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Sun N, Chu B, Choi DH, Lim L, Song H. ETV2 Enhances CXCL5 Secretion from Endothelial Cells, Leading to the Promotion of Vascular Smooth Muscle Cell Migration. Int J Mol Sci 2023; 24:9904. [PMID: 37373052 DOI: 10.3390/ijms24129904] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 06/05/2023] [Accepted: 06/07/2023] [Indexed: 06/29/2023] Open
Abstract
Abnormal communication between endothelial cells (ECs) and vascular smooth muscle cells (VSMCs) promotes vascular diseases, including atherogenesis. ETS variant transcription factor 2 (ETV2) plays a substantial role in pathological angiogenesis and the reprogramming of ECs; however, the role of ETV2 in the communication between ECs and VSMCs has not been revealed. To investigate the interactive role of ETV2 in the EC to VSMC phenotype, we first showed that treatment with a conditioned medium from ETV2-overexpressed ECs (Ad-ETV2 CM) significantly increased VSMC migration. The cytokine array showed altered levels of several cytokines in Ad-ETV2 CM compared with those in normal CM. We found that C-X-C motif chemokine 5 (CXCL5) promoted VSMC migration using the Boyden chamber and wound healing assays. In addition, an inhibitor of C-X-C motif chemokine receptor 2 (CXCR2) (the receptor for CXCL5) significantly inhibited this process. Gelatin zymography showed that the activities of matrix metalloproteinase (MMP)-2 and MMP-9 increased in the media of VSMCs treated with Ad-ETV2 CM. Western blotting revealed a positive correlation between Akt/p38/c-Jun phosphorylation and CXCL5 concentration. The inhibition of Akt and p38-c-Jun effectively blocked CXCL5-induced VSMC migration. In conclusion, CXCL5 from ECs induced by ETV2 promotes VSMC migration via MMP upregulation and the activation of Akt and p38/c-Jun.
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Affiliation(s)
- Ningning Sun
- Department of Biochemistry and Molecular Biology, Chosun University School of Medicine, Gwangju 61452, Republic of Korea
| | - Beyongsam Chu
- Department of Medical Sciences, Chosun University Graduate School, Gwangju 61452, Republic of Korea
| | - Dong-Hyun Choi
- Department of Internal Medicine, Chosun University School of Medicine, Gwangju 61452, Republic of Korea
| | - Leejin Lim
- Advanced Cancer Controlling Research Center, Chosun University, Gwangju 61452, Republic of Korea
| | - Heesang Song
- Department of Biochemistry and Molecular Biology, Chosun University School of Medicine, Gwangju 61452, Republic of Korea
- Department of Medical Sciences, Chosun University Graduate School, Gwangju 61452, Republic of Korea
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2
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Lee B, Kim BG, Baraki TG, Kim JS, Lee YJ, Lee SJ, Hong SJ, Ahn CM, Shin DH, Kim BK, Ko YG, Choi DH, Honh MK, Jang YS. Stent expansion evaluated by optical coherence tomography and subsequent outcomes. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Regarding stent expansion indexes, previous optical coherence tomography (OCT) studies have shown minimal stent area (MSA) to be most predictive of adverse events.
Purpose
We sought to evaluate the impact of various stent expansion indexes by post-stent OCT on long-term clinical outcomes, and hence to find OCT-defined optimal stent expansion criteria.
Methods
Of the patients registered in the Yonsei OCT registry, a total of 1071 patients with 1123 native coronary artery lesions treated with new-generation drug-eluting stents under the OCT guidance and analyzable final post-stent OCT were included. Stent expansion indexes and different suboptimal stent expansion criteria were evaluated for their association with device-oriented clinical endpoints (DoCE) including cardiac death, target vessel-related myocardial infarction (TVMI) or stent thrombosis, and target lesion revascularization. Major safety events (MSE) included cardiac death, TVMI or stent thrombosis.
Results
The median follow-up period was 40.6 (interquartile range 22.0–50.0) months. As a continuous variable, MSA, adaptive volumetric stent expansion (stent volume/adaptive reference lumen volume) and overall volumetric stent expansion (stent volume/post-stent lumen volume) were significantly predictive of DoCE. As a categorical criteria, MSA <5.0 mm2 (hazard ratio [HR] 3.80; 95% confidence interval [CI] 1.53–9.45), MSA/distal reference lumen area <90% (HR 2.13; 95% CI 1.10–4.14), and overall volumetric stent expansion ≥96.6% (HR 2.38; 95% CI 1.09–5.22) were independently associated with DoCE after adjusting for confounders, and a total malapposition volume ≥7.0 mm3 (HR 3.38; 95% CI 1.05–10.93) was linked to MSE.
Conclusions
This OCT study highlights that sufficient stent expansion to achieve adequate absolute MSA and relative MSA by distal reference lumen area and alleviate significant malapposition is important to improve clinical outcome, but overall stent overexpansion may have deleterious effect.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- B Lee
- Severance Hospital, Cardiology , Seoul , Korea (Republic of)
| | - B G Kim
- Sanggye Paik Hospital , Seoul , Korea (Republic of)
| | - T G Baraki
- Severance Hospital, Cardiology , Seoul , Korea (Republic of)
| | - J S Kim
- Severance Hospital, Cardiology , Seoul , Korea (Republic of)
| | - Y J Lee
- Severance Hospital, Cardiology , Seoul , Korea (Republic of)
| | - S J Lee
- Severance Hospital, Cardiology , Seoul , Korea (Republic of)
| | - S J Hong
- Severance Hospital, Cardiology , Seoul , Korea (Republic of)
| | - C M Ahn
- Severance Hospital, Cardiology , Seoul , Korea (Republic of)
| | - D H Shin
- Severance Hospital, Cardiology , Seoul , Korea (Republic of)
| | - B K Kim
- Severance Hospital, Cardiology , Seoul , Korea (Republic of)
| | - Y G Ko
- Severance Hospital, Cardiology , Seoul , Korea (Republic of)
| | - D H Choi
- Severance Hospital, Cardiology , Seoul , Korea (Republic of)
| | - M K Honh
- Severance Hospital, Cardiology , Seoul , Korea (Republic of)
| | - Y S Jang
- Cha Bundang Medical Center, cardiology , Seongnam , Korea (Republic of)
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3
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Lim L, Ki YJ, Kim H, Chu B, Choi IY, Choi DH, Song H. Plantamajoside Attenuates Neointima Formation via Upregulation of Tissue Inhibitor of Metalloproteinases in Balloon-Injured Rats. J Med Food 2022; 25:503-512. [PMID: 35483086 DOI: 10.1089/jmf.2021.k.0162] [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] [Indexed: 01/18/2023] Open
Abstract
The abnormal change of vascular smooth muscle cell (VSMC) behavior is an important cellular event leading to neointimal hyperplasia in atherosclerosis and restenosis. Plantamajoside (PMS), a phenylethanoid glycoside compound of the Plantago asiatica, has been reported to have anti-inflammatory, antioxidative, and anticancer activities. In this study, the protective effects of PMS against intimal hyperplasia and the mechanisms underlying the regulation of VSMC behavior were investigated. MTT and BrdU assays were performed to evaluate the cytotoxicity and cell proliferative activity of PMS, respectively. Rat aortic VSMC migrations after treatment with the determined concentration of PMS (50 and 150 μM) were evaluated using wound healing and Boyden chamber assays. The inhibitory effects of PMS on intimal hyperplasia were evaluated in balloon-injured (BI) rat carotid artery. PMS suppressed the proliferation in platelet-derived growth factor-BB-induced VSMC, as confirmed from the decrease in cyclin-dependent kinase (CDK)-2, CDK-4, cyclin D1, and proliferating cell nuclear antigen levels. PMS also inhibited VSMC migration, consistent with the downregulated expression and zymolytic activities of matrix metalloproteinase (MMP)2, MMP9, and MMP13. PMS specifically regulated MMP expression through p38 mitogen-activated protein kinase and focal adhesion kinase pathways. Tissue inhibitor of metalloproteinase (TIMP)1 and TIMP2 levels were upregulated via Smad1. TIMPs inhibited the conversion of pro-MMPs to active MMPs. PMS significantly inhibited neointimal formation in BI rat carotid arteries. In conclusion, PMS inhibits VSMC proliferation and migration by upregulating TIMP1 and TIMP2 expression. Therefore, PMS could be a potential therapeutic agent for vascular atherosclerosis and restenosis treatment.
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Affiliation(s)
- Leejin Lim
- Cancer Mutation Research Center, Chosun University, Gwangju, Korea
| | - Young-Jae Ki
- Department of Internal Medicine, Chosun University School of Medicine, Gwangju, Korea
| | - Hyeonhwa Kim
- Department of Biomedical Sciences, Chosun University Graduate School, Gwangju, Korea
| | - Byeongsam Chu
- Department of Biomedical Sciences, Chosun University Graduate School, Gwangju, Korea
| | - In Young Choi
- Department of Internal Medicine, Chosun University School of Medicine, Gwangju, Korea
| | - Dong-Hyun Choi
- Department of Internal Medicine, Chosun University School of Medicine, Gwangju, Korea
| | - Heesang Song
- Department of Biomedical Sciences, Chosun University Graduate School, Gwangju, Korea.,Department of Biochemistry and Molecular Biology, Chosun University School of Medicine, Gwangju, Korea
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Ju S, Lim L, Ki YJ, Choi DH, Song H. Oxidative stress generated by polycyclic aromatic hydrocarbons from ambient particulate matter enhance vascular smooth muscle cell migration through MMP upregulation and actin reorganization. Part Fibre Toxicol 2022; 19:29. [PMID: 35449013 PMCID: PMC9026692 DOI: 10.1186/s12989-022-00472-z] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 03/15/2022] [Indexed: 08/29/2023] Open
Abstract
Background Epidemiological studies have suggested that elevated concentrations of particulate matter (PM) are strongly associated with the incidence of atherosclerosis, however, the underlying cellular and molecular mechanisms of atherosclerosis by PM exposure and the components that are mainly responsible for this adverse effect remain to be established. In this investigation, we evaluated the effects of ambient PM on vascular smooth muscle cell (VSMC) behavior. Furthermore, the effects of polycyclic aromatic hydrocarbons (PAHs), major components of PM, on VSMC migration and the underlying mechanisms were examined. Results VSMC migration was significantly increased by treatment with organic matters extracted from ambient PM. The total amount of PAHs contained in WPM was higher than that in SPM, leading to higher ROS generation and VSMC migration. The increased migration was successfully inhibited by treatment with the anti-oxidant, N-acetyl-cysteine (NAC). The levels of matrix metalloproteinase (MMP) 2 and 9 were significantly increased in ambient PM-treated VSMCs, with MMP9 levels being significantly higher in WPM-treated VSMCs than in those treated with SPM. As expected, migration was significantly increased in all tested PAHs (anthracene, ANT; benz(a)anthracene, BaA) and their oxygenated derivatives (9,10-Anthraquinone, AQ; 7,12-benz(a)anthraquinone, BAQ, respectively). The phosphorylated levels of focal adhesion kinase (FAK) and formation of the focal adhesion complex were significantly increased in ambient PM or PAH-treated VSMCs, and these effects were blocked by administration of NAC or α-NF, an inhibitor of AhR, the receptor that allows PAH uptake. Subsequently, the levels of phosphorylated Src and NRF, the downstream targets of FAK, were altered with a pattern similar to that of p-FAK. Conclusions PAHs, including oxy-PAHs, in ambient PM may have dual effects that lead to an increase in VSMC migration. One is the generation of oxidative stress followed by MMP upregulation, and the other is actin reorganization that results from the activation of the focal adhesion complex.
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Affiliation(s)
- Sujin Ju
- Department of Biochemistry and Molecular Biology, Chosun University School of Medicine, Gwangju, 61452, Korea
| | - Leejin Lim
- Cancer Mutation Research Center, Chosun University, Gwangju, 61452, Korea
| | - Young-Jae Ki
- Department of Internal Medicine, Chosun University School of Medicine, Gwangju, 61452, Korea
| | - Dong-Hyun Choi
- Department of Internal Medicine, Chosun University School of Medicine, Gwangju, 61452, Korea
| | - Heesang Song
- Department of Biochemistry and Molecular Biology, Chosun University School of Medicine, Gwangju, 61452, Korea.
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5
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Park KH, Jeong MH, Kim HK, Ki YJ, Kim SS, Choi DH, Koh YY, Ahn Y, Kim HS, Gwon HC, Rha SW, Hwang JY. Clinical Outcomes of Ticagrelor in Korean Patients with Acute Myocardial Infarction without High Bleeding Risk. J Korean Med Sci 2021; 36:e268. [PMID: 34725976 PMCID: PMC8560314 DOI: 10.3346/jkms.2021.36.e268] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Accepted: 09/02/2021] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Although ticagrelor is known to increase the bleeding risk compared to clopidogrel in East Asian patients, its clinical benefits in patients with acute myocardial infarction (AMI) without high bleeding risk (HBR) remains unknown. METHODS A total of 7,348 patients who underwent successful percutaneous coronary intervention (PCI) from the Korea Acute Myocardial Infarction Registry-National Institute of Health (KAMIR-NIH), between November 2011 and December 2015, were divided into two groups according to the Academic Research Consortium for HBR criteria (KAMIR-HBR, 2,469 patients; KAMIR-non HBR, 4,879 patients). We compared in-hospital major adverse cardiovascular events (MACEs, defined as a composite of cardiac death, non-fatal myocardial infarction, or stroke), and the thrombolysis in myocardial infarction (TIMI) major bleeding between ticagrelor and clopidogrel in the KAMIR-HBR and the KAMIR-non HBR groups, respectively. RESULTS After propensity score matching, ticagrelor had a higher incidence of in-hospital TIMI major bleeding than clopidogrel in all patients (odds ratio [OR], 1.683; 95% confidence interval [CI], 1.010-2.805; P = 0.046) and the KAMIR-HBR group (OR, 3.460; 95% CI, 1.374-8.714; P = 0.008). However, there was no significant difference in in-hospital TIMI major bleeding between ticagrelor and clopidogrel in the KAMIR-non HBR group (OR, 1.436; 95% CI, 0.722-2.855; P = 0.303). No differences were observed in the cumulative incidences of in-hospital and 6-month MACEs between ticagrelor and clopidogrel in both groups. CONCLUSIONS The bleeding risk of ticagrelor was attenuated in Korean patients with AMI without HBR. Appropriate patient selection could reduce in-hospital bleeding complications associated with ticagrelor in Korean patients with AMI who underwent successful PCI.
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Affiliation(s)
- Keun-Ho Park
- Department of Internal Medicine, Chosun University Hospital, Gwangju, Korea
| | - Myung Ho Jeong
- Department of Cardiovascular Medicine, Chonnam National University Hospital and Medical School, Gwangju, Korea.
| | - Hyun Kuk Kim
- Department of Internal Medicine, Chosun University Hospital, Gwangju, Korea
| | - Young-Jae Ki
- Department of Internal Medicine, Chosun University Hospital, Gwangju, Korea
| | - Sung Soo Kim
- Department of Internal Medicine, Chosun University Hospital, Gwangju, Korea
| | - Dong-Hyun Choi
- Department of Internal Medicine, Chosun University Hospital, Gwangju, Korea
| | - Young-Youp Koh
- Department of Internal Medicine, Chosun University Hospital, Gwangju, Korea
| | - Youngkeun Ahn
- Department of Cardiovascular Medicine, Chonnam National University Hospital and Medical School, Gwangju, Korea
| | - Hyo-Soo Kim
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Hyeon-Cheol Gwon
- Heart Vascular and Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Seung-Woon Rha
- Cardiovascular Center, Korea University Guro Hospital, Seoul, Korea
| | - Jin-Yong Hwang
- Department of Internal Medicine, Gyeongsang National University Hospital and School of Medicine, Jinju, Korea
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Ju S, Lim L, Wi K, Park C, Ki YJ, Choi DH, Song H. LRP5 Regulates HIF-1α Stability via Interaction with PHD2 in Ischemic Myocardium. Int J Mol Sci 2021; 22:ijms22126581. [PMID: 34205318 PMCID: PMC8235097 DOI: 10.3390/ijms22126581] [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] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 06/12/2021] [Accepted: 06/16/2021] [Indexed: 12/22/2022] Open
Abstract
Low-density lipoprotein receptor-related protein 5 (LRP5) has been studied as a co-receptor for Wnt/β-catenin signaling. However, its role in the ischemic myocardium is largely unknown. Here, we show that LRP5 may act as a negative regulator of ischemic heart injury via its interaction with prolyl hydroxylase 2 (PHD2), resulting in hypoxia-inducible factor-1α (HIF-1α) degradation. Overexpression of LRP5 in cardiomyocytes promoted hypoxia-induced apoptotic cell death, whereas LRP5-silenced cardiomyocytes were protected from hypoxic insult. Gene expression analysis (mRNA-seq) demonstrated that overexpression of LRP5 limited the expression of HIF-1α target genes. LRP5 promoted HIF-1α degradation, as evidenced by the increased hydroxylation and shorter stability of HIF-1α under hypoxic conditions through the interaction between LRP5 and PHD2. Moreover, the specific phosphorylation of LRP5 at T1492 and S1503 is responsible for enhancing the hydroxylation activity of PHD2, resulting in HIF-1α degradation, which is independent of Wnt/β-catenin signaling. Importantly, direct myocardial delivery of adenoviral constructs, silencing LRP5 in vivo, significantly improved cardiac function in infarcted rat hearts, suggesting the potential value of LRP5 as a new target for ischemic injury treatment.
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Affiliation(s)
- Sujin Ju
- Department of Biochemistry and Molecular Biology, Chosun University School of Medicine, Gwangju 61452, Korea; (S.J.); (K.W.)
| | - Leejin Lim
- Cancer Mutation Research Center, Chosun University, Gwangju 61452, Korea;
| | - Kwanhwan Wi
- Department of Biochemistry and Molecular Biology, Chosun University School of Medicine, Gwangju 61452, Korea; (S.J.); (K.W.)
| | - Changwon Park
- Department of Molecular & Cellular Physiology, Louisiana State University Health Sciences Center, Shreveport, LA 71103, USA;
| | - Young-Jae Ki
- Department of Internal Medicine, Chosun University School of Medicine, Gwangju 61452, Korea; (Y.-J.K.); (D.-H.C.)
| | - Dong-Hyun Choi
- Department of Internal Medicine, Chosun University School of Medicine, Gwangju 61452, Korea; (Y.-J.K.); (D.-H.C.)
| | - Heesang Song
- Department of Biochemistry and Molecular Biology, Chosun University School of Medicine, Gwangju 61452, Korea; (S.J.); (K.W.)
