1.Clinical outcomes between different stent designs with the same polymer and drug: comparison between the Taxus Express and Taxus Liberte stents.
Jang Won SON ; Ung KIM ; Jong Seon PARK ; Young Jo KIM ; Jae Sik JANG ; Tae Hyun YANG ; Dong Soo KIM ; Dong Kie KIM ; Sang Hoon SEOL ; Doo Il KIM ; Chang Wook NAM ; Seung Ho HUR ; Kwon Bae KIM
The Korean Journal of Internal Medicine 2013;28(1):72-80
BACKGROUND/AIMS: The Taxus Liberte stent (Boston Scientific Co.) evolved from the Taxus Express stent, with enhanced stent deliverability and uniform drug delivery. This study was designed to compare angiographic and clinical outcomes in real-world practice between the Taxus Liberte and Taxus Express stents. METHODS: Between 2006 and 2008, 240 patients receiving the Taxus Liberte stent at three centers were registered and compared to historical control patients who had received the Taxus Express stent (n = 272). After propensity score matching, 173 patients treated with the Taxus Liberte stent and the same number of patients treated with the Taxus Express stent were selected. The primary outcome was a composite of major adverse cardiac events (MACE), including cardiac death, myocardial infarction (MI), ischemia driven target vessel revascularization (TVR), and stent thrombosis (ST) at 1 year. An additional angiographic assessment was conducted at 9 to 12 months. RESULTS: The study showed no significant difference between the Taxus Express and Taxus Liberte stents (death, 1.73% vs. 2.31%, p = 1.000; MI, 0% vs. 1.73%, p = 0.2478; TVR, 2.31% vs. 1.16%, p = 0.6848; and ST, 0% vs. 1.16%, p = 0.4986). The total MACE rate at 1 year did not differ between the groups (4.05% in Taxus Express vs. 4.05% in Taxus Liberte, p = 1.000). In addition, the binary restenosis rate did not differ (2.25% in Taxus Express vs. 1.80% in Taxus Liberte, p = 0.6848). CONCLUSIONS: In real-world experience with the two Taxus stent designs, both stents showed similarly good clinical and angiographic outcomes at 1 year. A long-term follow-up study is warranted.
Aged
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Angioplasty, Balloon, Coronary/adverse effects/*instrumentation/mortality
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Cardiovascular Agents/administration & dosage
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Chi-Square Distribution
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Coronary Angiography
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Coronary Artery Disease/mortality/radiography/*therapy
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Coronary Restenosis/etiology/mortality
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Coronary Thrombosis/etiology/mortality
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*Drug-Eluting Stents
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Female
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Humans
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Male
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Middle Aged
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Myocardial Infarction/etiology/mortality
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Paclitaxel/*administration & dosage
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Propensity Score
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Prosthesis Design
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Registries
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Republic of Korea
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Retrospective Studies
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Risk Factors
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Stainless Steel
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Time Factors
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Treatment Outcome
2.Trans-Radial versus Trans-Femoral Intervention for the Treatment of Coronary Bifurcations: Results from Coronary Bifurcation Stenting Registry.
Seungmin CHUNG ; Sung Ho HER ; Pil Sang SONG ; Young Bin SONG ; Joo Yong HAHN ; Jin Ho CHOI ; Sang Hoon LEE ; Yangsoo JANG ; Jung Han YOON ; Seung Jea TAHK ; Seung Jung PARK ; Seung Hyuk CHOI ; Ki Bae SEUNG ; Hyeon Cheol GWON
Journal of Korean Medical Science 2013;28(3):388-395
Trans-radial (TR) approach is increasingly recognized as an alternative to the routine use of trans-femoral (TF) approach. However, there are limited data comparing the outcomes of these two approaches for the treatment of coronary bifurcation lesions. We evaluated outcomes of TR and TF percutaneous coronary interventions (PCI) in this complex lesion. Procedural outcomes and clinical events were compared in 1,668 patients who underwent PCI for non-left main bifurcation lesions, according to the vascular approach, either TR (n = 503) or TF (n = 1,165). The primary outcome was major adverse cardiac events (MACE), including cardiac death, myocardial infarction (MI), and target lesion revascularization (TLR) in all patients and in 424 propensity-score matched pairs of patients. There were no significant differences between TR and TF approaches for procedural success in the main vessel (99.6% vs 98.6%, P = 0.08) and side branches (62.6% vs 66.7%, P = 0.11). Over a mean follow-up of 22 months, cardiac death or MI (1.8% vs 2.2%, P = 0.45), TLR (4.0% vs 5.2%, P = 0.22), and MACE (5.2% vs 7.0%, P = 0.11) did not significantly differ between TR and TF groups, respectively. These results were consistent after propensity score-matched analysis. In conclusion, TR PCI is a feasible alternative approach to conventional TF approaches for bifurcation PCI (clinicaltrials.gov number: NCT00851526).
