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- 저자 : ( Mineok Chang ) (검색결과 3 건)
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S-256 NT- proBNP complements the ACEF Score in Predicting 3-Year Mortality following AMI
( Da Won Kim ),( Kwan Yong Lee ),( Mineok Chang ),( Young Choi ),( Ha-Wook Park ),( Young Soo Lee ),( Young Kyoung Sa ),( Jaeho Byeon ),( Tae-Hoon Kim ),( Yoon Seok Koh ),( Hun-Jun Park ),( PumJoon Ki 대한내과학회 2016 대한내과학회 추계학술대회 Vol.2016 No.1
Background: The ACEF score and NT-proBNP are useful in predicting mortality in ACS. But few data exists regarding acute MI. We aimed to use ACEF score and NT-proBNP level to predict risk of long term mortality after AMI. Methods: We enrolled AMI patients who had PCI between January 2004 and December 2009 from 9 university hospitals in South Korea. Patients were ACEF scored and serum NT-proBNP was checked. The primary endpoint was all-cause mortality during a median follow-up of 3.38 years. Results: Of 3217 patients,the all-cause mortality was 18.59% and was significantly related to higher ACEF scores (p<0.001). Higher NT-proBNP level was associated with increased mortality (p<0.001). In a Cox proportional hazards model, the independent predictors of all-cause death included the ACEF score[adjusted HR 1.829, 95% CI 1.603-2.087; p<0.001] and NT-proBNP[adjusted HR 1.657, 95% CI 1.461-1.879; p<0.001]. When NT-proBNP was added to the individual components of the ACEF score,it displaced many factors in the score. The Kaplan-Meier survival curve related to whether the patients had a below or above-median ACEF score and a below or above-median NT-proBNP level (pooled over strata,log rank 301.8, p<0.001). The combination of ACEF score and NT-proBNP improved risk prediction for mortality[AUC, 0.75 (95% CI, 0.734-0.765); p<0.001], which significantly exceeded ACEF score and NT-proBNP (p<0.001). Conclusions: NT-proBNP complements ACEF score for predicting long term mortality.Inclusion of NT-proBNP is useful in risk-stratifying patients following AMI.
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Roh, Jae-Hyung,Kim, Young-Hak,Kang, Hee Jun,Lee, Pil Hyung,Yoon, Sung-Han,Chang, Mineok,Ahn, Jung-Min,Park, Duk-Woo,Kang, Soo-Jin,Lee, Seung-Whan,Lee, Cheol Whan,Park, Seong-Wook,Park, Seung-Jung Williams & Wilkins Co 2018 Medicine Vol.97 No.42
<P><B>Abstract</B></P><P>This study aimed to investigate the feasibility and safety of the modified balloon crush technique.</P><P>The conventional crush technique accompanies difficult and suboptimal final kissing balloon inflation (FKI)</P><P>In a single-center percutaneous coronary intervention registry, 515 patients with 515 bifurcation lesions were treated with the modified balloon technique (n = 70) or the conventional crush technique (n = 445). In contrast to the conventional crush technique, where the implanted side branch (SB) stent is crushed by expansion of the main branch (MB) stent, the modified balloon crush technique uses balloon crushing and additional SB ballooning across the crushed SB stent before MB stenting to facilitate FKI. The primary outcome of interest was major adverse cardiovascular event (MACE), a composite of all-cause death, spontaneous myocardial infarction, and target vessel revascularization.</P><P>Baseline clinical and angiographic characteristics were similar between the 2 treatment groups. FKI had comparable success rates in both groups (97.1% for the modified balloon group and 98.4% for the conventional crush group; <I>P</I> = .35). There were no differences in procedure time, fluoroscopic time, or contrast amount between the 2 groups. At 1-year follow up, the cumulative MACE incidences were comparable between the 2 groups (7.3% vs 8.8%; <I>P</I> = .73). The incidence of target lesion revascularization (TLR) was significantly lower after the modified balloon crush technique compared with the conventional crush technique (0% vs 5.6%; <I>P</I> = .048).</P><P>The modified balloon crush technique appears to be a feasible and safe alternative to the conventional crush technique with the potential to reduce the revascularization rate.</P>
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Park, Gyung-Min,Kim, Young-Hak,Yun, Sung-Cheol,Ahn, Jung-Min,Choi, Hyo-In,Roh, Jae-Hyung,Lee, Pil Hyung,Chang, Mineok,Lee, Sang Gyu,Jo, Min-Woo,Park, Duk-Woo,Kang, Soo-Jin,Lee, Seung-Whan,Lee, Cheol W Society of Nuclear Medicine 2016 The Journal of nuclear medicine Vol.57 No.9
<P>Little data are available to compare the clinical implications of coronary angiography (CAG) or myocardial perfusion imaging (MPI) as an initial evaluation for stable coronary artery disease (CAD). Methods: From national health insurance claims data in South Korea, patients aged 18 y or older without a known history of CAD, who underwent CAG or MPI for the diagnosis of stable CAD between 2009 and 2013, were enrolled. Patients were divided into CAG (n = 117,134) and MPI (n = 19,932) groups. The primary endpoint, defined as a composite of all cause death and myocardial infarction, was compared by a propensity score analysis between the 2 groups. Results: There was a significant increase (39%) in the annual rate of CAG from 23,985 in 2009-2010 to 33,373 in 2012-2013. However, a substantial reduction (41%) in the annual MPI rate was also noted from 6,389 in 2009-2010 to 3,790 in 2012-2013. During the follow-up period (median, 2.4 y; interquartile range, 1.5-3.5), coronary revascularization was more frequently performed in the CAG group (adjusted hazard ratio [aHR] of CAG, 24.15; 95% confidence interval [CI], 19.66-29.68; P < 0.001). However, the incidence of the primary endpoint was significantly higher in the CAG group (aHR, 1.26; 95% CI, 1.17-1.36; P < 0.001). The individual end-points of death (aHR, 1.16; 95% CI, 1.06-1.25; P = 0.001) and myocardial infarction (aHR, 1.95; 95% CI, 1.60-2.36; P < 0.001) were also higher in the CAG group. Conclusion: As an initial diagnostic test in patients with stable CAD, MPI is associated with a better clinical outcomes than CAG.</P>
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