- Correspondence: ; Tel.: +82-62-230-6290
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Ju S, Lim L, Jiao HY, Choi S, Jun JY, Ki YJ, Choi DH, Lee JY, Song H. Oxygenated polycyclic aromatic hydrocarbons from ambient particulate matter induce electrophysiological instability in cardiomyocytes. Part Fibre Toxicol 2020; 17:25. [PMID: 32527278 PMCID: PMC7288552 DOI: 10.1186/s12989-020-00351-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Accepted: 05/12/2020] [Indexed: 12/14/2022] Open
Abstract
Background Epidemiologic studies have suggested that elevated concentrations of particulate matter (PM) are strongly associated with an increased risk of developing cardiovascular diseases, including arrhythmia. However, the cellular and molecular mechanisms by which PM exposure causes arrhythmia and the component that is mainly responsible for this adverse effect remains to be established. In this study, the arrhythmogenicity of mobilized organic matter from two different types of PM collected during summer (SPM) and winter (WPM) seasons in the Seoul metropolitan area was evaluated. In addition, differential effects between polycyclic aromatic hydrocarbons (PAHs) and oxygenated PAHs (oxy-PAHs) on the induction of electrophysiological instability were examined. Results We extracted the bioavailable organic contents of ambient PM, measuring 10 μm or less in diameter, collected from the Seoul metropolitan area using a high-volume air sampler. Significant alterations in all factors tested for association with electrophysiological instability, such as intracellular Ca2+ levels, reactive oxygen species (ROS) generation, and mRNA levels of the Ca2+-regulating proteins, sarcoplasmic reticulum Ca2+ATPase (SERCA2a), Ca2+/calmodulin-dependent protein kinase II (CaMK II), and ryanodine receptor 2 (RyR2) were observed in cardiomyocytes treated with PM. Moreover, the alterations were higher in WPM-treated cardiomyocytes than in SPM-treated cardiomyocytes. Three-fold more oxy-PAH concentrations were observed in WPM than SPM. As expected, electrophysiological instability was induced higher in oxy-PAHs (9,10-anthraquinone, AQ or 7,12-benz(a) anthraquinone, BAQ)-treated cardiomyocytes than in PAHs (anthracene, ANT or benz(a) anthracene, BaA)-treated cardiomyocytes; oxy-PAHs infusion of cells mediated by aryl hydrocarbon receptor (AhR) was faster than PAHs infusion. In addition, ROS formation and expression of calcium-related genes were markedly more altered in cells treated with oxy-PAHs compared to those treated with PAHs. Conclusions The concentrations of oxy-PAHs in PM were found to be higher in winter than in summer, which might lead to greater electrophysiological instability through the ROS generation and disruption of calcium regulation.
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Affiliation(s)
- Sujin Ju
- Department of Biomaterials, Chosun University Graduate School, Gwangju, 61452, South Korea
| | - Leejin Lim
- Department of Biomaterials, Chosun University Graduate School, Gwangju, 61452, South Korea.,Cancer mutation Research Center, Chosun University, Gwangju, 61452, South Korea
| | - Han-Yi Jiao
- Department of Physiology, Chosun University School of Medicine, Gwangju, 61452, South Korea
| | - Seok Choi
- Department of Physiology, Chosun University School of Medicine, Gwangju, 61452, South Korea
| | - Jae Yeoul Jun
- Department of Physiology, Chosun University School of Medicine, Gwangju, 61452, South Korea
| | - Young-Jae Ki
- Department of Internal Medicine, Chosun University School of Medicine, Gwangju, 61452, South Korea
| | - Dong-Hyun Choi
- Department of Internal Medicine, Chosun University School of Medicine, Gwangju, 61452, South Korea
| | - Ji Yi Lee
- Department of Environmental Science and Engineerings, Ewha Womans University, Seoul, 03760, South Korea.
| | - Heesang Song
- Department of Biomaterials, Chosun University Graduate School, Gwangju, 61452, South Korea. .,Department of Biochemistry and Molecular Biology, Chosun University School of Medicine, Gwangju, 61452, South Korea.
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Ju S, Park S, Lim L, Choi DH, Song H. Low density lipoprotein receptor-related protein 1 regulates cardiac hypertrophy induced by pressure overload. Int J Cardiol 2019; 299:235-242. [PMID: 31350035 DOI: 10.1016/j.ijcard.2019.07.049] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [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: 05/27/2019] [Revised: 07/05/2019] [Accepted: 07/15/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Cardiac hypertrophy is associated with functional changes in cardiomyocytes, which often results in heart failure. The low-density lipoprotein receptor-related protein 1 (LRP1) is a large multifunctional endocytic receptor involved in many physiological and pathological processes. However, its function in the development of cardiac hypertrophy remains largely unclear. METHODS Adenoviral constructs were used for either overexpression or silencing of LRP1 in both in vitro and in vivo experiments. Cardiac function was measured using the Millar catheter. RESULTS LRP1 expression was upregulated in both transverse aortic constriction (TAC)-induced hypertrophic myocardium and catecholamine (phenylephrine (PE) and norepinephrine (NE))- and angiotensin II (AngII)-induced hypertrophic cardiomyocytes. In addition, cell surface area, protein/DNA ratio, and the mRNA levels of hypertrophic markers were significantly increased in LRP1-overexpressing cardiomyocytes without catecholamine stimulation. Conversely, LRP1 inhibition by LRP1-specific siRNA or a specific ligand-binding antagonist (RAP) significantly rescued hypertrophic effects in PE, NE, or AngII-induced cardiomyocytes. LRP1 overexpression induced PKCα, then activated ERK, resulting in cardiac hypertrophy with the downregulation of SERCA2a and calcium accumulation, which was successfully restored in both LRP1-silenced cardiomyocytes and TAC-induced hearts. CONCLUSIONS LRP1 regulates cardiac hypertrophy via the PKCα-ERK dependent signaling pathway resulting in the alteration of intracellular calcium levels, demonstrating that LRP1 might be a potential therapeutic target for cardiac hypertrophy.
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Affiliation(s)
- Sujin Ju
- Department of Medical of Sciences, Chosun University Graduate School, Gwangju 61452, Republic of Korea
| | - Seulki Park
- Department of Medical of Sciences, Chosun University Graduate School, Gwangju 61452, Republic of Korea
| | - Leejin Lim
- Department of Medical of Sciences, Chosun University Graduate School, Gwangju 61452, Republic of Korea; Cancer Mutation Research Center, Chosun University, Gwangju 61452, Republic of Korea
| | - Dong-Hyun Choi
- Department of Internal Medicine, Chosun University School of Medicine, Gwangju 61452, Republic of Korea
| | - Heesang Song
- Department of Medical of Sciences, Chosun University Graduate School, Gwangju 61452, Republic of Korea; Department of Biochemistry and Molecular Biology, Chosun University School of Medicine, Gwangju 61452, Republic of Korea.
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Kim H, Park W, Choi DH, Ahn SJ, Kim SS, Kim ES, Lee JH, Lee KC, Kim JH, Lee HS, Kim JH, Kim MY, Park HJ, Kim K, Song SH, Kwon J, Lee IJ, Kim TH, Kim TG, Chang AR, Cho O, Jeong BK, Ha B, Lee J, Ki Y. Abstract OT2-04-02: A phase 3 study of post-lumpectomy radiotherapy to whole breast + regional lymph nodes vs whole breast alone for patients with pN1 breast cancer treated with taxane-based chemotherapy (KROG 1701): Trial in progress. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-ot2-04-02] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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
Background
In patients with early stage breast cancer, regional nodal irradiation (RNI) is added to whole breast irradiation (WBI) in order to control microscopic regional disease and to prevent systemic spread of cancer. According to recent randomized trials (MA.20 and EORTC 22922-10925), prophylactic RNI was associated with improvement in disease-free survival (DFS) in the patients with high-risk node negative or pN1 breast cancer. However, systemic agents now known to improve loco-regional control, such as taxane or endocrine therapy, were prescribed to a small percentage of patients in the studies. The benefit of RNI found in the previous studies might be attributed to incorporation of less effective systemic treatments. The impact of prophylactic RNI in pN1 breast cancer should be evaluated in the patients receiving modern systemic treatment. The current study was conducted to compare the effect of post-lumpectomy WBI vs WBI plus RNI on DFS in pN1 breast cancer patients who received adjuvant taxane-based chemotherapy.
Methods
This study is a multicenter, phase 3, randomized controlled non-inferiority trial (NCT03269981). Eligibility criteria are ≥ 20 years female; pathologically proven invasive carcinoma of the breast; one to three positive axillary lymph nodes (pN1) in pathologic specimen; receiving breast-conserving surgery followed by taxane-based chemotherapy; having adjuvant endocrine therapy or anti-HER2 treatment according to molecular subtype of tumor. Patients are randomly assigned in a 1:1 ratio to receive WBI or WBI plus RNI. Patient randomization was stratified by molecular subtype of tumor (i.e. luminal A/luminal B/luminal HER2/HER2-enriched/triple-negative) and methods of axillary management (i.e. sentinel lymph node biopsy/axillary lymph node dissection). The primary outcome is DFS. The secondary outcomes include DFS according to molecular subtype, treatment-related toxicity, and patient's quality of life per EORTC QLQ-C30 and QLQ-BR23. Patients will be followed for survival and disease recurrence for seven years. A total of 1,926 patients are planned to be enrolled, with recruitment initiated in April 2017. As of June 2018, a total of 236 patients were enrolled.
Acknowledgement
This study was supported by a grant from the National R&D Program for Cancer Control, Ministry of Health & Welfare, Republic of Korea (grant number: HA17C0043010018).
Citation Format: Kim H, Park W, Choi DH, Ahn SJ, Kim SS, Kim ES, Lee JH, Lee KC, Kim JH, Lee H-S, Kim JH, Kim MY, Park HJ, Kim K, Song SH, Kwon J, Lee IJ, Kim TH, Kim TG, Chang AR, Cho O, Jeong BK, Ha B, Lee J, Ki Y. A phase 3 study of post-lumpectomy radiotherapy to whole breast + regional lymph nodes vs whole breast alone for patients with pN1 breast cancer treated with taxane-based chemotherapy (KROG 1701): Trial in progress [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 OT2-04-02.
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Affiliation(s)
- H Kim
- Samsung Medical Center, Seoul, Republic of Korea; Chonnam National University Medical School, Gwangju, Republic of Korea; Asan Medical Center, Seoul, Republic of Korea; Soonchunhyang University College of Medicine, Cheonan, Republic of Korea; St. Vincent's Hospital, The Catholic University of Korea College of Medicine, Suwon, Republic of Korea; Gachon University Gil Medical Center, Incheon, Republic of Korea; Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Republic of Korea; Dong-A University Hospital, Busan, Republic of Korea; Seoul National University Hospital, Seoul, Republic of Korea; Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea; Hanyang University College of Medicine, Seoul, Republic of Korea; Ewha Womans University Mokdong Hospital, Seoul, Republic of Korea; Kangwon National University School of Medicine, Chuncheon, Republic of Korea; Chungnam National University College of Medicine, Daejeon, Republic of Korea; Gangnam Severance Hospital, Yonsei Univer
| | - W Park
- Samsung Medical Center, Seoul, Republic of Korea; Chonnam National University Medical School, Gwangju, Republic of Korea; Asan Medical Center, Seoul, Republic of Korea; Soonchunhyang University College of Medicine, Cheonan, Republic of Korea; St. Vincent's Hospital, The Catholic University of Korea College of Medicine, Suwon, Republic of Korea; Gachon University Gil Medical Center, Incheon, Republic of Korea; Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Republic of Korea; Dong-A University Hospital, Busan, Republic of Korea; Seoul National University Hospital, Seoul, Republic of Korea; Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea; Hanyang University College of Medicine, Seoul, Republic of Korea; Ewha Womans University Mokdong Hospital, Seoul, Republic of Korea; Kangwon National University School of Medicine, Chuncheon, Republic of Korea; Chungnam National University College of Medicine, Daejeon, Republic of Korea; Gangnam Severance Hospital, Yonsei Univer
| | - DH Choi
- Samsung Medical Center, Seoul, Republic of Korea; Chonnam National University Medical School, Gwangju, Republic of Korea; Asan Medical Center, Seoul, Republic of Korea; Soonchunhyang University College of Medicine, Cheonan, Republic of Korea; St. Vincent's Hospital, The Catholic University of Korea College of Medicine, Suwon, Republic of Korea; Gachon University Gil Medical Center, Incheon, Republic of Korea; Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Republic of Korea; Dong-A University Hospital, Busan, Republic of Korea; Seoul National University Hospital, Seoul, Republic of Korea; Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea; Hanyang University College of Medicine, Seoul, Republic of Korea; Ewha Womans University Mokdong Hospital, Seoul, Republic of Korea; Kangwon National University School of Medicine, Chuncheon, Republic of Korea; Chungnam National University College of Medicine, Daejeon, Republic of Korea; Gangnam Severance Hospital, Yonsei Univer
| | - SJ Ahn
- Samsung Medical Center, Seoul, Republic of Korea; Chonnam National University Medical School, Gwangju, Republic of Korea; Asan Medical Center, Seoul, Republic of Korea; Soonchunhyang University College of Medicine, Cheonan, Republic of Korea; St. Vincent's Hospital, The Catholic University of Korea College of Medicine, Suwon, Republic of Korea; Gachon University Gil Medical Center, Incheon, Republic of Korea; Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Republic of Korea; Dong-A University Hospital, Busan, Republic of Korea; Seoul National University Hospital, Seoul, Republic of Korea; Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea; Hanyang University College of Medicine, Seoul, Republic of Korea; Ewha Womans University Mokdong Hospital, Seoul, Republic of Korea; Kangwon National University School of Medicine, Chuncheon, Republic of Korea; Chungnam National University College of Medicine, Daejeon, Republic of Korea; Gangnam Severance Hospital, Yonsei Univer
| | - SS Kim
- Samsung Medical Center, Seoul, Republic of Korea; Chonnam National University Medical School, Gwangju, Republic of Korea; Asan Medical Center, Seoul, Republic of Korea; Soonchunhyang University College of Medicine, Cheonan, Republic of Korea; St. Vincent's Hospital, The Catholic University of Korea College of Medicine, Suwon, Republic of Korea; Gachon University Gil Medical Center, Incheon, Republic of Korea; Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Republic of Korea; Dong-A University Hospital, Busan, Republic of Korea; Seoul National University Hospital, Seoul, Republic of Korea; Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea; Hanyang University College of Medicine, Seoul, Republic of Korea; Ewha Womans University Mokdong Hospital, Seoul, Republic of Korea; Kangwon National University School of Medicine, Chuncheon, Republic of Korea; Chungnam National University College of Medicine, Daejeon, Republic of Korea; Gangnam Severance Hospital, Yonsei Univer
| | - ES Kim
- Samsung Medical Center, Seoul, Republic of Korea; Chonnam National University Medical School, Gwangju, Republic of Korea; Asan Medical Center, Seoul, Republic of Korea; Soonchunhyang University College of Medicine, Cheonan, Republic of Korea; St. Vincent's Hospital, The Catholic University of Korea College of Medicine, Suwon, Republic of Korea; Gachon University Gil Medical Center, Incheon, Republic of Korea; Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Republic of Korea; Dong-A University Hospital, Busan, Republic of Korea; Seoul National University Hospital, Seoul, Republic of Korea; Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea; Hanyang University College of Medicine, Seoul, Republic of Korea; Ewha Womans University Mokdong Hospital, Seoul, Republic of Korea; Kangwon National University School of Medicine, Chuncheon, Republic of Korea; Chungnam National University College of Medicine, Daejeon, Republic of Korea; Gangnam Severance Hospital, Yonsei Univer
| | - JH Lee
- Samsung Medical Center, Seoul, Republic of Korea; Chonnam National University Medical School, Gwangju, Republic of Korea; Asan Medical Center, Seoul, Republic of Korea; Soonchunhyang University College of Medicine, Cheonan, Republic of Korea; St. Vincent's Hospital, The Catholic University of Korea College of Medicine, Suwon, Republic of Korea; Gachon University Gil Medical Center, Incheon, Republic of Korea; Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Republic of Korea; Dong-A University Hospital, Busan, Republic of Korea; Seoul National University Hospital, Seoul, Republic of Korea; Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea; Hanyang University College of Medicine, Seoul, Republic of Korea; Ewha Womans University Mokdong Hospital, Seoul, Republic of Korea; Kangwon National University School of Medicine, Chuncheon, Republic of Korea; Chungnam National University College of Medicine, Daejeon, Republic of Korea; Gangnam Severance Hospital, Yonsei Univer
| | - KC Lee
- Samsung Medical Center, Seoul, Republic of Korea; Chonnam National University Medical School, Gwangju, Republic of Korea; Asan Medical Center, Seoul, Republic of Korea; Soonchunhyang University College of Medicine, Cheonan, Republic of Korea; St. Vincent's Hospital, The Catholic University of Korea College of Medicine, Suwon, Republic of Korea; Gachon University Gil Medical Center, Incheon, Republic of Korea; Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Republic of Korea; Dong-A University Hospital, Busan, Republic of Korea; Seoul National University Hospital, Seoul, Republic of Korea; Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea; Hanyang University College of Medicine, Seoul, Republic of Korea; Ewha Womans University Mokdong Hospital, Seoul, Republic of Korea; Kangwon National University School of Medicine, Chuncheon, Republic of Korea; Chungnam National University College of Medicine, Daejeon, Republic of Korea; Gangnam Severance Hospital, Yonsei Univer
| | - JH Kim
- Samsung Medical Center, Seoul, Republic of Korea; Chonnam National University Medical School, Gwangju, Republic of Korea; Asan Medical Center, Seoul, Republic of Korea; Soonchunhyang University College of Medicine, Cheonan, Republic of Korea; St. Vincent's Hospital, The Catholic University of Korea College of Medicine, Suwon, Republic of Korea; Gachon University Gil Medical Center, Incheon, Republic of Korea; Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Republic of Korea; Dong-A University Hospital, Busan, Republic of Korea; Seoul National University Hospital, Seoul, Republic of Korea; Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea; Hanyang University College of Medicine, Seoul, Republic of Korea; Ewha Womans University Mokdong Hospital, Seoul, Republic of Korea; Kangwon National University School of Medicine, Chuncheon, Republic of Korea; Chungnam National University College of Medicine, Daejeon, Republic of Korea; Gangnam Severance Hospital, Yonsei Univer
| | - H-S Lee
- Samsung Medical Center, Seoul, Republic of Korea; Chonnam National University Medical School, Gwangju, Republic of Korea; Asan Medical Center, Seoul, Republic of Korea; Soonchunhyang University College of Medicine, Cheonan, Republic of Korea; St. Vincent's Hospital, The Catholic University of Korea College of Medicine, Suwon, Republic of Korea; Gachon University Gil Medical Center, Incheon, Republic of Korea; Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Republic of Korea; Dong-A University Hospital, Busan, Republic of Korea; Seoul National University Hospital, Seoul, Republic of Korea; Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea; Hanyang University College of Medicine, Seoul, Republic of Korea; Ewha Womans University Mokdong Hospital, Seoul, Republic of Korea; Kangwon National University School of Medicine, Chuncheon, Republic of Korea; Chungnam National University College of Medicine, Daejeon, Republic of Korea; Gangnam Severance Hospital, Yonsei Univer
| | - JH Kim
- Samsung Medical Center, Seoul, Republic of Korea; Chonnam National University Medical School, Gwangju, Republic of Korea; Asan Medical Center, Seoul, Republic of Korea; Soonchunhyang University College of Medicine, Cheonan, Republic of Korea; St. Vincent's Hospital, The Catholic University of Korea College of Medicine, Suwon, Republic of Korea; Gachon University Gil Medical Center, Incheon, Republic of Korea; Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Republic of Korea; Dong-A University Hospital, Busan, Republic of Korea; Seoul National University Hospital, Seoul, Republic of Korea; Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea; Hanyang University College of Medicine, Seoul, Republic of Korea; Ewha Womans University Mokdong Hospital, Seoul, Republic of Korea; Kangwon National University School of Medicine, Chuncheon, Republic of Korea; Chungnam National University College of Medicine, Daejeon, Republic of Korea; Gangnam Severance Hospital, Yonsei Univer
| | - MY Kim
- Samsung Medical Center, Seoul, Republic of Korea; Chonnam National University Medical School, Gwangju, Republic of Korea; Asan Medical Center, Seoul, Republic of Korea; Soonchunhyang University College of Medicine, Cheonan, Republic of Korea; St. Vincent's Hospital, The Catholic University of Korea College of Medicine, Suwon, Republic of Korea; Gachon University Gil Medical Center, Incheon, Republic of Korea; Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Republic of Korea; Dong-A University Hospital, Busan, Republic of Korea; Seoul National University Hospital, Seoul, Republic of Korea; Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea; Hanyang University College of Medicine, Seoul, Republic of Korea; Ewha Womans University Mokdong Hospital, Seoul, Republic of Korea; Kangwon National University School of Medicine, Chuncheon, Republic of Korea; Chungnam National University College of Medicine, Daejeon, Republic of Korea; Gangnam Severance Hospital, Yonsei Univer
| | - HJ Park
- Samsung Medical Center, Seoul, Republic of Korea; Chonnam National University Medical School, Gwangju, Republic of Korea; Asan Medical Center, Seoul, Republic of Korea; Soonchunhyang University College of Medicine, Cheonan, Republic of Korea; St. Vincent's Hospital, The Catholic University of Korea College of Medicine, Suwon, Republic of Korea; Gachon University Gil Medical Center, Incheon, Republic of Korea; Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Republic of Korea; Dong-A University Hospital, Busan, Republic of Korea; Seoul National University Hospital, Seoul, Republic of Korea; Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea; Hanyang University College of Medicine, Seoul, Republic of Korea; Ewha Womans University Mokdong Hospital, Seoul, Republic of Korea; Kangwon National University School of Medicine, Chuncheon, Republic of Korea; Chungnam National University College of Medicine, Daejeon, Republic of Korea; Gangnam Severance Hospital, Yonsei Univer
| | - K Kim
- Samsung Medical Center, Seoul, Republic of Korea; Chonnam National University Medical School, Gwangju, Republic of Korea; Asan Medical Center, Seoul, Republic of Korea; Soonchunhyang University College of Medicine, Cheonan, Republic of Korea; St. Vincent's Hospital, The Catholic University of Korea College of Medicine, Suwon, Republic of Korea; Gachon University Gil Medical Center, Incheon, Republic of Korea; Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Republic of Korea; Dong-A University Hospital, Busan, Republic of Korea; Seoul National University Hospital, Seoul, Republic of Korea; Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea; Hanyang University College of Medicine, Seoul, Republic of Korea; Ewha Womans University Mokdong Hospital, Seoul, Republic of Korea; Kangwon National University School of Medicine, Chuncheon, Republic of Korea; Chungnam National University College of Medicine, Daejeon, Republic of Korea; Gangnam Severance Hospital, Yonsei Univer
