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1. Impact of genetic variants on major bleeding after percutaneous coronary intervention based on a prospective multicenter registry

Author

Won-Yong Shin, Woong Chol Kang, Soon Jun Hong, Yong Hoon Kim, Sung Gyun Ahn, Hyeon Cheol Gwon, Do Sun Lim, Weon Kim, Byeong Keuk Kim, Tae Hoon Ahn, Jae Hyoung Park, Hyung Joon Joo, Woong Gil Choi, Yun Hyeong Cho, Jung Han Yoon, Young Hyo Lim, and Jung-Joon Cha

Subjects
Male, Platelets, medicine.medical_specialty, ATP Binding Cassette Transporter, Subfamily B, Percutaneous, medicine.medical_treatment, Science, Cardiology, Hemorrhage, Single-nucleotide polymorphism, CYP2C19, 030204 cardiovascular system & hematology, Polymorphism, Single Nucleotide, Article, 03 medical and health sciences, Percutaneous Coronary Intervention, 0302 clinical medicine, Text mining, Internal medicine, medicine, Clinical endpoint, Humans, Prospective Studies, Registries, 030212 general & internal medicine, Aged, Multidisciplinary, Aryldialkylphosphatase, business.industry, Hazard ratio, Percutaneous coronary intervention, Middle Aged, Prognosis, Receptors, Purinergic P2Y12, Cardiovascular biology, Confidence interval, Cytochrome P-450 CYP2C19, Medicine, Female, business, Interventional cardiology, Platelet Aggregation Inhibitors
Abstract

Although dual antiplatelet therapy is essential for patients who undergo percutaneous coronary interventions, the risk of bleeding remains an unsolved problem, and there is limited information on the potential relationship between genetic variants and major bleeding. We analyzed the correlations between four major single nucleotide polymorphisms (CYP2C19, ABCB1, PON1, and P2Y12 G52T polymorphisms) and clinical outcomes in 4489 patients from a prospective multicenter registry. The primary endpoint was major bleeding, defined as a Bleeding Academic Research Consortium ≥ 3 bleeding event. The allelic frequencies of ABCB1, PON1, and both individual and combined CYP2C19 variants did not differ significantly between patient groups with and without major bleeding. However, the allelic frequency of the P2Y12 variant differed significantly between the two groups. Focusing on the P2Y12 G52T variant, patients in the TT group had a significantly higher rate of major bleeding (6.4%; adjusted hazard ratio [HR] 2.51; 95% confidence interval [CI] 1.08–5.84; p = 0.033) than patients in the other groups (GG [2.9%] or GT [1.9%]). Therefore, the TT variant of the P2Y12 G52T polymorphism may be an independent predictor of major bleeding.Trial registration: NCT02707445 (https://clinicaltrials.gov/ct2/show/NCT02707445?term=02707445&draw=2&rank=1).

Published
2021

2. Comparison of 1-Year Outcomes of Triple (Aspirin + Clopidogrel + Cilostazol) Versus Dual Antiplatelet Therapy (Aspirin + Clopidogrel + Placebo) After Implantation of Second-Generation Drug-Eluting Stents into One or More Coronary Arteries: from the DECREASE-PCI Trial

Author

Jae-Hwan Lee, Duk-Woo Park, Jae Bin Seo, Si Wan Choi, Cheol Whan Lee, Seong Wook Park, Pil-Ki Min, Cheol Hyun Lee, Seung-Whan Lee, Pil Hyung Lee, Jung-Min Ahn, Sung Ho Her, Youngjin Choi, Gyung Min Park, Jang Hyun Cho, Seung-Jung Park, Soo Jin Kang, Young-Hak Kim, Chang-Wook Nam, Jong-Young Lee, Won-Yong Shin, and Hyun-Sook Kim

Subjects
Male, medicine.medical_specialty, Endpoint Determination, medicine.medical_treatment, Myocardial Infarction, Coronary Artery Disease, 030204 cardiovascular system & hematology, Coronary Angiography, Coronary artery disease, 03 medical and health sciences, Percutaneous Coronary Intervention, 0302 clinical medicine, Double-Blind Method, Internal medicine, Republic of Korea, Myocardial Revascularization, medicine, Humans, Prospective Studies, cardiovascular diseases, 030212 general & internal medicine, Myocardial infarction, Stroke, Aspirin, business.industry, Percutaneous coronary intervention, Drug-Eluting Stents, Middle Aged, medicine.disease, Clopidogrel, Cilostazol, Survival Rate, Treatment Outcome, Cardiology, Platelet aggregation inhibitor, Drug Therapy, Combination, Female, Cardiology and Cardiovascular Medicine, business, Immunosuppressive Agents, Platelet Aggregation Inhibitors, medicine.drug
Abstract

This study sought to evaluate the impact of triple antiplatelet therapy on clinical outcomes in patients treated with second-generation drug-eluting stents (DES) for coronary artery disease. There are limited data regarding the impact of triple antiplatelet therapy in patients who underwent implantation of second-generation DES. We planned to randomly assign 2,110 patients treated with second-generation DES to triple (aspirin, clopidogrel, and cilostazol) and dual (aspirin, clopidogrel, and placebo) antiplatelet therapy groups. The primary end point was a composite of death, myocardial infarction, ischemic stroke, or target vessel revascularization (TVR) at 1 year since randomization. The study was stopped early owing to slow enrollment. In total, 404 patients (202 patients each in the triple and dual antiplatelet therapy groups) were finally enrolled. At 1 year, the primary end point had occurred in 3.6% and 9.4% of patients in the triple and dual antiplatelet therapy groups, respectively (hazard ratio [HR] of the triple group 0.396; 95% confidence interval [CI] 0.166 to 0.949; p = 0.038). There was no significant difference between the 2 groups regarding the occurrence of a composite of all-cause death, myocardial infarction, or ischemic stroke (HR 0.583; 95% CI 0.229 to 1.481; p = 0.256). However, the rates of TVR were significantly lower in the triple antiplatelet therapy group than in the dual antiplatelet therapy group (HR 0.118; 95% CI 0.015 to 0.930; p = 0.043). In conclusion, triple antiplatelet therapy with cilostazol after implantation of second-generation DES improved clinical outcomes, mainly by reducing TVR.

Published
2018
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3. Effects of genetic variants on platelet reactivity and one-year clinical outcomes after percutaneous coronary intervention: A prospective multicentre registry study

Author

Hyung Joon Joo, Weon Kim, Yong Hoon Kim, Scot Garg, Jae Hyoung Park, Ji Young Park, Yangsoo Jang, Do Sun Lim, Woong Gil Choi, Seok Yeon Kim, Hyeon Cheol Gwon, Young Hyo Lim, Myeong Ki Hong, Woong Chol Kang, Yun Hyeong Cho, Jung Han Yoon, Sung Gyun Ahn, Won-Yong Shin, and Soon Jun Hong

Subjects
Male, medicine.medical_specialty, ATP Binding Cassette Transporter, Subfamily B, Ticlopidine, Platelet Aggregation, medicine.medical_treatment, lcsh:Medicine, CYP2C19, 030204 cardiovascular system & hematology, Polymorphism, Single Nucleotide, Article, 03 medical and health sciences, Percutaneous Coronary Intervention, Postoperative Complications, 0302 clinical medicine, P2Y12, Internal medicine, medicine, Humans, 030212 general & internal medicine, Myocardial infarction, lcsh:Science, Aged, Cytochrome P-450 CYP2C9, Multidisciplinary, Aryldialkylphosphatase, Proportional hazards model, business.industry, Hazard ratio, lcsh:R, Percutaneous coronary intervention, Thrombosis, Middle Aged, medicine.disease, Clopidogrel, Receptors, Purinergic P2Y12, Cytochrome P-450 CYP2C19, Conventional PCI, Cardiology, Female, lcsh:Q, business, Platelet Aggregation Inhibitors, medicine.drug
Abstract

Clopidogrel is the mainstay for antiplatelet treatment after percutaneous coronary intervention (PCI). The relationship of platelet reactivity and genetic polymorphism with clinical outcomes with newer-generation drug-eluting stents is unclear. We analysed 4,587 patients for the most powerful single-nucleotide polymorphisms (CYP2C19, CYP2C9, ABCB1, PON1, and P2Y12) related to on-treatment platelet reactivity (OPR). The optimal cut-off value of high OPR for major adverse thrombotic events was 266. CYP2C19 was significantly associated with high OPR and the number of CYP2C19*R (*2 or *3) alleles was proportional to the increased risk of high OPR. Death, myocardial infarction (MI), stroke, stent thrombosis, and bleeding events were assessed during a 1-year follow-up period. Primary endpoints were death and non-fatal MI. The cumulative 1-year incidence of death and stent thrombosis was significantly higher in patients with CYP2C19*2/*2, CYP2C19*2/*3, and CYP2C19*3/*3 (Group 3) than in patients with CYP2C19*1/*1 (Group 1). Multivariate Cox proportional hazard model showed that cardiac death risk was significantly higher in Group 3 than in Group 1 (hazard ratio 2.69, 95% confidence interval 1.154–6.263, p = 0.022). No association was reported between bleeding and OPR. Thus, CYP2C19 may exert a significant impact on the prognosis of PCI patients even in the era of newer-generation drug-eluting stents.

Published
2018
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4. Ticagrelor in patients with diabetes and stable coronary artery disease with a history of previous percutaneous coronary intervention (THEMIS-PCI): a phase 3, placebo-controlled, randomised trial

