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Young-Hwa Lee,
Seung-Ho Hur,
Jihyun Sohn,
Ho-Myung Lee,
Nam-Hee Park,
Yun-Kyeong Cho,
Hyoung-Seob Park,
Hyuck-Jun Yoon,
Hyungseop Kim,
Chang-Wook Nam, Yoon-Nyun Kim,
Kwon-Bae Kim
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ABSTRACT: Recent studies have suggested a favorable effect of cardiac rehabilitation (CR) on patients with cardiovascular disease. This study aimed to evaluate the impact of home-based exercise training with wireless monitoring on acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI). A total of 55 ACS patients undergoing PCI were randomly divided into home based exercise training with wireless monitoring cardiac rehabilitation (CR, n = 26) and usual care (UC, n = 29). Exercise capacity and quality of life (QOL) were evaluated at baseline and after 12 weeks. Change of metabolic equivalent of the tasks, maximal exercise time and QOL were significantly increased (+2.47 vs +1.43, P = 0.021; +169.68 vs +88.31 sec, P = 0.012; and +4.81 vs +0.89, P = 0.022, respectively), and the change of submaximal rate pressure product, and of submaximal rate of perceived exertion were significantly decreased (-28.24 vs -16.21, P = 0.013; and -1.92 vs -1.62, P = 0.018, respectively) in the CR group compared to the UC group after 12 weeks. CR using home-based exercise training with wireless monitoring led to improvement of exercise capacity and QOL relative to conventional care in ACS patients undergoing PCI. Our findings suggest that early scheduled CR may be considered in ACS patients undergoing PCI.
Journal of Korean medical science 04/2013; 28(4):564-8. · 0.84 Impact Factor
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ABSTRACT: Coronary artery disease (CAD) results from atherosclerosis, a chronic inflammatory disease mediated in part by proinflammatory cytokines, particularly tumor necrosis factor-α (TNF-α), which is expressed by atherosclerotic plaques. In this study, we investigated whether TNF-α gene promoter polymorphisms affect the incidence of CAD in Koreans by genotyping. 404 Control subjects and 197 patients who previously received a coronary artery stent for the G/A, C/T, and C/A polymorphisms at position -238, -857 and -863, respectively. The G/G, G/A and A/A genotypes at position -238 occurred in 85.8%, 14.2% and 0% CAD patients and 91.8%, 7.9% and 0.3% control subjects, respectively. The G/A polymorphisms at position -238 were significantly associated with CAD when assuming a dominant model of inheritance (OR=1.87; 95% CI=1.10-3.20; P=0.02), and A allele carriers had a significantly increased risk of developing CAD relative to the G allele (OR=1.74; 95% CI=1.04-2.92; P=0.03). However, the polymorphisms at positions -857 and -863 were not associated with CAD. Haplotype-based analysis revealed the CAD and control groups differed significantly in the frequencies of haplotype ACC at positions -238, -857 and -863 (OR=1.77; 95% CI=1.05-2.98; P=0.03). This was confirmed by multivariate analysis after adjusting body mass index and the presence of diabetes and hypertension (OR=2.06; 95% CI=1.15-3.68; P=0.015). Thus, the -238A allele of TNF-α is associated with an increased risk of CAD and could be used as predictor for CAD in Koreans. Further studies are needed to elucidate the clinical implications of these findings.
Cytokine 03/2013; · 3.02 Impact Factor
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The Korean Journal of Internal Medicine 03/2013; 28(2):247-50.
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ABSTRACT: The purpose of this study was to find risk factors that are associated with complications of cerebral infarction in patients with atrial fibrillation (AF) and to discover useful association rules among these factors.
The risk factors with respect to cerebral infarction were selected using logistic regression analysis with the Wald's forward selection approach. The rules to identify the complications of cerebral infarction were obtained by using the association rule mining (ARM) approach.
We observed that 4 independent factors, namely, age, hypertension, initial electrocardiographic rhythm, and initial echocardiographic left atrial dimension (LAD), were strong predictors of cerebral infarction in patients with AF. After the application of ARM, we obtained 4 useful rules to identify complications of cerebral infarction: age (>63 years) and hypertension (Yes) and initial ECG rhythm (AF) and initial Echo LAD (>4.06 cm); age (>63 years) and hypertension (Yes) and initial Echo LAD (>4.06 cm); hypertension (Yes) and initial ECG rhythm (AF) and initial Echo LAD (>4.06 cm); age (>63 years) and hypertension (Yes) and initial ECG rhythm (AF).