| | - SH Song
- Samsung Medical Center, Seoul, Republic of Korea; Chonnam National University Medical School, Gwangju, Republic of Korea; Asan Medical Center, Seoul, Republic of Korea; Soonchunhyang University College of Medicine, Cheonan, Republic of Korea; St. Vincent's Hospital, The Catholic University of Korea College of Medicine, Suwon, Republic of Korea; Gachon University Gil Medical Center, Incheon, Republic of Korea; Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Republic of Korea; Dong-A University Hospital, Busan, Republic of Korea; Seoul National University Hospital, Seoul, Republic of Korea; Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea; Hanyang University College of Medicine, Seoul, Republic of Korea; Ewha Womans University Mokdong Hospital, Seoul, Republic of Korea; Kangwon National University School of Medicine, Chuncheon, Republic of Korea; Chungnam National University College of Medicine, Daejeon, Republic of Korea; Gangnam Severance Hospital, Yonsei Univer
| | - J Kwon
- Samsung Medical Center, Seoul, Republic of Korea; Chonnam National University Medical School, Gwangju, Republic of Korea; Asan Medical Center, Seoul, Republic of Korea; Soonchunhyang University College of Medicine, Cheonan, Republic of Korea; St. Vincent's Hospital, The Catholic University of Korea College of Medicine, Suwon, Republic of Korea; Gachon University Gil Medical Center, Incheon, Republic of Korea; Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Republic of Korea; Dong-A University Hospital, Busan, Republic of Korea; Seoul National University Hospital, Seoul, Republic of Korea; Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea; Hanyang University College of Medicine, Seoul, Republic of Korea; Ewha Womans University Mokdong Hospital, Seoul, Republic of Korea; Kangwon National University School of Medicine, Chuncheon, Republic of Korea; Chungnam National University College of Medicine, Daejeon, Republic of Korea; Gangnam Severance Hospital, Yonsei Univer
| | - IJ Lee
- Samsung Medical Center, Seoul, Republic of Korea; Chonnam National University Medical School, Gwangju, Republic of Korea; Asan Medical Center, Seoul, Republic of Korea; Soonchunhyang University College of Medicine, Cheonan, Republic of Korea; St. Vincent's Hospital, The Catholic University of Korea College of Medicine, Suwon, Republic of Korea; Gachon University Gil Medical Center, Incheon, Republic of Korea; Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Republic of Korea; Dong-A University Hospital, Busan, Republic of Korea; Seoul National University Hospital, Seoul, Republic of Korea; Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea; Hanyang University College of Medicine, Seoul, Republic of Korea; Ewha Womans University Mokdong Hospital, Seoul, Republic of Korea; Kangwon National University School of Medicine, Chuncheon, Republic of Korea; Chungnam National University College of Medicine, Daejeon, Republic of Korea; Gangnam Severance Hospital, Yonsei Univer
| | - TH Kim
- Samsung Medical Center, Seoul, Republic of Korea; Chonnam National University Medical School, Gwangju, Republic of Korea; Asan Medical Center, Seoul, Republic of Korea; Soonchunhyang University College of Medicine, Cheonan, Republic of Korea; St. Vincent's Hospital, The Catholic University of Korea College of Medicine, Suwon, Republic of Korea; Gachon University Gil Medical Center, Incheon, Republic of Korea; Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Republic of Korea; Dong-A University Hospital, Busan, Republic of Korea; Seoul National University Hospital, Seoul, Republic of Korea; Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea; Hanyang University College of Medicine, Seoul, Republic of Korea; Ewha Womans University Mokdong Hospital, Seoul, Republic of Korea; Kangwon National University School of Medicine, Chuncheon, Republic of Korea; Chungnam National University College of Medicine, Daejeon, Republic of Korea; Gangnam Severance Hospital, Yonsei Univer
| | - TG Kim
- Samsung Medical Center, Seoul, Republic of Korea; Chonnam National University Medical School, Gwangju, Republic of Korea; Asan Medical Center, Seoul, Republic of Korea; Soonchunhyang University College of Medicine, Cheonan, Republic of Korea; St. Vincent's Hospital, The Catholic University of Korea College of Medicine, Suwon, Republic of Korea; Gachon University Gil Medical Center, Incheon, Republic of Korea; Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Republic of Korea; Dong-A University Hospital, Busan, Republic of Korea; Seoul National University Hospital, Seoul, Republic of Korea; Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea; Hanyang University College of Medicine, Seoul, Republic of Korea; Ewha Womans University Mokdong Hospital, Seoul, Republic of Korea; Kangwon National University School of Medicine, Chuncheon, Republic of Korea; Chungnam National University College of Medicine, Daejeon, Republic of Korea; Gangnam Severance Hospital, Yonsei Univer
| | - AR Chang
- Samsung Medical Center, Seoul, Republic of Korea; Chonnam National University Medical School, Gwangju, Republic of Korea; Asan Medical Center, Seoul, Republic of Korea; Soonchunhyang University College of Medicine, Cheonan, Republic of Korea; St. Vincent's Hospital, The Catholic University of Korea College of Medicine, Suwon, Republic of Korea; Gachon University Gil Medical Center, Incheon, Republic of Korea; Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Republic of Korea; Dong-A University Hospital, Busan, Republic of Korea; Seoul National University Hospital, Seoul, Republic of Korea; Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea; Hanyang University College of Medicine, Seoul, Republic of Korea; Ewha Womans University Mokdong Hospital, Seoul, Republic of Korea; Kangwon National University School of Medicine, Chuncheon, Republic of Korea; Chungnam National University College of Medicine, Daejeon, Republic of Korea; Gangnam Severance Hospital, Yonsei Univer
| | - O Cho
- Samsung Medical Center, Seoul, Republic of Korea; Chonnam National University Medical School, Gwangju, Republic of Korea; Asan Medical Center, Seoul, Republic of Korea; Soonchunhyang University College of Medicine, Cheonan, Republic of Korea; St. Vincent's Hospital, The Catholic University of Korea College of Medicine, Suwon, Republic of Korea; Gachon University Gil Medical Center, Incheon, Republic of Korea; Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Republic of Korea; Dong-A University Hospital, Busan, Republic of Korea; Seoul National University Hospital, Seoul, Republic of Korea; Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea; Hanyang University College of Medicine, Seoul, Republic of Korea; Ewha Womans University Mokdong Hospital, Seoul, Republic of Korea; Kangwon National University School of Medicine, Chuncheon, Republic of Korea; Chungnam National University College of Medicine, Daejeon, Republic of Korea; Gangnam Severance Hospital, Yonsei Univer
| | - BK Jeong
- Samsung Medical Center, Seoul, Republic of Korea; Chonnam National University Medical School, Gwangju, Republic of Korea; Asan Medical Center, Seoul, Republic of Korea; Soonchunhyang University College of Medicine, Cheonan, Republic of Korea; St. Vincent's Hospital, The Catholic University of Korea College of Medicine, Suwon, Republic of Korea; Gachon University Gil Medical Center, Incheon, Republic of Korea; Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Republic of Korea; Dong-A University Hospital, Busan, Republic of Korea; Seoul National University Hospital, Seoul, Republic of Korea; Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea; Hanyang University College of Medicine, Seoul, Republic of Korea; Ewha Womans University Mokdong Hospital, Seoul, Republic of Korea; Kangwon National University School of Medicine, Chuncheon, Republic of Korea; Chungnam National University College of Medicine, Daejeon, Republic of Korea; Gangnam Severance Hospital, Yonsei Univer
| | - B Ha
- Samsung Medical Center, Seoul, Republic of Korea; Chonnam National University Medical School, Gwangju, Republic of Korea; Asan Medical Center, Seoul, Republic of Korea; Soonchunhyang University College of Medicine, Cheonan, Republic of Korea; St. Vincent's Hospital, The Catholic University of Korea College of Medicine, Suwon, Republic of Korea; Gachon University Gil Medical Center, Incheon, Republic of Korea; Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Republic of Korea; Dong-A University Hospital, Busan, Republic of Korea; Seoul National University Hospital, Seoul, Republic of Korea; Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea; Hanyang University College of Medicine, Seoul, Republic of Korea; Ewha Womans University Mokdong Hospital, Seoul, Republic of Korea; Kangwon National University School of Medicine, Chuncheon, Republic of Korea; Chungnam National University College of Medicine, Daejeon, Republic of Korea; Gangnam Severance Hospital, Yonsei Univer
| | - J Lee
- Samsung Medical Center, Seoul, Republic of Korea; Chonnam National University Medical School, Gwangju, Republic of Korea; Asan Medical Center, Seoul, Republic of Korea; Soonchunhyang University College of Medicine, Cheonan, Republic of Korea; St. Vincent's Hospital, The Catholic University of Korea College of Medicine, Suwon, Republic of Korea; Gachon University Gil Medical Center, Incheon, Republic of Korea; Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Republic of Korea; Dong-A University Hospital, Busan, Republic of Korea; Seoul National University Hospital, Seoul, Republic of Korea; Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea; Hanyang University College of Medicine, Seoul, Republic of Korea; Ewha Womans University Mokdong Hospital, Seoul, Republic of Korea; Kangwon National University School of Medicine, Chuncheon, Republic of Korea; Chungnam National University College of Medicine, Daejeon, Republic of Korea; Gangnam Severance Hospital, Yonsei Univer
| | - Y Ki
- Samsung Medical Center, Seoul, Republic of Korea; Chonnam National University Medical School, Gwangju, Republic of Korea; Asan Medical Center, Seoul, Republic of Korea; Soonchunhyang University College of Medicine, Cheonan, Republic of Korea; St. Vincent's Hospital, The Catholic University of Korea College of Medicine, Suwon, Republic of Korea; Gachon University Gil Medical Center, Incheon, Republic of Korea; Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Republic of Korea; Dong-A University Hospital, Busan, Republic of Korea; Seoul National University Hospital, Seoul, Republic of Korea; Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea; Hanyang University College of Medicine, Seoul, Republic of Korea; Ewha Womans University Mokdong Hospital, Seoul, Republic of Korea; Kangwon National University School of Medicine, Chuncheon, Republic of Korea; Chungnam National University College of Medicine, Daejeon, Republic of Korea; Gangnam Severance Hospital, Yonsei Univer
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Kim K, Jeong Y, Shin KH, Kim JH, Ahn SD, Kim SS, Suh CO, Kim YB, Choi DH, Park W, Cha J, Chun M, Lee DS, Lee SY, Kim JH, Park HJ. Abstract P3-12-12: Impact of regional nodal irradiation for breast cancer patients with supraclavicular and/or internal mammary lymph node involvement: A multicenter, retrospective study (KROG 16-14). Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p3-12-12] [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
Purpose: To evaluate the treatment outcomes of radiotherapy (RT) for breast cancer with ipsilateral supraclavicular (SCL) and/or internal mammary (IMN) lymph node involvement.
Methods: A total of 353 patients from 11 institutions were included. One hundred and thirty-six patients had SCL involvement, 148 had IMN involvement, and 69 had both. All patients received neoadjvant systemic therapy followed by breast conserving surgery or mastectomy, and postoperative RT to whole breast/chest wall. As for regional lymph node irradiation, SCL RT was given to 344 patients, and IMN RT to 236 patients. The median RT dose was 50.4 Gy.
Results: The median follow-up duration was 61 months (range, 7-173). In-field progression was present in SCL (n=20) and/or IMN (n=7). The 5-year disease-free survival (DFS) and overall survival rates were 57.8% and 75.1%, respectively. On multivariate analysis, both SCL/IMN involvement, number of axillary lymph node ≥4, triple negative subtype, and mastectomy were significant adverse prognosticators for DFS (p = 0.022, 0.001, 0.001, and 0.004, respectively). Regarding the impact of regional nodal irradiation, SCL RT dose ≥54 Gy was not associated with DFS (5-yr rate, 52.9% vs. 50.9%, p = 0.696) in SCL-involved patients, and the receipt of IMN RT was not associated with DFS (5-yr rate, 56.1% vs. 78.1%, p = 0.099) in IMN-involved patients.
Conclusion: Neoadjuvant chemotherapy followed by surgery and postoperative RT achieved an acceptable in-field regional control rate in patients with SCL and/or IMN involvement. However, a higher RT dose to SCL or IMN RT was not associated with the improved DFS in these patients.
Citation Format: Kim K, Jeong Y, Shin KH, Kim JH, Ahn SD, Kim SS, Suh C-O, Kim YB, Choi DH, Park W, Cha J, Chun M, Lee DS, Lee SY, Kim JH, Park HJ. Impact of regional nodal irradiation for breast cancer patients with supraclavicular and/or internal mammary lymph node involvement: A multicenter, retrospective study (KROG 16-14) [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 P3-12-12.
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Affiliation(s)
- K Kim
- Ewha Womans University College of Medicine, Seoul, Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Seoul National University College of Medicine, Seoul, Korea; Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Wonju Severance Christian Hospital, Wonju, Korea; Ajou University School of Medicine, Suwon, Korea; Uijeongbu St. Mary's Hospital, The Catholic University of Korea, Uijeongbu, Korea; Chonbuk National University Hospital, Jeonju, Korea; Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea; Hanyang University College of Medicine, Seoul, Korea
| | - Y Jeong
- Ewha Womans University College of Medicine, Seoul, Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Seoul National University College of Medicine, Seoul, Korea; Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Wonju Severance Christian Hospital, Wonju, Korea; Ajou University School of Medicine, Suwon, Korea; Uijeongbu St. Mary's Hospital, The Catholic University of Korea, Uijeongbu, Korea; Chonbuk National University Hospital, Jeonju, Korea; Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea; Hanyang University College of Medicine, Seoul, Korea
| | - KH Shin
- Ewha Womans University College of Medicine, Seoul, Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Seoul National University College of Medicine, Seoul, Korea; Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Wonju Severance Christian Hospital, Wonju, Korea; Ajou University School of Medicine, Suwon, Korea; Uijeongbu St. Mary's Hospital, The Catholic University of Korea, Uijeongbu, Korea; Chonbuk National University Hospital, Jeonju, Korea; Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea; Hanyang University College of Medicine, Seoul, Korea
| | - JH Kim
- Ewha Womans University College of Medicine, Seoul, Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Seoul National University College of Medicine, Seoul, Korea; Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Wonju Severance Christian Hospital, Wonju, Korea; Ajou University School of Medicine, Suwon, Korea; Uijeongbu St. Mary's Hospital, The Catholic University of Korea, Uijeongbu, Korea; Chonbuk National University Hospital, Jeonju, Korea; Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea; Hanyang University College of Medicine, Seoul, Korea
| | - SD Ahn
- Ewha Womans University College of Medicine, Seoul, Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Seoul National University College of Medicine, Seoul, Korea; Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Wonju Severance Christian Hospital, Wonju, Korea; Ajou University School of Medicine, Suwon, Korea; Uijeongbu St. Mary's Hospital, The Catholic University of Korea, Uijeongbu, Korea; Chonbuk National University Hospital, Jeonju, Korea; Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea; Hanyang University College of Medicine, Seoul, Korea
| | - SS Kim
- Ewha Womans University College of Medicine, Seoul, Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Seoul National University College of Medicine, Seoul, Korea; Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Wonju Severance Christian Hospital, Wonju, Korea; Ajou University School of Medicine, Suwon, Korea; Uijeongbu St. Mary's Hospital, The Catholic University of Korea, Uijeongbu, Korea; Chonbuk National University Hospital, Jeonju, Korea; Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea; Hanyang University College of Medicine, Seoul, Korea
| | - C-O Suh
- Ewha Womans University College of Medicine, Seoul, Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Seoul National University College of Medicine, Seoul, Korea; Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Wonju Severance Christian Hospital, Wonju, Korea; Ajou University School of Medicine, Suwon, Korea; Uijeongbu St. Mary's Hospital, The Catholic University of Korea, Uijeongbu, Korea; Chonbuk National University Hospital, Jeonju, Korea; Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea; Hanyang University College of Medicine, Seoul, Korea
| | - YB Kim
- Ewha Womans University College of Medicine, Seoul, Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Seoul National University College of Medicine, Seoul, Korea; Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Wonju Severance Christian Hospital, Wonju, Korea; Ajou University School of Medicine, Suwon, Korea; Uijeongbu St. Mary's Hospital, The Catholic University of Korea, Uijeongbu, Korea; Chonbuk National University Hospital, Jeonju, Korea; Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea; Hanyang University College of Medicine, Seoul, Korea
| | - DH Choi
- Ewha Womans University College of Medicine, Seoul, Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Seoul National University College of Medicine, Seoul, Korea; Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Wonju Severance Christian Hospital, Wonju, Korea; Ajou University School of Medicine, Suwon, Korea; Uijeongbu St. Mary's Hospital, The Catholic University of Korea, Uijeongbu, Korea; Chonbuk National University Hospital, Jeonju, Korea; Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea; Hanyang University College of Medicine, Seoul, Korea
| | - W Park
- Ewha Womans University College of Medicine, Seoul, Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Seoul National University College of Medicine, Seoul, Korea; Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Wonju Severance Christian Hospital, Wonju, Korea; Ajou University School of Medicine, Suwon, Korea; Uijeongbu St. Mary's Hospital, The Catholic University of Korea, Uijeongbu, Korea; Chonbuk National University Hospital, Jeonju, Korea; Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea; Hanyang University College of Medicine, Seoul, Korea
| | - J Cha
- Ewha Womans University College of Medicine, Seoul, Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Seoul National University College of Medicine, Seoul, Korea; Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Wonju Severance Christian Hospital, Wonju, Korea; Ajou University School of Medicine, Suwon, Korea; Uijeongbu St. Mary's Hospital, The Catholic University of Korea, Uijeongbu, Korea; Chonbuk National University Hospital, Jeonju, Korea; Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea; Hanyang University College of Medicine, Seoul, Korea
| | - M Chun
- Ewha Womans University College of Medicine, Seoul, Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Seoul National University College of Medicine, Seoul, Korea; Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Wonju Severance Christian Hospital, Wonju, Korea; Ajou University School of Medicine, Suwon, Korea; Uijeongbu St. Mary's Hospital, The Catholic University of Korea, Uijeongbu, Korea; Chonbuk National University Hospital, Jeonju, Korea; Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea; Hanyang University College of Medicine, Seoul, Korea
| | - DS Lee
- Ewha Womans University College of Medicine, Seoul, Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Seoul National University College of Medicine, Seoul, Korea; Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Wonju Severance Christian Hospital, Wonju, Korea; Ajou University School of Medicine, Suwon, Korea; Uijeongbu St. Mary's Hospital, The Catholic University of Korea, Uijeongbu, Korea; Chonbuk National University Hospital, Jeonju, Korea; Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea; Hanyang University College of Medicine, Seoul, Korea
| | - SY Lee
- Ewha Womans University College of Medicine, Seoul, Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Seoul National University College of Medicine, Seoul, Korea; Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Wonju Severance Christian Hospital, Wonju, Korea; Ajou University School of Medicine, Suwon, Korea; Uijeongbu St. Mary's Hospital, The Catholic University of Korea, Uijeongbu, Korea; Chonbuk National University Hospital, Jeonju, Korea; Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea; Hanyang University College of Medicine, Seoul, Korea
| | - JH Kim
- Ewha Womans University College of Medicine, Seoul, Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Seoul National University College of Medicine, Seoul, Korea; Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Wonju Severance Christian Hospital, Wonju, Korea; Ajou University School of Medicine, Suwon, Korea; Uijeongbu St. Mary's Hospital, The Catholic University of Korea, Uijeongbu, Korea; Chonbuk National University Hospital, Jeonju, Korea; Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea; Hanyang University College of Medicine, Seoul, Korea
| | - HJ Park
- Ewha Womans University College of Medicine, Seoul, Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Seoul National University College of Medicine, Seoul, Korea; Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Wonju Severance Christian Hospital, Wonju, Korea; Ajou University School of Medicine, Suwon, Korea; Uijeongbu St. Mary's Hospital, The Catholic University of Korea, Uijeongbu, Korea; Chonbuk National University Hospital, Jeonju, Korea; Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea; Hanyang University College of Medicine, Seoul, Korea
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11
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Abstract
This study compared the frequency of abnormal electrocardiogram (ECG) types between scrub typhus patient group and age- and gender-matched health checkup group and their associations with disease severity in scrub typhus patient. Demographic characteristics and ECG and laboratory findings of patients with scrub typhus admitted to Chosun University Hospital, and normal subjects visiting the hospital for health checkup from January 2008 to December 2012 were retrospectively studied. Electrocardiogram abnormalities at admission were observed in 72 of 165 (43.6%) scrub typhus confirmed patients. The following ECG abnormalities were observed: arrhythmic group (31 cases, 18.8%), ischemic change group (25 cases, 15.1%), prolonged QT group (32 cases, 19.4%).Compared with the age and gender-matched health checkup group, ECG abnormalities were more commonly observed in scrub typhus patient group (13.9% versus 43.6%, P < 0.001). In addition, when compared with the normal ECG group, scrub typhus in the abnormal ECG group showed greater disease severity and this phenomenon was particularly prominent in the prolonged QT group. Based on our study prolonged QT observed in approximately 20% of patients with scrub typhus, clinicians should pay additional attention to drugs that affect QT interval.
