artery or left main as the nonculprit vessel. The incidence of MACEs increased linearly with the CONVERSE score. The receiver operating characteristic curve showed that the cutoff value was 3 points. CONCLUSION The results suggest that patients with a CONVERSE score of 3 or more should undergo MV PCI.
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Affiliation(s)
- Hae Chang Jeong
- Department of Cardiology, Cardiovascular Center, Miraero 21 Hospital, Gwangju, Korea
| | - Joon Ho Ahn
- Department of Cardiology, Cardiovascular Center, Chonnam National University Hospital, Gwangju, Korea
| | - Min Chul Kim
- Department of Cardiology, Cardiovascular Center, Chonnam National University Hospital, Gwangju, Korea
| | - Doo Sun Sim
- Department of Cardiology, Cardiovascular Center, Chonnam National University Hospital, Gwangju, Korea
| | - Keun Ho Park
- Department of Cardiology, Chosun University Hospital, Gwangju, Korea
| | - Young Joon Hong
- Department of Cardiology, Cardiovascular Center, Chonnam National University Hospital, Gwangju, Korea
| | - Ju Han Kim
- Department of Cardiology, Cardiovascular Center, Chonnam National University Hospital, Gwangju, Korea
| | - Myung Ho Jeong
- Department of Cardiology, Cardiovascular Center, Chonnam National University Hospital, Gwangju, Korea
| | - Ki-Bae Seung
- Department of Cardiology, Cardiovascular Center, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
| | - Kiyuk Chang
- Department of Cardiology, Cardiovascular Center, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
| | - Youngkeun Ahn
- Department of Cardiology, Cardiovascular Center, Chonnam National University Hospital, Gwangju, Korea
- Correspondence to Youngkeun Ahn, M.D. Department of Cardiology, Cardiovascular Center, Chonnam National University Hospital, 42 Jebong-ro, Dong-gu, Gwangju 61469, Korea Tel: +82-62-220-4764 Fax: +82-62-224-4764 E-mail:
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Kim J, Jo WK, Kim KY, Kim BJ, Lee SB, Lee HJ, Yu JH, Kim HJ, Chung IY, Ko BS, Kim SB, Jung KH, Ahn JH, Chang S, Lee JW, Son BH, Ahn SH. Abstract P4-01-11: Genomic alterations of cell-free DNA in early breast cancer patients with recurrence. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p4-01-11] [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] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Cell-free DNA (cfDNA), as a non-invasive strategy, provides substantial benefit to overcome tumor heterogeneity. Surveillance of recurrence after standard treatment in early breast cancer (BC) using cfDNA, enables to detect minimal residual disease (MRD), also to identify genomic alterations driving recurrences. We aimed to assess the role of cfDNA in detecting MRD by investigating genomic alterations of 1)primary, recurred tumor and 2)cfDNA at time of recurrence using deep targeted sequencing. Fifty-four early BC patients were enrolled prospectively between 2014 and 2017 at time of recurrence. Median disease free interval was 28.5 months (rage 6.2-49.8). 62.7% (32/51) were hormone receptor (HR) positive (28 HRpos/HER2neg, 4 HRpos/HER2pos), 11.8% (6/51) were HRneg/HER2pos and 25.5% (13/51) were triple negative BCs. 59.3% (32/54) patients developed loco-regional recurrence (15 local recurrence only, 13 regional only, 4 with both) and distant metastasis was observed among 40.7% (22/54) patients. Cell-free DNA was extracted from 5cc blood at time of recurrence. Deep targeted sequencing was performed using customized NGS panel –encompassing 426 cancer-related target coding region, 242 fusion and amplification-related region- of cfDNA and FFPE(formalin fixed paraffin embedded) tumor samples archived from surgical resection or biopsy. Deep targeted sequencing data was successfully performed in 72.1% (31/43) plasma samples and sequencing yield was significantly lower when stored for more than 2yrs (46.2% vs 83.3%).
Mutations of cfDNA and tumor (primary, recurred) were analyzed. Mean sequencing depth of cfDNA and FFPE were x425.7 and x777.6 respectively. Median number of pathogenic mutations found in primary tumor, cfDNA and recurred tumor were 27(range 12-99), 25(range 8-85) and 9(range 0-23). Among mutations found in primary tumor, 27.4% were shared mutations (range 8.1%-72.7%) with recurred tumor and 26.1% were shared mutations (range 4.7%-69.2%) observed in cfDNA sample. Among mutations found in recurred tumor, 40.9% were observed in cfDNA (range 17.7-87.5%). In primary tumor, median number of mutations with allelic fraction (MAF)>10% were 12 (range 4-21) and at least one mutation was found in cfDNA at time of recurrence. Among mutations with MAF>10%, 59.4% and 69.1% were found in cfDNA and recurred tumor. Known oncogenic mutations of PIK3CA, TP53, GATA3, AKT1, ESR1, RELN, ERBB2, ERBB3, BRCA1 mutation were found. PIK3CA gene (p.H1047R) was found in two cases both in primary tumor and cfDNA at recurrence (MAF 11.4% vs 5.3% and 12.3% vs 15.4%) suggesting de novo driver mutation. One patient developed regional recurrence during adjuvant aromatase inhibitor with ESR1 V392I mutation in both cfDNA and recurred tumor (MAF 48.1 and 54.5%), while another patient's recurred tumor during aromatase inhibitor harbored ESR1 D538G mutation exclusively in recurred tumor with MAF <1%. Both patients had no ESR1 hotpot mutation in primary tumor.
Our data showed sequencing yield of 83.3% in plasma samples within 2yr. Pathogenic mutations in primary tumor, especially when MAF>10%, half of them was observed in cfDNA at time of recurrence. ESR1 mutation should be included in cfDNA surveillance for patients undergoing endocrine therapy even absent in primary tumor.
Citation Format: Kim J, Jo WK, Kim KY, Kim BJ, Lee SB, Lee HJ, Yu JH, Kim HJ, Chung IY, Ko BS, Kim S-B, Jung KH, Ahn JH, Chang S, Lee JW, Son BH, Ahn SH. Genomic alterations of cell-free DNA in early breast cancer patients with recurrence [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P4-01-11.
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Affiliation(s)
- J Kim
- Asan Medical Center, Seoul, Republic of Korea; Macrogen Inc, Seoul, Republic of Korea; Samsung Medical Center, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - WK Jo
- Asan Medical Center, Seoul, Republic of Korea; Macrogen Inc, Seoul, Republic of Korea; Samsung Medical Center, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - KY Kim
- Asan Medical Center, Seoul, Republic of Korea; Macrogen Inc, Seoul, Republic of Korea; Samsung Medical Center, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - BJ Kim
- Asan Medical Center, Seoul, Republic of Korea; Macrogen Inc, Seoul, Republic of Korea; Samsung Medical Center, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - SB Lee
- Asan Medical Center, Seoul, Republic of Korea; Macrogen Inc, Seoul, Republic of Korea; Samsung Medical Center, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - HJ Lee
- Asan Medical Center, Seoul, Republic of Korea; Macrogen Inc, Seoul, Republic of Korea; Samsung Medical Center, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - JH Yu
- Asan Medical Center, Seoul, Republic of Korea; Macrogen Inc, Seoul, Republic of Korea; Samsung Medical Center, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - HJ Kim
- Asan Medical Center, Seoul, Republic of Korea; Macrogen Inc, Seoul, Republic of Korea; Samsung Medical Center, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - IY Chung
- Asan Medical Center, Seoul, Republic of Korea; Macrogen Inc, Seoul, Republic of Korea; Samsung Medical Center, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - BS Ko
- Asan Medical Center, Seoul, Republic of Korea; Macrogen Inc, Seoul, Republic of Korea; Samsung Medical Center, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - S-B Kim
- Asan Medical Center, Seoul, Republic of Korea; Macrogen Inc, Seoul, Republic of Korea; Samsung Medical Center, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - KH Jung
- Asan Medical Center, Seoul, Republic of Korea; Macrogen Inc, Seoul, Republic of Korea; Samsung Medical Center, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - JH Ahn
- Asan Medical Center, Seoul, Republic of Korea; Macrogen Inc, Seoul, Republic of Korea; Samsung Medical Center, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - S Chang
- Asan Medical Center, Seoul, Republic of Korea; Macrogen Inc, Seoul, Republic of Korea; Samsung Medical Center, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - JW Lee
- Asan Medical Center, Seoul, Republic of Korea; Macrogen Inc, Seoul, Republic of Korea; Samsung Medical Center, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - BH Son
- Asan Medical Center, Seoul, Republic of Korea; Macrogen Inc, Seoul, Republic of Korea; Samsung Medical Center, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - SH Ahn
- Asan Medical Center, Seoul, Republic of Korea; Macrogen Inc, Seoul, Republic of Korea; Samsung Medical Center, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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Ahn JH, Kim IS, Yang JH, Lee IG, Seo DH, Kim SP. Transoesophageal echocardiographic evaluation of central venous catheter positioning using Peres' formula or a radiological landmark-based approach: a prospective randomized single-centre study. Br J Anaesth 2018; 118:215-222. [PMID: 28100525 DOI: 10.1093/bja/aew430] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/22/2016] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The lower superior vena cava (SVC), near its junction with the right atrium (RA), is considered the ideal location for the central venous catheter tip to ensure proper function and prevent injuries. We determined catheter insertion depth with a new formula using the sternoclavicular joint and the carina as radiological landmarks, with a 1.5 cm safety margin. The accuracy of tip positioning with the radiological landmark-based technique (R) and Peres' formula (P) was compared using transoesophageal echocardiography. METHODS Real-time ultrasound-guided central venous catheter insertion was done through the right internal jugular or subclavian vein. Patients were randomly assigned to either the P group (n=93) or the R group (n=95). Optimal catheter tip position was considered to be within 2 cm above and 1 cm below the RA-SVC junction. Catheter tip position, abutment, angle to the vascular wall, and flow stream were evaluated on a bicaval view. RESULTS The distance from the skin insertion point to the RA-SVC junction and determined depth of catheter insertion were more strongly correlated in the R group [17.4 (1.2) and 16.7 (1.5) cm; r=0.821, P<0.001] than in the P group [17.3 (1.2) and 16.4 (1.1) cm; r=0.517, P<0.001], with z=3.96 (P<0.001). More tips were correctly positioned in the R group than in the P group (74 vs 93%, P=0.001). Abutment, tip angle to the lateral wall >40°, and disrupted flow stream were comparable. CONCLUSIONS Catheter tip position was more accurate with a radiological landmark-based technique than with Peres' formula. CLINICAL TRIAL REGISTRATION Clinical Trial Registry of Korea: https://cris.nih.go.kr/cris/index.jsp KCT0001937.
