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Park YJ, Bae MH. Screening and diagnosis of atrial fibrillation using wearable devices. Korean J Intern Med 2024:kjim.2023.521. [PMID: 38699800 DOI: 10.3904/kjim.2023.521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 01/06/2024] [Indexed: 05/05/2024] Open
Abstract
In recent years, the development and use of various devices for the screening of atrial fibrillation (AF) have significantly increased. Such devices include 12-lead electrocardiogram (ECG), photoplethysmography systems, and single-lead ECG and ECG patches. This review outlines several studies that have focused on the feasibility and efficacy of such devices for AF screening, and summarizes the risks and benefits involved in the initiation of anticoagulant therapy after early detection of AF. We also describe several ongoing trials on unresolved issues associated with AF screening. Overall, this review provides a comprehensive summary of the current state of AF screening and its implications for patient care.
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Affiliation(s)
- Yoon Jung Park
- Division of Cardiology, Department of Internal Medicine, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Myung Hwan Bae
- Division of Cardiology, Department of Internal Medicine, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, Korea
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Park BE, Jang SY, Park YJ, Bae MH, Lee JH, Yang DH, Park HS, Cho Y. Cardiomyopathy Without Amyloid Deposit in Systemic Light Chain Deposition Disease. Korean Circ J 2024; 54:221-222. [PMID: 38654569 PMCID: PMC11040263 DOI: 10.4070/kcj.2024.0022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Revised: 02/11/2024] [Accepted: 02/27/2024] [Indexed: 04/26/2024] Open
Affiliation(s)
- Bo Eun Park
- Division of Cardiology, Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Se Yong Jang
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
- Division of Cardiology, Department of Internal Medicine, Kyungpook National University Chilgok Hospital, Daegu, Korea.
| | - Yoon Jung Park
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
- Division of Cardiology, Department of Internal Medicine, Kyungpook National University Chilgok Hospital, Daegu, Korea
| | - Myung Hwan Bae
- Division of Cardiology, Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Jang Hoon Lee
- Division of Cardiology, Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Dong Heon Yang
- Division of Cardiology, Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Hun Sik Park
- Division of Cardiology, Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Yongkeun Cho
- Division of Cardiology, Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
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Joung B, Bae MH, Oh IY, Park HS, Shim J, Cho MS, Lee JM, Choi EK, Lee YS. Performance and Physician Experience of INGEVITY+ Active Fixation Leads: Prospective INGEVITY+ Lead Clinical Study in Korea. Cardiol Res Pract 2024; 2024:2172306. [PMID: 38239431 PMCID: PMC10796181 DOI: 10.1155/2024/2172306] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 12/27/2023] [Accepted: 01/04/2024] [Indexed: 01/22/2024] Open
Abstract
Background Boston Scientific INGEVITY+ pacing lead (Boston Scientific, Marlborough, MA, USA) has been upgraded to INGEVITY. The performance of the INGEVITY+ pacing lead has not yet been reported. This study aimed to evaluate the short- and long-term safety, effectiveness, and handling experience of INGEVITY+ leads. Methods Consecutive patients were included from 9 institutions in Korea, where 400 leads (200 right ventricular active fixation leads and 200 right atrial active fixation leads) were implanted or attempted in 200 subjects. Results During the implantation, only one patient required a lead change because of lead screw failure. The handling questionnaires of the lead received very positive feedback with 88% of operators agreeing that it is easy for leads to pass through small vessels or vessels with multiple leads. At the 3-month follow-up, 95.7% of RA leads and 99.5% of RV leads had pacing thresholds less than 1.5 V. A total of 92.4% of atrial leads had amplitudes greater than 1.5 mV, and 96.5% of ventricular leads had sensing amplitudes greater than 5 mV at 3 months. A total of 99.8% had impedances between 300 and 1,300 ohms. The lead-related complication-free rate for all leads during follow-up was 100%, and the overall rates of lead dislodgment, perforation, and pericardial effusion were all 0.0%. Conclusions The INGEVITY+ pacing lead exhibited exceptional clinical performance, with a high complication-free rate throughout the 3-month follow-up period. In addition, the lead displayed excellent electrical characteristics, and the lead-handling experience was reported to be very good.
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Affiliation(s)
- Boyoung Joung
- Yonsei University Health System, Seoul, Republic of Korea
| | - Myung Hwan Bae
- Kyungpook National University Hospital, Daegu, Republic of Korea
| | - Il-Young Oh
- Seoul National University Bundang Hospital, Soengnam-Si, Republic of Korea
| | | | - Jaemin Shim
- Korea University Hospital, Seoul, Republic of Korea
| | - Min Soo Cho
- University of Ulsan College of Medicine, Seoul, Republic of Korea
| | | | - Eue-Keun Choi
- Seoul National University Hospital, Seoul, Republic of Korea
| | - Young Soo Lee
- Daegu Catholic University Medical Center, Daegu, Republic of Korea
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Park HK, Park JS, Kim MS, Lee E, Choi H, Park YJ, Park BE, Kim HN, Kim N, Bae MH, Lee JH, Park HS, Cho Y, Jang SY, Yang DH. Long-term impact of angiotensin receptor-neprilysin inhibitor based on short-term treatment response in heart failure. ESC Heart Fail 2023; 10:3430-3437. [PMID: 37705397 PMCID: PMC10682893 DOI: 10.1002/ehf2.14505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 07/19/2023] [Accepted: 08/07/2023] [Indexed: 09/15/2023] Open
Abstract
AIMS The long-term effect of angiotensin receptor-neprilysin inhibitor (ARNI) remains uncertain in patients who have experienced improvements in left ventricular (LV) systolic function or significant LV reverse remodelling following a certain period of treatment. It is also unclear how ARNI performs in patients who have not shown these improvements. This study aimed to assess the impact of prolonged ARNI use compared with angiotensin-converting enzyme inhibitors (ACEIs)/angiotensin receptor blockers (ARBs) in patients with and without significant treatment response after 1 year of heart failure (HF) treatment. METHODS AND RESULTS The present study enrolled patients with HF with reduced ejection fraction (HFrEF) who were treated with either ARNI or ACEIs/ARBs within 1 year of undergoing index echocardiography. After 1 year of treatment, patients were reclassified into the following groups: (i) patients with HF with improved ejection fraction and persistent HFrEF and (ii) patients with and without LV reverse remodelling based on the follow-up echocardiography. The effect of ARNI versus that of ACEIs/ARBs in each group was assessed from the time of categorizing into new groups using the composite event of all-cause mortality and HF hospitalization. A total of 671 patients with HFrEF (age, 66.4 ± 14.1 years; males, 66.8%) were included, and 133 (19.8%) composite events of death and rehospitalization for HF were observed during the follow-up (median follow-up, 44 [interquartile range, 34-51] months). ARNI had a significantly lower event rate than ACEIs/ARBs in patients with HF with improved ejection fraction (7.0% vs. 30.4%, P = 0.020) and those with persistent HFrEF (17.6% vs. 49.7%, P < 0.001). Irrespective of whether patients exhibited LV reverse remodelling (15.8% vs. 31.1%, P = 0.001) or not (15.0% vs. 54.9%, P < 0.001), ARNIs were associated with a significantly lower event rate than ACEIs/ARBs. CONCLUSIONS Regardless of significant treatment response measured by either LVEF or LV reverse remodelling after 1 year of treatment, the extended utilization of ARNI demonstrated a more favourable prognosis than that of ACEIs/ARBs in patients with HFrEF.
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Affiliation(s)
- Hyuk Kyoon Park
- Department of Internal MedicineDaegu Fatima HospitalDaeguRepublic of Korea
| | - Jong Sung Park
- Department of Internal MedicineKyungpook National University HospitalDaeguRepublic of Korea
| | - Myeong Seop Kim
- Department of Internal MedicineKyungpook National University HospitalDaeguRepublic of Korea
| | - Eunkyu Lee
- Department of Internal MedicineKyungpook National University HospitalDaeguRepublic of Korea
| | - Hyohun Choi
- Department of Internal MedicineKyungpook National University HospitalDaeguRepublic of Korea
| | - Yoon Jung Park
- Department of Internal MedicineKyungpook National University Chilgok HospitalDaeguRepublic of Korea
- School of MedicineKyungpook National UniversityDaeguRepublic of Korea
| | - Bo Eun Park
- Department of Internal MedicineKyungpook National University HospitalDaeguRepublic of Korea
- School of MedicineKyungpook National UniversityDaeguRepublic of Korea
| | - Hong Nyun Kim
- Department of Internal MedicineKyungpook National University Chilgok HospitalDaeguRepublic of Korea
- School of MedicineKyungpook National UniversityDaeguRepublic of Korea
| | - Namkyun Kim
- Department of Internal MedicineKyungpook National University HospitalDaeguRepublic of Korea
- School of MedicineKyungpook National UniversityDaeguRepublic of Korea
| | - Myung Hwan Bae
- Department of Internal MedicineKyungpook National University HospitalDaeguRepublic of Korea
- School of MedicineKyungpook National UniversityDaeguRepublic of Korea
| | - Jang Hoon Lee
- Department of Internal MedicineKyungpook National University HospitalDaeguRepublic of Korea
- School of MedicineKyungpook National UniversityDaeguRepublic of Korea
| | - Hun Sik Park
- Department of Internal MedicineKyungpook National University HospitalDaeguRepublic of Korea
- School of MedicineKyungpook National UniversityDaeguRepublic of Korea
| | - Yongkeun Cho
- Department of Internal MedicineKyungpook National University HospitalDaeguRepublic of Korea
- School of MedicineKyungpook National UniversityDaeguRepublic of Korea
| | - Se Yong Jang
- Department of Internal MedicineKyungpook National University Chilgok HospitalDaeguRepublic of Korea
- School of MedicineKyungpook National UniversityDaeguRepublic of Korea
| | - Dong Heon Yang
- Department of Internal MedicineKyungpook National University HospitalDaeguRepublic of Korea
- Department of Internal MedicineKyungpook National University Chilgok HospitalDaeguRepublic of Korea
- School of MedicineKyungpook National UniversityDaeguRepublic of Korea
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Park JS, Lee JH, Hong CM, Park BE, Park YJ, Kim HN, Kim N, Jang SY, Bae MH, Yang DH, Park HS, Cho Y. Impact of Positron Emission Tomography Viability Imaging: Guided Revascularizations on Clinical Outcomes in Patients With Myocardial Scar on Single-Photon Emission Computed Tomography Scans. J Korean Med Sci 2023; 38:e399. [PMID: 38013651 PMCID: PMC10681844 DOI: 10.3346/jkms.2023.38.e399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Accepted: 08/23/2023] [Indexed: 11/29/2023] Open
Abstract
BACKGROUND Positron emission tomography (PET) viability scan is used to determine whether patients with a myocardial scar on single-photon emission computed tomography (SPECT) may need revascularization. However, the clinical utility of revascularization decision-making guided by PET viability imaging has not been proven yet. The purpose of this study was to investigate the impact of PET to determine revascularization on clinical outcomes. METHODS Between September 2012 and May 2021, 53 patients (37 males; mean age = 64 ± 11 years) with a myocardial scar on MIBI SPECT who underwent PET viability test were analyzed in this study. The primary outcome was a temporal change in echocardiographic findings. The secondary outcome was all-cause mortality. RESULTS Viable myocardium was presented by PET imaging in 29 (54.7%) patients. Revascularization was performed in 26 (49.1%) patients, including 18 (34.0%) with percutaneous coronary intervention (PCI) and 8 (15.1%) with coronary artery bypass grafting. There were significant improvements in echocardiographic findings in the revascularization group and the viable myocardium group. All-cause mortality was significantly lower in the revascularization group than in the medical therapy-alone group (19.2% vs. 44.4%, log-rank P = 0.002) irrespective of viable (21.4% vs. 46.7%, log-rank P = 0.025) or non-viable myocardium (16.7% vs. 41.7%, log-rank P = 0.046). All-cause mortality was significantly lower in the PCI group than in the medical therapy-alone group (11.1% vs. 44.4%, log-rank P < 0.001). CONCLUSION Revascularization improved left ventricular systolic function and survival of patients with a myocardial scar on SPECT scans, irrespective of myocardial viability on PET scans.
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Affiliation(s)
- Jong Sung Park
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
| | - Jang Hoon Lee
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
- School of Medicine, Kyungpook National University, Daegu, Korea.
| | - Chae Moon Hong
- School of Medicine, Kyungpook National University, Daegu, Korea
- Department of Nuclear Medicine, Kyungpook National University Hospital, Daegu, Korea
| | - Bo Eun Park
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
- School of Medicine, Kyungpook National University, Daegu, Korea
| | - Yoon Jung Park
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
- School of Medicine, Kyungpook National University, Daegu, Korea
| | - Hong Nyun Kim
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
- School of Medicine, Kyungpook National University, Daegu, Korea
| | - Namkyun Kim
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
- School of Medicine, Kyungpook National University, Daegu, Korea
| | - Se Yong Jang
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
- School of Medicine, Kyungpook National University, Daegu, Korea
| | - Myung Hwan Bae
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
- School of Medicine, Kyungpook National University, Daegu, Korea
| | - Dong Heon Yang
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
- School of Medicine, Kyungpook National University, Daegu, Korea
| | - Hun Sik Park
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
- School of Medicine, Kyungpook National University, Daegu, Korea
| | - Yongkeun Cho
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
- School of Medicine, Kyungpook National University, Daegu, Korea
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Kim J, Jung G, Jung S, Bae MH, Yeom J, Park J, Lee Y, Kim YR, Kang DH, Oh JH, Park S, An KS, Ko H. Shape-Configurable MXene-Based Thermoacoustic Loudspeakers with Tunable Sound Directivity. Adv Mater 2023; 35:e2306637. [PMID: 37740254 DOI: 10.1002/adma.202306637] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 09/19/2023] [Indexed: 09/24/2023]
Abstract
Film-type shape-configurable speakers with tunable sound directivity are in high demand for wearable electronics. Flexible, thin thermoacoustic (TA) loudspeakers-which are free from bulky vibrating diaphragms-show promise in this regard. However, configuring thin TA loudspeakers into arbitrary shapes is challenging because of their low sound pressure level (SPL) under mechanical deformations and low conformability to other surfaces. By carefully controlling the heat capacity per unit area and thermal effusivity of an MXene conductor and substrates, respectively, it fabricates an ultrathin MXene-based TA loudspeaker exhibiting high SPL output (74.5 dB at 15 kHz) and stable sound performance for 14 days. Loudspeakers with the parylene substrate, whose thickness is less than the thermal penetration depth, generated bidirectional and deformation-independent sound in bent, twisted, cylindrical, and stretched-kirigami configurations. Furthermore, it constructs parabolic and spherical versions of ultrathin, large-area (20 cm × 20 cm) MXene-based TA loudspeakers, which display sound-focusing and 3D omnidirectional-sound-generating attributes, respectively.