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Affiliation(s)
- Seo-Won Choi
- Department of Internal Medicine, School of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Na Ra Yun
- Department of Internal Medicine, School of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Dong-Hyun Choi
- Department of Internal Medicine, School of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Young-Jae Ki
- Department of Internal Medicine, School of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Seok Won Kim
- Department of Neurosurgery, School of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Choon-Mee Kim
- The Division of Natural Medical Sciences, College of Health Science, Chosun University, Gwangju, Republic of Korea
| | - Dong-Min Kim
- Department of Internal Medicine, School of Medicine, Chosun University, Gwangju, Republic of Korea
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12
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Kim MS, Choi DH, Kwon H, Ahn E, Cho HY, Baek MJ, Shin JE, Moon MJ. Procedural and obstetric outcomes after embryo reduction vs fetal reduction in multifetal pregnancy. Ultrasound Obstet Gynecol 2019; 53:214-218. [PMID: 29418029 DOI: 10.1002/uog.19024] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Revised: 01/28/2018] [Accepted: 02/02/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE To compare the obstetric outcome and incidence of procedure-related adverse events after embryo reduction (ER) vs fetal reduction (FR), in multifetal pregnancies undergoing reduction to twins or singletons. METHODS We analyzed retrospectively data from multifetal pregnancies that underwent transvaginal ER (n = 181) at a mean gestational age of 7.6 weeks or transabdominal FR (n = 115) at a mean gestational age of 12.9 weeks between December 2006 and January 2017. FR was performed after a detailed fetal anomaly scan. The two groups were compared with respect to obstetric outcomes, such as incidence of miscarriage, early or late preterm delivery, maternal complications and fetal loss, and procedure-related adverse events, including incidence of subchorionic hematoma and procedure-related fetal loss. RESULTS Compared with pregnancies that underwent ER, the incidence of procedure-related fetal loss was lower in the FR group (7.2% vs 0.9%; P = 0.039; odds ratio (OR), 0.12; 95% CI, 0.02-0.89). Mean gestational age at delivery for twins was 34.2 weeks in the ER group and 35.7 weeks in the FR group (P = 0.014). Compared with the ER group, the FR group had lower miscarriage (8.8% vs 2.6%; P = 0.045; OR, 0.28; 95% CI, 0.08-0.97) and overall fetal loss (13.3% vs 5.2%; P = 0.031; OR, 0.36; 95% CI, 0.14-0.91) rates. CONCLUSIONS The FR procedure is, overall, a better and safer approach to reducing morbidity and mortality in multifetal pregnancies. Spontaneous demise of one fetus may occur after ER, and FR has the advantage that chorionic villus sampling and ultrasound screening for increased nuchal translucency and anatomical defects can be conducted before the procedure. The ER approach is still reasonable when a patient's religious or other ethical concerns are of primary importance. Copyright © 2018 ISUOG. Published by John Wiley & Sons Ltd.
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Affiliation(s)
- M S Kim
- Department of Obstetrics and Gynecology, CHA Bundang Medical Center, Seongnam, Republic of Korea
| | - D H Choi
- Fertility Center of CHA Bundang Medical Center, Seongnam, Republic of Korea
| | - H Kwon
- Fertility Center of CHA Bundang Medical Center, Seongnam, Republic of Korea
| | - E Ahn
- Department of Obstetrics and Gynecology, CHA Bundang Medical Center, Seongnam, Republic of Korea
| | - H Y Cho
- Department of Obstetrics and Gynecology, CHA Bundang Medical Center, Seongnam, Republic of Korea
| | - M J Baek
- Department of Obstetrics and Gynecology, CHA Bundang Medical Center, Seongnam, Republic of Korea
| | - J E Shin
- Fertility Center of CHA Bundang Medical Center, Seongnam, Republic of Korea
| | - M J Moon
- Department of Obstetrics and Gynecology, CHA Bundang Medical Center, Seongnam, Republic of Korea
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13
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Seo JW, Park SH, Lee CJ, Choi DH. 422Comparison of the prognostic significance of blood pressure measurement by unattended automatic office blood pressure and ambulatory blood pressure in subjects with chronic kidney disease. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy564.422] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 11/13/2022] Open
Affiliation(s)
- J W Seo
- Yonsei Cardiovascular Center, Seoul, Korea Republic of
| | - S H Park
- Yonsei Cardiovascular Center, Seoul, Korea Republic of
| | - C J Lee
- Yonsei Cardiovascular Center, Seoul, Korea Republic of
| | - D H Choi
- Yonsei Cardiovascular Center, Seoul, Korea Republic of
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14
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Nishi T, Johnson NP, De Bruyne B, Berry C, Gould KL, Jeremias A, Oldroyd KG, Kobayashi Y, Choi DH, Pijls NHJ, Fearon WF. Influence of Contrast Media Dose and Osmolality on the Diagnostic Performance of Contrast Fractional Flow Reserve. Circ Cardiovasc Interv 2018; 10:CIRCINTERVENTIONS.117.004985. [PMID: 29042397 DOI: 10.1161/circinterventions.117.004985] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Accepted: 08/15/2017] [Indexed: 01/10/2023]
Abstract
BACKGROUND Contrast fractional flow reserve (cFFR) is a method for assessing functional significance of coronary stenoses, which is more accurate than resting indices and does not require adenosine. However, contrast media volume and osmolality may affect the degree of hyperemia and therefore diagnostic performance. METHODS AND RESULTS cFFR, instantaneous wave-free ratio, distal pressure/aortic pressure at rest, and FFR were measured in 763 patients from 12 centers. We compared the diagnostic performance of cFFR between patients receiving low or iso-osmolality contrast (n=574 versus 189) and low or high contrast volume (n=341 versus 422) using FFR≤0.80 as a reference standard. The sensitivity, specificity, and overall accuracy of cFFR for the low versus iso-osmolality groups were 73%, 93%, and 85% versus 87%, 90%, and 89%, and for the low versus high contrast volume groups were 69%, 99%, and 83% versus 82%, 93%, and 88%. By receiver operating characteristics (ROC) analysis, cFFR provided better diagnostic performance than resting indices regardless of contrast osmolality and volume (P<0.001 for all groups). There was no significant difference between the area under the curve of cFFR in the low- and iso-osmolality groups (0.938 versus 0.957; P=0.40) and in the low- and high-volume groups (0.939 versus 0.949; P=0.61). Multivariable logistic regression analysis showed that neither contrast osmolality nor volume affected the overall accuracy of cFFR; however, both affected the sensitivity and specificity. CONCLUSIONS The overall accuracy of cFFR is greater than instantaneous wave-free ratio and distal pressure/aortic pressure and not significantly affected by contrast volume and osmolality. However, contrast volume and osmolality do affect the sensitivity and specificity of cFFR. CLINICAL TRIAL REGISTRATION URL: https://www.clinicaltrials.gov. Unique identifier: NCT02184117.
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Affiliation(s)
- Takeshi Nishi
- From the Stanford University Medical Center, CA (T.N., Y.K., D.-H.C., W.F.F.); Stanford Cardiovascular Institute, CA (T.N., Y.K., D.-H.C., W.F.F.); University of Texas Medical School and Memorial Hermann Hospital, Houston (N.P.J., K.L.G.); Cardiovascular Center Aalst, Belgium (B.D.B.); West of Scotland Heart and Lung Center, Golden Jubilee National Hospital, Clydebank, Scotland (C.B., K.G.O.); British Heart Foundation Glasgow Cardiovascular Research Center, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Scotland (C.B.); Division of Cardiovascular Medicine, Stony Brook University Medical Center, NY (A.J.); Cardiovascular Research Foundation (CFR), New York, NY (A.J.); Catharina Hospital, Eindhoven, the Netherlands (N.H.J.P.); and Eindhoven University of Technology, the Netherlands (N.H.J.P.)
| | - Nils P Johnson
- From the Stanford University Medical Center, CA (T.N., Y.K., D.-H.C., W.F.F.); Stanford Cardiovascular Institute, CA (T.N., Y.K., D.-H.C., W.F.F.); University of Texas Medical School and Memorial Hermann Hospital, Houston (N.P.J., K.L.G.); Cardiovascular Center Aalst, Belgium (B.D.B.); West of Scotland Heart and Lung Center, Golden Jubilee National Hospital, Clydebank, Scotland (C.B., K.G.O.); British Heart Foundation Glasgow Cardiovascular Research Center, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Scotland (C.B.); Division of Cardiovascular Medicine, Stony Brook University Medical Center, NY (A.J.); Cardiovascular Research Foundation (CFR), New York, NY (A.J.); Catharina Hospital, Eindhoven, the Netherlands (N.H.J.P.); and Eindhoven University of Technology, the Netherlands (N.H.J.P.)
| | - Bernard De Bruyne
- From the Stanford University Medical Center, CA (T.N., Y.K., D.-H.C., W.F.F.); Stanford Cardiovascular Institute, CA (T.N., Y.K., D.-H.C., W.F.F.); University of Texas Medical School and Memorial Hermann Hospital, Houston (N.P.J., K.L.G.); Cardiovascular Center Aalst, Belgium (B.D.B.); West of Scotland Heart and Lung Center, Golden Jubilee National Hospital, Clydebank, Scotland (C.B., K.G.O.); British Heart Foundation Glasgow Cardiovascular Research Center, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Scotland (C.B.); Division of Cardiovascular Medicine, Stony Brook University Medical Center, NY (A.J.); Cardiovascular Research Foundation (CFR), New York, NY (A.J.); Catharina Hospital, Eindhoven, the Netherlands (N.H.J.P.); and Eindhoven University of Technology, the Netherlands (N.H.J.P.)
| | - Colin Berry
- From the Stanford University Medical Center, CA (T.N., Y.K., D.-H.C., W.F.F.); Stanford Cardiovascular Institute, CA (T.N., Y.K., D.-H.C., W.F.F.); University of Texas Medical School and Memorial Hermann Hospital, Houston (N.P.J., K.L.G.); Cardiovascular Center Aalst, Belgium (B.D.B.); West of Scotland Heart and Lung Center, Golden Jubilee National Hospital, Clydebank, Scotland (C.B., K.G.O.); British Heart Foundation Glasgow Cardiovascular Research Center, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Scotland (C.B.); Division of Cardiovascular Medicine, Stony Brook University Medical Center, NY (A.J.); Cardiovascular Research Foundation (CFR), New York, NY (A.J.); Catharina Hospital, Eindhoven, the Netherlands (N.H.J.P.); and Eindhoven University of Technology, the Netherlands (N.H.J.P.)
| | - K Lance Gould
- From the Stanford University Medical Center, CA (T.N., Y.K., D.-H.C., W.F.F.); Stanford Cardiovascular Institute, CA (T.N., Y.K., D.-H.C., W.F.F.); University of Texas Medical School and Memorial Hermann Hospital, Houston (N.P.J., K.L.G.); Cardiovascular Center Aalst, Belgium (B.D.B.); West of Scotland Heart and Lung Center, Golden Jubilee National Hospital, Clydebank, Scotland (C.B., K.G.O.); British Heart Foundation Glasgow Cardiovascular Research Center, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Scotland (C.B.); Division of Cardiovascular Medicine, Stony Brook University Medical Center, NY (A.J.); Cardiovascular Research Foundation (CFR), New York, NY (A.J.); Catharina Hospital, Eindhoven, the Netherlands (N.H.J.P.); and Eindhoven University of Technology, the Netherlands (N.H.J.P.)
| | - Allen Jeremias
- From the Stanford University Medical Center, CA (T.N., Y.K., D.-H.C., W.F.F.); Stanford Cardiovascular Institute, CA (T.N., Y.K., D.-H.C., W.F.F.); University of Texas Medical School and Memorial Hermann Hospital, Houston (N.P.J., K.L.G.); Cardiovascular Center Aalst, Belgium (B.D.B.); West of Scotland Heart and Lung Center, Golden Jubilee National Hospital, Clydebank, Scotland (C.B., K.G.O.); British Heart Foundation Glasgow Cardiovascular Research Center, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Scotland (C.B.); Division of Cardiovascular Medicine, Stony Brook University Medical Center, NY (A.J.); Cardiovascular Research Foundation (CFR), New York, NY (A.J.); Catharina Hospital, Eindhoven, the Netherlands (N.H.J.P.); and Eindhoven University of Technology, the Netherlands (N.H.J.P.)
| | - Keith G Oldroyd
- From the Stanford University Medical Center, CA (T.N., Y.K., D.-H.C., W.F.F.); Stanford Cardiovascular Institute, CA (T.N., Y.K., D.-H.C., W.F.F.); University of Texas Medical School and Memorial Hermann Hospital, Houston (N.P.J., K.L.G.); Cardiovascular Center Aalst, Belgium (B.D.B.); West of Scotland Heart and Lung Center, Golden Jubilee National Hospital, Clydebank, Scotland (C.B., K.G.O.); British Heart Foundation Glasgow Cardiovascular Research Center, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Scotland (C.B.); Division of Cardiovascular Medicine, Stony Brook University Medical Center, NY (A.J.); Cardiovascular Research Foundation (CFR), New York, NY (A.J.); Catharina Hospital, Eindhoven, the Netherlands (N.H.J.P.); and Eindhoven University of Technology, the Netherlands (N.H.J.P.)
| | - Yuhei Kobayashi
- From the Stanford University Medical Center, CA (T.N., Y.K., D.-H.C., W.F.F.); Stanford Cardiovascular Institute, CA (T.N., Y.K., D.-H.C., W.F.F.); University of Texas Medical School and Memorial Hermann Hospital, Houston (N.P.J., K.L.G.); Cardiovascular Center Aalst, Belgium (B.D.B.); West of Scotland Heart and Lung Center, Golden Jubilee National Hospital, Clydebank, Scotland (C.B., K.G.O.); British Heart Foundation Glasgow Cardiovascular Research Center, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Scotland (C.B.); Division of Cardiovascular Medicine, Stony Brook University Medical Center, NY (A.J.); Cardiovascular Research Foundation (CFR), New York, NY (A.J.); Catharina Hospital, Eindhoven, the Netherlands (N.H.J.P.); and Eindhoven University of Technology, the Netherlands (N.H.J.P.)
| | - Dong-Hyun Choi
- From the Stanford University Medical Center, CA (T.N., Y.K., D.-H.C., W.F.F.); Stanford Cardiovascular Institute, CA (T.N., Y.K., D.-H.C., W.F.F.); University of Texas Medical School and Memorial Hermann Hospital, Houston (N.P.J., K.L.G.); Cardiovascular Center Aalst, Belgium (B.D.B.); West of Scotland Heart and Lung Center, Golden Jubilee National Hospital, Clydebank, Scotland (C.B., K.G.O.); British Heart Foundation Glasgow Cardiovascular Research Center, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Scotland (C.B.); Division of Cardiovascular Medicine, Stony Brook University Medical Center, NY (A.J.); Cardiovascular Research Foundation (CFR), New York, NY (A.J.); Catharina Hospital, Eindhoven, the Netherlands (N.H.J.P.); and Eindhoven University of Technology, the Netherlands (N.H.J.P.)
| | - Nico H J Pijls
- From the Stanford University Medical Center, CA (T.N., Y.K., D.-H.C., W.F.F.); Stanford Cardiovascular Institute, CA (T.N., Y.K., D.-H.C., W.F.F.); University of Texas Medical School and Memorial Hermann Hospital, Houston (N.P.J., K.L.G.); Cardiovascular Center Aalst, Belgium (B.D.B.); West of Scotland Heart and Lung Center, Golden Jubilee National Hospital, Clydebank, Scotland (C.B., K.G.O.); British Heart Foundation Glasgow Cardiovascular Research Center, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Scotland (C.B.); Division of Cardiovascular Medicine, Stony Brook University Medical Center, NY (A.J.); Cardiovascular Research Foundation (CFR), New York, NY (A.J.); Catharina Hospital, Eindhoven, the Netherlands (N.H.J.P.); and Eindhoven University of Technology, the Netherlands (N.H.J.P.)
| | - William F Fearon
- From the Stanford University Medical Center, CA (T.N., Y.K., D.-H.C., W.F.F.); Stanford Cardiovascular Institute, CA (T.N., Y.K., D.-H.C., W.F.F.); University of Texas Medical School and Memorial Hermann Hospital, Houston (N.P.J., K.L.G.); Cardiovascular Center Aalst, Belgium (B.D.B.); West of Scotland Heart and Lung Center, Golden Jubilee National Hospital, Clydebank, Scotland (C.B., K.G.O.); British Heart Foundation Glasgow Cardiovascular Research Center, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Scotland (C.B.); Division of Cardiovascular Medicine, Stony Brook University Medical Center, NY (A.J.); Cardiovascular Research Foundation (CFR), New York, NY (A.J.); Catharina Hospital, Eindhoven, the Netherlands (N.H.J.P.); and Eindhoven University of Technology, the Netherlands (N.H.J.P.).
