Revascularization Strategies in Patients With ST-Segment Elevation Myocardial Infarction and Multivessel Disease: Is FFR-Guided Strategy Still Valuable?

Doosup Shin,Tae-Min Rhee,Seung Hun Lee,Joo Myung Lee 대한심장학회 2022 Korean Circulation Journal Vol.52 No.4

Several studies have shown the benefit of complete revascularization (CR) over culprit-only percutaneous coronary intervention (PCI) in patients with ST-segment elevated myocardial infarction (STEMI) and multivessel disease (MVD). Nevertheless, optimal strategy to select targets for non-culprit PCI has not been clarified. In this paper, we critically discuss and compare the safety and efficacy of different strategies for CR in patients with STEMI and MVD using a Bayesian network meta-analysis including all previous randomized controlled trials (RCTs). In Bayesian network meta-analysis of 13 RCTs, culprit-only PCI was associated with higher risk of major adverse cardiac events (MACE), compared with angiography-guided or fractional flow reserve (FFR)-guided CR strategies. However, there was no significant difference between angiography-guided and FFR-guided CR strategies in the risk of MACE and its individual components including all-cause death, cardiac death, myocardial infarction (MI), and revascularization. These evidence support that both angiography-guided and FFR-guided complete revascularization strategies would be reasonable treatment option in patients with STEMI and MVD. If the non-culprit lesion is severe on visual assessment, angiography-guided PCI can be considered. If the non-culprit lesion is intermediate in severity or unclear based on visual assessment, FFR-guided strategy can be used as a reliable and objective tool, providing similar benefits with less stents compared with an angiography-guided strategy. Further RCT is needed to evaluate direct comparison between angiography-guided and FFR-guided CR strategies in patients with STEMI and MVD. Ongoing FRAME-AMI trial (NCT02715518) will provide more evidence regarding this issue.

Synthesis of (E)-α-Ethynyl-α,β-unsaturated Esters from Allenyl Acetates Catalyzed by DABCO and Their Application to Sonogashira Cross-Coupling Reactions

Hyunseok Kim,Doosup Shin,Kwangmoo Lee,Sangkyu Lee,Sanghyuk Kim,Phil Ho Lee, 대한화학회 2010 Bulletin of the Korean Chemical Society Vol.31 No.3

The Association between Body Weight Misperception and Psychosocial Factors in Korean Adult Women Less than 65 Years Old with Normal Weight

Choi, Yoonhee,Choi, Eunjoo,Shin, Doosup,Park, Sang Min,Lee, Kiheon The Korean Academy of Medical Sciences 2015 JOURNAL OF KOREAN MEDICAL SCIENCE Vol.30 No.11

<P>With society's increasing interest in weight control and body weight, we investigated the association between psychological factors and body image misperception in different age groups of adult Korean women with a normal weight. On a total of 4,600 women from the Korea National Health and Nutrition Examination Survey 2007-2009, a self-report questionnaire was used to assess body weight perception and 3 psychological factors: self-rated health status, stress recognition, and depressed mood. Through logistic regression analysis, a poor self-rated health status (<I>P</I> = 0.001) and a higher recognition of stress (<I>P</I> = 0.001) were significantly associated with body image misperception and this significance remained after controlling for several sociodemographic (Model 1: adjusted odds ratio [aOR], 1.62; 95% confidence interval [CI], 1.31-2.00), health behavior and psychological factors (Model 2: aOR, 1.59; 95% CI, 1.29-1.96; Model 3: aOR, 1.36; 95% CI, 1.01-1.84). Especially, highly stressed middle-aged (50-64 yr) women were more likely to have body image misperception (Model 2: aOR, 2.85; 95% CI, 1.30-6.26). However, the correlation between depressed mood and self-reported body weight was inconsistent between different age groups. In conclusion, self-rated health status and a high recognition rate of severe stress were related to body weight misperception which could suggest tailored intervention to adult women especially women in younger age or low self-rated health status or a high recognition rate of severe stress.</P>

Chronic Irreducible Anterior Dislocation of the Shoulder without Significant Functional Deficit

Hoejeong Chung,Yeo-Seung Yoon,Ji-Soo Shin,John Junghun Shin,Doosup Kim 대한정형외과학회 2016 Clinics in Orthopedic Surgery Vol.8 No.3

Shoulder dislocation is frequently encountered by orthopedists, and closed manipulation is often sufficient to treat the injury in an acute setting. Although most dislocations are diagnosed and managed promptly, there are rare cases that are missed or neglected, leading to a chronically dislocated state of the joint. They are usually irreducible and cause considerable pain and functional disability in most affected patients, prompting the need to find a surgical method to reverse the worsening conditions caused by the dislocated joint. However, there are cases of even greater rarity in which chronic shoulder dislocations are asymptomatic with minimal functional or structural degeneration in the joint. These patients are usually left untreated, and most show good tolerance to their condition without developing disabling symptoms or significant functional loss over time. We report on one such patient who had a chronic shoulder dislocation for more than 2 years without receiving treatment.

