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Sung Il Im,
Seung Yong Shin,
Jin Oh Na,
Yong Hyun Kim,
Cheol Ung Choi,
Seong Hwan Kim,
Jin Won Kim,
Eung Ju Kim,
Seong Woo Han, Seung-Woon Rha,
Chang Gyu Park,
Hong Seog Seo,
Dong Joo Oh,
Chun Hwang,
Hong Euy Lim
International journal of cardiology 05/2013; · 7.08 Impact Factor
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Suk Min Seo,
Sang Hong Baek,
Hui Kyung Jeon,
Seok-Min Kang,
Dong-Soo Kim,
Woo-Shik Kim,
Hyung Seop Kim, Seung Woon Rha,
Jong Seon Park,
In Whan Seong,
Young Keun Ahn,
Jung Han Yoon,
Tae Joon Cha
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ABSTRACT: Aim: We assessed the relationship between the level of high-sensitivity C-reactive protein (hsCRP) and cardiovascular risk factors in Korean adults.Methods: We reviewed 1,561 patients with cardiovascular disease or diabetes mellitus with hsCRP levels measured within the past year. Four cardiovascular risk groups were determined: low (<10%, 0-1 risk), moderate (<10%, >2 risk), high (10-20%) and very high (>20%) risk, according to the number of risk factors and the Framingham/NCEP ATP III risk score. The correlations between the hsCRP level and cardiovascular risk factors (age, smoking, hypertension, lipid profiles and familial history of premature coronary heart disease) were investigated.Results: The mean and median hsCRP (mg/L) levels were 1.32±9.69 and 0.29 (range: 0.01-7.48), respectively. Men had a higher median level of hsCRP than women (p<0.001). The levels of hs CRP significantly increased from the low to the very high risk group (0.15, 0.23, 0.27 and 0.47, respectively) and were significantly correlated with age, the level of glycosylated hemoglobin, body mass index (BMI), the level of high-density lipoprotein cholesterol (HDL-C), the low-density lipoprotein cholesterol (LDL-C)/HDL-C ratio, the LDL-C/total cholesterol (TC) ratio, the HDL-C/TC ratio, the HDL-C/triglyceride (TG) ratio and the TC/TG ratio. Neither smoking, the LDL-C level nor the TG level affected the hsCRP level. In a multivariate regression analysis, age, the HDL-C level, the LDL-C/TC ratio and BMI were found to be independently correlated with the hsCRP level.Conclusions: There is a significant relationship between the degree of cardiovascular risk and the hsCRP level in Korean adults with cardiovascular disease or diabetes mellitus. Assessing the hsCRP levels may thus provide additive value in predicting cardiovascular risks.
Journal of atherosclerosis and thrombosis 05/2013; · 2.69 Impact Factor
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ABSTRACT: Coronary artery fistulas (CAFs) are one of the most rare cardiac anomalies. Some patients with CAF may suffer from ischemic chest pain that originates from combined significant coronary artery spasm (CAS). Spontaneous regression of CAF has been reported in a few cases, almost all of which were infants. We report an adult patient who presented with ischemic chest pain due to multiple coronary arteries to pulmonary artery fistulas and combined significant CAS induced by intracoronary acetylcholine provocation test. Spontaneous regression of one of the fistulas was observed at 2-year angiography follow-up.
Korean Circulation Journal 05/2013; 43(5):351-5.
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ABSTRACT: Percutaneous recanalization of chronic total occlusions (CTOs) in peripheral arteries, especially TASC D classification including the distal aorta and both iliac arteries is still technically challenging. The conventional technique using standard guidewires and catheters guided by computed tomography and angiography can achieve a limited initial success, depending on lesion characteristics and operator's experience. A special imaging technique using 3-dimensional rotational angiography and spatio-temporal reconstruction with endoview for a better examination of the proximal stump, exact obstruction location, and distal stump direction in a stumpless lesion can be indispensable for successful intervention. We report a successful revascularization case of stumpless distal aorta and bi-iliac CTO guided by this specialized imaging technique.
Korean Circulation Journal 04/2013; 43(4):261-4.
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ABSTRACT: Aortic coarctation is a correctable hypertensive disease. For safety reasons and due to the invasiveness of surgical techniques, percutaneous interventions have become drastically more popular in recent times. In elderly patients with aortic coarctation who are at risk of an aortic wall aneurysm and rupture, covered stents are preferred but in younger patients, bare metal stenting may be sufficient for long-term safety. Herein we present a 47-year-old typical aortic coarctation patient who was successfully treated with a bare metal stent.
