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Moon-Sik Park,
Jong-Pil Park,
So-Hee Yun,
Jae-Un Lee,
Joong-Keun Kim,
Na-Eun Lee,
Ji-Eun Song,
Shin-Eun Lee,
Sung-Hee John,
Ji-Hyun Lim, Jay-Young Rhew
[show abstract]
[hide abstract]
ABSTRACT: A paradoxical embolism is defined as a systemic arterial embolism requiring the passage of a venous thrombus into the arterial circulatory system through a right-to-left shunt, and is commonly related to patent foramen ovale (PFO). However, coexisting pulmonary embolisms, deep vein thromboses (DVT), and multipe systemic arterial embolisms, associated with PFO, are rare. Here, we report a patient who had a cryptogenic ischemic stroke, associated with PFO, which is complicated with a massive pulmonary thromboembolism, DVT, and renal infarctions, and subsequently, the patient was treated using a thrombolytic therapy.
Korean Circulation Journal 12/2012; 42(12):853-6.
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Futoshi Yamanaka,
Myung Ho Jeong,
Shigeru Saito,
Youngkeun Ahn,
Shung Chull Chae,
Seung Ho Hur,
Taek Jong Hong,
Young Jo Kim,
In Whan Seong,
Jei Keon Chae, [......],
Jang Ho Bae,
Seung Woon Rha,
Chong Jin Kim,
Donghoon Choi,
Yang Soo Jang,
Junghan Yoon,
Wook Sung Chung,
Jeong Gwan Cho,
Ki Bae Seung,
Seung Jung Park
International journal of cardiology 05/2012; 158(1):139-43. · 7.08 Impact Factor
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Hae Chang Jeong,
Ji Min Jeong,
Myung Ho Jeong,
Youngkeun Ahn,
Shung Chull Chae,
Seung Ho Hur,
Taek Jong Hong,
Young Jo Kim,
In Whan Seong,
Jei Keon Chae, [......],
Jang Ho Bae,
Seung Woon Rha,
Chong Jin Kim,
Donghoon Choi,
Yang Soo Jang,
Junghan Yoon,
Wook Sung Chung,
Jeong Gwan Cho,
Ki Bae Seung,
Seung Jung Park
International journal of cardiology 04/2012; 157(3):408-11. · 7.08 Impact Factor
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Min Goo Lee,
Myung Ho Jeong,
Youngkeun Ahn,
Shung Chull Chae,
Seung Ho Hur,
Taek Jong Hong,
Young Jo Kim,
In Whan Seong,
Jei Keon Chae, Jay Young Rhew, [......],
Myeong Chan Cho,
Jang Ho Bae,
Seung Woon Rha,
Chong Jin Kim,
Donghoon Choi,
Yang Soo Jang,
Junghan Yoon,
Wook Sung Chung,
Ki Bae Seung,
Seung Jung Park
International journal of cardiology 04/2012; 157(2):283-5. · 7.08 Impact Factor
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[show abstract]
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ABSTRACT: Coronary artery disease is the most important cause of mortality in patients with systemic lupus erythematous (SLE). After stenting for coronary artery disease in SLE patients similar to non-SLE patients, the risk of stent thrombosis is always present. Although there are reports of stent thrombosis in SLE patients, very late recurrent stent thrombosis is rare. We experienced a case of very late recurrent stent thrombosis (4 times) in a patient with SLE.
Korean Circulation Journal 02/2012; 42(2):118-21.
