-
Hye Yeon Lee,
Sung-Ho Her, Mahn Won Park,
Min Seok Choi,
Jung Sun Cho,
Chan Joon Kim,
Hye Seon Kang,
Yoo A Choi,
Il Nam Ju,
Seon A Kim,
Jong-Ho Lee,
Jong-Bum Kwon,
Kuhn Park
[show abstract]
[hide abstract]
ABSTRACT: Patent ductus arteriosus (PDA) is a rare clinical finding in adult patients. Considering the increase in cases of PDA discovered incidentally on echocardiograms at young ages, and the life-shortening effect of PDA, it is rare to diagnose PDA in old patients. We report a case of an 80-year-old patient who experienced symptoms of congestive heart failure showed findings suggestive of PDA in echocardiogram and confirmed the diagnosis through a cardiac catheterization and a coronary angiography. After percutaneous occlusion of PDA with an Amplatzer duct occlusion device, symptoms related to congestive heart failure improved.
Korean Circulation Journal 12/2012; 42(12):849-52.
-
[show abstract]
[hide abstract]
ABSTRACT: Depression is present in 1 of 5 outpatients with coronary artery disease (CAD), and a well-documented risk factor for recurrent cardiac events and mortality. We examined the impact of percutaneous coronary intervention (PCI), on depressive symptoms, in chronic stable angina (CSA) patients.
On prospective and non-randomized trial, consecutive CSA patients (n=171), who had undergone coronary angiography from January 2006 to December 2007, were included. Patients were subdivided into PCI and non-PCI groups, and then completed 21-item the Beck Depression Inventory II (BDI-II), at the baseline and pre-discharge, to assess the depressive symptoms.
A total of 108 (63%) patients were assigned to the non-PCI group, and 63 (37%) patients to the PCI group. Using an independent t-test, we found that patients with PCI were significantly older (non-PCI vs. PCI; 57±11 vs. 64±10, years, p<0.001), had more joint disease (12.0 vs. 27.0%, p=0.013), more stroke history (5.6 vs. 17.5%, p=0.012) and higher incident of family history of cardiovascular disease (28.7 vs. 46.0%, p=0.025), but less religion (54.6 vs. 36.5%, p=0.002) and private health insurance (43.5 vs. 20.6%, p=0.002). The mean difference of BDI-II score between the baseline and pre-discharge was higher in patients with PCI (OR: 1.266; 95% CI: 1.146-1.398, p<0.001).
In conclusion, PCI contributes independently to higher risk of developing depressive symptoms in CSA patients during hospitalization; Routine assessment and management of PCI related depressive symptoms are justified.
Psychiatry investigation 09/2012; 9(3):252-6. · 0.99 Impact Factor
-
Mahn-Won Park,
Kiyuk Chang,
Sung Ho Her,
Jong-Min Lee,
Yun-Seok Choi,
Dong-Bin Kim,
Pum Joon Kim,
Jung Sun Cho,
Min Seok Choi,
Ju Yeol Baek,
Chul-Su Park,
Seong Gyu Yoon,
Wook Sung Chung,
Ki Bae Seung
[show abstract]
[hide abstract]
ABSTRACT: Almost all data on drug-eluting stents (DES) fracture have been derived from initial platform of first-generation DES such as Cypher Bx(®) (CBX) and Taxus Express(®). However, incidence and clinical impact of fracture of newer DES platforms (including Cypher Select(®), Taxus(®) Liberté™, Endeavor(®), and Xience™ V) that have been used widely in current clinical practice have not yet been studied.