Among the induced rules, 3 factors (the initial ECG rhythm [i.e., AF], initial Echo LAD, and age) were strongly associated with each other.
Healthcare informatics research. 03/2013; 19(1):25-32.
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The Korean Journal of Internal Medicine 01/2013; 28(1):108-11.
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ABSTRACT: Few studies have explored the clinical potentials of combined Cystatin C (Cys) and uric acid (UA) in heart failure (HF). The authors evaluated Cys and UA as predictors of clinical outcomes compared with conventional renal biomarkers. This prospective cohort study included 587 HF patients presenting with dyspnea. At admission, Cys, UA, and other renal measures including serum urea nitrogen (BUN), creatinine (Cr), and glomerular filtration rate (GFR) were obtained. The primary endpoint was the composite of cardiac death and rehospitalization for worsening HF. During a 25-month median follow-up period, 68 patients experienced clinical outcomes: 9 cardiac deaths and 59 HFs. They showed higher BUN and Cr values and lower GFR. Within these parameters, Cys and UA had the most favorable area under the curves, and patients with Cys ≥0.8 mg/L and UA ≥6.6 mg/dL showed more frequent events. The net reclassification improvement analysis showed the combination of Cys and UA had a greater incremental effect for cardiac prognosis. On multivariate Cox hazard analysis, Cys and UA were independent predictive markers for clinical outcomes. In HF patients presenting with dyspnea, Cys and UA appear to be more useful predictors of clinical events than other renal measures.
Congestive Heart Failure 12/2012;
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ABSTRACT: We performed a retrospective study to elucidate the frequency of tachycardia mechanisms and the characteristics of accessory pathways (APs), confirmed by radiofrequency catheter ablation (RFCA) in pediatric tachycardia. In addition, we analyzed the efficacy and safety of pediatric RFCA.
The authors retrospectively reviewed the records of a total of 260 patients (aged 2 to 18 years) who had undergone RFCA between August 1993 and July 2011 at two medical centers in Daegu.
Two hundred and sixty patients underwent 272 RFCAs at less than 18 years of age. Of these 260 patients, 9 patients (3%) were younger than 6 years, and 175 patients (67%) were older than 12 years. The tachycardia mechanisms observed were atrioventricular reentry tachycardia (AVRT) in 175 patients (65%), atrioventricular nodal reentry tachycardia (AVNRT) in 83 patients (30%), ventricular tachycardia in 12 patients (4%), and atrial tachycardia in 2 patients (0.7%). Among the patients with AVRT, there were 94 concealed APs and 81 manifest APs. Left-side APs were more common in concealed APs than in manifest APs (72/94, 77% vs. 33/81, 41%, p<0.001). Sixty-six percent (55/83) of AVNRT cases were located at the M1 and/or M2 sites. Four patients had multiple tachycardia mechanisms (AVNRT+AVRT) and 9 patients had multiple APs. The recurrence rate was 5% (13/272). Of these recurrent cases, 12 patients had AVRT. The overall success rate was 95%.
Pediatric RFCA provides a good success rate and an acceptable recurrence. In addition, we suggest that the APs location may be associated with concealed or manifest property of APs.
Korean Circulation Journal 11/2012; 42(11):735-40.
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Hong Won Shin,
Hyuck Jun Yoon,
Sang Woong Choi,
Han Jun Bae,
Ji Hyun Sohn,
Ho Myung Lee,
Hyun Ok Cho,
Yun Kyeong Cho,
Hyoung Seob Park,
Hyungseop Kim,
Chang Wook Nam,
Seung Ho Hur, Yoon Nyun Kim,
Kwon Bae Kim
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ABSTRACT: Heparin is an essential drug in the treatment of acute coronary syndrome and it is used during percutaneous coronary intervention (PCI). Heparin-induced thrombocytopenia (HIT), albeit a serious complication of heparin therapy characterized by thrombocytopenia and high risk for venous and arterial thrombosis, has rarely been previously reported during PCI. We report a case of an acute stent thrombosis due to an unusual cause, HIT during primary PCI, in a patient with acute myocardial infarction.
Korean Circulation Journal 09/2012; 42(9):646-9.
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ABSTRACT: A system is being developed for measurement of biologic active points (BAPs) in humans using a modified dry electrode. The BAPs measuring system analyzed the electrical characteristics and searched for the position of BAPs using modified dry electrodes.