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Hyun Su Jo,
Jong Seon Park,
Jang Won Sohn,
Joon Cheol Yoon,
Chang Woo Sohn,
Sang Hee Lee,
Geu Ru Hong,
Dong Gu Shin,
Young Jo Kim,
Myung Ho Jeong, [......],
Myeong Chan Cho,
Jang Ho Bae,
Seung Woon Rha,
Chong Jin Kim,
Dong Hoon Choi,
Yang Soo Jang,
Jung Han Yoon,
Wook Sung Chung,
Ki Bae Seung,
Seung Jung Park
[show abstract]
[hide abstract]
ABSTRACT: In patients with ST-segment elevation myocardial infarction (STEMI) and multivessel disease, complete revascularization (CR) for non-culprit lesions is not routinely recommended. The aim of this study was to compare the clinical outcomes of multivessel compared with infarct-related artery (IRA)-only revascularization in patients undergoing primary percutaneous coronary intervention (PCI) for STEMI.
From the Korean Acute Myocardial Infarction Registry (KAMIR) database, 1,094 STEMI patients with multivessel disease who underwent primary PCI with drug-eluting stents were enrolled in this study. The patients were divided into two groups: culprit-vessel-only revascularization (COR, n=827) group; multivessel revascularization, including non-IRA (MVR, n=267) group. The primary endpoint of this study included major adverse cardiac events (MACEs), such as death, myocardial infarction, or target or nontarget lesion revascularization at one year.
There was no difference in clinical characteristics between the two groups. During the one-year follow-up, 102 (15.2%) patients in the COR group and 32 (14.2%) in the MVR group experienced at least one MACE (p=0.330). There were no differences between the two groups in terms of rates of death, myocardial infarction, or revascularization (2.1% vs. 2.0%, 0.7% vs. 0.8%, and 11.7% vs. 10.1%, respectively; p=0.822, 0.910, and 0.301, respectively). The MACE rate was higher in the incompletely revascularized patients than in the completely revascularized patients (15% vs. 9.5%, p=0.039), and the difference was attributable to a higher rate of nontarget vessel revascularization (8.6% vs. 1.8%, p=0.002).
Although multivessel angioplasty during primary PCI for STEMI did not reduce the MACE rate compared with culprit-vessel-only PCI, CR was associated with a lower rate of repeat revascularization after multivessel PCI.
Korean Circulation Journal 12/2011; 41(12):718-25.
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Min Goo Lee,
Myung Ho Jeong,
Youngkeun Ahn,
Jeong Gwan Cho,
Jong Chun Park,
Jung Chaee Kang,
Shung Chull Chae,
Seung Ho Hur,
Taek Jong Hong,
Young Jo Kim, [......],
Myeong Chan Cho,
Jang Ho Bae,
Seung Woon Rha,
Chong Jin Kim,
Donghoon Choi,
Yang Soo Jang,
Junghan Yoon,
Wook Sung Chung,
Ki Bae Seung,
Seung Jung Park
[show abstract]
[hide abstract]
ABSTRACT: The purpose of the present study was to compare the efficacy and safety of paclitaxel-eluting stent (PES), sirolimus-eluting stent (SES), and zotarolimus-eluting stent (ZES) in primary percutaneous coronary intervention (PCI) for acute ST-segment elevation myocardial infarction (STEMI) with metabolic syndrome (MS).
Using data from Korea Acute Myocardial Infarction Registry (KAMIR; November 2005-December 2007), a total of 1,768 MS patients with STEMI who underwent primary PCI were enrolled: The PES group was 634, SES group, 906, and ZES group, 228. The primary endpoint was major adverse cardiac event (all-cause death, re-myocardial infarction, target lesion revascularization) during 12 months follow-up. At 12 months, the cumulative incidence of primary endpoint in the PES, SES, and ZES groups was 10.9%, 9.1%, and 11.0%, respectively (P=0.086). Incidence of death, recurrent myocardial infarction, or target lesion revascularization did not differ among the 3 groups. There were 7 episodes of acute (0.3% in PES group, 0.4% in SES group, and 0.4% in ZES group, respectively, P=0.773) and 18 episodes of cumulative stent thrombosis including late stent thrombosis (0.9% in PES group, 1.0% in SES group, and 1.3% in ZES group, respectively, P=0.448).