Author

Deepak L Bhatt, Philippe Gabriel Steg, Shamir R Mehta, Lawrence A Leiter, Tabassome Simon, Kim Fox, Claes Held, Marielle Andersson, Anders Himmelmann, Wilhelm Ridderstråle, Jersey Chen, Yang Song, Rafael Diaz, Shinya Goto, Stefan K James, Kausik K Ray, Alexander N Parkhomenko, Mikhail N Kosiborod, Darren K McGuire, Robert A Harrington, Vladimir Santos, Ashit Jain, Irina Lendel, Michael Russo, W H Haught, Manuel Bouza, Harinder Gogia, Supratim Banerjee, George Kichura, Louis Kantaros, Francisco Padron, Rakesh Passi, Jay Stone, Michael Pursley, Michael D'Urso, Timothy Gardner, James Bennett, Khaled Nour, Satinder Saini, Wenwu Zhang, Dharam Kumbhani, Dustin Thomas, Dominick Angiolillo, Barry Bertolet, Amaury Roman-Miranda, Robert Black, Ramin Manshadi, Carlos Vaca, Antonio Blanco, Mark Napoli, David Brabham, Ayim Akyea-Djamson, Pratik Desai, Sudhir Prasada, Ajit Khaira, Leslie Forgosh, Ira Lieber, Guillermo Umpierrez, Dinesh Singal, Juan Londono, Neil Fraser, Jose Ruiz, Damaris Vega, Lilia Rodriguez, Christopher Brown, Faizullah Syed, Guarav Aggarwala, William Eaves, Michael Foster, Dinesh Gupta, David Avino, Wail Asfour, Glen Tonnessen, Xue-Qiao Zhao, Narendra Singh, Andrew Brockmyre, Norman Lepor, Nicolas Shammas, David Blick, Steven Hearne, John Prodafikas, Edgar Carell, Mark Izzo, Amin Karim, Bosh Zakhary, Mahmoud Atieh, Steven Leichter, Charles Meadows, David Hotchkiss, Mazen Abu-Fadel, Alan Wiseman, Jeffrey Bander, Mahesh Shah, Subhash Banerjee, Ricky Ganim, Karen Sopko, Misal Khan, Ramon Lloret, Troy Weirick, Rajendra Mehta, Udho Thadani, Anuj Bhargava, Mikhail Kosiborod, Jaynier Moya, Cezar Staniloae, Yamirka D Guerra, Anil Chhabra, Douglas Kosmicki, Wassim Shaheen, Akber Mohammed, J'Cinda Bitters, Jan Pattanayak, Julian Javier, Sunny Srivastava, Roland Phillips, Jessie Al-Amin, Michael Lillestol, Patrick Simpson, Lydie Hazan, Amit Amin, Gopi Shah, Denes Korpas, Bruce Platt, Jim Dickert, Orlando Puente, Louis Hiotis, Timothy Doyle, Raj Rajan, Alan Meholick, Christian Gring, Elie Hage-Korban, Robert Feldman, Harry Colfer, Samuel Butman, Malcolm Foster, Terence Hart, Randall Huling, Shervin Eshaghian, Ofsman Quintana, Deanna Cheung, Franklin Handel, Mara Rodriguez, David Suh, Paul Gordon, Gregg Pressman, Michael Bauer, William French, Mark Barettella, Sridhar Chatrathi, Damodhar Suresh, Ronald Goldberg, Mark Huth, Liwa Younis, Aref Rahman, Richard Mascolo, Michelle Welch, Randeep Suneja, Stephen Smith, Scott Shurmur, John Agaiby, Ahmad Jingo, Janice Johnston, Mary Beth, Anthony Vlastaris, Susan Kemp, Hamid Taheri, Edward Pereira, Michael Deyoung, Zafir Hawa, Ray Smith, Thomas Galski, Samer Garas, M Reddy, Susheel Sharma, Joeseph Hargrove, Charles Treasure, Ronald Emerson, Tariq Haddad, Kathryn Rohr, Larry Levinson, Raul Gaona, Barry Uretsky, Hiralal Maheshwari, Denny Lee, Stephanie Kinnaman, Robert Singal, Jeffrey Geohas, Osvaldo Gigliotti, Ajit Raisinghani, Charanjit Khurana, Brent Hella, Michael Kelberman, Steven Voyce, Sanjay Singh, Eric Lo, Pradeep Singh, Ross Goodfellow, Stuart Fischer, Richard Lorraine, Traci Turner, Jeffrey Shanes, Robert Busch, Robert Broker, Michelle Zaniewski, Kevin Pounds, Giselle Debs-Perez, Stephen Ong, Brad Frandsen, Douglas Fullington, Naseem Jaffrani, Ahtaram Khan, Marcus Lee, Joe Pouzar, George Revtyak, Julian Gonzalez, Samer Nakhle, Abel Murillo, Douglas Young, Sashi Makam, Mushtaq Syed, Kevin Woolf, Paul Grena, Sarab Alfata, Sharan Mahal, David Hoffman, Tinoy Kizhakekuttu, Joseph Deering, Janak Bhavsar, Scott Mikesell, William Wilson, Vance Wilson, Salah El, Francis Spinale, Vinod Kannarkat, Sunder Rao, Lenita Hanson, John Bertsch, Elena Gonzalez-Ortiz, Norma Severino, John Willis, Joel Schock, Ladan Bakhtari, Raul Gazmuri, Saadat Ansari, Jason Hall, Arvind Mehta, Neal Shealy, Stuart Zarich, Deovrat Singh, Kishor Vora, Nabil Andrawis, Darron Molter, David Maron, Jose Cardona, Ronald D'Agostino, Tamjeed Arshad, Rodney Samaan, David Jones, Dale Presser, John Heath, Sandy Green, George Bittar, Sheldon Henry, David Korn, John Schmedtje, Venkatesh Nadar, Bruce Graham, Ajay Labroo, Leonardo Clavijo, Hal Roseman, Gilbert Ledesma, Robert Rosen, Isaac Dor, William Kirby, Jennefer Sutton, Frank Eder, Bruce Iteld, Jose Gomez-Cortes, Maurice Buchbinder, Joseph Kasper, Antonio Terrelonge, Gustavo Torres, Ted Jagielo, Jose Alvarez, Yehuda Handelsman, Mario Guillen, Randall Richwine, Lorena Lewy-Alterbaum, Clinton Corder, Moogali Arvind, David Bolshoun, Magdy Mikhail, Stephen Minton, Odilon Alvarado, J Abbott, Brett Cauthen, Ryan Welter, Randy Mintz, John Cox, Annette Quick, Melvin Weiss, Johnny Dy, James Zebrack, Glenn Gandelman, Vinayak Hegde, Marc Silver, Michele DeGregorio, William Lawson, Christopher Paa, Anna Bortnick, Merrill Krolick, Rodolfo Sotolongo, Jorge Cheirif, Priya Kumar, Preetham Jetty, Ambar Patel, Mariusz Kruk, Iwona Kobielusz-Gembala, Barbara Rewerska, Adam Madrzejewski, Krzysztof Milewski, Jerzy Cygler, Joanna Petryka-Mazurkiewicz, Waldemar Jastrzebski, Janusz Korecki, Wojciech Fil, Janusz Prokopczuk, Anna Bochenek, Marek Wujkowski, Robert Witek, Piotr Konczakowski, Pawel Miekus, Marcin Szczasny, Wlodzimierz Musial, Krzysztof Cymerman, Jacek Lampart, Jacek Mikosinski, Slawomir Szynal, Issa Fares, Grzegorz Opolski, Stanislaw Mazur, Beata Wozakowska-Kaplon, Renata Bijata-Bronisz, Lukasz Wierucki, Beata Losa, Grzegorz Drelich, Marek Konieczny, Pawel Starczewski, Lidia Pawlowicz, Pawel Jesionowski, Jaroslaw Jurowiecki, Jacek Gniot, Mariusz Czyzycki, Karol Stania, Izabela Kucharczyk-Bauman, Benita Busz-Papiez, Agnieszka Karczmarczyk, Wanda Sudnik, Alina Koszek, Piotr Kolodziej, Bartosz Skwarna, Nicolás Jaramillo, Maciej Jankowski, Wojciech Czochra, Leszek Kinasz, Beata Miklaszewicz, Teresa Stasinska, Wladyslaw Pluta, Marcin Basiak, Teresa Rusicka, Izabela Niedbal-Yahfouf, Grazyna Popenda, Romuald Korzeniak, Agnieszka Mirek, Rafal Mariankowski, Lukasz Wojnowski, Marek Korol, Jacek Baszak, Piotr Podolec, Wojciech Piesiewicz, Aleksander Zurakowski, Carlos Luengas, Marek Skura, Piotr Pilecki, Piotr Majchrzak, Ewa Krzyzagórska, Marcin Drozd, Barbara Kaczmarek, Teresa Sliwinska, Katarzyna Zelazowska, Rafal Sztembis, Katarzyna Landa, Lidia Matyszczak-Toniak, Krzysztof Strojek, Marek Piepiorka, Robert Malinowski, Maria Górska, Edyta Stolarczyk-Sowa, Leszek Romanowski, Elzbieta Zinka, Zygfryd Reszka, Joanna Skierkowska, Anna Uzunow, Ewa Laskowska-Derlaga, Ekaterina Puntus, Elena D Kosmacheva, Natalia Koziolova, Prokhor Pavlov, Tatiana Supryadkina, Yury Didenko, Philipp Kopylov, Andrei Kazakov, Sergei Aksentiev, Elena Vishneva, Alexey Repin, Olga Smolenskaya, Olga Mantserova, Oleg Khrustalev, Elena Privalova, Vladimir Konstantinov, Svetlana Boldueva, Andrey Ezhov, Alexander Chernyavsky, Gadel Kamalov, Albert Galyavich, Galina Zubeeva, Galina Nechaeva, Sergey Shustov, Nino Dzhaiani, Tatiana Treshkur, Nataliya Osokina, Alexey Panov, Elena Shutemova, Valeriy Makukhin, Tatiana Kropotina, Larisa Tsyba, Yuri Karpov, J M Sizova, Marina Ballyuzek, Nikolay Tarasov, Elena Demchenko, Olga Barbarash, Valentin Moiseev, Valentin Markov, Vadim Kuznetsov, Inna Viktorova, Igor Sergienko, Lyudmila Ermoshkina, Niyaz Khasanov, Tatiana Khlevchuk, Andrey Baglikov, Sergey Shalaev, Elena Zonova, Elena Reznik, Larisa Haisheva, Tatyana Morugova, Nikita Lomakin, Alexander Vishnevsky, Yuri Shvarts, Olga Magnitskaya, Marina Mikhailusova, Elena Pavlysh, Igor Libov, Anna Zateyschikova, Victor Kostenko, Anton Edin, Yaroslava Khovaeva, Konstantin Zakharov, Raisa Stryuk, Vladimir Khirmanov, Sergey Kanorskiy, Sergey Yakushin, Anna Barabashkina, Hongwei Li, Qiang Zhao, Jian Zhang, Jianhua Ma, Yong He, Ming Luo, Aidong Zhang, Ningru Zhang, Yingru Chai, Genshan Ma, Hao Wang, Zhigang Liu, Lanjie He, Zhifang Song, Xiaolin Dong, Liang Tao, Zhanquan Li, Xi Su, Xiangqing Kong, Heping Niu, Junbo Ge, Zhurong Luo, Wenjun Huang, Daoquan Peng, Zuyi Yuan, Maria Milanova, Doncho Tenev, Antoni Gogov, Dimitar Karageorgiev, Todor Kolchev, Nikolay Rusev, Nikolina Georgieva, Rumen Kondov, Veselin Rusinov, Ivo Petrov, Georgi Stanchev, Mariana Konteva, Adriana Dincheva, Zdravka Yaneva, Ralitsa Vatova, Katya Ilieva, Nikolai Runev, Borislav Kolomanov, Ivan Petrov, Nikolay Iliev, Snezhanka Tisheva, Boryana Chompalova, Maria Tokmakova, Dimitar Raev, Kolyo Byanov, Dimitar Markov, Lenko Mihov, Atanas Mihov, Nora Milcheva, Milen Minchev, Mihail Mollov, Borislav Borisov, Tihomir Tihchev, Venelin Karakolev, Bojidar Dimov, Svetoslav Georgiev, Lachezar Smilov, Bon K Koo, Taehoon Ahn, Soon J Hong, Junghan Yoon, Seok K Oh, Myung H Jeong, Doo-Il Kim, Kiyuk Chang, Weon Kim, Joo-Yong Hahn, Kwang S Cha, Jung-Hee Lee, Si-Wan Choi, Chang-Wook Nam, In-Ho Chae, Yong H Park, Seung-Jea Tahk, Won-Yong Shin, Jei-Keon Chae, Byung J Kim, Jang-Whan Bae, Woo J Park, Seung W Rha, Young J Choi, Jin-Yong Hwang, Hun S Park, Luciano Baracioli, Fabio Guimaraes, Eduardo Vasconcellos, José Saraiva, Adamastor Pereira, Queulla Santos, Paulo Rossi, Lilia Maia, Miguel Madeira, Marcio Pereira, Roberto Botelho, Gilmar Reis, Freddy Eliaschewitz, Joao Borges, Carlos Nascimento, Jose A Fortes, Weimar de Souza, Pedro Pimentel, Miguel Hissa, Marcos Franchetti, Dalton Precoma, Costantino Ortiz, Mauro Hernandes, Wladmir Saporito, Fabio R dos Santos, Adrian Kormann, Fernando Neuenschwander, Oscar Dutra, Nelson Rassi, Luiz Tanajura, Juliana Souza, Delcio S Junior, Paulo Leaes, Adriana Forte, Teresa C Bonansea, Jose Marin, Bruno Machado, Maria J Cerqueira, Frederico Silva, Yorghos Michalaros, Euler Manenti, Cintia Cercato, Estevao Figueiredo, Ming-En Liu, Yi-Chih Wang, Tsung-Ming Lee, Chih Fang, Yen-Wen Wu, Kwo-Chang Ueng, Huey-Herng Sheu, Wen T Lai, I-Chang Hsieh, Zhih-Cherng Chen, Mu-Jang Lee, Chern Chiang, Kou-Gi Shyu, Chien-Hsun Hsia, Guang-Yuan Mar, Shih-Hung Chan, Chih-Cheng Wu, Wei-Kung Tseng, Kuan-Cheng Chang, Hung-I Yeh, Ji-Hung Wang, Charles Hou, Inna Sorokina, Maryna Dolzhenko, Olha Horoshko, Oleksandr Karpenko, Leonid Rudenko, Igor Vakaliuk, Anna Kulyk, Olena Levchenko, Oleksandr Prokhorov, Dmytro Reshotko, Mykhaylo Sorokivskyy, Nataliia Velichko, Valentyn Maslovskyi, Zinaida Teliatnikova, Sergiy Dotsenko, Olena Krakhmalova, Igor Kraiz, Viktoria Zharinova, Larysa Bula, Igor Kaydashev, Valeriy Molodtsov, Lesya Rasputina, Viktoriya Pidlisna, Olena Lysunets, Anatoliy Kravchenko, Liubomyr Glushko, Tetyana Khomazyuk, Yevgeniya Svyshchenko, Oleksandr Parkhomenko, Boris Mankovsky, Orest Abrahamovych, Andriy Yagensky, Mykola Stanislavchuk, Larisa Vasilyeva, Liubov Sokolova, Oleg Sychov, Vira Tseluyko, Igor Kyrychenko, Mykola Rishko, Sergiy Furkalo, Richard Gallo, Olivier Bertrand, Shamir Mehta, Christian Constance, Bruce Sussex, Remo Zadra, Simon Kouz, Raja Chehayeb, Amritanshu Pandey, Danielle Dion, Gordon Bailey, Laurie Hill, Krishnan Ramanathan, Micha Dorsch, Alykhan Nanji, Mohan Babapulle, Martine Montigny, Gilbert Gosselin, Payam Dehghani, Dennis Rupka, Michel Le May, Francis Pichette, Francois St-Maurice, Patrick Teefy, Samer Mansour, Saleem Kassam, Stephen Cheung, Anthony D Siega, Dennis O'Keefe, Eric Sabbah, Alan Bell, Guy Chouinard, Brian Wong, Mark Miller, Daniel Gaudet, Pierre Lachance, Iqbal Bata, Robert Petrella, Denis Gossard, Richard Dumas, Douglas Ing, Hagop Boyrazian, Ricardo Bessoudo, Thao T Huynh, Randy Hart, Jasmin Belle-Isle, Dinkar Shukla, Allan Kelly, Giuseppe Mazza, James Cha, Sam Henein, Andre Frechette, Saul Vizel, Joanne F Liutkus, Michael O'Mahony, Frank Halperin, Jacobus Kooy, John Graham, Allan Bailey, Ronald Wojcik, Igor Wilderman, Tibor Turi, Ákos Motyovszki, Béla Merkely, Csaba Király, Péter Andrássy, Zsolt Sárszegi, Tibor Fülöp, Zsolt Zilahi, István Édes, Andras Papp, Gábor Müller, Anna Czigány, Szilárd Zólyomi, László Korányi, János Takács, Ferenc Juhász, Bela Benczur, Sándor Kancz, András Földi, András C Nagy, Judit Bakai, István Greschik, László Püski, László Nagy, Róbert Kirschner, Roman Kuchar, Petr Hajek, Ladislav Busak, Daniel Michalik, Ivo Matyasek, Ivana Marusincova, Dusan Kucera, Ondrej Jerabek, Michaela Honkova, Vratislav Dedek, Ivan Rihacek, Pavel Kos, Josef Slaby, Martina Machkova, Eva Zidkova, Lubomir Elbl, Hana Grunfeldova, Jiri Carda, Vladimir Mrozek, Jiri Maly, Richard Milkovic, Jan Malecha, Hana Skalicka, Ivo Oral, Eva Krcova, Libor Lisa, Jan Belohlavek, Roman Miklik, Ondrej Cermak, Jana Bednarova, Zdenek Peroutka, Jindrich Spinar, Andreas Wilke, Karl-Friedrich Appel, Jens Taggeselle, Andreas Förster, Nicole Toursarkissian, Ekkehard Schmidt, Jochen Bott, Ayham Al-Zoebi, Dirk Hennig, Sabine Fischer, Norbert Schön, Joachim Sauter, Gregor Simonis, Ruth Nischik, Werner Rieker, Isabelle Schenkenberger, Thomas Behnke, Gerhard Klausmann, Michael Jeserich, Dietmar Trenk, Ingo Weigmann, Hannes Reuter, Reinhard Rummel, Candy von Münchhausen, Charlotte von Engelhardt, Eishun Horibe, Taro Shibasaki, Tomohiko Sato, Tsunekazu Kakuta, Ichiro Michishita, Michinao Tan, Ryoji Ishiki, Takahiko Aoyama, Shinichi Higashiue, Yawara Niijima, Akira Idogaki, Toru Hasegawa, Arihiro Kiyosue, Yoshiaki Tomobuchi, Katsunori Kawamitsu, Satsuki Kawasaki, Yoshiki Hata, Kazuki Fukui, Kozaburo Seki, Takashi Takenaka, Mitsuru Abe, Noriaki Utsu, Atsuyuki Oono, Kazuhisa Mitsuo, Atsushi Sueyoshi, Atsushi Hirohata, Mitsuru Tsujimoto, Osamu Ueda, Shinichi Takase, Masahiro Suzuki, Satoru Sakuragi, Fumi Yamamoto, Noritaka Fujimoto, Shigeo Kakinoki, Tatsushi Sugiura, Hiroshi Sugino, Toshihiro Nakamura, Toshiaki Kadokami, Hiroki Uehara, Masahiro Ono, Koichi Yokoya, Akihiro Koike, Sei Komatsu, Masahiro Sonoda, Hideki Ueno, Tomofumi Doi, Yuichiro Takagi, Kazuteru Fujimoto, Yutaka Eki, Munenori Okubo, Kenichiro Sasaki, Martijn van Eck, Eelko Ronner, Salem The, Ruud van de Wal, Pieter Nierop, Cornelis de Nooijer, Henri Werner, Iris Westendorp, Coen van der Zwaan, Hendrikus Crijns, Jan H Cornel, Sipke Strikwerda, Robert Bos, Edwin de Melker, Adrianus Kuijper, Hans Louwerenburg, Jacobus Plomp, Jan-Melle Dantzig, Francisco Prins, Henricus van Kesteren, Frank Willems, Giovanni Amoroso, Gabriela Carnero, Ernesto Duronto, Diego Besada, Carolina Chacon, Pedro Zangroniz, Silvana Solis, Alberto Liberman, Virginia Sernia, Andres Alvarisqueta, Laura Maffei, Oscar G Vilamajo, Celso García, Maximiliano Sicer, Juan Muntaner, Anselmo Bordonava, Juan Albisu, Alejandra Zanini, Lucas Rista, Miguel Hominal, José N Estrada, Aldo Prado, Diego M Gosparini, Beatriz Schiavi, Armando G Castillo, José G Ruíz, Guillermo R Martinez, Víctor G López, Enrique L Rosas, Gabriel R Lopez, Elias G Cantu, Manuel de los Ríos Ibarra, Francisco P Padilla, Jose P Carrasco, Luis V Carrillo, Joel D García, Alfredo N Askar, Carlos A Salinas, Marco A Gamba, Carlos G Sanchez, Arnulfo G Cantú, Raul V Sánchez, Jaime C Madrigal, Rafael H Urbano, Andrés Í Romo, José R González Juanatey, Paolo Racugno, Angel C Fillat, José M de la Torre Hernández, Juan A Peláez, Jorge B Cortada, Pablo G Pavia, Manuel J Navarro, Roberto M Asenjo, Francisco F Díaz, Eduard B Peligero, Fernando A Manterola, Antonio F Ortiz, Juan D Mediavilla García, Francisco M Ortuño, Tomás R Vera, Alfonso S González, Jaime A Viñas, Francisco J Fernández Portales, Petra S Mayordomo, Francisco B Ojeda, Antonio R Domínguez, Rosa S González, Diego B Guerrero, Juan M Ruiz Nodar, Xavier G Marimon, José G Margáez, Roberto M Aguilera, José F Díaz Fernández, José L Zamorano Gómez, Vicente B González, Bruno G del Blanco, Ignacio P Pérez, Mercé R Moreno, Ainhoa R Ereño, José A García Lledó, Juan Prieto, Alex Villablanca, Carlos Raffo, Christian Pincetti, Carlos Conejeros, Oscar Roman, Manuel Rodriguez, Paola Varleta, Cindy Goldberg, Jorge Sandoval, German Arriagada, Lucio Leon, Sergio Potthoff, Jorge Cobos, Christian Figueroa, Ellen Makotoko, Nyda Fourie, Lesley Burgess, Hendrik Nortje, Rust Theron, Perumal Pillai, Naresh Ranjith, Julien Trokis, Soobramoney Pillay, Jeevren Reddy, Theema Nunkoo, Cornelia Kapp, Dorothea Urbach, Lawrence Distiller, Adrian Horak, Louis van Zyl, Kathleen Coetzee, Zelda Punt, Junaid Bayat, Saleem Dawood, Ismail Mitha, Trevenesan Padayachee, Farzana Hoosen, Anthony Dalby, null Prabhavathi, Prakash Gowdaiah, Vimal Mehta, Milan Chag, Milind Gadkari, Kannaiyan Ramamurthee, Asit Das, Jitendra S Sawhney, Suvro Banerjee, Prachee Sathe, Srilakshmi Adhyapak, Tuan Nguyen, Vinh Pham, Huan Do, Anh Nguyen, Hien Nguyen, Binh Truong, Shahnaz Jamil-Copley, Chim Lang, Alastair Pell, Azfar Zaman, Robert Storey, Neil Swanson, Simon Smith, David Sharman, Denise Braganza, Peter Hammond, Andrew Moriarty, Stephen Bain, Maurice Pye, Andrew Sharp, Mark Blagden, Harpal Randeva, Timothy Myhill, Girish Viswanathan, Philip Keeling, Piers Clifford, Manish Saxena, Kristopher Lyons, John McMurray, Feeroz Jaafar, Clare Murphy, Simon Cartwright, Kamal Abouglila, Lubomir Antalik, Peter Krajci, Miroslav Urban, Frantisek Fazekas, Daniel Pella, Daniel Koleny, Tatiana Vykoukalova, Vladimir Macek, Daniela Vinanska, Livia Jamriskova, Slavomir Such, Peter Fulop, Stefan Farsky, Viliam Bugan, Jaroslava Strbova, Karol Micko, Juraj Palka Jr, Vladimir Sivak, Dalby Kristensen, Jens Refsgaard, Lene Holmvang, Ulrik Dixen, Henrik Nielsen, Kenneth Egstrup, Lisette O Jensen, Roman Sykulski, Ole Rasmussen, Alin Andries, Anders Luckow, Gitte Nielsen, Torben Sørensen, Chaiyasith Wongvipaporn, Noppadol Chamnarnphol, Suphot Srimahachota, Nakarin Sansanayudh, Srun Kuanprasert, Damras Tresukosol, Bancha Sookananchai, Mehmet Kanadasi, Turkay Ozcan, Murathan Kucuk, Zeki Ongen, Ertugrul Okuyan, Alev Arat, Sadik Acikel, Ahmet Yalcin, Umit Guray, Ceyhun Ceyhan, Necla Ozer, Sakir Arslan, Oskar Angerås, Nina Johnston, Ann-Charlotte Weiderman, Stellan Bandh, Ole Hansen, Hans Larnefeldt, Dawid Kusiak, Carl-Johan Lindholm, Anders Hedman, David Erlinge, Dan Curiac, Pia Lundman, Roberto Zucconi-Mazzini, Layth Aladellie, Jens Jensen, Jan Verwerft, Mathias Vrolix, Dirk Faes, Harry Striekwold, Peter Sinnaeve, Patrick Timmermans, Antoine Guedes, Marc Delforge, Jan Nimmegeers, Francis Stammen, Ian Buysschaert, Etienne Hoffer, Geert Hollanders, Geert Vervoort, Patrick Coussement, Stefan de Maeseneire, Luc Janssens, Stein A Gravdal, Knut Risberg, Lars Gullestad, Ola D Hofseth, Dennis Nilsen, Knut T Lappegård, Christian van den Heuvel, Charlotte Gibbs, Alamdar Khusrawi, Satish Arora, Tadeusz Tomala, Thorbjørn Kjærnli, Jan Berg-Johansen, Robert Hagemeier, Gunnar Skjelvan, David Colquhoun, John Amerena, Claire Morbey, Christopher Hammett, Anthony Dart, Ronald Lehman, Andrew Hamilton, Matthew Worthley, Peter Purnell, Alan Whelan, Richard MacIsaac, Ktut Arya, Sultan Linjawi, Joseph Proietto, Lakshman Prasad, Aldo Rodriguez, Armando Godoy, Victor Rodriguez, Percy Berrospi, Carlos Chavez, Sandra Negron, Javier Heredia, Felix Medina, Helard Manrique, Walter Cabrera, Fernando Cordova, Trinidad Quinteros, Jaime M Haro, Susana Regalado, Javier Guitton, Hugo Arbanil, Michel Pansieri, Eric Decoulx, Pascal Goube, Axel de Labriolle, Jean N Labeque, Gregoire Range, Yves Cottin, Gilles Montalescot, Guillaume Cayla, Nicolas Danchin, Denis Angoulvant, Emile