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Lee, Ji-Eun,Jin, Yong-ri,Seo, Joo-beom,Yoon, Il,Song, Mi-Ryoung,Lee, So-Young,Park, Ki-Min,Lee, Shim-Sung Korean Chemical Society 2006 Bulletin of the Korean Chemical Society Vol.27 No.2
Isomeric series of dilinked $NO_2S_2$ macrocycles ($L^2$: para-, $L^3$: meta- and $L^4$: ortho-linked) capable of binuclear complexing ability were prepared from its monomeric analog $L^1$ in reasonable yields except ortho-type reaction, which led to mixture due to the formation of monomer-type macrocyclic quaternary ammonium bromide $L^5$. Moreover, L2 (as $2HNO_3$ form) and $L^5$ were confirmed by an X-ray crystallography. Reaction of $HgCl_2$ with $L^2$ yielded a binuclear complex $[Hg_2(L^2)Cl_4]$. In the complex, each mercury(II) has a distorted tetrahedral environment made up of S and N donors from an exodentate $L^2$ and two coordinated Cl atoms.
Edoxaban in Asian Patients With Atrial Fibrillation : Effectiveness and Safety
Lee, So-Ryoung,Choi, Eue-Keun,Han, Kyung-Do,Jung, Jin-Hyung,Oh, Seil,Lip, Gregory Y.H. Elsevier 2018 JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY - Vol.72 No.8
<P><B>Abstract</B></P> <P><B>Background</B></P> <P>It is unclear whether edoxaban shows better risk reduction of ischemic stroke, bleeding, and all-cause mortality than warfarin in Asian patients with nonvalvular atrial fibrillation (AF).</P> <P><B>Objectives</B></P> <P>This study compared the effectiveness and safety of edoxaban with those of warfarin in a Korean population with AF.</P> <P><B>Methods</B></P> <P>Using the Korean National Health Insurance Service database, we included new users of edoxaban and warfarin in patients with AF from January 2014 to December 2016 (n = 4,200 on edoxaban, and n = 31,565 on warfarin) and analyzed the risk of ischemic stroke, intracranial hemorrhage (ICH), hospitalization for gastrointestinal (GI) bleeding, hospitalization for major bleeding, and all-cause death. The propensity score matching method was used to balance covariates across edoxaban and warfarin users.</P> <P><B>Results</B></P> <P>We compared a 1:3 propensity score−matched cohort of patients with AF who were new users of edoxaban and warfarin (n = 4,061 and n = 12,183, respectively). Baseline characteristics were balanced between the 2 groups (median age 72 years; median CHA<SUB>2</SUB>DS<SUB>2</SUB>-VASc [congestive heart failure, hypertension, age ≥75 years, diabetes mellitus, prior stroke, transient ischemic attack, or thromboembolism, vascular disease, age 65–74 years, sex category (female)] score 3). Edoxaban users had a significantly lower risk of ischemic stroke (hazard ratio [HR]: 0.693; 95% confidence interval [CI]: 0.487 to 0.959), ICH (HR: 0.407; 95% CI: 0.182 to 0.785), hospitalization for GI bleeding (HR: 0.597; 95% CI: 0.363 to 0.930), hospitalization for major bleeding (HR: 0.532; 95% CI: 0.352 to 0.773), and all-cause death (HR: 0.716; 95% CI: 0.549 to 0.918) than warfarin users. All subgroups (age, sex, CHA<SUB>2</SUB>DS<SUB>2</SUB>-VASc score, renal function, edoxaban dose) showed better clinical outcomes with edoxaban than with warfarin.</P> <P><B>Conclusions</B></P> <P>In this real-world Asian population with AF, edoxaban might be associated with reduced risk of ischemic stroke, major bleeding, and all-cause death compared with warfarin. These benefits were consistent across various high-risk subgroups.</P>
So-Ryoung Lee,Ji Hyun Lee,Eue-Keun Choi,Eun-Kyung Jung,So-Jeong You,Seil Oh,Gregory YH Lip 대한심장학회 2024 Korean Circulation Journal Vol.54 No.1