Skin electrical resistance at BAPs and non-BAPs was examined with a modified electrode system for healthy male subjects (ages 21-40). Four (4) acupuncture points of PC-4, PC-5, PC-6, and PC-7 on the left arms were chosen for BAPs. Bio-impedance was then conducted for BAPs and non-BAPS using a lock-in amplifier with a frequency range of 1 Hz-1 kHz.
Resistances of four BAPs were found to decrease to about 29%-59% of non-BAPs and reactance of BAPs was found to decrease to about 23%-41% of non-BAPs. The difference in electrical impedance between BAPs and non-BAPs was easily recognized since the average value of BAPs was measured at lower values than that of non-BAPs. Through these experiments, BAPs could be distinguished from non-BAPs based on electrical impedance. In addition, the electrical impedance model used-the electrical BAPs model-appears to be better suited for skin.
The proposed BAPs electrical model of skin can be adapted for interpretation of changes in the impedance characterization of skin. This system would be used for various skin diagnoses due to the simplicity and reliability of bio-impedance analysis.
Journal of alternative and complementary medicine (New York, N.Y.) 08/2012; 18(9):864-9. · 1.69 Impact Factor
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ABSTRACT: The aim of this study was to analyze comorbidity in patients with type 2 diabetes mellitus (T2DM) by using association rule mining (ARM).
We used data from patients who visited Keimyung University Dongsan Medical Center from 1996 to 2007. Of 411,414 total patients, T2DM was present in 20,314. The Dx Analyze Tool was developed for data cleansing and data mart construction, and to reveal associations of comorbidity.
Eighteen associations reached threshold (support, ≥ 3%; confidence, ≥ 5%). The highest association was found between T2DM and essential hypertension (support, 17.43%; confidence, 34.86%). Six association rules were found among three comorbid diseases. Among them, essential hypertension was an important node between T2DM and stroke (support, 4.06%; confidence, 8.12%) as well as between T2DM and dyslipidemia (support, 3.44%; confidence, 6.88%).
Essential hypertension plays an important role in the association between T2DM and its comorbid diseases. The Dx Analyze Tool is practical for comorbidity studies that have an enormous clinical database.
The Korean Journal of Internal Medicine 06/2012; 27(2):197-202.
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ABSTRACT: Recent several studies have shown that the genetic variation of SCN5A is related with atrioventricular conduction block (AVB); no study has yet been published in Koreans. Therefore, to determine the AVB-associated genetic variation in Korean patients, we investigated the genetic variation of SCN5A in Korean patients with AVB and compared with normal control subjects. We enrolled 113 patients with AVB and 80 normal controls with no cardiac symptoms. DNA was isolated from the peripheral blood, and all exons (exon 2-exon 28) except the untranslated region and exon-intron boundaries of the SCN5A gene were amplified by multiplex PCR and directly sequenced using an ABI PRISM 3100 Genetic Analyzer. When a variation was discovered in genomic DNA from AVB patients, we confirmed whether the same variation existed in the control genomic DNA. In the present study, a total of 7 genetic variations were detected in 113 AVB patients. Of the 7 variations, 5 (G87A-A29A, intervening sequence 9-3C>A, A1673G-H558R, G3578A-R1193Q, and T5457C-D1819D) have been reported in previous studies, and 2 (C48G-F16L and G3048A-T1016T) were novel variations that have not been reported. The 2 newly discovered variations were not found in the 80 normal controls. In addition, G298S, G514C, P1008S, G1406R, and D1595N, identified in other ethnic populations, were not detected in this study. We found 2 novel genetic variations in the SCN5A gene in Korean patients with AVB. However, further functional study might be needed.
Genomics & informatics. 06/2012; 10(2):110-6.
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Gyeong-Im Yu,
Ho-Chan Cho,
Yun-Kyeong Cho,
Hyoung-Seob Park,
Hyuck-Jun Yoon,
Hyung-Seop Kim,
Chang-Wook Nam, Yoon-Nyun Kim,
Kwon-Bae Kim,
Eunyoung Ha,
Dong-Hoon Shin,
Seung-Ho Hur
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ABSTRACT: Ischemic heart disease (IHD) is a disease characterized by ischemia of the heart muscle, usually due to coronary artery disease. Interleukin-10 (IL10) is a proinflammatory cytokine known to protect endothelial function. In this study, we investigated the association of promoter region polymorphisms of the IL10 gene with IHD.