Korean Circulation Journal 04/2013; 43(4):269-72.
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Hong Euy Lim,
Cheol Ung Choi,
Jin Oh Na,
Jong-Il Choi,
Seong Hwan Kim,
Jin Won Kim,
Eung Ju Kim,
Seong Woo Han,
Sang Weon Park, Seung-Woon Rha,
Chang Gyu Park,
Hong-Seog Seo,
Dong Joo Oh,
Chun Hwang,
Young-Hoon Kim
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ABSTRACT: BACKGROUND: -Iatrogenic myocardial injury by radiofrequency catheter ablation (RFCA) releases pro-inflammatory substances from damaged myocardium, and these may contribute to endothelial dysfunction in systemic vascular structure. The aim of this study is to evaluate effect of non-ischemic myocardial damage on coronary microvascular function in patients undergoing atrial fibrillation (AF) ablation. METHODS AND RESULTS: -We included 49 patients who underwent AF ablation (paroxysmal AF[PAF] = 25, persistent AF[PeAF] = 24) and 34 controls. Immediately before and after RFCA, index of microvascular resistance (IMR) was assessed at left anterior descending coronary artery and blood samples were obtained for analyses of nitric oxide (NO), activated leukocyte cell adhesion molecule (ALCAM), and lipoprotein-associated phospholipase (LpPLA2). Transthoracic echocardiography was performed at baseline, one day, one month, and 3 months after RFCA. Compared with baseline, IMR, ALCAM, and LpPLA2 increased and NO decreased after RFCA. In 36 subjects with increasing IMR, E/E' ratio increased at one day and returned to baseline level at 3 months after RFCA. Changes in ALCAM and LpPLA2 between baseline and after RFCA were independently related to the increase in IMR. In 14 subjects (28.6%), arrhythmia recurred. Using a cutoff value of 9.3 mmHg/s, sensitivity was 56.7% and specificity was 91.2% for IMR change in predicting AF recurrence (P = 0.028). CONCLUSIONS: -Myocardial damage by RFCA provoked coronary microvascular dysfunction through systemic pro-inflammatory reaction that may contribute to transient diastolic dysfunction. This phenomenon may represent a mechanism for early recurrence of arrhythmia following RFCA. Clinical Trial Registration Information-http://cris.cdc.go.kr; Identifier: KCT0000030.
Circulation Arrhythmia and Electrophysiology 03/2013; · 6.46 Impact Factor
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Doo Sun Sim,
Myung Ho Jeong,
Kyung Hoon Cho,
Youngkeun Ahn,
Young Jo Kim,
Shung Chull Chae,
Taek Jong Hong,
In Whan Seong,
Jei Keon Chae,
Chong Jin Kim,
Myeong Chan Cho, Seung-Woon Rha,
Jang Ho Bae,
Ki Bae Seung,
Seung Jung Park
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ABSTRACT: The benefit of early statin treatment following acute myocardial infarction (MI) complicated with cardiogenic shock (CS) has not been well studied. We sought to assess the effect of early statin therapy in patients with CS complicating acute MI.
We studied 553 statin-naive patients with acute MI and CS (Killip class IV) who underwent revascularization therapy between November 2005 and January 2008 at 51 hospitals in the Korea Acute Myocardial Infarction Registry. Patients were divided into 2 groups: those who received statins during hospitalization (n=280) and those who did not (n=273). The influence of statin treatment on a 12-month clinical outcome was examined using a matched-pairs analysis (n=200 in each group) based on the propensity for receiving statin therapy during hospitalization.
Before adjustment, patients receiving statin, compared to those not receiving statin, had a more favorable clinical profile, were less likely to suffer procedural complications, and more likely to receive adequate medical therapy. Patients receiving statin had lower unadjusted in-hospital mortality and composite rate of mortality, MI, and repeat revascularization at 12 months, which remained significantly lower after adjustment for patient risk, procedural characteristics, and treatment propensity.
In CS patients with acute MI undergoing revascularization therapy, early statin treatment initiated during hospitalization was associated with lower rates of in-hospital death and 12-month adverse cardiac events.
Korean Circulation Journal 02/2013; 43(2):100-109.