Implantation of SES, PES, and ZES in MS patients with STEMI undergoing primary PCI provided comparable clinical outcomes in patients enrolled in KAMIR.
Circulation Journal 07/2011; 75(9):2120-7. · 3.77 Impact Factor
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Seon Gyu Choi,
Myung Ho Jeong,
Youngkeun Ahn,
Jeong Gwan Cho,
Jung Chaee Kang,
Shung Chull Chae,
Seung Ho Hur,
Taek Jong Hong,
Young Jo Kim,
In Whan Seong, [......],
Myeong Chan Cho,
Jang Ho Bae,
Seung Woon Rha,
Chong Jin Kim,
Donghoon Choi,
Yang Soo Jang,
Junghan Yoon,
Wook Sung Chung,
Ki Bae Seung,
Seung Jung Park
[show abstract]
[hide abstract]
ABSTRACT: Recently, the prognostic value of N-terminal brain natriuretic peptide (NT-proBNP) in acute coronary syndrome has been demonstrated in many studies. However, NT-proBNP levels are influenced by various factors such as sex, age, renal function, heart failure severity, and obesity. NT-proBNP concentrations tend to decrease with higher body mass index (BMI). The aim of this study was to examine the influence of obesity on NT-proBNP as a predictive prognostic factor in acute myocardial infarction (AMI) patients.
Using data from the Korea Acute Myocardial Infarction Registry (January 2005 to September 2008), 2,736 AMI patients were included in this study. These patients were divided into men (n=1,972, 70%) and women (n=764, 30%), and were grouped according to their BMIs. Major adverse cardiac events (MACE) during 1 year clinical follow-up were evaluated.
NT-proBNP was significantly higher in lower BMI (p<0.001). Mean NT-proBNP levels of each obesity group were 2,393±4,022 pg/mL in the lean group (n=875), 1,506±3,074 pg/mL in the overweight group (n=724) and 1,100±1,137 pg/mL in the obese group (n=1,137) (p<0.01). NT-proBNP was an independent prognostic factor of AMI in obese patients by multivariative analysis of independent risk factors of MACE (p=0.01).
NT-proBNP is lower in obese AMI patients than in non-obese AMI patients, but NT-proBNP is still of independent prognostic value in obese AMI patients.
Korean Circulation Journal 11/2010; 40(11):558-64.
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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
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Min Goo Lee,
Myung Ho Jeong,
Youngkeun Ahn,
Shung Chull Chae,
Seung Ho Hur,
Taek Jong Hong,
Young Jo Kim,
In Whan Seong,
Jei Keon Chae, Jay Young Rhew, [......],
Jang Ho Bae,
Seung Woon Rha,
Chong Jin 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: We sought to determine the prevalence of metabolic syndrome (MS) in patients with acute myocardial infarction and its effect on clinical outcomes. Employing data from the Korea Acute Myocardial Infarction Registry, a total of 1,990 patients suffered from acute ST-elevation myocardial infarction (STEMI) between November 2005 and December 2006 were categorized according to the National Cholesterol Education Program-Adult Treatment Panel III criteria of MS. Primary study outcomes included major adverse cardiac events (MACE) during one-year follow-up. Patients were grouped based on existence of MS: group I: MS (n=1,182, 777 men, 62.8±12.3 yr); group II: Non-MS (n=808, 675 men, 64.2±13.1 yr). Group I showed lower left ventricular ejection fraction (LVEF) (P=0.005). There were no differences between two groups in the coronary angiographic findings except for multivessel involvement (P=0.01). The incidence of in-hospital death was higher in group I than in group II (P=0.047), but the rates of composite MACE during one-year clinical follow-up showed no significant differences. Multivariate analysis showed that low LVEF, old age, MS, low high density lipoprotein cholesterol and multivessel involvement were associated with high in-hospital death rate. In conclusion, MS is an important predictor for in-hospital death in patients with STEMI.
