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Jeehoon Kang,Jung-Kyu Han,Do-Yoon Kang,Chengbin Zheng,Han-Mo Yang,Kyung Woo Park,Hyun-Jae Kang,Bon-Kwon Koo,Hyo-Soo Kim 대한심장학회 2020 Korean Circulation Journal Vol.50 No.1
Background and Objectives: The impact of SYNergy between percutaneous coronary intervention with TAXus and cardiac surgery score (SS) and SS II in patients who receive percutaneous coronary intervention with second-generation everolimus-eluting stents (EES) has not been fully validated. Methods: The SS, SS II were calculated in 1,248 patients with left main and/or 3-vessel disease treated with EES. Patient-oriented composite endpoint (POCE; all-cause death, any myocardial infarction (MI), any revascularization) and target lesion failure (TLF: cardiac death, target-vessel MI, target lesion revascularization) were analyzed. Results: The mean SS was 21.1±9.6. Three-year POCE increased according to the SS group (15.2% vs. 19.9% vs. 27.4% for low (≤22), intermediate (≥23, ≤32), high (≥33) SS groups, p<0.001). By multivariate Cox proportional hazard analysis, SS group was an independent predictor of 3-year POCE (hazard ratio, 1.324; 95% confidence interval, 1.095–1.601; p=0.004). The receiver operating characteristic curves revealed that the SS II was superior to the SS for 3-year POCE prediction (area under the curve [AUC]: 0.611 vs. 0.669 for SS vs. SS II, p=0.019), but not for 3-year TLF (AUC: 0.631 vs. 0.660 for SS vs. SS II, p=0.996). In subgroup analysis, SS II was superior to SS in patients with cardiovascular clinical risk factors, and in those presenting as stable angina. Conclusions: The usefulness of SS and SS II was still valid in patients with left main and/or 3-vessel disease. SS II was superior to SS for the prediction of patient-oriented outcomes, but not for lesion-oriented outcomes.
Jeehoon Kang,In-Chang Hwang,Chang-Hwan Yoon 대한중환자의학회 2012 Acute and Critical Care Vol.27 No.4
The ergonovine provocation test is often used in diagnosing variant angina. Most patients with an ergonovine-induced coronary artery spasm respond promptly to intracoronary nitroglycerin administration within 3 to 5 minutes. However, in a few patients ergonovine results in serious cardiovascular complications due to intractable coronary artery spasm. We report a case of a severe and medically intractable coronary spasm induced by ergonovine, followed by cardiac arrest. Aided by percutaneous cardiopulmonary support (PCPS) and mechanical ventilation, the patient could survive after four days of hospitalization despite a recurrent vasospasm. Recovery was largely attributed to full supportive care and the use of PCPS.
Kang, Jeehoon,Yun, Ji-Yeon,Hur, Jin,Kang, Jin-A,Choi, Jae-Il,Ko, Seung Bum,Lee, Jaewon,Kim, Ju-Young,Hwang, In-Chang,Park, Young-Bae,Kim, Hyo-Soo Oxford University Press 2014 Cardiovascular research Vol.104 No.1
<P><B>Aims</B></P><P>From our previous clinical trials, intracoronary infusion of granulocyte-colony stimulating factor (G-CSF)-mobilized peripheral blood mononuclear cells (<SUP>mob</SUP>PBMCs) proved to be effective in improving myocardial contractility and reducing infarct volume in acute myocardial infarction. We tested the effect of priming <SUP>mob</SUP>PBMCs with erythropoietin (EPO) to augment its therapeutic efficacy.</P><P><B>Methods and results</B></P><P><SUP>mob</SUP>PBMCs were obtained from healthy volunteers after a 3-day subcutaneous injection of G-CSF (10 μg/kg). About 40% of <SUP>mob</SUP>PBMCs were EPO receptor (EPOR) (+) and responded to 6 h EPO-priming (10 IU/mL) by increasing the expression of vasculogenic factors (i.e. IL8, IL10, bFGF, PDGF, MMP9) and adhesion molecules (i.e. integrin αV, β1, β2, β8) through the JAK2 and Akt pathway. These responses were also observed in PBMCs from elderly patients with coronary disease. The conditioned media from EPO-primed <SUP>mob</SUP>PBMCs contained various cytokines such as IL8, IL10, TNFα, and PDGF, which enhanced the migration and tube formation capability of endothelial cells. EPO-primed <SUP>mob</SUP>PBMCs also showed increased adhesion on endothelial cells or fibronectin. Augmented vasculogenic potential of EPO-primed <SUP>mob</SUP>PBMCs was confirmed in a Matrigel plug assay, ischaemic hindlimb, and myocardial infarction models of athymic nude mice. There were two action mechanisms: (i) cellular effects confirmed by direct incorporation of human <SUP>mob</SUP>PBSCs into mouse vasculature and (ii) indirect humoral effects confirmed by the therapeutic effect of the supernatant of EPO-primed <SUP>mob</SUP>PBMCs.</P><P><B>Conclusion</B></P><P>Brief <I>ex vivo</I> EPO-priming is a novel method to augment the vasculogenic potential of human <SUP>mob</SUP>PBMCs, which would help to achieve better results after intracoronary infusion in myocardial infarction patients.</P>
Kang, Jeehoon,Han, Jung-Kyu,Ahn, Youngkeun,Chae, Shung Chull,Kim, Young Jo,Chae, In-ho,Hur, Seung-Ho,Seong, In-Whan,Chae, Jei-Keon,Cho, Myeong Chan F K SCHATTAUER VERLAGSGESELLSCHAFT MBH 2018 Thrombosis and Haemostasis Vol.118 No.3