Background and Objectives: Comprehensive epidemiological data are lacking on the incident atrial fibrillation (AF) in patients with cardiac implantable electronic devices (CIEDs). This study aimed to examine the incidence, risk factors, and AF-related adverse outcomes of patients with CIEDs. Methods: This was an observational cohort study that analyzed patients without prevalent AF who underwent CIED implantation in 2009–2018 using a Korean nationwide claims database. The subjects were divided into three groups by CIED type and indication: pacemaker (n=21,438), implantable cardioverter defibrillator (ICD)/cardiac resynchronization therapy (CRT) with heart failure (HF) (n=3,450), and ICD for secondary prevention without HF (n=2,146). The incidence of AF, AF-associated predictors, and adverse outcomes were evaluated. Results: During follow-up, the incidence of AF was 4.3, 7.3, and 5.1 per 100 person-years in the pacemaker, ICD/CRT with HF, and ICD without HF cohorts, respectively. Across the three cohorts, older age and valvular heart disease were commonly associated with incident AF. Incident AF was consistently associated with an increased risk of ischemic stroke (3.8–11.4-fold), admission for HF (2.6–10.5-fold), hospitalization for any cause (2.4–2.7-fold), all-cause death (4.1–5.0-fold), and composite outcomes (3.4–5.7-fold). Oral anticoagulation rates were suboptimal in patients with incident AF (pacemaker, 51.3%; ICD/CRT with HF, 51.7%; and ICD without HF, 33.8%, respectively). Conclusions: A substantial proportion of patients implanted CIED developed newly diagnosed AF. Incident AF was associated with a higher risk of adverse events. The importance of awareness, early detection, and appropriate management of AF in patients with CIED should be emphasized.
Atrial fibrillation risk in metabolically healthy obesity: A nationwide population-based study
Lee, HyunJung,Choi, Eue-Keun,Lee, Seung-Hwan,Han, Kyung-Do,Rhee, Tae-Min,Park, Chan-Soon,Lee, So-Ryoung,Choe, Won-Seok,Lim, Woo-Hyun,Kang, Si-Hyuck,Cha, Myung-Jin,Oh, Seil Elsevier/North-Holland Biomedical Press 2017 International journal of cardiology Vol.240 No.-
<P><B>Abstract</B></P> <P><B>Background</B></P> <P>Metabolically healthy obese (MHO) individuals are reported to have a marginal increase in cardiovascular risk; however, their atrial fibrillation (AF) risk is unclear. We aimed to assess AF risk in MHO individuals and identify whether AF development is associated with obesity or influenced by metabolic comorbidities.</P> <P><B>Methods</B></P> <P>A retrospective cohort of 389,321 individuals (age, 45.6±14.5years; male, 52.1%) was extracted from the Korean National Health Insurance sample database between 2004 and 2006 and followed-up for new-onset AF until 2013. Subjects with diabetes mellitus, hypertension, and/or dyslipidemia were classified as “metabolically unhealthy.” The cohort was stratified into four groups according to obesity and metabolic healthiness: metabolically healthy non-obese (MHNO), metabolically unhealthy non-obese (MUNO), MHO, and metabolically unhealthy obese (MUO).</P> <P><B>Results</B></P> <P>AF was newly diagnosed in 5106 (1.3%) individuals during a mean follow-up of 7.5±1.5years. The AF incidence rates for the MHNO, MUNO, MHO, and MUO groups were 0.76, 2.66, 1.10, and 2.88 per 1000 person-years, respectively. Compared with the MHNO group, the MHO group had increased AF risk (adjusted hazard ratio, 1.30; 95% CI, 1.14–1.48) on multivariate analysis. One fourth of the MHO cohort became metabolically unhealthy, contributing to increased AF risk. Obesity was an independent risk factor for AF, and increased AF risk by 20%. Metabolic unhealthiness increased AF risk by around 40%, and of its components, hypertension contributed the most.</P> <P><B>Conclusions</B></P> <P>MHO individuals are at increased risk for AF development, and obesity was independently associated with elevated AF risk.</P>
