3.Impact of Home-Based Exercise Training with Wireless Monitoring on Patients with Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention.
Young Hwa LEE ; Seung Ho HUR ; Jihyun SOHN ; Ho Myung LEE ; Nam Hee PARK ; Yun Kyeong CHO ; Hyoung Seob PARK ; Hyuck Jun YOON ; Hyungseop KIM ; Chang Wook NAM ; Yoon Nyun KIM ; Kwon Bae KIM
Journal of Korean Medical Science 2013;28(4):564-568
Recent studies have suggested a favorable effect of cardiac rehabilitation (CR) on patients with cardiovascular disease. This study aimed to evaluate the impact of home-based exercise training with wireless monitoring on acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI). A total of 55 ACS patients undergoing PCI were randomly divided into home based exercise training with wireless monitoring cardiac rehabilitation (CR, n = 26) and usual care (UC, n = 29). Exercise capacity and quality of life (QOL) were evaluated at baseline and after 12 weeks. Change of metabolic equivalent of the tasks, maximal exercise time and QOL were significantly increased (+2.47 vs +1.43, P = 0.021; +169.68 vs +88.31 sec, P = 0.012; and +4.81 vs +0.89, P = 0.022, respectively), and the change of submaximal rate pressure product, and of submaximal rate of perceived exertion were significantly decreased (-28.24 vs -16.21, P = 0.013; and -1.92 vs -1.62, P = 0.018, respectively) in the CR group compared to the UC group after 12 weeks. CR using home-based exercise training with wireless monitoring led to improvement of exercise capacity and QOL relative to conventional care in ACS patients undergoing PCI. Our findings suggest that early scheduled CR may be considered in ACS patients undergoing PCI.
Acute Coronary Syndrome/*therapy
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Adult
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Blood Pressure
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Cellular Phone
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Exercise Therapy
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Female
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Heart Rate
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Humans
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Male
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Middle Aged
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Percutaneous Coronary Intervention/instrumentation/*methods
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Quality of Life
;
Treatment Outcome
4.Type 4 dual left anterior descending coronary artery.
Chan Joon KIM ; Hee Jeoung YOON ; Sung Ho HER ; Jun Han JEON ; Seung Min JUNG ; Eun Hee JANG ; Seung Won JIN
The Korean Journal of Internal Medicine 2015;30(5):727-729
No abstract available.
Aged
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Angina Pectoris/diagnosis/etiology
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Coronary Angiography
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Coronary Artery Disease/*complications/diagnosis/therapy
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Coronary Stenosis/*complications/diagnosis/therapy
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Coronary Vessel Anomalies/*complications/diagnosis
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Humans
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Male
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Percutaneous Coronary Intervention/instrumentation
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Stents
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Treatment Outcome
5.A case of primary aldosteronism presenting as non-ST elevation myocardial infarction.
Ja Min BYUN ; Suk CHON ; Soo Joong KIM
The Korean Journal of Internal Medicine 2013;28(6):739-742
No abstract available.
Adrenal Cortex Neoplasms/*complications/diagnosis/surgery
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Adrenalectomy
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Adrenocortical Adenoma/*complications/diagnosis/surgery
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Adult
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Biopsy
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Coronary Angiography
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Drug-Eluting Stents
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Humans
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Hyperaldosteronism/diagnosis/*etiology
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Male
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Myocardial Infarction/diagnosis/*etiology/therapy
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Percutaneous Coronary Intervention/instrumentation
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Tomography, X-Ray Computed
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Treatment Outcome
6.Treatment of coronary in-stent restenosis with drug-eluting balloon catheter: real-world outcome and literature review.
Hong Yuan XIA ; Adrian F H LOW ; Chi Hang LEE ; Swee Guan TEO ; Mark CHAN ; Koo Hui CHAN ; Huay Cheem TAN
Annals of the Academy of Medicine, Singapore 2013;42(1):49-51
Aged
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Cardiac Catheters
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Combined Modality Therapy
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Coronary Restenosis
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therapy
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Female
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Follow-Up Studies
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Humans
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Male
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Middle Aged
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Paclitaxel
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administration & dosage
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therapeutic use
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Percutaneous Coronary Intervention
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instrumentation
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Stents
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Treatment Outcome
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Tubulin Modulators
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administration & dosage
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therapeutic use
7.Clinical impact of routine follow-up coronary angiography after second- or third-generation drug-eluting stent insertion in clinically stable patients.