Journal of Korean medical science 10/2010; 25(10):1456-61. · 0.84 Impact Factor
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Hae Chang Jeong,
Youngkeun Ahn,
Myung Ho Jeong,
Shung Chull Chae,
Seung Ho Hur,
Taek Jong Hong,
Young Jo Kim,
In Whan Seong,
Jei Keon Chae, Jay Young Rhew, [......],
Jang Ho Bae,
Seung Woon Rha,
Chong Jin 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: There is still debate about the timing of revascularization in patients with acute non-ST-segment elevation myocardial infarction (NSTEMI). We analyzed the long-term clinical outcomes of the timing of revascularization in patients with acute NSTEMI obtained from the Korea Acute Myocardial Infarction Registry (KAMIR).
2,845 patients with acute NSTEMI (65.6 +/- 12.5 years, 1,836 males) who were enrolled in KAMIR were included in the present study. The therapeutic strategy of NSTEMI was categorized into early invasive (within 48 hours, 65.8 +/- 12.6 years, 856 males) and late invasive treatment (65.3 +/- 12.1 years, 979 males). The initial- and long-term clinical outcomes were compared between two groups according to the level of Thrombolysis In Myocardial Infarction (TIMI) risk score.
There were significant differences in-hospital mortality and the incidence of major adverse cardiac events during one-year clinical follow-up between two groups (2.1% vs. 4.8%, p < 0.001, 10.0% vs. 13.5%, p = 0.004, respectively). According to the TIMI risk score, there was no significant difference of long-term clinical outcomes in patients with low to moderate TIMI risk score, but significant difference in patients with high TIMI risk score (>or= 5 points).
The old age, high Killip class, low ejection fraction, high TIMI risk score, and late invasive treatment strategy are the independent predictors for the long-term clinical outcomes in patients with NSTEMI.
Yonsei medical journal 01/2010; 51(1):58-68. · 0.77 Impact Factor
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Dong Goo Kang,
Myung Ho Jeong,
Yongkeun Ahn,
Shung Chull Chae,
Seung Ho Hur,
Taek Jong Hong,
Young Jo Kim,
In Whan Seong,
Jei Keon Chae, Jay Young Rhew,
In Ho Chae,
Myeong Chan Cho,
Jang Ho Bae,
Seung Woon Rha,
Chong Jin Kim,
Yang Soo Jang,
Junghan Yoon,
Ki Bae Seung,
Seung Jung Park
[show abstract]
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ABSTRACT: The incidence of ischemic heart disease has been increased rapidly in Korea. However, the clinical effects of antecedent hypertension on acute myocardial infarction have not been identified. We assessed the relationship between antecedent hypertension and clinical outcomes in 7,784 patients with acute myocardial infarction in the Korea Acute Myocardial Infarction Registry during one-year follow-up. Diabetes mellitus, hyperlipidemia, cerebrovascular disease, heart failure, and peripheral artery disease were more prevalent in hypertensives (n=3,775) than nonhypertensives (n=4,009). During hospitalization, hypertensive patients suffered from acute renal failure, shock, and cerebrovascular event more frequently than in nonhypertensives. During follow-up of one-year, the incidence of major adverse cardiac events was higher in hypertensives. In multi-variate adjustment, old age, Killip class > or =III, left ventricular ejection fraction <45%, systolic blood pressure <90 mmHg on admission, post procedural TIMI flow grade < or =2, female sex, and history of hypertension were independent predictors for in-hospital mortality. However antecedent hypertension was not significantly associated with one-year mortality. Hypertension at the time of acute myocardial infarction is associated with an increased rate of in-hospital mortality.
Journal of Korean medical science 10/2009; 24(5):800-6. · 0.84 Impact Factor
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Min Goo Lee,
Myung Ho Jeong,
Youngkeun Ahn,
Shung Chull Chae,
Seung Ho Hur,
Taek Jong Hong,
Young Jo Kim,
In Whan Seong,
Jei Keon Chae, Jay Young Rhew, [......],
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: It is thought that patients with diabetes mellitus (DM) have a poor prognosis after an acute myocardial infarction (AMI), but the effect of diabetes on the outcomes of hypertensive patients with AMIs has not been elucidated in the Korean population. The aim of this study was to investigate the effects of diabetes on long-term clinical outcomes following AMIs in patients with hypertension.