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Affiliation(s)
- Jinyoung Kim
- School of Energy and Chemical Engineering, Ulsan National Institute of Science and Technology (UNIST), Ulsan Metropolitan City, 44919, Republic of Korea
| | - Geonyoung Jung
- School of Energy and Chemical Engineering, Ulsan National Institute of Science and Technology (UNIST), Ulsan Metropolitan City, 44919, Republic of Korea
| | - Seokhee Jung
- School of Energy and Chemical Engineering, Ulsan National Institute of Science and Technology (UNIST), Ulsan Metropolitan City, 44919, Republic of Korea
| | - Myung Hwan Bae
- School of Mechanical Engineering, Ulsan National Institute of Science and Technology (UNIST), Ulsan Metropolitan City, 44919, Republic of Korea
| | - Jeonghee Yeom
- School of Energy and Chemical Engineering, Ulsan National Institute of Science and Technology (UNIST), Ulsan Metropolitan City, 44919, Republic of Korea
| | - Jonghwa Park
- School of Energy and Chemical Engineering, Ulsan National Institute of Science and Technology (UNIST), Ulsan Metropolitan City, 44919, Republic of Korea
| | - Youngoh Lee
- School of Energy and Chemical Engineering, Ulsan National Institute of Science and Technology (UNIST), Ulsan Metropolitan City, 44919, Republic of Korea
| | - Young-Ryul Kim
- School of Energy and Chemical Engineering, Ulsan National Institute of Science and Technology (UNIST), Ulsan Metropolitan City, 44919, Republic of Korea
| | - Dong-Hee Kang
- School of Energy and Chemical Engineering, Ulsan National Institute of Science and Technology (UNIST), Ulsan Metropolitan City, 44919, Republic of Korea
| | - Joo Hwan Oh
- School of Mechanical Engineering, Ulsan National Institute of Science and Technology (UNIST), Ulsan Metropolitan City, 44919, Republic of Korea
| | - Seungyoung Park
- Thin Film Materials Research Center, Korea Research Institute of Chemical Technology (KRICT), Daejeon, 34114, Republic of Korea
| | - Ki-Seok An
- Thin Film Materials Research Center, Korea Research Institute of Chemical Technology (KRICT), Daejeon, 34114, Republic of Korea
| | - Hyunhyub Ko
- School of Energy and Chemical Engineering, Ulsan National Institute of Science and Technology (UNIST), Ulsan Metropolitan City, 44919, Republic of Korea
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Hwang J, Oh YS, Park HS, Choi JI, Lee YS, Choi EK, Shin DG, On YK, Kim TH, Park HW, Cho MS, Bae MH, Han S. Comparing the Efficacy of Carvedilol and Flecainide on the Treatment of Idiopathic Premature Ventricular Complexes from Ventricular Outflow Tract: A Multicenter, Randomized, Open-Label Pilot Study. J Clin Med 2023; 12:jcm12082887. [PMID: 37109225 PMCID: PMC10144596 DOI: 10.3390/jcm12082887] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 04/10/2023] [Accepted: 04/14/2023] [Indexed: 04/29/2023] Open
Abstract
The mechanism of premature ventricular complexes (PVC) occurring in the ventricular outflow tract (OT) is related to an intracellular calcium overload and delayed afterdepolarizations that lead to triggered activity. The guidelines recommend using beta-blockers and flecainide for idiopathic PVCs, but they also acknowledge the limited evidence supporting this recommendation. We conducted a multicenter, randomized, open-label pilot study comparing the effect of carvedilol and flecainide on OT PVC, which are widely used to treat this arrhythmia. Patients with a 24 h Holter recording a PVC burden ≥ 5%, which showed positive R waves in leads II, III, and aVF, and without structural heart disease were enrolled. They were randomly assigned to the carvedilol or flecainide group, and the maximum tolerated dose was administered for 12 weeks. A total of 103 participants completed the protocol: 51 with carvedilol and 52 with flecainide. After 12 weeks of treatment, the mean PVC burden significantly decreased in both groups: 20.3 ± 11.5 to 14.6 ± 10.8% with carvedilol (p < 0.0001) and 17.1 ± 9.9 to 6.6 ± 9.9% with flecainide (p < 0.0001). Both carvedilol and flecainide effectively suppressed OT PVCs in patients without structural heart disease, with flecainide showing a superior efficacy compared to carvedilol.
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Affiliation(s)
- Jongmin Hwang
- Cardiovascular Center, Keimyung University Dongsan Hospital, Daegu 42601, Republic of Korea
| | - Yong-Seog Oh
- Division of Cardiology, Department of Internal Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul 06591, Republic of Korea
| | - Hyoung-Seob Park
- Cardiovascular Center, Keimyung University Dongsan Hospital, Daegu 42601, Republic of Korea
| | - Jong-Il Choi
- Arrhythmia Center, Korea University Medical Center Anam Hospital, Seoul 02841, Republic of Korea
| | - Young Soo Lee
- Department of Cardiology, Catholic University of Daegu, Daegu 42472, Republic of Korea
| | - Eue-Keun Choi
- Department of Internal Medicine, Seoul National University Hospital, Seoul 03080, Republic of Korea
| | - Dong-Gu Shin
- Division of Cardiology, Department of Internal Medicine, Yeungnam University Medical Center, Yeungnam University College of Medicine, Daegu 42415, Republic of Korea
| | - Young Keun On
- Division of Cardiology, Department of Internal Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Republic of Korea
| | - Tae-Hoon Kim
- Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
| | - Hyung Wook Park
- Department of Cardiology, Chonnam National University Hospital, Gwangju 61469, Republic of Korea
| | - Min Soo Cho
- Department of Cardiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, Republic of Korea
| | - Myung Hwan Bae
- Division of Cardiology, Department of Internal Medicine, Kyungpook National University Hospital, Daegu 41944, Republic of Korea
| | - Seongwook Han
- Cardiovascular Center, Keimyung University Dongsan Hospital, Daegu 42601, Republic of Korea
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Choi H, Bae MH, Park YJ, Park HK, Lee E, Kim MS, Park JS, Kim HJ, Park BE, Kim HN, Kim N, Lee JH, Jang SY, Yang DH, Park HS, Cho Y. Predictors of stroke or systemic embolism in patients with non-valvular atrial fibrillation with CHA 2 DS 2 -VASc score of 0. Ann Noninvasive Electrocardiol 2023; 28:e13036. [PMID: 36625408 PMCID: PMC10023890 DOI: 10.1111/anec.13036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 11/27/2022] [Accepted: 12/13/2022] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Anticoagulant therapy has been important for stroke prevention in patients with atrial fibrillation (AF). However, it was not recommended due to its relatively higher risk of bleeding than its lower risk of stroke in patients with a CHA2 DS2 -VASc score of 0. HYPOTHESIS This study aimed to evaluate the predictors of stroke in AF patients with very low risk of stroke. METHODS Between 1990 and 2020, 542 patients with non-valvular AF (NVAF) with a CHA2 DS2 -VASc score of 0 followed up for at least 6 months were enrolled. Patients with only being woman as a risk factor were included as a CHA2 DS2 -VASc score of 0 in this study. The primary outcome was stroke or systemic embolism. RESULTS The primary outcome rate was 0.78%/year. In Cox hazard model, age of ≥50 years at diagnosis (hazard ratio [HR] 6.710, 95% confidence interval [CI] 1.811-24.860, p = .004), LVEDD of ≥46 mm (HR 4.513, 95% CI 1.038-19.626, p = .045), and non-paroxysmal AF (HR 5.575, 95% CI 1.621-19.175, p = .006) were identified as independent predictors of stroke or systemic embolism. Patients with all three independent predictors had a higher risk of stroke or systemic embolism (4.21%/year), whereas those without did not have a stroke or systemic embolism. CONCLUSION The annual stroke or systemic embolism rate in NVAF patients with CHA2 DS2 -VASc score of 0 was 0.78%/year, and age at AF diagnosis, LVEDD, and non-paroxysmal AF were independent predictors of stroke or systemic embolism in patients considered to have a very low risk of stroke.
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Affiliation(s)
- Hyohun Choi
- Department of Internal MedicineKyungpook National University HospitalDaeguKorea
| | - Myung Hwan Bae
- Department of Internal MedicineKyungpook National University HospitalDaeguKorea
- School of MedicineKyungpook National UniversityDaeguKorea
| | - Yoon Jung Park
- Department of Internal MedicineKyungpook National University HospitalDaeguKorea
| | - Hyuk Kyoon Park
- Department of Internal MedicineKyungpook National University HospitalDaeguKorea
| | - Eunkyu Lee
- Department of Internal MedicineKyungpook National University HospitalDaeguKorea
| | - Myeong Seop Kim
- Department of Internal MedicineKyungpook National University HospitalDaeguKorea
| | - Jong Sung Park
- Department of Internal MedicineKyungpook National University HospitalDaeguKorea
| | - Hyeon Jeong Kim
- Department of Internal MedicineKyungpook National University HospitalDaeguKorea
| | - Bo Eun Park
- Department of Internal MedicineKyungpook National University HospitalDaeguKorea
| | - Hong Nyun Kim
- Department of Internal MedicineKyungpook National University HospitalDaeguKorea
- School of MedicineKyungpook National UniversityDaeguKorea
| | - Namkyun Kim
- Department of Internal MedicineKyungpook National University HospitalDaeguKorea
- School of MedicineKyungpook National UniversityDaeguKorea
| | - Jang Hoon Lee
- Department of Internal MedicineKyungpook National University HospitalDaeguKorea
- School of MedicineKyungpook National UniversityDaeguKorea
| | - Se Yong Jang
- Department of Internal MedicineKyungpook National University HospitalDaeguKorea
- School of MedicineKyungpook National UniversityDaeguKorea
| | - Dong Heon Yang
- Department of Internal MedicineKyungpook National University HospitalDaeguKorea
- School of MedicineKyungpook National UniversityDaeguKorea
| | - Hun Sik Park
- Department of Internal MedicineKyungpook National University HospitalDaeguKorea
- School of MedicineKyungpook National UniversityDaeguKorea
| | - Yongkeun Cho
- Department of Internal MedicineKyungpook National University HospitalDaeguKorea
- School of MedicineKyungpook National UniversityDaeguKorea
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Kim N, Kim CY, Roh JH, Jung MS, Kwon Y, Park JS, Kim HN, Jang SY, Bae MH, Lee JH, Yang DH, park HS, Cho Y. THE ASSOCIATION OF NON-ALCOHOLIC FATTY LIVER DISEASE AND VENOUS THROMBOEMBOLIC DISEASE IN HEALTHY ADULTS: A NATIONWIDE STUDY OF KOREAN PEOPLE. J Am Coll Cardiol 2023. [DOI: 10.1016/s0735-1097(23)02520-2] [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: 03/06/2023]
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Park BE, Bae MH, Park YJ, Kim HN, Kim N, Jang SY, Lee JH, Yang DH, Park HS, Cho Y, Chae SC. Preoperative cardiac troponin I as a predictor of postoperative cardiac events in patients with end stage renal disease undergoing non-cardiac surgery. Heart Vessels 2023; 38:265-273. [PMID: 36114377 PMCID: PMC9816183 DOI: 10.1007/s00380-022-02159-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] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 08/18/2022] [Indexed: 01/10/2023]
Abstract
We investigated if elevated cardiac troponin I (cTnI) serum levels before non-cardiac surgery were predictors of postoperative cardiac events in patients with end stage renal disease (ESRD) undergoing dialysis. In total, 703 consecutive patients with ESRD undergoing dialysis who underwent non-cardiac surgery were enrolled. Preoperative cTnI serum levels were measured at least once in all patients. The primary endpoint was defined as a composite of cardiac death, myocardial infarction (MI), and pulmonary edema during hospitalization or within 30 days after surgery in patients with a hospitalization longer than 30 days after surgery. Postoperative cardiac events occurred in 48 (6.8%) out of 703 patients (cardiac death 1, MI 18, and pulmonary edema 33). Diabetes mellitus (DM), previous ischemic heart disease, and congestive heart failure were more common in patients with postoperative cardiac events. Peak cTnI serum levels were higher in patients with postoperative cardiac event (180 ± 420 ng/L vs. 80 ± 190 ng/L, p = 0.008), and also elevated peak cTnI levels > 45 ng/L were more common in patients with postoperative cardiac events (66.8% vs. 30.5%, p < 0.001). Multivariate logistic regression analysis showed that DM (odds ratio [OR] 2.509, 95% confidence interval [CI] 1.178-5.345, p = 0.017) and serum peak cTnI levels ≥ 45 ng/L (OR 3.167, 95% CI 1.557-6.444, p = 0.001) were independent predictors for the primary outcome of cardiac death/MI/pulmonary edema. Moreover, cTnI levels ≥ 45 ng/L had an incremental prognostic value to the revised cardiac risk index (RCRI) (Chi-square = 23, p < 0.001), and to the combined RCRI and left ventricular ejection fraction (Chi-square = 12, p = 0.001). Elevated preoperative cTnI levels are predictors of postoperative cardiac events including cardiac death, MI, and pulmonary edema in patients with ESRD undergoing non-cardiac surgery.
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Affiliation(s)
- Bo Eun Park
- Division of Cardiology, Department of Internal Medicine, Kyungpook National University Hospital, School of Medicine, 130, Dongdeok-ro, Jung-gu, Daegu, 41944, South Korea
| | - Myung Hwan Bae
- Division of Cardiology, Department of Internal Medicine, Kyungpook National University Hospital, School of Medicine, 130, Dongdeok-ro, Jung-gu, Daegu, 41944, South Korea.
| | - Yoon Jung Park
- Division of Cardiology, Department of Internal Medicine, Kyungpook National University Hospital, School of Medicine, 130, Dongdeok-ro, Jung-gu, Daegu, 41944, South Korea
| | - Hong Nyun Kim
- Division of Cardiology, Department of Internal Medicine, Kyungpook National University Hospital, School of Medicine, 130, Dongdeok-ro, Jung-gu, Daegu, 41944, South Korea
| | - Namkyun Kim
- Division of Cardiology, Department of Internal Medicine, Kyungpook National University Hospital, School of Medicine, 130, Dongdeok-ro, Jung-gu, Daegu, 41944, South Korea
| | - Se Yong Jang
- Division of Cardiology, Department of Internal Medicine, Kyungpook National University Hospital, School of Medicine, 130, Dongdeok-ro, Jung-gu, Daegu, 41944, South Korea
| | - Jang Hoon Lee
- Division of Cardiology, Department of Internal Medicine, Kyungpook National University Hospital, School of Medicine, 130, Dongdeok-ro, Jung-gu, Daegu, 41944, South Korea
| | - Dong Heon Yang
- Division of Cardiology, Department of Internal Medicine, Kyungpook National University Hospital, School of Medicine, 130, Dongdeok-ro, Jung-gu, Daegu, 41944, South Korea
| | - Hun Sik Park
- Division of Cardiology, Department of Internal Medicine, Kyungpook National University Hospital, School of Medicine, 130, Dongdeok-ro, Jung-gu, Daegu, 41944, South Korea
| | - Yongkeun Cho
- Division of Cardiology, Department of Internal Medicine, Kyungpook National University Hospital, School of Medicine, 130, Dongdeok-ro, Jung-gu, Daegu, 41944, South Korea
| | - Shung Chull Chae
- Division of Cardiology, Department of Internal Medicine, Kyungpook National University Hospital, School of Medicine, 130, Dongdeok-ro, Jung-gu, Daegu, 41944, South Korea
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Yoon JY, Lee JH, Kim HN, Kim N, Jang SY, Bae MH, Yang DH, Park HS, Cho Y. The novel bio-SYNTAX scoring system for predicting the prognosis of patients undergoing percutaneous coronary intervention with left main coronary artery disease. Front Cardiovasc Med 2022; 9:912286. [PMID: 36211557 PMCID: PMC9538309 DOI: 10.3389/fcvm.2022.912286] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 07/19/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundSimple and effective risk models incorporating biomarkers associated with left main coronary artery (LMCA) stenosis are limited. This study aimed to validate the novel Bio-Clinical SYNTAX score (Bio-CSS) incorporating N-terminal pro-B-type natriuretic peptide (NT-proBNP) in patients with LMCA stenosis.MethodsPatients who underwent percutaneous coronary intervention (PCI) for LMCA stenosis using a drug-eluting stent (n = 275) were included in the study. We developed the Bio-CSS incorporating NT-proBNP and validated the ability of the Bio-CSS to predict major adverse cardiac events (MACEs) and compared its performance to that of the SYNTAX score (SS) and SS II. The MACEs were defined as death, non-fatal myocardial infarction (MI), and repeat revascularizations.ResultsThe Bio-CSS (34.7 ± 18.3 vs. 51.9 ± 28.4, p < 0.001), as well as SS (23.6 ± 7.3 vs. 26.7 ± 8.1, p = 0.003) and SS II (29.4 ± 9.9 vs. 36.1 ± 12.8, p < 0.001), was significantly higher in patients with MACEs. In the Cox proportional hazards model, the log Bio-CSS (hazard ratio 8.31, 95% CI 1.84–37.55) was an independent prognostic factor for MACEs after adjusting for confounding variables. In the receiver operating characteristic curves, the area under the curve of the Bio-CSS was significantly higher compared to those of SS (0.608 vs. 0.706, p = 0.001) and SS II (0.655 vs. 0.706, p = 0.026). Patients were categorized into the three groups based on the tertiles of the Bio-CSS. Patients in the highest tertile of the Bio-CSS had significantly higher MACEs compared to those in the lower two tertiles (log-rank p < 0.001).ConclusionIn patients who underwent PCI for LMCA stenosis, the novel Bio-CSS improved the discrimination accuracy of established combined scores, such as SS and SS II. The addition of NT-proBNP to the clinical and angiographic findings in the Bio-CSS could potentially provide useful long-term prognostic information in these patients.