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Affiliation(s)
- J H Ahn
- Department of Emergency Medicine, Ajou University School of Medicine, Woncheon-Dong, Yeongtong-Gu, Suwon, Gyeonggi-Do 443-721, Republic of Korea
| | - I S Kim
- Department of Anesthesiology and Pain Medicine, Kangdong Sacred Heart Hospital, Hallym University Medical Center, 150 Sungan-ro, Gangdong-gu, Seoul 134-701, Republic of Korea
| | - J H Yang
- Department of Anesthesiology and Pain Medicine, Kangdong Sacred Heart Hospital, Hallym University Medical Center, 150 Sungan-ro, Gangdong-gu, Seoul 134-701, Republic of Korea
| | - I G Lee
- Department of Anesthesiology and Pain Medicine, Kangdong Sacred Heart Hospital, Hallym University Medical Center, 150 Sungan-ro, Gangdong-gu, Seoul 134-701, Republic of Korea
| | - D H Seo
- Department of Anesthesiology and Pain Medicine, Kangdong Sacred Heart Hospital, Hallym University Medical Center, 150 Sungan-ro, Gangdong-gu, Seoul 134-701, Republic of Korea
| | - S P Kim
- Department of Cardiovascular Surgery, Pusan National University Hospital, 305 Gudeok-ro, Seo-gu, Busan 602-739, Republic of Korea
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Agostini M, Lim DH, Sadd M, Hwang JY, Brutti S, Heo JW, Ahn JH, Sun YK, Matic A. Rational Design of Low Cost and High Energy Lithium Batteries through Tailored Fluorine-free Electrolyte and Nanostructured S/C Composite. ChemSusChem 2018; 11:2981-2986. [PMID: 29879310 DOI: 10.1002/cssc.201801017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Indexed: 06/08/2023]
Abstract
We report a new Li-S cell concept based on an optimized F-free catholyte solution and a high loading nanostructured C/S composite cathode. The Li2 S8 present in the electrolyte ensures both buffering against active material dissolution and Li+ conduction. The high S loading is obtained by confining elemental S (≈80 %) in the pores of a highly ordered mesopores carbon (CMK3). With this concept we demonstrate stabilization of a high energy density and excellent cycling performance over 500 cycles. This Li-S cell has a specific capacity that reaches over 1000 mA h g-1 , with an overall S loading of 3.6 mg cm-2 and low electrolyte volume (i.e., 10 μL cm-2 ), resulting in a practical energy density of 365 Wh kg-1 . The Li-S system proposed thus meets the requirements for large scale energy storage systems and is expected to be environmentally friendly and have lower cost compared with the commercial Li-ion battery thanks to the removal of both Co and F from the overall formulation.
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Affiliation(s)
- M Agostini
- Department of Physics, Chalmers University of Technology, SE41296, Göteborg, Sweden
| | - D-H Lim
- Department of Physics, Chalmers University of Technology, SE41296, Göteborg, Sweden
| | - M Sadd
- Department of Physics, Chalmers University of Technology, SE41296, Göteborg, Sweden
| | - J-Y Hwang
- Department of Energy Engineering, Hanyang University, Seoul, 04763, South Korea
| | - S Brutti
- CNR-ISC, U.O.S. Sapienza, Piazzale A. Moro 5, 00185, Roma, Italy
| | - J W Heo
- Department of Materials Engineering and Convergence Technology, Research Institute for Green Energy Convergence Technology, Gyeongsang National University, 501 Jinju-daero, Jinju, 52828, South Korea
| | - J H Ahn
- Department of Materials Engineering and Convergence Technology, Research Institute for Green Energy Convergence Technology, Gyeongsang National University, 501 Jinju-daero, Jinju, 52828, South Korea
| | - Y K Sun
- Department of Energy Engineering, Hanyang University, Seoul, 04763, South Korea
| | - A Matic
- Department of Physics, Chalmers University of Technology, SE41296, Göteborg, Sweden
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Park SJ, Kim SM, Ahn JH, Cho KH, Chang SA, Lee SC, Park SW, Choe YH, Oh JK. P6299Extracellular volume by cardiac magnetic resonance predicts outcomes in patients with severe aortic stenosis who underwent aortic valve replacement. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p6299] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- S.-J Park
- Samsung Medical Center, Seoul, Korea Republic of
| | - S M Kim
- Samsung Medical Center, Seoul, Korea Republic of
| | - J H Ahn
- Samsung Medical Center, Seoul, Korea Republic of
| | - K H Cho
- Samsung Medical Center, Seoul, Korea Republic of
| | - S A Chang
- Samsung Medical Center, Seoul, Korea Republic of
| | - S C Lee
- Samsung Medical Center, Seoul, Korea Republic of
| | - S W Park
- Samsung Medical Center, Seoul, Korea Republic of
| | - Y H Choe
- Samsung Medical Center, Seoul, Korea Republic of
| | - J K Oh
- Samsung Medical Center, Seoul, Korea Republic of
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Park C, Sim CS, Sung JH, Lee J, Ahn JH, Choe YM, Park J. Low Income as a Vulnerable Factor to the Effect of Noise on Insomnia. Psychiatry Investig 2018; 15:602-612. [PMID: 29865781 PMCID: PMC6018138 DOI: 10.30773/pi.2018.01.14] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Accepted: 01/14/2018] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE The present study aimed to examine the potential mediating effect of income level on the association between noise exposure and insomnia. METHODS 706 individuals were evaluated in conjunction with 2014 noise map data from Seoul, South Korea. Cross-sectional analysis was performed to examine differences in noise level according to household income, while three separate logistic regression models were used to examine factors influencing insomnia. Odds ratios (ORs) were calculated after adjusting for depression, anxiety, auditory acuity and noise sensitivity in the first model. Analyses were adjusted for sociodemographic variables in the second model, lifestyle factors and medical illnesses in the third model. RESULTS Noise level was significantly associated with an increased risk of insomnia in the low-income group, although no such association was observed in the high-income group. Groups exposed to >60 dB of noise (Lden; day-evening-night equivalent) exhibited a 1.79-fold increase in the incidence of insomnia relative to those exposed to <50 dB. The result was significant after adjusting sociodemographic variables, although not significant when adjusted for lifestyle factors and medical illnesses. CONCLUSION Individuals with low income may be more vulnerable to the deleterious effects of noise exposure on health. Various aspects including income should be considered to ascertain the influence of noise on insomnia.
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Affiliation(s)
- Choongman Park
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Chang Sun Sim
- Department of Occupational & Environmental Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea
| | - Joo Hyun Sung
- Department of Occupational & Environmental Medicine, Gyeongsang National University Changwon Hospital, Gyeongsang National University School of Medicine, Changwon, Republic of Korea
| | - Jiho Lee
- Department of Occupational & Environmental Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea
| | - Joon Ho Ahn
- Department of Psychiatry, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea
| | - Young Min Choe
- Department of Neuropsychiatry, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Republic of Korea
| | - Jangho Park
- Department of Psychiatry, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea
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Abstract
Introduction The events of 11th September 2001, and the subsequent anthrax attacks in the United States brought the threat of bioterrorism to the forefront of concern for public health departments. Moreover, the rising confrontation between North and South Korea emphasizes the possibility of aggression with biological weapons and our vulnerability to bioterrorism. While the importance of physicians' interests and management ability is becoming more critical, no studies have yet been undertaken in Korea to assess whether primary care physicians are well informed and capable of managing bioterrorism. This study evaluates the awareness and response of young male physicians to potential bioterrorism in South Korea. Method A total of 692 young male physicians completed the knowledge and awareness survey during the education period of military service on 9th April 2005. Results Forty-five percent of the participants responded that the possibility of biological warfare in Korea was high. The level of bioterrorism knowledge, however, was low. Eighty-seven percent acknowledged the necessity of education and training for bioterrorism, and 69.9% were willing to accept education and training in bioterrorism preparedness. Conclusion These findings suggest that young physicians should receive continuous education and training to improve preparedness for biological terrorism and warfare in South Korea.
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Affiliation(s)
- JH Ahn
- Chung-Ang University Hospital, Department of Internal Medicine, Chung-Ang University College of Medicine, 224-1, Heukseok-dong, Dongjak-gu, 156-757, Seoul, Korea
| | - JW Chung
- Chung-Ang University Hospital, Department of Internal Medicine, Chung-Ang University College of Medicine, 224-1, Heukseok-dong, Dongjak-gu, 156-757, Seoul, Korea
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Ahn JH, Choi SC, Jung YS, Min YG. Clinical Characteristics of Patients with Pseudo-Subarachnoid Haemorrhage who were Successfully Resuscitated from Out-of-Hospital Cardiopulmonary Arrest. HONG KONG J EMERG ME 2017. [DOI: 10.1177/102490791201900202] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Introduction Pseudo-subarachnoid haemorrhage (PSAH) is a rare neuroradiological finding seen in patients with diffuse cerebral edemas. We investigated clinical characteristics and risk factors for the development of PSAH. Method The successfully resuscitated patients in emergency department were classified into two groups: those with pseudo-SAH [PSAH (+)] and those without pseudo-SAH [PSAH (-)]. Clinical variables were analysed. Results Pseudo-SAH was found in 31.6% of patients. PSAH was more common in males (p=0.042). The mean age was 39.9±10.3 years in the PSAH (+) group and 54.4±22.0 years in the PSAH (-) group (p=0.038). Outcomes measured by Cerebral Performance Category score were also significantly different between the two groups (p=0.037). Logistic regression analysis found that serum lactate concentration and duration of anoxia were associated with the development of PSAH (with odds ratios and p values of 1.92, p=0.01 and 1.13, p=0.02, respectively). Conclusions PSAH itself is a phenomenon that could be seen in post-resuscitation encephalopathy as a consequence of severe anoxic insult.