Ferrario, Meyer Elbaz, Olivier Dubreuil, Philippe G Steg, Caroline Fontaine, Emmanuel Sorbets, Hafiz Omer, Shukri Al-Saif, Hussam Al-Faleh, Abdullah Al-Shehri, Halia Alshehri, Rasha Bazari, Pak Hei, Man Ying, Michael Chan, Michelle Wong, Ronald Ma, Shing C Siu, Chiu C Tsang, Maurizio Ferrario, Emilio Assanelli, Michele Senni, Piermarco Piatti, Paolo Calabrò, Stefano Urbinati, Massimo Michisanti, Ferdinando Varbella, Salvatore de Cosmo, Roberto Trevisan, Sandro Bellotti, Giuseppe Di Pasquale, Angelo S Bongo, Massimo Uguccioni, Edoardo Mannucci, Ciro Mauro, Mauro Ragonese, Claudio Fresco, Maurizio Turturo, Rossella Marcucci, Manuel J Lievano Triana, Camilo Arana, Jose Accini, Rodrigo Botero, Marlena Muzyk-Osikowicz, Fredy T Dada, Gregorio S Vallejo, Fernando Manzur, Daniel Isaza, Dora Molina, Juan G Mesa, Alvaro Quintero, Kai Nyman, Jyrki Mäkelä, Jorma Strand, Sakari Nieminen, Jyrki Taurio, Matti Kuusela, Timo Valle, Mikko Pietilä, Sakari Kekki, Timo Strandberg, Marc Klutstein, Gabriel Greenberg, Yoseph Rozenman, Ehud Chorin, Ariel Roguin, Basil Lewis, Amir Bashkin, Edgar Tan, Jose P Prado, Arthur Ferrolino, Noe Babilonia, Benny Barbas, Generoso Matiga, Raul M Coching, Heinz Drexel, Helmut Brath, Christoph Schnack, Ursula Hanusch, Evelyn Fließer-Görzer, Bernhard Paulweber, Christoph Ebenbichler, Rudolf Prager, Kurt Huber, Michael Wolzt, Johann Auer, Rudolf Berger, Gerit-Holger Schernthaner, Gabriela Stanciulescu, Mihai Creteanu, Marilena Spiridon, Viorica Dobreanu, Dragos Vinereanu, Laura C Iosipescu, Octavian Istratoaie, Ioan Coman, Constantin Militaru, Mircea Cinteza, Peter R Sinnaeve, José C Nicolau, José F Kerr Saraiva, Ramón Corbalán, Petr Widimský, Steen D Kristensen, Juha Hartikainen, Harald Darius, Hung F Tse, Robert G Kiss, Prem Pais, Eli Lev, Leonardo de Luca, Gabriel A Ramos López, Frederic Kontny, Noe A Babilonia, Dmitry A Zateyshchikov, Mikhail Ruda, Omer Elamin, František Kovář, Anthony J Dalby, Héctor Bueno, Chern-En Chiang, Alexander Parkhomenko, Tuan Q Nguyen, Maria Leonsson-Zachrisson, Herrada, Anthony, Brigham & Women’s Hospital [Boston] (BWH), Harvard Medical School [Boston] (HMS), AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Laboratoire de Recherche Vasculaire Translationnelle (LVTS (UMR_S_1148 / U1148)), Université Paris 13 (UP13)-Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), Royal Brompton Hospital, McMaster University [Hamilton, Ontario], Keenan Research Centre of the Li Ka Shing Knowledge Institute [Toronto], St. Michael's Hospital, University of Toronto, Service de Pharmacologie médicale = service de pharmacologie - Dosage de médicaments [CHU Saint-Antoine], CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Sorbonne Université (SU), National Heart and Lung Institute [London] (NHLI), Imperial College London-Royal Brompton and Harefield NHS Foundation Trust, Uppsala University Hospital, Uppsala Universitet [Uppsala], AstraZeneca, Tokai University, Uppsala University, Imperial College London, Saint Luke's Mid America Heart Institute, University of Missouri [Kansas City] (UMKC), University of Missouri System, University of New South Wales [Sydney] (UNSW), University of Texas Southwestern Medical Center [Dallas], Stanford University, Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), Université de Montpellier (UM), Bhatt, D, Steg, P, Mehta, S, Leiter, L, Simon, T, Fox, K, Held, C, Andersson, M, Himmelmann, A, Ridderstrale, W, Chen, J, Song, Y, Diaz, R, Goto, S, James, S, Ray, K, Parkhomenko, A, Kosiborod, M, Mcguire, D, Harrington, R, Santos, V, Jain, A, Lendel, I, Russo, M, Haught, W, Bouza, M, Gogia, H, Banerjee, S, Kichura, G, Kantaros, L, Padron, F, Passi, R, Stone, J, Pursley, M, D'Urso, M, Gardner, T, Bennett, J, Nour, K, Saini, S, Zhang, W, Kumbhani, D, Thomas, D, Angiolillo, D, Bertolet, B, Roman-Miranda, A, Black, R, Manshadi, R, Vaca, C, Blanco, A, Napoli, M, Brabham, D, Akyea-Djamson, A, Desai, P, Prasada, S, Khaira, A, Forgosh, L, Lieber, I, Umpierrez, G, Singal, D, Londono, J, Fraser, N, Ruiz, J, Vega, D, Rodriguez, L, Brown, C, Syed, F, Aggarwala, G, Eaves, W, Foster, M, Gupta, D, Avino, D, Asfour, W, Tonnessen, G, Zhao, X, Singh, N, Brockmyre, A, Lepor, N, Shammas, N, Blick, D, Hearne, S, Prodafikas, J, Carell, E, Izzo, M, Karim, A, Zakhary, B, Atieh, M, Leichter, S, Meadows, C, Hotchkiss, D, Abu-Fadel, M, Wiseman, A, Bander, J, Shah, M, Ganim, R, Sopko, K, Khan, M, Lloret, R, Weirick, T, Mehta, R, Thadani, U, Bhargava, A, Moya, J, Staniloae, C, Guerra, Y, Chhabra, A, Kosmicki, D, Shaheen, W, Mohammed, A, Bitters, J, Pattanayak, J, Javier, J, Srivastava, S, Phillips, R, Al-Amin, J, Lillestol, M, Simpson, P, Hazan, L, Amin, A, Shah, G, Korpas, D, Platt, B, Dickert, J, Puente, O, Hiotis, L, Doyle, T, Rajan, R, Meholick, A, Gring, C, Hage-Korban, E, Feldman, R, Colfer, H, Butman, S, Hart, T, Huling, R, Eshaghian, S, Quintana, O, Cheung, D, Handel, F, Rodriguez, M, Suh, D, Gordon, P, Pressman, G, Bauer, M, French, W, Barettella, M, Chatrathi, S, Suresh, D, Goldberg, R, Huth, M, Younis, L, Rahman, A, Mascolo, R, Welch, M, Suneja, R, Smith, S, Shurmur, S, Agaiby, J, Jingo, A, Johnston, J, Beth, M, Vlastaris, A, Kemp, S, Taheri, H, Pereira, E, Deyoung, M, Hawa, Z, Smith, R, Galski, T, Garas, S, Reddy, M, Sharma, S, Hargrove, J, Treasure, C, Emerson, R, Haddad, T, Rohr, K, Levinson, L, Gaona, R, Uretsky, B, Maheshwari, H, Lee, D, Kinnaman, S, Singal, R, Geohas, J, Gigliotti, O, Raisinghani, A, Khurana, C, Hella, B, Kelberman, M, Voyce, S, Singh, S, Lo, E, Singh, P, Goodfellow, R, Fischer, S, Lorraine, R, Turner, T, Shanes, J, Busch, R, Broker, R, Zaniewski, M, Pounds, K, Debs-Perez, G, Ong, S, Frandsen, B, Fullington, D, Jaffrani, N, Khan, A, Lee, M, Pouzar, J, Revtyak, G, Gonzalez, J, Nakhle, S, Murillo, A, Young, D, Makam, S, Syed, M, Woolf, K, Grena, P, Alfata, S, Mahal, S, Hoffman, D, Kizhakekuttu, T, Deering, J, Bhavsar, J, Mikesell, S, Wilson, W, Wilson, V, El, S, Spinale, F, Kannarkat, V, Rao, S, Hanson, L, Bertsch, J, Gonzalez-Ortiz, E, Severino, N, Willis, J, Schock, J, Bakhtari, L, Gazmuri, R, Ansari, S, Hall, J, Mehta, A, Shealy, N, Zarich, S, Singh, D, Vora, K, Andrawis, N, Molter, D, Maron, D, Cardona, J, D'Agostino, R, Arshad, T, Samaan, R, Jones, D, Presser, D, Heath, J, Green, S, Bittar, G, Henry, S, Korn, D, Schmedtje, J, Nadar, V, Graham, B, Labroo, A, Clavijo, L, Roseman, H, Ledesma, G, Rosen, R, Dor, I, Kirby, W, Sutton, J, Eder, F, Iteld, B, Gomez-Cortes, J, Buchbinder, M, Kasper, J, Terrelonge, A, Torres, G, Jagielo, T, Alvarez, J, Handelsman, Y, Guillen, M, Richwine, R, Lewy-Alterbaum, L, Corder, C, Arvind, M, Bolshoun, D, Mikhail, M, Minton, S, Alvarado, O, Abbott, J, Cauthen, B, Welter, R, Mintz, R, Cox, J, Quick, A, Weiss, M, Dy, J, Zebrack, J, Gandelman, G, Hegde, V, Silver, M, Degregorio, M, Lawson, W, Paa, C, Bortnick, A, Krolick, M, Sotolongo, R, Cheirif, J, Kumar, P, Jetty, P, Patel, A, Kruk, M, Kobielusz-Gembala, I, Rewerska, B, Madrzejewski, A, Milewski, K, Cygler, J, Petryka-Mazurkiewicz, J, Jastrzebski, W, Korecki, J, Fil, W, Prokopczuk, J, Bochenek, A, Wujkowski, M, Witek, R, Konczakowski, P, Miekus, P, Szczasny, M, Musial, W, Cymerman, K, Lampart, J, Mikosinski, J, Szynal, S, Fares, I, Opolski, G, Mazur, S, Wozakowska-Kaplon, B, Bijata-Bronisz, R, Wierucki, L, Losa, B, Drelich, G, Konieczny, M, Starczewski, P, Pawlowicz, L, Jesionowski, P, Jurowiecki, J, Gniot, J, Czyzycki, M, Stania, K, Kucharczyk-Bauman, I, Busz-Papiez, B, Karczmarczyk, A, Sudnik, W, Koszek, A, Kolodziej, P, Skwarna, B, Jaramillo, N, Jankowski, M, Czochra, W, Kinasz, L, Miklaszewicz, B, Stasinska, T, Pluta, W, Basiak, M, Rusicka, T, Niedbal-Yahfouf, I, Popenda, G, Korzeniak, R, Mirek, A, Mariankowski, R, Wojnowski, L, Korol, M, Baszak, J, Podolec, P, Piesiewicz, W, Zurakowski, A, Luengas, C, Skura, M, Pilecki, P, Majchrzak, P, Krzyzagorska, E, Drozd, M, Kaczmarek, B, Sliwinska, T, Zelazowska, K, Sztembis, R, Landa, K, Matyszczak-Toniak, L, Strojek, K, Piepiorka, M, Malinowski, R, Gorska, M, Stolarczyk-Sowa, E, Romanowski, L, Zinka, E, Reszka, Z, Skierkowska, J, Uzunow, A, Laskowska-Derlaga, E, Puntus, E, Kosmacheva, E, Koziolova, N, Pavlov, P, Supryadkina, T, Didenko, Y, Kopylov, P, Kazakov, A, Aksentiev, S, Vishneva, E, Repin, A, Smolenskaya, O, Mantserova, O, Khrustalev, O, Privalova, E, Konstantinov, V, Boldueva, S, Ezhov, A, Chernyavsky, A, Kamalov, G, Galyavich, A, Zubeeva, G, Nechaeva, G, Shustov, S, Dzhaiani, N, Treshkur, T, Osokina, N, Panov, A, Shutemova, E, Makukhin, V, Kropotina, T, Tsyba, L, Karpov, Y, Sizova, J, Ballyuzek, M, Tarasov, N, Demchenko, E, Barbarash, O, Moiseev, V, Markov, V, Kuznetsov, V, Viktorova, I, Sergienko, I, Ermoshkina, L, Khasanov, N, Khlevchuk, T, Baglikov, A, Shalaev, S, Zonova, E, Reznik, E, Haisheva, L, Morugova, T, Lomakin, N, Vishnevsky, A, Shvarts, Y, Magnitskaya, O, Mikhailusova, M, Pavlysh, E, Libov, I, Zateyschikova, A, Kostenko, V, Edin, A, Khovaeva, Y, Zakharov, K, Stryuk, R, Khirmanov, V, Kanorskiy, S, Yakushin, S, Barabashkina, A, Li, H, Zhao, Q, Zhang, J, Ma, J, He, Y, Luo, M, Zhang, A, Zhang, N, Chai, Y, Ma, G, Wang, H, Liu, Z, He, L, Song, Z, Dong, X, Tao, L, Li, Z, Su, X, Kong, X, Niu, H, Ge, J, Luo, Z, Huang, W, Peng, D, Yuan, Z, Milanova, M, Tenev, D, Gogov, A, Karageorgiev, D, Kolchev, T, Rusev, N, Georgieva, N, Kondov, R, Rusinov, V, Petrov, I, Stanchev, G, Konteva, M, Dincheva, A, Yaneva, Z, Vatova, R, Ilieva, K, Runev, N, Kolomanov, B, Iliev, N, Tisheva, S, Chompalova, B, Tokmakova, M, Raev, D, Byanov, K, Markov, D, Mihov, L, Mihov, A, Milcheva, N, Minchev, M, Mollov, M, Borisov, B, Tihchev, T, Karakolev, V, Dimov, B, Georgiev, S, Smilov, L, Koo, B, Ahn, T, Hong, S, Yoon, J, Oh, S, Jeong, M, Kim, D, Chang, K, Kim, W, Hahn, J, Cha, K, Lee, J, Choi, S, Nam, C, Chae, I, Park, Y, Tahk, S, Shin, W, Chae, J, Kim, B, Bae, J, Park, W, Rha, S, Choi, Y, Hwang, J, Park, H, Baracioli, L, Guimaraes, F, Vasconcellos, E, Saraiva, J, Pereira, A, Santos, Q, Rossi, P, Maia, L, Madeira, M, Pereira, M, Botelho, R, Reis, G, Eliaschewitz, F, Borges, J, Nascimento, C, Fortes, J, de Souza, W, Pimentel, P, Hissa, M, Franchetti, M, Precoma, D, Ortiz, C, Hernandes, M, Saporito, W, dos Santos, F, Kormann, A, Neuenschwander, F, Dutra, O, Rassi, N, Tanajura, L, Souza, J, Junior, D, Leaes, P, Forte, A, Bonansea, T, Marin, J, Machado, B, Cerqueira, M, Silva, F, Michalaros, Y, Manenti, E, Cercato, C, Figueiredo, E, Liu, M, Wang, Y, Lee, T, Fang, C, Wu, Y, Ueng, K, Sheu, H, Lai, W, Hsieh, I, Chen, Z, Chiang, C, Shyu, K, Hsia, C, Mar, G, Chan, S, Wu, C, Tseng, W, Yeh, H, Wang, J, Hou, C, Sorokina, I, Dolzhenko, M, Horoshko, O, Karpenko, O, Rudenko, L, Vakaliuk, I, Kulyk, A, Levchenko, O, Prokhorov, O, Reshotko, D, Sorokivskyy, M, Velichko, N, Maslovskyi, V, Teliatnikova, Z, Dotsenko, S, Krakhmalova, O, Kraiz, I, Zharinova, V, Bula, L, Kaydashev, I, Molodtsov, V, Rasputina, L, Pidlisna, V, Lysunets, O, Kravchenko, A, Glushko, L, Khomazyuk, T, Svyshchenko, Y, Parkhomenko, O, Mankovsky, B, Abrahamovych, O, Yagensky, A, Stanislavchuk, M, Vasilyeva, L, Sokolova, L, Sychov, O, Tseluyko, V, Kyrychenko, I, Rishko, M, Furkalo, S, Gallo, R, Bertrand, O, Constance, C, Sussex, B, Zadra, R, Kouz, S, Chehayeb, R, Pandey, A, Dion, D, Bailey, G, Hill, L, Ramanathan, K, Dorsch, M, Nanji, A, Babapulle, M, Montigny, M, Gosselin, G, Dehghani, P, Rupka, D, Le May, M, Pichette, F, St-Maurice, F, Teefy, P, Mansour, S, Kassam, S, Cheung, S, Siega, A, O'Keefe, D, Sabbah, E, Bell, A, Chouinard, G, Wong, B, Miller, M, Gaudet, D, Lachance, P, Bata, I, Petrella, R, Gossard, D, Dumas, R, Ing, D, Boyrazian, H, Bessoudo, R, Huynh, T, Hart, R, Belle-Isle, J, Shukla, D, Kelly, A, Mazza, G, Cha, J, Henein, S, Frechette, A, Vizel, S, Liutkus, J, O'Mahony, M, Halperin, F, Kooy, J, Graham, J, Bailey, A, Wojcik, R, Wilderman, I, Turi, T, Motyovszki, A, Merkely, B, Kiss, R, Kiraly, C, Andrassy, P, Sarszegi, Z, Fulop, T, Zilahi, Z, Edes, I, Papp, A, Muller, G, Czigany, A, Zolyomi, S, Koranyi, L, Takacs, J, Juhasz, F, Benczur, B, Kancz, S, Foldi, A, Nagy, A, Bakai, J, Greschik, I, Puski, L, Nagy, L, Kirschner, R, Kuchar, R, Hajek, P, Busak, L, Michalik, D, Matyasek, I, Marusincova, I, Kucera, D, Jerabek, O, Honkova, M, Dedek, V, Rihacek, I, Kos, P, Slaby, J, Machkova, M, Zidkova, E, Elbl, L, Grunfeldova, H, Carda, J, Mrozek, V, Maly, J, Milkovic, R, Malecha, J, Skalicka, H, Oral, I, Krcova, E, Lisa, L, Belohlavek, J, Miklik, R, Cermak, O, Bednarova, J, Peroutka, Z, Spinar, J, Wilke, A, Appel, K, Taggeselle, J, Forster, A, Toursarkissian, N, Schmidt, E, Bott, J, Al-Zoebi, A, Hennig, D, Schon, N, Sauter, J, Simonis, G, Nischik, R, Rieker, W, Schenkenberger, I, Behnke, T, Klausmann, G, Jeserich, M, Trenk, D, Weigmann, I, Reuter, H, Rummel, R, von Munchhausen, C, von Engelhardt, C, Horibe, E, Shibasaki, T, Sato, T, Kakuta, T, Michishita, I, Tan, M, Ishiki, R, Aoyama, T, Higashiue, S, Niijima, Y, Idogaki, A, Hasegawa, T, Kiyosue, A, Tomobuchi, Y, Kawamitsu, K, Kawasaki, S, Hata, Y, Fukui, K, Seki, K, Takenaka, T, Abe, M, Utsu, N, Oono, A, Mitsuo, K, Sueyoshi, A, Hirohata, A, Tsujimoto, M, Ueda, O, Takase, S, Suzuki, M, Sakuragi, S, Yamamoto, F, Fujimoto, N, Kakinoki, S, Sugiura, T, Sugino, H, Nakamura, T, Kadokami, T, Uehara, H, Ono, M, Yokoya, K, Koike, A, Komatsu, S, Sonoda, M, Ueno, H, Doi, T, Takagi, Y, Fujimoto, K, Eki, Y, Okubo, M, Sasaki, K, van Eck, M, Ronner, E, The, S, van de Wal, R, Nierop, P, de Nooijer, C, Werner, H, Westendorp, I, van der Zwaan, C, Crijns, H, Cornel, J, Strikwerda, S, Bos, R, de Melker, E, Kuijper, A, Louwerenburg, H, Plomp, J, Dantzig, J, Prins, F, van Kesteren, H, Willems, F, Amoroso, G, Carnero, G, Duronto, E, Besada, D, Chacon, C, Zangroniz, P, Solis, S, Liberman, A, Sernia, V, Alvarisqueta, A, Maffei, L, Vilamajo, O, Garcia, C, Sicer, M, Muntaner, J, Bordonava, A, Albisu, J, Zanini, A, Rista, L, Hominal, M, Estrada, J, Prado, A, Gosparini, D, Schiavi, B, Castillo, A, Martinez, G, Lopez, V, Rosas, E, Lopez, G, Cantu, E, de los Rios Ibarra, M, Padilla, F, Carrasco, J, Carrillo, L, Garcia, J, Askar, A, Salinas, C, Gamba, M, Sanchez, C, Cantu, A, Sanchez, R, Madrigal, J, Urbano, R, Romo, A, Gonzalez Juanatey, J, Racugno, P, Fillat, A, de la Torre Hernandez, J, Pelaez, J, Cortada, J, Pavia, P, Navarro, M, Asenjo, R, Diaz, F, Peligero, E, Manterola, F, Ortiz, A, Mediavilla Garcia, J, Ortuno, F, Vera, T, Gonzalez, A, Vinas, J, Fernandez Portales, F, Mayordomo, P, Ojeda, F, Dominguez, A, Gonzalez, R, Guerrero, D, Ruiz Nodar, J, Marimon, X, Margaez, J, Aguilera, R, Diaz Fernandez, J, Zamorano Gomez, J, Gonzalez, V, del Blanco, B, Perez, I, Moreno, M, Ereno, A, Garcia Lledo, J, Prieto, J, Villablanca, A, Raffo, C, Pincetti, C, Conejeros, C, Roman, O, Varleta, P, Goldberg, C, Sandoval, J, Arriagada, G, Corbalan, R, Leon, L, Potthoff, S, Cobos, J, Figueroa, C, Makotoko, E, Fourie, N, Burgess, L, Nortje, H, Theron, R, Pillai, P, Ranjith, N, Trokis, J, Pillay, S, Reddy, J, Nunkoo, T, Kapp, C, Urbach, D, Distiller, L, Horak, A, van Zyl, L, Coetzee, K, Punt, Z, Bayat, J, Dawood, S, Mitha, I, Padayachee, T, Hoosen, F, Dalby, A, Prabhavathi, Gowdaiah, P, Mehta, V, Chag, M, Gadkari, M, Ramamurthee, K, Das, A, Sawhney, J, Sathe, P, Adhyapak, S, Nguyen, T, Pham, V, Do, H, Nguyen, A, Nguyen, H, Truong, B, Jamil-Copley, S, Lang, C, Pell, A, Zaman, A, Storey, R, Swanson, N, Sharman, D, Braganza, D, Hammond, P, Moriarty, A, Bain, S, Pye, M, Sharp, A, Blagden, M, Randeva, H, Myhill, T, Viswanathan, G, Keeling, P, Clifford, P, Saxena, M, Lyons, K, Mcmurray, J, Jaafar, F, Murphy, C, Cartwright, S, Abouglila, K, Antalik, L, Krajci, P, Urban, M, Fazekas, F, Pella, D, Koleny, D, Vykoukalova, T, Macek, V, Vinanska, D, Jamriskova, L, Such, S, Fulop, P, Farsky, S, Bugan, V, Strbova, J, Micko, K, Palka Jr, J, Sivak, V, Kristensen, D, Refsgaard, J, Holmvang, L, Dixen, U, Nielsen, H, Egstrup, K, Jensen, L, Sykulski, R, Rasmussen, O, Andries, A, Luckow, A, Nielsen, G, Sorensen, T, Wongvipaporn, C, Chamnarnphol, N, Srimahachota, S, Sansanayudh, N, Kuanprasert, S, Tresukosol, D, Sookananchai, B, Kanadasi, M, Ozcan, T, Kucuk, M, Ongen, Z, Okuyan, E, Arat, A, Acikel, S, Yalcin, A, Guray, U, Ceyhan, C, Ozer, N, Arslan, S, Angeras, O, Johnston, N, Weiderman, A, Bandh, S, Hansen, O, Larnefeldt, H, Kusiak, D, Lindholm, C, Hedman, A, Erlinge, D, Curiac, D, Lundman, P, Zucconi-Mazzini, R, Aladellie, L, Jensen, J, Verwerft, J, Vrolix, M, Faes, D, Striekwold, H, Sinnaeve, P, Timmermans, P, Guedes, A, Delforge, M, Nimmegeers, J, Stammen, F, Buysschaert, I, Hoffer, E, Hollanders, G, Vervoort, G, Coussement, P, de Maeseneire, S, Janssens, L, Gravdal, S, Risberg, K, Gullestad, L, Hofseth, O, Nilsen, D, Lappegard, K, van den Heuvel, C, Gibbs, C, Khusrawi, A, Arora, S, Tomala, T, Kjaernli, T, Berg-Johansen, J, Hagemeier, R, Skjelvan, G, Colquhoun, D, Amerena, J, Morbey, C, Hammett, C, Dart, A, Lehman, R, Hamilton, A, Worthley, M, Purnell, P, Whelan, A, Macisaac, R, Arya, K, Linjawi, S, Proietto, J, Prasad, L, Rodriguez, A, Godoy, A, Rodriguez, V, Berrospi, P, Chavez, C, Negron, S, Heredia, J, Medina, F, Manrique, H, Cabrera, W, Cordova, F, Quinteros, T, Haro, J, Regalado, S, Guitton, J, Arbanil, H, Pansieri, M, Decoulx, E, Goube, P, de Labriolle, A, Labeque, J, Range, G, Cottin, Y, Montalescot, G, Cayla, G, Danchin, N, Angoulvant, D, Ferrario, E, Elbaz, M, Dubreuil, O, Fontaine, C, Sorbets, E, Omer, H, Al-Saif, S, Al-Faleh, H, Al-Shehri, A, El-Amin, O, Alshehri, H, Bazari, R, Hei, P, Ying, M, Chan, M, Wong, M, Ma, R, Siu, S, Tsang, C, Ferrario, M, Assanelli, E, Senni, M, Piatti, P, Calabro, P, Urbinati, S, Michisanti, M, Varbella, F, de Cosmo, S, Trevisan, R, Bellotti, S, Di Pasquale, G, Bongo, A, Uguccioni, M, Mannucci, E, Mauro, C, Ragonese, M, Fresco, C, Turturo, M, Marcucci, R, Lievano Triana, M, Arana, C, Accini, J, Botero, R, Muzyk-Osikowicz, M, Dada, F, Vallejo, G, Manzur, F, Isaza, D, Molina, D, Mesa, J, Quintero, A, Nyman, K, Makela, J, Strand, J, Nieminen, S, Taurio, J, Kuusela, M, Valle, T, Pietila, M, Kekki, S, Strandberg, T, Klutstein, M, Greenberg, G, Rozenman, Y, Chorin, E, Roguin, A, Lewis, B, Bashkin, A, Tan, E, Prado, J, Ferrolino, A, Babilonia, N, Barbas, B, Matiga, G, Coching, R, Drexel, H, Brath, H, Schnack, C, Hanusch, U, Fliesser-Gorzer, E, Paulweber, B, Ebenbichler, C, Prager, R, Huber, K, Wolzt, M, Auer, J, Berger, R, Schernthaner, G, Stanciulescu, G, Creteanu, M, Spiridon, M, Dobreanu, V, Vinereanu, D, Iosipescu, L, Istratoaie, O, Coman, I, Militaru, C, Cinteza, M, Nicolau, J, Kerr Saraiva, J, Widimsky, P, Kristensen, S, Hartikainen, J, Darius, H, Tse, H, Pais, P, Lev, E, de Luca, L, Ramos Lopez, G, Kontny, F, Zateyshchikov, D, Ruda, M, Elamin, O, Kovar, F, Bueno, H, Leonsson-Zachrisson, M, Université Paris Diderot - Paris 7 (UPD7)-Université Paris 13 (UP13)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de pharmacologie - Dosage de médicaments [CHU Saint-Antoine], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), and Royal Brompton and Harefield NHS Foundation Trust-Imperial College London