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Dong Joo Oh,
Cheol Ung Choi,
Sunwon Kim,
Seong Il Im,
Jin Oh Na,
Hong Euy Lim,
Jin Won Kim,
Eung Ju Kim,
Seong Woo Han, Seung-Woon Rha,
Chang Gyu Park,
Hong Seog Seo
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ABSTRACT: INTRODUCTION: The gold standard for evaluating stent expansion after percutaneous coronary intervention (PCI) is intravascular ultrasound (IVUS). However, the routine use of this modality is costly and time consuming. StentBoost is a new imaging technique that improves fluoroscopy-based assessments of stent expansion. The purpose of this study was to evaluate the effect of StentBoost imaging-guided PCI on mid-term angiographic and clinical outcomes. METHODS AND RESULTS: A total of 870 consecutive patients were recruited (mean age: 64.34±11.61; men: 64.5%), all of whom underwent PCI with drug-eluting stents (DESs). The subjects were divided into a no StentBoost group (n=569 patients) and a StentBoost group (n=301 patients). The 6-month angiographic and 12-month clinical outcomes were compared between the two groups. At 1month, clinical outcomes were similar between the two groups. At 6months, the StentBoost group had significantly lower rates of late loss (0.32±0.40 vs. 0.48±0.59; p=0.005) and binary restenosis (1.2% vs. 8.3%; p=0.029) compared with the no-StentBoost group. At 12months, StentBoost group had significantly lower the incidence of target lesion revascularization (TLR) (1.7% vs. 7%; p=0.034) and TLR-major adverse cardiac events (6% vs. 13.2%; p=0.037) compared with the no-StentBoost group. CONCLUSION: We conclude that the routine clinical use of StentBoost during PCI can be useful, and results in better medium-term angiographic and clinical outcomes.
International journal of cardiology 01/2013; · 7.08 Impact Factor
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ABSTRACT: There is no current guideline for percutaneous coronary angioplasty in stenotic ectatic coronary arteries because of the heterogeneity of the coronary artery morphology. We report two successful angioplasty cases in coronary artery ectasia with different clinical scenarios. One case showed atherosclerotic stenosis in the ectatic portion of the right coronary artery that was aggravated after a coronary artery bypass graft. In this case, balloon angioplasty alone without stenting showed acceptable results at the 6-month follow-up coronary angiography. In the other case, we used a peripheral artery balloon and stent for stenosis in the ectatic portion of a large coronary artery. Six-month follow-up coronary angiography showed excellent patency of the previously implanted peripheral stent.
Chonnam medical journal. 12/2012; 48(3):185-9.
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Daisuke Hachinohe,
Myung Ho Jeong,
Shigeru Saito,
Min Chol Kim,
Kyung Hoon Cho,
Khurshid Ahmed,
Seung Hwan Hwang,
Min Goo Lee,
Doo Sun Sim,
Keun-Ho Park, [......],
Taek Jong Hong,
Donghoon Choi,
Myeong Chan Cho,
Chong Jin Kim,
Ki Bae Seung,
Wook Sung Chung,
Yang Soo Jang, Seung Woon Rha,
Jang Ho Bae,
Seung Jung Park
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ABSTRACT: To determine which drug-eluting stents are more effective in acute myocardial infarction (MI) patients with chronic kidney disease (CKD).
This study included a total of 3,566 acute MI survivors with CKD from the Korea Acute Myocardial Infarction Registry who were treated with stenting and followed up for 12 months: 1,845 patients who received sirolimus-eluting stents (SES), 1,356 who received paclitaxel-eluting stents (PES), and 365 who received zotarolimus-eluting stents (ZES). CKD was defined as an estimated glomerular filtration rate < 60 mL/min/1.73 m(2) calculated by the modification of diet in renal disease method.
At the 12-month follow-up, patients receiving ZES demonstrated a higher incidence (14.8%) of major adverse cardiac events (MACEs) compared to those receiving SES (10.1%) and PES (12%, p = 0.019). The ZES patients also had a higher incidence (3.9%) of target lesion revascularization (TLR) compared to those receiving SES (1.5%) and PES (2.4%, p = 0.011). After adjusting for confounding factors, ZES was associated with a higher incidence of MACE and TLR than SES (adjusted hazard ratio [HR], 0.623; 95% confidence interval [CI], 0.442 to 0.879; p = 0.007; adjusted HR, 0.350; 95% CI, 0.165 to 0.743; p = 0.006, respectively), and with a higher rate of TLR than PES (adjusted HR, 0.471; 95% CI, 0.223 to 0.997; p = 0.049).