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Ahn JH, Kang DM, Choi KJ. Bilateral simultaneous unicompartmental knee arthroplasty versus unilateral total knee arthroplasty: A comparison of the amount of blood loss and transfusion, perioperative complications, hospital stay, and functional recovery. Orthop Traumatol Surg Res 2017; 103:1041-1045. [PMID: 28827053 DOI: 10.1016/j.otsr.2017.06.014] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [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: 05/17/2017] [Revised: 06/25/2017] [Accepted: 06/29/2017] [Indexed: 02/02/2023]
Abstract
BACKGROUND Unicompartmental knee arthroplasty (UKA) is a good alternative treatment option to total knee arthroplasty (TKA) for single compartment knee osteoarthritis. Several recent reports suggest that UKA results in more rapid functional recovery than TKA, together with fewer complications. Few performed a comparison of bilateral simultaneous UKA and unilateral TKA. HYPOTHESIS Bilateral simultaneous UKA would result in fewer perioperative complications, less blood loss, less transfusion and faster recovery of short-term clinical outcomes, compared with unilateral TKA patients. MATERIAL AND METHODS In a retrospective trial, the bilateral simultaneous UKA (bUKA) cases were matched one to one with a cohort of unilateral TKA (uTKA) cases according to age, body mass index, gender, Kellgren-Lawrence grade of knee osteoarthritis and American Society of Anesthesiologists score. In bilateral simultaneous UKA group, patients had KL grade 4 of bilateral knee osteoarthritis, and in unilateral TKA group, patients had KL grade 4 of unilateral knee osteoarthritis. The transfusion requirements, estimated blood loss (EBL), duration of hospital stay, incidence of complications, and knee clinical scores of the bUKA and uTKA groups were compared at the 6-month short-term follow-up. RESULTS Patients were categorized into the bUKA group (n=52) and uTKA group (n=52). The number of patients requiring transfusion and the amount of EBL was smaller in the bUKA group (P<0.001 for transfusion and P=0.043 for EBL). The duration of hospital stay was shorter and the number of complications was smaller in the bUKA group (P<0.001 for hospital stay and P=0.028 for complications). The clinical outcomes were also superior in the bUKA group (P<0.001). CONCLUSIONS Bilateral simultaneous UKA shows fewer perioperative complications, less blood loss, less transfusion, and better functional outcomes at 6 months postoperatively than unilateral TKA. The data suggest that bilateral simultaneous UKA can be performed safely, and results in acceptable clinical outcomes. LEVEL OF EVIDENCE III, case-control study.
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Affiliation(s)
- J H Ahn
- Department of orthopedic surgery, Dongguk university, Ilsan hospital, 814 Siksadong, Ilsandonggu, Goyangsi, Gyeonggido, Korea.
| | - D M Kang
- Department of orthopedic surgery, Dongguk university, Ilsan hospital, 814 Siksadong, Ilsandonggu, Goyangsi, Gyeonggido, Korea
| | - K J Choi
- Department of orthopedic surgery, Dongguk university, Ilsan hospital, 814 Siksadong, Ilsandonggu, Goyangsi, Gyeonggido, Korea
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Jung Y, Ahn JH, Kim RY, Yoon JH, Lee SJ. Effective therapeutic strategy for massive retroperitoneal hematoma after conization: arterial embolization and pigtail catheter insertion. EUR J GYNAECOL ONCOL 2017; 38:135-138. [PMID: 29767883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The loop electrosurgical excision procedure (LEEP) is commonly used to remove cervical intraepithelial neoplasia (CIN) because of its safety profile and likelihood of fewer complications. The authors report a rare case of massive retroperitoneal bleeding combined with hypovolemic shock after LEEP conization. Vessel injury was detected by angiographic computed tomography (CT) and embolization of the uterine artery was successfully performed to achieve hemostasis by an intervention radiologist. A pigtail catheter was subsequently inserted for the drainage of the large retroperitoneal hematoma. The patient did not show any further hemorrhage and recovered safely from hypovolemic shock. Th present case demonstrates a successful multidisciplinary and minimal invasive approach to manage retroperitoneal bleeding with uterine artery embolization. Thus, it should be considered a potential treatment option for hemostasis.
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Lee JD, Cho MJ, Sohn JH, Park S, Seong S, Ahn JH, Hahm BJ, Hong JP. Evaluation of a Functional Model of Acquired Capability for Suicide in a Nationwide Sample of Korean Adults. Psychiatry Investig 2016; 13:601-608. [PMID: 27909450 PMCID: PMC5128347 DOI: 10.4306/pi.2016.13.6.601] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2015] [Revised: 07/24/2015] [Accepted: 08/03/2015] [Indexed: 12/05/2022] Open
Abstract
OBJECTIVE We examined a functional model of acquired capability for suicide, which was elaborated from the "Interpersonal-Psychological Theory of Suicide". METHODS A total of 6,027 Korean community subjects were recruited from The Korean Epidemiologic Catchment Area study conducted in 2011. The subjects were assessed systematically using the Korean version of the Composite International Diagnostic Interview version 2.1, the Korean version of the Barratt Impulsiveness Scale, and the Korean version of the Mood Disorder Questionnaire. We used structural equation modeling to identify potential factors contributing to a suicide attempt. RESULTS Most aspects of the model were supported by the data and "the short-term enhancer for the acquired capability for suicide" had direct effects on suicide attempts. However, the suicidal planning effects of "the short-term enhancer for the acquired capability for suicide" were eliminated by the rule of parsimony. CONCLUSION The main finding was that "the short-term enhancer for the acquired capability for suicide" is relevant to suicide attempts when it's direct, indirect, and reciprocal effects are tested within a more complete system of relationships than found in existing studies. The implications of these findings are discussed with regard to future conceptual work and empirical research.
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Affiliation(s)
- Joon Deuk Lee
- Department of Psychology, Seoul National University, Seoul, Republic of Korea
| | - Maeng Je Cho
- Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jee Hoon Sohn
- Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Subin Park
- Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Sujeong Seong
- Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Joon Ho Ahn
- Department of Psychiatry, University of Ulsan College of Medicine, Ulsan University Hospital, Ulsan, Republic of Korea
| | - Bong-Jin Hahm
- Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jin Pyo Hong
- Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
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Lee JI, Yoon RG, Lee JH, Park JW, Yoo MH, Ahn JH, Chung JW, Park HJ. Prognostic Value of Labyrinthine 3D-FLAIR Abnormalities in Idiopathic Sudden Sensorineural Hearing Loss. AJNR Am J Neuroradiol 2016; 37:2317-2322. [PMID: 27516239 DOI: 10.3174/ajnr.a4901] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Accepted: 06/16/2016] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE According to recent research, modern MR imaging can detect the presense of abnormalities on labyrinthine. Our aim was to report the patterns and prognostic role of abnormal findings on labyrinthine imaging in patients with sudden sensorineural hearing loss. MATERIALS AND METHODS This study comprised 113 patients who were diagnosed with unilateral sudden sensorineural hearing loss and underwent 3T MR imaging, including pre-/postcontrast 3D fluid-attenuated inversion recovery and T1-weighted imaging. We analyzed abnormalities on MR imaging and correlated them with audiometric results. RESULTS Thirty-one (27%) patients showed abnormal findings on labyrinthine MR imaging in the affected ear. The initial/final hearing levels of the MRI+ group (91 ± 25/73 ± 27 dB hearing loss) were significantly worse than those of the MRI- group (69 ± 30/48 ± 24 dB hearing loss). The incidence of abnormalities on labyrinthine MR imaging was significantly lower (3 of 40, 8%) in 40 patients with initial mild-to-moderate hearing loss than in those with profound hearing loss (16 of 34, 47%). Considering hearing improvement by the Siegel criteria, the rate of complete or partial recovery was significantly higher in the MRI- group (34%) than in the MRI+ group (10%). In patients with initial severe or profound hearing loss, the MRI- group showed greater hearing improvement (38 ± 21 dB) than the MRI+ group (23 ± 22 dB). CONCLUSIONS Abnormalities on labyrinthine MR imaging were found in 27% of patients with sudden sensorineural hearing loss. The initial hearing loss was worse in the MRI+ group than in the MRI- group. In patients with initial severe and profound hearing loss, the presence of abnormalities on labyrinthine MR imaging indicated a poor prognosis.
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Affiliation(s)
- J I Lee
- From the Departments of Otolaryngology (J.I.L., J.W.P., J.H.A., J.W.C., H.J.P.)
| | - R G Yoon
- Department of Radiology (R.G.Y.), Catholic Kwandong University International St. Mary's Hospital, Catholic Kwandong University College of Medicine, Incheon, Korea
| | - J H Lee
- Radiology (J.H.L.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - J W Park
- From the Departments of Otolaryngology (J.I.L., J.W.P., J.H.A., J.W.C., H.J.P.)
| | - M H Yoo
- Department of Otolaryngology (M.H.Y.), College of Medicine, Kyungpook National University, Daegu, Korea
| | - J H Ahn
- From the Departments of Otolaryngology (J.I.L., J.W.P., J.H.A., J.W.C., H.J.P.)
| | - J W Chung
- From the Departments of Otolaryngology (J.I.L., J.W.P., J.H.A., J.W.C., H.J.P.)
| | - H J Park
- From the Departments of Otolaryngology (J.I.L., J.W.P., J.H.A., J.W.C., H.J.P.)