Aged
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Angioplasty, Balloon, Coronary/adverse effects/*methods
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Coronary Angiography
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Coronary Stenosis/mortality/radiography/*therapy
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Coronary Vessels/radiography/surgery
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*Drug-Eluting Stents
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Female
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Follow-Up Studies
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Hemorrhage/etiology
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Humans
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Kaplan-Meier Estimate
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Male
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Middle Aged
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Myocardial Infarction/etiology
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Myocardial Revascularization
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Proportional Hazards Models
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Registries
3.Seven-Year Clinical Outcomes of Sirolimus-Eluting Stent Versus Bare-Metal Stent: A Matched Analysis From A Real World, Single Center Registry.
Ung KIM ; Jong Seon PARK ; Sang Hee LEE ; Dong Gu SHIN ; Young Jo KIM
Journal of Korean Medical Science 2013;28(3):396-401
The aim of this study is to compare clinical outcomes for seven years, between sirolimus-eluting stent (SES) and bare metal stent (BMS). During the BMS and drug-eluting stent (DES) transition period (from April 2002 to April 2004), 434 consecutive patients with 482 lesions underwent percutaneous coronary intervention, using BMS or SES. Using propensity score matching, 186 patients with BMS and 166 patients with SES were selected. Seven year clinical outcomes of major adverse cardiac events (MACE), such as cardiac death, myocardial infarction (MI) and ischemia-driven target vessel revascularization (TVR), and angiographic definite stent thrombosis (ST) were compared. At one-year follow up, patients with SES showed significantly lower MACE (9.1% in BMS vs 3.0% in SES, P = 0.024). However, cumulative MACE for 7 yr was not significantly different between two groups (24.7% in BMS vs 17.4% in SES, P = 0.155). There was no significant difference in MI, TVR, death and ST. The TVR were gradually increased from 1 to 7 yr in SES, on the contrary to that of BMS. In conclusion, although SES showed better clinical outcomes in the early period after implantation, it did not show significant benefits in the long-term follow up, compared with that of BMS.
Aged
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Angioplasty, Balloon, Coronary/adverse effects/*methods
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Coronary Angiography
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Coronary Stenosis/mortality/radiography/*therapy
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Databases, Factual
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*Drug-Eluting Stents
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Female
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Follow-Up Studies
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Humans
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Ischemia/etiology
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Kaplan-Meier Estimate
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Male
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Middle Aged
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Myocardial Infarction/etiology
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Myocardial Revascularization
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Registries
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Sirolimus/*therapeutic use
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*Stents
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Thrombosis/etiology
4.The Role of C-Reactive Protein on the Long-Term Clinical Outcome after Primary or Rescue Percutaneous Coronary Intervention.