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Affiliation(s)
- Jae Yong Yoon
- Department of Internal Medicine, CHA Gumi Medical Center, CHA University, Gumi, South Korea
| | - Jang Hoon Lee
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, South Korea
- School of Medicine, Kyungpook National University, Daegu, South Korea
- *Correspondence: Jang Hoon Lee
| | - Hong Nyun Kim
- School of Medicine, Kyungpook National University, Daegu, South Korea
- Department of Internal Medicine, Kyungpook National University Chilgok Hospital, Daegu, South Korea
| | - Namkyun Kim
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, South Korea
- School of Medicine, Kyungpook National University, Daegu, South Korea
| | - Se Yong Jang
- School of Medicine, Kyungpook National University, Daegu, South Korea
- Department of Internal Medicine, Kyungpook National University Chilgok Hospital, Daegu, South Korea
| | - Myung Hwan Bae
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, South Korea
- School of Medicine, Kyungpook National University, Daegu, South Korea
| | - Dong Heon Yang
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, South Korea
- School of Medicine, Kyungpook National University, Daegu, South Korea
| | - Hun Sik Park
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, South Korea
- School of Medicine, Kyungpook National University, Daegu, South Korea
| | - Yongkeun Cho
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, South Korea
- School of Medicine, Kyungpook National University, Daegu, South Korea
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12
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Choi H, Lee JH, Park HK, Lee E, Kim MS, Kim HJ, Park BE, Kim HN, Kim N, Jang SY, Bae MH, Yang DH, Park HS, Cho Y. Impact of the COVID-19 Pandemic on Patient Delay and Clinical Outcomes for Patients With Acute Myocardial Infarction. J Korean Med Sci 2022; 37:e167. [PMID: 35638194 PMCID: PMC9151994 DOI: 10.3346/jkms.2022.37.e167] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [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: 12/06/2021] [Accepted: 04/12/2022] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND It has been known that the fear of contagion during the coronavirus disease 2019 (COVID-19) creates time delays with subsequent impact on mortality in patients with acute myocardial infarction (AMI). However, difference of time delay and clinical outcome in patients with ST-segment elevation myocardial infarction (STEMI) or non-STEMI between the COVID-19 pandemic and pre-pandemic era has not been fully investigated yet in Korea. The aim of this study was to investigate the impact of COVID-19 pandemic on time delays and clinical outcome in patients with STEMI or non-STEMI compared to the same period years prior. METHODS A total of 598 patients with STEMI (n = 195) or non-STEMI (n = 403) who underwent coronary angiography during the COVID-19 pandemic (February 1 to April 30, 2020) and pre-pandemic era (February 1 to April 30, 2017, 2018, and 2019) were analyzed in this study. Main outcomes were the incidence of time delay, cardiac arrest, and in-hospital death. RESULTS There was 13.5% reduction in the number of patients hospitalized with AMI during the pandemic compared to pre-pandemic era. In patients with STEMI, door to balloon time tended to be longer during the pandemic compared to pre-pandemic era (55.7 ± 12.6 minutes vs. 60.8 ± 13.0 minutes, P = 0.08). There were no significant differences in cardiac arrest (15.6% vs. 10.4%, P = 0.397) and in-hospital mortality (15.6% vs. 10.4%, P = 0.397) between pre-pandemic and the pandemic era. In patients with non-STEMI, symptom to door time was significantly longer (310.0 ± 346.2 minutes vs. 511.5 ± 635.7 minutes, P = 0.038) and the incidence of cardiac arrest (0.9% vs. 3.5%, P = 0.017) and in-hospital mortality (0.3% vs. 2.3%, P = 0.045) was significantly greater during the pandemic compared to pre-pandemic era. Among medications, angiotensin converting enzyme inhibitors/angiotensin type 2 receptor blockers (ACE-I/ARBs) were underused in STEMI (64.6% vs. 45.8%, P = 0.021) and non-STEMI (67.8% vs. 57.0%, P = 0.061) during the pandemic. CONCLUSION During the COVID-19 pandemic, there has been a considerable reduction in hospital admissions for AMI, time delay, and underuse of ACE-I/ARBs for the management of AMI, and this might be closely associated with the excess death in Korea.
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Affiliation(s)
- Hyohun Choi
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
| | - Jang Hoon Lee
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
- School of Medicine, Kyungpook National University, Daegu, Korea.
| | - Hyuk Kyoon Park
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
| | - Eunkyu Lee
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
| | - Myeong Seop Kim
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
| | - Hyeon Jeong Kim
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
| | - Bo Eun Park
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
| | - Hong Nyun Kim
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
- School of Medicine, Kyungpook National University, Daegu, Korea
| | - Namkyun Kim
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
- School of Medicine, Kyungpook National University, Daegu, Korea
| | - Se Yong Jang
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
- School of Medicine, Kyungpook National University, Daegu, Korea
| | - Myung Hwan Bae
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
- School of Medicine, Kyungpook National University, Daegu, Korea
| | - Dong Heon Yang
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
- School of Medicine, Kyungpook National University, Daegu, Korea
| | - Hun Sik Park
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
- School of Medicine, Kyungpook National University, Daegu, Korea
| | - Yongkeun Cho
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
- School of Medicine, Kyungpook National University, Daegu, Korea
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Hwang J, Seog Oh Y, Park H, Choi JI, Lee YS, Choi EK, Shin DG, On YK, Kim TH, Cho MS, Bae MH, Han S. PO-654-06 ANTI-ARRHYTHMIC EFFECT OF CARVEDILOL ON SUPPRESSING IDIOPATHIC VENTRICULAR ARRHYTHMIAS ORIGINATING FROM VENTRICULAR OUTFLOW TRACT. Heart Rhythm 2022. [DOI: 10.1016/j.hrthm.2022.03.267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Bae HJ, Cho HJ, Lee CH, Bae MH, Park HS, Jung BC, Shin DG, Cho Y, Hwang J, Han S, Park KH, Jang SY, Lee YS. Electrocardiographic Manifestations in Patients with COVID-19: Daegu in South Korea. Korean Circ J 2021; 51:851-862. [PMID: 34595853 PMCID: PMC8484995 DOI: 10.4070/kcj.2021.0116] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 06/15/2021] [Accepted: 07/14/2021] [Indexed: 12/12/2022] Open
Abstract
As COVID-19 spreads worldwide, cardiac injury in patients infected with COVID-19 becomes a significant concern. Thus, this study investigates the impact of several electrocardiogram parameters and disease severity in COVID-19 patients. The deceased patients showed increased dispersion of QTc and Tpe-c compared with surviving patients (78.2±41.1 vs. 40.8±24.6 ms and 60.2±37.3 vs 40.8±24.5 ms, both p<0.05). The QTc dispersion of more than 56.1 ms could predict the mortality in multivariate analysis (Odd ratio 8.06, 95% Confidence Interval 2.843–25.750). A prolonged QTc dispersion could be an independent predictable factor of mortality. Background and Objectives As the coronavirus disease 2019 (COVID-19) spreads worldwide, cardiac injury in patients infected with COVID-19 becomes a significant concern. Thus, this study investigates the impact of several electrocardiogram (ECG) parameters and disease severity in COVID-19 patients. Methods Seven medical centers in Daegu admitted 822 patients with COVID-19 between February and April 2020. This study examined 267 patients among them who underwent an ECG test and evaluated their biochemical parameters like C-reactive protein (CRP), log N-terminal pro-B-type Natriuretic Peptide (NT-proBNP), cardiac enzyme, and ECG parameters (heart rate, PR interval, QRS interval, T inversion, QT interval, and Tpe [the interval between peak to end in a T wave]). Results Those patients were divided into 3 groups of mild (100 patients), moderate (89 patients), and severe (78 patients) according to clinical severity score. The level of CRP, log NT-proBNP, and creatinine kinase-myocardial band were significantly increased in severe patients. Meanwhile, severe patients exhibited prolonged QT intervals (QTc) and Tpe (Tpe-c) compared to mild or moderate patients. Moreover, deceased patients (58; 21.7%) showed increased dispersion of QTc and Tpe-c compared with surviving patients (78.2±41.1 vs. 40.8±24.6 ms and 60.2±37.3 vs. 40.8±24.5 ms, both p<0.05, respectively). The QTc dispersion of more than 56.1 ms could predict the mortality in multivariate analysis (odd ratio, 11.55; 95% confidence interval, 3.746–42.306). Conclusions COVID-19 infections could involve cardiac injuries, especially cardiac repolarization abnormalities. A prolonged QTc dispersion could be an independent predictable factor of mortality.
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Affiliation(s)
- Han-Joon Bae
- Division of Cardiology, Daegu Catholic University College of Medicine, Daegu, Korea
| | - Hyun Jun Cho
- Division of Cardiology, Daegu Fatima General Hospital, Daegu, Korea
| | - Chan-Hee Lee
- Division of Cardiology, Yeungnam University College of Medicine, Daegu, Korea
| | - Myung Hwan Bae
- Division of Cardiology, Kyungpook National University, Daegu, Korea
| | - Hyoung-Seob Park
- Division of Cardiology, Keimyung University Dongsan Medical Center, Daegu, Korea
| | - Byung Chun Jung
- Division of Cardiology, Daegu Fatima General Hospital, Daegu, Korea
| | - Dong-Gu Shin
- Division of Cardiology, Yeungnam University College of Medicine, Daegu, Korea
| | - Yongkeun Cho
- Division of Cardiology, Kyungpook National University, Daegu, Korea
| | - Jongmin Hwang
- Division of Cardiology, Keimyung University Dongsan Medical Center, Daegu, Korea
| | - Seongwook Han
- Division of Cardiology, Keimyung University Dongsan Medical Center, Daegu, Korea
| | - Kyu-Hwan Park
- Division of Cardiology, Daegu Veterans Hospital, Daegu, Korea
| | - Se Yong Jang
- Division of Cardiology, Kyungpook National University Chilgok Hospital, Daegu, Korea
| | - Young Soo Lee
- Division of Cardiology, Daegu Catholic University College of Medicine, Daegu, Korea.
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15
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Kim HN, Bae MH, Park BE, Lee J. A case of paroxysmal complete atrioventricular block in a COVID-19 patient. Clin Case Rep 2021; 9:e04268. [PMID: 34721847 PMCID: PMC8536923 DOI: 10.1002/ccr3.4268] [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: 02/02/2021] [Revised: 04/19/2021] [Indexed: 12/12/2022] Open
Abstract
Many types of cardiac arrhythmias can occur in people with COVID-19, and these arrhythmias can affect the patient's outcomes. We have experienced paroxysmal complete atrioventricular block in a patient with COVID-19 and would like to share the course of treatment.
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Affiliation(s)
- Hong Nyun Kim
- Division of CardiologyDepartment of Internal MedicineKyungpook National University HospitalDaeguKorea
| | - Myung Hwan Bae
- Division of CardiologyDepartment of Internal MedicineKyungpook National University HospitalDaeguKorea
- Department of Internal MedicineSchool of MedicineKyungpook National UniversityDaeguKorea
| | - Bo Eun Park
- Division of CardiologyDepartment of Internal MedicineKyungpook National University HospitalDaeguKorea
| | - Jaehee Lee
- Division of PulmonologyDepartment of Internal MedicineKyungpook National University HospitalSchool of MedicineKyungpook National UniversityDaeguKorea
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Kim HJ, Lee JH, Jang SY, Bae MH, Yang DH, Park HS, Cho Y, Jeong MH, Park JS, Kim HS, Hur SH, Seong IW, Cho MC, Chae SC. Prognostic value of novel neutrophil-to-hemoglobin and lymphocyte score in patients with acute myocardial infarction. EUR J INFLAMM 2021. [DOI: 10.1177/20587392211039095] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
We developed and assessed whether a novel neutrophil-to-hemoglobin and lymphocyte (NHL) score would improve the ability to predict clinical outcome compared with neutrophil-to-lymphocyte ratio (NLR) and systemic immune-inflammation index (SII) in acute myocardial infarction (AMI). We examined 13,072 AMI patients from the Korean AMI Registry–National Institute of Health database. NHL score was calculated as follows: NHL score (U) = N/(Hb × L), where N, Hb, and L are baseline blood neutrophil, hemoglobin, and lymphocyte count. The primary outcome was the occurrence of major adverse cerebrocardiovascular events (MACCEs) at 2 years. The NLR, SII, and NHL score were independent predictors of 2-year MACCEs. The area under the curve of the NHL score (0.637) for predicting 2-year MACCEs was significantly higher compared with those of SII (0.589) and NLR (0.607). The NHL score significantly improved the reclassification and integrated discrimination compared with NLR ( p < 0.0001) and SII ( p < 0.0001). A high NHL score (≥ 0.35 U) was an independent predictor of 2-year MACCEs (adjusted hazard ratio, 1.41; 95% confidence interval, 1.29–1.55; p < 0.001). The NHL score could be a novel model for predicting long-term MACCEs in patients with AMI.