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Gowran A, Kulikova T, Lewis FC, Foldes G, Fuentes L, Viiri LE, Spinelli V, Costa A, Perbellini F, Sid-Otmane C, Bax NAM, Pekkanen-Mattila M, Schiano C, Chaloupka A, Forini F, Sarkozy M, De Jager SCA, Vajen T, Glezeva N, Lee HW, Golovkin A, Kucera T, Musikhina NA, Korzhenkov NP, Santuchi MDEC, Munteanu D, Garcia RG, Ang R, Usui S, Kamilova U, Jumeau C, Aberg M, Kostina DA, Brandt MM, Muntean D, Lindner D, Sadaba R, Bacova B, Nikolov A, Sedmera D, Ryabov V, Neto FP, Lynch M, Portero V, Kui P, Howarth FC, Gualdoni A, Prorok J, Diolaiuti L, Vostarek F, Wagner M, Abela MA, Nebert C, Xiang W, Kloza M, Maslenko A, Grechanyk M, Bhattachariya A, Morawietz H, Babaeva AR, Martinez Sanchez SM, Krychtiuk KA, Starodubova J, Fiorelli S, Rinne P, Ozkaramanli Gur D, Hofbauer T, Starodubova J, Stellos K, Pinon P, Tsoref O, Thaler B, Fraga-Silva RA, Fuijkschot WW, Shaaban MNS, Matthaeus C, Deluyker D, Scardigli M, Zahradnikova A, Dominguez A, Kondrat'eva D, Sosorburam T, Murarikova M, Duerr GD, Griecsova L, Portnichenko VI, Smolina N, Duicu OANAM, Elder JM, Zaglia T, Lorenzon A, Ruperez C, Woudstra L, Suffee N, De Lucia C, Tsoref O, Russell-Hallinan A, Menendez-Montes I, Kapelko VI, Emmens RW, Hetman O, Van Der Laarse WJ, Goncharov S, Adao R, Huisamen B, Sirenko O, Kamilova U, Nassiri I, Tserendavaa SUMIYA, Yushko K, Baldan Martin M, Falcone C, Vigorelli V, Nigro P, Pompilio G, Stepanova O, Valikhov M, Samko A, Masenko V, Tereschenko S, Teoh T, Domenjo-Vila E, Theologou T, Field M, Awad W, Yasin M, Nadal-Ginard B, Ellison-Hughes GM, Hellen N, Vittay O, Harding SE, Gomez-Cid L, Fernandez-Santos ME, Suarez-Sancho S, Plasencia V, Climent A, Sanz-Ruiz R, Hedhammar M, Atienza F, Fernandez-Aviles F, Kiamehr M, Oittinen M, Viiri KM, Kaikkonen M, Aalto-Setala K, Diolaiuti L, Laurino A, Sartiani L, Vona A, Zanardelli M, Cerbai E, Failli P, Hortigon-Vinagre MP, Van Der Heyden M, Burton FL, Smith GL, Watson S, Scigliano M, Tkach S, Alayoubi S, Harding SE, Terracciano CM, Ly HQ, Mauretti A, Van Marion MH, Van Turnhout MC, Van Der Schaft DWJ, Sahlgren CM, Goumans MJ, Bouten CVC, Vuorenpaa H, Penttinen K, Sarkanen R, Ylikomi T, Heinonen T, Aalto-Setala K, Grimaldi V, Aprile M, Esposito R, Maiello C, Soricelli A, Colantuoni V, Costa V, Ciccodicola A, Napoli C, Rowe GC, Johnson K, Arany ZP, Del Monte F, D'aurizio R, Kusmic C, Nicolini G, Baumgart M, Groth M, Ucciferri N, Iervasi G, Pitto L, Pipicz M, Gaspar R, Siska A, Foldesi I, Kiss K, Bencsik P, Thum T, Batkai S, Csont T, Haan JJ, Bosch L, Brans MAD, Van De Weg SM, Deddens JC, Lee SJ, Sluijter JPG, Pasterkamp G, Werner I, Projahn D, Staudt M, Curaj A, Soenmez TT, Simsekyilmaz S, Hackeng TM, Von Hundelshausen P, Koenen RR, Weber C, Liehn EA, Santos-Martinez M, Medina C, Watson C, Mcdonald K, Gilmer J, Ledwidge M, Song SH, Lee MY, Park MH, Choi JC, Ahn JH, Park JS, Oh JH, Choi JH, Lee HC, Cha KS, Hong TJ, Kudryavtsev I, Serebryakova M, Malashicheva A, Shishkova A, Zhiduleva E, Moiseeva O, Durisova M, Blaha M, Melenovsky V, Pirk J, Kautzner J, Petelina TI, Gapon LI, Gorbatenko EA, Potolinskaya YV, Arkhipova EV, Solodenkova KS, Osadchuk MA, Dutra MF, Oliveira FCB, Silva MM, Passos-Silva DG, Goncalves R, Santos RAS, Da Silva RF, Gavrilescu CM, Paraschiv CM, Manea P, Strat LC, Gomez JMG, Merino D, Hurle MA, Nistal JF, Aires A, Cortajarena AL, Villar AV, Abramowitz J, Birnbaumer L, Gourine AV, Tinker A, Takamura M, Takashima S, Inoue O, Misu H, Takamura T, Kaneko S, Alieva TOHIRA, Mougenot N, Dufilho M, Hatem S, Siegbahn A, Kostina AS, Uspensky VE, Moiseeva OM, Kostareva AA, Malashicheva AB, Van Dijk CGM, Chrifi I, Verhaar MC, Duncker DJ, Cheng C, Sturza A, Petrus A, Duicu O, Kiss L, Danila M, Baczko I, Jost N, Gotzhein F, Schon J, Schwarzl M, Hinrichs S, Blankenberg S, Volker U, Hammer E, Westermann D, Martinez-Martinez E, Arrieta V, Fernandez-Celis A, Jimenez-Alfaro L, Melero A, Alvarez-Asiain V, Cachofeiro V, Lopez-Andres N, Tribulova N, Wallukat G, Knezl V, Radosinska J, Barancik M, Tsinlikov I, Tsinlikova I, Nicoloff G, Blazhev A, Pesevski Z, Kvasilova A, Stopkova T, Eckhardt A, Buffinton CM, Nanka O, Kercheva M, Suslova T, Gusakova A, Ryabova T, Markov V, Karpov R, Seemann H, Alcantara TC, Santuchi MDEC, Fonseca SG, Da Silva RF, Barallobre-Barreiro J, Oklu R, Fava M, Baig F, Yin X, Albadawi H, Jahangiri M, Stoughton J, Mayr M, Podliesna SP, Veerman CCV, Verkerk AOV, Klerk MK, Lodder EML, Mengarelli IM, Bezzina CRB, Remme CAR, Takacs H, Polyak A, Morvay N, Lepran I, Tiszlavicz L, Nagy N, Ordog B, Farkas A, Forster T, Varro A, Farkas AS, Jayaprakash P, Parekh K, Ferdous Z, Oz M, Dobrzynski H, Adrian TE, Landi S, Bonzanni M, D'souza A, Boyett M, Bucchi A, Baruscotti M, Difrancesco D, Barbuti A, Kui P, Takacs H, Oravecz K, Hezso T, Polyak A, Levijoki J, Pollesello P, Koskelainen T, Otsomaa L, Farkas AS, Papp JGY, Varro A, Toth A, Acsai K, Dini L, Mazzoni L, Sartiani L, Cerbai E, Mugelli A, Svatunkova J, Sedmera D, Deffge C, Baer C, Weinert S, Braun-Dullaeus RC, Herold J, Cassar AC, Zahra GZ, Pllaha EP, Dingli PD, Montefort SM, Xuereb RGX, Aschacher T, Messner B, Eichmair E, Mohl W, Reglin B, Rong W, Nitzsche B, Maibier M, Guimaraes P, Ruggeri A, Secomb TW, Pries AR, Baranowska-Kuczko M, Karpinska O, Kusaczuk M, Malinowska B, Kozlowska H, Demikhova N, Vynnychenko L, Prykhodko O, Grechanyk N, Kuryata A, Cottrill KA, Du L, Bjorck HM, Maleki S, Franco-Cereceda A, Chan SY, Eriksson P, Giebe S, Cockcroft N, Hewitt K, Brux M, Brunssen C, Tarasov AA, Davidov SI, Reznikova EA, Tapia Abellan A, Angosto Bazarra D, Pelegrin Vivancos P, Montoro Garcia S, Kastl SP, Pongratz T, Goliasch G, Gaspar L, Maurer G, Huber K, Dostal E, Pfaffenberger S, Oravec S, Wojta J, Speidl WS, Osipova I, Sopotova I, Eligini S, Cosentino N, Marenzi G, Tremoli E, Rami M, Ring L, Steffens S, Gur O, Gurkan S, Mangold A, Scherz T, Panzenboeck A, Staier N, Heidari H, Mueller J, Lang IM, Osipova I, Sopotova I, Gatsiou A, Stamatelopoulos K, Perisic L, John D, Lunella FF, Eriksson P, Hedin U, Zeiher A, Dimmeler S, Nunez L, Moure R, Marron-Linares G, Flores X, Aldama G, Salgado J, Calvino R, Tomas M, Bou G, Vazquez N, Hermida-Prieto M, Vazquez-Rodriguez JM, Amit U, Landa N, Kain D, Tyomkin D, David A, Leor J, Hohensinner PJ, Baumgartner J, Krychtiuk KA, Maurer G, Huber K, Baik N, Miles LA, Wojta J, Seeman H, Montecucco F, Da Silva AR, Costa-Fraga FP, Anguenot L, Mach FP, Santos RAS, Stergiopulos N, Da Silva RF, Kupreishvili K, Vonk ABA, Smulders YM, Van Hinsbergh VWM, Stooker W, Niessen HWM, Krijnen PAJ, Ashmawy MM, Salama MA, Elamrosy MZ, Juettner R, Rathjen FG, Bito V, Crocini C, Ferrantini C, Gabbrielli T, Silvestri L, Coppini R, Tesi C, Cerbai E, Poggesi C, Pavone FS, Sacconi L, Mackova K, Zahradnik I, Zahradnikova A, Diaz I, Sanchez De Rojas De Pedro E, Hmadcha K, Calderon Sanchez E, Benitah JP, Gomez AM, Smani T, Ordonez A, Afanasiev SA, Egorova MV, Popov SV, Wu Qing P, Cheng X, Carnicka S, Pancza D, Jasova M, Kancirova I, Ferko M, Ravingerova T, Wu S, Schneider M, Marggraf V, Verfuerth L, Frede S, Boehm O, Dewald O, Baumgarten G, Kim SC, Farkasova V, Gablovsky I, Bernatova I, Ravingerova T, Nosar V, Portnychenko A, Drevytska T, Mankovska I, Gogvadze V, Sejersen T, Kostareva A, Sturza A, Wolf A, Privistirescu A, Danila M, Muntean D, O ' Gara P, Sanchez-Alonso JL, Harding SE, Lyon AR, Prando V, Pianca N, Lo Verso F, Milan G, Pesce P, Sandri M, Mongillo M, Beffagna G, Poloni G, Dazzo E, Sabatelli P, Doliana R, Polishchuk R, Carnevale D, Lembo G, Bonaldo P, Braghetta P, Rampazzo A, Cairo M, Giralt M, Villarroya F, Planavila A, Biesbroek PS, Emmens RWE, Juffermans LJM, Van Der Wall AC, Van Rossum AC, Niessen JWM, Krijnen PAJ, Moor Morris T, Dilanian G, Farahmand P, Puceat M, Hatem S, Gambino G, Petraglia L, Elia A, Komici K, Femminella GD, D'amico ML, Pagano G, Cannavo A, Liccardo D, Koch WJ, Nolano M, Leosco D, Ferrara N, Rengo G, Amit U, Landa N, Kain D, Leor J, Neary R, Shiels L, Watson C, Baugh J, Palacios B, Escobar B, Alonso AV, Guzman G, Ruiz-Cabello J, Jimenez-Borreguero LJ, Martin-Puig S, Lakomkin VL, Lukoshkova EV, Abramov AA, Gramovich VV, Vyborov ON, Ermishkin VV, Undrovinas NA, Shirinsky VP, Smilde BJ, Woudstra L, Fong Hing G, Wouters D, Zeerleder S, Murk JL, Van Ham SM, Heymans S, Juffermans LJM, Van Rossum AC, Niessen JWM, Krijnen PAJ, Krakhmalova O, Van Groen D, Bogaards SJP, Schalij I, Portnichenko GV, Tumanovska LV, Goshovska YV, Lapikova-Bryhinska TU, Nagibin VS, Dosenko VE, Mendes-Ferreira P, Maia-Rocha C, Santos-Ribeiro D, Potus F, Breuils-Bonnet S, Provencher S, Bonnet S, Rademaker M, Leite-Moreira AF, Bras-Silva C, Lopes J, Kuryata O, Lusynets T, Alikulov I, Nourddine M, Azzouzi L, Habbal R, Tserendavaa SUMIYA, Enkhtaivan ODKHUU, Enkhtaivan ODKHUU, Shagdar ZORIGO, Shagdar ZORIGO, Malchinkhuu MUNKHZ, Malchinkhuu MUNLHZ, Koval S, Starchenko T, Mourino-Alvarez L, Gonzalez-Calero L, Sastre-Oliva T, Lopez JA, Vazquez J, Alvarez-Llamas G, Ruilope LUISM, De La Cuesta F, Barderas MG, Bozzini S, D'angelo A, Pelissero G. Poster session 3Cell growth, differentiation and stem cells - Heart511The role of the endocannabinoid system in modelling muscular dystrophy cardiac