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15
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Choi DH, Kobayashi Y, Nishi T, Kim HK, Ki YJ, Kim SS, Park KH, Song H, Fearon WF. Combination of Mean Platelet Volume and Neutrophil to Lymphocyte Ratio Predicts Long-Term Major Adverse Cardiovascular Events After Percutaneous Coronary Intervention. Angiology 2018; 70:345-351. [DOI: 10.1177/0003319718768658] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
We hypothesized that the combination of a high neutrophil to lymphocyte ratio (NLR) and mean platelet volume (MPV) would be a stronger predictor of future cardiovascular events after percutaneous coronary intervention (PCI). Both NLR and MPV were measured in 364 consecutive patients undergoing PCI. The primary end point was the incidence of major adverse cardiovascular events (MACEs), including cardiac death, nonfatal myocardial infarction, and stent thrombosis. The median values of NLR and MPV were 2.8 and 8.2 fL, respectively. There were 26 MACEs during a median follow-up duration of 29.3 months. Kaplan-Meier analysis revealed that the higher NLR group had a significantly higher MACE rate than the lower NLR group and that the higher MPV group had a significantly higher MACE rate than the lower MPV group (log-rank: P = .0064 and P = .0004, respectively). The cumulative MACE-free survival can be further stratified by the combination of NLR and MPV. This value was especially useful in patients with acute coronary syndrome (ACS). By multivariate Cox proportional hazards model, the combination of high NLR and high MPV was independently associated with MACE ( P = .026). The combination of a high NLR and high MPV is an independent predictor of MACE after PCI, especially in patients with ACS.
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Affiliation(s)
- Dong-Hyun Choi
- Department of Internal Medicine, Chosun University School of Medicine, Gwangju, Republic of Korea
| | - Yuhei Kobayashi
- Division of Cardiovascular Medicine, Stanford University Medical Center, Stanford, CA, USA
| | - Takeshi Nishi
- Division of Cardiovascular Medicine, Stanford University Medical Center, Stanford, CA, USA
| | - Hyun Kuk Kim
- Department of Internal Medicine, Chosun University School of Medicine, Gwangju, Republic of Korea
| | - Young-Jae Ki
- Department of Internal Medicine, Chosun University School of Medicine, Gwangju, Republic of Korea
| | - Sung Soo Kim
- Department of Internal Medicine, Chosun University School of Medicine, Gwangju, Republic of Korea
| | - Keun-Ho Park
- Department of Internal Medicine, Chosun University School of Medicine, Gwangju, Republic of Korea
| | - Heesang Song
- Department of Biochemistry and Molecular Biology, Chosun University School of Medicine, Gwangju, Republic of Korea
| | - William F. Fearon
- Division of Cardiovascular Medicine, Stanford University Medical Center, Stanford, CA, USA
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Mittal K, Choi DH, Maganti N, Ogden A, Melton BD, Kaur J, Gupta MV, Jonsdottir K, Janseen EAM, Aleskandarany MA, Rakha EA, Rida PCG, Aneja R. Abstract P1-01-23: Hypoxia induced centrosome amplification via HIF-1α/Plk4 signaling axis associates with poorer overall survival in TNBC. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p1-01-23] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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
Background: Centrosome amplification (CA) which refers to presence of supernumerary or abnormally large centrosomes drives tumor progression by promoting chromosomal instability and the generation of aggressive tumor clones. Although the role of CA in cancer progression is well-defined, no studies have yet discussed how CA is induced in tumor cells. We report here that intra-tumoral hypoxia, which is considered one of the major contributors to intratumor heterogeneity, induces CA via HIF-1α.
Methods: We first immunohistochemically labeled 24 breast carcinoma and uninvolved adjacent normal tissue samples for HIF-1α and calculated weighted indices (WIs) for nuclear HIF-1α. Adjacent serial sections from the same tumors were also immunofluorescently labeled for γ-tubulin and CA was calculated. Using public microarray datasets (Kao dataset, n=327), we investigated whether centrosomal gene expression is enriched in breast tumors characterized by a hypoxia gene expression signature. Finally, to determine the role of hypoxia in CA induction we exposed cultured TNBC cells (MDA-MB-231 and MDA-MB-468) to hypoxia and overexpressed (OE) and knocked out (KO) HIF-1α in TNBC cells and quantitated CA. Additionally, to discern the biological pathway through which HIF-1α induces CA we performed ChIP assay and in silico analyses to identify the possible targets of HIF-1α.
Results: A strong positive correlation between nuclear HIF-1α WI and CA was found in breast tumor samples (Spearman's rho p=0.722, p<0.001). In addition, we found that higher nuclear HIF-1α was associated with worse overall survival (p=0.041; HR=1.03). Our in silico findings suggest that breast tumors with high expression of hypoxia-associated genes exhibited higher expression of centrosomal genes than breast tumors with low expression of hypoxia-associated genes. In addition, cells cultured in hypoxic conditions exhibited ˜1.5 fold higher (p<0.05) CA when compared to the cells cultured in normoxic conditions. Interestingly level of CA decreased when HIF-1α KO TNBC cells were exposed to hypoxia and it increased when HIF-1α OE TNBC cells were culture in normoxic conditions. Furthermore, we discovered that HIF-1α induced CA by directly regulating the expression of Plk4 which was confirmed by performing ChIP assay. Our results indicated HIF-1α interaction with the motif in the PLK4 promoter from genomic DNA of MDA-MB 231 cells under hypoxic conditions, was significantly (p=0.04) higher when compared with the cells cultured under normoxic conditions. Plk4 mRNA expression was assessed using the online BC gene expression data sets (n=25). We found significantly higher expression of Plk4 in TNBC (n=374) when compared with non-TNBC (n=4098) and it was associated with poor overall survival (HR=1.76; p=0.054) in TNBC.
Conclusion: Collectively our findings suggest that hypoxia drives CA in TNBC via HIF-1α and contribute to poor outcomes. Thus, determination of CA and HIF-1α can help risk stratification in TNBC patients for more personalized treatments.
Citation Format: Mittal K, Choi DH, Maganti N, Ogden A, Melton BD, Kaur J, Gupta MV, Jonsdottir K, Janseen EAM, Aleskandarany MA, Rakha EA, Rida PCG, Aneja R. Hypoxia induced centrosome amplification via HIF-1α/Plk4 signaling axis associates with poorer overall survival in TNBC [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P1-01-23.
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Affiliation(s)
- K Mittal
- Georgia State University, Atlanta, GA; West Georgia Hospital; Stavanger University Hospital, Norway; University of Nottingham and Nottingham University Hospitals NHS Trust
| | - DH Choi
- Georgia State University, Atlanta, GA; West Georgia Hospital; Stavanger University Hospital, Norway; University of Nottingham and Nottingham University Hospitals NHS Trust
| | - N Maganti
- Georgia State University, Atlanta, GA; West Georgia Hospital; Stavanger University Hospital, Norway; University of Nottingham and Nottingham University Hospitals NHS Trust
| | - A Ogden
- Georgia State University, Atlanta, GA; West Georgia Hospital; Stavanger University Hospital, Norway; University of Nottingham and Nottingham University Hospitals NHS Trust
| | - BD Melton
- Georgia State University, Atlanta, GA; West Georgia Hospital; Stavanger University Hospital, Norway; University of Nottingham and Nottingham University Hospitals NHS Trust
| | - J Kaur
- Georgia State University, Atlanta, GA; West Georgia Hospital; Stavanger University Hospital, Norway; University of Nottingham and Nottingham University Hospitals NHS Trust
| | - MV Gupta
- Georgia State University, Atlanta, GA; West Georgia Hospital; Stavanger University Hospital, Norway; University of Nottingham and Nottingham University Hospitals NHS Trust
| | - K Jonsdottir
- Georgia State University, Atlanta, GA; West Georgia Hospital; Stavanger University Hospital, Norway; University of Nottingham and Nottingham University Hospitals NHS Trust
| | - EAM Janseen
- Georgia State University, Atlanta, GA; West Georgia Hospital; Stavanger University Hospital, Norway; University of Nottingham and Nottingham University Hospitals NHS Trust
| | - MA Aleskandarany
- Georgia State University, Atlanta, GA; West Georgia Hospital; Stavanger University Hospital, Norway; University of Nottingham and Nottingham University Hospitals NHS Trust
| | - EA Rakha
- Georgia State University, Atlanta, GA; West Georgia Hospital; Stavanger University Hospital, Norway; University of Nottingham and Nottingham University Hospitals NHS Trust
| | - PCG Rida
- Georgia State University, Atlanta, GA; West Georgia Hospital; Stavanger University Hospital, Norway; University of Nottingham and Nottingham University Hospitals NHS Trust
| | - R Aneja
- Georgia State University, Atlanta, GA; West Georgia Hospital; Stavanger University Hospital, Norway; University of Nottingham and Nottingham University Hospitals NHS Trust
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Kobayashi Y, Fearon WF, Nishi T, Choi DH, Lee JM, Lee JH, Zimmermann FM, Jung JH, Lee HJ, Doh JH, Nam CW, Shin ES, Koo BK. Response by Kobayashi et al to Letter Regarding Article, “Three-Vessel Assessment of Coronary Microvascular Dysfunction in Patients with Clinical Suspicion of Ischemia: Prospective Observation Study With the Index of Microcirculatory Resistance”. Circ Cardiovasc Interv 2018; 11:e006302. [DOI: 10.1161/circinterventions.117.006302] [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: 11/16/2022]
Affiliation(s)
- Yuhei Kobayashi
- Division of Cardiovascular Medicine, Stanford University, CA
| | | | - Takeshi Nishi
- Division of Cardiovascular Medicine, Stanford University, CA
| | - Dong-Hyun Choi
- Division of Cardiovascular Medicine, Stanford University, CA
| | - Joo Myung Lee
- Division of Cardiology, Department of Internal Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Seoul, Republic of Korea
| | - Jang Hoon Lee
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea
| | | | - Ji-Hyun Jung
- Department of Medicine, Seoul National University Hospital, Republic of Korea
| | - Hyun-Jung Lee
- Department of Medicine, Seoul National University Hospital, Republic of Korea
| | - Joon-Hyung Doh
- Department of Medicine, Inje University Ilsan Paik Hospital, Goyang, Republic of Korea
| | - Chang-Wook Nam
- Department of Medicine, Keimyung University Dongsan Medical Center, Daegu, Republic of Korea
| | - Eun-Seok Shin
- Department of Cardiology, Ulsan University Hospital, University of Ulsan College of Medicine, Republic of Korea
| | - Bon-Kwon Koo
- Department of Medicine, Seoul National University Hospital, Republic of Korea
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Kobayashi Y, Lee JM, Fearon WF, Lee JH, Nishi T, Choi DH, Zimmermann FM, Jung JH, Lee HJ, Doh JH, Nam CW, Shin ES, Koo BK. Three-Vessel Assessment of Coronary Microvascular Dysfunction in Patients With Clinical Suspicion of Ischemia. Circ Cardiovasc Interv 2017; 10:CIRCINTERVENTIONS.117.005445. [DOI: 10.1161/circinterventions.117.005445] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Accepted: 10/23/2017] [Indexed: 01/08/2023]
Affiliation(s)
- Yuhei Kobayashi
- From the Division of Cardiovascular Medicine, Stanford University, CA (Y.K., W.F.F., T.N., D.-H.C.); Division of Cardiology, Department of Internal Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Seoul, Republic of Korea (J.M.L.); Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea (J.H.L.); Department of Cardiology, Catharina Hospital Eindhoven, the Netherlands (F.M.Z.); Department of Medicine, Seoul National University Hospital,
| | - Joo Myung Lee
- From the Division of Cardiovascular Medicine, Stanford University, CA (Y.K., W.F.F., T.N., D.-H.C.); Division of Cardiology, Department of Internal Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Seoul, Republic of Korea (J.M.L.); Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea (J.H.L.); Department of Cardiology, Catharina Hospital Eindhoven, the Netherlands (F.M.Z.); Department of Medicine, Seoul National University Hospital,
| | - William F. Fearon
- From the Division of Cardiovascular Medicine, Stanford University, CA (Y.K., W.F.F., T.N., D.-H.C.); Division of Cardiology, Department of Internal Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Seoul, Republic of Korea (J.M.L.); Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea (J.H.L.); Department of Cardiology, Catharina Hospital Eindhoven, the Netherlands (F.M.Z.); Department of Medicine, Seoul National University Hospital,
| | - Jang Hoon Lee
- From the Division of Cardiovascular Medicine, Stanford University, CA (Y.K., W.F.F., T.N., D.-H.C.); Division of Cardiology, Department of Internal Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Seoul, Republic of Korea (J.M.L.); Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea (J.H.L.); Department of Cardiology, Catharina Hospital Eindhoven, the Netherlands (F.M.Z.); Department of Medicine, Seoul National University Hospital,
| | - Takeshi Nishi
- From the Division of Cardiovascular Medicine, Stanford University, CA (Y.K., W.F.F., T.N., D.-H.C.); Division of Cardiology, Department of Internal Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Seoul, Republic of Korea (J.M.L.); Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea (J.H.L.); Department of Cardiology, Catharina Hospital Eindhoven, the Netherlands (F.M.Z.); Department of Medicine, Seoul National University Hospital,
| | - Dong-Hyun Choi
- From the Division of Cardiovascular Medicine, Stanford University, CA (Y.K., W.F.F., T.N., D.-H.C.); Division of Cardiology, Department of Internal Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Seoul, Republic of Korea (J.M.L.); Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea (J.H.L.); Department of Cardiology, Catharina Hospital Eindhoven, the Netherlands (F.M.Z.); Department of Medicine, Seoul National University Hospital,
| | - Frederik M. Zimmermann
- From the Division of Cardiovascular Medicine, Stanford University, CA (Y.K., W.F.F., T.N., D.-H.C.); Division of Cardiology, Department of Internal Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Seoul, Republic of Korea (J.M.L.); Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea (J.H.L.); Department of Cardiology, Catharina Hospital Eindhoven, the Netherlands (F.M.Z.); Department of Medicine, Seoul National University Hospital,
| | - Ji-Hyun Jung
- From the Division of Cardiovascular Medicine, Stanford University, CA (Y.K., W.F.F., T.N., D.-H.C.); Division of Cardiology, Department of Internal Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Seoul, Republic of Korea (J.M.L.); Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea (J.H.L.); Department of Cardiology, Catharina Hospital Eindhoven, the Netherlands (F.M.Z.); Department of Medicine, Seoul National University Hospital,
| | - Hyun-Jung Lee
- From the Division of Cardiovascular Medicine, Stanford University, CA (Y.K., W.F.F., T.N., D.-H.C.); Division of Cardiology, Department of Internal Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Seoul, Republic of Korea (J.M.L.); Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea (J.H.L.); Department of Cardiology, Catharina Hospital Eindhoven, the Netherlands (F.M.Z.); Department of Medicine, Seoul National University Hospital,
| | - Joon-Hyung Doh
- From the Division of Cardiovascular Medicine, Stanford University, CA (Y.K., W.F.F., T.N., D.-H.C.); Division of Cardiology, Department of Internal Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Seoul, Republic of Korea (J.M.L.); Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea (J.H.L.); Department of Cardiology, Catharina Hospital Eindhoven, the Netherlands (F.M.Z.); Department of Medicine, Seoul National University Hospital,
| | - Chang-Wook Nam
- From the Division of Cardiovascular Medicine, Stanford University, CA (Y.K., W.F.F., T.N., D.-H.C.); Division of Cardiology, Department of Internal Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Seoul, Republic of Korea (J.M.L.); Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea (J.H.L.); Department of Cardiology, Catharina Hospital Eindhoven, the Netherlands (F.M.Z.); Department of Medicine, Seoul National University Hospital,
| | - Eun-Seok Shin
- From the Division of Cardiovascular Medicine, Stanford University, CA (Y.K., W.F.F., T.N., D.-H.C.); Division of Cardiology, Department of Internal Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Seoul, Republic of Korea (J.M.L.); Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea (J.H.L.); Department of Cardiology, Catharina Hospital Eindhoven, the Netherlands (F.M.Z.); Department of Medicine, Seoul National University Hospital,
| | - Bon-Kwon Koo
- From the Division of Cardiovascular Medicine, Stanford University, CA (Y.K., W.F.F., T.N., D.-H.C.); Division of Cardiology, Department of Internal Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Seoul, Republic of Korea (J.M.L.); Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea (J.H.L.); Department of Cardiology, Catharina Hospital Eindhoven, the Netherlands (F.M.Z.); Department of Medicine, Seoul National University Hospital,
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Choi DH, Kobayashi Y, Nishi T, Luikart H, Dimbil S, Kobashigawa J, Khush K, Fearon WF. Change in lymphocyte to neutrophil ratio predicts acute rejection after heart transplantation. Int J Cardiol 2017; 251:58-64. [PMID: 29074043 DOI: 10.1016/j.ijcard.2017.10.060] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Revised: 09/07/2017] [Accepted: 10/17/2017] [Indexed: 11/18/2022]
Abstract
AIMS Most immunosuppressive drugs provide targeted immunosuppression by selective inhibition of lymphocyte activation and proliferation. This study evaluated whether a change in the lymphocyte to neutrophil ratio (LNR) is related to acute rejection. METHODS In 74 cardiac transplant recipients peripheral blood lymphocyte and neutrophil counts were measured soon after (baseline) and three, six, and 12months after heart transplantation. The primary endpoint was the incidence of acute rejection. RESULTS Significant acute rejection after heart transplantation occurred in 20 patients (27%) during a median follow-up of 49.4 [IQR 37.4-61.1] months. LNR significantly increased over time (0.1149±0.1354 at baseline, 0.2330±0.2266 at 3months, 0.2961±0.2849 at 6months, and 0.3521±0.2383 at 12months; P<0.001), especially during the first 3months in the group without acute rejection. The area under the curve of the change in LNR during the first three months (ΔLNR) for acute rejection was 0.565 (95% CI 0.420 to 0.710, P=0.380) on ROC curve analysis. The best cutoff value of Δ LNR to differentiate those with and without acute rejection was ≤0.046 by ROC curve analysis. Kaplan-Meier analysis revealed that the low ΔLNR group (≤0.046) had a significantly higher rate of acute rejection than the high ΔLNR group (>0.046) (37.5% vs. 19.0%, log-rank: P=0.0358). The low ΔLNR for the first 3months was an independent predictor of clinically significant acute rejection after adjusting for cytomegalovirus donor seropositive and recipient seronegative. CONCLUSIONS The results of this study suggest that ΔLNR over the first 3months after heart transplantation is a strong and independent predictor of acute rejection after heart transplantation. ΔLNR can be used as an early biomarker for predicting of acute rejection after heart transplantation.
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Affiliation(s)
- Dong-Hyun Choi
- Division of Cardiovascular Medicine, Stanford University, Stanford, CA, USA; Department of Internal Medicine, Chosun University School of Medicine, Gwangju, Republic of Korea
| | - Yuhei Kobayashi
- Division of Cardiovascular Medicine, Stanford University, Stanford, CA, USA
| | - Takeshi Nishi
- Division of Cardiovascular Medicine, Stanford University, Stanford, CA, USA
| | - Helen Luikart
- Division of Cardiovascular Medicine, Stanford University, Stanford, CA, USA
| | - Sadia Dimbil
- Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Jon Kobashigawa
- Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Kiran Khush
- Division of Cardiovascular Medicine, Stanford University, Stanford, CA, USA
| | - William F Fearon
- Division of Cardiovascular Medicine, Stanford University, Stanford, CA, USA.