Subjects
Male, Platelet Aggregation Inhibitors/therapeutic use, THEMIS Steering Committee and Investigators, medicine.medical_treatment, Vascular damage Radboud Institute for Health Sciences [Radboudumc 16], 030204 cardiovascular system & hematology, Coronary Angiography, Stroke/epidemiology, Coronary artery disease, DOUBLE-BLIND, 0302 clinical medicine, Hemorrhage/chemically induced, acetylsalicylic acid, antidiabetic agent, placebo, ticagrelor, Secondary Prevention, Medicine, 030212 general & internal medicine, Myocardial infarction, Coronary Artery Bypass, Cardiovascular Diseases/mortality, 11 Medical and Health Sciences, OUTCOMES, Aspirin, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, General Medicine, Middle Aged, Clopidogrel, 3. Good health, Ticagrelor/therapeutic use, DRUG-ELUTING STENTS, CLOPIDOGREL, Cardiology, PLATELET INHIBITION, Drug Therapy, Combination, Female, Life Sciences & Biomedicine, Ticagrelor, TIMI, medicine.drug, Coronary Artery Disease/complications, medicine.medical_specialty, Hypoglycemic Agents/therapeutic use, POOLED ANALYSIS, 03 medical and health sciences, Medicine, General & Internal, Percutaneous Coronary Intervention, Double-Blind Method, General & Internal Medicine, Internal medicine, Myocardial Infarction/epidemiology, Humans, Aged, Science & Technology, ANTIPLATELET THERAPY, business.industry, Diabetes Mellitus, Type 2/complications, ELEVATION MYOCARDIAL-INFARCTION, RIVAROXABAN, Percutaneous coronary intervention, medicine.disease, ASPIRIN, Coronary Stenosis/diagnostic imaging, Aspirin/therapeutic use, Conventional PCI, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

Contains fulltext : 215333.pdf (Publisher’s version ) (Closed access) BACKGROUND: Patients with stable coronary artery disease and diabetes with previous percutaneous coronary intervention (PCI), particularly those with previous stenting, are at high risk of ischaemic events. These patients are generally treated with aspirin. In this trial, we aimed to investigate if these patients would benefit from treatment with aspirin plus ticagrelor. METHODS: The Effect of Ticagrelor on Health Outcomes in diabEtes Mellitus patients Intervention Study (THEMIS) was a phase 3 randomised, double-blinded, placebo-controlled trial, done in 1315 sites in 42 countries. Patients were eligible if 50 years or older, with type 2 diabetes, receiving anti-hyperglycaemic drugs for at least 6 months, with stable coronary artery disease, and one of three other mutually non-exclusive criteria: a history of previous PCI or of coronary artery bypass grafting, or documentation of angiographic stenosis of 50% or more in at least one coronary artery. Eligible patients were randomly assigned (1:1) to either ticagrelor or placebo, by use of an interactive voice-response or web-response system. The THEMIS-PCI trial comprised a prespecified subgroup of patients with previous PCI. The primary efficacy outcome was a composite of cardiovascular death, myocardial infarction, or stroke (measured in the intention-to-treat population). FINDINGS: Between Feb 17, 2014, and May 24, 2016, 11 154 patients (58% of the overall THEMIS trial) with a history of previous PCI were enrolled in the THEMIS-PCI trial. Median follow-up was 3.3 years (IQR 2.8-3.8). In the previous PCI group, fewer patients receiving ticagrelor had a primary efficacy outcome event than in the placebo group (404 [7.3%] of 5558 vs 480 [8.6%] of 5596; HR 0.85 [95% CI 0.74-0.97], p=0.013). The same effect was not observed in patients without PCI (p=0.76, pinteraction=0.16). The proportion of patients with cardiovascular death was similar in both treatment groups (174 [3.1%] with ticagrelor vs 183 (3.3%) with placebo; HR 0.96 [95% CI 0.78-1.18], p=0.68), as well as all-cause death (282 [5.1%] vs 323 [5.8%]; 0.88 [0.75-1.03], p=0.11). TIMI major bleeding occurred in 111 (2.0%) of 5536 patients receiving ticagrelor and 62 (1.1%) of 5564 patients receiving placebo (HR 2.03 [95% CI 1.48-2.76], p

Published
2019
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5. Acute myocardial infarction caused by a floating thrombus in the proximal ascending aorta

Author

Sang-Ho Park, Se Whan Lee, Dong Kyu Jin, Seung Jin Lee, Woong Jeon, and Won-Yong Shin

Subjects
medicine.medical_specialty, business.industry, Thrombosis, Chest pain, medicine.disease, Myocardial infarction, Paradoxical embolism, Left coronary artery, Embolism, Right coronary artery, medicine.artery, Internal medicine, Ascending aorta, cardiovascular system, medicine, Cardiology, cardiovascular diseases, Radiology, medicine.symptom, Thrombus, business, Letter to the Editor, Aorta
Abstract