disease with induced pluripotent stem cells.512An emerging role of T lymphocytes in cardiac regenerative processes in heart failure due to dilated cardiomyopathy513Canonical wnt signaling reverses the ‘aged/senescent’ human endogenous cardiac stem cell phenotype514Hippo signalling modulates survival of human induced pluripotent stem cell-derived cardiomyocytes515Biocompatibility of mesenchymal stem cells with a spider silk matrix and its potential use as scaffold for cardiac tissue regeneration516A snapshot of genome-wide transcription in human induced pluripotent stem cell-derived hepatocyte-like cells (iPSC-HLCs)517Can NOS/sGC/cGK1 pathway trigger the differentiation and maturation of mouse embryonic stem cells (ESCs)?518Introduction of external Ik1 to human-induced pluripotent stem cell-derived cardiomyocytes via Ik1-expressing HEK293519Cell therapy of the heart studied using adult myocardial slices in vitro520Enhancement of the paracrine potential of human adipose derived stem cells when cultured as spheroid bodies521Mechanosensitivity of cardiomyocyte progenitor cells: the strain response in 2D and 3D environments522The effect of the vascular-like network on the maturation of the human induced pluripotent stem cell derived cardiomyocytes.Transcriptional control and RNA species - Heart525Gene expression regulation in heart failure: from pathobiology to bioinformatics526Human transcriptome in idiopathic dilated cardiomyopathy - a novel high throughput screening527A high-throghput approach unveils putative miRNA-mediated mitochondria-targeted cardioprotective circuits activated by T3 in the post ischemia reperfusion setting528The effect of uraemia on the expression of miR-212/132 and the calcineurin pathway in the rat heartCytokines and cellular inflammation - Heart531Lack of growth differentiation factor 15 aggravates adverse cardiac remodeling upon pressure-overload in mice532Blocking heteromerization of platelet chemokines ccl5 and cxcl4 reduces inflammation and preserves heart function after myocardial infarction533Is there an association between low-dose aspirin use and clinical outcome in HFPEF? Implications of modulating monocyte function and inflammatory mediator release534N-terminal truncated intracellular matrix metalloproteinase-2 expression in diabetic heart.535Expression of CD39 and CD73 on peripheral T-cell subsets in calcific aortic stenosis536Mast cells in the atrial myocardium of patients with atrial fibrillation: a comparison with patients in sinus rhythm539Characteristics of the inflammatory response in patients with coronary artery disease and arterial hypertension540Pro-inflammatory cytokines as cardiovascular events predictors in rheumatoid arthritis and asymptomatic atherosclerosis541Characterization of FVB/N murinic bone marrow-derived macrophage polarization into M1 and M2 phenotypes542The biological expression and thoracic anterior pain syndromeSignal transduction - Heart545The association of heat shock protein 90 and TGFbeta receptor I is involved in collagen production during cardiac remodelling in aortic-banded mice546Loss of the inhibitory GalphaO protein in the rostral ventrolateral medulla of the brainstem leads to abnormalities in cardiovascular reflexes and altered ventricular excitablitiy547Selenoprotein P regulates pressure overload-induced cardiac remodeling548Study of adenylyl cyclase activity in erythrocyte membranes in patients with chronic heart failure549Direct thrombin inhibitors inhibit atrial myocardium hypertrophy in a rat model of heart failure and atrial remodeling550Tissue factor / FVIIa transactivates the IGF-1R by a Src-dependent phosphorylation of caveolin-1551Notch signaling is differently altered in endothelial and smooth muscle cells of ascending aortic aneurysm patients552Frizzled 5 expression is essential for endothelial proliferation and migration553Modulation of vascular function and ROS production by novel synthetic benzopyran analogues in diabetes mellitusExtracellular matrix and fibrosis - Heart556Cardiac fibroblasts as inflammatory supporter cells trigger cardiac inflammation in heart failure557A role for galectin-3 in calcific aortic valve stenosis558Omega-3 polyunsaturated fatty acids- can they decrease risk for ventricular fibrillation?559Serum levels of elastin derived peptides and circulating elastin-antielastin immune complexes in sera of patients with coronary artery disease560Endocardial fibroelastosis is secondary to hemodynamic alterations in the chick model of hypoplastic left heart syndrome561Dynamics of serum levels of matrix metalloproteinases in primary anterior STEMI patients564Deletion of the alpha-7 nicotinic acetylcholine receptor changes the vascular remodeling induced by transverse aortic constriction in mice.565Extracellular matrix remodelling in response to venous hypertension: proteomics of human varicose veinsIon channels, ion exchangers and cellular electrophysiology - Heart568Microtubule-associated protein RP/EB family member 1 modulates sodium channel trafficking and cardiac conduction569Investigation of electrophysiological abnormalities in a rabbit athlete's heart model570Upregulation of expression of multiple genes in the atrioventricular node of streptozotocin-induced diabetic rat571miR-1 as a regulator of sinoatrial rhythm in endurance training adaptation572Selective sodium-calcium exchanger inhibition reduces myocardial dysfunction associated with hypokalaemia and ventricular fibrillation573Effect of racemic and levo-methadone on action potential of human ventricular cardiomyocytes574Acute temperature effects on the chick embryonic heart functionVasculogenesis, angiogenesis and arteriogenesis577Clinical improvement and enhanced collateral vessel growth after monocyte transplantation in mice578The role of HIF-1 alpha, VEGF and obstructive sleep apnoea in the development of coronary collateral circulation579Initiating cardiac repair with a trans-coronary sinus catheter intervention in an ischemia/reperfusion porcine animal model580Early adaptation of pre-existing collaterals after acute arteriolar and venular microocclusion: an in vivo study in chick chorioallantoic membraneEndothelium583EDH-type responses to the activator of potassium KCa2.3 and KCa3.1 channels SKA-31 in the small mesenteric artery from spontaneously hypertensive rats584The peculiarities of endothelial dysfunction in patients with chronic renocardial syndrome585Endothelial dysfunction, atherosclerosis of the carotid arteries and level of leptin in patient with coronary heart disease in combination with hepatic steatosis depend from body mass index.586Role of non-coding RNAs in thoracic aortic aneurysm associated with bicuspid aortic valve587Cigarette smoke extract abrogates atheroprotective effects of high laminar flow on endothelial function588The prognostic value of anti-connective tissue antibodies in coronary heart disease and asymptomatic atherosclerosis589Novel potential properties of bioactive peptides from spanish dry-cured ham on the endothelium.Lipids592Intermediate density lipoprotein is associated with monocyte subset distribution in patients with stable atherosclerosis593The characteristics of dyslipidemia in rheumatoid arthritisAtherosclerosis596Macrophages differentiated in vitro are heterogeneous: morphological and functional profile in patients with coronary artery disease597Palmitoylethanolamide promotes anti-inflammatory phenotype of macrophages and attenuates plaque formation in ApoE-/- mice598Amiodarone versus esmolol in the perioperative period: an in vitro study of coronary artery bypass grafts599BMPRII signaling of fibrocytes, a mesenchymal progenitor cell population, is increased in STEMI and dyslipidemia600The characteristics of atherogenesis and systemic inflammation in rheumatoid arthritis601Role of adenosine-to-inosine RNA editing in human atherosclerosis602Presence of bacterial DNA in thrombus aspirates of patients with myocardial infarction603Novel E-selectin binding polymers reduce atherosclerotic lesions in ApoE(-/-) mice604Differential expression of the plasminogen receptor Plg-RKT in monocyte and macrophage subsets - possible functional consequences in atherogenesis605Apelin-13 treatment enhances the stability of atherosclerotic plaques606Mast cells are increased in the media of coronary lesions in patients with myocardial infarction and favor atherosclerotic plaque instability607Association of neutrophil to lymphocyte ratio with presence of isolated coronary artery ectasiaCalcium fluxes and excitation-contraction coupling610The coxsackie- and adenovirus receptor (CAR) regulates calcium homeostasis in the developing heart611HMW-AGEs application acutely reduces ICaL in adult cardiomyocytes612Measuring electrical conductibility of cardiac T-tubular systems613Postnatal development of cardiac excitation-contraction coupling in rats614Role of altered Ca2+ homeostasis during adverse cardiac remodeling after ischemia/reperfusion615Experimental study of sarcoplasmic reticulum dysfunction and energetic metabolism in failing myocardium associated with diabetes mellitusHibernation, stunning and preconditioning618Volatile