We analyzed data of 1518 lesions treated with the newer DES platforms in patients who underwent follow-up coronary angiography and compared the results with those of 622 lesions treated with the CBX. The group of newer DES platforms showed significantly lower incidence of stent fracture (SF) than the CBX group (1.25% vs. 5.8%, p<0.001). Binary restenosis (42.1% vs. 6.6%, p<0.001) and target lesion revascularization (TLR) (47.3% vs. 6.2%, p<0.001) related to SF in the newer DES platforms' group were significantly higher than those not related to SF. Notably, SF-related binary restenosis (42.1% vs. 36.1%, p=0.52) and TLR (47.3% vs. 41.6%, p=0.2) were similar between the newer DES platforms' group and the CBX group. On multivariable logistic regression analysis, lesion angulation >45° (odds ratio [OR]: 7.6; 95% confidence interval [CI]: 2.2-26.31), RCA stenting (OR: 5.14; 95% CI: 1.62-16.3) and total stent length (OR: 1.18; 95% CI: 1.03-1.33) were identified as independent predictors for fracture of the newer DES platforms, while closed-cell design stent (Cypher Select(®)) was not.
Although implantation of the newer DES platforms might reduce the occurrence of SF compared with the CBX, SF-related binary restenosis and TLR remain similarly high. And to predict SF in the newer DES platforms' era, lesion characteristics on index procedure are more important than implanted stent design.
Journal of Cardiology 08/2012; 60(3):215-21. · 1.28 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: The risk of excessive bleeding prompts physicians to stop multiple antiplatelet agents before minor surgery, which puts coronary stenting patients at risk for adverse thrombotic events.
We hypothesized that most dental extractions can be carried out safely without stopping multiple antiplatelet agents.
All dental extraction patients who had undergone coronary stenting and who were also on oral multiple antiplatelet agents therapy were enrolled. One hundred patients underwent dental procedures without stopping antiplatelet agents. All wounds were sutured and followed up at 24 hours, 1 week, and 1 month after the procedure. There were 2233 patients who had not taken oral antiplatelet agents from a health promotion center and had teeth extracted by the same method. After performing propensity-score matching for the entire population, a total of 100 matched pairs of patients were created. The primary outcome was a composite of excessive intraextraction blood loss, transfusion, and rehospitalization for bleeding, and the secondary outcome was a composite of death, nonfatal myocardial infarction, target lesion revascularization, and stent thrombosis within 1 month after the procedure.
There were 2 excessive intraextraction bleeding cases that continued at the extraction site for 4 and 5 hours, respectively, in the coronary stenting patients, and 1 excessive intraextraction bleeding case that continued for 3 hours in the control patients. There were no cases of transfusion, rehospitalization for bleeding, or major cardiovascular events for the 2 propensity-matched groups.
We found that most dental extractions in coronary stenting patients can be carried out safely without stopping multiple antiplatelet agents.
Clinical Cardiology 01/2012; 35(4):225-30. · 2.15 Impact Factor
-
Hun-Jun Park,
Hee-Yeol Kim,
Jong-Min Lee,
Yoon Seok Choi,
Chul-Soo Park,
Dong-Bin Kim,
Sung Ho Her,
Yoon Seok Koh, Mahn Won Park,
Beom-June Kwon,
Pum Joon Kim,
Kiyuk Chang,
Wook Sung Chung,
Ki-Bae Seung
[show abstract]
[hide abstract]
ABSTRACT: Limited data are available regarding the direct comparison of angiographic and clinical outcomes after percutaneous coronary intervention (PCI) with drug-eluting stents (DESs) for chronic total occlusion (CTO).
A prospective, randomized, multicenter trial was conducted to evaluate the non-inferiority of a zotarolimus-eluting stent (ZES; Endeavor Sprint®, n=80) to a sirolimus-eluting stent (SES; Cypher®, n=80) in patients with CTO lesion with a reference vessel diameter ≥ 2.5mm. The primary endpoint was in-segment binary restenosis rate at 9-month angiographic follow-up. Key secondary endpoints included target vessel failure (TVF; including cardiac death, myocardial infarction, and target vessel revascularization) and Academic Research Consortium-defined definite/probable stent thrombosis (ST) within 12 months. The ZES was non-inferior to the SES with respect to the primary endpoint, which occurred in 14.1% (95% confidence interval [CI]: 6.0-22.2) and in 13.7% (95%CI: 5.8-21.6) of patients, respectively (non-inferiority margin, 15.0%; P for non-inferiority <0.001). There were no significant between-group differences in the rate of TVF (10.0% vs. 17.5%; P=0.168) nor in the rate of ST (0.0% vs. 1.3%; P=0.316) during the 12-month clinical follow-up.