To the Editor, Acute myocardial infarction (AMI) is generally a consequence of complicated coronary atherosclerosis with thrombotic occlusion of the arterial lumen. Nevertheless, in some cases reported in literature, AMI was caused instead by ostium obstruction of the left or right coronary artery by a free-floating thrombus in the ascending aorta [1]. Development of aortic thrombosis in the absence of atherosclerosis, dissection or aneurysm is rare. Herein, we report a case of a 45-year-old man who died 3 days after undergoing transfemoral cerebral angiography (TFCA) from AMI caused by a floating thrombus in the left sinus of Valsalva, which had obstructed the left coronary artery. A 45-year-old man presented to the Emergency Department complaining of a headache in the left occipital and left periocular areas that had persisted for 7 days, and a gradual onset of memory disturbance a few hours prior to presentation. He was a nonsmoker with no medical history of hypertension, dyslipidemia, diabetes mellitus, ischemic heart disease, or stroke. Upon admission to the Neurology Department of our institution, he was hemodynamically stable with a blood pressure of 130/80 mmHg and a heart rate of 80 beats per minute. Upon physical examination, he had no focal motor or sensory deficits, but experienced naming and memory impairment. Results from chest radiography and electrocardiography were normal (Fig. 1A). Laboratory findings were non-specific because blood chemistry test results were almost within the normal limits, with the exception of a slightly increased lactate dehydrogenase of 260 IU/L. Coagulation markers, such as prothrombin and activated partial thrombin times, were also within normal limits. Cardiac enzymes, including creatine kinase-MB and troponin T, were within normal limits, and pro-BNP was 38.2 pg/mL. Brain magnetic resonance imaging revealed a 3.5 × 2.5 cm intracranial hemorrhage in the left anterior temporal lobe with surrounding edema (Fig. 2). The left anterior temporal location of the intracranial hemorrhage was unusual and required further evaluation to pinpoint the specific cause of bleeding, such as arteriovenous malformation. A neurologist at our institution performed TFCA, but did not find any abnormal cerebral vasculature. The procedure took 30 minutes and unfractionated heparin was not used during this time due to a risk of further bleeding from the cerebral hemorrhage. Conventional treatments aimed at decreasing the intracranial pressure, including intravenous mannitol (125 mL every 8 hours) and dexamethasone (5 mg every 24 hours), were administered. Following treatment, the patient’s vital signs stabilized, and the only remaining symptom was a mild headache. Three days after TFCA, he underwent transthoracic echocardiography (TTE) at a routine check-up. TTE identified a highly mobile 2.5 × 1.5 cm mass in the proximal ascending thoracic aorta attached by a pedicle to the sinus of Valsalva, near the ostium of the left main coronary artery. The mass was swinging in the aortic flow, had a characteristic hard echogenic surface but an echolucent inner body, and appeared fragile (Fig. 3). The sinus of Valsalva and proximal ascending aorta were neither dilated nor calcified, and no dissection or macroscopic atherosclerosis was observed. The aortic valve was tricuspid and normal, and the patient did not complain of chest pain. He was referred to our department, where transesophageal echocardiography (TEE) was planned for further investigation. Coronary angiography was not considered because the patient did not complain of chest pain and the risk of embolism was high. However, while preparing for the TEE, the patient complained of sudden chest pain. Electrocardiography was immediately performed, which revealed an ST depression on the I, II, III, and aVF leads, precordial leads from V2 to V6, and ST elevation on the aVR lead (Fig. 1B). Considering the high risk of left main coronary artery obstruction, we decided to perform emergency surgery. However, while preparing for the operation, the patient experienced sudden cardiac arrest. Cardiopulmonary resuscitation was performed for 2 hours, but did not induce a response and, unfortunately, the patient died. The family denied a request for autopsy. Figure 1. Electrocardiogram upon admission (A) and during chest pain (B). The electrocardiogram during chest pain shows a significant ST depression on the I, II, III, aVF leads and precordial leads from V2 to V6, and ST elevation on the aVR lead compatible with ... Figure 2. T1 weighted image (A) and T2 flair image (B) of brain magnetic resonance imaging showing an acute intracranial hemorrhage on the left anterior temporal lobe with surrounding edema (arrows). Figure 3. Transthoracic echocardiogram. (A) Parasternal long axis view (left) and magnified view of the aortic root (right) showing a pedunculated floating thrombus with an echogenic surface and echolucent inner body (arrows). (B) Parasternal short axis view of ... Virchow’s thrombus formation triad includes abnormalities in blood flow, blood constituents and vessel walls [1]. In general, an aortic thrombus occurs when atherosclerotic plaques are eroded or disrupted. Nader et al. [2] attributed thrombi etiologies to local erosive lesions and age-related degenerative changes to the aortic wall. Thromboses of the aortic arch are infrequent sources of systemic emboli, but mobile thrombi in the aortic arch in young patients without diffuse atherosclerosis have been reported previously. The high prevalence of inserted thrombi in the wall opposite the ostia of the aortic arch may be related to the fact that areas of low wall shear stress are predisposed to the development of atherosclerotic plaques, which, even when minute, are likely sites for thrombi attachment. However, unless underlying diseases or causes such as chest trauma, atherosclerosis, hypercoagulable state, chemotherapy, or instrumentation are present, a thrombus (in particular, one involving the ascending aorta) is rare. Thrombi originating from the sinus of Valsalva, responsible for coronary flow disturbance, have been reported by several authors [1,3]. In a literature review by Knoess et al. [4], younger women (mean age, 45.5 years; range, 30 to 59) with no history of cardiac symptoms and no atherosclerotic changes were reported to be predisposed to free-floating thrombus formation, with no predilection for occlusion of either the right or left coronary artery. A free-floating thrombus can cause acute coronary syndrome whether it interferes with coronary flow itself or its emboli occlude coronary flow. In the present case, while we could not perform coronary angiography or demonstrate a thrombus in the coronary artery, we hypothesized that the typical electrocardiographic changes observed during the presence of chest pain were sufficient evidence of a left coronary artery obstruction. Because our patient was a young man with no risk factors of cardiovascular disease, the cause of thrombus formation in the aortic root remains unclear. However, we assume that the TFCA performed 3 days prior to cardiac arrest was one cause of thrombus formation. Since heparin was not injected during the procedure, the risk of thrombus formation associated with the catheter or guide wire was high, and possible mechanical damage of the aortic wall by the catheter or guide wire may have potentiated thrombus formation. Another possible explanation is the presence of a hypercoagulable state. If TFCA was performed in a hypercoagulable state, the potency of thrombus formation would double. Because cardiac arrest occurred 2 hours after the patient was referred to our department, we were unable to perform an extensive serologic survey for hypercoagulable and vasculitis disorders (including antiphospholipid antibodies, antinuclear antibody, lupus anticoagulant, and protein C/S). However, a diagnosis of hypercoagulable disorder or systemic disease was less likely due to the absence of previously unexplained arterial or venous thromboses in the patient and members of his family. Ostium obstruction of the left main trunk has been previously reported in the context of paradoxical embolism through a patent foramen ovale [5]. It is unlikely that our patient was in the same situation because we could not find any evidence of a foramen ovale in TTE, and the patient did not complain of dyspnea or suspected pulmonary embolism. While we did not have time to perform TEE, its diagnostic value has been stressed by several authors [3]. Optimal treatment for ascending aortic thrombosis remains to be defined. Anticoagulant therapy appears to be a logical strategy, but persistence of the thrombus despite anticoagulant therapy and a highly mobile thrombus are indicative of operative therapy. If the thrombus location and shape are likely to occlude the coronary artery, surgery should be performed immediately. To the best of our knowledge, this is the first report on AMI due to an ascending aortic thrombus related to TFCA. A free-floating thrombus is rare, but should be considered in the differential diagnosis of AMI, especially in younger patients without definite cardiovascular risk factors.

Published
2015
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6. Randomized Comparisons Between Different Stenting Approaches for Bifurcation Coronary Lesions With or Without Side Branch Stenosis

Author

Jong-Young Lee, Cheol Whan Lee, Won-Yong Shin, Duk-Woo Park, Sung Cheol Yun, Junghan Yoon, Hyun-Sook Kim, Jung-Min Ahn, Jae-Sik Jang, Joo Young Yang, Nae Hee Lee, Ki Bae Seung, Seung-Jung Park, Seung-Whan Lee, Seong Wook Park, Min Su Hyon, Sung Han Yoon, Chang-Wook Nam, Soo Jin Kang, Jae-Hyung Roh, Keun Hwa Lee, Young-Hak Kim, Sang-Gon Lee, Bong Ki Lee, and Jae-Hwan Lee

Subjects
medicine.medical_specialty, Randomization, business.industry, medicine.medical_treatment, Stent, Percutaneous coronary intervention, medicine.disease, Surgery, Coronary artery disease, restenosis, Stenosis, Restenosis, Internal medicine, bifurcation, medicine, Cardiology, stent, Myocardial infarction, Cardiology and Cardiovascular Medicine, Prospective cohort study, business, coronary artery disease
Abstract

Objectives This study sought to evaluate the optimal percutaneous coronary intervention techniques using drug-eluting stents for bifurcation coronary lesions. Background The optimal bifurcation stenting technique needs to be evaluated. Methods The trial included 2 randomization studies separated by the presence of side branch (SB) stenosis for patients having non–left main bifurcation lesions. For 306 patients without SB stenosis, the routine final kissing balloon or leave-alone approaches were compared. Another randomization study compared the crush or single-stent approaches for 419 patients with SB stenosis. Results Between the routine final kissing balloon and leave-alone groups for nondiseased SB lesions, angiographic restenosis occurred in 17.9% versus 9.3% (p = 0.064), comprising 15.1% versus 3.7% for the main branch (p = 0.004) and 2.8% versus 5.6% for the SB (p = 0.50) from 214 patients (69.9%) receiving 8-month angiographic follow-up. Incidence of major adverse cardiac events including death, myocardial infarction, or target vessel revascularization over 1 year was 14.0% versus 11.6% between the routine final kissing balloon and leave-alone groups (p = 0.57). In another randomization study for diseased SB lesions, 28.2% in the single-stent group received SB stents. From 300 patients (71.6%) receiving angiographic follow-up, between the crush and single-stent groups, angiographic restenosis rate was 8.4% versus 11.0% (p = 0.44), comprising 5.2% versus 4.8% for the main branch (p = 0.90) and 3.9% versus 8.3% for the SB (p = 0.12). One-year major adverse cardiac events rate between the crush and single-stent groups was 17.9% versus 18.5% (p = 0.84). Conclusions Angiographic and clinical outcomes were excellent after percutaneous coronary intervention using drug-eluting stents with any stent technique for non–left main bifurcation lesions once the procedure was performed successfully.

Published
2015
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7. Comparison of Resolute Zotarolimus-Eluting Stents and Sirolimus-Eluting Stents in Patients With De Novo Long Coronary Artery Lesions

Author

Myeong Kon Kim, Seung-Jung Park, Soo Jin Kang, Seung-Whan Lee, Jung-Min Ahn, Jong Seon Park, Seungbong Han, Cheol Whan Lee, Won Kim, Hae-Geun Song, Young-Hak Kim, Jang Hyun Cho, Junghan Yoon, Bong Ki Lee, Jong-Young Lee, Moo Hyun Kim, Tae Hyun Yang, Seong Wook Park, Sung Cheol Yun, Won-Yong Shin, Nae Hee Lee, Sung Yun Lee, Duk-Woo Park, Joo Young Yang, Jang Ho Bae, and Young Rak Cho

Subjects
Male, medicine.medical_specialty, Time Factors, Percutaneous, medicine.medical_treatment, Myocardial Infarction, Coronary Artery Disease, Kaplan-Meier Estimate, Coronary Angiography, Prosthesis Design, law.invention, Coronary Restenosis, Randomized controlled trial, Risk Factors, law, Internal medicine, Angioplasty, Republic of Korea, medicine, Clinical endpoint, Humans, Zotarolimus, Prospective Studies, Angioplasty, Balloon, Coronary, Prospective cohort study, Aged, Sirolimus, Chi-Square Distribution, business.industry, Coronary Thrombosis, Stent, Cardiovascular Agents, Drug-Eluting Stents, Middle Aged, Surgery, Treatment Outcome, Cardiology, Female, Cardiology and Cardiovascular Medicine, business, medicine.drug
Abstract

Background— Procedural and clinical outcomes still remain unfavorable for patients with long coronary lesions who undergo stent-based coronary interventions. Therefore, we compared the relative efficacy and safety of resolute zotarolimus-eluting stents (R-ZES) and sirolimus-eluting stents (SES) for patients with de novo long coronary lesions. Methods and Results— This randomized, multicenter, prospective trial, called the Percutaneous Treatment of LONG Native Coronary Lesions With Drug-Eluting Stent-IV (LONG-DES IV) trial, compared long R-ZES and SES in 500 patients with long (≥25 mm) native coronary lesions. The primary end point of the trial was in-segment late luminal loss at 9-month angiographic follow-up. The baseline characteristics were not different between R-ZES and SES groups, including lesion lengths (32.4±13.5 mm versus 31.0±13.5 mm, P =0.27). At 9-month angiographic follow-up, the R-ZES was noninferior to the SES with respect to in-segment late luminal loss, the primary study end point (0.14±0.38 mm versus 0.12±0.43 mm, P for noninferiority=0.03, P for superiority=0.68). In addition, in-stent late luminal loss (0.26±0.36 mm versus 0.24±0.42 mm, P =0.78) and the rates of in-segment (5.2% versus 7.2%, P =0.44) and in-stent (4.0% versus 6.0%, P =0.41) binary restenosis were not significantly different between the 2 groups. There were no significant between-group differences in the rate of adverse clinical events (death, myocardial infarction, stent thrombosis, target-lesion revascularization, and composite outcomes). Conclusions— For patients with de novo long coronary artery disease, R-ZES implantation showed noninferior angiographic outcomes as compared with SES implantation. Clinical Trial Registration— URL: http://www.clinicaltrials.gov . Unique identifier: NCT01186094.

Published
2012
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8. Direct Comparison between Brachial Pressure Obtained by Oscillometric Method and Central Pressure Using Invasive Method

Author

Seungjin Lee, Minjeong Kim, Won-Yong Shin, Dong-Kyu Jin, Hyeok-Gyu Lee, A-Ra Cho, Sang-Ho Park, Se-Whan Lee, Ji Yeon Lee, and Jae Yun Kim

Subjects
medicine.medical_specialty, business.industry, medicine.medical_treatment, Limits of agreement, Significant difference, Central pressure, medicine.disease, Pulse pressure, Coronary artery disease, Blood pressure, Central blood pressure, Anesthesia, Internal medicine, Cardiology, Medicine, business, Cardiac catheterization
Abstract

Objective: The importance of central blood pressure evaluation for cardiovascular risk stratification has been emphasized. The aim of this study is to evaluate whether brachial blood pressure obtained by the oscillometric method accurately reflects central blood pressure. Methods: The subjects consisted of 84 consecutive patients with suspected coronary artery disease who underwent cardiac catheterization. Central blood pressure was invasively measured in the origin of the left subclavian artery by using the fluid-filled system, and at the same time, brachial blood pressure in the left upper arm was measured by the oscillometric method. Results: No significant difference was found between central systolic pressure and brachial systolic pressure (144.49±18.84 mmHg vs. 142.44±14.96 mmHg, P=0.063). Bland-Altman analysis accounted for only a small bias of +2.25 mmHg, and the limits of agreement were 24.15 mmHg and -19.65 mmHg. Central diastolic pressure was significantly lower than brachial diastolic pressure (75.80± 8.74 mmHg vs. 86.70±10.48 mmHg, P

Published
2011
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9. Preventive Strategies of Renal Insufficiency in Patients With Diabetes Undergoing Intervention or Arteriography (the PREVENT Trial)

Author

Sang-Yong Yoo, Won-Jang Kim, Jon Suh, Seong-Wook Park, Soo-Jin Kang, Nae-Hee Lee, Bong Ki Lee, Young-Hak Kim, Jae-Hwan Lee, Sang-Sig Cheong, Jong-Young Lee, Se-Whan Lee, Cheol Whan Lee, Sung-Cheol Yun, Si Wan Choi, Jae-Sik Jang, Duk-Woo Park, Won-Yong Shin, Seung-Jung Park, Yoon Haeng Cho, In Whan Seong, Min-Su Hyon, Sang-Gon Lee, and Seung-Whan Lee

Subjects
Male, medicine.medical_specialty, medicine.medical_treatment, Urology, Administration, Oral, Contrast Media, Renal function, Sodium Chloride, Coronary Angiography, Nephropathy, Diabetic nephropathy, chemistry.chemical_compound, Internal medicine, medicine, Humans, Diabetic Nephropathies, Renal Insufficiency, Myocardial infarction, Angioplasty, Balloon, Coronary, Aged, Creatinine, Sodium bicarbonate, business.industry, Middle Aged, medicine.disease, Acetylcysteine, Surgery, Sodium Bicarbonate, chemistry, Cardiology, Female, Hemodialysis, Cardiology and Cardiovascular Medicine, business, Kidney disease
Abstract

Few studies have compared the ability of sodium bicarbonate plus N-acetylcysteine (NAC) and sodium chloride plus NAC to prevent contrast-induced nephropathy (CIN) in diabetic patients with impaired renal function undergoing coronary or endovascular angiography or intervention. Diabetic patients (n = 382) with renal disease (serum creatinine ≥1.1 mg/dl and estimated glomerular filtration rate60 ml/min/1.73 m(2)) were randomly assigned to receive prophylactic sodium chloride (saline group, n = 189) or sodium bicarbonate (bicarbonate group, n = 193) before elective coronary or endovascular angiography or intervention. All patients received oral NAC 1,200 mg 2 times/day for 2 days. The primary end point was CIN, defined as an increase in serum creatinine25% or an absolute increase in serum creatinine ≥0.5 mg/dl within 48 hours after contrast exposure. There were no significant between-group differences in baseline characteristics. The primary end point was met in 10 patients (5.3%) in the saline group and 17 (9.0%) in the bicarbonate group (p = 0.17), with 2 (1.1%) and 4 (2.1%), respectively, requiring hemodialysis (p = 0.69). Rates of death, myocardial infarction, and stroke did not differ significantly at 1 month and 6 months after contrast exposure. In conclusion, hydration with sodium bicarbonate is not superior to hydration with sodium chloride in preventing CIN in patients with diabetic nephropathy undergoing coronary or endovascular angiography or intervention.

