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Shi Hyun Rhew,안영근,김민철,Su Young Jang,Kyung Hoon Cho,Seung Hwan Hwang,Min Goo Lee,고점석,Keun Ho Park,심두선,윤남식,윤현주,김계훈,홍영준,박형욱,김주한,정명호,조정관,박종춘,강정채 전남대학교 의과학연구소 2012 전남의대학술지 Vol.48 No.1
The present study aimed to investigate the clinical characteristics and 1-year outcomes of acute myocardial infarction (AMI) patients without significant stenosis on a coronary angiogram comparison with the clinical characteristics and outcomes of patients with significant coronary artery stenosis. A total of 1,220 patients with AMI were retrospectively classified into Group I (≥50% diameter stenosis, n=1,120) and Group II (<50%, n=100). Group II was further divided into two subgroups according to the underlying etiology: cryptogenic (Group II-a, n=54) and those with possible causative factors (Group II-b, n=46). Patients in Group II were younger, were more likely to be women,and were less likely to smoke and to have diabetes mellitus than were patients in Group I. The levels of cardiac enzymes, LDL-cholesterol levels, and the apo-B/A1 ratio were lower in Group II. However, 1-month and 12-month rates of major adverse cardiac events (MACE) were not significantly different between the two groups. The Group II-b subgroup comprised 29 patients with vasospasm, 11 with myocardial bridge, and 6 with spontaneous thrombolysis. Left ventricular ejection fraction and creatinine clearance were lower and levels of N-terminal pro-brain natriuretic peptide (NT-proBNP) and high-sensitivity C-reactive protein (hs-CRP) were higher in Group II-a than in Group II-b. However, outcomes including MACE and mortality at 12 months were not significantly different between the two subgroups. The 1-year outcomes of patients in Group II were similar to those of patients in Group I. The clinical outcomes in Group II-a were also similar to those of Group II-b, although the former group showed higher levels of NT-proBNP and hs-CRP.
Rhew, Shi Hyun,Ahn, Youngkeun,Kim, Min Chul,Jang, Su Young,Cho, Kyung Hoon,Hwang, Seung Hwan,Lee, Min Goo,Ko, Jum Suk,Park, Keun Ho,Sim, Doo Sun,Yoon, Nam Sik,Yoon, Hyun Ju,Kim, Kye Hun,Hong, Young Jo Chonnam National University Medical School 2012 CMJ Vol.48 No.1
<P>The present study aimed to investigate the clinical characteristics and 1-year outcomes of acute myocardial infarction (AMI) patients without significant stenosis on a coronary angiogram comparison with the clinical characteristics and outcomes of patients with significant coronary artery stenosis. A total of 1,220 patients with AMI were retrospectively classified into Group I (≥50% diameter stenosis, n=1,120) and Group II (<50%, n=100). Group II was further divided into two subgroups according to the underlying etiology: cryptogenic (Group II-a, n=54) and those with possible causative factors (Group II-b, n=46). Patients in Group II were younger, were more likely to be women, and were less likely to smoke and to have diabetes mellitus than were patients in Group I. The levels of cardiac enzymes, LDL-cholesterol levels, and the apo-B/A1 ratio were lower in Group II. However, 1-month and 12-month rates of major adverse cardiac events (MACE) were not significantly different between the two groups. The Group II-b subgroup comprised 29 patients with vasospasm, 11 with myocardial bridge, and 6 with spontaneous thrombolysis. Left ventricular ejection fraction and creatinine clearance were lower and levels of N-terminal pro-brain natriuretic peptide (NT-proBNP) and high-sensitivity C-reactive protein (hs-CRP) were higher in Group II-a than in Group II-b. However, outcomes including MACE and mortality at 12 months were not significantly different between the two subgroups. The 1-year outcomes of patients in Group II were similar to those of patients in Group I. The clinical outcomes in Group II-a were also similar to those of Group II-b, although the former group showed higher levels of NT-proBNP and hs-CRP.</P>
김성수,김지은,Shi Hyun Rhew,김주한,조정관,Young Wook Jeong,Seung Hun Lee,Jong Chun Park,박혁진,임이랑,정명호 전남대학교 의과학연구소 2014 전남의대학술지 Vol.50 No.2
An aneurysm of the subclavian artery is rare. Recently, we experienced a case of a rupturedsubclavian artery aneurysm presenting as hemoptysis. The patient had experiencedatypical chest discomfort, and computed tomography (CT) revealed a smallaneurysm of the left subclavian artery (SCA). Hemoptysis occurred 2 weeks later. Follow-up CT showed a ruptured aneurysm at the proximal left SCA. Endovasculartreatment with a graft stent was performed by bilateral arterial access with a 12-Frintroducer sheath placed via cutdown of the left axillary artery and an 8-Fr sheath inthe right femoral artery. A self-expandable Viabahn covered stent measuring 13×5 mmwas introduced retrogradely via the left axillary sheath and was positioned under contrastguidance with an 8-Fr JR4 guide through the femoral sheath. After the procedure,hemoptysis was not found, and the 3-month follow-up CT showed luminal patency ofthe left proximal SCA and considerable reduction of the hematoma.
Kim, Min Chul,Ahn, Youngkeun,Rhew, Shi Hyun,Jeong, Myung Ho,Kim, Ju Han,Hong, Young Joon,Chae, Shung Chull,Kim, Young Jo,Hur, Seung Ho,Seong, In Whan,Chae, Jei Keon International Heart Journal Association 2012 International heart journal Vol.53 No.3
<P>Some patients with non-ST-elevation myocardial infarction (NSTEMI) have a total occlusive infarct-related artery. However, the long-term prognosis of these patients is uncertain, particularly for those who underwent an early invasive strategy. The aim of this study was to determine the clinical impact of total occlusion (TO) of an infarct-related artery (IRA) in these patients. A total of 2,094 patients with NSTEMI who underwent an early invasive strategy with percutaneous coronary intervention (PCI) in the Korea Acute MI Registry (KAMIR) were analyzed (TO group; 665 patients, and non-TO group; 1,429 patients).In-hospital and one-year clinical outcomes were compared between the two groups. The left circumflex (42.9%) and right coronary artery (31.9%) were the major IRA in the TO group, while the left anterior descending artery was more common as an IRA in the non-TO group (44.1%). In-hospital complications including death and cardiogenic shock occurred frequently in the TO group. Also, the rates of one-month and 12-month adverse cardiac outcomes were higher in the TO group. In the Cox-proportional hazard model, TO in IRA predicted 12-month all-cause death. In conclusion, NSTEMI patients with TO in IRA showed worse short- and long-term clinical outcomes compared with those of non-TO patients.</P>