<P>Third-generation P2Y(12) inhibitors (prasugrel, ticagrelor) are recommended in acute myocardial infarction (AMI). We aimed to evaluate the efficacy and safety of third-generation P2Y(12) inhibitors in East Asian AMI patients. From the Korean AMI Registry, 9,355 patients who received dual antiplatelet agent (aspirin with clopidogrel [AC], 6,444 [70.5%] patients; aspirin with prasugrel [AP], 1,100 [11.8%] patients; or aspirin with ticagrelor [AT], 1,811 [19.4%] patients) were analysed. In-hospital endpoints were all-cause mortality or bleeding events during admission and 1-year endpoints were major adverse cardiac and cerebrovascular events(MACCE) andmajor bleedingevents. Regardingin-hospital events, AP andAT showed similar all-causemortality rates but higher bleeding event rates comparedwith AC. This trend was extended to 1-year endpoints; Cox regression analysis showed that thirdgeneration P2Y(12) inhibitors had significantly higher bleeding risk (AP vs. AC: hazard ratio [HR], 2.14; 95% confidence interval [CI], 1.53-2.99; p < 0.001; AT vs. AC: HR, 2.26; 95% CI, 1.73-2.95; p < 0.001). A propensity scorematched tripletof 572 patients showed similar 1year MACCE and higher bleeding events with third-generation P2Y(12) inhibitors (2.1 vs. 2.6 vs. 2.1%, p = 0.790 for MACCE and 3.1 vs. 8.0 vs. 8.0%, p < 0.001 for bleeding events, in AC, AP andAT groups, respectively). Inverse probabilityweighted regression analysis and pooled analysis after randomly imputing missing variables showed consistent results. Collectively, prasugrel and ticagrelor showed similar rates of 1-year MACCE, but a higher rate of bleeding events, compared with clopidogrel in Korean AMI patients. Further studies are warranted to adapt Western guidelines on third-generation P2Y(12) inhibitors for East Asians.</P>
Kang, Jeehoon,Park, Kyung,Palmerini, Tullio,Stone, Gregg,Lee, Michael,Colombo, Antonio,Chieffo, Alaide,Feres, Fausto,Abizaid, Alexandre,Bhatt, Deepak,Valgimigli, Marco,Hong, Myeong-Ki,Jang, Yangsoo,Gi Georg Thieme Verlag KG 2019 Thrombosis and Haemostasis Vol.119 No.1
<P> Background Prolonged dual anti-platelet therapy (DAPT) is intended to reduce ischaemic events, at the cost of an increased bleeding risk in patients undergoing percutaneous coronary intervention (PCI). In this study, we evaluated whether race influences the ischaemia/bleeding risk trade-off.</P><P> Methods We searched for randomized clinical trials (RCTs) comparing DAPT duration after PCI. To compare the benefit or harm between DAPT duration by race, individual patient-level landmark meta-analysis was performed after discontinuation of the shorter duration DAPT group in each RCT. The primary ischaemic endpoint was major adverse cardiac events (MACEs), and the primary bleeding endpoint was major bleeding events (clinicaltrials.gov NCT03338335).</P><P> Results Seven RCTs including 16,518 patients (8,605 East Asians, 7,913 non-East Asians) were pooled. MACE occurred more frequently in non-East Asians (0.8% vs. 1.8%, p < 0.001), while major bleeding events occurred more frequently in East Asians (0.6% vs. 0.3%, p = 0.001). In Cox proportional hazards model, prolonged DAPT significantly increased the risk of major bleeding in East Asians (hazard ratio [HR], 2.843, 95% confidence interval [CI], 1.474-5.152, p = 0.002), but not in non-East Asians (HR, 1.375, 95% CI, 0.523-3.616, p = 0.523). East Asians had a higher median probability risk ratio of bleeding to ischaemia (0.66 vs. 0.15), and the proportion of patients with higher probability of bleeding than ischaemia was significantly higher in East Asians (32.3% vs. 0.4%, p < 0.001).</P><P> Conclusion We suggest that the ischaemia/bleeding trade-off may be different between East Asians and non-East Asians. In East Asians, prolonged DAPT may have no effect in reducing the ischaemic risk, while significantly increases the bleeding risk.</P>
KANG, Ikjae,SEO, Hwi Won,PARK, Changhoon,OH, Yeonsu,LEE, Jeehoon,YOU, Ok Heui,KIM, Sung-Hoon,GOTTSCHALK, Marcelo,CHAE, Chanhee The Japanese Society of Veterinary Science 2014 The Journal of veterinary medical science Vol.76 No.1
<P><B>ABSTRACT</B></P><P>The objective of this study was to develop digoxigenin-labeled <I>in situ</I> hybridization (ISH) for the detection of <I>Streptococcus suis</I> in naturally infected pigs with polyserositis and to compare it with biotinylated ISH. Digoxigenin-labeled hybridization signals for <I>S. suis</I> were observed in cells that had infiltrated the fibrous polyserositis and microcolonies in the blood vessels. Mock hybridization showed no hybridization signals for endogenous digoxigenin. Biotinylated hybridization signals for <I>S. suis</I> were observed in cells that had infiltrated the fibrous polyserositis. However, similar hybridization signals were also observed in the fibrous inflammatory area using mock hybridization for endogenous biotin. The present study demonstrated that digoxigenin-labeled ISH is a valuable diagnostic tool for specific detection of <I>S. suis</I> in polyserositic tissues without nonspecific reactions compared with biotinylated ISH.</P>