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Affiliation(s)
- Hyeon Jeong Kim
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea
| | - Jang Hoon Lee
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea
- School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Se Yong Jang
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea
- School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Myung Hwan Bae
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea
- School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Dong Heon Yang
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea
- School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Hun Sik Park
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea
- School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Yongkeun Cho
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea
- School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Myung H Jeong
- Department of Internal Medicine, Chonnam National University Hospital, Gwangju, Republic of Korea
| | - Jong-Seon Park
- Department of Internal Medicine, Yeungnam University Hospital, Daegu, Republic of Korea
| | - Hyo-Soo Kim
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Seung-Ho Hur
- Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, Republic of Korea
| | - In-Whan Seong
- Department of Internal Medicine, Chungnam National University Hospital, Daejeon, Republic of Korea
| | - Myeong-Chan Cho
- Department of Internal Medicine, Chungbuk National University Hospital, Cheongju, Republic of Korea
| | - Shung Chull Chae
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea
- School of Medicine, Kyungpook National University, Daegu, Republic of Korea
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Cho HJ, Kim N, Kim HJ, Park BE, Kim HN, Jang SY, Bae MH, Lee JH, Yang DH, Park HS, Cho Y, Chae SC. Effectiveness of a new cardiac risk scoring model reclassified by QRS fragmentation as a predictor of postoperative cardiac event in patients with severe renal dysfunction. BMC Cardiovasc Disord 2021; 21:359. [PMID: 34330222 PMCID: PMC8323309 DOI: 10.1186/s12872-021-02182-4] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Accepted: 07/09/2021] [Indexed: 11/20/2022] Open
Abstract
Background It is difficult to evaluate the risk of patients with severe renal dysfunction before surgery due to various limitations despite high postoperative cardiac events. This study aimed to investigate the value of a newly reclassified Revised Cardiac Risk Index (RCRI) that incorporates QRS fragmentation (fQRS) as a predictor of postoperative cardiac events in patients with severe renal dysfunction. Methods
Among the patients with severe renal dysfunction, 256 consecutive patients who underwent both a nuclear stress test and noncardiac surgery were evaluated. We reclassified RCRI as fragmented RCRI (FRCRI) by integrating fQRS on electrocardiography. We defined postoperative major adverse cardiac event (MACE) as a composite of cardiac death, nonfatal myocardial infarction, and pulmonary edema. Results Twenty-eight patients (10.9%) developed postoperative MACE, and this was significantly frequent in patients with myocardial perfusion defect (41.4% vs. 28.0%, p = 0.031). fQRS was observed 84 (32.8%)
patients, and it was proven to be an independent predictor of postoperative MACE after adjusting for the RCRI (odds ratio 3.279, 95% confidence interval (CI) 1.419–7.580, p = 0.005). Moreover, fQRS had an incremental prognostic value for the RCRI (chi-square = 7.8, p = 0.005), and to the combination of RCRI and age (chi-square = 9.1, p = 0.003). The area under curve for predicting postoperative MACE significantly increased from 0.612 for RCRI to 0.667 for FRCRI (p = 0.027) and 23 patients (32.4%) originally classified as RCRI 2 were reclassified as FRCRI 3. Conclusions A newly reclassified FRCRI that incorporates fQRS, is a valuable predictor of postoperative MACE in patients with severe renal dysfunction undergoing noncardiac surgery.
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Affiliation(s)
- Hyun Jun Cho
- Department of Cardiology, Daegu Fatima Hospital, Daegu, Republic of Korea
| | - Namkyun Kim
- Department of Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Hyeon Jeong Kim
- Department of Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Bo Eun Park
- Department of Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Hong Nyun Kim
- Department of Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Se Yong Jang
- Department of Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Myung Hwan Bae
- Department of Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea.
| | - Jang Hoon Lee
- Department of Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Dong Heon Yang
- Department of Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Hun Sik Park
- Department of Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Yongkeun Cho
- Department of Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Shung Chull Chae
- Department of Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
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18
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Kim HN, Yang DH, Park BE, Park YJ, Kim HJ, Jang SY, Bae MH, Lee JH, Park HS, Cho Y, Chae SC. Prognostic impact of chromogranin A in patients with acute heart failure. Yeungnam Univ J Med 2021; 38:337-343. [PMID: 34233402 PMCID: PMC8688787 DOI: 10.12701/yujm.2020.00843] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 06/02/2021] [Indexed: 11/23/2022] Open
Abstract
Background Chromogranin A (CgA) levels have been reported to predict mortality in patients with heart failure. However, information on the prognostic value and clinical availability of CgA is limited. We compared the prognostic value of CgA to that of previously proven natriuretic peptide biomarkers in patients with acute heart failure. Methods We retrospectively evaluated 272 patients (mean age, 68.5±15.6 years; 62.9% male) who underwent CgA test in the acute stage of heart failure hospitalization between June 2017 and June 2018. The median follow-up period was 348 days. Prognosis was assessed using the composite events of 1-year death and heart failure hospitalization. Results In-hospital mortality rate during index admission was 7.0% (n=19). During the 1-year follow-up, a composite event rate was observed in 12.1% (n=33) of the patients. The areas under the receiver-operating characteristic curves for predicting 1-year adverse events were 0.737 and 0.697 for N-terminal pro-B-type natriuretic peptide (NT-proBNP) and CgA, respectively. During follow-up, patients with high CgA levels (>158 pmol/L) had worse outcomes than those with low CgA levels (≤158 pmol/L) (85.2% vs. 58.6%, p<0.001). When stratifying the patients into four subgroups based on CgA and NT-proBNP levels, patients with high NT-proBNP and high CgA had the worst outcome. CgA had an incremental prognostic value when added to the combination of NT-proBNP and clinically relevant risk factors. Conclusion The prognostic power of CgA was comparable to that of NT-proBNP in patients with acute heart failure. The combination of CgA and NT-proBNP can improve prognosis prediction in these patients.
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Affiliation(s)
- Hong Nyun Kim
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea.,Cardiology Center, Kyungpook National University Chilgok Hospital, Daegu, Korea
| | - Dong Heon Yang
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea.,Cardiology Center, Kyungpook National University Chilgok Hospital, Daegu, Korea.,Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Bo Eun Park
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
| | - Yoon Jung Park
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
| | - Hyeon Jeong Kim
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
| | - Se Yong Jang
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea.,Cardiology Center, Kyungpook National University Chilgok Hospital, Daegu, Korea.,Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Myung Hwan Bae
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea.,Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Jang Hoon Lee
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea.,Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Hun Sik Park
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea.,Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Yongkeun Cho
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea.,Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Shung Chull Chae
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea.,Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
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19
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Park BE, Lee JH, Kim HJ, Kim HN, Jang SY, Bae MH, Yang DH, Park HS, Cho Y, Chae SC. N-terminal pro-brain natriuretic peptide and coronary collateral formation in patients undergoing primary percutaneous coronary intervention. Heart Vessels 2021; 36:1775-1783. [PMID: 34047816 PMCID: PMC8556172 DOI: 10.1007/s00380-021-01866-3] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Accepted: 05/07/2021] [Indexed: 11/24/2022]
Abstract
There is insufficient information on the relationship between the N-terminal pro-brain natriuretic peptide (NT-proBNP) level and collateral circulation (CC) formation after primary percutaneous coronary intervention (PCI) in patients with ST-segment elevation myocardial infarction. We analyzed 857 patients who underwent primary PCI. The serum NT-proBNP levels were measured on the day of admission, and the CC was scored according to Rentrop’s classification. Log-transformed NT-proBNP levels were significantly higher in patients with good CC compared to those with poor CC (6.13 ± 2.01 pg/mL versus 5.48 ± 1.97 pg/mL, p < 0.001). The optimum cutoff value of log NT-proBNP for predicting CC was 6.04 pg/mL. Log NT-proBNP ≥ 6.04 pg/mL (odds ratio 2.23; 95% confidence interval 1.51–3.30; p < 0.001) was an independent predictor of good CC. CC development was higher in patients with a pre-TIMI flow of 0 or 1 than those with a pre-TIMI flow of 2 or 3 (22.6% versus 8.8%, p = 0.001). The incidence of left ventricular (LV) dysfunction (< 50%) was greater in patients with a pre-TIMI flow of 0 or 1 (49.8% versus 35.5%, p < 0.001). The release of NT-proBNP was greater in patients with LV dysfunction (34.3% versus 15.6%, p < 0.001). The incidence of good CC was greater in patients with log NT-proBNP levels ≥ 6.04 pg/ml (16.8% versus 26.2%, p = 0.003). The association between NT-proBNP and collateral formation was not influenced by pre-TIMI flow and LV function. NT-proBNP appears to reflect the degree of collateral formation in the early phase of STEMI and might have a new role as a useful surrogate biomarker for collateral formation in patients undergoing primary PCI.
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Affiliation(s)
- Bo Eun Park
- Department of Internal Medicine, Kyungpook National University Hospital, 130, Dongdeok-ro, Jung-gu, Daegu, 41944, Republic of Korea
| | - Jang Hoon Lee
- Department of Internal Medicine, Kyungpook National University Hospital, 130, Dongdeok-ro, Jung-gu, Daegu, 41944, Republic of Korea. .,School of Medicine, Kyungpook National University, Daegu, Republic of Korea.
| | - Hyeon Jeong Kim
- Department of Internal Medicine, Kyungpook National University Hospital, 130, Dongdeok-ro, Jung-gu, Daegu, 41944, Republic of Korea
| | - Hong Nyun Kim
- Department of Internal Medicine, Kyungpook National University Hospital, 130, Dongdeok-ro, Jung-gu, Daegu, 41944, Republic of Korea
| | - Se Yong Jang
- Department of Internal Medicine, Kyungpook National University Hospital, 130, Dongdeok-ro, Jung-gu, Daegu, 41944, Republic of Korea.,School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Myung Hwan Bae
- Department of Internal Medicine, Kyungpook National University Hospital, 130, Dongdeok-ro, Jung-gu, Daegu, 41944, Republic of Korea.,School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Dong Heon Yang
- Department of Internal Medicine, Kyungpook National University Hospital, 130, Dongdeok-ro, Jung-gu, Daegu, 41944, Republic of Korea.,School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Hun Sik Park
- Department of Internal Medicine, Kyungpook National University Hospital, 130, Dongdeok-ro, Jung-gu, Daegu, 41944, Republic of Korea.,School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Yongkeun Cho
- Department of Internal Medicine, Kyungpook National University Hospital, 130, Dongdeok-ro, Jung-gu, Daegu, 41944, Republic of Korea.,School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Shung Chull Chae
- Department of Internal Medicine, Kyungpook National University Hospital, 130, Dongdeok-ro, Jung-gu, Daegu, 41944, Republic of Korea.,School of Medicine, Kyungpook National University, Daegu, Republic of Korea
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20
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Kim HN, Lee JH, Kim HJ, Park BE, Jang SY, Bae MH, Yang DH, Park HS, Cho Y, Jeong MH, Park JS, Kim HS, Hur SH, Seong IW, Cho MC, Kim CJ, Chae SC. Derivation and validation of a combined in-hospital mortality and bleeding risk model in acute myocardial infarction. Int J Cardiol Heart Vasc 2021; 33:100732. [PMID: 33665352 PMCID: PMC7907424 DOI: 10.1016/j.ijcha.2021.100732] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 01/08/2021] [Accepted: 01/28/2021] [Indexed: 12/22/2022]
Abstract
Background In the potent new antiplatelet era, it is important issue how to balance the ischemic risk and the bleeding risk. However, previous risk models have been developed separately for in-hospital mortality and major bleeding risk. Therefore, we aimed to develop and validate a novel combined model to predict the combined risk of in-hospital mortality and major bleeding at the same time for initial decision making in patients with acute myocardial infarction (AMI). Methods Variables from the Korean Acute Myocardial Infarction Registry (KAMIR) - National Institute of Health (NIH) database were used to derive (n = 8955) and validate (n = 3838) a multivariate logistic regression model. Major adverse cardiovascular events (MACEs) were defined as in-hospital death and major bleeding. Results Seven factors were associated with MACE in the model: age, Killip class, systolic blood pressure, heart rate, serum glucose, glomerular filtration rate, and initial diagnosis. The risk model discriminated well in the derivation (c-static = 0.80) and validation (c-static = 0.80) cohorts. The KAMIR-NIH risk score was developed from the model and corresponded well with observed MACEs: very low risk (0.9%), low risk (1.7%), moderate risk (4.2%), high risk (8.6%), and very high risk (23.3%). In patients with MACEs, a KAMIR-NIH risk score ≤ 10 was associated with high bleeding risk, whereas a KAMIR-NIH risk score > 10 was associated with high in-hospital mortality. Conclusion The KAMIR-NIH in-hospital MACEs model using baseline variables stratifies comprehensive risk for in-hospital mortality and major bleeding, and is useful for guiding initial decision making.
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Affiliation(s)
- Hong Nyun Kim
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea
| | - Jang Hoon Lee
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea.,School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Hyeon Jeong Kim
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea
| | - Bo Eun Park
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea
| | - Se Yong Jang
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea.,School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Myung Hwan Bae
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea.,School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Dong Heon Yang
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea.,School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Hun Sik Park
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea.,School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Yongkeun Cho
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea.,School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Myung Ho Jeong
- Department of Internal Medicine, Chonnam National University Hospital, Gwangju, Republic of Korea
| | - Jong-Seon Park
- Department of Internal Medicine, Yeungnam University Hospital, Daegu, Republic of Korea
| | - Hyo-Soo Kim
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Seung-Ho Hur
- Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, Republic of Korea
| | - In-Whan Seong
- Department of Internal Medicine, Chungnam National University Hospital, Daejeon, Republic of Korea
| | - Myeong-Chan Cho
- Department of Internal Medicine, Chungbuk National University Hospital, Cheongju, Republic of Korea
| | - Chong-Jin Kim
- Department of Internal Medicine, Kyung Hee University East-West Neo Medical Center, Seoul, Republic of Korea
| | - Shung Chull Chae
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea.,School of Medicine, Kyungpook National University, Daegu, Republic of Korea
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21
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Park BE, Lee JH, Park HK, Kim HN, Jang SY, Bae MH, Yang DH, Park HS, Cho Y, Lee BY, Nam CW, Lee JB, Kim U, Chae SC. Impact of Cardiovascular Risk Factors and Cardiovascular Diseases on Outcomes in Patients Hospitalized with COVID-19 in Daegu Metropolitan City. J Korean Med Sci 2021; 36:e15. [PMID: 33429474 PMCID: PMC7801150 DOI: 10.3346/jkms.2021.36.e15] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [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: 08/28/2020] [Accepted: 12/18/2020] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Data regarding the association between preexisting cardiovascular risk factors (CVRFs) and cardiovascular diseases (CVDs) and the outcomes of patients requiring hospitalization for coronavirus disease 2019 (COVID-19) are limited. Therefore, the aim of this study was to investigate the impact of preexisting CVRFs or CVDs on the outcomes of patients with COVID-19 hospitalized in a Korean healthcare system. METHODS Patients with COVID-19 admitted to 10 hospitals in Daegu Metropolitan City, Korea, were examined. All sequentially hospitalized patients between February 15, 2020, and April 24, 2020, were enrolled in this study. All patients were confirmed to have COVID-19 based on the positive results on the polymerase chain reaction testing of nasopharyngeal samples. Clinical outcomes during hospitalization, such as requiring intensive care and invasive mechanical ventilation (MV) and death, were evaluated. Moreover, data on baseline comorbidities such as a history of diabetes, hypertension, dyslipidemia, current smoking, heart failure, coronary artery disease, cerebrovascular accidents, and other chronic cardiac diseases were obtained. RESULTS Of all the patients enrolled, 954 (42.0%) had preexisting CVRFs or CVDs. Among the CVRFs, the most common were hypertension (28.8%) and diabetes mellitus (17.0%). The prevalence rates of preexisting CVRFs or CVDs increased with age (P < 0.001). The number of patients requiring intensive care (P < 0.001) and invasive MV (P < 0.001) increased with age. The in-hospital death rate increased with age (P < 0.001). Patients requiring intensive care (5.3% vs. 1.6%; P < 0.001) and invasive MV (4.3% vs. 1.7%; P < 0.001) were significantly greater in patients with preexisting CVRFs or CVDs. In-hospital mortality (12.9% vs. 3.1%; P < 0.001) was significantly higher in patients with preexisting CVRFs or CVDs. Among the CVRFs, diabetes mellitus and hypertension were associated with increased requirement of intensive care and invasive MV and in-hospital death. Among the known CVDs, coronary artery disease and congestive heart failure were associated with invasive MV and in-hospital death. In multivariate analysis, preexisting CVRFs or CVDs (odds ratio [OR], 1.79; 95% confidence interval [CI], 1.07-3.01; P = 0.027) were independent predictors of in-hospital death after adjusting for confounding variables. Among individual preexisting CVRF or CVD components, diabetes mellitus (OR, 2.43; 95% CI, 1.51-3.90; P < 0.001) and congestive heart failure (OR, 2.43; 95% CI, 1.06-5.87; P = 0.049) were independent predictors of in-hospital death. CONCLUSION Based on the findings of this study, the patients with confirmed COVID-19 with preexisting CVRFs or CVDs had worse clinical outcomes. Caution is required in dealing with these patients at triage.