The effectiveness and safety of ZES are similar to those of SES and therefore it is a good treatment option in patients undergoing PCI for CTO with DESs.
Circulation Journal 01/2012; 76(4):868-75. · 3.77 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: We described here a patient who presented with symptoms of heart failure who was found to have severe bilateral impairment of atrioventricular inflow. Primary cardiac lymphoma (PCL) with extensive involvement of the two atria, pericardium and myocardium is an extremely rare tumor in immunocompetent patients. We report here a case of PCL in an immunocompetent patient with involvement of both atria and the atrial septum. The tumor had a butterfly shape. We could not do surgical excision because of the massive pericardiac invasion. The diagnosis was B-cell lymphoma and this was confirmed by the pericardiac biopsy.
Korean Circulation Journal 01/2012; 42(1):46-9.
-
[show abstract]
[hide abstract]
ABSTRACT: OBJECTIVES: We aimed at comparing the clinical outcomes of the patients who underwent percutaneous coronary intervention (PCI) for ST segment elevation myocardial infarction (STEMI) due to left main coronary arteries (LMCA) and non-LMCA determining the predictors of mortality in the patients. BACKGROUND: there are few data regarding the mid-term prognosis of STEMI due to LMCA as compared with them due to non-LMCA. Methods: A total of 4,697 patients with STEMI (61 patients with LMCA and 4,636 patients with non-LMCA) were enrolled in a nationwide Korea Acute Myocardial Infarction Registry (KAMIR) between November 2005 and September 2009. The primary endpoints were a composite of cardiac death, non-fatal myocardial infarction, and target lesion and vessel revascularization (TLR/TVR) during a 12-month clinical follow up. RESULTS: The LMCA group had a higher incidence of total MACEs (26.2% vs. 7.8%; P<0.001) at 12 months, which was largely attributable to cardiac deaths at 1 month (21.3% vs. 3.8%; P<0.001). Therefore, there was no statistical difference in cardiac deaths, non-fatal myocardial infarction, TLR/TVR, and MACEs after 1 month between the two groups. Presenting in cardiogenic shock (HR, 4.25; 95% CI, 1.01-17.97; P=0.049) and heart rate ≥100 bpm (HR, 4.97; 95% CI, 1.18-21.00; P=0.029) were independent predictors of cardiac death due to LMCA. CONCLUSION: Patients with STEMI and a LMCA had poor clinical outcomes, which is attributable to hemodynamic deterioration during the peri-procedural period. However, after that time, mid-term MACEs of the survivors following the peri-procedural period may not be different between STEMI due to LMCA and non-LMCA. © 2011 Wiley-Liss, Inc.
Catheterization and Cardiovascular Interventions 11/2011; · 2.29 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: A 56-year-old male presented with resting dyspnea and chest discomfort for several years. During transthoracic and transesophageal echocardiography, a spontaneously healed membranous type ventricular septal defect (VSD) with malaligned interventricular septal wall, aneurysmal changes, a subaortic ridge and a double-chambered right ventricle (DCRV) was observed. When combined with DCRV, VSD with malalignment between the outlet and trabecular septa was associated with tetralogy of Fallot. The subaortic ridge was due to turbulent flow caused by the malalignment-type VSD. The VSD with malaligned interventricular septal wall can be developed after aneurismal changes of a perimembranous VSD. We report here in the unusual case of a 56-year-old patient who had a pathology complex comprising DCRV, subaortic ridge, spontaneously healed membranous type VSD with malaligned interventricular septal wall, and survived with surgical treatment.
Journal of cardiovascular ultrasound 09/2011; 19(3):148-51.