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Kobayashi Y, Kobayashi Y, Luikart H, Nishi T, Choi DH, Schnittger I, Fearon W. TCT-858 Long-Term Prognostic Value of Invasive and Non-Invasive Measures Early after Heart Transplantation. J Am Coll Cardiol 2017. [DOI: 10.1016/j.jacc.2017.09.685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Kobayashi Y, Johnson N, Zimmermann F, Witt N, Berry C, Jeremias A, Koo BK, Esposito G, Rioufol G, Park SJ, Nishi T, Choi DH, Oldroyd K, Barbato E, Pijls N, De Bruyne B, Fearon W. TCT-708 Diagnostic Performance of Resting Distal to Aortic Coronary Pressure Using Instantaneous Wave-Free Ratio as a Reference Standard. J Am Coll Cardiol 2017. [DOI: 10.1016/j.jacc.2017.09.946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Kobayashi Y, Johnson NP, Zimmermann FM, Witt N, Berry C, Jeremias A, Koo BK, Esposito G, Rioufol G, Park SJ, Nishi T, Choi DH, Oldroyd KG, Barbato E, Pijls NH, De Bruyne B, Fearon WF. Agreement of the Resting Distal to Aortic Coronary Pressure With the Instantaneous Wave-Free Ratio. J Am Coll Cardiol 2017; 70:2105-2113. [DOI: 10.1016/j.jacc.2017.08.049] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Revised: 08/10/2017] [Accepted: 08/10/2017] [Indexed: 01/09/2023]
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Choi SW, Kim BB, Choi DH, Park G, Shin BC, Song H, Kim D, Kim DM. Stroke or left atrial thrombus prediction using antithrombin III and mean platelet volume in patients with nonvalvular atrial fibrillation. Clin Cardiol 2017; 40:1013-1019. [PMID: 28805957 DOI: 10.1002/clc.22759] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Accepted: 06/09/2017] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND CHADS2 (congestive heart failure, hypertension, age ≥ 75 years, diabetes mellitus, stroke) and CHA2 DS2 -VASc (congestive heart failure, hypertension, age ≥ 75 years, diabetes mellitus, stroke, vascular disease, age 65 to 74 years, sex category) scores showed just moderate discrimination ability in predicting thromboembolic complications in patients with nonvalvular atrial fibrillation (AF). HYPOTHESIS To determine the association of antithrombin III (AT-III) deficiency and mean platelet volume (MPV) with the development of stroke or left atrial (LA) thrombus in patients with AF. METHODS AT-III and MPV were analyzed in 352 patients with AF. The primary endpoint was a composite of ischemic stroke event and incidental LA thrombus. RESULTS There were 50 events (14.2%) during a mean 35.4 months of follow-up. A significantly higher stroke or LA thrombus rate was observed in the low-AT-III group (<70%) than that in the high-AT-III group (≥70%). A significantly higher stroke or LA thrombus rate was observed in the high-MPV group (≥7.0 fL) than that in the low-MPV group (<7.0 fL). AF patients with an MPV ≥7.0 fL and AT-III deficiency had higher stroke or LA thrombus risk than those without an MPV ≥7.0 fL and AT-III deficiency. In the Cox proportional hazard analysis, high MPV was found to be an independent predictor of stroke or LA thrombus risk (hazard ratio: 6.408; 95% confidence interval: 2.874-14.286). Although AT-III deficiency was not an independent predictor of stroke or LA thrombus risk, a trend was observed. CONCLUSIONS High MPV and AT-III deficiency were predictive markers for stroke or LA thrombus. Their predictive power for stroke was independent of antiplatelet treatment, anticoagulation therapy, and a high CHA2 DS2 -VASc score in patients with AF.
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Affiliation(s)
- Seo-Won Choi
- Department of Cardiology, Gwangju Veterans Hospital, Gwangju, Republic of Korea
| | - Bo-Bae Kim
- Department of Internal Medicine, Chosun University School of Medicine, Gwangju, Republic of Korea
| | - Dong-Hyun Choi
- Department of Internal Medicine, Chosun University School of Medicine, Gwangju, Republic of Korea
| | - Geon Park
- Department of Laboratory Medicine, Chosun University School of Medicine, Gwangju, Republic of Korea.,Research Center for Resistant Cells, Chosun University School of Medicine, Gwangju, Republic of Korea
| | - Byung Chul Shin
- Department of Internal Medicine, Chosun University School of Medicine, Gwangju, Republic of Korea
| | - Heesang Song
- Department of Biochemistry and Molecular Biology, Chosun University School of Medicine, Gwangju, Republic of Korea
| | - DongHun Kim
- Department of Radiology, Chosun University School of Medicine, Gwangju, Republic of Korea
| | - Dong-Min Kim
- Department of Internal Medicine, Chosun University School of Medicine, Gwangju, Republic of Korea
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Abstract
Platelets are essential for progression of atherosclerotic lesions, plaque destabilization, and thrombosis. They secrete and express many substances that are crucial mediators of coagulation, inflammation, and atherosclerosis. Mean platelet volume (MPV) is a precise measure of platelet size, and is routinely reported during complete blood count analysis. Emerging evidence supports the use of MPV as a biomarker predicting the risk of ischemic stroke in patients with atrial fibrillation, and as a guide for prescription of anticoagulation and rhythm-control therapy. In addition, MPV may predict the clinical outcome of percutaneous coronary intervention (PCI) in patients with coronary artery disease and indicate whether additional adjunctive therapy is needed to improve clinical outcomes. This review focuses on the current evidence that MPV may be a biomarker of the risk and prognosis of common heart diseases, particularly atrial fibrillation and coronary artery disease treated via PCI.
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Affiliation(s)
- Dong-Hyun Choi
- Department of Internal Medicine, Chosun University School of Medicine, Gwangju, Korea
- Correspondence to Dong-Hyun Choi, M.D. Department of Internal Medicine, Chosun University School of Medicine, 309 Pilmun-daero, Dong-gu, Gwangju 61452, Korea Tel: +82-62-220-3773 Fax: +82-62-222-3858 E-mail:
| | - Seong-Ho Kang
- Department of Laboratory Medicine, Chosun University School of Medicine, Gwangju, Korea
| | - Heesang Song
- Department of Biochemistry and Molecular Biology, Chosun University School of Medicine, Gwangju, Korea
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Kim D, Choi DH, Kim BB, Choi SW, Park KH, Song H. Prediction of Infarct Transmurality From C-Reactive Protein Level and Mean Platelet Volume in Patients With ST-Elevation Myocardial Infarction: Comparison of the Predictive Values of Cardiac Enzymes. J Clin Lab Anal 2016; 30:930-940. [PMID: 27075615 DOI: 10.1002/jcla.21959] [Citation(s) in RCA: 4] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Revised: 01/24/2016] [Accepted: 01/30/2016] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND High C-reactive protein (CRP) and mean platelet volume (MPV) levels are associated with poor prognosis in patients with ST-segment elevation myocardial infarction (STEMI). The aim of this study was to evaluate the relationship between CRP level or MPV and infarct transmurality in patients with STEMI. METHODS We retrospectively reviewed CRP level, MPV, and infarct transmurality in 112 STEMI patients who were assessed with contrast-enhanced cardiac magnetic resonance imaging. RESULTS When the cut-off peak CRP level and MPV were set at 2.35 mg/dl and 7.3 fl using receiver operating characteristic curves analysis, the sensitivity was 67.3/69.2% and specificity was 76.7/76.7% for differentiating between the groups with and those without transmural involvement. Peak CRP level, MPV, peak creatine kinase-MB (CK-MB) level, and peak high-sensitivity cardiac troponin T (hs-cTnT) level had comparable predictive values for transmural involvement (area under the curve, 0.749, 0.761, 0.680, and 0.696, respectively). High peak CRP level and MPV were independent predictors of transmural involvement after adjusting for the peak CK-MB level, peak hs-cTnT level, baseline thrombolysis in myocardial infarction flow grade, and left ventricular ejection fraction (odds ratio: 5.16/5.42, 95% confidence interval: 1.84-14.50/2.03-14.47, P = 0.002/0.001, respectively) in the logistic regression analysis. CONCLUSION The results of this study show that peak CRP level and MPV are predictive markers for transmural involvement. Their predictive power for transmural involvement is independent of and comparable to that of peak CK-MB and hs-cTnT levels.
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Affiliation(s)
- DongHun Kim
- Department of Radiology, Chosun University School of Medicine, Gwangju, Republic of Korea
| | - Dong-Hyun Choi
- Department of Internal Medicine, Chosun University School of Medicine, Gwangju, Republic of Korea.
| | - Bo-Bae Kim
- Department of Internal Medicine, Chosun University School of Medicine, Gwangju, Republic of Korea
| | - Seo-Won Choi
- Department of Internal Medicine, Chosun University School of Medicine, Gwangju, Republic of Korea
| | - Keun Ho Park
- Department of Internal Medicine, Chosun University School of Medicine, Gwangju, Republic of Korea
| | - Heesang Song
- Department of Biochemistry and Molecular Biology, Chosun University School of Medicine, Gwangju, Republic of Korea
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Koh YY, Kim HH, Choi DH, Lee YM, Ki YJ, Kang SH, Park G, Chung JW, Chang KS, Hong SP. Relation between the Change in Mean Platelet Volume and Clopidogrel Resistance in Patients Undergoing Percutaneous Coronary Intervention. Curr Vasc Pharmacol 2016; 13:687-93. [PMID: 25322834 DOI: 10.2174/1570161112666141017121118] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Revised: 08/10/2015] [Accepted: 09/15/2015] [Indexed: 11/22/2022]
Abstract
We aimed to determine the association between the change in mean platelet volume (MPV) over time and aspirin/ clopidogrel resistance in patients undergoing percutaneous coronary intervention (PCI). The MPV and platelet function were analysed in 302 patients who underwent PCI. MPV changes were associated with increased aspirin reaction units (ARU, r = 0.114; P = 0.047), increased P2Y12 reaction units (PRU, r = 0.193; P = 0.001), and decreased P2Y12% inhibition (PI%, r = - 0.273; P < 0.001). The group with increasing MPV values showed significantly higher PRU values and lower PI% compared with the group with decreasing MPV values (222.5 ± 73.9 vs. 195.6 ± 63.7 PRU, P = 0.001; 24.1 ± 21.0 vs. 32.8 ± 18.5 PI%, P < 0.001, respectively). The clopidogrel resistant group (≥235 PRU or ≤15% of PI%) showed a significantly higher positive change in MPV (ΔMPV) values than the clopidogrel responder group (0.53 ± 0.78 vs. 0.13 ± 0.69 fL, P < 0.001). When the ΔMPV cut-off level was set at 0.20 fL using the receiver operating characteristic curve, the sensitivity and specificity for differentiating between the clopidogrel resistant and responder groups were 72.6% and 59.3%, respectively. After adjusting for traditional risk factors, the odds ratio in the clopidogrel resistant group with ΔMPV ≥0.2 fL was 4.10 (95% confidence interval; 1.84-9.17). In conclusion, ΔMPV was associated with PRU and PI%; a positive ΔMPV was an independent predictive marker for clopidogrel resistance after PCI.
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Affiliation(s)
| | | | - Dong-Hyun Choi
- College of Medicine, Chosun University, 375 Seo-suk dong, Dong-Gu, Gwangju 501-759, Republic of Korea.
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Chung WY, Seo JB, Choi DH, Cho YS, Lee JM, Suh JW, Youn TJ, Chae IH, Choi DJ. Immediate multivessel revascularization may increase cardiac death and myocardial infarction in patients with ST-elevation myocardial infarction and multivessel coronary artery disease: data analysis from real world practice. Korean J Intern Med 2016; 31:488-500. [PMID: 27048252 PMCID: PMC4855085 DOI: 10.3904/kjim.2014.119] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2014] [Revised: 10/09/2014] [Accepted: 03/11/2015] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND/AIMS The best revascularization strategy for patients with both acute ST-elevation myocardial infarction (STEMI) and multivessel coronary disease (MVD) is still debatable. We aimed to compare the outcomes of multivessel revascularization (MVR) with those of culprit-only revascularization (COR). METHODS A cohort of 215 consecutive patients who had received primary angioplasty for STEMI and MVD were divided into two groups according to whether angioplasty had been also performed for a stenotic nonculprit artery. The primary endpoint was one-year major adverse cardiac events defined as a composite of cardiac death, recurrent myocardial infarction, or any repeat revascularization. RESULTS One-year major adverse cardiac events were not significantly different between MVR (n = 107) and COR (n = 108) groups. However, the one-year composite hard endpoint of cardiac death or recurrent myocardial infarction was notably increased in the MVR group compared to the COR group (20.0% vs. 8.9%, p = 0.024). In subgroup analysis, the hard endpoint was significantly more frequent in the immediate than in the staged MVR subgroup (26.6% vs. 9.8%, p = 0.036). The propensity score-matched cohorts confirmed these findings. CONCLUSIONS In patients with STEMI and MVD, MVR, especially immediate MVR with primary percutaneous intervention, was not beneficial and led to worse outcomes. Therefore, we conclude that COR or staged MVR would be better strategies for patients with STEMI and MVD.
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Affiliation(s)
- Woo-Young Chung
- Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Jae-Bin Seo
- Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Dong-Hyun Choi
- Department of Internal Medicine, Chosun University Hospital, Gwangju, Korea
| | - Young-Seok Cho
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
- Correspondence to Young-Seok Cho, M.D. Department of Internal Medicine, Seoul National University Bundang Hospital, 82 Gumi-ro 173beon-gil, Bundang-gu, Seongnam 13620, Korea Tel: +82-31-787-7018 Fax: +82-31-787-4051 E-mail:
| | - Joo Myung Lee
- Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Jung-Won Suh
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Tae-Jin Youn
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - In-Ho Chae
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Dong-Ju Choi
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
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Kim SC, Sun KH, Choi DH, Lee YM, Choi SW, Kang SH, Park KH, Song H. Prediction of Long-Term Mortality Based on Neutrophil-Lymphocyte Ratio After Percutaneous Coronary Intervention. Am J Med Sci 2016; 351:467-72. [DOI: 10.1016/j.amjms.2015.12.022] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Accepted: 12/15/2015] [Indexed: 11/28/2022]
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Kim H, Cho DY, Choi DH, Jung GH, Shin I, Park W, Huh SJ, Nam SJ, Lee JE, Gil WH, Kim SW. Abstract P1-08-08: Heterozygous germline mutations in RAD50 among Korean patients with high-risk breast cancer negative for BRCA1/2 mutation. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p1-08-08] [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
Background: The MRE11-RAD50-nibrin (MRN) complex participates in pathways of double-strand break induced DNA repair and cell cycle checkpoint control. RAD50 interacts with the MRE11 and NBS proteins, is involved in the maintenance of genomic integrity. The association of RAD50 mutation and breast cancer susceptibility has been reported in European patients. However, the impact of RAD50 mutation on a breast cancer predisposition among Koreans remains uncertain. In the current analysis, we evaluated the incidence of RAD50 mutations among Korean patients with non-BRCA1/2 high-risk breast cancer.
Materials and Methods: A total of 247 Korean patients with high-risk breast cancer who tested negative for BRCA1/2 mutation were enrolled. The criteria for high-risk breast cancer were as follows: having a family history of breast or ovarian cancer in any relative; diagnosed at age 40 years or younger; bilateral breast cancer; and male breast cancer. All participants were screened for BRCA1/2 mutations using fluorescent-conformation sensitive capillary electrophoresis (F-CSCE) and traditional sequencing. The entire RAD50 gene of each patient was sequenced using F-CSCE. In silico analyses of the RAD50 variants was performed using PolyPhen-2 and SIFT.
Results: There were two novel deleterious mutations in RAD50 (p.Q426X, p.E1271del). These mutations were found in two patients, including one with p.Q426X and the other with p.E1271del. Besides, five sequence variants in RAD50 were identified: four exonic variants (p.I118T, p.R486C, p.L1264F, and p.R1279H) and one intronic variant (c.1246-11T>C). Among the four missense variants, p.R486C and p.L1264F were variants predicted to be deleterious by in silico analyses.
Conclusions: We found protein-truncating mutations in RAD50 gene in a small proportion of Korean patients with high-risk breast cancer. The contribution of the mutation to the development of breast cancer should be clarified in further researches.
Citation Format: Kim H, Cho D-Y, Choi DH, Jung GH, Shin I, Park W, Huh SJ, Nam SJ, Lee JE, Gil WH, Kim SW. Heterozygous germline mutations in RAD50 among Korean patients with high-risk breast cancer negative for BRCA1/2 mutation. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P1-08-08.
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Affiliation(s)
- H Kim
- Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Republic of Korea; LabGenomics Clinical Research Institute, LabGenomics, Seongnam, Republic of Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - D-Y Cho
- Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Republic of Korea; LabGenomics Clinical Research Institute, LabGenomics, Seongnam, Republic of Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - DH Choi
- Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Republic of Korea; LabGenomics Clinical Research Institute, LabGenomics, Seongnam, Republic of Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - GH Jung
- Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Republic of Korea; LabGenomics Clinical Research Institute, LabGenomics, Seongnam, Republic of Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - I Shin
- Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Republic of Korea; LabGenomics Clinical Research Institute, LabGenomics, Seongnam, Republic of Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - W Park
- Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Republic of Korea; LabGenomics Clinical Research Institute, LabGenomics, Seongnam, Republic of Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - SJ Huh
- Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Republic of Korea; LabGenomics Clinical Research Institute, LabGenomics, Seongnam, Republic of Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - SJ Nam
- Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Republic of Korea; LabGenomics Clinical Research Institute, LabGenomics, Seongnam, Republic of Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - JE Lee
- Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Republic of Korea; LabGenomics Clinical Research Institute, LabGenomics, Seongnam, Republic of Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - WH Gil
- Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Republic of Korea; LabGenomics Clinical Research Institute, LabGenomics, Seongnam, Republic of Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - SW Kim
- Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Republic of Korea; LabGenomics Clinical Research Institute, LabGenomics, Seongnam, Republic of Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
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Lee YM, Ki YJ, Choi DH, Kim BB, Shin BC, Kim DM, Song H. Value of Low Triiodothyronine and Subclinical Myocardial Injury for Clinical Outcomes in Chest Pain. Am J Med Sci 2015; 350:393-7. [DOI: 10.1097/maj.0000000000000573] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Lim TH, Cho YA, Choi DH. Effects of cilostazol on the pharmacokinetics of carvedilol after oral and intravenous administration in rats. J Physiol Pharmacol 2015; 66:591-597. [PMID: 26348083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 01/13/2015] [Accepted: 06/02/2015] [Indexed: 06/05/2023]
Abstract
This study was designed to investigate the effects of cilostazol on the pharmacokinetics of carvedilol following oral or intravenous administration of carvedilol in rats. Clinically carvedilol and cilostazol can be prescribed for treatment of cardiovascular diseases. Carvedilol and cilostazol are all substrates of CYP2C9 enzymes. Carvedilol was administered orally or intravenously without or with oral administration of cilostazol to rats. The effects of cilostazol on cytochrome P450 (CYP) 2C9 activity and P-gp activity were also evaluated. Cilostazol inhibited CYP2C9 activity in a concentration-dependent manner with 50% inhibitory concentration (IC(50)) of 8.7 μM. Compared with the control group, the area under the plasma concentration-time curve (AUC) of carvedilol was significantly (P < 0.05) increased by 38.0%. The peak concentration (C(max)) was significantly (P < 0.05) increased by 49.2% in the presence of cilostazol after oral administration of carvedilol. Consequently, the relative bioavailability (R.B.) of carvedilol was increased by 1.15 - 1.38-fold, and the absolute bioavailability (A.B.) of carvedilol in the presence of cilostazol was significantly (P < 0.05) higher than that of the control. After intravenous administration, the AUC of carvedilol was significantly (P < 0.05) increased by 19.2% compared to that in the control by cilostazol. These results suggest that cilostazol effectively inhibited the metabolism of carvedilol. The increased oral bioavailability of carvedilol might be due to the inhibition of CYP2C9-mediated metabolism of carvedilol in the liver by cilostazol.