Using data from the Korea Acute Myocardial Infarction Registry (November 2005 to December 2006), 2,233 hypertensive patients with AMIs were grouped as follows based on the presence of DM: group I, diabetic hypertension (n=892, 544 men, mean age=66.2+/-10.9 years); and group II, non-diabetic hypertension (n=1341, 938 men, mean age=63.9+/-12.8 years). The primary study outcomes included in-hospital death and major adverse cardiac events (MACE; cardiac death, myocardial infarction (MI), repeat percutaneous coronary intervention, and coronary artery bypass surgery) at the 1 year follow-up.
Hypertensive patients with DM were older and more likely to be women. The diabetic group had lower blood pressure (p<0.001), a lower left ventricular ejection fraction (p<0.001), a more severe degree of heart failure (p<0.001), a longer duration of coronary care unit admission (p<0.001), and a higher incidence of hyperlipidemia (p=0.007). The N-terminal pro-brain natriuretic peptide level (4602.5+/-8710.6 pg/mL vs. 2320.8+/-5837.9 pg/mL, p<0.001) was higher and the creatinine clearance (62.4+/-29.9 mL/min vs. 73.0+/-40.8 mL/min, p<0.001) was lower in the diabetic group than the non-diabetic group. Coronary angiographic findings revealed more frequent involvement of the left main stem (p=0.002) and multiple vessels (p<0.001) in the diabetic group. The rate of in-hospital death was higher in the diabetic group (p<0.001). During follow-up, the rates of composite MACE at 1 month, 6 months, and 12 months were higher in the diabetic group (p<0.001).
In hypertensive patients with AMI, DM was associated with worse clinical and angiographic features, with a higher risk of development of severe heart failure, and an increased risk of MACE on long-term clinical follow-up.
Korean Circulation Journal 06/2009; 39(6):243-50.
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[show abstract]
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ABSTRACT: Previous randomized trials have shown that drug-eluting stents (DES) are superior to bare-metal stents in reducing the need for target lesion revascularization, but safety issues with DES have recently been raised. We report a rare case of very late stent thrombosis 35 months after sirolimus-eluting stent implantation associated with delayed 5-segment stent fractures and peri-stent aneurysm formation.
Circulation Journal 08/2008; 72(7):1201-4. · 3.77 Impact Factor
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Ju Han Kim,
Myung Ho Jeong, Jay Young Rhew,
Ji Hyun Lim,
Kyung Ho Yun,
Kye Hun Kim,
Dong Koo Kang,
Seo Na Hong,
Sang Yup Lim,
Sang Hyun Lee,
Yeon Sang Lee,
Young Joon Hong,
Hyung Wook Park,
Weon Kim,
Young Keun Ahn,
Yong Moon,
Jeong Gwang Cho,
Jong Chun Park,
Jung Chaee Kang
[show abstract]
[hide abstract]
ABSTRACT: Platelet activation and aggregation with resultant arterial thrombus formation play a pivotal role in the pathophysiology of acute coronary syndrome (ACS). In the present study the efficacy of tirofiban, a specific inhibitor of the platelet glycoprotein IIb/IIIa receptor, combined with heparin or low-molecular-weight heparin (dalteparin), was evaluated for the management of ACS.
