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RISS 인기검색어
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- 저자 : Briain O Hartaigh (검색결과 2 건)
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한동희,장혁재,Briain O Hartaigh,이지현,Asim Rizvi,박효은,최수연,성지동 연세대학교의과대학 2017 Yonsei medical journal Vol.58 No.1
Purpose: The 2013 American College of Cardiology (ACC)/American Heart Association (AHA) cholesterol management guidelinesadvocate the use of statin treatment for prevention of cardiovascular disease. We aimed to assess the usefulness of coronary artery calcium (CAC) for stratifying potential candidates of statin use among asymptomatic Korean individuals. Materials and Methods: A total of 31375 subjects who underwent CAC scoring as part of a general health examination were enrolledin the current study. Statin eligibility was categorized as statin recommended (SR), considered (SC), and not recommended(SN) according to ACC/AHA guidelines. Cox regression analysis was employed to estimate hazard ratios (HR) with 95% confidentialintervals (CI) after stratifying the subjects according to CAC scores of 0, 1–100, and >100. Number needed to treat (NNT) to prevent one mortality event during study follow up was calculated for each group. Results: Mean age was 54.4±7.5 years, and 76.3% were male. During a 5-year median follow-up (interquartile range; 3–7), there were 251 (0.8%) deaths from all-causes. A CAC >100 was independently associated with mortality across each statin group after adjusting for cardiac risk factors (e.g., SR: HR, 1.60; 95% CI, 1.07–2.38; SC: HR, 2.98; 95% CI, 1.09–8.13, and SN: HR, 3.14; 95% CI, 1.08–9.17). Notably, patients with CAC >100 displayed a lower NNT in comparison to the absence of CAC or CAC 1–100 in SC and SN groups. Conclusion: In Korean asymptomatic individuals, CAC scoring might prove useful for reclassifying patient eligibility for receiving statin therapy based on updated 2013 ACC/AHA guidelines.
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신동금,정보영,조익성,Briain o Hartaigh,문희선,이혜영,황의석,박진규,엄재선,박희남,이문형 연세대학교의과대학 2015 Yonsei medical journal Vol.56 No.6
Purpose: Electric cardioversion has been successfully used in terminating symptomatic atrial fibrillation (AF). Nevertheless, large-scale study about the acute cardiovascular events following electrical cardioversion of AF is lacking. This study was performed to evaluate the incidence, risk factors, and clinical consequences of acute cardiovascular events following electrical cardioversion of AF. Materials and Methods: The study enrolled 1100 AF patients (mean age 60±11 years) who received cardioversion at four tertiary hospitals. Hospitalizations for stroke/transient ischemic attack, major bleedings, and arrhythmic events during 30 days post electriccardioversion were assessed. Results: The mean duration of anticoagulation before cardioversion was 95.8±51.6 days. The mean International Normalized Ratioat the time of cardioversion was 2.4±0.9. The antiarrhythmic drugs at the time of cardioversion were class I (45%), amiodarone (40%), beta-blocker (53%), calcium-channel blocker (21%), and other medication (11%). The success rate of terminating AF via cardioversion was 87% (n=947). Following cardioversion, 5 strokes and 5 major bleedings occurred. The history of stroke/transient ischemic attack (OR 6.23, 95% CI 1.69–22.90) and heart failure (OR 6.40, 95% CI 1.77–23.14) were among predictors of thromboembolicor bleeding events. Eight patients were hospitalized for bradyarrhythmia. These patients were more likely to have had a lower heart rate prior to the procedure (p=0.045). Consequently, 3 of these patients were implanted with a permanent pacemaker. Conclusion: Cardioversion appears as a safe procedure with a reasonably acceptable cardiovascular event rate. However, to preventthe cardiovascular events, several risk factors should be considered before cardioversion.
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