We recruited 313 control and 173 IHD patients. The selected SNPs in IL10 were genotyped using pyrosequencing.
SNPs at positions -592C/A and -819C/T were statistically associated with IHD (P = 0.014 and P = 0.037). Similarly, the mean value of C-reactive protein in the C allele at -592C/A and -819C/T was significantly higher than that in the A allele at -592C/A (P = 0.026) and T allele at -819C/T (P = 0.026). The presence of hypertension in the C allele at -592C/A and -819C/T was significantly more frequent than that in the A allele at -592C/A (P = 0.044) and T allele at -819C/T (P = 0.044). In the haplotype of two SNPs (-592C/A and -819C/T), one haplotype (CC) presented an association with IHD (P = 0.012).
These results indicate that the C allele with SNPs at position -592C/A and -819C/T of IL10 gene may be associated with IHD in the Korean population.
Agents and Actions 05/2012; 61(8):899-905. · 1.59 Impact Factor
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ABSTRACT: The accurate diagnosis of heart failure in emergency room patients is quite important, but can also be quite difficult due to our insufficient understanding of the characteristics of heart failure. The purpose of this study is to design a decision-making model that provides critical factors and knowledge associated with congestive heart failure (CHF) using an approach that makes use of rough sets (RSs) and decision trees. Among 72 laboratory findings, it was determined that two subsets (RBC, EOS, Protein, O2SAT, Pro BNP) in an RS-based model, and one subset (Gender, MCHC, Direct bilirubin, and Pro BNP) in a logistic regression (LR)-based model were indispensable factors for differentiating CHF patients from those with dyspnea, and the risk factor Pro BNP was particularly so. To demonstrate the usefulness of the proposed model, we compared the discriminatory power of decision-making models that utilize RS- and LR-based decision models by conducting 10-fold cross-validation. The experimental results showed that the RS-based decision-making model (accuracy: 97.5%, sensitivity: 97.2%, specificity: 97.7%, positive predictive value: 97.2%, negative predictive value: 97.7%, and area under ROC curve: 97.5%) consistently outperformed the LR-based decision-making model (accuracy: 88.7%, sensitivity: 90.1%, specificity: 87.5%, positive predictive value: 85.3%, negative predictive value: 91.7%, and area under ROC curve: 88.8%). In addition, a pairwise comparison of the ROC curves of the two models showed a statistically significant difference (p<0.01; 95% CI: 2.63-14.6).
Journal of Biomedical Informatics 05/2012; 45(5):999-1008. · 1.79 Impact Factor
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ABSTRACT: PurposeAnalytic methods associated with P, QRS, and T waves in electrocardiography (ECG) are important in the diagnosis of cardiac
disease. Many methods have been proposed to enhance the robustness and accuracy of automatic detection and analysis methods.
Recently, remote monitoring with a mobile personal ECG using a patch-type electrode ECG remote monitoring system has been
used in a variety of conditions. Therefore, a new, simple and easily implemented method for R wave detection from mobile ECG
signals is needed.
MethodsThe proposed method is able to detect R waves and R-R interval calculation in the ECG even when the signal includes in arrhythmia,
baseline draft and abnormal signals. We evaluated the algorithm using the data acquired from patch-type electrode for validation
purposes.
ResultsThe results show the strong possibility of the auto-detection of R waves in QRS through a difference operation from an ECG
source signal. The proposed algorithm provides good performance of a 99.8% sensitivity using patch-type electrode ECG databases.
These results obtained are verified in relation to efficient R-wave detection algorithms.
ConclusionsThe results of this study offer useful technology for experts who interpret ECG signals based on an on-line u-health service.
In the future, additional algorithms can be created that can detect and discriminate the symptoms of other cardiovascular
diseases as needed for the purposes of u-healthcare.
KeywordsPatch-type electrode–Difference operation–R-R interval–Electrocardiogram (ECG)–Arrhythmia–U-healthcare
04/2012; 1(3):180-187.
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ABSTRACT: PurposeThe analysis of the ECG is required of accuracy for diagnosing many cardiac diseases. In this work, we propose an algorithm
using wavelet transform to analyze and classify ECG (electrocardiogram) signal obtained from the developed patch type electrode.
This paper presents a new combined wavelet transform artificial neural network (CWTANN) based system for classification and
detection of QRS complex, P and T waves. CWTANN provided useful information for detection of cardiac disease or abnormality.