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Affiliation(s)
- Bo Eun Park
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
| | - Jang Hoon Lee
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Korea.
| | - Hyuk Kyoon Park
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
| | - Hong Nyun Kim
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
| | - Se Yong Jang
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Myung Hwan Bae
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Dong Heon Yang
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Hun Sik Park
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Yongkeun Cho
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Bong Yul Lee
- Department of Internal Medicine, Daegu Fatima Hospital, Daegu, Korea
| | - Chang Wook Nam
- Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, Korea
| | - Jin Bae Lee
- Department of Internal Medicine, Daegu Catholic University Hospital, Daegu, Korea
| | - Ung Kim
- Department of Internal Medicine, Yeungnam University Hospital, Daegu, Korea
| | - Shung Chull Chae
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
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22
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Park BE, Yang DH, Kim HJ, Park YJ, Kim HN, Jang SY, Bae MH, Lee JH, Park HS, Cho Y, Chae SC. Incremental Predictive Value of Plasma Renin Activity as a Prognostic Biomarker in Patients with Heart Failure. J Korean Med Sci 2020; 35:e351. [PMID: 33140588 PMCID: PMC7606887 DOI: 10.3346/jkms.2020.35.e351] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 08/20/2020] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND The association of N-terminal pro-B type natriuretic peptide (NT-proBNP) and plasma renin activity (PRA) for the prognosis of the patients with acute heart failure (HF) has not been fully investigated. This study aimed to determine the association between NT-proBNP and PRA and to investigate the incremental value of PRA to NT-proBNP for predicting long term prognosis in patients with acute HF. METHODS Three hundred and ninety-six patients (mean age, 64.7 ± 15.9 years; 46.5% female) presenting with acute HF were enrolled between December 2004 and July 2013. Patients with newly diagnosed HF as well as patients with acute exacerbated chronic HF were included. The prognosis was assessed with the composite event of all-cause mortality and readmission for HF during a 2-year follow-up period. RESULTS The etiology of HF was ischemic in 116 (29.3%) patients. In a Cox proportional hazards model, log-transformed PRA (hazard ratio [HR], 1.205; P = 0.007) was an independent predictor of the composite outcome of all-cause mortality and readmission for HF in addition to age (HR, 1.032; P = 0.001), white blood cell (WBC) count (HR, 1.103; P < 0.001), and left ventricular ejection fraction (LVEF) (HR, 0.978; P = 0.013). Adding PRA to age, sex, LVEF, and NT-proBNP significantly improved the prediction for the composite outcome of all-cause mortality and readmission for HF, as shown by the net reclassification improvement (0.47; P < 0.001) and integrated discrimination improvement (0.10; P < 0.001). CONCLUSION PRA could provide incremental predictive value to NT-proBNP for predicting long term prognosis in patients with acute HF.
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Affiliation(s)
- Bo Eun Park
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
| | - Dong Heon Yang
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
- Cardiology Center, Kyungpook National University Chilgok Hospital, Daegu, Korea.
| | - Hyeon Jeong Kim
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
| | - Yoon Jung Park
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
| | - Hong Nyun Kim
- Cardiology Center, Kyungpook National University Chilgok Hospital, Daegu, Korea
| | - Se Yong Jang
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
- Cardiology Center, Kyungpook National University Chilgok Hospital, Daegu, Korea
| | - Myung Hwan Bae
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Jang Hoon Lee
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Hun Sik Park
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Yongkeun Cho
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Shung Chull Chae
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
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23
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Park YJ, Bae MH, Kim HJ, Park BE, Kim HN, Jang SY, Lee JH, Yang DH, Park HS, Cho Y, Chae SC. Osborn waves during therapeutic hypothermia and recurrence of fatal arrhythmia in patients resuscitated following sudden cardiac arrest. Pacing Clin Electrophysiol 2020; 43:1281-1288. [DOI: 10.1111/pace.14070] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 08/07/2020] [Accepted: 09/01/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Yoon Jung Park
- Division of Cardiology, Department of Internal Medicine, School of Medicine Kyungpook National University Daegu South Korea
| | - Myung Hwan Bae
- Division of Cardiology, Department of Internal Medicine, School of Medicine Kyungpook National University Daegu South Korea
| | - Hyeon Jeong Kim
- Division of Cardiology, Department of Internal Medicine, School of Medicine Kyungpook National University Daegu South Korea
| | - Bo Eun Park
- Division of Cardiology, Department of Internal Medicine, School of Medicine Kyungpook National University Daegu South Korea
| | - Hong Nyun Kim
- Division of Cardiology, Department of Internal Medicine, School of Medicine Kyungpook National University Daegu South Korea
| | - Se Yong Jang
- Division of Cardiology, Department of Internal Medicine, School of Medicine Kyungpook National University Daegu South Korea
| | - Jang Hoon Lee
- Division of Cardiology, Department of Internal Medicine, School of Medicine Kyungpook National University Daegu South Korea
| | - Dong Heon Yang
- Division of Cardiology, Department of Internal Medicine, School of Medicine Kyungpook National University Daegu South Korea
| | - Hun Sik Park
- Division of Cardiology, Department of Internal Medicine, School of Medicine Kyungpook National University Daegu South Korea
| | - Yongkeun Cho
- Division of Cardiology, Department of Internal Medicine, School of Medicine Kyungpook National University Daegu South Korea
| | - Shung Chull Chae
- Division of Cardiology, Department of Internal Medicine, School of Medicine Kyungpook National University Daegu South Korea
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24
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Park BE, Bae MH, Kim HJ, Park YJ, Kim HN, Jang SY, Lee JH, Yang DH, Park HS, Cho Y, Chae SC. Perioperative outcomes of interrupted anticoagulation in patients with non-valvular atrial fibrillation undergoing non-cardiac surgery. Yeungnam Univ J Med 2020; 37:321-328. [PMID: 32668522 PMCID: PMC7606955 DOI: 10.12701/yujm.2020.00353] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 06/17/2020] [Indexed: 12/21/2022] Open
Abstract
Background This study aimed to investigate the incidences of and risk factors for perioperative events following anticoagulant discontinuation in patients with non-valvular atrial fibrillation (NVAF) undergoing non-cardiac surgery. Methods A total of 216 consecutive patients who underwent cardiac consultation for suspending perioperative anticoagulants were enrolled. A perioperative event was defined as a composite of thromboembolism and major bleeding. Results The mean anticoagulant discontinuation duration was 5.7 (±4.2) days and was significantly longer in the warfarin group (p<0.001). Four perioperative thromboembolic (1.9%; three strokes and one systemic embolization) and three major bleeding events (1.4%) were observed. The high CHA2DS2-VASc and HAS-BLED scores and a prolonged preoperative anticoagulant discontinuation duration (4.4±2.1 vs. 2.9±1.8 days; p=0.028) were associated with perioperative events, whereas the anticoagulant type (non-vitamin K antagonist oral anticoagulants or warfarin) was not. The best cut-off levels of the HAS-BLED and CHA2DS2-VASc scores were 3.5 and 2.5, respectively, and the preoperative anticoagulant discontinuation duration for predicting perioperative events was 2.5 days. Significant differences in the perioperative event rates were observed among the four risk groups categorized according to the sum of these values: risk 0, 0%; risk 1, 0%; risk 2, 5.9%; and risk 3, 50.0% (p<0.001). Multivariate logistic regression analysis showed that the HAS-BLED score was an independent predictor for perioperative events. Conclusion Thromboembolic events and major bleeding are not uncommon during perioperative anticoagulant discontinuation in patients with NVAF, and interrupted anticoagulation strategies are needed to minimize these.
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Affiliation(s)
- Bo Eun Park
- Department of Internal Medicine, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Myung Hwan Bae
- Department of Internal Medicine, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Hyeon Jeong Kim
- Department of Internal Medicine, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Yoon Jung Park
- Department of Internal Medicine, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Hong Nyun Kim
- Department of Internal Medicine, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Se Yong Jang
- Department of Internal Medicine, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Jang Hoon Lee
- Department of Internal Medicine, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Dong Heon Yang
- Department of Internal Medicine, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Hun Sik Park
- Department of Internal Medicine, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Yongkeun Cho
- Department of Internal Medicine, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Shung Chull Chae
- Department of Internal Medicine, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, Korea
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Kim HN, Lee JH, Park HS, Yang DH, Jang SY, Bae MH, Cho Y, Chae SC, Lee YH. A Case of COVID-19 with Acute Myocardial Infarction and Cardiogenic Shock. J Korean Med Sci 2020; 35:e258. [PMID: 32657091 PMCID: PMC7358062 DOI: 10.3346/jkms.2020.35.e258] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [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: 06/19/2020] [Accepted: 06/24/2020] [Indexed: 12/18/2022] Open
Abstract
A 60-year-old male patient with coronavirus disease-2019 showed new onset ST-segment elevation in V1-V2 leads on electrocardiogram and cardiac enzyme elevation in intensive care unit. He had a history of type 2 diabetes mellitus, hypertension, and dyslipidemia. He was receiving mechanical ventilation and veno-venous extracorporeal membrane oxygenation treatment for severe hypoxia. Two-D echocardiogram showed regional wall motion abnormalities. We performed primary percutaneous coronary intervention for acute myocardial infarction complicating cardiogenic shock under hemodynamic support. He expired on the 16th day of admission because of cardiogenic shock and multi-organ failure. Active surveillance and intensive treatment strategy are important for saving lives of COVID-19 patients with acute myocardial infarction.
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Affiliation(s)
- Hong Nyun Kim
- Division of Cardiology, Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
| | - Jang Hoon Lee
- Division of Cardiology, Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Korea.
| | - Hun Sik Park
- Division of Cardiology, Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea.
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Dong Heon Yang
- Division of Cardiology, Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea.
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Se Yong Jang
- Division of Cardiology, Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea.
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Myung Hwan Bae
- Division of Cardiology, Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea.
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Yongkeun Cho
- Division of Cardiology, Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea.
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Shung Chull Chae
- Division of Cardiology, Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea.
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Yong Hoon Lee
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, Korea
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Bae MH, Cho Y, Hwang J, Park HS, Han S, Lee YS, Cho HJ, Jung BC, Lee CH, Hyun DW, Park JS, Ahn J, Kim KH, Shin DG. Clinical Impact of Implantable Cardioverter-Defibrillator Therapy and Mortality Prediction Model for Effective Primary Prevention in Korean Patients. J Korean Med Sci 2020; 35:e49. [PMID: 32141247 PMCID: PMC7061144 DOI: 10.3346/jkms.2020.35.e49] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Accepted: 01/07/2020] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Studies on the efficacy of implantable cardioverter-defibrillator (ICD) therapy for primary prevention in Asian patients are relatively lacking compared to those for secondary prevention. Also, it is important to stratify which patients will benefit from ICD therapy for primary prevention. METHODS Of 483 consecutive patients who received new implantation of ICD in 9 centers in Korea, 305 patients with reduced left ventricular systolic function and/or documented ventricular fibrillation/tachycardia were enrolled and divided into primary (n = 167) and secondary prevention groups (n = 138). RESULTS During mean follow-up duration of 2.6 ± 1.6 years, appropriate ICD therapy occurred in 78 patients (25.6%), and appropriate ICD shock and anti-tachycardia pacing occurred in 15.1% and 15.1% of patients, respectively. Appropriate ICD shock rate was not different between the two groups (primary 12% vs. secondary 18.8%, P = 0.118). However, appropriate ICD therapy rate including shock and anti-tachycardia pacing was significantly higher (primary 18% vs. secondary 34.8%, P = 0.001) in the secondary prevention group. Type of prevention and etiology, appropriate and inappropriate ICD shock did not affect all-cause death. High levels of N-terminal pro-B-type natriuretic peptide, New York Heart Association functional class, low levels of estimated glomerular filtration ratio, and body mass index were associated with death before appropriate ICD shock in the primary prevention group. When patients were categorized in 5 risk score groups according to the sum of values defined by each cut-off level, significant differences in death rate before appropriate ICD shock were observed among risk 0 (0%), 1 (3.6%), 2 (3%), 3 (26.5%), and 4 (40%) (P < 0.001). CONCLUSION In this multicenter regional registry, the frequency of appropriate ICD therapy is not low in the primary prevention group. In addition, combination of poor prognostic factors of heart failure is useful in risk stratification of patients who are not benefiting from ICD therapy for primary prevention.
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Affiliation(s)
- Myung Hwan Bae
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Yongkeun Cho
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Jongmin Hwang
- Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, Korea
| | - Hyoung Seob Park
- Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, Korea
| | - Seongwook Han
- Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, Korea
| | - Young Soo Lee
- Department of Internal Medicine, Daegu Catholic University Medical Center, Daegu, Korea
| | - Hyun Jun Cho
- Department of Internal Medicine, Daegu Fatima General Hospital, Daegu, Korea
| | - Byung Chun Jung
- Department of Internal Medicine, Daegu Fatima General Hospital, Daegu, Korea
| | - Chan Hee Lee
- Department of Internal Medicine, Yeungnam University Medical Center, Daegu, Korea
| | - Dae Woo Hyun
- Department of Internal Medicine, Andong General Hospital, Andong, Korea
| | - Jong Sung Park
- Department of Internal Medicine, Dong-A University Hospital, Busan, Korea
| | - Jinhee Ahn
- Department of Internal Medicine, Pusan National University Hospital, Busan, Korea
| | - Ki Hun Kim
- Department of Internal Medicine, Inje University Busan Haeundae Paik Hospital, Busan, Korea
| | - Dong Gu Shin
- Department of Internal Medicine, Yeungnam University Medical Center, Daegu, Korea.
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Park YJ, Lee JH, Park BE, Kim HN, Jang SY, Bae MH, Yang DH, Park HS, Cho Y, Chae SC. P3617Systolic blood pressure, glycemic control and clinical outcome in diabetic patients with acute myocardial infarction. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Recent blood pressure guidelines recommend intensive blood pressure control in diabetic patients with cardiovascular disease.
Purpose
We sought to investigate combined impact of intensive blood glucose lowering and blood pressure control on clinical outcome in diabetic patients with acute myocardial infarction (AMI) has not been fully investigated yet.