One hundred and sixty patients (60.9+/-11.1 years, 104 male) with unstable angina or non-ST elevation myocardial infarction and who had ST-T changes and elevated troponin were randomly assigned to 4 groups: group I (n=40: heparin alone), group II (n=40: dalteparin alone), group III (n=40: tirofiban + heparin) and group IV (n=40: tirofiban + dalteparin). The occurrence of major adverse cardiac events (MACE) was compared prospectively during a 6-month clinical follow-up. Percutaneous coronary intervention or coronary artery bypass graft was performed in 32 cases in group I, 29 in group II, 28 in group III and 31 in group IV (p=0.72). Minor bleeding complication developed in 2 patients (5.0%) in group I, 2 (5.0%) in group II, 4 (10.0%) in group III and 3 (7.5%) in group IV (p=0.78). During the follow-up MACE occurred in 10 patients (31.3%) in group I, 9 (31.0%) in group II, 4 (14.3%) in group III and 4 (12.9%) in group IV (p=0.02: Group I and II vs Group III and IV).
Tirofiban combined with dalteparin was associated with relatively more bleeding complications in the short term, but was effective in reducing the incidence of MACE during long-term clinical follow-up in patients with ACS.
Circulation Journal 03/2005; 69(2):159-64. · 3.77 Impact Factor
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Young Joon Hong,
Myung Ho Jeong,
Seung Hyun Lee,
Ok Young Park,
Ju Han Kim,
Weon Kim, Jay Young Rhew,
Young Keun Ahn,
Jeong Gwan Cho,
Jong Chun Park,
Soon Pal Suh,
Byoung Hee Ahn,
Sang Hyung Kim,
Jung Chaee Kang
[show abstract]
[hide abstract]
ABSTRACT: Antithrombotic therapy with heparin reduces the rate of ischemic events in patients with acute coronary syndrome. Low-molecular-weight heparin, given subcutaneously twice daily, has a more predictable anticoagulant effect than standard unfractionated heparin. Moreover, it is easier to administer and does not require monitoring.
We prospectively analyzed 180 patients with unstable angina who had undergone percutaneous coronary intervention (PCI) between 1999 and 2001 at Chonnam National University Hospital and had received either 120 U/kg of dalteparin (Fragmin), administered subcutaneously twice daily (Group I; n = 90, 61.8 +/- 8.9 years, male 67.8%), or had received continuous intravenous unfractionated heparin (Group II; n = 90, 62.6 +/- 9.7 years, male 70.0%). During hospitalization and at 6 month after PCI, major adverse cardiac events such as acute myocardial infarction, target vessel revascularization, death, and restenosis were examined.
During hospitalization, the incidence of acute myocardial infarction, target vessel revascularization and death were not different between the two groups. At follow-up coronary angiography 6 months after PCI, the incidence of restenosis was lower in group I than in group II (Group I; 26/90, 28.8% vs. Group II; 32/90, 35.6%, p = 0.041) and the incidence of target vessel revascularization was lower in group I than in group II (Group I; 21/90, 23.3% vs. Group II; 27/90, 30.0%, p = 0.039). No difference was found in the rates of major and minor hemorrhages, ischemic strokes or thrombocytopenia between two groups. By multivariate analysis, the factors related to restenosis were lesion length, postprocedural minimal luminal diameter, CRP on admission, diabetes mellitus, the type of heparin, and stent use.
Dalteparin, a low molecular weight heparin, is superior to standard unfractionated heparin in terms of reducing the restenosis rate and target vessel revascularization without increasing bleeding complications.
The Korean Journal of Internal Medicine 10/2003; 18(3):167-73.
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Doo Sun Sim,
Myung Ho Jeong,
Weon Kim, Jay Young Rhew,
Ju Hyup Yum,
Ju Han Kim,
Jeong Gwan Cho,
Young Keun Ahn,
Jong Chun Park,
Byoung Hee Ahn,
Sang Hyung Kim,
Jung Chaee Kang
[show abstract]
[hide abstract]
ABSTRACT: High-risk percutaneous coronary interventions (PCIs) are associated with a high complication rate, a low procedural success rate and a high restenosis rate, especially in diabetics. We sought to determine whether abciximab (ReoPro) therapy affects long-term clinical outcomes of Korean patients with diabetes undergoing high-risk PCI.
