2.Clinical Impact of Beta Blockers in Patients with Myocardial Infarction from the Korean National Health Insurance Database
Hoyoun WON ; Yongsung SUH ; Gwang Sil KIM ; Young-Guk KO ; Myeong-Ki HONG
Korean Circulation Journal 2020;50(6):499-508
Background and Objectives:
Whether beta blockers favorably impact the clinical outcome in patients with acute myocardial infarction (AMI) remains in debate. We investigated the impact of beta blocker on major clinical outcomes during 2 years after percutaneous coronary intervention (PCI) in patients with AMI.
Methods:
All patients with the first AMI treated with PCI for the period of 2005 to 2014 from the Korean National Health Insurance Service claims database were enrolled. We defined the regular user as medication possession ratio (MPR) ≥80% and non-user as MPR=0%. We compared the occurrence of all cause death, myocardial infarction (MI) and stroke according to adherence of beta-blockers. A 1:1 propensity score-matching was conducted to adjust for between-group differences.
Results:
We identified a total 81,752 patients with met eligible criteria. At discharge, 63,885 (78%) patients were prescribed beta blockers. For 2 years follow up period, regular users were 53,991 (66%) patients, non-users were 10,991 (13%). In the propensity score matched population, regular use of beta blocker was associated with a 36% reduced risk of composite adverse events (all death, MI or stroke) (hazard ratio [HR], 0.636; 95% confidence interval [CI], 0.555–0.728; p<0.001). Compared to no use of beta blocker, regular use significantly reduced all death (HR, 0.736; 95% CI, 0.668–0.812; p<0.001), MI (HR, 0.729; 95% CI, 0.611–0.803; p<0.001) and stroke (HR, 0.717; 95% CI, 0.650–0.791; p<0.001).
Conclusions
Prescription of beta blocker in patients with AMI after PCI was sequentially increased. Continuous regular use of beta blocker for 2 years after AMI reduced major adverse events compared to no use of beta blocker.
4.2024 KSoLA Consensus on Secondary Dyslipidemia
Hoyoun WON ; Jae Hyun BAE ; Hyunjung LIM ; Minji KANG ; Minjoo KIM ; Sang-Hak LEE ;
Journal of Lipid and Atherosclerosis 2024;13(3):215-231
Elevated blood cholesterol and triglyceride levels induced by secondary causes are frequently observed. The identification and appropriate handling of these causes are essential for secondary dyslipidemia treatment. Major secondary causes of hypercholesterolemia and hypertriglyceridemia include an unhealthy diet, diseases and metabolic conditions affecting lipid levels, and therapeutic side effects. It is imperative to correct secondary causes prior to initiating conventional lipid-lowering therapy. Guideline-based lipid therapy can then be administered based on the subsequent lipid levels.
5.2024 KSoLA consensus on secondary dyslipidemia
Hoyoun WON ; Jae Hyun BAE ; Hyunjung LIM ; Minji KANG ; Minjoo KIM ; Sang-Hak LEE ;
The Korean Journal of Internal Medicine 2024;39(5):717-790
Elevated blood cholesterol and triglyceride levels induced by secondary causes are frequently observed. The identification and appropriate handling of these causes are essential for secondary dyslipidemia treatment. Major secondary causes of hypercholesterolemia and hypertriglyceridemia include an unhealthy diet, diseases and metabolic conditions affecting lipid levels, and therapeutic side effects. It is imperative to correct secondary causes prior to initiating conventional lipid-lowering therapy. Guideline-based lipid therapy can then be administered based on the subsequent lipid levels.
6.2024 KSoLA Consensus on Secondary Dyslipidemia
Hoyoun WON ; Jae Hyun BAE ; Hyunjung LIM ; Minji KANG ; Minjoo KIM ; Sang-Hak LEE ;
Journal of Lipid and Atherosclerosis 2024;13(3):215-231
Elevated blood cholesterol and triglyceride levels induced by secondary causes are frequently observed. The identification and appropriate handling of these causes are essential for secondary dyslipidemia treatment. Major secondary causes of hypercholesterolemia and hypertriglyceridemia include an unhealthy diet, diseases and metabolic conditions affecting lipid levels, and therapeutic side effects. It is imperative to correct secondary causes prior to initiating conventional lipid-lowering therapy. Guideline-based lipid therapy can then be administered based on the subsequent lipid levels.
7.2024 KSoLA consensus on secondary dyslipidemia
Hoyoun WON ; Jae Hyun BAE ; Hyunjung LIM ; Minji KANG ; Minjoo KIM ; Sang-Hak LEE ;
The Korean Journal of Internal Medicine 2024;39(5):717-790
Elevated blood cholesterol and triglyceride levels induced by secondary causes are frequently observed. The identification and appropriate handling of these causes are essential for secondary dyslipidemia treatment. Major secondary causes of hypercholesterolemia and hypertriglyceridemia include an unhealthy diet, diseases and metabolic conditions affecting lipid levels, and therapeutic side effects. It is imperative to correct secondary causes prior to initiating conventional lipid-lowering therapy. Guideline-based lipid therapy can then be administered based on the subsequent lipid levels.
8.2024 KSoLA consensus on secondary dyslipidemia
Hoyoun WON ; Jae Hyun BAE ; Hyunjung LIM ; Minji KANG ; Minjoo KIM ; Sang-Hak LEE ;
The Korean Journal of Internal Medicine 2024;39(5):717-790
Elevated blood cholesterol and triglyceride levels induced by secondary causes are frequently observed. The identification and appropriate handling of these causes are essential for secondary dyslipidemia treatment. Major secondary causes of hypercholesterolemia and hypertriglyceridemia include an unhealthy diet, diseases and metabolic conditions affecting lipid levels, and therapeutic side effects. It is imperative to correct secondary causes prior to initiating conventional lipid-lowering therapy. Guideline-based lipid therapy can then be administered based on the subsequent lipid levels.
9.2024 KSoLA Consensus on Secondary Dyslipidemia
Hoyoun WON ; Jae Hyun BAE ; Hyunjung LIM ; Minji KANG ; Minjoo KIM ; Sang-Hak LEE ;
Journal of Lipid and Atherosclerosis 2024;13(3):215-231
Elevated blood cholesterol and triglyceride levels induced by secondary causes are frequently observed. The identification and appropriate handling of these causes are essential for secondary dyslipidemia treatment. Major secondary causes of hypercholesterolemia and hypertriglyceridemia include an unhealthy diet, diseases and metabolic conditions affecting lipid levels, and therapeutic side effects. It is imperative to correct secondary causes prior to initiating conventional lipid-lowering therapy. Guideline-based lipid therapy can then be administered based on the subsequent lipid levels.
10.2024 KSoLA consensus on secondary dyslipidemia
Hoyoun WON ; Jae Hyun BAE ; Hyunjung LIM ; Minji KANG ; Minjoo KIM ; Sang-Hak LEE ;
The Korean Journal of Internal Medicine 2024;39(5):717-790
Elevated blood cholesterol and triglyceride levels induced by secondary causes are frequently observed. The identification and appropriate handling of these causes are essential for secondary dyslipidemia treatment. Major secondary causes of hypercholesterolemia and hypertriglyceridemia include an unhealthy diet, diseases and metabolic conditions affecting lipid levels, and therapeutic side effects. It is imperative to correct secondary causes prior to initiating conventional lipid-lowering therapy. Guideline-based lipid therapy can then be administered based on the subsequent lipid levels.