Method
Korean Acute Myocardial Infarction Registry (KAMIR) – National Institute of Health (NIH) database included 12,179 patients (9,046 men; mean age = 63.6±12.6 year-old) who were discharged alive. Among them, 3,430 (28.2%) had a diabetes mellitus (DM). MACCEs were defined as a composition of all cause death, non-fatal MI, repeat revascularizations including repeated percutaneous coronary intervention and coronary bypass grafting, cerebrovascular accident and rehospitalizations at 1 year. This research was supported by a fund by Research of Korea Centers for Disease Control and Prevention.
Result
We determined cut-off value of discharge systolic blood pressure (SBP) to predict 1-year MACCE in DM and non-DM patients. Discharge SBP of less than 130mmHg was associated with a lower MACCE at 1 year compared to SBP level of 130mmHg or greater (10.8% versus 15.4%; log-rank p=0.001) in DM patients, whereas discharge SBP cut-off level was 140mmHg to discriminate 1-year MACCE in non-DM patients (6.4% versus 8.5%, log-rank p=0.045). In DM patients, there were no significant difference in 1-year MACCEs between patients with HbA1c less than 7% versus 7% or greater (12.0% versus 10.7%; log-rank p=0.325). DM patients were categorized into 4 groups; discharge SBP <130mmHg and HbA1c <7% (Group 1); discharge SBP <130mmHg and HbA1c ≥7% (Group 2); discharge SBP ≥130mmHg and HbA1c <7% (Group 3); discharge SBP ≥130mmHg and HbA1c ≥7% (Group 4). Intensive BP control was associated lower 1-year MACCEs in patients with good glycemic control (Group 1 & 3; 10.7% versus 16.7%; log-rank p=0.009). However, in patients with poor glycemic control, intensive BP control did not improve 1-year MACCEs (Group 2 & 4; 10.6% versus 11.1%; log-rank p=0.761).
Conclusion
Strict BP control is more important than glycemic control to improve short-term clinical outcome in DM patients with AMI. However, in patients with poor glycemic control, strict BP control did not improve clinical outcome.
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Affiliation(s)
- Y J Park
- Kyungpook National University Hospital, Daegu, Korea (Republic of)
| | - J H Lee
- Kyungpook National University Hospital, Daegu, Korea (Republic of)
| | - B E Park
- Kyungpook National University Hospital, Daegu, Korea (Republic of)
| | - H N Kim
- Kyungpook National University Hospital, Daegu, Korea (Republic of)
| | - S Y Jang
- Kyungpook National University Hospital, Daegu, Korea (Republic of)
| | - M H Bae
- Kyungpook National University Hospital, Daegu, Korea (Republic of)
| | - D H Yang
- Kyungpook National University Hospital, Daegu, Korea (Republic of)
| | - H S Park
- Kyungpook National University Hospital, Daegu, Korea (Republic of)
| | - Y Cho
- Kyungpook National University Hospital, Daegu, Korea (Republic of)
| | - S C Chae
- Kyungpook National University Hospital, Daegu, Korea (Republic of)
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Park YJ, Lee JH, Park BE, Kim HN, Jang SY, Bae MH, Yang DH, Park HS, Cho Y, Chae SC. P3583Optimal procedural strategy to improve clinical outcome in primary percutaneous coronary intervention. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Current guideline recommends potent antiplatelet agents and transradial intervention. However, it is uncertain whether routine use of IVUS, thrombus aspiration and glycoprotein IIB-IIIA inhibitor is beneficial for improving clinical outcome in patients with ST-segment elevation myocardial infarction (STEMI).
Purpose
The aim of this study was to investigate optimal procedural strategy to improve clinical outcome.
Methods
A total of 6,046 patients who underwent primary percutaneous coronary intervention (PCI) for STEMI were analyzed from the Korean Acute Myocardial Infarction Registry (KAMIR) – National Institute of Health (NIH) database. MACCEs were defined as a composition of all cause death, non-fatal MI, repeat revascularizations including repeated percutaneous coronary intervention and coronary bypass grafting, cerebrovascular accident and rehospitalizations. This research was supported by a fund by Research of Korea Centers for Disease Control and Prevention.
Results
During the primary PCI, potent antiplatelet agents such as prasugrel and ticagrelor were used in 2342 (38.4%). PCI was performed through transradial approach in 1490 (25.2%). Thrombus aspiration and intravascular ultrasound (IVUS) examination was done in 2204 (36.1%) and 1079 (18.1%), respectively. Glycoprotein IIB-IIIA inhibitor was administered in 1295 (21.7%). Among them, potent antiplatelet agents, transradial intervention, IVUS, and thrombus aspiration significantly reduced MACCEs at 1 year. Glycoprotein IIB-IIIA inhibitor was not effective to improved clinical outcome. In Cox-proportional hazards model, potent antiplatelet agents (hazard ratio 0.82, 95% confidence interval 0.67–0.99; p=0.045) and transradial intervention (hazard ratio 0.61, 95% confidence interval 0.47–0.78; p<0.001) was an independent predictor of MACCEs after adjusting for confounding variables. Combined use of potent antiplatelet agents and transradial intervention (hazard ratio 0.54; 95% confidence interval 0.37–0.80; p=0.002) substantially reduced MACCEs at 1 year.
Conclusion
Among evidence based procedures during the primary PCI, combined use of potent antiplatelet agents and transradial intervention was optimal procedural strategy to improve clinical outcome.
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Affiliation(s)
- Y J Park
- Kyungpook National University Hospital, Daegu, Korea (Republic of)
| | - J H Lee
- Kyungpook National University Hospital, Daegu, Korea (Republic of)
| | - B E Park
- Kyungpook National University Hospital, Daegu, Korea (Republic of)
| | - H N Kim
- Kyungpook National University Hospital, Daegu, Korea (Republic of)
| | - S Y Jang
- Kyungpook National University Hospital, Daegu, Korea (Republic of)
| | - M H Bae
- Kyungpook National University Hospital, Daegu, Korea (Republic of)
| | - D H Yang
- Kyungpook National University Hospital, Daegu, Korea (Republic of)
| | - H S Park
- Kyungpook National University Hospital, Daegu, Korea (Republic of)
| | - Y Cho
- Kyungpook National University Hospital, Daegu, Korea (Republic of)
| | - S C Chae
- Kyungpook National University Hospital, Daegu, Korea (Republic of)
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Kim HJ, Lee JH, Park BE, Kim HN, Jang SY, Bae MH, Yang D, Park HS, Cho Y, Chae SC, Jeong MH. TCT-797 Clinical Outcome in Femoral Access of High Volume Radial Percutaneous Coronary Intervention Center in Patients With ST-Segment Elevation Myocardial Infarction. J Am Coll Cardiol 2019. [DOI: 10.1016/j.jacc.2019.08.944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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30
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Yoon JY, Yang DH, Cho HJ, Kim NK, Kim CY, Son J, Roh JH, Jang SY, Bae MH, Lee JH, Park HS, Cho Y, Chae SC. Serum levels of carbohydrate antigen 125 in combination with N-terminal pro-brain natriuretic peptide in patients with acute decompensated heart failure. Korean J Intern Med 2019; 34:811-818. [PMID: 30616330 PMCID: PMC6610187 DOI: 10.3904/kjim.2017.313] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Accepted: 01/26/2018] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND/AIMS Carbohydrate antigen 125 (CA-125) is an emerging prognostic biomarker for heart failure. We aimed to test the long-term prognostic value of CA-125 in combination with N-terminal pro-brain natriuretic peptide (NT-proBNP) in patients with acute decompensated heart failure (ADHF). METHODS This observational study included a total of 413 patients (64.1 ± 15.6 yearold, 214 men) with ADHF. All-cause mortality during the 2-year follow-up was investigated for the prognosis. RESULTS During the follow-up (mean follow-up, 591 ± 233 days), 109 deaths (26.0%) were recorded. In the multivariable analysis model, CA-125 was an independent factor associated with all-cause mortality (log CA-125: hazard ratio, 1.23; 95% confidence interval, 1.02 to 1.48; p = 0.030) together with age, sex, New York Heart Association class, β-blocker, and NT-proBNP. The Kaplan-Meier survival analysis demonstrated that the group with both low marker levels showed the best 2-year survival (87.9%) followed by the group with low NT-proBNP and high CA-125 (76.1%), high NT-proBNP and low CA-125 (64.7%) and high NT-proBNP and high CA-125 levels (54.3%) (p < 0.001). Addition of CA-125 in combination with NT-proBNP and established risk factors further increased the predictive power for mortality in patients with ADHF. CONCLUSION CA-125 was an independent factor associated with all-cause mortality in patients with ADHF. Combination of CA-125 with NT-proBNP significantly improved the prediction of mortality in patients with ADHF.
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Affiliation(s)
- Jae Yong Yoon
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
| | - Dong Heon Yang
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
- Cardiology Center, Kyungpook National University Medical Center, Daegu, Korea
- Correspondence to Dong Heon Yang, M.D. Department of Internal Medicine, Kyungpook National University Hospital, 130 Dongdeok-ro,
Jung-gu, Daegu 41944, Korea Tel: +82-53-420-6587 Fax: +82-53-426-2046 E-mail:
| | - Hyun Jun Cho
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
| | - Nam Kyun Kim
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
| | - Chang-Yeon Kim
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
| | - Jihyun Son
- Cardiology Center, Kyungpook National University Medical Center, Daegu, Korea
| | - Jae-Hyung Roh
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
| | - Se Yong Jang
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
- Cardiology Center, Kyungpook National University Medical Center, Daegu, Korea
| | - Myung Hwan Bae
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
| | - Jang Hoon Lee
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
| | - Hun Sik Park
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
| | - Yongkeun Cho
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
| | - Shung Chull Chae
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
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31
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Bae MH. Cardiac Implantable Electronic Device Therapy in Korea: Increasing but Still Quite Low. Korean Circ J 2019; 49:853-855. [PMID: 31165602 PMCID: PMC6713822 DOI: 10.4070/kcj.2019.0131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Accepted: 05/07/2019] [Indexed: 11/11/2022] Open
Affiliation(s)
- Myung Hwan Bae
- Division of Cardiology, Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Korea.
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32
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Kim N, Lee JH, Jang SY, Bae MH, Yang DH, Park HS, Cho Y, Jeong MH, Park J, Kim H, Hur S, Seong I, Cho M, Kim C, Chae SC. Intravascular modality‐guided versus angiography‐guided percutaneous coronary intervention in acute myocardial infarction. Catheter Cardiovasc Interv 2019; 95:696-703. [DOI: 10.1002/ccd.28359] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [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: 12/10/2018] [Revised: 04/24/2019] [Accepted: 05/16/2019] [Indexed: 11/06/2022]
Affiliation(s)
- Namkyun Kim
- Department of Internal MedicineKyungpook National University Hospital Daegu Republic of Korea
| | - Jang Hoon Lee
- Department of Internal MedicineKyungpook National University Hospital Daegu Republic of Korea
- School of MedicineKyungpook National University Daegu Republic of Korea
| | - Se Yong Jang
- Department of Internal MedicineKyungpook National University Hospital Daegu Republic of Korea
- School of MedicineKyungpook National University Daegu Republic of Korea
| | - Myung Hwan Bae
- Department of Internal MedicineKyungpook National University Hospital Daegu Republic of Korea
- School of MedicineKyungpook National University Daegu Republic of Korea
| | - Dong Heon Yang
- Department of Internal MedicineKyungpook National University Hospital Daegu Republic of Korea
- School of MedicineKyungpook National University Daegu Republic of Korea
| | - Hun Sik Park
- Department of Internal MedicineKyungpook National University Hospital Daegu Republic of Korea
- School of MedicineKyungpook National University Daegu Republic of Korea
| | - Yongkeun Cho
- Department of Internal MedicineKyungpook National University Hospital Daegu Republic of Korea
- School of MedicineKyungpook National University Daegu Republic of Korea
| | - Myung Ho Jeong
- Department of Internal MedicineChonnam National University Hospital Gwangju Republic of Korea
| | - Jong‐Seon Park
- Department of Internal medicineYeungnam University Hospital Daegu Republic of Korea
| | - Hyo‐Soo Kim
- Department of Internal MedicineSeoul National University Hospital Seoul Republic of Korea
| | - Seung‐Ho Hur
- Department of Internal MedicineKeimyung University Dongsan Medical Center Daegu Republic of Korea
| | - In‐Whan Seong
- Department of Internal MedicineChungnam National University Hospital Daejeon Republic of Korea
| | - Myeong‐Chan Cho
- Department of Internal MedicineChungbuk National University Hospital Cheongju Republic of Korea
| | - Chong‐Jin Kim
- Department of Internal MedicineKyung Hee University East‐West Neo Medical Center Seoul Republic of Korea
| | - Shung Chull Chae
- Department of Internal MedicineKyungpook National University Hospital Daegu Republic of Korea
- School of MedicineKyungpook National University Daegu Republic of Korea
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Kim N, Lee JH, Jang SY, Bae MH, Yang DH, Park HS, Cho Y, Yoon JY, Jeong MH, Park JS, Kim HS, Hur SH, Seong IW, Cho MC, Kim CJ, Chae SC. Radial Versus Femoral Access With or Without Vascular Closure Device in Patients With Acute Myocardial Infarction. Am J Cardiol 2019; 123:742-749. [PMID: 30563616 DOI: 10.1016/j.amjcard.2018.11.040] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Revised: 11/17/2018] [Accepted: 11/26/2018] [Indexed: 11/24/2022]
Abstract
Compared with transradial intervention (TRI), it is unclear whether transfemoral intervention (TFI) with vascular closure device (VCD) improves major adverse cardiocerebrovascular events (MACCE) in patients with acute myocardial infarction (AMI). The aim of this study is to compare TRI versus TFI with or without VCD for reducing MACCEs. We examined 11,596 patients who underwent TRI or TFI from the Korean AMI Registry - National Institute of Health database. The MACCE at 1-year was defined as death, nonfatal MI, repeat revascularization, cerebrovascular accident, hospitalizations, and major bleedings. Because the patients were not randomly assigned to vascular access sites, propensity-score (PS) matching was performed. In the PS-matched cohorts, compared with TFI, TRI significantly reduced 1-year MACCEs (7.1% vs 10.1%; log-rank p < 0.001) through a reduction in major bleeding (0.6% vs 2.2%; p < 0.001). Compared with TRI, 1-year MACCEs (11.3% vs 7.9%, log-rank p < 0.001) and major bleedings (0.6% vs 2.2%; p < 0.001) were significantly greater in TFI without VCD, whereas TFI with VCD was comparable in 1-year MACCEs (7.5% vs 8.1%, log-rank p = 0.437) and major bleeding (0.7% vs 1.0%; p = 0.409). In conclusion, the use of VCD could be an alternative to avoid major bleeding and to improve clinical outcomes, particularly in high-risk patients who are not suitable for TRI.