-
Suk Min Seo,
Eun-Ho Choo,
Yoon-Seok Koh, Mahn Won Park,
Dong Il Shin,
Yoon Seok Choi,
Hun-Jun Park,
Dong Bin Kim,
Sung Ho Her,
Jong Min Lee,
Chul Soo Park,
Pum-Joon Kim,
Keon Woong Moon,
Kiyuk Chang,
Hee Yeol Kim,
Ki Dong Yoo,
Doo Soo Jeon,
Wook Sung Chung,
Yong Gyu Park,
Ki-Bae Seung
[show abstract]
[hide abstract]
ABSTRACT: A low level of high-density lipoprotein cholesterol (HDL-C) is strongly associated with cardiovascular events. However, the significance of HDL-C after statin therapy on the outcome of patients who have undergone percutaneous coronary intervention (PCI) with drug eluting stents (DES) is unclear.
To investigate the significance of HDL-C after statin therapy on cardiovascular events in patients with coronary artery disease after DES implantation.
Patients who underwent PCI with DES from January 2004 to December 2009 were prospectively enrolled. The follow-up lipid panel of 2693 patients (median lab follow-up duration 225 days) who had continued using statins after PCI and who attained low-density lipoprotein cholesterol (LDL-C) <100 mg/dl was analysed. Major adverse cardiac events (MACE), including all-cause death, non-fatal myocardial infarction, and target vessel revascularisation according to follow-up HDL-C level (40 mg/dl for men or 50 mg/dl for women) were compared with the use of propensity scores matching.
Median follow-up duration was 832 days. 1585 (58.9%) patients had low follow-up HDL-C and 1108 had high follow-up HDL-C. The low follow-up HDL-C group had significantly higher rates of MACE. Low follow-up HDL-C was a significant independent predictor of MACE (adjusted HR 1.404, 95% CI 1.111 to 1.774, p=0.004). In further analysis with propensity scores matching, overall findings were consistent.
Raising HDL-C levels may be a subsequent goal after achieving target LDL-C levels in patients with DES implantation.
Heart (British Cardiac Society) 06/2011; 97(23):1943-50. · 4.22 Impact Factor
-
Jung Sun Cho,
Ho-Joong Youn,
Eun-Joo Cho,
Sung-Ho Her,
Ju Yeal Baek, Mahn-Won Park,
Sung Gyu Yoon,
Jeong U Baeg,
Chan Seok Park,
Mi-Jeong Kim,
Hae-Ok Jung,
Hui-Kyung Jeon,
Jae-Hyung Kim
[show abstract]
[hide abstract]
ABSTRACT: We designed this study to evaluate the possibility that dyssynchrony might lead to false-positive myocardial perfusion single photon emission computed tomography myocardial perfusion image (MPS) results in stable angina patients.
This study included 61 patients with both clinically diagnosed stable angina and quantitative MPS results who underwent coronary angiography. The patients were divided into two groups: those who had positive MPS results and normal coronary angiography (Group I, n = 28, 64.05 ± 10.14 years, 11 males and 17 females) and those who had positive MPS results and significant coronary lesions as determined by coronary angiography (Group II, n = 33, 69.2 ± 10.4 years, 14 males and 19 females). The maximal difference in time-to-peak myocardial sustained systolic velocity among all 12 left ventricular (LV) segments (maximal difference in TS) was significantly delayed in Group I as compared with Group II (125.00 ± 46.10 vs. 87.33 ± 40.53 ms, P=0.001). The standard deviation of the time-to-peak myocardial sustained systolic velocity of all 12 LV segments (TS-SD) was also significantly different in the two groups (45.12 ± 19.25 vs. 30.10 ± 15.80 , P=0.002).
Dyssynchrony may be a cause of false-positive quantitative MPS results, even if patients have narrow QRS complexes on ECG. Dyssynchrony index can increase the specificity of quantitative MPS in stable angina patients.