One hundred and nineteen patients with 152 lesion sites were administered ReoPro among 2,231 patients who underwent PCI at Chonnam National University Hospital from March 1999 to Feb 2001. These 119 patients were divided into two groups, 30 were allocated to a diabetic group (Group 1, 57.7 +/- 8.2 years, 22 male), and 89 to a non-diabetic group (Group II, 59.6 +/- 10.8 years, 68 male). Early and long-term clinical outcomes after PCI were analyzed.
In terms of clinical diagnosis, the number of acute myocardial infarctions in Group I was 25 (83.3%) and 76 in Group II (85.4%). As for risk factors, target artery lesions, and ACC/AHA types, no differences were found between the two groups. The number of patients with total occlusion was 21 (55.3%) and 62 (53.9%), and the number with a thrombus-containing lesion was 28 (93.3%) and 88 (98.9%) in Groups I and II, respectively. The procedure was successful in 27 (90.0%) in Group I, and in 80 (89.9%) in Group II, and no differences were evident between the two groups in terms of bleeding complications. No major adverse cardiac events (MACE), including myocardial infarction, repeat revascularization or cardiac death, were observed in Group I, but 8 cases of MACE occurred in Group II during hospitalization. Clinical follow-up was performed in 116 patients (97.5%) over 18.5 +/- 6.7 (5-28) months. The number of overall MACEs was 10 (3.3%) in Group I and 14 (15.7%) in Group II (p = 0.038).
ReoPro used in high-risk PCI in diabetics was effective in terms of early clinical outcomes, but its long-term clinical benefits were not proven.
The Korean Journal of Internal Medicine 10/2003; 18(3):129-37.
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Weon Kim,
Myung Ho Jeong,
Ok Young Park, Jay Young Rhew,
Hee Seung Bom,
Sun Joo Choi,
Kyung Bae Park,
Eun Hee Kim,
Ju Han Kim,
Young Keun Ahn,
Jong Tae Park,
Jeong Gwan Cho,
Jong Chun Park,
Jung Chaee Kang
[show abstract]
[hide abstract]
ABSTRACT: Brachytherapy is a promising method of preventing and treating coronary stent restenosis. The present study was designed to observe the therapeutic effects of a radioactive balloon loaded with Holmium-166 ((166)Ho) in a porcine coronary stent restenosis model. A radioisotope of (166)Ho was coated onto the balloon surface using polyurethane (20 Gy at 0.5 mm depth). Stent overdilation injuries were induced in 2 coronary arteries in each pig (n=8). Four weeks after the injury, control balloon dilation was performed in one coronary artery (Group I) and radiation therapy using the (166)Ho coated balloon in the other coronary artery (Group II) in each pig. Follow-up coronary angiography and histopathologic assessment were performed at 4 weeks after the radiation therapy or the control balloon dilations. With regard to complete blood cell counts, liver function tests, lipid profiles and coagulation tests, there were no differences between the baseline and after radiation. On quantitative coronary angiographic analysis, reference and target artery diameter showed no differences between the 2 groups before, or 4 and 8 weeks after stenting. On histopathologic analysis of groups I and II, the injury score was 1.34+/-0.09 and 1.32+/-0.10, the area of internal elastic lamina was 4.99+/-0.17 mm(2) and 4.82+/-0.20 mm(2), and the luminal area was 3.20+/-0.10 mm(2) and 3.45+/-0.14 mm(2), respectively (p=NS). The neointimal area was 1.78+/-0.11 mm(2) in group I and 1.36+/-0.12 mm(2) in group II (p=0.017), and the histopathologic area of stenosis was 35.1+/-1.6% in group I and 27.6+/-1.9% in group II (p=0.005). In conclusion, beta-radiation of the stented porcine coronary artery using a radioactive (166)Ho coated balloon inhibited stent restenosis without any side effects.
