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 the Management of Secondary Dyslipidemia
Hoyoun WON ; Jae Hyun BAE ; Hyunjung LIM ; Minji KANG ; Minjoo KIM ; Sang-Hak LEE ;
Korean Journal of Medicine 2025;100(1):5-18
Secondary dyslipidemia, characterized by elevated blood cholesterol and triglycerides, arises from various underlying conditions. The identification and appropriate handling of these causes is crucial for effective treatment. Major contributors include unhealthy diets, diseases impacting lipid metabolism, and medication side effects. Prioritizing the correction of secondary causes before initiating conventional lipid-lowering therapies is essential. Subsequent lipid profiles guide the selection of appropriate guideline-based lipid-lowering interventions.
5.2024 KSoLA Consensus on the Management of Secondary Dyslipidemia
Hoyoun WON ; Jae Hyun BAE ; Hyunjung LIM ; Minji KANG ; Minjoo KIM ; Sang-Hak LEE ;
Korean Journal of Medicine 2025;100(1):5-18
Secondary dyslipidemia, characterized by elevated blood cholesterol and triglycerides, arises from various underlying conditions. The identification and appropriate handling of these causes is crucial for effective treatment. Major contributors include unhealthy diets, diseases impacting lipid metabolism, and medication side effects. Prioritizing the correction of secondary causes before initiating conventional lipid-lowering therapies is essential. Subsequent lipid profiles guide the selection of appropriate guideline-based lipid-lowering interventions.
6.2024 KSoLA Consensus on the Management of Secondary Dyslipidemia
Hoyoun WON ; Jae Hyun BAE ; Hyunjung LIM ; Minji KANG ; Minjoo KIM ; Sang-Hak LEE ;
Korean Journal of Medicine 2025;100(1):5-18
Secondary dyslipidemia, characterized by elevated blood cholesterol and triglycerides, arises from various underlying conditions. The identification and appropriate handling of these causes is crucial for effective treatment. Major contributors include unhealthy diets, diseases impacting lipid metabolism, and medication side effects. Prioritizing the correction of secondary causes before initiating conventional lipid-lowering therapies is essential. Subsequent lipid profiles guide the selection of appropriate guideline-based lipid-lowering interventions.
7.2024 KSoLA Consensus on the Management of Secondary Dyslipidemia
Hoyoun WON ; Jae Hyun BAE ; Hyunjung LIM ; Minji KANG ; Minjoo KIM ; Sang-Hak LEE ;
Korean Journal of Medicine 2025;100(1):5-18
Secondary dyslipidemia, characterized by elevated blood cholesterol and triglycerides, arises from various underlying conditions. The identification and appropriate handling of these causes is crucial for effective treatment. Major contributors include unhealthy diets, diseases impacting lipid metabolism, and medication side effects. Prioritizing the correction of secondary causes before initiating conventional lipid-lowering therapies is essential. Subsequent lipid profiles guide the selection of appropriate guideline-based lipid-lowering interventions.
8.2024 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.
9.2024 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.
10.Successful Management of a Rare Case of Stent Fracture and Subsequent Migration of the Fractured Stent Segment Into the Ascending Aorta in In-Stent Restenotic Lesions of a Saphenous Vein Graft.
Hoyoun WON ; Jaewon OH ; Youngjun YANG ; Mihyun KIM ; Choongki KIM ; Junbeom PARK ; Byeong Keuk KIM ; Donghoon CHOI ; Myeong Ki HONG
Korean Circulation Journal 2012;42(1):58-61
Stent fracture is a complication following implantation of drug eluting stents and is recognized as one of the risk factors for in-stent restenosis. We present the first case of successfully managing a stent fracture and subsequent migration of the fractured stent into the ascending aorta that occurred during repeat revascularization for in-stent restenosis of an ostium of saphenous vein graft after implantation of a zotarolimus-eluting stent. Although the fractured stent segment had migrated into the ascending aorta with a pulled balloon catheter, it was successfully repositioned in the saphenous vein graft using an inflated balloon catheter. Then, the fractured stent segment was successfully connected to the residual segment of the zotarolimus-eluting stent by covering it with an additional sirolimuseluting stent.
Aorta
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Catheters
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Coronary Artery Disease
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Drug-Eluting Stents
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Risk Factors
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Saphenous Vein
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Stents
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Transplants