Young Joon HONG ; Myung Ho JEONG ; Ok Young PARK ; Weon KIM ; Ju Han KIM ; Young Keun AHN ; Jeong Gwan CHO ; Byoung Hee AHN ; Soon Pal SUH ; Jong Chun PARK ; Sang Hyung KIM ; Jung Chaee KANG
The Korean Journal of Internal Medicine 2003;18(1):29-34
BACKGROUND: We examined the clinical and angiographic outcomes, success rate of the percutaneous coronary intervention (PCI) and long-term survival rate after primary or rescue PCI in patients with acute myocardial infarction (AMI) according to the level of the C-Reactive Protein (CRP) on admission. METHODS: Two hundred and eight consecutive patients with AMI who underwent primary or rescue PCI between 1997 and 1999 at Chonnam National University Hospital were divided into two groups: Group I (n=86, 59.9+/-9.3 years, male 74.4%) with a normal CRP (< 1.0 mg/dL, mean value=0.43+/-0.14 mg/dL) on admission and Group II (n=122, 59.1+/-10.4 years, male 83.6%) with an elevated CRP (> or==1.0 mg/dL, mean value=3.50+/-0.93 mg/dL) on admission. RESULTS: There were no significant differences in the baseline characteristics noted between the two groups. The incidence of cardiogenic shock was higher in Group II than in Group I (Group I; 3/86, 3.5% vs. Group II; 15/122, 12.3%, p=0.026). The coronary angiographic findings did not differ between the two groups. The ejection fraction and Thrombolysis In Myocardial Infarction flow grade improved after PCI in both groups. The primary success rate of PCI was 94.2% (81/86) in Group I and 95.1% (116/122) in Group II (p=0.776). The survival rates for Group I were 97.7%, 97.7% and 96.5%, and those for Group II were 91.8%, 91.0% and 86.9% at 1, 6 and 12 months, respectively (p=0.043 at 1 month, p=0.040 at 6 months, p=0.018 at 12 months). CONCLUSION: A high incidence of cardiogenic shock and worse long-term survival after PCI are observed in AMI patients with an elevated CRP.
Age Factors
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Aged
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Angioplasty, Transluminal, Percutaneous Coronary/*methods/mortality
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Biological Markers/analysis
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C-Reactive Protein/analysis/*metabolism
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Chi-Square Distribution
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Cohort Studies
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Coronary Angiography
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Female
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Humans
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Logistic Models
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Male
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Middle Aged
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Myocardial Infarction/*mortality/radiography/*therapy
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Probability
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Prognosis
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Prospective Studies
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Risk Assessment
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Severity of Illness Index
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Sex Factors
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Survival Analysis
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Time Factors
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Treatment Outcome
5.Effectiveness of Drug-Eluting Stents versus Bare-Metal Stents in Large Coronary Arteries in Patients with Acute Myocardial Infarction.
Doo Sun SIM ; Myung Ho JEONG ; Youngkeun AHN ; Young Jo KIM ; Shung Chull CHAE ; Taek Jong HONG ; In Whan SEONG ; Jei Keon CHAE ; Chong Jin KIM ; Myeong Chan CHO ; Ki Bae SEUNG ; Seung Jung PARK
Journal of Korean Medical Science 2011;26(4):521-527
This study compared clinical outcomes of drug-eluting stents (DES) versus bare-metal stents (BMS) in large coronary arteries in patients with acute myocardial infarction (MI). A total of 985 patients who underwent single-vessel percutaneous coronary intervention (PCI) in large coronary arteries (> or = 3.5 mm) in lesions < 25 mm were divided into DES group (n = 841) and BMS group (n = 144). Clinical outcomes during 12 months were compared. In-hospital outcome was similar between the groups. At six months, death/MI rate was not different. However, DES group had significantly lower rates of target-lesion revascularization (TLR) (1.7% vs 5.6%, P = 0.021), target-vessel revascularization (TVR) (2.2% vs 5.6%, P = 0.032), and total major adverse cardiac events (MACE) (3.4% vs 11.9%, P = 0.025). At 12 months, the rates of TLR and TVR remained lower in the DES group (2.5% vs 5.9%, P = 0.032 and 5.9% vs 3.1%, P = 0.041), but the rates of death/MI and total MACE were not statistically different. The use of DES in large vessels in the setting of acute MI is associated with lower need for repeat revascularization compared to BMS without compromising the overall safety over the course of one-year follow-up.
Acute Disease
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Adult
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Aged
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*Angioplasty, Balloon, Coronary/adverse effects/instrumentation
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Coronary Angiography
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Coronary Vessels/pathology
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*Drug-Eluting Stents/adverse effects
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Female
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Follow-Up Studies
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Hospital Mortality
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Humans
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Male
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Middle Aged
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Myocardial Infarction/mortality/radiography/*therapy
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*Stents/adverse effects
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Survival Rate
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Time Factors