European Heart Journal – Cardiovascular Imaging 06/2011; 12(6):461-6. · 2.32 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Combined interpretation of late diastolic mitral annulus velocity (A') with left atrial volume index (LAVi) may have additional benefits in the assessment of diastolic dysfunction.
The LAVi/A' ratio may be useful in the identifying advanced diastolic dysfunction (ADD) and predicting clinical outcomes in patients with dyspnea.
We enrolled 395 consecutive patients hospitalized with dyspnea (New York Heart Association class II-IV) and performed transthoracic Doppler echocardiography and B-type natriuretic peptide (BNP) measurement. LAVi/A' values were evaluated in terms of diagnosing ADD and predicting clinical outcome.
On the receiver operation characteristic curve analysis for the determination of ADD, the area under the curves of LAVi/A' in the entire population was comparable to those of BNP (0.94 vs 0.93, P = 0.845) and mitral E/E' (0.94 vs 0.93, P = 0.614) and higher than that of LAVi (0.94 vs 0.87; P = 0.014). A LAVi/A' of 4.0 was the best cut-off value to identify ADD. During a median follow-up of 31.9 months (range, 0.3 to 45.7 months), the group with LAVi/A' ≥4.0 had a higher incidence of primary composite outcomes (cardiac death and/or rehospitalization for heart failure) than the group with LAVi/A'<4.0 (25.0% vs 3.3%, P < 0.001). LAVi/A' ≥4.0 was an independent predictor of clinical outcomes (odds ratio, 3.245; 95% confidence interval, 1.386-7.598; P = 0.007).
As a new echo index, LAVi/A' is a useful parameter to identify ADD and predict clinical outcomes in patients with dyspnea.
Clinical Cardiology 02/2011; 34(2):124-30. · 2.15 Impact Factor
-
Hun-Jun Park,
Suk Min Seo,
Woo Seung Shin,
Hee-Yeol Kim,
Yoon Seok Choi,
Yoon Seok Koh,
Sung-Gyu Youn, Mahn Won Park,
Kiyuk Chang,
Pum Joon Kim,
Hae-Ok Jung,
Sang Hong Baek,
Wook Sung Chung,
Ki-Bae Seung,
Ki-Dong Yoo
[show abstract]
[hide abstract]
ABSTRACT: The levels of soluble receptor for advanced glycation end products (sRAGE) may reflect the activity of the advanced glycation end products-RAGE axis, which has been proposed as a potential mechanism of vascular inflammation in patients with type 2 diabetes (T2D). However, the role of sRAGE in in-stent restenosis (ISR) is not yet known in patients with T2D with drug-eluting stent (DES) implantation.
We enrolled 35 patients with T2D with ISR (T2D-ISR) and 35 patients with age-matched T2D without ISR (T2D-control) at the time of follow-up coronary angiography after DES implantation. Plasma levels of glycosylated hemoglobin (HbA(1c)), C-reactive protein (CRP), insulin-like growth factor-1 (IGF-1), and sRAGE were measured in blood samples obtained at the time of the index procedure. Baseline characteristics showed no difference between the groups. Plasma levels of sRAGE were significantly higher in the T2D-ISR group than in the T2D-control group (7.29 ± 2.91 vs. 5.36 ± 2.20 ng/ml, P= 0.003), but levels of HbA(1c) (7.65 ± 1.59% vs. 7.60 ± 1.65%, P = 0.89), CRP (8.15 ± 13.82 vs. 5.59 ± 7.68 mg/l, P = 0.34), and IGF-1 (0.93 ± 0.37 vs. 0.99 ± 0.30 ng/ml, P = 0.42) did not differ significantly between the two study groups. In multivariate logistic regression analysis, elevated plasma level of sRAGE (above the median) was a significant predictor of ISR [odds ratio (OR): 4.33, 95% confidence interval (CI): 1.38–13.59, P = 0.01], followed by mean stent diameter less than 3.0mm (OR: 3.35, CI: 0.98–11.46, P = 0.05).