Our findings suggest that ZES is less effective than SES and PES in terms of 12-month TLR, and has a higher incidence of MACE due to a higher TLR rate compared with SES, in acute MI patients with CKD.
The Korean Journal of Internal Medicine 12/2012; 27(4):397-406.
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Kyeom Hwang,
Yun Kyung Kim, Seung-Woon Rha,
Ji Eun Ra,
Bong Soo Seo,
Ji Kyoung Lee,
Jin Oh Na,
Cheol Ung Choi,
Hong Euy Lim,
Seong Woo Han,
Eung Ju Kim,
Chang Gyu Park,
Hong Seog Seo,
Dong Joo Oh,
Sang Myung Choi,
Byoung Gy Chae,
Sung-Jin Kim,
Seong Gyu Yoon,
Il Woo Suh
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ABSTRACT: BACKGROUND: Insulin resistance (IR) is known to be a risk factor for coronary artery disease (CAD). We aimed to evaluate the impact of IR on 1-year clinical outcomes in non-diabetic CAD patients who underwent percutaneous coronary intervention (PCI) with drug-eluting stents (DESs). METHODS AND RESULTS: A total of 229 consecutive non-diabetic CAD patients treated with DESs were enrolled. Study population was divided into IR group [homeostasis model assessment (HOMA) index≥2.5, n=54] and non-IR group (HOMA index<2.5, n=175). Baseline clinical and procedural characteristics were similar between the groups except higher incidence of high-sensitivity C-reactive protein and lower incidence of multivessel disease as the target vessel in the non-IR group. There was a trend toward longer restenosis lesion length in the IR group at 6 months angiographic follow up but composite major clinical outcomes up to 1 year were similar between the two groups. CONCLUSIONS: Despite worse trend in angiographic outcomes in the IR group (HOMA index≥2.5), it was not translated into worse 1-year major clinical outcomes following PCI with DESs as compared to the non-IR group.
Journal of Cardiology 11/2012; · 1.28 Impact Factor
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Kang-Yin Chen, Seung-Woon Rha,
Lin Wang,
Yong-Jian Li,
Guang-Ping Li,
Kanhaiya L Poddar,
Ji-Young Park,
Cheol Ung Choi,
Chang-Gyu Park,
Hong Seog Seo, [......],
Myeong Chan Cho,
Jang Ho Bae,
Dong Hoon Choi,
Yang Soo Jang,
In Ho Chae,
Chong Jin Kim,
Jung Han Yoon,
Wook Sung Chung,
Ki Bae Seung,
Seung Jung Park
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ABSTRACT: This study sought to compare everolimus-eluting stents (EES) with zotarolimus-eluting stents (ZES) in patients with acute myocardial infarction (AMI).
There is a paucity of data to exclusively evaluate the safety and efficacy of second-generation drug-eluting stents (DES) in the setting of AMI.
The present study enrolled 3,309 AMI patients treated with ZES (n = 1,608) or EES (n = 1,701) in a large-scale, prospective, multicenter registry-KAMIR (Korea Acute Myocardial Infarction Registry). Propensity score matching was applied to adjust for differences in baseline clinical and angiographic characteristics, producing a total of 2,646 patients (1,343 receiving ZES, and 1,343 receiving EES). Target lesion failure (TLF) was defined as the composite of cardiac death, recurrent nonfatal myocardial infarction, or target lesion revascularization. Major clinical outcomes at 1 year were compared between the 2 propensity score-matched groups.
After propensity score matching, baseline clinical and angiographic characteristics were similar between the 2 groups. Clinical outcomes of the propensity score-matched patients showed that, despite similar incidences of recurrent nonfatal myocardial infarction and in-hospital and 1-year mortality, patients in the EES group had significantly lower rates of TLF (6.5% vs. 8.7%, p = 0.029) and probable or definite stent thrombosis (0.3% vs. 1.6%, p < 0.001), compared with those in the ZES group. Furthermore, there was a numerically lower rate of target lesion revascularization (1.2% vs. 2.2%, p = 0.051) in the EES group than in the ZES group.
In this propensity-matched comparison, EES seems to be superior to ZES in reducing TLF and stent thrombosis in patients with AMI.