Seonghoon CHOI ; Hee Sun MUN ; Min Kyung KANG ; Jung Rae CHO ; Seong Woo HAN ; Namho LEE
The Korean Journal of Internal Medicine 2015;30(1):49-55
BACKGROUND/AIMS: In the bare-metal stent era, routine follow-up coronary angiography (RFU CAG) was used to ensure stent patency. With the advent of drug-eluting stents (DESs) with better safety and efficacy profiles, RFU CAG has been performed less often. There are few data on the clinical impact of RFU CAG after second- or third-generation DES implantation in clinically stable patients with coronary artery disease; the aim of this study was to examine this issue. METHODS: We analyzed clinical outcomes retrospectively of 259 patients who were event-free at 12-month after stent implantation and did not undergo RFU CAG (clinical follow-up group) and 364 patients who were event-free prior to RFU CAG (angiographic follow-up group). Baseline characteristics were compared between the groups. RESULTS: The Kaplan-Meier estimated total survival and major adverse cardiac event (MACE)-free survival did not differ between the groups (p = 0.100 and p = 0.461, respectively). The cumulative MACE rate was also not different between the groups (hazard ratio, 0.85; 95% confidence interval, 0.35 to 2.02). In the angiographic follow-up group, 8.8% revascularization was seen at RFU CAG. CONCLUSIONS: RFU CAG did not affect long-term clinical outcome after second- or third-generation DES implantation in clinically stable patients.
Aged
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*Coronary Angiography
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Coronary Artery Bypass
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Coronary Artery Disease/radiography/*therapy
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Coronary Restenosis/etiology/radiography/surgery
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Coronary Vessels/*radiography
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Disease Progression
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Disease-Free Survival
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*Drug-Eluting Stents
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Female
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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/radiography/surgery
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Patient Selection
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Percutaneous Coronary Intervention/adverse effects/*instrumentation
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Predictive Value of Tests
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Proportional Hazards Models
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Prosthesis Design
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Retrospective Studies
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Risk Factors
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Time Factors
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Treatment Outcome
8.Migration of a sirolimus-eluting stent from the ostium of the left main coronary artery to the right deep femoral artery.
Ki Bum WON ; Byeong Keuk KIM ; Young Guk KO ; Myeong Ki HONG ; Yangsoo JANG ; Won Heum SHIM
The Korean Journal of Internal Medicine 2013;28(1):116-119
No abstract available.
Aged
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Cardiovascular Agents/*administration & dosage
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Drug-Eluting Stents/*adverse effects
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*Femoral Artery/radiography/ultrasonography
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Foreign-Body Migration/diagnosis/*etiology
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Humans
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Male
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Percutaneous Coronary Intervention/*adverse effects/instrumentation
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Prosthesis Design
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Sirolimus/*administration & dosage
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Ultrasonography, Interventional
9.Long-term outcomes of intravascular ultrasound-guided implantation of bare metal stents versus drug-eluting stents in primary percutaneous coronary intervention.