Published
2011
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10. A Randomized, Double-Blind, Multicenter Comparison Study of Triple Antiplatelet Therapy With Dual Antiplatelet Therapy to Reduce Restenosis After Drug-Eluting Stent Implantation in Long Coronary Lesions

Author

Jae-Hwan Lee, Se-Whan Lee, Soo-Jin Kang, Si Wan Choi, Seung-Whan Lee, Cheol Whan Lee, Chang-Bum Park, Bong Ki Lee, In Whan Seong, Duk-Woo Park, Yoon Haeng Cho, Nae-Hee Lee, Seung Jin Lee, Won-Yong Shin, Hyun-Sook Kim, Seong-Wook Park, Sang-Gon Lee, Young Jin Choi, Kyoung Ha Park, Duk-Won Bang, Min-Kyu Kim, Hoon Ki Park, Seung-Jung Park, Min-Su Hyon, Keun Hwa Lee, Declare-Long Ii Study Investigators, Young-Hak Kim, Woo-Jung Park, and Sung-Cheol Yun

Subjects
medicine.medical_specialty, Intimal hyperplasia, medicine.diagnostic_test, business.industry, medicine.medical_treatment, Stent, medicine.disease, Clopidogrel, Cilostazol, Coronary artery disease, Restenosis, Drug-eluting stent, Internal medicine, Intravascular ultrasound, medicine, Cardiology, Cardiology and Cardiovascular Medicine, business, medicine.drug
Abstract

Objectives The purpose of this study was to determine whether cilostazol reduces intimal hyperplasia in patients undergoing long zotarolimus-eluting stent implantation (stent length: ≥30 mm) for native long coronary lesions (length: ≥25 mm). Background Restenosis after drug-eluting stent implantation remains a significant clinical problem in long coronary lesions. Methods Patients (n = 499) were assigned randomly to triple (aspirin, clopidogrel, and cilostazol, triple group: n = 250) or dual antiplatelet therapy (aspirin and clopidogrel and placebo, dual group: n = 249) for 8 months after long zotarolimus-eluting stent implantation. The primary end point was in-stent late loss at the 8-month angiography according to the intention-to-treat principle. Results The 2 groups had similar baseline characteristics. The in-stent (0.56 ± 0.55 mm vs. 0.68 ± 0.59 mm, p = 0.045) and in-segment (0.32 ± 0.54 mm vs. 0.47 ± 0.54 mm, p = 0.006) late loss were significantly lower in the triple versus dual group, as were 8-month in-stent restenosis (10.8% vs. 19.1%, p = 0.016), in-segment restenosis (12.2% vs. 20.0%, p = 0.028), and 12-month ischemic-driven target lesion revascularization (5.2% vs. 10.0%, p = 0.042) rates. At 12 months, major adverse cardiac events including death, myocardial infarction, and ischemic-driven target lesion revascularization tended to be lower in the triple group than the dual group (7.2% vs. 12.0%, p = 0.07). Percent intimal hyperplasia volume by volumetric intravascular ultrasound analysis was reduced from 27.1 ± 13.2% for the dual group to 22.1 ± 9.9% for the triple group (p = 0.017). Conclusions Patients receiving triple antiplatelet therapy after long zotarolimus-eluting stent implantation had decreased extent of late luminal loss, percent intimal hyperplasia volume, and angiographic restenosis, resulting in a reduced risk of 12-month target lesion revascularization compared with patients receiving dual antiplatelet therapy. (Triple Versus Dual Antiplatelet Therapy after ABT578-Eluting Stent; NCT00589927)

Published
2011
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11. Comparison of Transradial and Transfemoral Approaches for Percutaneous Coronary Intervention in Patients With Acute Coronary Syndrome and Anemia

Author

Keum Soo Park, Kyoo Rok Han, Junghan Yoon, Seung-Hun Lee, Sang Sig Cheong, Kwang Soo Cha, Myung Ho Jeong, Young Jin Youn, Doo Sun Sim, Seung-Woon Rha, Byung Ryeol Cho, Byung Ok Kim, Min Su Hyon, and Won-Yong Shin

Subjects
Male, medicine.medical_specialty, Acute coronary syndrome, Percutaneous, Anemia, medicine.medical_treatment, 030204 cardiovascular system & hematology, Postoperative Hemorrhage, Independent predictor, 03 medical and health sciences, 0302 clinical medicine, Percutaneous Coronary Intervention, Intervention (counseling), Internal medicine, Republic of Korea, medicine, Humans, In patient, 030212 general & internal medicine, Hospital Mortality, Prospective Studies, Registries, Acute Coronary Syndrome, Aged, business.industry, Incidence, Percutaneous coronary intervention, medicine.disease, Prognosis, Surgery, Femoral Artery, Radial Artery, Cardiology, Feasibility Studies, Female, Cardiology and Cardiovascular Medicine, business, Kidney disease, Follow-Up Studies
Abstract

Anemia is an independent predictor of bleeding complications and poor clinical outcomes after percutaneous coronary intervention. Percutaneous coronary transradial intervention (TRI) is better than percutaneous coronary transfemoral intervention (TFI) in terms of reducing bleeding complications that can affect the prognosis. This study aims to investigate the clinical outcomes between TRI and TFI for patients with anemia. We analyzed periprocedure complications, in-hospital mortality, and major adverse cardiac events for one year in the Korean TRI registry from January 2013 to April 2014. Patients with chronic kidney disease for whom TFI is preferred were excluded. Anemia was defined as hemoglobin13 g/dl for men and12 g/dl for women. A total of 1,279 patients were finally enrolled. Of these, 348 patients had anemia. Among them, 253 patients (72.7%) underwent TRI and 95 patients (27.3%) underwent TFI. There were no significant differences of baseline demographic characteristics between the TRI and TFI groups, except for the incidence of dyslipidemia (TRI 23.7% vs TFI 12.6%, p = 0.023). Multivariate logistic regression analysis revealed lower incidence of composite severe bleeding complications (hazard ratio 0.34, 95% CI 0.12 to 0.99, p = 0.049) and lower incidence of in-hospital mortality than TFI group (hazard ratio 0.74, 95% CI 0.62 to 0.88, p = 0.042). In conclusion, this study suggests that the TRI for patients with anemia may be translated into better prognosis in terms of lower rates of bleeding complications and in-hospital mortality.

Published
2015

12. Impact of female gender on bleeding complications after transradial coronary intervention (from the Korean Transradial Coronary Intervention registry)

Author

Kyoo Rok Han, Kyoung Woo Seo, Sang Sig Cheong, Won-Yong Shin, Yong Woo Choi, Myung Ho Jeong, Keum Soo Park, Sejun Park, Min Su Hyon, Young Jin Youn, Byung Ryeol Cho, Hong-Seok Lim, So-Yeon Choi, You Hong Lee, Byung Ok Kim, Myeong-Ho Yoon, Seung-Jea Tahk, Hyoung-Mo Yang, Seung-Woon Rha, Junghan Yoon, Jeoung-Sook Shin, Byoung-Joo Choi, and Kwang Soo Cha

Subjects
Male, medicine.medical_specialty, Cardiac Catheterization, medicine.medical_treatment, Female group, Postoperative Hemorrhage, Coronary Angiography, Risk Assessment, Severity of Illness Index, Cohort Studies, Percutaneous Coronary Intervention, Intervention (counseling), Internal medicine, Republic of Korea, medicine, Confidence Intervals, Odds Ratio, Humans, In patient, Myocardial infarction, Hospital Mortality, Registries, Sex Distribution, Stroke, Aged, Retrospective Studies, business.industry, Incidence (epidemiology), Incidence, Coronary Stenosis, Percutaneous coronary intervention, Middle Aged, medicine.disease, Surgery, Survival Rate, Treatment Outcome, Propensity score matching, Radial Artery, Cardiology, Female, Cardiology and Cardiovascular Medicine, business, Follow-Up Studies
Abstract

Besides poor clinical outcomes, female gender has been known as a high-risk factor for bleeding complications. This study aimed to investigate the impact of gender on clinical outcomes and bleeding complications after transradial coronary intervention (TRI). The Korean TRI registry is a retrospective multicenter registry with 4,890 patients who underwent percutaneous coronary intervention in 2009 at 12 centers. To compare clinical outcomes and bleeding complications between the male and female groups, we performed a propensity score matching in patients who received TRI. A total of 1,194 patients (597 in each group) were studied. The primary outcome was 1-year major adverse cardiac events, including all-cause mortality, myocardial infarction, target vessel revascularization, and stroke. The secondary outcome was major bleeding (composite of bleeding requiring transfusion of ≥2 units of packed cells or bleeding that was fatal). The proportion of major adverse cardiac events was similar between the 2 groups (6.2% vs 4.7%, p = 0.308). The female group had a greater incidence of major bleeding (0.3% vs 3.2%, p0.001). On multivariate analysis, female gender (odds ratio [OR] 7.748, 95% confidence interval [CI] 1.767 to 13.399), age ≥75 years (OR 5.824, 95% CI 2.085 to 16.274), and chronic kidney disease (OR 7.264, 95% CI 2.369 to 12.276) were independent predictors of major bleeding. In conclusion, the female gender had a tendency for more bleeding complications than male gender after TRI without difference in the clinical outcome.

Published
2014

13. Comparison of Zotarolimus-Eluting stent versus Sirolimus-Eluting stent for de novo coronary artery disease in patients with diabetes mellitus from the ESSENCE-DIABETES II trial

Author

Seung Jin Lee, Mahn-Won Park, Cheol Whan Lee, Duk-Woo Park, Yoon Haeng Cho, Soo-Jin Kang, Jon Suh, Seung-Whan Lee, Sung Ho Her, Jung-Min Ahn, Seung-Jung Park, Sang-Gon Lee, Sung-Cheol Yun, Seong-Wook Park, Young-Hak Kim, Won-Jang Kim, Gyung-Min Park, Chan Joon Kim, Bong Ki Lee, Woo-Jung Park, Se-Whan Lee, Sang-Sig Cheong, Jong-Young Lee, Won-Yong Shin, Hyun-Sook Kim, Nae-Hee Lee, and Young-Rak Cho

Subjects
Male, medicine.medical_specialty, medicine.medical_treatment, Coronary Artery Disease, Coronary Angiography, Prosthesis Design, law.invention, Coronary artery disease, Electrocardiography, Randomized controlled trial, law, Diabetes mellitus, Internal medicine, medicine, Clinical endpoint, Diabetes Mellitus, Humans, Prospective Studies, Sirolimus, business.industry, Stent, Drug-Eluting Stents, Middle Aged, medicine.disease, Confidence interval, Surgery, Patient recruitment, Treatment Outcome, Cardiology, Female, Cardiology and Cardiovascular Medicine, business, Immunosuppressive Agents, medicine.drug, Follow-Up Studies
Abstract

Angiographic and clinical outcomes remain relatively unfavorable for diabetic patients even after the use of drug-eluting stent. This prospective, multicenter, randomized study compared the relative efficacy and safety of resolute zotarolimus-eluting stent (R-ZES) and sirolimus-eluting stent (SES) implantation in diabetic patients with coronary artery disease. The primary end point was noninferiority of angiographic in-segment late loss at 9 months. Clinical events were also monitored for at least 12 months. Patient recruitment was prematurely stopped after enrollment of 256 patients (127 in R-ZES group and 129 in SES) because of discontinuing production of SES. The R-ZES was noninferior to the SES for 9-month in-segment late loss (0.34 ± 0.30 vs 0.39 ± 0.43 mm; difference -0.048; 95% confidence interval -0.157 to 0.061; upper 1-sided 95% confidence interval 0.044; p0.001 for noninferiority). In addition, in-stent late loss (0.22 ± 0.29 vs 0.21 ± 0.40 mm, p = 0.849) and the rates of in-segment (1.2% vs 6.7%, p = 0.119) and in-stent (1.2% vs 3.3%, p = 0.621) binary restenoses were similar between the 2 groups. At 12 months, there were no statistical differences between the 2 groups in the incidence of any clinical outcomes (death, myocardial infarction, stent thrombosis, ischemia-driven target lesion revascularization, ischemia-driven target vessel revascularization, and composite outcomes). In conclusion, despite having reduced power because of early study termination, our study suggests that the R-ZES has noninferior angiographic outcomes at 9 months to the SES in diabetic patients with coronary artery disease.

Published
2013

14. Use of drug-eluting stent with provisional T-stenting technique in the treatment of renal artery bifurcation stenosis; long-term angiographic follow-up

Author

Se-Whan Lee, Won-Yong Shin, Dong-Kyu Jin, Sang-Ho Park, Jihun Ahn, Dohoi Kim, Seung Jin Lee, and Tae Hoon Kim

Subjects
Male, medicine.medical_specialty, Percutaneous, Renal Artery Bifurcation, medicine.medical_treatment, Cardiovascular Disorders, Case Report, Renal Artery Obstruction, Main branch, Renal Artery, Restenosis, medicine.artery, Internal medicine, Atherosclerotic renal artery stenosis, medicine, Humans, cardiovascular diseases, Renal artery, Aged, business.industry, Angioplasty, Drug-Eluting Stents, General Medicine, medicine.disease, equipment and supplies, Radiography, Ostium, Stenosis, surgical procedures, operative, Treatment Outcome, Drug-eluting stent, Cardiology, Radiology, business
Abstract

Atherosclerotic renal artery stenosis (RAS) usually involves the ostium and the proximal one-third of the renal artery main branch. Percutaneous renal artery angioplasty with stent placement is a well recognized treatment for atherosclerotic RAS. Occasionally, atherosclerotic RAS involves renal artery bifurcations. However, stent implantation in atherosclerotic RAS involving bifurcation is not only troublesome, but also challenging because of side branch occlusion and in-stent restenosis (ISR). In the present report, we describe the use of drug-eluting stents (DES) with provisional T-stenting technique for the treatment of renal artery bifurcation lesion. Follow-up angiogram showed no significant ISR 18 months after the procedure. In the treatment of renal bifurcation lesions, a two-stent strategy using DES could be a viable option in selected patients.

Published
2011

15. Long QT syndrome and torsade de pointes associated with Takotsubo cardiomyopathy

Author

Se Whan Lee, Ji Hun Ahn, Won-Yong Shin, Han Min Lee, Jun Young Eun, Sang-Ho Park, Seung Jin Lee, and Dong Kyu Jin

Subjects
Bradycardia, medicine.medical_specialty, Long QT syndrome, Cardiovascular Disorders, Cardiomyopathy, Torsades de pointes, Case Report, QT prolongation, Coronary Angiography, QT interval, Diagnosis, Differential, Electrocardiography, Takotsubo Cardiomyopathy, Torsades de Pointes, Internal medicine, medicine, Humans, Torsade de pointes, Aged, Ultrasonography, medicine.diagnostic_test, business.industry, Cardiac Pacing, Artificial, General Medicine, medicine.disease, Permanent pacemaker insertion, Heart Arrest, Long QT Syndrome, Anesthesia, Cardiology, Female, medicine.symptom, Permanent pacemaker, business
Abstract

Prolongation of QTc interval associated with Takotsubo cardiomyopathy (TC) has previously been reported in published case series. We report an unusual case of a patient who presented with TC associated with long-QT syndrome and developed cardiac arrest secondary to torsade de pointes. Since QT prolongation and bradycardia persisted after the resolution of TC, the patient received permanent pacemaker. Since then additional event did not occur. QT prolongation and bradycardia could be persistent even after recovery of TC, and permanent pacemaker insertion may be a treatment option of long QT syndrome related with TC.

Published
2011

16. TCTAP A-200 The Diffuse and Multi-vessel Coronary Artery Spasm Increase the Incidence of Recurrent Chest Pain During 3-year Clinical Follow up

Author

Byoung Geol Choi, Cheol Ung Choi, Hong Euy Lim Lim, Sang-Ho Park, Won-Yong Shin, Ji Bak Kim, Chang Gyu Park, Sung Il Im, Dong Joo Oh, Eung Ju Kim, Dong-Kyu Jin, Jin Won Kim, Jin Oh Na, Se Yeon Choi, Hong Seog Seo, Yoonjee Park, Sunki Lee, Akkala Raghavender Goud Hu Li, and Seung-Woon Rha

Subjects
medicine.medical_specialty, medicine.anatomical_structure, business.industry, Internal medicine, Incidence (epidemiology), medicine, Cardiology, medicine.symptom, Cardiology and Cardiovascular Medicine, Chest pain, business, Artery
Published
2014
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17. Restenotic Stented Versus De Novo Chronic Total Occlusion Outcomes Following Successful Intervention with Drug-Eluting Stents

Author

Se-Whan Lee, Dong-Kyu Jin, Dong Joo Oh, Byoung Geol Choi, Chang Gyu Park, Jin Oh Na, Hong Euy Lim, Cheol Ung Choi, Jin Won Kim, Sung Il Im, Seung Jin Lee, Eung Ju Kim, Won-Yong Shin, Se Yeon Choi, Ung Jun, Hong Seog Seo, Sun Won Kim, Seung-Woon Rha, and Sang-Ho Park

Subjects
Drug, medicine.medical_specialty, business.industry, Internal medicine, Intervention (counseling), media_common.quotation_subject, medicine, Cardiology, Cardiology and Cardiovascular Medicine, business, Total occlusion, media_common
Published
2013
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18. Predictors Associated with Ischemic ECG Changes During Acetylcholine Provocation Test; Is Uric Acid Can Be an Useful Biomarker for Significant Coronary Endothelial Dysfunction?