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Cho HJ, Yoon JY, Kim N, Jang SY, Bae MH, Lee JH, Yang DH, Park HS, Cho Y, Chae SC. Predictive value of a fragmented QRS complex in diagnosing patients with myocardial ischemia. Clin Cardiol 2019; 42:379-384. [PMID: 30597592 PMCID: PMC6712309 DOI: 10.1002/clc.23148] [Citation(s) in RCA: 6] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2018] [Accepted: 12/27/2018] [Indexed: 11/26/2022] Open
Abstract
Background A fragmented QRS complex (fQRS) is caused by conduction abnormalities of the ventricle secondary to myocardial ischemia and/or scar in patients with myocardial infarction. However, the implications of the fQRS in the development of coronary artery disease with myocardial ischemia in those without a scar remain unknown. Methods We studied electrocardiograms (ECGs) obtained from 150 patients (60.5 ± 8.5 years, 102 men) with myocardial ischemia, which was confirmed by performing both, a nuclear exercise stress test and coronary angiography. We also studied ECGs obtained from 601 patients (58.5 ± 10.0 years, 315 men) who showed a negative nuclear exercise stress test (control group). Patients in whom the nuclear exercise stress test showed a myocardial scar were excluded. Results An fQRS was more commonly observed in patients with myocardial ischemia (n = 48, 32.0%) than in the control group (n = 133, 22.1%) (P = 0.011). The sensitivity, specificity, positive, and negative predictive values of fQRS in diagnosing myocardial ischemia were 32.0, 77.9, 26.5, and 82.1%, respectively. The fQRS (odds ratio 1.580, 95% confidence interval 1.020‐2.446, P = 0.040) was an independent predictor of myocardial ischemia after adjusting for age, sex, current smoking habits, ST‐T changes on ECG, as well as histories of hypertension, diabetes, and dyslipidemia. Moreover, the fQRS showed an incremental prognostic value over conventional risk factors (χ2 = 5, P = 0.032) and over a combination of conventional factors and ST‐T changes (χ2 = 9, P = 0.014). Conclusions The fQRS is a moderately sensitive and independent predictor of myocardial ischemia.
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Affiliation(s)
- H J Cho
- Department of Cardiology, Daegu Fatima Hospital, Daegu, Republic of Korea
| | - J Y Yoon
- Department of Cardiology, CHA Gumi Medical Center, CHA University, Gumi, Republic of Korea
| | - N Kim
- Department of Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - S Y Jang
- Department of Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - M H Bae
- Department of Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - J H Lee
- Department of Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - D H Yang
- Department of Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - H S Park
- Department of Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Y Cho
- Department of Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - S C Chae
- Department of Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
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Jang SY, Chae SC, Bae MH, Lee JH, Yang DH, Park HS, Cho Y, Cho HJ, Lee HY, Oh BH, Choi JO, Jeon ES, Kim MS, Lee SE, Kim JJ, Hwang KK, Cho MC, Baek SH, Kang SM, Choi DJ, Yoo BS, Ahn Y, Kim KH, Park HY. Effect of renin-angiotensin system blockade in patients with severe renal insufficiency and heart failure. Int J Cardiol 2018; 266:180-186. [DOI: 10.1016/j.ijcard.2018.03.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Revised: 02/12/2018] [Accepted: 03/05/2018] [Indexed: 01/11/2023]
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Cho HJ, Bae MH, Kim JH. P3459The implication of simple standard 12-lead electrocardiographic parameters for predicting prognosis in hospital survivors after acute myocardial infarction. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p3459] [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: 11/13/2022] Open
Affiliation(s)
- H J Cho
- Fatima General Hospital, Department of cardiology, Daegu, Korea Republic of
| | - M H Bae
- Kyungpook National University Hospital, 1Department of Cardiology, Daegu, Korea Republic of
| | - J H Kim
- Fatima General Hospital, Department of cardiology, Daegu, Korea Republic of
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Lee JH, Park BE, Park YJ, Kim HN, Kim NK, Song JH, Jang SY, Bae MH, Yang DH, Park HS, Cho Y, Chae SC, Jeong MH. P5533Impact of thrombus aspiration and Glycoprotein IIb/IIIa inhibitor between new antiplatelet agents and clopidogrel in patients undergoing primary percutaneous coronary intervention. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p5533] [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: 11/14/2022] Open
Affiliation(s)
- J H Lee
- Kyungpook National University Hospital, Daegu, Korea Republic of
| | - B E Park
- Kyungpook National University Hospital, Daegu, Korea Republic of
| | - Y J Park
- Kyungpook National University Hospital, Daegu, Korea Republic of
| | - H N Kim
- Kyungpook National University Hospital, Daegu, Korea Republic of
| | - N K Kim
- Kyungpook National University Hospital, Daegu, Korea Republic of
| | - J H Song
- Kyungpook National University Hospital, Daegu, Korea Republic of
| | - S Y Jang
- Kyungpook National University Hospital, Daegu, Korea Republic of
| | - M H Bae
- Kyungpook National University Hospital, Daegu, Korea Republic of
| | - D H Yang
- Kyungpook National University Hospital, Daegu, Korea Republic of
| | - H S Park
- Kyungpook National University Hospital, Daegu, Korea Republic of
| | - Y Cho
- Kyungpook National University Hospital, Daegu, Korea Republic of
| | - S C Chae
- Kyungpook National University Hospital, Daegu, Korea Republic of
| | - M H Jeong
- Kyungpook National University Hospital, Daegu, Korea Republic of
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Lee JH, Pakr BE, Park YJ, Kim HN, Song JH, Kim NK, Jang SY, Bae MH, Yang DH, Park HS, Cho Y, Chae SC, Jeong MH. P5575Practice-level variation in use of optimal medical treatment during hospitalization: a multi-level methodological approach. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p5575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- J H Lee
- Kyungpook National University Hospital, Daegu, Korea Republic of
| | - B E Pakr
- Kyungpook National University Hospital, Daegu, Korea Republic of
| | - Y J Park
- Kyungpook National University Hospital, Daegu, Korea Republic of
| | - H N Kim
- Kyungpook National University Hospital, Daegu, Korea Republic of
| | - J H Song
- Kyungpook National University Hospital, Daegu, Korea Republic of
| | - N K Kim
- Kyungpook National University Hospital, Daegu, Korea Republic of
| | - S Y Jang
- Kyungpook National University Hospital, Daegu, Korea Republic of
| | - M H Bae
- Kyungpook National University Hospital, Daegu, Korea Republic of
| | - D H Yang
- Kyungpook National University Hospital, Daegu, Korea Republic of
| | - H S Park
- Kyungpook National University Hospital, Daegu, Korea Republic of
| | - Y Cho
- Kyungpook National University Hospital, Daegu, Korea Republic of
| | - S C Chae
- Kyungpook National University Hospital, Daegu, Korea Republic of
| | - M H Jeong
- Kyungpook National University Hospital, Daegu, Korea Republic of
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Lee JH, Yoon JY, Park BE, Park YJ, Kim HN, Kim NK, Jang SY, Bae MH, Yang DH, Park HS, Cho Y, Chae SC. P3576Impact of intravascular ultrasound and final kissing balloon dilatation on 10-year clinical outcome in percutaneous revascularization with 1-stent strategy for left main coronary artery stenosis. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p3576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- J H Lee
- Kyungpook National University Hospital, Daegu, Korea Republic of
| | - J Y Yoon
- Gumi Cha Hospital, Internal Medicine, Gumi, Korea Republic of
| | - B E Park
- Kyungpook National University Hospital, Daegu, Korea Republic of
| | - Y J Park
- Kyungpook National University Hospital, Daegu, Korea Republic of
| | - H N Kim
- Kyungpook National University Hospital, Daegu, Korea Republic of
| | - N K Kim
- Kyungpook National University Hospital, Daegu, Korea Republic of
| | - S Y Jang
- Kyungpook National University Hospital, Daegu, Korea Republic of
| | - M H Bae
- Kyungpook National University Hospital, Daegu, Korea Republic of
| | - D H Yang
- Kyungpook National University Hospital, Daegu, Korea Republic of
| | - H S Park
- Kyungpook National University Hospital, Daegu, Korea Republic of
| | - Y Cho
- Kyungpook National University Hospital, Daegu, Korea Republic of
| | - S C Chae
- Kyungpook National University Hospital, Daegu, Korea Republic of
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Hwang J, Park HS, Kim J, Kim JS, Park JS, Kim KH, Bae MH, Lee SH, Lee YS, Han S, Kim DK, Cha TJ, Shin DG, Jung BC, Kim YN. Supraventricular tachyarrhythmias in patients with a persistent left superior vena cava. Europace 2018. [PMID: 28641381 DOI: 10.1093/europace/eux164] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Aims A persistent left superior vena cava (PLSVC) is the most common thoracic venous anomaly. This venous anomaly can impact the evaluation and treatment of supraventricular tachyarrhythmia (SVA). The aim of this study was to assess the proportion and characteristics of PLSVC in adult SVA patients. Methods and results From July 2002 to July 2012, clinical and procedural data from databases of 10 cardiac electrophysiology laboratories in the Yeungnam region of the Republic of Korea were reviewed. Of 6662 adult SVA patients who underwent an EP study or catheter ablation of SVA during the 10-year study period, 18 patients had PLSVC (mean age 47.6 ± 14.8 years, 10 men). The proportion of PLSVC in adult SVA patients was 0.27% (18/6662). SVA type and procedural outcomes of radiofrequency (RF) catheter ablation in these patients were investigated and the results were as follows: successful slow pathway modification in six of seven patients with atrioventricular nodal reentrant tachycardia (AVNRT), successful ablation of accessory pathway in three of four patients with atrioventricular reentrant tachycardia, and successful ablation of atrial tachycardia (cavotricuspid isthmus-dependent in two, septal macroreentry in one, focal from the PLSVC in one) in three of four patients. In one patient with junctional tachycardia, catheter ablation failed. In two patients with atrial fibrillation, catheter ablation was successful. Conclusion Among adult SVA patients who underwent an EP study or RF catheter ablation during the 10-year study period, 0.27% had PLSVC. The most common type of SVA was AVNRT. The success rate of catheter ablation was 82% in SVA patients with PLSVC. There were no procedure-related complications.
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Affiliation(s)
- Jongmin Hwang
- Division of Cardiology, Department of Internal Medicine, Pusan National University Yangsan Hospital, 20, Geumo-ro, Mulgeum-eup, Yangsan-si, Gyeongsangnam-do, Korea
| | - Hyoung-Seob Park
- Division of Cardiology, Department of Internal Medicine, Keimyung University Dongsan Medical Center, 56, Dalseong-ro, Jung-gu, Daegu, Korea
| | - Jun Kim
- Division of Cardiology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, Korea
| | - Jeong Su Kim
- Division of Cardiology, Department of Internal Medicine, Pusan National University Yangsan Hospital, 20, Geumo-ro, Mulgeum-eup, Yangsan-si, Gyeongsangnam-do, Korea
| | - Jong Sung Park
- Division of Cardiology, Department of Internal Medicine, Dong-A University Medical Center, 26, Daesingongwon-ro, Seo-gu, Busan, Korea
| | - Ki-Hun Kim
- Division of Cardiology, Department of Internal Medicine, Inje University Haeundae Paik Hospital, Inje University College of Medicine, 875, Haeun-daero, Haeundae-gu, Busan, Korea
| | - Myung Hwan Bae
- Division of Cardiology, Department of Internal Medicine, Kyungpook National University Hospital, 130, Dongdeok-ro, Jung-gu, Daegu, Korea
| | - Sang-Hee Lee
- Division of Cardiology, Department of Internal Medicine, Yeungnam University Hospital, 170, Hyeonchung-ro, Nam-gu, Daegu, Korea
| | - Young Soo Lee
- Division of Cardiology, Department of Internal Medicine, Daegu Catholic University Medical Center, 33, Duryugongwon-ro 17-gil, Nam-gu, Daegu, Korea
| | - Seongwook Han
- Division of Cardiology, Department of Internal Medicine, Keimyung University Dongsan Medical Center, 56, Dalseong-ro, Jung-gu, Daegu, Korea
| | - Dae-Kyeong Kim
- Division of Cardiology, Department of Internal Medicine, Inje University Busan Paik Hostpital, 75, Bokji-ro, Busanjin-gu, Busan, Korea
| | - Tae-Joon Cha
- Division of Cardiology, Department of Internal Medicine, Kosin University Gospel Hospital, 262, Gamcheon-ro, Seo-gu, Busan, Korea
| | - Dong Gu Shin
- Division of Cardiology, Department of Internal Medicine, Yeungnam University Hospital, 170, Hyeonchung-ro, Nam-gu, Daegu, Korea
| | - Byung Chun Jung
- Division of Cardiology, Department of Medicine, Daegu Fatima Hospital, 99, Ayang-ro, Dong-gu, Daegu, Korea
| | - Yoon-Nyun Kim
- Division of Cardiology, Department of Internal Medicine, Keimyung University Dongsan Medical Center, 56, Dalseong-ro, Jung-gu, Daegu, Korea
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Kim N, Bae MH. Left Main Coronary Artery Stenosis Presenting as Syncope with Brugada Type Electrocardiography. Int J Arrhythm 2018. [DOI: 10.18501/arrhythmia.2018.003] [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: 11/04/2022] Open
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Lee JH, Kim CY, Kim N, Jang SY, Bae MH, Yang DH, Cho Y, Chae SC, Park HS. Coronary Collaterals Function and Clinical Outcome Between Patients With Acute and Chronic Total Occlusion. JACC Cardiovasc Interv 2017; 10:585-593. [PMID: 28335895 DOI: 10.1016/j.jcin.2016.12.009] [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: 08/21/2016] [Revised: 11/28/2016] [Accepted: 12/12/2016] [Indexed: 11/16/2022]
Abstract
OBJECTIVES This study sought to demonstrate how changes in the collateral function and its clinical significance before and after percutaneous coronary interventions (PCIs) are compared between patients with acute coronary syndrome and total or nearly total occlusions (ATOs) and chronic total occlusions (CTOs). BACKGROUND The functional relevance of the collateral circulation in patients with ATOs and CTOs has not been fully investigated. METHODS The pressure-derived collateral pressure index (CPI), myocardial fractional flow reserve (FFRmyo), and coronary fractional flow reserve (FFRcor) at maximum hyperemia induced by intravenous adenosine were evaluated in occluded vessels at baseline, after the PCI, and at 1 year in 23 ATO and 74 CTO patients. RESULTS The FFRmyo and FFRcor were significantly lower, but the CPI was significantly higher in the CTO than ATO patients at baseline and after the PCI. There were significant increases in the FFRmyo (p < 0.001) and FFRcor (p < 0.001), whereas there was no significant change in the CPI immediately after the PCI in both ATO and CTO patients. In the CTO patients, a post-PCI FFRmyo <0.90 (p = 0.01) and post-PCI CPI <0.25 (p = 0.033) were independent predictors of the clinical outcome. Patients with a high post-PCI CPI had better clinical outcomes in CTO patients with a low post-PCI FFRmyo (log-rank p = 0.009), but not a high post-PCI FFRmyo (log-rank p = 0.492). CONCLUSIONS Recruitable coronary collateral flow did not regress completely immediately after the PCI both in patients with ATOs and CTOs. Despite good collaterals in CTO patients, aggressive efforts to reduce the ischemic burden might improve the clinical outcome.
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Affiliation(s)
- Jang Hoon Lee
- Department of Cardiology, Kyungpook National University Hospital, Daegu, Republic of Korea
| | - Chang-Yeon Kim
- Department of Cardiology, Kyungpook National University Hospital, Daegu, Republic of Korea
| | - Namkyun Kim
- Department of Cardiology, Kyungpook National University Hospital, Daegu, Republic of Korea
| | - Se Yong Jang
- Department of Cardiology, Kyungpook National University Hospital, Daegu, Republic of Korea
| | - Myung Hwan Bae
- Department of Cardiology, Kyungpook National University Hospital, Daegu, Republic of Korea
| | - Dong Heon Yang
- Department of Cardiology, Kyungpook National University Hospital, Daegu, Republic of Korea
| | - Yongkeun Cho
- Department of Cardiology, Kyungpook National University Hospital, Daegu, Republic of Korea
| | - Shung Chull Chae
- Department of Cardiology, Kyungpook National University Hospital, Daegu, Republic of Korea
| | - Hun Sik Park
- Department of Cardiology, Kyungpook National University Hospital, Daegu, Republic of Korea.