Yun Kyeong CHO ; Seung Ho HUR ; Nam Hee PARK ; Sang Woong CHOI ; Ji Hyun SOHN ; Hyun Ok CHO ; Hyoung Seob PARK ; Hyuck Jun YOON ; Hyungseop KIM ; Chang Wook NAM ; Yoon Nyun KIM ; Kwon Bae KIM
The Korean Journal of Internal Medicine 2014;29(1):66-75
BACKGROUND/AIMS: While drug-eluting stents (DESs) have shown favorable outcomes in ST-segment elevation myocardial infarction (STEMI) compared to bare metal stents (BMSs), there are concerns about the risk of stent thrombosis (ST) with DESs. Because intravascular ultrasound (IVUS) guidance may help optimize stent placement and improve outcomes in percutaneous coronary intervention (PCI) patients, we evaluated the impact of IVUS-guided BMS versus DES implantation on long-term outcomes in primary PCI. METHODS: In all, 239 STEMI patients received DES (n = 172) or BMS (n = 67) under IVUS guidance in primary PCI. The 3-year incidence of major adverse cardiac events (MACEs) including death, myocardial infarction (MI), target vessel revascularization (TVR), and ST was evaluated. RESULTS: There was no difference in all cause mortality or MI. However, the incidence of TVR was 23.9% with BMS versus 9.3% with DES (p = 0.005). Thus, the number of MACEs was significantly lower with DES (11.0% vs. 29.9%; p = 0.001). The incidence of definite or probable ST was not different (1.5% vs. 2.3%; p = 1.0). IVUS-guided DES implantation (hazard ratio [HR], 0.25; 95% confidence interval [CI], 0.08 to 0.78; p = 0.017), stent length (HR, 1.03; 95% CI, 1.00 to 1.06; p = 0.046), and multivessel disease (HR, 3.01; 95% CI, 1.11 to 8.15; p = 0.030) were independent predictors of MACE. CONCLUSIONS: In patients treated with primary PCI under IVUS guidance, the use of DES reduced the incidence of 3-year TVR versus BMS. However, all cause mortality and MI were similar between the groups. The incidence of ST was low in both groups.
Aged
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Drug-Eluting Stents/*statistics & numerical data
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Female
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Follow-Up Studies
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Humans
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Male
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Middle Aged
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Myocardial Infarction/mortality/*surgery
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Percutaneous Coronary Intervention/*instrumentation/statistics & numerical data
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Reoperation/statistics & numerical data
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Republic of Korea/epidemiology
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Retrospective Studies
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Treatment Outcome
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*Ultrasonography, Interventional
10.Impact of an endothelial progenitor cell capturing stent on coronary microvascular function: comparison with drug-eluting stents.
Woong Gil CHOI ; Soo Hyun KIM ; Hyung Seok YOON ; Eun Joo LEE ; Dong Woon KIM
The Korean Journal of Internal Medicine 2015;30(1):42-48
BACKGROUND/AIMS: Although drug-eluting stents (DESs) effectively reduce restenosis following percutaneous coronary intervention (PCI), they also delay re-endothelialization and impair microvascular function, resulting in adverse clinical outcomes. Endothelial progenitor cell (EPC) capturing stents, by providing a functional endothelial layer on the stent, have beneficial effects on microvascular function. However, data on coronary microvascular function in patients with EPC stents versus DESs are lacking. METHODS: Seventy-four patients who previously underwent PCI were enrolled in this study. Microvascular function was evaluated 6 months after PCI based on the index of microvascular resistance (IMR) and the coronary flow reserve (CFR). IMR was calculated as the ratio of the mean distal coronary pressure at maximal hyperemia to the inverse of the hyperemic mean transit time (hTmn). The CFR was calculated by dividing the hTmn by the baseline mean transit time. RESULTS: Twenty-one patients (age, 67.2 +/- 9.6 years; male:female, 15:6) with an EPC stent and 53 patients (age, 61.5 +/- 14.7 years; male:female, 40:13) with second-generation DESs were included in the study. There were no significant differences in the baseline clinical and angiographic characteristics of the two groups. Angiography performed 6 months postoperatively did not show significant differences in their CFR values. However, patients with the EPC stent had a significantly lower IMR than patients with second-generation DESs (median, 25.5 [interquartile range, 12.85 to 28.18] vs. 29.0 [interquartile range, 15.42 to 39.23]; p = 0.043). CONCLUSIONS: Microvascular dysfunction was significantly improved after 6 months in patients with EPC stents compared to those with DESs. The complete re-endothelialization achieved with the EPC stent may provide clinical benefits over DESs, especially in patients with microvascular dysfunction.
Aged
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Blood Flow Velocity
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Coronary Angiography
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Coronary Artery Disease/diagnosis/physiopathology/*therapy
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*Coronary Circulation
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Coronary Vessels/*physiopathology/radiography
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Drug-Eluting Stents
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*Endothelial Progenitor Cells/radiography
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Female
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Humans
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Male
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Microvessels/*physiopathology/radiography
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Middle Aged
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Percutaneous Coronary Intervention/*instrumentation
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Prosthesis Design
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*Re-Epithelialization
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*Stents
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Time Factors
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Treatment Outcome
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Vascular Resistance