Author

Dong-Kyu Jin, Eung Ju Kim, Sang-Ho Park, Sun Won Kim, Jin Oh Na, Sung Il Im, Cheol Ung Choi, Se-Whan Lee, Hong Seog Seo, Dong Joo Oh, Jin Won Kim, Seung Jin Lee, Seung-Woon Rha, Hong Euy Lim, Ung Jun, Se Yeon Choi, Byoung Geol Choi, Won-Yong Shin, and Chang Gyu Park

Subjects
medicine.medical_specialty, business.industry, Provocation test, medicine.disease, chemistry.chemical_compound, chemistry, Internal medicine, Cardiology, Medicine, Uric acid, Biomarker (medicine), Endothelial dysfunction, Cardiology and Cardiovascular Medicine, business, Acetylcholine, medicine.drug
Published
2013
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19. Left Ventricular Mass Index and Septal E/E' Ratio Is Associated with Coronary Artery Calcium Score Severity in Subjects with Normal Left Ventricular Ejection Fraction

Author

Byoung Geol Choi, Won-Yong Shin, Cheol Ung Choi, Sang-Ho Park, Seung-Woon Rha, Seung Jin Lee, Dong-Kyu Jin, Se-Whan Lee, Dong Joo Oh, and Ung Jun

Subjects
Left ventricular mass, medicine.medical_specialty, Ejection fraction, business.industry, Coronary artery calcium score, Internal medicine, Cardiology, Medicine, Cardiology and Cardiovascular Medicine, business
Published
2013
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20. AS-228 Effect of Left Ventricular Ejection Fraction on 2-Year Clinical Cutcomes in Patients with Acute Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention with Drug-Eluting Stents

Author

SunWon Kim, Hyeok-Gyu Lee, Eung Ju Kim, Hong Euy Lim, Sung Il Im, Seung Jin Lee, Sang-Ho Park, A-Ra Cho, Jin Won Kim, Seong Woo Han, Cheol Ung Choi, Hong Seog Seo, Seung-Woon Rha, Dong-Kyu Jin, Jin Oh Na, Chang Gyu Park, Won-Yong Shin, Se-Whan Lee, Dong Joo Oh, Byoung Geol Choi, and Amro Elnagar

Subjects
Drug, medicine.medical_specialty, Ejection fraction, business.industry, medicine.medical_treatment, media_common.quotation_subject, Electrocardiography in myocardial infarction, Percutaneous coronary intervention, medicine.disease, Internal medicine, Cardiology, Medicine, In patient, Myocardial infarction, Cardiology and Cardiovascular Medicine, business, media_common
Published
2012
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21. AS-279: Serum Fibroblast Growth Factor 21 is a Predictable Marker of Coronary Artery Disease in Type 2 Diabetes Mellitus

Author

Chang Gyu Park, Byoung Geol Choi, Se-Whan Lee, Seung-Woon Rha, Hong Euy Lim, Dong Joo Oh, Seong Woo Han, Dong-Kyu Jin, Jin Won Kim, Won-Yong Shin, Sang-Ho Park, Eung Ju Kim, A-Ra Cho, Seung Jin Lee, Cheol Ung Choi, Sung Il Im, Hong Seog Seo, Jin Oh Na, SunWon Kim, Hyeok-Gyu Lee, and Amro Elnagar

Subjects
Coronary artery disease, medicine.medical_specialty, Endocrinology, FGF21, business.industry, Internal medicine, Cardiology, Type 2 Diabetes Mellitus, Medicine, Cardiology and Cardiovascular Medicine, business, medicine.disease
Published
2012
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22. AS-134: Impact of Left Anterior Descending Artery Lesion versus Non-Left Anterior Descending Artery Lesion on 1-Year Clinical Outcomes in Patients with Acute Myocardial Infarction Undergoing Percutaneous Coronary Intervention

Author

Sang-Ho Park, Seong Woo Han, Hong Euy Lim, A-Ra Cho, Amro Elnagar, SunWon Kim, Dong-Kyu Jin, Hyeok-Gyu Lee, Seung-Woon Rha, Won-Yong Shin, Hong Seog Seo, Chang Gyu Park, Byoung Geol Choi, Seung Jin Lee, Jin Won Kim, Eung Ju Kim, Se-Whan Lee, Jin Oh Na, Sung Il Im, Dong Joo Oh, and Cheol Ung Choi

Subjects
medicine.medical_specialty, business.industry, medicine.medical_treatment, Percutaneous coronary intervention, medicine.disease, Lesion, medicine.anatomical_structure, Internal medicine, medicine, Cardiology, In patient, Myocardial infarction, medicine.symptom, Cardiology and Cardiovascular Medicine, business, Artery
Published
2012
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23. AS-164 Crushing versus Kissing Stenting in ‘Real World' Unprotected Left Main Bifurcation Intervention with Drug-Eluting Stents

Author

Sang-Ho Park, Seung-Woon Rha, A-Ra Cho, Hyeok-Gyu Lee, Se-Whan Lee, Won-Yong Shin, Seung-Jin Lee, Dong-Kyu Jin, Amro Elnagar, Byoung Geol Choi, Sung Il Im, SunWon Kim, Jin Oh Na, Seong Woo Han, Cheol Ung Choi, Hong Euy Lim, Jin Won Kim, Eung Ju Kim, Hong Seog Seo, Chang Gyu Park, and Dong Joo Oh

Subjects
Drug, medicine.medical_specialty, business.industry, Internal medicine, Intervention (counseling), media_common.quotation_subject, medicine, Cardiology, Cardiology and Cardiovascular Medicine, business, Surgery, media_common
Published
2012
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24. AS-263: Serum Adipocyte-Specific Fatty Acid-Binding Protein is a Predictable Marker of Coronary Artery Disease and Diabetes Mellitus

Author

SunWon Kim, Hong Seog Seo, Hyeok-Gyu Lee, A-Ra Cho, Seung-Woon Rha, Amro Elnagar, Jin Oh Na, Seong Woo Han, Chang Gyu Park, Seung Jin Lee, Dong-Kyu Jin, Byoung Geol Choi, Sung Il Im, Jin Won Kim, Cheol Ung Choi, Eung Ju Kim, Se-Whan Lee, Dong Joo Oh, Sang-Ho Park, Won-Yong Shin, and Hong Euy Lim

Subjects
Coronary artery disease, medicine.medical_specialty, Endocrinology, Adipocyte-Specific Fatty Acid-Binding Protein, business.industry, Diabetes mellitus, Internal medicine, medicine, Cardiology, Cardiology and Cardiovascular Medicine, medicine.disease, business
Published
2012
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25. IMPACT OF MYOCARDIAL BRIDGE ON 3-YEAR CLINICAL OUTCOME IN PATIENT WITH POSITIVE CORONARY ARTERY SPASM AS ASSESSED BY ACETYLCHOLINE PROVOCATION TEST

Author

Dong Joo Oh, Dong-Kyu Jin, Chang Gyu Park, Won Yu Kang, Byoung Geol Choi, Taehoon Ahn, Won-Yong Shin, Cheol Ung Choi, Seung-Woon Rha, Hong-Seog Seo, and Sang-Ho Park

Subjects
Myocardial bridge, medicine.medical_specialty, business.industry, Provocation test, eye diseases, humanities, medicine.anatomical_structure, Anesthesia, Internal medicine, embryonic structures, Cardiology, Medicine, In patient, Cardiology and Cardiovascular Medicine, business, Acetylcholine, Artery, medicine.drug
Published
2014
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26. TCTAP A-001 Twelve-month Clinical Outcomes of Transradial Coronary Artery Intervention: Comparison of the Right and Left Radial Artery Approach

Author

Sung Kee Ryu, Hyunmin Choe, Hee Yeol Kim, Byung Ryul Cho, Kyoo Rok Han, Hyoung-Mo Yang, Seung-Woon Rha, Won-Yong Shin, Keum Soo Park, Jae Woong Choi, Junghan Yoon, Jang-Whan Bae, Sang Sik Jung, Byoung Geol Choi, Byung Ok Kim, Moo Hyun Kim, Min Soo Hyun, Kwang Soo Cha, Ji Young Park, Dong Joo Oh, and Myung Ho Jeong

Subjects
medicine.medical_specialty, medicine.anatomical_structure, Left radial artery, business.industry, Intervention (counseling), Internal medicine, Cardiology, Medicine, Cardiology and Cardiovascular Medicine, business, Artery
Published
2014
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27. IMPACT OF BASELINE SPASM ON 3-YEAR CLINICAL OUTCOME (RECURRENT CHEST PAIN REQUIRING REPEAT CORONARY ANGIOGRAPHY) IN PATIENT WITH POSITIVE CORONARY ARTERY SPASM AS ASSESSED BY ACETYLCHOLINE PROVOCATION TEST

Author

Cheol Ung Choi, Chang Gyu Park, Seung-Woon Rha, Won Yu Kang, Dong-Kyu Jin, Taehoon Ahn, Dong Joo Oh, Won-Yong Shin, Byoung Geol Choi, Sang-Ho Park, and Hong-Seog Seo

Subjects
Coronary angiography, medicine.medical_specialty, business.industry, Provocation test, Chest pain, medicine.anatomical_structure, Anesthesia, Internal medicine, medicine, Cardiology, In patient, medicine.symptom, Cardiology and Cardiovascular Medicine, business, Acetylcholine, medicine.drug, Artery
Published
2014
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28. TCTAP A-207 Impact of Hemodialysis in Critical Limb Ischemia Patients with Infra-popliteal Arterial Lesion on Clinical Outcomes Following Percutaneous Transluminal Angioplasty

Author

Won-Yong Shin, Sang-Ho Park, Cheol Ung Choi, Hong Seog Seo, Chang Gyu Park, Sunki Lee, Hu Li, Yoonjee Park, Ji Bak Kim, Hong Euy Lim, Jin Won Kim, Akkala Raghavender Goud, Seung-Woon Rha, Eung Ju Kim, Jin Oh Na, Se Yeon Choi, Dong Joo Oh, Sung Il Im, and Byoung Geol Choi

Subjects
medicine.medical_specialty, Percutaneous, business.industry, medicine.medical_treatment, nutritional and metabolic diseases, Critical limb ischemia, Transluminal Angioplasty, Internal medicine, Arterial lesion, Cardiology, Medicine, Hemodialysis, medicine.symptom, Cardiology and Cardiovascular Medicine, business
Published
2014
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29. Predictors Associated with Major Adverse Cardiac Events Following Successful Chronic Total Occlusion Intervention with Drug-eluting Stents

Author

Se-Whan Lee, Dong Joo Oh, Jin Won Kim, Won-Yong Shin, Eung Ju Kim, Chang Gyu Park, Hong Euy Lim, Ung Jun, Hong Seog Seo, Dong-Kyu Jin, Cheol Ung Choi, Se Yeon Choi, Seung-Woon Rha, Seung Jin Lee, Jin Oh Na, Sang-Ho Park, Sung Il Im, Sun Won Kim, and Byoung Geol Choi

Subjects
Drug, medicine.medical_specialty, business.industry, Intervention (counseling), Internal medicine, media_common.quotation_subject, Emergency medicine, Cardiology, Medicine, Cardiology and Cardiovascular Medicine, business, Total occlusion, media_common
Published
2013
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30. Risk Factors, Biomarkers, and Echocardiographic Parameters According to Coronary Artery Calcium Scoring (Agatstone) Measured by 64-channel Multidetector Computed Tomography

Author

Dong-Kyu Jin, Se-Whan Lee, Dong Joo Oh, Seung Jin Lee, Sang-Ho Park, Won-Yong Shin, Cheol Ung Choi, Byoung Geol Choi, Seung-Woon Rha, and Ung Jun

Subjects
medicine.medical_specialty, Channel (digital image), business.industry, Internal medicine, Multidetector computed tomography, Cardiology, Medicine, Radiology, Cardiology and Cardiovascular Medicine, business, Coronary Artery Calcium Scoring
Published
2013
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31. Crushing Versus Kissing Stenting in ‘Real World’ Unprotected Left Main Bifurcation Intervention with Drug-eluting Stents

Author

Jin Oh Na, Se Yeon Choi, Eung Ju Kim, Chang Gyu Park, Dong-Kyu Jin, Sang-Ho Park, Byoung Geol Choi, Seung Jin Lee, Sun Won Kim, Cheol Ung Choi, Ung Jun, Sung Il Im, Jin Won Kim, Se-Whan Lee, Seung-Woon Rha, Hong Seog Seo, Won-Yong Shin, Dong Joo Oh, and Hong Euy Lim

Subjects
Drug, medicine.medical_specialty, business.industry, media_common.quotation_subject, Internal medicine, Intervention (counseling), medicine, Cardiology, Cardiology and Cardiovascular Medicine, business, media_common, Surgery
Published
2013
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32. TCT-626 Impact of Periprocedural Myocardial Infarction on In-Hospital and 2-Year Clinical Outcomes in Patients Undergoing Percutaneous Coronary Intervention with Drug-Eluting Stents

Author

Eung Ju Kim, Won-Yong Shin, Seung-Woon Rha, Sun Won Kim, Chang Gyu Park, Byoung Geol Choi, Hyeok-Gyu Lee, Sung Il Im, Seung Jin Lee, A-Ra Cho, Seong Woo Han, Jin Oh Na, Amro Elnagar, Jin Won Kim, Dong-Kyu Jin, Hong Seog Seo, Sang-Ho Park, Se Yeon Choi, Cheol Ung Choi, Hong Euy Lim, and Dong Joo Oh

Subjects
Drug, medicine.medical_specialty, business.industry, media_common.quotation_subject, medicine.medical_treatment, Percutaneous coronary intervention, medicine.disease, Internal medicine, Cardiology, medicine, In patient, Myocardial infarction, Cardiology and Cardiovascular Medicine, business, media_common
Published
2012
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33. AS-276: Impact of Lipid Profiles and Classical Risk Factors on Coronary Artery Spasm as assessed by Acetylcholine Provocation test

Author

Sang-Ho Park, Dong-Kyu Jin, Sung Il Im, A-Ra Cho, Seong Woo Han, Jin Oh Na, Se-Whan Lee, Cheol Ung Choi, Dong Joo Oh, Won-Yong Shin, SunWon Kim, Chang Gyu Park, Hong Seog Seo, Seung Jin Lee, Hyeok-Gyu Lee, Byoung Geol Choi, Amro Elnagar, Jin Won Kim, Eung Ju Kim, Hong Euy Lim, and Seung-Woon Rha

Subjects
medicine.medical_specialty, medicine.anatomical_structure, business.industry, Internal medicine, Anesthesia, Provocation test, Cardiology, Medicine, Cardiology and Cardiovascular Medicine, business, Acetylcholine, medicine.drug, Artery
Published
2012
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34. AS-188: Two-Year Clinical Cutcomes of in ‘Real world’, Chronic Total Occlusive Lesions; Comparison of Sirolimus-Eluting and Paclitaxel-Eluting stents

Author

Se-Whan Lee, Dong Joo Oh, Eung Ju Kim, Seong Woo Han, Hong Euy Lim, Jin Oh Na, A-Ra Cho, Sung Il Im, Seung-Woon Rha, Sang-Ho Park, Dong-Kyu Jin, SunWon Kim, Hyeok-Gyu Lee, Seung Jin Lee, Jin Won Kim, Hong Seog Seo, Cheol Ung Choi, Byoung Geol Choi, Chang Gyu Park, Won-Yong Shin, and Amro Elnagar

Subjects
medicine.medical_specialty, business.industry, Occlusive, chemistry.chemical_compound, Paclitaxel, chemistry, Internal medicine, Sirolimus, Cardiology, Medicine, Radiology, Cardiology and Cardiovascular Medicine, business, medicine.drug
Published
2012
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35. AS-252: Impact of Intravascular Ultrasound Guided Left Main Intervention with Drug-eluting Stents on 2-year Clinical Outcomes

Author

Seung Jin Lee, Sang-Ho Park, Eung Ju Kim, Won-Yong Shin, Jin Oh Na, Se-Whan Lee, Chang Gyu Park, Sung Il Im, Dong-Kyu Jin, Dong Joo Oh, Seong Woo Han, SunWon Kim, Hyeok-Gyu Lee, Byoung Geol Choi, Hong Seog Seo, Hong Euy Lim, Seung-Woon Rha, A-Ra Cho, Jin Won Kim, Amro Elnagar, and Cheol Ung Choi

Subjects
Drug, medicine.medical_specialty, medicine.diagnostic_test, business.industry, media_common.quotation_subject, Internal medicine, Intervention (counseling), Intravascular ultrasound, Cardiology, medicine, Radiology, Cardiology and Cardiovascular Medicine, business, media_common
Published
2012
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36. AS-165 Effect of Left Main versus Non-Left Main Disease on 1-Year Clinical Outcomes in Patients with Acute Myocardial Infarction Undergoing Percutaneous Coronary Intervention

Author

Se-Whan Lee, Sung Il Im, Dong Joo Oh, Jin Won Kim, Cheol Ung Choi, Dong-Kyu Jin, Hong Seog Seo, Seung Jin Lee, A-Ra Cho, Eung Ju Kim, SunWon Kim, Hyeok-Gyu Lee, Won-Yong Shin, Jin Oh Na, Chang Gyu Park, Byoung Geol Choi, Hong Euy Lim, Sang-Ho Park, Amro Elnagar, Seung-Woon Rha, and Seong Woo Han

Subjects
medicine.medical_specialty, business.industry, medicine.medical_treatment, Electrocardiography in myocardial infarction, Percutaneous coronary intervention, medicine.disease, Internal medicine, medicine, Cardiology, In patient, Myocardial infarction, Cardiology and Cardiovascular Medicine, business, Left main disease
Published
2012
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37. IMPACT OF LIPID PROFILES AND CLASSICAL RISK FACTORS ON CORONARY ARTERY SPASM AS ASSESSED BY ACETYLCHOLINE PROVOCATION TEST

Author

Seongwoo Han, Chang Gyu Park, Cheol Ung Choi, Amro Elnagar, Eung Ju Kim, Dong-Kyu Jin, Won-Yong Shin, Jin Won Kim, Seung-Woon Rha, Byoung Geol Choi, Sung Il Im, Dong Joo Oh, Seungjin Lee, A-Ra Cho, Jin Oh Na, Hong Euy Lim, SunWon Kim, Hyeok-Gyu Lee, Hong-Seog Seo, and Sang-Ho Park

Subjects
medicine.medical_specialty, medicine.anatomical_structure, business.industry, Internal medicine, Anesthesia, Provocation test, medicine, Cardiology, Cardiology and Cardiovascular Medicine, business, Acetylcholine, medicine.drug, Artery
Published
2012
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38. AS-215 Impact of ApoB/ApoA-I Ratio on One-Year Clinical Outcomes in Patients Undergoing Percutaneous Coronary Intervention with Drug-Eluting Stents