Lee, So-Ryoung,Choi, Eue-Keun,Rhee, Tae-Min,Lee, Hyun-Jung,Lim, Woo-Hyun,Kang, Si-Hyuck,Han, Kyung-Do,Cha, Myung-Jin,Cho, Youngjin,Oh, Il-Young,Oh, Seil Elsevier 2016 INTERNATIONAL JOURNAL OF CARDIOLOGY Vol.223 No.-
<P><B>Abstract</B></P> <P><B>Background</B></P> <P>Atrial fibrillation (AF) is prevalent among type 2 diabetic patients. However, the association between diabetic retinopathy (DR) and AF is controversial.</P> <P><B>Methods</B></P> <P>We included 40,500 patients with type 2 diabetes (≥40years, mean age 62±11years, 53% men) without AF from the Korean National Insurance Service-National Sample Cohort (2002–2007). Subjects were classified without DR (non-DR, n=30,178), with DR (DR, n=8920), and with proliferative DR (PDR, n=1402).</P> <P><B>Results</B></P> <P>During a mean 5.9-year follow-up, 1261 (3.1%) patients were newly diagnosed as having AF (4.9, 6.0, and 8.3 per 1000 person-years in the non-DR, DR, and PDR groups, respectively). In multivariate Cox proportional hazard models, patients in the DR and PDR groups had a significantly higher risk of AF than those in the non-DR group (DR group: hazard ratio [HR] 1.14, 95% confidence interval [CI] 1.00–1.30; PDR group: HR 1.46, 95% CI 1.13–1.87); p for trend <0.001). The risk of AF increased in patients with DR and end-stage renal disease (ESRD) (HR 2.39, 95% CI 1.31–3.96, p<0.001) and in those with PDR and ESRD (HR 3.59, 95% CI 1.96–5.97, p<0.001) compared to those without DR and ESRD.</P> <P><B>Conclusions</B></P> <P>The presence and severity of DR was significantly associated with the incidence of AF. Also, the presence of ESRD had an impact on the incidence of AF in patients with DR.</P>
Lee, So-Ryoung,Choi, Eue-Keun,Han, Kyung-Do,Cha, Myung-Jin,Oh, Seil Elsevier 2017 INTERNATIONAL JOURNAL OF CARDIOLOGY Vol.236 No.-
<P><B>Abstract</B></P> <P><B>Background</B></P> <P>Data on the epidemiology of atrial fibrillation (AF) and temporal trends are not well established in the Korean population. We aimed to estimate the incidence and prevalence of AF in Korea between 2008 and 2015.</P> <P><B>Methods</B></P> <P>Using the National Health Insurance Service database, we analyzed as a nationwide cohort the entire Korean adult population from 2008 to 2015 (<I>n</I> =41,505,679 in 2015). AF was identified by using diagnostic codes.</P> <P><B>Results</B></P> <P>During an 8-year period representing 314,311,360 person-years of follow-up, 496,341 individuals were newly diagnosed with AF. The incidence of AF increased to >1.12-fold as follows: from 15.34 to 17.14 per 10,000 person-years (<I>p</I> <0.001). We also found a 1.68-fold increase in the prevalence of AF, from 0.46% in 2008 to 0.67% in 2015 (<I>p</I> <0.001). The incidence and prevalence of AF increased with advancing age. The median age of the AF patients increased from 68 to 71years (<I>p</I> <0.001). The prevalence of diabetes and heart failure in AF subjects increased (<I>p</I> <0.001). The percentage of patients with a CHA<SUB>2</SUB>DS<SUB>2</SUB>-VASc score of ≥2, who were strongly recommended for anticoagulation treatment, increased from 80.2% to 86.8% (<I>p</I> <0.001).</P> <P><B>Conclusion</B></P> <P>The incidence and prevalence of AF gradually increased from 2008 to 2015. The proportion of AF patients who were candidates for anticoagulation therapy also significantly increased owing to population aging and increasing comorbidities (i.e., heart failure and diabetes). These findings may provide a framework to understand the actual disease burden and establish the optimal management strategy for AF.</P>