09/2012; 5(9):936-45. · 1.07 Impact Factor
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Doo Sun Sim,
Myung-Ho Jeong,
Youngkeun Ahn,
Young Jo Kim,
Shung Chull Chae,
Taek Jong Hong,
In Whan Seong,
Jei Keon Chae,
Chong Jin Kim,
Myeong Chan Cho, Seung-Woon Rha,
Jang Ho Bae,
Ki Bae Seung,
Seung Jung Park
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ABSTRACT: The clinical benefit of percutaneous coronary intervention (PCI) is controversial in stable early latecomers with ST-segment elevation myocardial infarction (STEMI). We evaluated the efficacy of PCI in 2,344 stable patients with STEMI presenting 12 to 72 hours after symptom onset. Patients who had impaired hemodynamics or who had undergone fibrinolysis or immediate or urgent PCI were excluded. The patients were divided into the PCI group (n = 1,889) and medical treatment group (n = 455). The 12-month clinical outcome was compared between the 2 groups. After adjustment using propensity score stratification, the PCI group had lower mortality (3.1% vs 10.1%; hazard ratio 0.31; 95% confidence interval 0.20 to 0.47; p <0.001) and a lower incidence of composite death/myocardial infarction (3.8% vs 11.2%; hazard ratio 0.36; 95% confidence interval 0.25 to 0.53; p <0.001) at 12 months. The benefit of PCI was consistent across all subgroups, including patients presenting without chest pain. In conclusion, in stable patients with STEMI presenting 12 to 72 hours after symptom onset, PCI was associated with significant improvement in the 12-month clinical outcome.
The American journal of cardiology 07/2012; 110(9):1275-81. · 3.58 Impact Factor
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Ji Young Park, Seung-Woon Rha,
Kanhaiya L Poddar,
Sureshkumar Ramasamy,
Kang-Yin Chen,
Yong-Jian Li,
Byoung Geol Choi,
Sung Kee Ryu,
Jae Woong Choi,
Sang Hyun Park, [......],
Sun Won Kim,
Jin Oh Na,
Cheol Ung Choi,
Hong Euy Lim,
Jin Won Kim,
Eung Ju Kim,
Seong Woo Han,
Chang Gyu Park,
Hong Seog Seo,
Dong Joo Oh
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ABSTRACT: High-dose aspirin has been reported to aggravate coronary artery spasm (CAS). However, it is unknown whether low-dose aspirin (LDA; 100mg) has deleterious impact on CAS. We assessed the impact of LDA on CAS induced by intracoronary acetylcholine (ACh) provocation test. A total of 2789 consecutive patients without significant coronary artery disease who underwent ACh test between November 2004 and March 2010 were enrolled. The patients were divided into two groups: the aspirin group taking LDA before ACh test (n=221) and the no aspirin group not taking aspirin (n=2568). At baseline, the prevalence of old age, diabetes mellitus, hypertension, and hyperlipidemia were higher in the aspirin group. During the ACh test, the incidence of significant CAS, ischemic chest pain, as well as severe and multivessel spasm was higher in the aspirin group. The response rate to lower ACh dose was higher in the aspirin group. Multivariate analysis showed that the previous use of LDA was an independent predictor of CAS (adjusted odds ratio, 1.6, 95% confidence interval, 1.0-2.3; p=0.031). However, it is likely that the association of LDA and CAS that we have observed is not causal but may be hypothesis generating due to significant baseline differences. Further, male gender, old age, lipid-lowering drugs, baseline spasm, and myocardial bridge were independent predictors of CAS. LDA was more frequently associated with CAS and ischemic symptoms, as well as severe and multivessel spasm, suggesting the patients who have received LDA would require more intensive medical therapies and close follow up.
Journal of Cardiology 07/2012; 60(3):187-91. · 1.28 Impact Factor
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Young-Hak Kim,
Duk-Woo Park,
Jung-Min Ahn,
Sung-Cheol Yun,
Hae Geun Song,
Jong-Young Lee,
Won-Jang Kim,
Soo-Jin Kang,
Seung-Whan Lee,
Cheol Whan Lee, [......],
Yangsoo Jang,
Myung-Ho Jeong,
Hyo-Soo Kim,
Seung-Ho Hur, Seung-Woon Rha,
Do-Sun Lim,
Sung-Ho Her,
Ki Bae Seung,
In-Whan Seong,
Seung-Jung Park
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ABSTRACT: This study sought to evaluate the safety and efficacy of second-generation drug-eluting stents (DES) for patients with unprotected left main coronary artery (ULMCA) stenosis.
