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      • S-271 Comparison of 5-year Clinical Outcomes between Stabilized Myocardial Infarction and Angina Pectoris

        ( Hanbeol Jang ),( Ju Yeol Baek ),( Yong Mo Yang ),( Won Ik Lee ),( Seung-Woon Rha ),( Se Yeon Choi ),( Byoung Geol Choi ),( Jae Kyeong Byun ),( Hu Li ),( Jun Hyuk Kang ),( Eun Jin Park ),( Sung Hun P 대한내과학회 2016 대한내과학회 추계학술대회 Vol.2016 No.1

        Backgrounds:?Clinical impact of stabilized myocardial infarction (MI) following successful percutaneous coronary intervention (PCI) after 1 year is not clearly elucidated yet.?Methods:?We pooled 3,583 patients underwent PCI with drug-eluting stents (DESs). Of them, 658 was ST-elevation MI (STEMI), 632 non-ST segment elevation MI (NSTEMI), 1,297 unstable angina (UA), and 996 stable angina (SA). We compared 0-1 year and 1-5 years composite of cardiac death (CD) and MI among 4 groups.?Results:?With survival analysis of 0-1 year clinical follow up, a stepwise increase of the composite of CD and MI was observed in the transition from SA to STEMI. (SA; 1.2% vs. UA; 1.4% vs. NSTEMI; 5.2% vs. STEMI; 8.1%; Log-Rank <0.001). Even in the comparison of 1-5 year clinical outcomes between 4 groups, there was the same pattern of transition (SA; 1.7% vs. UA; 2.0% vs. NSTEMI; 3.9% vs. STEMI; 4.3%; Log-Rank=0.002, Figure). After Unadjusted cox-proportional analysis, STEMI and NSTEMI were independently associated with greater risk of 1-5 year CD or MI rather than SA (HR 2.70; 95% CI 1.361 to 5.364; p=0.004, HR 2.45; 95% CI 1.201 to 5.001; p=0.014), whereas UA were not significantly influential on CD or MI.?Conclusions:?Across the clinical spectrum of different coronary artery disease, STEMI and NSTEMI were associated with a greater risk of long-term CD or MI at 1 year. Even after stabilized by PCI in STEMI and NSTEMI patients beyond 1 year, the incidence of CD or MI was still higher than that of the patients with UA and SA

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        The successful clinical outcomes of pregnant women with advanced chronic kidney disease

        ( Ji Yeun Chang ),( Hanbeol Jang ),( Byung Ha Chung ),( Young Ah Youn ),( In Kyung Sung ),( Yong Soo Kim ),( Chul Woo Yang ) 대한신장학회 2016 Kidney Research and Clinical Practice Vol.35 No.2

        Background: Successful pregnancy outcomes in patients with advanced chronic kidney disease (CKD) are increasingly common in Western countries. However, in Korea, the available literature addressing this clinical issue is scarce. Methods: We reviewed 5 successful parturitions [1 patient with Stage 5 CKD and 4 with maintenance hemodialysis (HD)] at Seoul St. Mary``s Hospital over 3 years and investigated changes in dialysis prescription, anemia management, and the incidence of maternal and neonatal complications. Results: There were no maternal or neonatal deaths in this cohort. The mean age at the time of conception and delivery was 35.8 ± 3.7 and 36.2 ± 3.5 years, respectively. Dialysis patients received more frequent and intensified HD during pregnancy, 20.0 ± 5.7 h/wk of HD over 5 visits with the ultrafiltration dose maintained between 1 and 2 kg per session. All patients received erythropoietin-stimulating agents and iron replacement therapy during pregnancy. The mean hematocrit was 33.1 ± 1.9% before pregnancy and was well maintained during gestation (33.9 ± 3.8% at the first trimester, 29.2 ± 4.2% at the second trimester, and 33.6 ± 8.7% at delivery). The mean gestation period was 32.7 ± 4.7 weeks, with 60% of patients experiencing premature delivery. The primary maternal complication was pre-eclampsia; 3 women developed pre-eclampsia and underwent emergency cesarean sections. Most neonatal complications were related to preterm birth. Conclusion: Dialysis-related care and general clinical management improved the clinical outcome of pregnancy for patients with advanced CKD.

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