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Affiliation(s)
- T H Lim
- Department of Pharmacy, Chosun University Hospital, Gwangju, Republic of Korea
| | - Y A Cho
- Biomedical Research Institute, Kyeongsang National University Hospital, Jinju, Republic of Korea
| | - D H Choi
- Department of Internal Medicine, School of Medicine, Chosun University, Gwangju, Republic of Korea.
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Yang SW, Lim L, Ju S, Choi DH, Song H. Corrigendum to “Effects of matrix metalloproteinase 13 on vascular smooth muscle cells migration via Akt–ERK dependent pathway” [Tissue Cell 47 (1) (2015) 115–121]. Tissue Cell 2015. [DOI: 10.1016/j.tice.2015.03.001] [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: 10/23/2022]
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Cho S, Shin EH, Kim J, Ahn SH, Chung K, Kim DH, Han Y, Choi DH. SU-E-T-569: Neutron Shielding Calculation Using Analytical and Multi-Monte Carlo Method for Proton Therapy Facility. Med Phys 2015. [DOI: 10.1118/1.4924931] [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: 11/07/2022] Open
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Yang SW, Lim L, Ju S, Choi DH, Song H. Effects of matrix metalloproteinase 13 on vascular smooth muscle cells migration via Akt–ERK dependent pathway. Tissue Cell 2015; 47:115-21. [DOI: 10.1016/j.tice.2014.12.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2014] [Revised: 12/12/2014] [Accepted: 12/13/2014] [Indexed: 02/08/2023]
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Lee CK, Choi JS, Choi DH. Effects of HMG-CoA reductase inhibitors on the pharmacokinetics of nifedipine in rats: Possible role of P-gp and CYP3A4 inhibition by HMG-CoA reductase inhibitors. Pharmacol Rep 2015; 67:44-51. [DOI: 10.1016/j.pharep.2014.08.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2014] [Revised: 08/04/2014] [Accepted: 08/08/2014] [Indexed: 01/12/2023]
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Choi JS, Choi I, Choi DH. Effects of pioglitazone on the pharmacokinetics of nifedipine and its main metabolite, dehydronifedipine, in rats. Eur J Drug Metab Pharmacokinet 2014; 41:231-8. [PMID: 25549928 DOI: 10.1007/s13318-014-0249-y] [Citation(s) in RCA: 8] [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: 07/07/2014] [Accepted: 12/19/2014] [Indexed: 12/23/2022]
Abstract
The purpose of this study was to investigate the possible effects of pioglitazone on the pharmacokinetics of nifedipine and its main metabolite, dehydronifedipine, in rats. The effects of pioglitazone on P-glycoprotein (P-gp) and cytochrome P450 (CYP)3A4 activities were also evaluated. Nifedipine was mainly metabolized by CYP3A4. The pharmacokinetic parameters of nifedipine and dehydronifedipine were determined after oral and intravenous administrations of nifedipine to rats in the presence and absence of pioglitazone (0.3 and 1.0 mg/kg). Pioglitazone inhibited the CYP3A4 enzyme activity in a concentration-dependent manner. Inhibitory concentration (IC50) was 12.1 μM. In addition, pioglitazone significantly increased the cellular accumulation of rhodamine-123 in MCF-7/ADR cells overexpressing P-gp. The areas under the plasma concentration-time curve (AUC0-∞) and the peak plasma concentration (C max) of nifedipine were significantly increased by 52.1 and 59.1 %, respectively, in the presence of pioglitazone (1.0 mg/kg) compared with control group. The total body clearance (CL/F) of nifedipine was significantly (1.0 mg/kg) decreased by pioglitazone (35.8 %). Consequently, the absolute bioavailability (AB) of nifedipine in the presence of pioglitazone (1.0 mg/kg) was significantly higher (25.3 %) than that of the control. The metabolite-parent AUC ratio (MR) in the presence of pioglitazone (1.0 mg/kg) significantly decreased (23.9 %) compared to that of the control group. The increased bioavailability of nifedipine in the presence of pioglitazone may be due to an inhibition of the P-gp-mediated efflux transporter in the small intestine and to the inhibition of the metabolism by inhibition of CYP3A4 in the small intestine and/or the liver, and/or to a reduction of CL/F of nifedipine by pioglitazone.
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Affiliation(s)
- Jin-Seok Choi
- College of Pharmacy, Ajou University, Suwon, 443-749, Gyenggi-do, Republic of Korea
| | - In Choi
- Department of Pharmacy, Chosun University Hospital, Gwangju, 501-759, Republic of Korea
| | - Dong-Hyun Choi
- College of Medicine, Chosun University, 309, Pilmundero, Dong-gu, Gwangju, 501-759, Republic of Korea.
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Seo HJ, Ki YJ, Han MA, Choi DH, Ryu SW. Brachial-ankle pulse wave velocity and mean platelet volume as predictive values after percutaneous coronary intervention for long-term clinical outcomes in Korea: A comparable and additive study. Platelets 2014; 26:665-71. [PMID: 25383727 DOI: 10.3109/09537104.2014.978274] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
This study aimed to determine the association of the brachial-ankle pulse wave velocity (baPWV) and mean platelet volume (MPV) with the development of adverse outcomes after percutaneous coronary intervention (PCI). The baPWV and MPV were analyzed in 372 patients who underwent PCI, with the primary endpoint as cardiac death. The secondary endpoint was cardiovascular events (CVE): a composite of cardiac death, myocardial infarction (MI), target vessel revascularization (TVR), ischemic stroke, and stent thrombosis (ST). During the follow-up period (mean, 25.8 months), there were 21 cardiac deaths, 10 MIs including four events of ST, seven ischemic strokes, and 29 TVRs. The baPWV cut-off level was set at 1672 cm/s using the receiver operating characteristic curve; the sensitivity and specificity was 85.7 and 60.1%, respectively, to differentiate between the groups with and without cardiac death. The MPV cut-off level was set at 8.20 fL using the receiver operating characteristic curve; the sensitivity and specificity were 81 and 53.3%, respectively, to differentiate between the groups with and without cardiac death. Kaplan-Meier analysis revealed that the higher baPWV group (≥ 1672 cm/s) had a significantly higher cardiac death and CVE rate than the lower baPWV group (<1672 cm/s) (11.4 vs. 1.4%, log-rank: p < 0.0001; 25.3 vs. 7.5%, log-rank: p < 0.0001; respectively), and the higher MPV group (median, >8.20 fL,) had a significantly higher cardiac death and CVE rate than the lower MPV group (≤ 8.20 fL) (9.4 vs. 2.1%, log-rank: p = 0.0026; 23.8 vs. 6.8%, log-rank: p < 0.0001; respectively). Furthermore, the high baPWV and MPV groups were significantly associated with an increased risk of cardiac death. These results show that baPWV and MPV are predictive markers after PCI for cardiac death; they are also additively associated with a higher risk of cardiac death.
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Affiliation(s)
- Hong-Joo Seo
- a Department of Thoracic and Cardiovascular Surgery , Chosun University Hospital , Gwangju , Republic of Korea
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Kim DH, Choi DH, Lee YM, Kang JT, Chae SS, Kim BB, Ki YJ, Kim JH, Chung JW, Koh YY. Massive thoracoabdominal aortic thrombosis in a patient with iatrogenic Cushing syndrome. Korean J Radiol 2014; 15:637-40. [PMID: 25246825 PMCID: PMC4170165 DOI: 10.3348/kjr.2014.15.5.637] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2013] [Accepted: 05/25/2014] [Indexed: 11/21/2022] Open
Abstract
Massive thoracoabdominal aortic thrombosis is a rare finding in patients with iatrogenic Cushing syndrome in the absence of any coagulation abnormality. It frequently represents an urgent surgical situation. We report the case of an 82-year-old woman with massive aortic thrombosis secondary to iatrogenic Cushing syndrome. A follow-up computed tomography scan showed a decreased amount of thrombus in the aorta after anticoagulation therapy alone.
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Affiliation(s)
- Dong Hun Kim
- Department of Radiology, Chosun University School of Medicine, Gwangju 501-717, Korea
| | - Dong-Hyun Choi
- Department of Internal Medicine, Chosun University School of Medicine, Gwangju 501-717, Korea
| | - Young-Min Lee
- Department of Internal Medicine, Chosun University School of Medicine, Gwangju 501-717, Korea
| | - Joon Tae Kang
- Department of Internal Medicine, Mokpo Jung-Ang General Hospital, Mokpo 530-830, Korea
| | - Seung Seok Chae
- Department of Internal Medicine, Mokpo Jung-Ang General Hospital, Mokpo 530-830, Korea
| | - Bo-Bae Kim
- Department of Internal Medicine, Chosun University School of Medicine, Gwangju 501-717, Korea
| | - Young-Jae Ki
- Department of Internal Medicine, Chosun University School of Medicine, Gwangju 501-717, Korea
| | - Jin Hwa Kim
- Department of Internal Medicine, Chosun University School of Medicine, Gwangju 501-717, Korea
| | - Joong-Wha Chung
- Department of Internal Medicine, Chosun University School of Medicine, Gwangju 501-717, Korea
| | - Young-Youp Koh
- Department of Internal Medicine, Chosun University School of Medicine, Gwangju 501-717, Korea
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Choi JS, Choi JS, Choi DH. Effects of licochalcone A on the bioavailability and pharmacokinetics of nifedipine in rats: possible role of intestinal CYP3A4 and P-gp inhibition by licochalcone A. Biopharm Drug Dispos 2014; 35:382-90. [PMID: 24903704 DOI: 10.1002/bdd.1905] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [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: 12/02/2013] [Revised: 04/14/2014] [Accepted: 06/02/2014] [Indexed: 12/23/2022]
Abstract
The purpose of this study was to investigate the possible effects of licochalcone A (a herbal medicine) on the pharmacokinetics of nifedipine and its main metabolite, dehydronifedipine, in rats. The pharmacokinetic parameters of nifedipine and/or dehydronifedipine were determined after oral and intravenous administration of nifedipine to rats in the absence (control) and presence of licochalcone A (0.4, 2.0 and 10 mg/kg). The effect of licochalcone A on P-glycoprotein (P-gp) and cytochrome P450 (CYP) 3A4 activity was also evaluated. Nifedipine was mainly metabolized by CYP3A4. Licochalcone A inhibited CYP3A4 enzyme activity in a concentration-dependent manner with a 50% inhibition concentration (IC50 ) of 5.9 μm. In addition, licochalcone A significantly enhanced the cellular accumulation of rhodamine-123 in MCF-7/ADR cells overexpressing P-gp. The area under the plasma concentration-time curve from time 0 to infinity (AUC) and the peak plasma concentration (Cmax ) of oral nifedipine were significantly greater and higher, respectively, with licochalcone A. The metabolite (dehydronifedipine)-parent AUC ratio (MR) in the presence of licochalcone A was significantly smaller compared with the control group. The above data could be due to an inhibition of intestinal CYP3A4 and P-gp by licochalcone A. The AUCs of intravenous nifedipine were comparable without and with licochalcone A, suggesting that inhibition of hepatic CYP3A4 and P-gp was almost negligible.
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Affiliation(s)
- Jin-Seok Choi
- College of Pharmacy, Ajou University, Suwon, Republic of Korea
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Choi JS, Choi I, Choi DH. Effects of nifedipine on the pharmacokinetics of repaglinide in rats: possible role of CYP3A4 and P-glycoprotein inhibition by nifedipine. Pharmacol Rep 2014; 65:1422-30. [PMID: 24399740 DOI: 10.1016/s1734-1140(13)71502-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2012] [Revised: 05/16/2013] [Indexed: 12/29/2022]
Abstract
BACKGROUND The aim of this study was to investigate the effects of nifedipine on the bioavailability and pharmacokinetics of repaglinide in rats. METHODS The effect of nifedipine on P-glycoprotein (P-gp) and cytochrome P450 (CYP) 3A4 activity was evaluated. The pharmacokinetic parameters of repaglinide and blood glucose concentrations were also determined in rats after oral (0.5 mg/kg) and intravenous (0.2 mg/kg) administration of repaglinide to rats in the presence and absence of nifedipine (1 and 3 mg/kg). RESULTS Administration of nifedipine resulted in inhibition CYP3A4 activity with an IC50 value of 7.8 μM, and nifedipine significantly inhibited P-gp activity in a concentration-dependent manner. Compared to the oral control group, nifedipine significantly increased the area under the plasma concentration-time curve (AUC0-∞) and the peak plasma concentration (Cmax) of repaglinide by 49.3 and 25.5%, respectively. Nifedipine significantly decreased the total body clearance (CL/F) of repaglinide by 22.0% compared to the oral control group. Nifedipine also increased the absolute bioavailability (AB) of repaglinide by 50.0% compared to the oral control group (33.6%). In addition, the relative bioavailability (RB) of repaglinide was 1.16- to 1.49-fold greater than that of the control group. Compared to the intravenous control, nifedipine significantly increased AUC0-∞ of repaglinide. Blood glucose concentrations had significant differences compared to the oral control groups. CONCLUSION Nifedipine enhanced the oral bioavailability of repaglinide, which may be mainly attributable to inhibition of CYP3A4-mediated metabolism of repaglinide in the small intestine and/or in the liver and to inhibition of the P-gp efflux transporter in the small intestine and/or reduction of total body clearance by nifedipine. The current study has raised awareness of potential drug interactions by concomitant use of repaglinide with nifedipine.
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Affiliation(s)
- Jin-Seok Choi
- Department of Food and Drug, Chosun University, Gwangju 501-759, Republic of Korea.
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Kim TG, Park W, Choi DH, Kim SH, Kim HC, Lee WY, Park JO, Park YS. The adequacy of the distal resection margin after preoperative chemoradiotherapy for rectal cancer. Colorectal Dis 2014; 16:O257-63. [PMID: 24422744 DOI: 10.1111/codi.12554] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2013] [Accepted: 10/20/2013] [Indexed: 02/08/2023]
Abstract
AIM The study aimed to determine the adequacy of the distal margin in patients having preoperative chemoradiotherapy (CRT) followed by restorative surgery for rectal cancer. METHOD A total of 368 patients with locally advanced rectal cancer treated for cure at our institution between July 1999 and March 2009 were included in the study. All underwent preoperative CRT and sphincter-sparing surgery. The distal margin and other factors were examined for their effect on recurrence and survival. The median duration of follow-up was 48 months. RESULTS The length of distal margin ranged from 0 to 9.0 cm (median 1.5 cm). The pelvic control and disease-free survival rates at 5 years for patients with a margin of ≤ 3 mm were no different from those in whom it was > 3 mm (P = 0.6 and 0.8). The 5-year pelvic control rates between the ≤ 3 mm and > 3 mm groups were 66.7 and 86.2% in patients with a ypT3-4 tumour (P = 0.049) and 70.0 and 89.1% in patients who showed no response to CRT (P = 0.039). CONCLUSION The results suggest that a distal margin of < 3 mm in the surgical specimen after preoperative CRT is associated with a lower rate of pelvic tumour control at 5 years in patients with Stage ypT3-4 tumours or in those who do not respond to CRT.
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Affiliation(s)
- T G Kim
- Department of Radiation Oncology, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea
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Kim HW, Choi DH, Lim L, Lee YM, Kang JT, Chae SS, Ki YJ, Song H, Koh YY. Usefulness of serum bilirubin levels as a biomarker for long-term clinical outcomes after percutaneous coronary intervention. Heart Vessels 2014; 30:728-33. [DOI: 10.1007/s00380-014-0546-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2014] [Accepted: 06/27/2014] [Indexed: 12/16/2022]
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Kim DH, Choi DH, Kim HW, Choi SW, Kim BB, Chung JW, Koh YY, Chang KS, Hong SP. Prediction of infarct severity from triiodothyronine levels in patients with ST-elevation myocardial infarction. Korean J Intern Med 2014; 29:454-65. [PMID: 25045293 PMCID: PMC4101592 DOI: 10.3904/kjim.2014.29.4.454] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [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: 04/24/2013] [Revised: 09/04/2013] [Accepted: 10/28/2013] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND/AIMS The aim of the present study was to evaluate the relationship between thyroid hormone levels and infarct severity in patients with ST-elevation myocardial infarction (STEMI). METHODS We retrospectively reviewed thyroid hormone levels, infarct severity, and the extent of transmurality in 40 STEMI patients evaluated via contrast-enhanced cardiac magnetic resonance imaging. RESULTS The high triiodothyronine (T3) group (≥ 68.3 ng/dL) exhibited a significantly higher extent of transmural involvement (late transmural enhancement > 75% after administration of gadolinium contrast agent) than did the low T3 group (60% vs. 15%; p = 0.003). However, no significant difference was evident between the high- and low-thyroid-stimulating hormone/free thyroxine (FT4) groups. When the T3 cutoff level was set to 68.3 ng/dL using a receiver operating characteristic curve, the sensitivity was 80% and the specificity 68% in terms of differentiating between those with and without transmural involvement. Upon logistic regression analysis, high T3 level was an independent predictor of transmural involvement after adjustment for the presence of diabetes mellitus (DM) and the use of glycoprotein IIb/IIIa inhibitors (odds ratio, 40.62; 95% confidence interval, 3.29 to 502; p = 0.004). CONCLUSIONS The T3 level predicted transmural involvement that was independent of glycoprotein IIb/IIIa inhibitor use and DM positivity.
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Affiliation(s)
- Dong Hun Kim
- Department of Radiology, Chosun University School of Medicine, Gwangju, Korea
| | - Dong-Hyun Choi
- Department of Internal Medicine, Chosun University School of Medicine, Gwangju, Korea
| | - Hyun-Wook Kim
- Department of Internal Medicine, Chosun University School of Medicine, Gwangju, Korea
| | - Seo-Won Choi
- Department of Internal Medicine, Chosun University School of Medicine, Gwangju, Korea
| | - Bo-Bae Kim
- Department of Internal Medicine, Chosun University School of Medicine, Gwangju, Korea
| | - Joong-Wha Chung
- Department of Internal Medicine, Chosun University School of Medicine, Gwangju, Korea
| | - Young-Youp Koh
- Department of Internal Medicine, Chosun University School of Medicine, Gwangju, Korea
| | - Kyong-Sig Chang
- Department of Internal Medicine, Chosun University School of Medicine, Gwangju, Korea
| | - Soon-Pyo Hong
- Department of Internal Medicine, Chosun University School of Medicine, Gwangju, Korea
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Ki YJ, Choi DH, Lee YM, Lim L, Song H, Koh YY. Predictive value of brachial-ankle pulse wave velocity for long-term clinical outcomes after percutaneous coronary intervention in a Korean cohort. Int J Cardiol 2014; 175:554-9. [PMID: 25015023 DOI: 10.1016/j.ijcard.2014.06.032] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2013] [Revised: 05/11/2014] [Accepted: 06/24/2014] [Indexed: 11/15/2022]
Abstract
OBJECTIVE The aim of this study was to determine the associations of brachial-ankle pulse wave velocity (baPWV), high-sensitivity cardiac troponin T (hs-cTnT) and N-terminal pro-B type natriuretic peptide (NT-proBNP) with the development of adverse outcomes after percutaneous coronary intervention (PCI). METHODS The baPWV, hs-cTnT and NT-proBNP were analyzed in 372 patients who underwent PCI. The primary endpoint was cardiac death. RESULTS There were 21 events of cardiac death during a mean of 25.8 months of follow-up. When the baPWV cut-off level was set to 1672 cm/s using the receiver operating characteristic curve, the sensitivity was 85.7% and the specificity was 60.1% for differentiating between the group with cardiac death and the group without cardiac death. Kaplan-Meier analysis revealed that the higher baPWV group (≥1672 cm/s) had a significantly higher cardiac death rate than the lower baPWV group (<1672 cm/s) (11.4% vs. 1.4%, log-rank: P<0.0001). This value was more useful in patients with myocardial injury (hs-cTnT≥0.1 ng/mL) or heart failure (NT-proBNP≥450 pg/mL). CONCLUSIONS The results of this study show that high baPWV is a predictive marker for cardiac death after PCI.