The clinical benefit of second-generation DES for ULMCA stenosis has not been determined.
The authors assessed 334 consecutive patients who received everolimus-eluting stents (EES) for ULMCA stenosis between 2009 and 2010. The 18-month incidence rates of major adverse cardiac or cerebrovascular events (MACCE), including death, myocardial infarction (MI), stroke, or ischemia-driven target vessel revascularization (TVR), were compared with those of a randomized study comparing patients who received sirolimus-eluting stents (SES) (n = 327) or coronary artery bypass grafts (CABG) (n = 272).
EES (8.9%) showed a comparable incidence of MACCE as SES (10.8%; adjusted hazard ratio [aHR] of EES: 0.84; 95% confidence interval [CI]: 0.51 to 1.40; p = 0.51) and CABG (6.7%, aHR of EES: 1.40; 95% CI: 0.78 to 2.54; p = 0.26). The composite incidence of death, MI, or stroke also did not differ among patients receiving EES (3.3%), SES (3.7%; aHR of EES: 0.63; 95% CI: 0.27 to 1.47; p = 0.29), and CABG (4.8%; aHR of EES: 0.67; 95% CI: 0.29 to 1.54; p = 0.34). However, the incidence of ischemia-driven TVR in the EES group (6.5%) was higher than in the CABG group (2.6%, aHR of EES: 2.77; 95% CI: 1.17 to 6.58; p = 0.02), but comparable to SES (8.2%, aHR of EES: 1.14; 95% CI: 0.64 to 2.06; p = 0.65). Angiographic restenosis rates were similar in the SES and EES groups (13.8% vs. 9.2%, p = 0.16).
Second-generation EES had a similar 18-month risk of MACCE for ULMCA stenosis as first-generation SES or CABG.
07/2012; 5(7):708-17. · 1.07 Impact Factor
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Ki Hoon Han, Seung Woon Rha,
Hyun-Jae Kang,
Jang-Whan Bae,
Byoung-Joo Choi,
So-Yeon Choi,
Hyeon-Cheol Gwon,
Jang-Ho Bae,
Bum-Kee Hong,
Dong-Hoon Choi,
Kyoo-Rok Han
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ABSTRACT: We evaluated the safety and efficacy of the 3-hydroxyl-3-methylglutaryl coenzyme A reductase inhibitors atorvastatin and pitavastatin in patients with mild-to-moderate increased levels of hepatic enzymes.
In this 12-week, prospective, randomized, open-label, active drug-controlled, and dose-titration study, 189 subjects with elevated low-density lipoprotein cholesterol (≥3.36 mmol/L) and alanine transaminase (ALT; ×1.25≥ and ≤×2.5 ULN; 50-100 IU/L) concentrations, but nonalcoholic and serologically negative for viral hepatitis markers at screening, were randomized to 12 weeks of treatment with pitavastatin 2-4 mg/day (PITA, n = 97) or atorvastatin 10-20 mg/day (ATOR, n = 92). Pitavastatin and atorvastatin equally reduced low-density lipoprotein cholesterol concentrations (-34.6 ± 16.0% and -38.1 ± 16.2%, respectively, P < .0001 each by analysis of variance). Seven (n = 4 PITA, n = 3 ATOR) and 10 (n = 5 PITA, n = 5 ATOR) patients experienced episodes of ALT >100 IU/L at weeks 4 and 12, respectively, with one patient in each group excluded because of severe ALT elevation >3× ULN (>120 IU/L) at week 4. The 135 patients with persistently increased ALT concentrations at screening and randomization showed significant reductions in ALT after 12 weeks of treatment with PITA (n = 68, -8.4%) or ATOR (n = 67, -8.9%; P < .05, analysis of variance). Serial nonenhanced computed tomography in 38 subjects (n = 18 PITA, n = 20 ATOR) showed that both statins reduced the severity of hepatic steatosis, especially in subjects with clear hepatic steatosis at baseline (n = 9 PITA, n = 10 ATOR). Statin treatment of another 38 subjects with spontaneous normalization of ALT at randomization had little effect on ALT levels but did not induce severe ALT elevation (>100 IU/L).
Conventional doses of pitavastatin and atorvastatin effectively and safely reduce elevated hepatic enzyme concentrations.