Circulation Journal 08/2003; 67(7):625-9. · 3.77 Impact Factor
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Young Joon Hong,
Myung Ho Jeong,
Seung Hyun Lee,
Ok Young Park,
Woo Kon Jeong,
Sang Rok Lee,
Weon Kim, Jay Young Rhew,
Sang Hyun Lee,
Young Keun Ahn,
Jeong Gwan Cho,
Byoung Hee Ahn,
Jong Chun Park,
Sang Hyung Kim,
Jung Chaee Kang
[show abstract]
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ABSTRACT: Rescue percutaneous coronary intervention (PCI) has been used to treat patients after failed thrombolysis in acute myocardial infarction. However, the short- and long-term benefits of rescue PCI have not been known exactly. The goal of this study was to examine the clinical and angiographic outcomes, the success rate of the procedure, and the long-term survival rate after rescue PCI. The clinical and angiographic outcomes of 31 patients (Group I; 59.7 +/- 11.4 years, 80.6% male), who underwent rescue PCI were compared with those of 177 patients (Group II; 59.7 +/- 9.7 years, 79.7% male), who underwent primary PCI at Chonnam National University Hospital between January 1997 and December 1999. There were no significant differences in the risk factors for coronary artery diseases except for smoking (Group I; 24/31, 77.4% vs. Group II; 76/177, 42.9%, P = 0.011). The incidence of cardiogenic shock was higher in Group I than in Group II (Group I; 7/31, 22.6% vs. Group II; 11/177, 6.2%, P = 0.021). The coronary angiographic findings were not different between two groups, except for Thrombolysis in Myocardial Infarction (TIMI) flow of Group I was lower than in Group II (Group I; 1.14 +/- 0.93 vs. Group II; 1.61 +/- 1.14, P = 0.001). The primary success rate was 93.6% (29/31) in Group I and 94.9% (168/177) in Group II (P = 0.578). The baseline ejection fraction was lower in Group I than in Group II (Group I; 44.2 +/- 8.9% vs. Group II; 50.8 +/- 11.7, P = 0.023), which improved in both groups (Group I; 51.7 +/- 7.9% vs. Group II; 60.7 +/- 13.4%, P = 0.001 respectively) at 6 months after the procedures. The survival rates of Group I were 93.5%, 93.5%, and 90.3% and those of Group II were 94.5%, 93.7%, and 91% at 1, 6, and 12 months, respectively. Rescue PCI is associated with the risk factor of smoking. The indication for rescue PCI was more common in patents with cardiogenic shock. The success rate of rescue PCI was comparable to that of primary PCI, and left ventricular function is improved after rescue PCI on long-term clinical follow-up with relatively high survival rate.
Journal of Interventional Cardiology 07/2003; 16(3):209-16. · 1.18 Impact Factor
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Sang Rok Lee,
Myung Ho Jeong, Jay Young Rhew,
Young Keun Ahn,
Kook Joo Na,
Ho-Cheun Song,
Hee Seung Bom,
Jeong Gwan Cho,
Byoung Hee Ahn,
Jong Chun Park,
Sang Hyung Kim,
Jung Chaee Kang
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ABSTRACT: Atherosclerotic disease of the coronary artery may simultaneously involve the subclavian artery, and a significant stenosis of the left subclavian artery may result in recurrent myocardial ischemia in patients with patent left internal mammary artery (LIMA) grafts because of 'coronary steal' through the LIMA. Isometric exercise of the left arm may improve myocardial perfusion through vertebral - subclavian steal by flow reversal in the ipsilateral vertebral artery because of the change in the pressure gradient between the circle of Willis and the distal subclavian artery. The present patient had coronary steal through a LIMA after coronary artery bypass surgery and a transient vertebral - subclavian steal with improved myocardial perfusion as a result of exercise of the left arm.
Circulation Journal 06/2003; 67(5):464-6. · 3.77 Impact Factor