Author

Se-Whan Lee, Dong-Kyu Jin, Meera Kumari, Won-Yong Shin, Eung Ju Kim, Cheol Ung Choi, Chang Gyu Park, Seung-Woon Rha, Sang-Ho Park, Jin Won Kim, Byoung Geol Choi, Dong Joo Oh, Jin Oh Na, Seung Jin Lee, Hong Seog Seo, Ji Young Park, Kanhaiya L. Poddar, Yun Kyung Kim, and Hong Euy Lim

Subjects
Drug, medicine.medical_specialty, Apolipoprotein B, biology, business.industry, media_common.quotation_subject, medicine.medical_treatment, Percutaneous coronary intervention, Internal medicine, biology.protein, medicine, Cardiology, In patient, Cardiology and Cardiovascular Medicine, business, media_common
Published
2011
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39. AS-206 Uric Acid and Hemoglobin Level; Novel Risk Predictors of Acute Kidney Injury in Patient Undergoing Percutaneous Coronary Intervention with Drug-Eluting Stents

Author

Hong Euy Lim, Chang Gyu Park, Yun Kyung Kim, Seung Jin Lee, Ji Young Park, Byoung Geol Choi, Jin Won Kim, Eung Ju Kim, Hong Seog Seo, Won-Yong Shin, Sang-Ho Park, Se-Whan Lee, Dong Joo Oh, Jin Oh Na, Cheol Ung Choi, Seung-Woon Rha, Dong-Kyu Jin, Meera Kumari, and Kanhaiya L. Poddar

Subjects
Drug, medicine.medical_specialty, business.industry, medicine.medical_treatment, media_common.quotation_subject, Acute kidney injury, Percutaneous coronary intervention, medicine.disease, chemistry.chemical_compound, chemistry, Internal medicine, Cardiology, medicine, Uric acid, In patient, Hemoglobin, Cardiology and Cardiovascular Medicine, business, media_common
Published
2011
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40. AS-160 Calcium Channel Blockers of Dihydropyridine Class Reduce The Antiplatelet Effect of Clopidogrel ?: What Is Clinical Impact

Author

Sang-Ho Park, Yun Kyung Kim, Chang Gyu Park, Se-Whan Lee, Cheol Ung Choi, Jin Won Kim, Ji Young Park, Jin Oh Na, Byoung Geol Choi, Eung Ju Kim, Dong Joo Oh, Dong-Kyu Jin, Kanhaiya L. Poddar, Meera Kumari, Won-Yong Shin, Seung-Woon Rha, Hong Seog Seo, Seung Jin Lee, and Hong Euy Lim

Subjects
medicine.medical_specialty, business.industry, Internal medicine, Calcium channel, Dihydropyridine, medicine, Cardiology, Cardiology and Cardiovascular Medicine, Clopidogrel, business, medicine.drug
Published
2011
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41. AS-225 Lipoprotein(a) level and One-Year Clinical Outcome in Patients in Patients Undergoing Percutaneous Coronary Intervention with Drug-Eluting Stents

Author

Byoung Geol Choi, Dong-Kyu Jin, Meera Kumari, Won-Yong Shin, Se-Whan Lee, Chang Gyu Park, Jin Oh Na, Yun Kyung Kim, Ji Young Park, Seung Jin Lee, Cheol Ung Choi, Seung-Woon Rha, Hong Seog Seo, Jin Won Kim, Sang-Ho Park, Hong Euy Lim, Kanhaiya L. Poddar, and Dong Joo Oh

Subjects
Drug, medicine.medical_specialty, biology, business.industry, media_common.quotation_subject, medicine.medical_treatment, Percutaneous coronary intervention, Lipoprotein(a), Outcome (game theory), Internal medicine, medicine, biology.protein, Cardiology, In patient, Cardiology and Cardiovascular Medicine, business, media_common
Published
2011
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42. An Extremely Rare Variety of Anomalous Coronary Artery: Right Coronary Artery Originating From the Distal Left Circumflex Artery

Author

Dong-Kyu Jin, Seung Kyu Chung, Seung Jin Lee, Won-Yong Shin, Se-Whan Lee, and Sang-Ho Park

Subjects
Aorta, medicine.medical_specialty, business.industry, Angina pectoris, medicine.medical_treatment, Stent, Case Report, medicine.disease, Chest pain, Coronary circulation, Stenosis, medicine.anatomical_structure, medicine.artery, Right coronary artery, Internal medicine, Internal Medicine, medicine, Cardiology, Radiology, medicine.symptom, Coronary vessel anomalies, Cardiology and Cardiovascular Medicine, business, Perfusion, Artery
Abstract

A single coronary artery (SCA) is a rare congenital anomaly of the coronary circulation, which is often associated with myocardial ischemia and other congenital cardiac anomalies. A 77-year-old woman visited our hospital complaining of typical chest pain. Coronary angiography revealed an isolated SCA. The right coronary artery did not originate from the aorta, but instead emerged from the distal left circumflex artery, with significant stenosis at the proximal portion of the left anterior descending artery. A stent was successfully implanted at the culprit lesion. There was no perfusion defect detected by a cardiac SPECT study.

Published
2010
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43. Coronary Artery Thrombosis Associated With Paclitaxel in Advanced Ovarian Cancer

Author

Sang-Ho Park, Se Whan Lee, Seung Jin Lee, Jin Soo Byon, Won-Yong Shin, and Dong Kyu Jin

Subjects
medicine.medical_specialty, Aspirin, Paclitaxel, business.industry, Case Report, Tirofiban, Anterior Descending Coronary Artery, medicine.disease, Clopidogrel, Thrombosis, medicine.anatomical_structure, Coronary thrombosis, Internal medicine, Internal Medicine, medicine, Cardiology, cardiovascular diseases, Myocardial infarction, Radiology, Cardiology and Cardiovascular Medicine, business, medicine.drug, Artery
Abstract

A 63-year-old woman was diagnosed with ovarian cancer and peritoneal carcinomatosis. The day after paclitaxel was administered, an acute myocardial infarction occurred. Emergency coronary angiography revealed a filling defect in the left main coronary artery and total occlusion in the distal left anterior descending coronary artery, with no luminal irregularity or narrowing. Intravascular ultrasonography showed no significant plaque in the left main coronary artery. A thrombophilia work-up was negative, and the patient was treated with tirofiban, clopidogrel, and aspirin. The follow-up coronary angiogram showed that the occlusion of the distal obtuse marginal branch and distal left anterior descending artery had cleared. Paclitaxel has been associated with acute myocardial infarction. However, the pathogenesis of myocardial infarction associated with paclitaxel is not known. This case raises the possibility that paclitaxel can induce coronary artery thrombosis, resulting in myocardial infarction.

Published
2009
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44. The Association Between Left Ventricular Hypertrophy and Biomarkers in Patients on Continuous Ambulatory Peritoneal Dialysis

Author

Jong-Oh Yang, Sae-Yong Hong, Won-Yong Shin, Eun Young Lee, Dong-Kyu Jin, Seung Jin Lee, Sang-Ho Park, Hyo-Wook Gil, and Se-Whan Lee

Subjects
medicine.medical_specialty, medicine.medical_treatment, Peritoneal dialysis, Hematocrit, Left ventricular hypertrophy, End stage renal disease, chemistry.chemical_compound, Internal medicine, Internal Medicine, medicine, cardiovascular diseases, Aldosterone, medicine.diagnostic_test, Troponin T, business.industry, Continuous ambulatory peritoneal dialysis, medicine.disease, chemistry, Cardiology, Original Article, Hemodialysis, Cardiology and Cardiovascular Medicine, business, Type-B natriuretic peptide
Abstract

Background and Objectives: Left ventricular hypertrophy (LVH) is a major cardiovascular complication and an important predictor of mortality in patients with end stage renal disease. Some studies have shown that the serum aldosterone levels are correlated with LVH in non-diabetic patients undergoing hemodialysis. The objective of this study was to elucidate the relationships between serum biomarkers, including aldosterone, and echocardiographic findings, such as LVH, in patients on peritoneal dialysis. Subjects and Methods: Thirty patients on continuous ambulatory peritoneal dialysis (CAPD) for >12 months at Soonchunhyang University Cheonan Hospital were included. Transthoracic echocardiography was performed and the left ventricular mass index (LVMI) was calculated using the Devereux formula. Serum biomarkers {N-terminal pro B-type natriuretic peptide (NT-proBNP), troponin T, C-reactive protein, renin, and aldosterone} were measured. Results: Sixteen of 30 patients had LVH on the basis of the LVMI. The mean serum aldosterone level was 62.53±60.73 pg/mL (range, 5.03-250.68 pg/mL). LVH, on the basis of the LVMI, was not correlated with the serum aldosterone level. The serum aldosterone levels were not associated with echocardiographic findings, even with co-existing diabetes mellitus. The LVMI had a negative correlation with the hemoglobin (r=-0.405, p=0.029) and hematocrit (r=-0.374, p=0.042), and a positive correlation with NT-proBNP (r=0.560, p=0.002). The other biomarkers (renin, aldosterone, troponin T, and Creactive protein) were not correlated with the LVMI. The LVMI was correlated with the left atrium volume index (r=0.675, p

Published
2009
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45. Probable Left Atrial Myxoma Presenting as Concurrent Cerebral and Myocardial Infarctions

Author

Se-Whan Lee, Do-Hoi Kim, Seung Jin Lee, Ung Jeon, Won-Yong Shin, Sang-Ho Park, Young-Sin Cho, and Dong-Kyu Jin

Subjects
medicine.medical_specialty, Cerebral infarction, business.industry, Myxoma, medicine.disease, Chest pain, medicine.artery, Internal medicine, Right coronary artery, Middle cerebral artery, Occlusion, cardiovascular system, Internal Medicine, medicine, Cardiology, cardiovascular diseases, Myocardial infarction, medicine.symptom, Left Atrial Myxoma, Cardiology and Cardiovascular Medicine, business
Abstract

Concurrent cerebral and coronary artery embolization is a theoretically possible, but extremely rare complication of an atrial myxoma. We present a paitent with a left atrial mass (a probable myxoma) who presented with concurrent cerebral and myocardial infarctions due to emboli of tumor origin. An 84-year-old woman presented with an acute cerebral infarction of the middle cerebral artery territory. Several hours after admission, she complained of chest pain consistent with a myocardial infarction. Transthoracic and transesophageal echocardiographic studies revealed the presence of a large, mobile, heteroechoic mass with a few daughter nodules in the left atrium, compatible with a myxoma. Coronary angiography disclosed subtotal occlusion of the ramus intermedius branch and visible tumor vascularization adjacent to the right coronary artery. With medical treatment, including anticoagulation, the patient was stabilized and had an uneventful clinical course for the ensuing 6 months since discharge. (Korean Circ J 2008;38:622-626)

Published
2008
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46. A Case of Hypereosinophilic Syndrome Presenting as Pericardial Effusion, Myocarditis and Ascites

Author

Won-Yong Shin, Min-Hyok Jeon, Se-Whan Lee, Seungjin Lee, Sang-Ho Park, and Dong-Kyu Jin

Subjects
medicine.medical_specialty, Pathology, Myocarditis, Hypereosinophilic syndrome, business.industry, medicine.disease, Pericardial effusion, Eosinophilic infiltration, Internal medicine, Ascites, Internal Medicine, Cardiology, medicine, Eosinophilia, medicine.symptom, Cardiology and Cardiovascular Medicine, business, Organ system
Abstract

Hypereosinophilic syndrome is a clinical disorder characterized by peripheral eosinophilia and eosinophilic infiltration of multiple organ systems, including the cardiovascular system. The manifestations are variable, but cardiac involvement is the major source of morbidity and mortality, and several case reports have highlighted the various types of cardiac involvement. However, no reported case has simultaneously presented with pericardial effusion, myocarditis, and ascites. We report a case of a 28-year-old woman with hypereosinophilic syndrome involving both the heart and intra-abdominopelvic cavity. (Korean Circ J 2008;38:436-439)

Published
2008
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47. The Effect of Isosorbide Dinitrate Intravenous Injection on the Hemodynamics and Arterial Stiffness of Patients with Isolated Systolic Hypertension

Author

Dong Joo Oh, Chang Gyu Park, Won-Yong Shin, Dong Gyu Jin, Seung Jin Lee, Se Whan Lee, and Hong G. Seo

Subjects
medicine.medical_specialty, business.industry, Diastole, Hemodynamics, medicine.disease, Pulse pressure, Blood pressure, Anesthesia, Internal medicine, Internal Medicine, Cardiology, Arterial stiffness, Medicine, Isosorbide dinitrate, Cardiology and Cardiovascular Medicine, business, Pulse wave velocity, Dyslipidemia, medicine.drug
Abstract

Background and Objectives：In clinical practice, isolated systolic hypertension (ISH) is common for elderly patients and it is correlated with cardiovascular mortality. However, it is difficult to control the systolic blood pressure (BP) with using the currently available antihypertensive drugs without influencing the diastolic BP. The purpose of this study is to evaluate the effect of isosorbide dinitrate on the central BP and arterial stiffness by performing invasive testing. Subjects and Methods：Thirty subjects who had ISH and who underwent coronary angiography were enrolled in this study. The invasively measured central blood pressure, pulse pressure and pulse wave velocity were obtained after isosorbide dinitrate was injected intravenously and these values were analyzed in relation to age, gender, the body mass index, diabetes mellitus, dyslipidemia, smoking and the current dosing with antihypertensive drugs. Results：One minute after intravenous injection of isosorbide dinitrate, the central systolic BP was significantly decreased compare to the baseline value (142.23±12.32 mmHg vs 164.97±14.43 mmHg, respectively, p

Published
2007
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48. Assessment of Normal Mitral Annulus Velocity by Doppler Tissue Imaging

Author

Won Yong Shin, Chan Il Moon, Yong Bum Cho, Jae Woong Choi, and Chang Seob Song

Subjects
medicine.medical_specialty, Doppler tissue imaging, business.industry, Diastole, musculoskeletal system, Flow velocity, Peak velocity, Internal medicine, Reference values, Healthy volunteers, cardiovascular system, Cardiology, Medicine, Early diastolic, cardiovascular diseases, Mitral annulus, business
Abstract

Background and Objectives:The objective of this study was to establish the reference values of mitral annulus velocity using Doppler tissue imaging, which has been previously thought of as a new parameter of left ventricular diastolic function. Many parameters, including the mitral inflow, that have been used in the evaluation of left ventricular diastolic function are affected by several conditions, sometimes limiting the information they can provide about left ventricular diastolic function. The knowledge of mitral annulus velocity by Doppler tissue imaging will provide new guidelines for the evaluation of diastolic function. However, reference values in normal systems and changes according to age have not been fully evaluated. Methods:We examined 246 patients lacking symptoms related to the either cardiac systolic or diastolic dysfunction, as well as 80 healthy volunteers, according to an age. Early (E) and late (A) transmitral flow velocity and the ratio of early to late peak velocity (E/A) were obtained by pulsed Doppler echocardiography. Early diastolic velocity of mitral annulus (E’) and peak atrial systolic velocity of mitral annulus(A’) were obtained from the medial (or septal) corner of the mitral annulus and subsequently from the lateral corner by Doppler tissue imaging. We obtained E’, A’ and the ratio of E’ to A’(E’/A’) and E/E’ according to age. Results:E’ from the medial corner was the highest in subjects in their twenties and declined gradually and A’ from the medial corner was the lowest in the same age group and gradually increased. The E’/A’ ratio from the medial corner was the highest in subjects in their twenties, declined gradually and reversed in subjects in their forties. E’, A’ and E’/A’ from the lateral corner were similar to the medial corner however the E’/A’ was reversed in subjects in their fifties. The E/E’ from the medial and lateral corner was the lowest in subjects in their twenties and gradually increased with age. In our comparison between the transmitral flow velocity and mitral annulus velocity, there was a good relationship between E/A and E’/A’ (p=0.01). Conclusion:We measured the reference values of mitral annulus velocity by Doppler tissue imaging and E/E、 according to an age. (Korean Circulation J 2001;31(7):662-669)

Published
2001
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49. A Case of Marfan Syndrome with Dissecting Aortic Aneurysm Involving Thoracic and Abdominal Aorta

Author

Young Joo Kwon, Tae Myung Choi, Sung Koo Kim, Won-Yong Shin, Jong Yong Oh, Seog Ki Yun, Kwang-Hee Lee, and Cheol Hyun Kim

Subjects
Marfan syndrome, Aortic dissection, medicine.medical_specialty, Connective Tissue Disorder, Aorta, business.industry, Abdominal aorta, medicine.disease, Surgery, Aortic aneurysm, medicine.artery, Descending aorta, Internal medicine, Ascending aorta, cardiovascular system, Cardiology, Medicine, cardiovascular diseases, business
Abstract

Marfan syndrome is an inheritable connective tissue disorder with protean clinical manifestations involving the ocular, skeletal and cardiovascular system. It is well estabalished that the major cause of morbidity in Marfan syndrome is the dilation of the aortic root as well as the associated aortic regurgitation and dissection. Aortic dissection usually begins just above the coronary ostia in the ascending aorta and extends the entire length of aorta. We report a rare case of Marfan syndrome with aortic dissection which begins distal to the left subclavian artery in the descending aorta.

Published
1998
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50. A Case of Atrial Septal Aneurysm with Recurrent Atrial Fibrillation and Cerebellar Infarction

Author

Min Su Hyon, Sung Koo Kim, Kwang-Hee Lee, Jong Yong Oh, Jong Dae Bong, Young Joo Kwon, Cheo Hyun Kim, Won-Yong Shin, Sung Han Bae, Ki Won Jeon, Moon Soo Kang, and Tae Myung Choi

Subjects
medicine.medical_specialty, Atrial septal aneurysm, business.industry, Internal medicine, Recurrent atrial fibrillation, P wave, Cardiology, Medicine, Cerebellar infarction, business
Published
1998
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