Journal of Clinical Lipidology 07/2012; 6(4):340-51. · 1.58 Impact Factor
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Duk-Woo Park,
Young-Hak Kim,
Hae-Geun Song,
Jung-Min Ahn,
Won-Jang Kim,
Jong-Young Lee,
Soo-Jin Kang,
Seung-Whan Lee,
Cheol Whan Lee,
Seong-Wook Park, [......],
Won-Yong Shin, Seung-Woon Rha,
Kee-Sik Kim,
Seung-Jea Tahk,
Byoung Eun Park,
Taehoon Ahn,
Joo-Young Yang,
Yong Seok Jeong,
Jay-Hyun Rhew,
Seung-Jung Park
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ABSTRACT: It remains unclear whether there are differences in the safety and efficacy outcomes between everolimus-eluting stents (EES) and sirolimus-eluting stents (SES) in contemporary practice.
We prospectively enrolled 6166 consecutive patients who received EES (3081 patients) and SES (3085 patients) between April 2008 and June 2010, using data from the Interventional Cardiology Research In-Cooperation Society-Drug-Eluting Stents Registry. The primary end point was a composite of death, nonfatal myocardial infarction (MI), or target-vessel revascularization (TVR). At 2 years of follow-up, the 2 study groups did not differ significantly in crude risk of the primary end point (12.1% for EES versus 12.4% for SES; HR, 0.97; 95% CI, 0.84-1.12, P=0.66). After adjustment for differences in baseline risk factors, the adjusted risk for the primary end point remained similar for the 2 stent types (HR, 0.96; 95% CI, 0.82-1.12, P=0.60). There were also no differences between the stent groups in the adjusted risks of the individual component of death (HR, 0.93; 95% CI, 0.67-1.30, P=0.68), MI (HR, 0.97; 95% CI, 0.79-1.18, P=0.74), and TVR (HR, 1.10; 95% CI, 0.82-1.49, P=0.51). The adjusted risk of stent thrombosis also was similar (HR, 1.16; 95% CI, 0.47-2.84, P=0.75).
In contemporary practice of percutaneous coronary intervention procedures, the unrestricted use of EES and SES showed similar rates of safety and efficacy outcomes with regard to death, MI, sent thrombosis, and TVR. Future longer-term follow-up is needed to better define the relative benefits of these drug-eluting stents.
URL: http://www.clinicaltrials.gov. Unique identifier: NCT01070420.
Circulation Cardiovascular Interventions 06/2012; 5(3):365-71. · 6.06 Impact Factor
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Seung-Woon Rha,
Kang-Yin Chen,
Dong Joo Oh,
Yong-Jian Li,
Zhe Jin,
Kanhaiya Lal Poddar,
Sureshkumar Ramasamy,
Yoshiyasu Minami,
Amro Elnagar,
Byoung Geol Choi, [......],
Cheol Ung Choi,
Hong Euy Lim,
Jin Won Kim,
Eung Ju Kim,
Seong Woo Han,
Chang Gyu Park,
Hong Seog Seo,
Jung Ha Kim,
Young Joon Hong,
Myung Ho Jeong
[show abstract]
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ABSTRACT: Although the use of heterogeneous overlapping drug-eluting stents (DES) is not uncommon in clinical practice, whether the implantation sequences of heterogeneous DES will influence the endothelialization or arterial responses differently remains unclear.
Twenty-one rabbits were randomized to receive overlapping stents in the iliac artery for 3 months {distal sirolimus-eluting stent (SES, Cypher™)+proximal paclitaxel-eluting stent (PES, Taxus™) (C+T, n=7), distal Taxus+proximal Cypher (T+C, n=7) and bare metal stent (BMS)+BMS (B+B, n=7)}. Endothelial function was evaluated by the acetylcholine provocation test during follow-up angiography. Histopathological changes in proximal, overlapped, and distal stented segments were evaluated.
Although the overall angiographic outcomes were comparable, late loss (mm) in the distal stented segment was higher in the B+B (0.39±0.07) and C+T (0.40±0.20) than that in the T+C (0.06±0.02) group (p<0.001). The incidence of acetylcholine-induced spasm was higher in the DES groups compared with BMS, regardless of the implantation sequences (85.7% in C+T vs. 14.3% in B+B vs. 71.4% in T+C, p=0.017). Notably, only the distal Cypher implantation group (C+T) had three cases of stent fracture. A histopathological analysis showed that despite similar arterial injury scores, Taxus and Cypher stents had higher inflammatory reactions at the overlapped and distal segments compared with those of BMS.