anesthetic preconditioning attenuates ischemic-reperfusion injury in type II diabetic patients undergoing on-pump heart surgery619The effect of early and delayed phase of remote ischemic preconditioning on ischemia-reperfusion injury in the isolated hearts of healthy and diabetic rats620Post-conditioning with 1668-thioate leads to attenuation of the inflammatory response and remodeling with less fibrosis and better left ventricular function in a murine model of myocardial infarction621Maturation-related changes in response to ischemia-reperfusion injury and in effects of classical ischemic preconditioning and remote preconditioningMitochondria and energetics624Phase changes in myocardial mitochondrial respiration caused by hypoxic preconditioning or periodic hypoxic training625Desmin mutations depress mitochondrial metabolism626Methylene blue modulates mitochondrial function and monoamine oxidases-related ROS production in diabetic rat hearts627Doxorubicin modulates the real-time oxygen consumption rate of freshly isolated adult rat and human ventricular cardiomyocytesCardiomyopathies and fibrosis630Effects of genetic or pharmacologic inhibition of the ubiquitin/proteasome system on myocardial proteostasis and cardiac function631Suppression of Wnt signalling in a desmoglein-2 transgenic mouse model for arrhythmogenic cardiomyopathy632Cold-induced cardiac hypertrophy is reversed after thermo-neutral deacclimatization633CD45 is a sensitive marker to diagnose lymphocytic myocarditis in endomyocardial biopsies of living patients and in autopsies634Atrial epicardial adipose tissue derives from epicardial progenitors635Caloric restriction ameliorates cardiac function, sympathetic cardiac innervation and beta-adrenergic receptor signaling in an experimental model of post-ischemic heart failure636High fat diet improves cardiac remodelling and function after extensive myocardial infarction in mice637Epigenetic therapy reduces cardiac hypertrophy in murine models of heart failure638Imbalance of the VHL/HIF signaling in WT1+ Epicardial Progenitors results in coronary vascular defects, fibrosis and cardiac hypertrophy639Diastolic dysfunction is the first stage of the developing heart failure640Colchicine aggravates coxsackievirus B3 infection in miceArterial and pulmonary hypertension642Osteopontin as a marker of pulmonary hypertension in patients with coronary heart disease combined with chronic obstructive pulmonary disease643Myocardial dynamic stiffness is increased in experimental pulmonary hypertension partly due to incomplete relaxation644Hypotensive effect of quercetin is possibly mediated by down-regulation of immunotroteasome subunits in aorta of spontaneously hypertensive rats645Urocortin-2 improves right ventricular function and attenuates experimental pulmonary arterial hypertension646A preclinical evaluation of the anti-hypertensive properties of an aqueous extract of Agathosma (Buchu)Biomarkers648The adiponectin level in hypertensive females with rheumatoid arthritis and its relationship with subclinical atherosclerosis649Markers for identification of renal dysfunction in the patients with chronic heart failure650cardio-hepatic syndromes in chronic heart failure: North Africa profile651To study other biomarkers that assess during myocardial infarction652Interconnections of apelin levels with parameters of lipid metabolism in hypertension patients653Plasma proteomics in hypertension: prediction and follow-up of albuminuria during chronic renin-angiotensin system suppression654Soluble RAGE levels in plasma of patients with cerebrovascular events. Cardiovasc Res 2016. [DOI: 10.1093/cvr/cvw150] [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: 11/12/2022] Open
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Kim J, Han Y, Ahn JH, Kim SW, Lee SI, Lee KH, Ahn K. Airborne formaldehyde causes skin barrier dysfunction in atopic dermatitis. Br J Dermatol 2016; 175:357-63. [PMID: 27535603 DOI: 10.1111/bjd.14357] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/27/2015] [Indexed: 12/24/2022]
Abstract
BACKGROUND It remains to be elucidated whether exposure to air pollutants aggravates atopic dermatitis (AD). OBJECTIVES This study aimed to evaluate the effects of exposure to formaldehyde for 1 h and 2 h on skin barrier function in both the control and the AD groups. METHODS In 41 patients with AD and 34 healthy children, a provocation test was performed in which two different areas of normal-appearing skin on the forearm were stimulated with airborne formaldehyde at 500 μg m(-3) or placebo for 2 h. We measured transepidermal water loss (TEWL) and skin pH, and calculated the percentage change from baseline. RESULTS Exposure to formaldehyde increased TEWL in the control group [P < 0·001; median of difference 1·4; interquartile range (IQR) 0·9-1·6] and in the AD group (P < 0·001; median of difference 2·5; IQR 2·0-3·6). The percentage change of TEWL after formaldehyde exposure in the AD group was higher than in the control group (P < 0·001), whereas exposure to placebo showed no differences between both groups. The AD group also demonstrated a higher percentage increase in skin pH after exposure to formaldehyde than the control group (P < 0·001). CONCLUSIONS Short-term exposure to formaldehyde causes skin barrier dysfunction in both healthy children and children with AD, and this effect is more prominent in children with AD.
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Affiliation(s)
- J Kim
- Department of Pediatrics, Samsung Medical Centre, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 135-710, Korea.,Environmental Health Centre for Atopic Diseases, Samsung Medical Centre, Seoul, Korea
| | - Y Han
- Environmental Health Centre for Atopic Diseases, Samsung Medical Centre, Seoul, Korea
| | - J H Ahn
- Biostatistics Team, Samsung Biomedical Research Institute, Seoul, Korea
| | - S W Kim
- Biostatistics Team, Samsung Biomedical Research Institute, Seoul, Korea
| | - S I Lee
- Department of Pediatrics, Samsung Medical Centre, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 135-710, Korea
| | - K H Lee
- Korea Institute of Toxicology, Jeongeup, Jeollabuk-do, Korea
| | - K Ahn
- Department of Pediatrics, Samsung Medical Centre, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 135-710, Korea.,Environmental Health Centre for Atopic Diseases, Samsung Medical Centre, Seoul, Korea
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Cho YJ, Lee KH, Ahn JH, Hong CK, Ha YR. Evaluation of a novel simulation method of teaching B-lines: hand ultrasound with a wet foam dressing material. Crit Ultrasound J 2015. [PMCID: PMC4401507 DOI: 10.1186/2036-7902-7-s1-a30] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Ahn JH, Kim IS, Shin KM, Kang SS, Hong SJ, Park JH, Kim HJ, Lee SH, Kim DY, Jung JH. Influence of arm position on catheter placement during real-time ultrasound-guided right infraclavicular proximal axillary venous catheterization. Br J Anaesth 2015; 116:363-9. [PMID: 26487153 DOI: 10.1093/bja/aev345] [Citation(s) in RCA: 16] [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] [Subscribe] [Scholar Register] [Accepted: 07/14/2015] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Real-time ultrasound-guided infraclavicular proximal axillary venous catheterization is used in many clinical situations and provides the advantages of catheter stabilization, a reduced risk of catheter-related infection, and comfort for the patient without limitation of movement. However, unintended catheter tip dislocation and accidental arterial puncture occur occasionally. This study was designed to investigate the influence of arm position on catheter placement and complications. METHODS Patients were randomized to either the neutral group (n=240) or the abduction group (n=241). In the neutral group, patients were positioned with the head and shoulders placed in an anatomically neutral position and the arms kept by the side during catheterization. In the abduction group, the right upper arm was abducted at 90° from the trunk during catheterization. After real-time ultrasound-guided catheterization was carried out in the right infraclavicular proximal axillary vein, misplacement of the catheter and all complications were evaluated with ultrasound and chest radiography. RESULTS The success rate of complete catheterization before evaluating the placement of the catheter was high in both groups (97.1 vs 98.8%, P=not significant). The incidence of accidental arterial puncture was not different (1.7 vs 0%, P=not significant). The incidence of misplacement of the catheter was higher in the neutral group than in the abduction group (3.9 vs 0.4%, P=0.01). There were no complications, such as haemothorax, pneumothorax, or injury to the brachial plexus and phrenic nerve, in either group. CONCLUSIONS Upper arm abduction may minimize the risk of misplacement of the catheter during real-time ultrasound-guided infraclavicular proximal axillary venous catheterization. CLINICAL TRIAL REGISTRATION The trial was registered with the Clinical Trial Registry of Korea: https://cris.nih.go.kr/cris/index.jsp. Identifier: KCT0001417.