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Affiliation(s)
- Young-Jae Ki
- Department of Internal Medicine, Chosun University School of Medicine, Gwangju 501-759, Republic of Korea
| | - Dong-Hyun Choi
- Department of Internal Medicine, Chosun University School of Medicine, Gwangju 501-759, Republic of Korea.
| | - Young-Min Lee
- Department of Internal Medicine, Chosun University School of Medicine, Gwangju 501-759, Republic of Korea
| | - Leejin Lim
- Department of Biomaterials, Chosun University Graduate School, Gwangju 501-759, Republic of Korea
| | - Heesang Song
- Department of Biochemistry and Molecular Biology, Chosun University School of Medicine, Gwangju 501-759, Republic of Korea
| | - Young-Youp Koh
- Department of Internal Medicine, Chosun University School of Medicine, Gwangju 501-759, Republic of Korea
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Hong SP, Choi DH, Kim HW, Kim BB, Chung JW, Koh YY, Chang KS. Stroke prevention in patients with non-valvular atrial fibrillation: new insight in selection of rhythm or rate control therapy and impact of mean platelet volume. Curr Pharm Des 2014; 19:5824-9. [PMID: 23713815 DOI: 10.2174/13816128113199990075] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2013] [Accepted: 05/23/2013] [Indexed: 11/22/2022]
Abstract
The aim of this study was to determine the impact of mean platelet volume (MPV) on the strategy for treatment of atrial fibrillation (AF) with respect to stroke prevention. MPV was analyzed in 265 patients with AF who were undergoing treatment using rhythm or rate control. The primary endpoint was ischemic stroke or a transient ischemic attack (TIA) event. Kaplan-Meier analysis revealed a significantly higher stroke rate in the rate control group compared to the rhythm control group. A significantly higher stroke rate was observed in the higher tertile MPV group (≥7.9 fL) compared to the lower tertile MPV group (<7.3 fL). When the MPV cut-off level was set to 7.85 fL using the receiver operating characteristic curve, the sensitivity was 80.0% and the specificity was 70.4% for differentiating between the group with stroke and the group without stroke. In the Cox proportional hazard analysis, after adjusting for sex, treatment strategy for AF, high MPV level, antithrombotic treatment, and high CHADS2 score, higher MPV, rate control strategy for treatment of AF, and high CHADS2 score were found to be independent predictors of stroke risk. In addition, patients with AF who were treated using rate control had high stroke risk with an MPV over 7.85 fL and high CHADS2 score. The results of this study demonstrate that the MPV and the rate control strategy for treatment of AF were predictive markers for stroke; its predictive power for stroke was independent of female sex and high CHADS2 score in patients with AF.
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Affiliation(s)
- Soon-Pyo Hong
- College of Medicine, Chosun University, 375 Seo-suk dong, Dong-Gu, Gwangju 501-759, Republic of Korea
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Noh JM, Park W, Suh CO, Keum KC, Kim YB, Shin KH, Kim K, Chie EK, Ha SW, Kim SS, Ahn SD, Shin HS, Kim JH, Lee HS, Lee NK, Huh SJ, Choi DH. Is elective nodal irradiation beneficial in patients with pathologically negative lymph nodes after neoadjuvant chemotherapy and breast-conserving surgery for clinical stage II-III breast cancer? A multicentre retrospective study (KROG 12-05). Br J Cancer 2014; 110:1420-6. [PMID: 24481403 PMCID: PMC3960607 DOI: 10.1038/bjc.2014.26] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [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: 11/05/2013] [Revised: 12/29/2013] [Accepted: 01/08/2014] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND To evaluate the effects of elective nodal irradiation (ENI) in clinical stage II-III breast cancer patients with pathologically negative lymph nodes (LNs) (ypN0) after neoadjuvant chemotherapy (NAC) followed by breast-conserving surgery (BCS) and radiotherapy (RT). METHODS We retrospectively analysed 260 patients with ypN0 who received NAC followed by BCS and RT. Elective nodal irradiation was delivered to 136 (52.3%) patients. The effects of ENI on survival outcomes were evaluated. RESULTS After a median follow-up period of 66.2 months (range, 15.6-127.4 months), 26 patients (10.0%) developed disease recurrence. The 5-year locoregional recurrence-free survival and disease-free survival (DFS) for all patients were 95.5% and 90.5%, respectively. Pathologic T classification (0-is vs 1 vs 2-4) and the number of LNs sampled (<13 vs ≥13) were associated with DFS (P=0.0086 and 0.0012, respectively). There was no significant difference in survival outcomes according to ENI. Elective nodal irradiation also did not affect survival outcomes in any of the subgroups according to pathologic T classification or the number of LNs sampled. CONCLUSIONS ENI may be omitted in patients with ypN0 breast cancer after NAC and BCS. But until the results of the randomised trials are available, patients should be put on these trials.
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Affiliation(s)
- J M Noh
- Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 135-710, Republic of Korea
| | - W Park
- Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 135-710, Republic of Korea
| | - C-O Suh
- Department of Radiation Oncology, Yonsei Cancer Center, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Republic of Korea
| | - K C Keum
- Department of Radiation Oncology, Yonsei Cancer Center, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Republic of Korea
| | - Y B Kim
- Department of Radiation Oncology, Yonsei Cancer Center, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Republic of Korea
| | - K H Shin
- Proton Therapy Center, Research Institute and Hospital, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do 410-769, Republic of Korea
| | - K Kim
- Department of Radiation Oncology, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul 110-799, Republic of Korea
| | - E K Chie
- Department of Radiation Oncology, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul 110-799, Republic of Korea
| | - S W Ha
- Department of Radiation Oncology, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul 110-799, Republic of Korea
| | - S S Kim
- Department of Radiation Oncology, Asan Medical Center, University of Ulsan, College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 138-736, Republic of Korea
| | - S D Ahn
- Department of Radiation Oncology, Asan Medical Center, University of Ulsan, College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 138-736, Republic of Korea
| | - H S Shin
- Department of Radiation Oncology, Bundang CHA Hospital, School of Medicine, CHA University, 59 Yatap-ro, Bundang-gu, Seongnam-si, Gyeonggi-do 463-712, Republic of Korea
| | - J H Kim
- Department of Radiation Oncology, Dongsan Medical Center, Keimyung University School of Medicine, 56 Dalseong-ro, Jung-gu, Daegu 700-712, Republic of Korea
| | - H-S Lee
- Department of Radiation Oncology, Dong-A University Hospital, Dong-A University School of Medicine, 26 Daesingongwon-ro, Seo-gu, Busan 602-715, Republic of Korea
| | - N K Lee
- Department of Radiation Oncology, Korea Medical Center, Korea University School of Medicine, 73 Inchon-ro, Seongbuk-gu, Seoul 136-705, Republic of Korea
| | - S J Huh
- Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 135-710, Republic of Korea
| | - D H Choi
- Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 135-710, Republic of Korea
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Kim BB, Kim DM, Choi DH, Chung JW, Koh YY, Chang KS, Hong SP. Amiodarone toxicity showing high liver density on CT scan with normal liver function and plasma amiodarone levels in a long-term amiodarone user. Int J Cardiol 2014; 172:494-5. [PMID: 24485640 DOI: 10.1016/j.ijcard.2014.01.020] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [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: 12/27/2013] [Revised: 12/31/2013] [Accepted: 01/07/2014] [Indexed: 02/04/2023]
Affiliation(s)
- Bo-Bae Kim
- Chosun University Hospital, Department of Internal Medicine, Republic of Korea
| | - Dong-Min Kim
- Chosun University Hospital, Department of Internal Medicine, Republic of Korea.
| | - Dong-Hyun Choi
- Chosun University Hospital, Department of Internal Medicine, Republic of Korea
| | - Joong-Wha Chung
- Chosun University Hospital, Department of Internal Medicine, Republic of Korea
| | - Young-Youp Koh
- Chosun University Hospital, Department of Internal Medicine, Republic of Korea
| | - Kyong-Sig Chang
- Chosun University Hospital, Department of Internal Medicine, Republic of Korea
| | - Soon-pyo Hong
- Chosun University Hospital, Department of Internal Medicine, Republic of Korea
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Kim JH, Choi DH, Park W, Ha SW, Kim K, Ye JW, Suh CO, Shin KH, Kim DW, Lee JH. Abstract P5-16-03: Influence of radiotherapy boost in patients with ductal carcinoma in situ of breast cancer: A multicenter, retrospective study in Korea (KROG 11-04). Cancer Res 2013. [DOI: 10.1158/0008-5472.sabcs13-p5-16-03] [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
Purpose
We aimed to estimate the effect of boost radiotherapy on local relapse-free survival (LRFS) in patients with ductal carcinoma in situ (DCIS) of breast cancer.
Material and Methods
We included patients from 8 institutions who met the following inclusion criteria: having tumor status Tis, age 18 years or older at diagnosis, having had breast conserving surgery (BCS) and radiotherapy within 12 weeks after surgery. From January 1995 through December 2006, 594 patients with DCIS breast cancer treated with BCS and radiotherapy were analyzed retrospectively in a study by Korean Radiation Oncology Group (KROG). All patients received whole breast radiotherapy (median 5040 cGy) after BCS. Among them, 154 patients (25.9%) received boost radiotherapy (median 1000 cGy) after whole breast radiotherapy. Patients who received boost radiotherapy had higher tumor grade, more comedo pattern and less papillary pattern. Other patients’ or tumor characteristics were not statistically different between boost group and no boost group.
Results
After median follow-up of 89 months (range 26-200), 5 year and 10 year LRFS was 98.3% and 95.6%. There was no statistically significant difference of LRFS between boost group and no boost group.
Local relapse free survival according to boost radiotherpay 5-year LRFS* (%)10-year LRFS (%)p-value**Boost group98.196.20.626No boost group98.495.4 *Local relapse free survival, **Log-rank test
Nineteen (3.2%) patients had ipsilateral breast recurrences, of whom, 12 patients had invasive breast cancer and 7 had DCIS. Positive HER2 receptor was associated with higher invasive recurrences.
Ipsilateral breast recurrences according to HER2 receptor TotalHER2 receptor (+)HER2 receptor (-)p-value*Ipsilateral breast121110.017Invasive8800.023DCIS**4310.642*Fisher's exact test, **Ductal carcinoma in situ
Nine (1.5%) patients developed contralateral breast cancer, of whom, 6 were invasive breast cancer and 3 were DCIS. On multivariate analysis, only margin status was a significant prognostic factor for LRFS.
Conclusion
In the absence of randomized trials, boost radiotherapy could not decrease local recurrence in DCIS of breast cancer after BCS and radiotherapy. In addition, patients with positive HER2 receptor would need further treatment like target agent, trastuzumab. NSABP B-43 study result would answer the question.
Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P5-16-03.
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Affiliation(s)
- JH Kim
- Dongsan Medical Center Keimyung University School of Medicine; Samsung Medical Center Sungkyunkwan University School of Medicine; Seoul National University Hospital; Yeungnam University Medical Center; Severance Hospital Yonsei University College of Medicine; National Cancer Center; Pusan National University Hospital; Ewha Womans University Mokdong Hospital
| | - DH Choi
- Dongsan Medical Center Keimyung University School of Medicine; Samsung Medical Center Sungkyunkwan University School of Medicine; Seoul National University Hospital; Yeungnam University Medical Center; Severance Hospital Yonsei University College of Medicine; National Cancer Center; Pusan National University Hospital; Ewha Womans University Mokdong Hospital
| | - W Park
- Dongsan Medical Center Keimyung University School of Medicine; Samsung Medical Center Sungkyunkwan University School of Medicine; Seoul National University Hospital; Yeungnam University Medical Center; Severance Hospital Yonsei University College of Medicine; National Cancer Center; Pusan National University Hospital; Ewha Womans University Mokdong Hospital
| | - SW Ha
- Dongsan Medical Center Keimyung University School of Medicine; Samsung Medical Center Sungkyunkwan University School of Medicine; Seoul National University Hospital; Yeungnam University Medical Center; Severance Hospital Yonsei University College of Medicine; National Cancer Center; Pusan National University Hospital; Ewha Womans University Mokdong Hospital
| | - K Kim
- Dongsan Medical Center Keimyung University School of Medicine; Samsung Medical Center Sungkyunkwan University School of Medicine; Seoul National University Hospital; Yeungnam University Medical Center; Severance Hospital Yonsei University College of Medicine; National Cancer Center; Pusan National University Hospital; Ewha Womans University Mokdong Hospital
| | - JW Ye
- Dongsan Medical Center Keimyung University School of Medicine; Samsung Medical Center Sungkyunkwan University School of Medicine; Seoul National University Hospital; Yeungnam University Medical Center; Severance Hospital Yonsei University College of Medicine; National Cancer Center; Pusan National University Hospital; Ewha Womans University Mokdong Hospital
| | - C-O Suh
- Dongsan Medical Center Keimyung University School of Medicine; Samsung Medical Center Sungkyunkwan University School of Medicine; Seoul National University Hospital; Yeungnam University Medical Center; Severance Hospital Yonsei University College of Medicine; National Cancer Center; Pusan National University Hospital; Ewha Womans University Mokdong Hospital
| | - KH Shin
- Dongsan Medical Center Keimyung University School of Medicine; Samsung Medical Center Sungkyunkwan University School of Medicine; Seoul National University Hospital; Yeungnam University Medical Center; Severance Hospital Yonsei University College of Medicine; National Cancer Center; Pusan National University Hospital; Ewha Womans University Mokdong Hospital
| | - DW Kim
- Dongsan Medical Center Keimyung University School of Medicine; Samsung Medical Center Sungkyunkwan University School of Medicine; Seoul National University Hospital; Yeungnam University Medical Center; Severance Hospital Yonsei University College of Medicine; National Cancer Center; Pusan National University Hospital; Ewha Womans University Mokdong Hospital
| | - JH Lee
- Dongsan Medical Center Keimyung University School of Medicine; Samsung Medical Center Sungkyunkwan University School of Medicine; Seoul National University Hospital; Yeungnam University Medical Center; Severance Hospital Yonsei University College of Medicine; National Cancer Center; Pusan National University Hospital; Ewha Womans University Mokdong Hospital
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Choi JS, Choi JS, Choi DH. Effects of licochalcon A on the pharmacokinetics of losartan and its active metabolite, EXP-3174, in rats. Pharmazie 2013; 68:882-888. [PMID: 24380237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Losartan and licochalcon A interact with cytochrome P-450 (CYP) enzymes and P-glycoprotein (P-gp), and the increase in the use of health supplements may result in licochalcon A being taken concomitantly with losartan to treat or prevent cardiovascular diseases as a combination therapy. The effect of licochalcon A, a natural flavonoid, on the pharmacokinetics of losartan and its active metabolite, EXP-3174, was investigated in rats. Pharmacokinetic parameters of losartan and EXP-3174 were determined after oral administration of losartan (9 mg/kg) to rats in the presence or absence of licochalcon A (0.5, 2.5 and 10 mg/kg). The effect of licochalcon A on P-glycoprotein (P-gp) as well as CYP3A4 and 2C9 activities was also evaluated. Licochalcon A inhibited CYP3A4 and CYP2C9 enzyme activities with 50% inhibition concentrations (IC50) of 2.0 and 0.1 microM, respectively. In addition, licochalcon A significantly enhanced the cellular accumulation of rhodamine-123 in a concentration-dependent manner in MCF-7/ADR cells overexpressing P-gp. The pharmacokinetic parameters of losartan were significantly altered by licochalcon A. Licochalcon A (2.5 mg/kg or 10 mg/kg) increased AUC0-infinity of losartan by 33.4-63.2% and Cmax of losartan by 34.0-62.8%. The total body clearance (CL/F) was significantly decreased (2.5 mg/kg, p < 0.05; 10 mg/kg, p < 0.01) by licochalcon A. Consequently, the absolute bioavailability of losartan in the presence of licochalcon A increased significantly (2.5 mg/kg, p < 0.05; 10 mg/kg, p < 0.01) compared to that in the control group. The relative bioavailability (R.B.) of losartan was 1.15- to 1.63-fold greater than that of the control group. However, there was no significant change in Tmax and t1/2 of losartan in the presence of licochalcon A. Licochalcon A (10 mg/kg) increased the AUC0-infinity of EXP-3174 but this was not significant. Furthermore, concurrent use of licochalcon A (10 mg/kg) significantly decreased the metabolite-parent AUC ratio (M.R.) by 20%, suggesting that licochalcon A inhibited the CYP-mediated metabolism of losartan to its active metabolite, EXP-3174. In conclusion, the enhanced oral bioavailability of losartan in the presence of licochalcon A may mainly result from decreased P-gp-mediated efflux transporter in the small intestine and from the inhibition of CYP 3A- and CYP2C9-mediated metabolism in the small intestine and liver and/or from the reduction of total body clearance of losartan by licochalcon A.
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Affiliation(s)
- J S Choi
- Department of Food and Drug, Chosun University, Gwangju, Republic of Korea
| | - J S Choi
- College of Pharmacy, Chosun University, Gwangju, Republic of Korea
| | - D H Choi
- College of Medicine, Chosun University, Gwangju, Republic of Korea
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Ki YJ, Park S, Ha SI, Choi DH, Song H. Usefulness of mean platelet volume as a biomarker for long-term clinical outcomes after percutaneous coronary intervention in Korean cohort: a comparable and additive predictive value to high-sensitivity cardiac troponin T and N-terminal pro-B type natriuretic peptide. Platelets 2013; 25:427-32. [PMID: 24102424 DOI: 10.3109/09537104.2013.835393] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The aim of this study was to determine the associations of the mean platelet volume (MPV) high-sensitivity cardiac troponin T (hs-cTnT) and N-terminal pro-B type natriuretic peptide (NT-proBNP) with the development of adverse outcomes after percutaneous coronary intervention (PCI). MPV hs-cTnT and NT-proBNP were analyzed in 372 patients who underwent PCI. The primary endpoint was cardiac death. The secondary endpoint analyzed was cardiovascular events (CVE): the composite of cardiac death, myocardial infarction (MI), target vessel revascularization (TVR), ischemic stroke and stent thrombosis (ST). The median MPV hs-cTnT and NT-proBNP levels were 8.20 (IQR 7.70-8.70) fL, 0.291 (IQR 0.015-3.785) ng/mL, and 105.25 (IQR 50.84-1128.5) pg/mL, respectively. There were 21 events of cardiac death, 10 MI (including 4 events of ST), 7 ischemic strokes and 29 TVR during a mean of 25.8 months of follow-up. The Kaplan-Meier analysis revealed that the higher MPV group (>8.20 fL, median) had a significantly higher cardiac death rate than the lower MPV group (≤8.20 fL; 9.4% vs. 2.1%, log-rank: p = 0.0026). When the MPV cut-off level was set to 8.20 fL using the receiver operating characteristic curve, the sensitivity was 81% and the specificity was 53.3% for differentiating between the group with cardiac death and the group without cardiac death. This value was more useful in patients with myocardial injury (hs-cTnT ≥ 0.1 ng/mL) or heart failure (NT-proBNP ≥ 450 pg/mL). The results of this study show that MPV is a predictive marker for cardiac death after PCI; its predictive power for cardiac death is more useful in patients with myocardial injury or heart failure.
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Affiliation(s)
- Young-Jae Ki
- Department of Internal Medicine, Chosun University School of Medicine , Gwangju , Republic of Korea
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