MethodsIn this paper, we proposed a method to detect characteristic waves, such as P, QRS and T wave from abnormal ECG signal. Daubechies,
Coiflets and Symlets order 5 wavelet transform were applied to the ECG. The methods have been proven out for detection of
normal signal, ventricular tachycardia (VT) and PVC (premature ventricular contraction) in the ECG through subband decomposition
and combined wavelet transform.
ResultsFrom the results, the detection rate achieved was 96.2% for off-line classification, which is indeed a good rate of accuracy
for data recognition. Using the simple proposed wavelet scheme, the developed methodology achieves higher detection rates.
ConclusionsThe proposed ECG detection method can be used P, QRS, T wave detection by sum of combined scale using DWT. Thus the clinical
use of the methodology is to be beneficial in the analysis of various heart diseases. The new CWTANN method is expected used
in monitoring of ECG for mobile home healthcare applications.
KeywordsECG (electrocardiogram)–Heart type patch electrode–CWTANN (combined wavelet transform artificial neural network)–Ventricular tachycardia(VT)–PVC(premature ventricular contraction)
04/2012; 1(2):108-115.
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ABSTRACT: The aim of this study is to develop a simple and reliable hybrid decision support model by combining statistical analysis and decision tree algorithms to ensure high accuracy of early diagnosis in patients with suspected acute appendicitis and to identify useful decision rules.
We enrolled 326 patients who attended an emergency medical center complaining mainly of acute abdominal pain. Statistical analysis approaches were used as a feature selection process in the design of decision support models, including the Chi-square test, Fisher's exact test, the Mann-Whitney U-test (p < 0.01), and Wald forward logistic regression (entry and removal criteria of 0.01 and 0.05, or 0.05 and 0.10, respectively). The final decision support models were constructed using the C5.0 decision tree algorithm of Clementine 12.0 after pre-processing.
Of 55 variables, two subsets were found to be indispensable for early diagnostic knowledge discovery in acute appendicitis. The two subsets were as follows: (1) lymphocytes, urine glucose, total bilirubin, total amylase, chloride, red blood cell, neutrophils, eosinophils, white blood cell, complaints, basophils, glucose, monocytes, activated partial thromboplastin time, urine ketone, and direct bilirubin in the univariate analysis-based model; and (2) neutrophils, complaints, total bilirubin, urine glucose, and lipase in the multivariate analysis-based model. The experimental results showed that the model with univariate analysis (80.2%, 82.4%, 78.3%, 76.8%, 83.5%, and 80.3%) outperformed models using multivariate analysis (71.6%, 69.3%, 73.7%, 69.7%, 73.3%, and 71.5% with entry and removal criteria of 0.01 and 0.05; 73.5%, 66.0%, 80.0%, 74.3%, 72.9%, and 73.0% with entry and removal criteria of 0.05 and 0.10) in terms of accuracy, sensitivity, specificity, positive predictive value, negative predictive value, and area under ROC curve, during a 10-fold cross validation. A statistically significant difference was detected in the pairwise comparison of ROC curves (p < 0.01, 95% CI, 3.13-14.5; p < 0.05, 95% CI, 1.54-13.1). The larger induced decision model was more effective for identifying acute appendicitis in patients with acute abdominal pain, whereas the smaller induced decision tree was less accurate with the test data.
The decision model developed in this study can be applied as an aid in the initial decision making of clinicians to increase vigilance in cases of suspected acute appendicitis.
BMC Medical Informatics and Decision Making 03/2012; 12:17. · 1.48 Impact Factor
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Hong-Won Shin, Yoon-Nyun Kim,
Han-Jun Bae,
Ho-Myung Lee,
Hyun-Ok Cho,
Yun-Kyeong Cho,
Hyoung-Seob Park,
Hyuck-Jun Yoon,
Hyungseop Kim,
Chang-Wook Nam,
Seung-Ho Hur,
Kwon-Bae Kim,
Young-Soo Lee
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ABSTRACT: Anticoagulation with vitamin K antagonists (VKAs) such as warfarin provides effective stroke prophylaxis in patients with atrial fibrillation (AF). We conducted a large multicenter survey of Korean patients with AF to determine trends in VKA use.
Eligible patients were adults with AF that had been prescribed VKAs. Medical records from a total of 5616 patients {mean age 63.6±12.2 years, male 3150 (56.1%)} in 27 hospitals from Jan. 2001 to Oct. 2007 were reviewed.