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Affiliation(s)
- J H Ahn
- Department of Emergency Medicine, Bundang Jesaeng General Hospital, Kyonggi-do, Seongnam, Republic of Korea
| | - I S Kim
- Department of Anesthesiology and Pain Medicine, Kangdong Sacred Heart Hospital, Hallym University Medical Center, 150 Sungan-ro, Gangdong-gu, Seoul 134-701, Republic of Korea
| | - K M Shin
- Department of Anesthesiology and Pain Medicine, Kangdong Sacred Heart Hospital, Hallym University Medical Center, 150 Sungan-ro, Gangdong-gu, Seoul 134-701, Republic of Korea
| | - S S Kang
- Department of Anesthesiology and Pain Medicine, Kangdong Sacred Heart Hospital, Hallym University Medical Center, 150 Sungan-ro, Gangdong-gu, Seoul 134-701, Republic of Korea
| | - S J Hong
- Department of Anesthesiology and Pain Medicine, Kangdong Sacred Heart Hospital, Hallym University Medical Center, 150 Sungan-ro, Gangdong-gu, Seoul 134-701, Republic of Korea
| | - J H Park
- Department of Anesthesiology and Pain Medicine, Kangdong Sacred Heart Hospital, Hallym University Medical Center, 150 Sungan-ro, Gangdong-gu, Seoul 134-701, Republic of Korea
| | - H J Kim
- Department of Anesthesiology and Pain Medicine, Kangdong Sacred Heart Hospital, Hallym University Medical Center, 150 Sungan-ro, Gangdong-gu, Seoul 134-701, Republic of Korea
| | - S H Lee
- Department of Anesthesiology and Pain Medicine, Kangdong Sacred Heart Hospital, Hallym University Medical Center, 150 Sungan-ro, Gangdong-gu, Seoul 134-701, Republic of Korea
| | - D Y Kim
- Department of Anesthesiology and Pain Medicine, Kangdong Sacred Heart Hospital, Hallym University Medical Center, 150 Sungan-ro, Gangdong-gu, Seoul 134-701, Republic of Korea
| | - J H Jung
- Department of Anesthesiology and Pain Medicine, Kangdong Sacred Heart Hospital, Hallym University Medical Center, 150 Sungan-ro, Gangdong-gu, Seoul 134-701, Republic of Korea
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Kim HK, Jeong MH, Seo HW, Ahn JH, Cho KH, Hong YJ, Kim JH, Ahn Y, Cho JG, Park JC, Park KW, Kim HS, Lee SR, Chae JK. Clinical impacts of high-sensitivity C-reactive protein reduction for secondary prevention in Asian patients with one-year survivor after acute myocardial infarction. Int J Cardiol 2015; 193:20-2. [PMID: 26005168 DOI: 10.1016/j.ijcard.2015.05.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2015] [Accepted: 05/06/2015] [Indexed: 11/26/2022]
Affiliation(s)
- Hyun Kuk Kim
- Chonnam National University Hospital, South Korea
| | | | | | - Joon Ho Ahn
- Chonnam National University Hospital, South Korea
| | | | | | - Ju Han Kim
- Chonnam National University Hospital, South Korea
| | | | | | | | | | - Hyo-Soo Kim
- Seoul National University Hospital, South Korea
| | - Sang Rok Lee
- Chonbuk National University Hospital, South Korea
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Cho MJ, Seong SJ, Park JE, Chung IW, Lee YM, Bae A, Ahn JH, Lee DW, Bae JN, Cho SJ, Park JI, Son J, Chang SM, Hahm BJ, Lee JY, Sohn JH, Kim JS, Hong JP. Prevalence and Correlates of DSM-IV Mental Disorders in South Korean Adults: The Korean Epidemiologic Catchment Area Study 2011. Psychiatry Investig 2015; 12:164-70. [PMID: 25866515 PMCID: PMC4390585 DOI: 10.4306/pi.2015.12.2.164] [Citation(s) in RCA: 88] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2014] [Revised: 06/11/2014] [Accepted: 06/11/2014] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE The aim of this study was to estimate the prevalence and correlates of mental disorders in Korean adults. METHODS Door to door household surveys were conducted with community residents aged 18-74 years from July 19, 2011, to November 16, 2011 (n=6,022, response rate 78.7%). The sample was drawn from 12 catchment areas using a multistage cluster method. Each subject was assessed using the Korean version of the World Health Organization Composite International Diagnostic Interview (CIDI) based on the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). RESULTS Lifetime and 12-month prevalence estimates were as follows: alcohol use disorders, 13.4% and 4.4%, respectively; nicotine use disorders, 7.2% and 4.0%, respectively; anxiety disorders, 8.7% and 6.8%, respectively; and mood disorders, 7.5% and 3.6%, respectively. The prevalence rates of all types of DSM-IV mental disorders were 27.6% and 16.0%, respectively. Being female; young; divorced, separated, or widowed; and in a low-income group were associated with mood and anxiety disorders after adjustment for various demographic variables, whereas being male and young were associated with alcohol use disorders. Higher income was not correlated with alcohol use disorder as it had been in the 2001 survey. CONCLUSION The rate of depressive disorders has increased since 2001 (the first national survey), whereas that of anxiety disorders has been relatively stable. The prevalence of nicotine and alcohol use disorders has decreased, and the male-to-female ratio of those with this diagnosis has also decreased.
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Affiliation(s)
- Maeng Je Cho
- Department of Psychiatry and Behavioral Science, College of Medicine, Seoul National University, Seoul, Republic of Korea
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - Su Jeong Seong
- Department of Psychiatry and Behavioral Science, College of Medicine, Seoul National University, Seoul, Republic of Korea
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Jee Eun Park
- Department of Psychiatry and Behavioral Science, College of Medicine, Seoul National University, Seoul, Republic of Korea
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - In-Won Chung
- Department of Neuropsychiatry, Dongguk University International Hospital, Goyang, Republic of Korea
| | - Young Moon Lee
- Department of Psychiatry, Gongju National Hospital, Gongju, Republic of Korea
| | - Ahn Bae
- Department of Psychiatry, Kwangju National Hospital, Gwangju, Republic of Korea
| | - Joon Ho Ahn
- Department of Psychiatry, College of Medicine, University of Ulsan, Ulsan, Republic of Korea
| | - Dong-Woo Lee
- Department of Psychiatry, Sanggye Paik Hospital, College of Medicine, Inje University, Seoul, Republic of Korea
| | - Jae Nam Bae
- Department of Psychiatry, College of Medicine, Inha University, Incheon, Republic of Korea
| | - Seong-Jin Cho
- Department of Psychiatry, Gachon Medical School, Gachon University of Medicine and Science, Incheon, Republic of Korea
| | - Jong-Ik Park
- Department of Psychiatry, College of Medicine, Kangwon National University, Chuncheon, Republic of Korea
| | - Jungwoo Son
- Department of Psychiatry, College of Medicine, Chungbuk National University, Cheongju, Republic of Korea
| | - Sung Man Chang
- Department of Psychiatry, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Bong-Jin Hahm
- Department of Psychiatry and Behavioral Science, College of Medicine, Seoul National University, Seoul, Republic of Korea
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - Jun-Young Lee
- Department of Psychiatry and Behavioral Science, College of Medicine, Seoul National University, Seoul, Republic of Korea
- Department of Neuropsychiatry, Seoul Metropolitan Boramae Medical Center, Seoul, Republic of Korea
| | - Jee Hoon Sohn
- Department of Psychiatry and Behavioral Science, College of Medicine, Seoul National University, Seoul, Republic of Korea
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - Jin Sun Kim
- Department of Psychiatry, Samjung Hospital, Incheon, Republic of Korea
| | - Jin Pyo Hong
- Department of Psychiatry, Samsung Medical Center, Seoul, Republic of Korea
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Kim IY, Cha SW, Ahn JH, Kim YW. Factors affecting the restaging accuracy of magnetic resonance imaging after preoperative chemoradiation in patients with rectal cancer. Eur J Surg Oncol 2015; 41:493-8. [PMID: 25648465 DOI: 10.1016/j.ejso.2014.12.008] [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] [Subscribe] [Scholar Register] [Received: 11/05/2014] [Accepted: 12/26/2014] [Indexed: 01/11/2023] Open
Abstract
PURPOSES We evaluated patient or tumor factors associated with the preoperative restaging accuracy of magnetic resonance imaging (MRI) for determining T and N stages as well as circumferential resection margin (CRM) involvement after chemoradiation (CRT) in patients with locally advanced rectal cancer. METHODS Seventy-seven patients with rectal cancer that were treated with preoperative CRT (50.4 Gy) followed by radical resection were included. Post-CRT MRI was performed approximately 4 weeks after preoperative CRT. RESULTS The median tumor distance from the anal verge was 6 cm, 48 (62%) of which were anterior and 29 (38%) posterior. The median tumor diameter was 3 cm. A stage-by-stage comparison showed that correct staging occurred in 62%, 43%, and 86% of patients for T staging, N staging, and CRM prediction, respectively. Shorter distance to the anal verge (<5 cm), smaller tumor diameter (<1 cm), and anterior tumor location were associated with incorrect T staging. There were no significant variables in terms of N staging accuracy. Shorter tumor distance and anterior tumor location were associated with incorrect CRM prediction. CONCLUSIONS Our findings suggest that specific tumor factors such as small, distal, or anterior rectal tumors are closely associated with the accuracy of MRI after preoperative CRT.