Plasma level of sRAGE may be positively associated with ISR and RAGE-dependent inflammatory responses may contribute more to ISR development than IGF-1-dependent proliferative responses in patients with T2D with DES implantation.
Coronary artery disease 01/2011; 22(1):12-7. · 1.56 Impact Factor
-
Jung Sun Cho,
Sung-Ho Her,
Ju Yeal Baek, Mahn-Won Park,
Hyoung Doo Kim,
Myung Ho Jeong,
Young keun Ahn,
Shung Chull Chae,
Seung Ho Hur,
Taek Jong Hong, [......],
Jang Ho Bae,
Seung Woon Rha,
Chong Jim Kim,
Donghoon Choi,
Yang Soo Jang,
Junghan Yoon,
Wook Sung Chung,
Jeong Gwan Cho,
Ki Bae Seung,
Seung Jung Park
[show abstract]
[hide abstract]
ABSTRACT: The efficacy of low molecular weight heparin (LMWH) with low dose unfractionated heparin (UFH) during percutaneous coronary intervention (PCI) with or without glycoprotein (Gp) IIb/IIIa inhibitor compared to UFH with or without Gp IIb/IIIa inhibitor has not been elucidated. Between October 2005 and July 2007, 2,535 patients with ST elevation acute myocardial infarction (STEMI) undergoing PCI in the Korean Acute Myocardial Infarction Registry (KAMIR) were assigned to either of two groups: a group with Gp IIb/IIIa inhibitor (n=476) or a group without Gp IIb/IIIa inhibitor (n=2,059). These groups were further subdivided according to the use of LMWH with low dose UFH (n=219) or UFH alone (n=257). The primary end points were cardiac death or myocardial infarction during the 30 days after the registration. The primary end point occurred in 4.1% (9/219) of patients managed with LMWH during PCI and Gp IIb/IIIa inhibitor and 10.8% (28/257) of patients managed with UFH and Gp IIb/IIIa inhibitor (odds ratio [OR], 0.290; 95% confidence interval [CI], 0.132-0.634; P=0.006). Thrombolysis In Myocardial Infarction (TIMI) with major bleeding was observed in LMHW and UFH with Gp IIb/IIIa inhibitor (1/219 [0.5%] vs 1/257 [0.4%], P=1.00). For patients with STEMI managed with a primary PCI and Gp IIb/IIIa inhibitor, LMWH is more beneficial than UFH.
Journal of Korean medical science 11/2010; 25(11):1601-8. · 0.84 Impact Factor
-
Yoon-Seok Koh,
Hae-Ok Jung, Mahn-Won Park,
Joo-Yeoul Baek,
Sung-Gyu Yoon,
Pum-Joon Kim,
Sang-Hyun Ihm,
Kiyuk Chang,
Yong-Seog Oh,
Ho-Joong Youn,
Sang Hong Baek,
Wook-Sung Chung,
Ki-Bae Seung,
Jae-Hyung Kim
[show abstract]
[hide abstract]
ABSTRACT: Left ventricular hypertrophy (LVH) has been known as an important predictor of prognosis of cardiovascular disease. Carboxy-terminal propeptide of procollagen type I (PIP) is related with myocardial fibrosis. We sought to analyze the differences in the characteristics of LVH, myocardial fibrosis, and LV functions among hypertension (HBP), diabetes mellitus (DM) and chronic renal failure (CRF).
We enrolled consecutive patients with LVH. Patients were grouped as HBP (n=50), DM (n=41), CRF (n=31). Age and sex-matched normal control was also enrolled (n=32). Echocardiography and blood sampling for serum PIP level measuring was performedin all participants.