Despite similar arterial injury, higher inflammatory reactions were observed in overlapping DES segments regardless of the implantation sequence compared with that of BMS. Moreover, DES was associated with impaired endothelial function on the adjacent non-stented segments.
Korean Circulation Journal 06/2012; 42(6):397-405.
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Keun-Ho Park,
Youngkeun Ahn,
Myung Ho Jeong,
Shung Chull Chae,
Seung Ho Hur,
Young Jo Kim,
In Whan Seong,
Jei Keon Chae,
Taek Jong Hong,
Myeong Chan Cho,
Jang Ho Bae, Seung Woon Rha,
Yang Soo Jang
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ABSTRACT: The aim of this study was to evaluate the impact of diabetes mellitus (DM) on in-hospital and 1-year mortality in patients who suffered acute myocardial infarction (AMI) and underwent successful percutaneous coronary intervention (PCI).
Among 5,074 consecutive patients from the Korea AMI Registry with successful revascularization between November 2005 and June 2007, 1,412 patients had a history of DM.
The DM group had a higher mean age prevalence of history of hypertension, dyslipidemia, ischemic heart disease, high Killip class, and diagnoses as non-ST elevation MI than the non-DM group. Left ventricular ejection fraction (LVEF) and creatinine clearance were lower in the DM group, which also had a significantly higher incidence of in-hospital and 1-year mortality of hospital survivors (4.6% vs. 2.8%, p = 0.002; 5.0% vs. 2.5%, p < 0.001). A multivariate analysis revealed that independent predictors of in-hospital mortality were Killip class IV or III at admission, use of angiotensin converting enzyme inhibitors or angiotensin-II receptor blockers, LVEF, creatinine clearance, and a diagnosis of ST-elevated MI but not DM. However, a multivariate Cox regression analysis showed that DM was an independent predictor of 1-year mortality (hazard ratio, 1.504; 95% confidence interval, 1.032 to 2.191).
DM has a higher association with 1-year mortality than in-hospital mortality in patients with AMI who underwent successful PCI. Therefore, even when patients with AMI and DM undergo successful PCI, they may require further intensive treatment and continuous attention.
The Korean Journal of Internal Medicine 06/2012; 27(2):180-8.
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Young Joon Hong,
Myung Ho Jeong,
Youngkeun Ahn,
Sang Wook Kim,
Jang Ho Bae,
Seung Ho Hur,
Tae Hoon Ahn, Seung Woon Rha,
Kee Sik Kim,
In Ho Chae,
Jong Hyun Kim,
Kyeong Ho Yun,
Seok Kyu Oh
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ABSTRACT: There are few data regarding the effect of statins on regression and compositional changes of plaque according to the reduction in high-sensitivity C-reactive protein (hs-CRP) levels in acute myocardial infarction (AMI) patients.
We used serial virtual histology-intravascular ultrasound to assess the efficacy of pitavastatin (dosage: 2mg/day) on plaque regression and compositional changes according to the degree of reduction in hs-CRP levels from baseline to follow-up [≥1mg/dl (n=62) vs. <1mg/dl (n=32)] in non-intervened non-infarct related artery in AMI patients who were enrolled in the Livalo in acute myocardial infarction study (LAMIS).
Total atheroma and percent atheroma volumes decreased more significantly in patients with reduction in hs-CRP ≥1mg/dl compared with those with reduction in hs-CRP <1mg/dl (-1.7±12.4mm(3) vs. +2.7±7.8mm(3), p<0.015, and -0.4±3.4% vs. +0.4±4.8%, p<0.001, respectively). Absolute and %necrotic core volumes decreased more significantly in patients with reduction in hs-CRP ≥1mg/dl compared with those with reduction in hs-CRP <1mg/dl (-0.4±3.5mm(3) vs. +1.9±3.4mm(3), p=0.038, and -1.1±4.9% vs. +2.7±4.7%, p=0.016, respectively). Reduction in hs-CRP ≥1mg/dl at follow-up was the independent predictor of reduction of percent atheroma volume and %necrotic core volume at follow-up [odds ratio (OR), 2.228; 95% confidence interval (CI), 1.390-2.977, p=0.016, and OR, 2.204; 95% CI, 1.512-2.916, p=0.020, respectively].
Reduction in hs-CRP levels in AMI patients plays an important role in the beneficial effects of statins on the regression and compositional change of coronary plaque.
Journal of Cardiology 05/2012; 60(4):277-82. · 1.28 Impact Factor