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Affiliation(s)
- I Y Kim
- Department of Surgery, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - S W Cha
- Department of Radiology, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - J H Ahn
- Department of Radiology, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Y W Kim
- Department of Surgery, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea.
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Ahn JH, Kim HK, Kim JY, Won J, Seo HW, Hong YJ, Kim JH, Jeong MH, Cho JG, Park JC, Cho SH, Ahn Y. The Impacts of Living Alone in in-Hospital and One-Year Clinical Outcomes after Acute Myocardial Infarction in Korean Patients. J Lipid Atheroscler 2015. [DOI: 10.12997/jla.2015.4.2.115] [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: 11/09/2022] Open
Affiliation(s)
- Joon Ho Ahn
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Korea
| | - Hyun Kuk Kim
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Korea
| | - Jong Yoon Kim
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Korea
| | - Jumin Won
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Korea
| | - Hyeong Won Seo
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Korea
| | - Young Joon Hong
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Korea
| | - Ju Han Kim
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Korea
| | - Myung Ho Jeong
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Korea
| | - Jeong Gwan Cho
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Korea
| | - Jong Chun Park
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Korea
| | - Sook Hee Cho
- Department of Nursing, Mokpo National University, Mokpo, Korea
| | - Youngkeun Ahn
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Korea
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Nam IS, Choi JH, Seo KM, Ahn JH. In vitro and Lactation Responses in Mid-lactating Dairy Cows Fed Protected Amino Acids and Fat. Asian-Australas J Anim Sci 2014; 27:1705-11. [PMID: 25358363 PMCID: PMC4213681 DOI: 10.5713/ajas.2014.14089] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2014] [Revised: 04/07/2014] [Accepted: 07/08/2014] [Indexed: 11/27/2022]
Abstract
The objective of this study was to evaluate the effect of ruminally protected amino acids (RPAAs) and ruminally protected fat (RPF) supplementation on ruminal fermentation characteristics (in vitro) and milk yield and milk composition (in vivo). Fourteen mid-lactating Holstein dairy cows (mean weight 653±62.59 kg) were divided into two groups according to mean milk yield and number of days of postpartum. The cows were then fed a basal diet during adaptation (2 wk) and experimental diets during the treatment period (6 wk). Dietary treatments were i) a basal diet (control) and ii) basal diet containing 50 g of RPAAs (lysine and methionine, 3:1 ratio) and 50 g of RPF. In rumen fermentation trail (in vitro), RPAAs and RPF supplementation had no influence on the ruminal pH, dry matter digestibility, total volatile fatty acid production and ammonia-N concentration. In feeding trial (in vivo), milk yield (p<0.001), 4% fat corrected milk (p<0.05), milk fat (p<0.05), milk protein (p<0.001), and milk urea nitrogen (p<0.05) were greater in cows fed RPAAs and RPF than the corresponding values in the control group. With an index against as 0%, the rates of decrease in milk yield and milk protein were lower in RPAAs and RPF treated diet than those of basal diet group (p<0.05). In conclusion, diet supplemented with RPAAs and RPF can improve milk yield and milk composition without negatively affecting ruminal functions in Holstein dairy cows at mid-lactating.
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Affiliation(s)
- I S Nam
- Department of Animal Life and Environment Science, Hankyong National University, Ansong 456-749, Korea ; GRRC, Hankyong National University, Ansong 456-749, Korea
| | - J H Choi
- Department of Animal Life and Environment Science, Hankyong National University, Ansong 456-749, Korea ; Nutritional Resource Research Institute, Seoul 137-887, Korea
| | - K M Seo
- Department of Animal Life and Environment Science, Hankyong National University, Ansong 456-749, Korea
| | - J H Ahn
- Department of Animal Life and Environment Science, Hankyong National University, Ansong 456-749, Korea
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Oh SH, Lee YE, Kim DY, Lee JH, Kim D, Hwang JS, Bae SC, Ahn JH, Sung YK. Comparison of Diagnostic Strategies to Detect Prevalent Vertebral Fracture for Adults Over Age 50: Use of Vertebral Fracture Assessment or Spine Radiography. Value Health 2014; 17:A381. [PMID: 27200850 DOI: 10.1016/j.jval.2014.08.2618] [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] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- S H Oh
- National Evidence-based Healthcare Collaborating Agency, Seoul, South Korea
| | - Y E Lee
- National Evidence-based Healthcare Collaborating Agency, Seoul, South Korea
| | - D Y Kim
- Hanyang University Hospital for Rheumatic Diseases, Seoul, South Korea
| | - J H Lee
- Inje University Ilsan paik Hospital, Seoul, South Korea
| | - D Kim
- Hanyang University Hospital for Rheumatic Diseases, Seoul, South Korea
| | - J S Hwang
- National Evidence-based Healthcare Collaborating Agency (NECA), Seoul, South Korea
| | - S C Bae
- Hanyang University Hospital for Rheumatic Diseases, Seoul, South Korea
| | - J H Ahn
- National Evidence-based Healthcare Collaborating Agency, Seoul, South Korea
| | - Y K Sung
- Hanyang University Hospital for Rheumatic Diseases, Seoul, South Korea
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Park Y, Jeong YH, Tantry US, Ahn JH, Kim KH, Koh JS, Park JR, Hwang SJ, Kwak CH, Hwang JY, Gurbel PA. Effect of adjunctive dipyridamole to DAPT on platelet function profiles in stented patients with high platelet reactivity. The result of the ACCEL-DIP Study. Thromb Haemost 2014; 112:1198-208. [PMID: 25182660 DOI: 10.1160/th14-01-0040] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2014] [Accepted: 07/05/2014] [Indexed: 12/27/2022]
Abstract
Adjunctive use of phosphodiesterase (PDE) inhibitor can enhance antiplatelet and vasoprotective properties in patients with cardiovascular disease. The aim of this study was to evaluate the impact of PDE5 inhibitor dipyridamole on platelet function in stented patients with high platelet reactivity (HPR) during dual antiplatelet therapy (DAPT) with aspirin and clopidogrel. Patients with HPR after 600-mg clopidogrel loading were randomly assigned to adjunctive dipyridamole 75 mg twice daily to standard DAPT (DIP group; n = 45) or double-dose clopidogrel of 150 mg daily (DOUBLE group; n = 46) for 30 days. Platelet function was assessed at baseline and 30-day follow-up with platelet reactivity index (PRI) by vasodilator-stimulated phosphoprotein-phosphorylation (VASP-P) assay and platelet aggregation (PA) by light transmittance aggregometry (LTA). Primary endpoint was PRI at 30-day follow-up. HPR was defined as PRI > 50%. Baseline platelet function did not differ between the groups. Following 30-day therapy, platelet function was significantly reduced in the DIP and DOUBLE groups (all p-values ≤ 0.004 and ≤ 0.068, respectively). PRI values were not significantly different between the two groups (mean difference: 3.1%; 95% confidence interval: -2.8% to 9.0%: p = 0.295). PA values and prevalence of HPR were similar between the groups. However, a significant number of patients still exhibited HPR in the DIP (75.6%) and DOUBLE (67.4%) groups. In conclusion, among stented HPR patients, adding dipyridamole to DAPT does not reduce platelet reactivity and prevalence of HPR compared with double-dose clopidogrel therapy, and therefore both strategies are inadequate to overcome HPR.
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Affiliation(s)
| | - Y-H Jeong
- Dr. Young-Hoon Jeong, Division of Cardiology, Department of Internal Medicine, Gyeongsang National University Hospital and, Gyeongsang National University School of Medicine, 79 Gangnam-ro, Jinju, Gyeongsangnam-do, 660-702, Korea, Tel.: +82 55 750 8873, Fax: +82 55 750 8873, E-mail:
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Kim KH, Pandey SK, Ahn JH, Szulejko JE, Sohn JR. Effects of sorbent materials on the cryofocusing analysis of gaseous reduced sulphur compounds. Environ Technol 2014; 35:1971-1978. [PMID: 24956791 DOI: 10.1080/09593330.2014.889217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The relative performance of different sorbent materials employed in the cryofocusing (e.g. in cold trap (CT) unit) stage was investigated at sub-ambient temperature by the thermal desorption (TD)-gas chromatography (GC)-pulsed flame photometric detector. To this end, the TD-based calibration of five reduced sulphur compounds (RSC: H2S, CH3SH, CS2, DMS and DMDS) and SO2 was carried out via the Peltier cooling system with five types of sorbent combinations such as two single-bed (Tenax TA and Silica gel) plus three multibed types (a combination of either two from the following three sorbents: Tenax TA, Silica gel and Carbopack B). Relative performance of each of all five CT options, if evaluated in terms of response factors for each compound, demonstrated that each CT composition acts as an important criterion to distinguish detection properties between light and heavy sulphur species. Although the relative response of H2S and CH3 SH was systematically distinguishable between the CT types, that of SO2 was the most complicated to interpret. According to this study, the two CT types consisting of Carbopack B and Silica gel (CS-0.4 and CS-0.6) were the optimum choices for sulphur gas analysis in terms of basic QA parameters (sensitivity, reproducibility and linearity).
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