The mean international normalized ratio (INR) was 2.04±0.64, and mean dosage of VKA was 3.66±1.50 mg. Individuals in their sixties (1852 patients) accounted for about one third of patients studied. As patients grew older, INR increased and VKA dosage decreased. The dosage of VKA in male patients was larger than that in females for all ages. A total of 2146 (42.4%) patients had an INR of 2-3, and less than 40% patients in their sixties had an INR within optimal range. The dosage of oral anticoagulant for optimal INR level was 3.71 mg.
In this study, less than half of the Korean patients with AF on VKA reached the therapeutic range of INR. Mean dosage of VKA was 3.66±1.50 mg, and the dosage of oral anticoagulant for optimal INR level was 3.71 mg, which decreased with age.
Korean Circulation Journal 02/2012; 42(2):113-7.
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ABSTRACT: Right ventricular function is associated with long-term outcomes of heart failure (HF), particularly with atrial fibrillation (AF). The aim of this study was to evaluate the prognostic value of Doppler tissue imaging at the mitral and tricuspid annuli in patients with HF and AF.
In this prospective observational study, 457 patients (mean age, 67 years; 283 men) referred for HF with AF were enrolled and underwent conventional echocardiography including pulsed-wave Doppler tissue imaging. Systolic (s') and early diastolic (e') velocities of the tricuspid and mitral annuli were recorded from the apical four-chamber view. The development of clinical adverse events during the follow-up period was defined as the composite of cardiac death and readmission for HF.
During the follow-up period (median, 20 months), 37 patients reached the primary end point (nine deaths and 28 cases of HF). Patients with cardiac events were significantly older and more often had previous HF admissions and diuretic use, higher New York Heart Association classes, and greater average ratios of peak early diastolic mitral inflow to annular velocity. Additionally, Doppler tissue imaging of s' and e' at the tricuspid, septal, and lateral mitral annuli were all reduced. Multivariate analysis showed that tricuspid s' and septal e' remained significant predictors of cardiac events. By Kaplan-Meier analysis, the occurrence of cardiac events was more frequent when tricuspid s' was <9.0 cm/sec (P < .001) and when septal e' was <7.3 cm/sec (P < .001).
In patients with HF and AF with a high risk for cardiac events, tricuspid s' and septal e' can be independent risk predictors of outcomes.
Journal of the American Society of Echocardiography: official publication of the American Society of Echocardiography 01/2012; 25(4):436-43. · 2.98 Impact Factor
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ABSTRACT: Under conditions of Na(+) channel hyperactivation with aconitine, the changes in action potential duration (APD) and the restitution characteristics have not been well defined in the context of aconitine-induced arrhythmogenesis. Optical mapping of voltage using RH237 was performed with eight extracted rabbit hearts that were perfused using the Langendorff system. The characteristics of APD restitution were assessed using the steady-state pacing protocol at baseline and 0.1 µM aconitine concentration. In addition, pseudo-ECG was analyzed at baseline, and with 0.1 and 1.0 µM of aconitine infusion respectively. Triggered activity was not shown in dose of 0.1 µM aconitine but overtly presented in 1.0 µM of aconitine. The slopes of the dynamic APD restitution curves were significantly steeper with 0.1 µM of aconitine than at baseline. With aconitine administration, the cycle length of initiation of APD alternans was significantly longer than at baseline (287.5 ± 9.6 vs 247.5 ± 15.0 msec, P = 0.016). The functional reentry following regional conduction block appears with the progression of APD alternans. Ventricular fibrillation is induced reproducibly at pacing cycle length showing a 2:1 conduction block. Low-dose aconitine produces arrhythmogenesis at an increasing restitution slope with APD alternans as well as regional conduction block that proceeds to functional reentry.
Journal of Korean medical science 12/2011; 26(12):1576-81. · 0.84 Impact Factor
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ABSTRACT: Neointimal hyperplasia mainly develops within several months of coronary stent deployment, after which it stabilizes. Although it was widely accepted, particularly during the bare-metal stent (BMS) era, that in-stent restenosis (ISR) generally does not present as an acute coronary syndrome (ACS), but rather as a gradual recurrence of angina symptoms, recent data have shown that a substantial number of patients with ISR present as ACS. There has also been consistent postmortem evidence of plaque rupture secondary to atherosclerotic change within the neointima of a BMS. We report here a case of ACS in which intravascular ultrasound and optical coherent tomographic assessments revealed neointimal atherosclerotic change and ruptured plaque 10 years after BMS deployment.
Korean Circulation Journal 11/2011; 41(11):671-3.
