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S-317 Influence of Additional Ballooning after Stent Implantation in Acute Myocardial Infarction.
( Hanna Joung ),( Ju Yeol Baek ),( Yong Mo Yang ),( Won Ik Lee ),( Seung-woon Rha ),( Byoung Geol Choi ),( Seung Won Jin ),( Byung Ryul Cho ),( Moo Hyun Kim ),( Doo-il Kim ),( Myung-ho Jeong ),( Sang 대한내과학회 2016 대한내과학회 추계학술대회 Vol.2016 No.1
Objective:?Most studies evaluating the benefit and risk of additional ballooning after stent implantation have involved patients with stable angina. However, it may be questionable in the context of patients presenting with acute myocardial infarction (AMI). We evaluated the clinical outcomes of additional ballooning after stent implantation in the patients who underwent AMI. Methods:?A total of 1618 AMI patients in the Korea TRI registry, a retrospective multicenter registry with 4890 patients who underwent percutaneous coronary intervention in 2009 at 12 centers were grouped according to performing additional ballooning (AB; N=814) and non-additional ballooning (Non-AB; N=804) after stent implantation. We compared TLR MACE at 12 month follow up, defined as total mortality, any myocardial infarction (MI), target vessel revascularization (TVR) between two groups.?Results:?After adjustment using 1:1 propensity score stratification, the incidence of TVR MACE at 12 month follow up was similar between both groups. However AB group had higher mortality (5.0% vs 2.4%; hazard ratio 2.15; 95% confidence interval 1.01 to 4.57; p=0.046) and the incidence of myocardial infarction (0.9% vs 1.6%; p=0.363) and TVR (3.8% vs 5.7%; p=0.195) were similar between two groups.?Conclusions: In patients with AMI, clinical result of AB after stent implantation could be similar with it of Non-AB in the 12month TVR MACE. However AB could be associated with significantly higher total mortality at 12 month follow up.
Eun-Jae Lee,Sun U. Kwon,Jong-Ho Park,Yong-Jae Kim,Keun-Sik Hong,Sungwook Yu,Yang-Ha Hwang,Ji Sung Lee,Juneyoung Lee,Joung-Ho Rha,Sung Hyuk Heo,Sung Hwan Ahn,Woo-Keun Seo,Jong-Moo Park,Ju-Hun Lee,Jee-H 대한뇌졸중학회 2020 Journal of stroke Vol.22 No.1
Background and purpose Whether pharmacologically altered high-density lipoprotein cholesterol (HDL-C) affects the risk of cardiovascular events is unknown. Recently, we have reported the Prevention of Cardiovascular Events in Asian Patients with Ischaemic Stroke at High Risk of Cerebral Haemorrhage (PICASSO) trial that demonstrated the non-inferiority of cilostazol to aspirin and superiority of probucol to non-probucol for cardiovascular prevention in ischemic stroke patients (clinicaltrials.gov: NCT01013532). We aimed to determine whether on-treatment HDL-C changes by cilostazol and probucol influence the treatment effect of each study medication during the PICASSO study. Methods Of the 1,534 randomized patients, 1,373 (89.5%) with baseline cholesterol parameters were analyzed. Efficacy endpoint was the composite of stroke, myocardial infarction, and cardiovascular death. Cox proportional hazards regression analysis examined an interaction between the treatment effect and changes in HDL-C levels from randomization to 1 month for each study arm. Results One-month post-randomization mean HDL-C level was significantly higher in the cilostazol group than in the aspirin group (1.08 mmol/L vs. 1.00 mmol/L, P<0.001). The mean HDL-C level was significantly lower in the probucol group than in the non-probucol group (0.86 mmol/L vs. 1.22 mmol/L, P<0.001). These trends persisted throughout the study. In both study arms, no significant interaction was observed between HDL-C changes and the assigned treatment regarding the risk of the efficacy endpoint. Conclusions Despite significant HDL-C changes, the effects of cilostazol and probucol treatment on the risk of cardiovascular events were insignificant. Pharmacologically altered HDL-C levels may not be reliable prognostic markers for cardiovascular risk.