There were no differences in baseline characteristics except systolic blood pressure among four groups. In three patients groups, their LV mass indices were significantly increased than control. Serum PIP level in CRF was much higher than others (CRF 1505.5 vs. HBP 868.7 vs. DM 687.5 vs. control 826.4, p<0.0001). LV diastolic and systolic function evaluated by E', E/E, S' and midwall fractional shortening was significantly decreased in three patients groups. However, LAVi was significantly elevated and LV ejection fraction was significantly decreased in CRF compared to others. In correlation analysis, indices of diastolic function were weakly, but statistically correlated with PIP (E': r=0.234, p=0.006; LAVi: r=0.231, p=0.006).
In CRF, LV function was more deteriorated and serum PIP was more elevated when compared to HBP or DM. Therefore, myocardial fibrosis may play an important role to LV dysfunction as well as LV hypertrophy in CRF in some degree.
Journal of cardiovascular ultrasound 12/2009; 17(4):127-34.
-
Mahn-Won Park,
Ki-Bae Seung,
Pum-Joon Kim,
Hun-Jun Park,
Sung-Gyu Yoon,
Joo-Yeoul Baek,
Yoon-Seok Koh,
Hae-Ok Jung,
Kiyuk Chang,
Hee-Yeoul Kim,
Sang Hong Baek
[show abstract]
[hide abstract]
ABSTRACT: After successful percutaneous coronary intervention (PCI), unpredictable coronary events occur that are caused by in-stent restenosis and the progression of preexisting nonculprit coronary lesions. However, little is known about the long-term clinically driven PCI rates for the progression of nonculprit coronary lesions discovered during culprit-lesion PCI or its independent predictors, including several biomarkers. In this study, the clinical and angiographic data of 1,395 PCI patients treated from January 2004 to May 2007 were retrospectively analyzed. Of these patients, 507 were eligible for this study. After baseline PCI (i.e., culprit-lesion PCI), 81 patients (16%) underwent additional clinically driven PCI to treat preexisting nonculprit coronary lesions during the study period. The cumulative rates of clinically driven PCI for nonculprit coronary lesions were 7.7% (n = 39) at 1 year, 14% (n = 70) at 2 years, and 16% (n = 81) at 3 years. The independent predictors of clinically driven PCI included a larger number of significant coronary lesions (odds ratio [OR] 2.29, 95% confidence interval [CI] 1.5 to 3.5, p <0.001), low high-density lipoprotein (<40 mg/dl; OR 2.01, 95% CI 1.01 to 3.98, p = 0.046), hypercholesterolemia (total cholesterol >200 mg/dl; OR 1.46, 95% CI 1.22 to 1.97, p = 0.04), history of PCI (OR 1.24, 95% CI 1.09 to 1.60, p = 0.003), and increased triglyceride levels (OR 1.003, 95% CI 1.001 to 1.007, p = 0.038) at the time of baseline PCI. In conclusion, PCI patients with nonculprit coronary lesions underwent additional clinically driven PCI at rates of 7.7% at 1 year, 14% at 2 years, and 16% at 3 years because of the progression of preexisting nonculprit coronary lesions. Overall coronary artery disease burden and poor lipid profiles at baseline PCI confer significant risks for clinically driven PCI.
The American journal of cardiology 09/2009; 104(5):648-52. · 3.58 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Superior mesenteric artery (SMA) syndrome is a rare disease in which the third portion of the duodenum is compressed by SMA. There are many causes leading to the SMA syndrome, however it's extremely rare that aortic aneurysm causes a SMA syndrome. We report a case of a successfully treated SMA syndrome due to an abdominal aortic aneurysm in a renal transplant recipient. The patient was a 52-yr-old woman with a thin stature (weight 40 kg, height 164 cm). She received a renal transplant 8 yr before, and had hypertension and abdominal aortic aneurysm. Her SMA syndrome developed in a prolonged supine position for the accidental rib fractures and was diagnosed by clinical and radiological findings. After a surgical correction (resection of an aneurysm and aortobiiliac bypass with an inverted Y graft), her symptoms relieved without deterioration of the graft function.
Journal of Korean Medical Science 09/2002; 17(4):552-4. · 0.99 Impact Factor