A regio- and stereoselective synthesis of trisubstituted alkenes <i>via</i> gold(<small>I</small>)-catalyzed hydrophosphoryloxylation of haloalkynes

Chary, Bathoju Chandra,Kim, Sunggak,Shin, Doosup,Lee, Phil Ho Royal Society of Chemistry 2011 Chemical communications Vol.47 No.27

<P>A new stereoselective synthesis of trisubstituted alkenes is developed. Hydrophosphoryloxylation of haloalkynes provides <I>Z</I>-alkenyl halophosphates, which undergo Pd-catalyzed consecutive cross-coupling reactions to afford regio- and stereodefined trisubstituted alkenes.</P> <P>Graphic Abstract</P><P>A highly efficient stereodefined synthesis of trisubstituted alkenes is developed and utilizes gold(I)-catalyzed regio- and stereoselective hydrophosphoryloxylation of haloalkynes and subsequent Pd-catalyzed consecutive cross-coupling reactions. <IMG SRC='http://pubs.rsc.org/services/images/RSCpubs.ePlatform.Service.FreeContent.ImageService.svc/ImageService/image/GA?id=c1cc12052b'> </P>

Metformin Association with Lower Prostate Cancer Recurrence in Type 2 Diabetes: a Systematic Review and Meta-analysis

Hwang, In Cheol,Park, Sang Min,Shin, Doosup,Ahn, Hong Yup,Rieken, Malte,Shariat, Shahrokh F. Asian Pacific Journal of Cancer Prevention 2015 Asian Pacific journal of cancer prevention Vol.16 No.2

Background: Accumulating evidence suggests that metformin possesses anticarcinogenic properties, and its use is associated with favorable outcomes in several cancers. However, it remains unclear whether metformin influences prognosis in prostate cancer (PCa) with concurrent type 2 diabetes (T2D). Materials and Methods: We searched PubMed, EMBASE, and the Cochrane Library from database inception to April 16, 2014 without language restrictions to identify studies investigating the effect of metformin treatment on outcomes of PCa with concurrent T2D. We conducted a meta-analysis to quantify the risk of recurrence, progression, cancer-specific mortality, and all-cause mortality. Summary relative risks (RRs) with corresponding 95% confidence intervals (CIs) were calculated. Publication bias was assessed by Begg's rank correlation test. Results: A total of eight studies fulfilled the eligibility criteria. We found that diabetic PCa patients who did not use metformin were at increased risk of cancer recurrence (RR, 1.20; 95%CI, 1.00-1.44), compared with those who used metformin. A similar trend was observed for other outcomes, but their relationships did not reach statistical significance. Funnel plot asymmetry was not observed among studies reporting recurrence (p=0.086). Conclusions: Our results suggest that metformin may improve outcomes in PCa patients with concurrent T2D. Well-designed large studies and collaborative basic research are warranted.

Safety and Efficacy of Everolimus-Eluting Bioresorbable Vascular Scaffold Versus Second-Generation Drug-Eluting Stents in Real-World Practice

이주명,조현성,Choi Ki Hong,Hong David,박택규,Yang Jeong Hoon,송영빈,Choi Jin-Ho,Choi Seung-Hyuk,정진옥,이종영,Choi Young Jin,Chae Jei-Keon,허승호,Bae Jang-Whan,Oh Ju-Hyeon,전국진,Kim Hyun-Joong,조병렬,Shin Doosup,Lee Seung Hun 대한의학회 2023 Journal of Korean medical science Vol.38 No.5

Background: The risk of device thrombosis and device-oriented clinical outcomes with bioresorbable vascular scaffold (BVS) was reported to be significantly higher than with contemporary drug-eluting stents (DESs). However, optimal device implantation may improve clinical outcomes in patients receiving BVS. The current study evaluated mid-term safety and efficacy of Absorb BVS with meticulous device optimization under intravascular imaging guidance. Methods: The SMART-REWARD and PERSPECTIVE-PCI registries in Korea prospectively enrolled 390 patients with BVS and 675 patients with DES, respectively. The primary endpoint was target vessel failure (TVF) at 2 years and the secondary major endpoint was patientoriented composite outcome (POCO) at 2 years. Results: Patient-level pooled analysis evaluated 1,003 patients (377 patients with BVS and 626 patients with DES). Mean scaffold diameter per lesion was 3.24 ± 0.30 mm in BVS group. Most BVSs were implanted with pre-dilatation (90.9%), intravascular imaging guidance (74.9%), and post-dilatation (73.1%) at proximal to mid segment (81.9%) in target vessel. Patients treated with BVS showed comparable risks of 2-year TVF (2.9% vs. 3.7%, adjusted hazard ratio [HR], 1.283, 95% confidence interval [CI], 0.487–3.378, P = 0.615) and 2-year POCO (4.5% vs. 5.9%, adjusted HR, 1.413, 95% CI, 0.663–3.012, P = 0.370) than those with DES. The rate of 2-year definite or probable device thrombosis (0.3% vs. 0.5%, P = 0.424) was also similar. The sensitivity analyses consistently showed comparable risk of TVF and POCO between the 2 groups. Conclusion: With meticulous device optimization under imaging guidance and avoidance of implantation in small vessels, BVS showed comparable risks of 2-year TVF and device thrombosis with DES.