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Kim N, Park HS, Yoon JY, Cho HJ, Kim CY, Roh JH, Bae MH, Lee JH, Yang DH, Cho Y, Chae SC, Sohn J, Jang SY. Predictive Value of Estimated Glomerular Filtration Rate for the Prognosis of Elderly Patients With Acute Myocardial Infarction. Ann Geriatr Med Res 2017. [DOI: 10.4235/agmr.2017.21.1.10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Affiliation(s)
- Namkyun Kim
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
| | - Hun Sik Park
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
| | - Jae Yong Yoon
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
| | - Hyun Jun Cho
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
| | - Chang-Yeon Kim
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
| | - Jae-Hyung Roh
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
| | - Myung Hwan Bae
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
| | - Jang Hoon Lee
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
| | - Dong Heon Yang
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
| | - Yongkeun Cho
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
| | - Shung Chull Chae
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
| | - Jihyun Sohn
- Cardioloy Center, Kyungpook National University Hospital, Daegu, Korea
| | - Se Yong Jang
- Cardioloy Center, Kyungpook National University Hospital, Daegu, Korea
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Jang SY, Cho Y, Kim NK, Kim CY, Sohn J, Roh JH, Bae MH, Lee JH, Yang DH, Park HS, Chae SC, Oh TH, Kim GJ. Video-Assisted Thoracoscopic Left Cardiac Sympathetic Denervation in Patients with Hereditary Ventricular Arrhythmias. Pacing Clin Electrophysiol 2017; 40:232-241. [PMID: 28012188 DOI: 10.1111/pace.13008] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Revised: 12/12/2016] [Accepted: 12/18/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND Left cardiac sympathetic denervation (LCSD) has been underutilized in patients with hereditary ventricular arrhythmia syndromes such as congenital long QT syndrome (LQTS) and catecholaminergic polymorphic ventricular tachycardia (CPVT). The purpose of this study was to investigate the safety and efficacy of video-assisted thoracoscopic (VATS) LCSD in such patients. METHODS Fifteen patients (four men, 24.6 ± 10.5 years old) who underwent VATS-LCSD between November 2010 and January 2015 for hereditary ventricular arrhythmia syndromes at Kyungpook National University Hospital were enrolled in this study. The safety and efficacy of VATS-LCSD were evaluated by periprocedural epinephrine tests and assessing the development of complications and cardiac events during follow-up. RESULTS Fourteen patients with LQTS and one patient with CPVT underwent VATS-LCSD. Six and one patients developed ventricular tachyarrhythmia during preprocedural and postprocedural epinephrine test, respectively (P = 0.063). No serious complications such as Horner syndrome, pneumothorax, or bleeding developed after LCSD. Mean hospital stay after VATS-LCSD was 3.7 ± 1.5 days. During a mean follow-up of 927 ± 350 days, one LQTS patient and one CPVT patient, neither of whom manifested tachyarrhythmia during post-LCSD epinephrine test, developed torsades de pointes and syncope, respectively. The annual event rates of six patients who were symptomatic during the period preceding LCSD decreased from 0.97 to 0.19 events/year (P = 0.045). CONCLUSIONS VATS-LCSD was a safe, and effective procedure for patients with hereditary ventricular tachycardia syndrome, with no serious adverse events and with short hospital stay.
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Affiliation(s)
- Se Yong Jang
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea.,Cardiology Center, Kyungpook National University Medical Center, Daegu, Republic of Korea
| | - Yongkeun Cho
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea
| | - Nam Kyun Kim
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea
| | - Chang-Yeon Kim
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea
| | - Jihyun Sohn
- Cardiology Center, Kyungpook National University Medical Center, Daegu, Republic of Korea
| | - Jae-Hyung Roh
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea
| | - Myung Hwan Bae
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea
| | - Jang Hoon Lee
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea
| | - Dong Heon Yang
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea.,Cardiology Center, Kyungpook National University Medical Center, Daegu, Republic of Korea
| | - Hun Sik Park
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea
| | - Shung Chull Chae
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea
| | - Tak-Hyuk Oh
- Department of Thoracic and Cardiovascular Surgery, Kyungpook National University Hospital, Daegu, Republic of Korea
| | - Gun Jik Kim
- Department of Thoracic and Cardiovascular Surgery, Kyungpook National University Hospital, Daegu, Republic of Korea
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Choi WS, Kim JH, Jang SY, Park SH, Bae MH, Lee JH, Yang DH, Park HS, Cho Y, Chae SC. Optimal International Normalized Ratio for Warfarin Therapy in Elderly Korean Patients with Non-Valvular Atrial Fibrillation. Int J Arrhythm 2016. [DOI: 10.18501/arrhythmia.2016.029] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Park KH, Lee CH, Jung BC, Cho Y, Bae MH, Kim YN, Park HS, Han S, Lee YS, Hyun DW, Kim J, Kim DK, Cha TJ, Shin DG. Effectiveness of Implantable Cardioverter-Defibrillator Therapy for Heart Failure Patients according to Ischemic or Non-Ischemic Etiology in Korea. Korean Circ J 2016; 47:72-81. [PMID: 28154594 PMCID: PMC5287190 DOI: 10.4070/kcj.2016.0242] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Revised: 08/25/2016] [Accepted: 09/13/2016] [Indexed: 11/20/2022] Open
Abstract
Background and Objectives This study was performed to describe clinical characteristics of patients with left ventriculars (LV) dysfunction and implantable cardioverter-defibrillator (ICD), and to evaluate the effect of ICD therapy on survival in Yeongnam province of Korea. Subjects and Methods From a community-based device registry (9 centers, Yeongnam province, from November 1999 to September 2012), 146 patients with LV dysfunction and an ICD implanted for primary or secondary prophylaxis, were analyzed. The patients were divided into two groups, based on the etiology (73 with ischemic cardiomyopathy and 73 with non-ischemic cardiomyopathy), and indication for the device implantation (36 for primary prevention and 110 for secondary prevention). The cumulative first shock rate, all cause death, and type and mode of death, were determined according to the etiology and indication. Results Over a mean follow-up of 3.5 years, the overall ICD shock rate was about 39.0%. ICD shock therapy was significantly more frequent in the secondary prevention group (46.4% vs. 16.7%, p=0.002). The cumulative probability of a first appropriate shock was higher in the secondary prevention group (p=0.015). There was no significant difference in the all-cause death, cardiac death, and mode of death between the groups according to the etiology and indication. Conclusion Studies from this multicenter regional registry data shows that in both ischemic and non-ischemic cardiomyopathy patients, the ICD shock therapy rate was higher in the secondary prevention group than primary prevention group.
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Affiliation(s)
- Kyu-Hwan Park
- Division of Cardiology, Department of Internal Medicine, Yeungnam University Medical Center, Daegu, Korea
| | - Chan-Hee Lee
- Division of Cardiology, Department of Internal Medicine, Yeungnam University Medical Center, Daegu, Korea
| | - Byung Chun Jung
- Division of Cardiology, Department of Internal Medicine, Daegu Fatima Hospital, Daegu, Korea
| | - Yongkeun Cho
- Division of Cardiology, Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
| | - Myung Hwan Bae
- Division of Cardiology, Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
| | - Yoon-Nyun Kim
- Division of Cardiology, Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, Korea
| | - Hyoung-Seob Park
- Division of Cardiology, Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, Korea
| | - Seongwook Han
- Division of Cardiology, Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, Korea
| | - Young Soo Lee
- Division of Cardiology, Department of Internal Medicine, Catholic University Medical Center, Daegu, Korea
| | - Dae-Woo Hyun
- Cardiovascular Center, Andong Medical Group, Andong, Korea
| | - Jun Kim
- Division of Cardiology, Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Dae Kyeong Kim
- Division of Cardiology, Department of Internal Medicine, Inje University Busan Paik Hospital, Busan, Korea
| | - Tae-Jun Cha
- Division of Cardiology, Department of Internal Medicine, Kosin University Gospel Hospital, Busan, Korea
| | - Dong-Gu Shin
- Division of Cardiology, Department of Internal Medicine, Yeungnam University Medical Center, Daegu, Korea
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Jang SY, Yang DH, Kim NK, Kim CY, Bae MH, Lee JH, Park HS, Cho Y, Chae SC. Difference in the Prognostic Impact of Left Ventricular Global Longitudinal Strain between Anterior and Nonanterior Myocardial Infarction. Echocardiography 2016; 33:984-90. [PMID: 27316949 DOI: 10.1111/echo.13208] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Speckle tracking-derived global longitudinal strain (GLS) of left ventricle is a potent prognostic marker for patients with ST-segment elevation myocardial infarction (STEMI). The purpose of this study was to investigate the difference of prognostic impact of GLS between anterior and nonanterior myocardial infarction. METHODS This study included 686 patients who underwent primary percutaneous coronary intervention for their first STEMI between November 2007 and April 2012. Differences in the prognostic impact of GLS between anterior MI group and nonanterior MI group were evaluated. The composite of all-cause mortality and hospitalization for heart failure in 2 years was investigated for outcome. RESULTS During the follow-up period, 77 (11.2%) adverse events occurred. The anterior and nonanterior MI groups included 339 and 347 patients, respectively. Among patients with anterior MI, GLS significantly predicted 2-year outcome in an adjusted model (adjusted hazard ratio [HR] 1.186; 95% confidence interval [CI] 1.071-1.314, P = 0.001), whereas the association between GLS and mortality was weaker in the nonanterior MI group (adjusted HR 0.977; 95% CI 0.884-1.081, P = 0.657). The interaction between the infarction territory and GLS was significant (P for interaction = 0.018), indicating that GLS was a more sensitive predictor of mortality in patients with anterior MI than that in those with nonanterior MI. CONCLUSIONS Speckle tracking-derived GLS of left ventricle more sensitively predicted clinical outcome in patients with anterior MI than in those with nonanterior MI.
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Affiliation(s)
- Se Yong Jang
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
| | - Dong Heon Yang
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
| | - Nam Kyun Kim
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
| | - Chang-Yeon Kim
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
| | - Myung Hwan Bae
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
| | - Jang Hoon Lee
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
| | - Hun Sik Park
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
| | - Yongkeun Cho
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
| | - Shung Chull Chae
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
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Jang SY, Kim NK, Kim CY, Bae MH, Lee JH, Yang DH, Park HS, Cho Y, Chae SC. IMPACT OF SIMPLE THREE RISK FACTORS (AGE, BODY WEIGHT, AND HISTORY OF STROKE) ON IN-HOSTPIAL BLEEDINGS IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION. J Am Coll Cardiol 2016. [DOI: 10.1016/s0735-1097(16)30486-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Lee JH, Bae MH, Yang DH, Park HS, Cho Y, Lee WK, Jeong MH, Kim YJ, Cho MC, Kim CJ, Chae SC. Angiotensin II type 1 receptor blockers as a first choice in patients with acute myocardial infarction. Korean J Intern Med 2016; 31:267-76. [PMID: 26701233 PMCID: PMC4773713 DOI: 10.3904/kjim.2014.268] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2014] [Revised: 11/19/2014] [Accepted: 12/17/2014] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND/AIMS Angiotensin II type 1 receptor blockers (ARBs) have not been adequately evaluated in patients without left ventricular (LV) dysfunction or heart failure after acute myocardial infarction (AMI). METHODS Between November 2005 and January 2008, 6,781 patients who were not receiving angiotensin-converting enzyme inhibitors (ACEIs) or ARBs were selected from the Korean AMI Registry. The primary endpoints were 12-month major adverse cardiac events (MACEs) including death and recurrent AMI. RESULTS Seventy percent of the patients were Killip class 1 and had a LV ejection fraction ≥ 40%. The prescription rate of ARBs was 12.2%. For each patient, a propensity score, indicating the likelihood of using ARBs during hospitalization or at discharge, was calculated using a non-parsimonious multivariable logistic regression model, and was used to match the patients 1:4, yielding 715 ARB users versus 2,860 ACEI users. The effect of ARBs on in-hospital mortality and 12-month MACE occurrence was assessed using matched logistic and Cox regression models. Compared with ACEIs, ARBs significantly reduced in-hospital mortality(1.3% vs. 3.3%; hazard ratio [HR], 0.379; 95% confidence interval [CI], 0.190 to0.756; p = 0.006) and 12-month MACE occurrence (4.6% vs. 6.9%; HR, 0.661; 95% CI, 0.457 to 0.956; p = 0.028). However, the benefit of ARBs on 12-month mortality compared with ACEIs was marginal (4.3% vs. 6.2%; HR, 0.684; 95% CI, 0.467 to 1.002; p = 0.051). CONCLUSIONS Our results suggest that ARBs are not inferior to, and may actually be better than ACEIs in Korean patients with AMI.
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Affiliation(s)
- Jang Hoon Lee
- Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea
| | - Myung Hwan Bae
- Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea
| | - Dong Heon Yang
- Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea
| | - Hun Sik Park
- Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea
| | - Yongkeun Cho
- Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea
| | - Won Kee Lee
- Department of Preventive Medicine, Kyungpook National University School of Medicine, Daegu, Korea
| | - Myung Ho Jeong
- Department of Internal Medicine, Chonnam National University Hospital, Gwangju, Korea
| | - Young Jo Kim
- Department of Internal Medicine, Yeungnam University Medical Center, Daegu, Korea
| | - Myeong Chan Cho
- Department of Internal Medicine, Chungbuk National University School of Medicine, Cheongju, Korea
| | - Chong Jin Kim
- Department of Internal Medicine, Kyung Hee University East-West Neo Medical Center, Seoul, Korea
| | - Shung Chull Chae
- Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea
- Correspondence to Shung Chull Chae, M.D. Department of Internal Medicine, Kyungpook National University Hospital, 130 Dongdeok-ro, Junggu, Daegu 41944, Korea Tel: +82-53-420-5527 Fax: +82-53-426-2046 E-mail:
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Yang YA, Yang DH, Kim HN, Kwon SH, Jang SY, Bae MH, Lee JH, Chae SC. Tachycardia-Induced Right Heart Failure and Severe Tricuspid Regurgitation That Improved with Medication. Chonnam Med J 2016; 51:135-8. [PMID: 26730365 PMCID: PMC4697114 DOI: 10.4068/cmj.2015.51.3.135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Revised: 08/10/2015] [Accepted: 08/17/2015] [Indexed: 11/17/2022] Open
Abstract
Secondary tricuspid regurgitation (TR) primarily develops due to left heart failure or primary pulmonary diseases. Tricuspid annular dilation, which is commonly caused by right ventricular volume and pressure overload followed by right ventricle dilation, is believed to be the main mechanism underlying secondary TR. It is reported that once the tricuspid annulus is dilated, its size cannot spontaneously return to normal, and it may continue to dilate. These reports also suggest the use of an aggressive surgical approach for secondary TR. In the present report, we describe a case of tachycardia-induced severe TR that was completely resolved without the need for surgery.
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Affiliation(s)
- Young Ae Yang
- Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea
| | - Dong Heon Yang
- Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea
| | - Hong Nyun Kim
- Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea
| | - Sang Hoon Kwon
- Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea
| | - Se Young Jang
- Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea
| | - Myung Hwan Bae
- Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea
| | - Jang Hoon Lee
- Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea
| | - Shung Chull Chae
- Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea
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