Coronary artery disease, especially acute myocardial infarction (AMI), is a leading cause of death in the Asia-Pacific region. The Korea Acute Myocardial Infarction Registry (KAMIR) is the first nationwide, prospective, multicenter registry of Korean patients with AMI. Since the KAMIR first began in November 2005, more than 70,000 patients have been enrolled, and 230 papers have been published (as of October 2018). Moreover, published data from the KAMIR have revealed different characteristics from those of Western AMI registries regarding risk factors, interventional strategies, and clinical outcomes. As a result, the KAMIR study has improved the outcomes of percutaneous coronary intervention and reduced mortality. We propose the use of the KAMIR score in the prediction of 1-year mortality. Using data from the KAMIR, we provide an overview of the current status of AMI in Korea, including trends in demographic characteristics, risk factors, medications, treatment strategies, and clinical outcomes.
Cause of Death ; Coronary Artery Disease ; Humans ; Korea* ; Mortality ; Myocardial Infarction* ; Percutaneous Coronary Intervention ; Prognosis ; Prospective Studies ; Registries ; Risk Factors

No abstract available.
Humans ; Myocardial Infarction

BACKGROUND AND OBJECTIVES: Feasibility of coronary angiography (CAG) and percutaneous coronary intervention (PCI) via left snuffbox approach is still concerned. We aimed to investigate efficacy and safety of the left snuffbox approach for CAG and PCI. METHODS: Left snuffbox approach was tried in 150 patients who planned to perform CAG or PCI for suspected myocardial ischemia between 1 November 2017 and 31 March 2018. RESULTS: Success rate of radial artery (RA) cannulation via snuffbox approach was 88.0% (n=132). Among 132 individuals, 58 (43.9%) acute coronary syndrome (ACS) patients were included. The diameter of snuffbox RA was significantly smaller than conventional RA (2.57 mm vs. 2.72 mm, p < 0.001) from quantitative computed angiography of 101 patients. However, CAG via snuffbox approach by 6 French sheath was successfully performed in all 132 patients. In addition, there was significant correlation between the snuffbox and conventional RA diameter (r=0.856, p < 0.001). In 42 PCI cases, including 25 patients with acute myocardial infarction (AMI), the success rate of PCI via snuffbox approach was 97.6% (n=41). Intravascular imaging-guided PCI was performed in 8 (19.5%) patients and multi-vessel PCI in 4 (9.8%) cases. Regarding vascular complication, forearm swelling with bruising, not requiring surgery or transfusion, occurred in 2 (4.9%) PCI cases. CONCLUSIONS: Left snuffbox approach is suitable for CAG and PCI compared with the conventional radial approach.
Acute Coronary Syndrome ; Angiography ; Catheterization ; Coronary Angiography ; Forearm ; Humans ; Myocardial Infarction ; Myocardial Ischemia ; Percutaneous Coronary Intervention ; Radial Artery

No abstract available.
Drug-Eluting Stents ; Percutaneous Coronary Intervention

BACKGROUND AND OBJECTIVES: Feasibility of coronary angiography (CAG) and percutaneous coronary intervention (PCI) via left snuffbox approach is still concerned. We aimed to investigate efficacy and safety of the left snuffbox approach for CAG and PCI. METHODS: Left snuffbox approach was tried in 150 patients who planned to perform CAG or PCI for suspected myocardial ischemia between 1 November 2017 and 31 March 2018. RESULTS: Success rate of radial artery (RA) cannulation via snuffbox approach was 88.0% (n=132). Among 132 individuals, 58 (43.9%) acute coronary syndrome (ACS) patients were included. The diameter of snuffbox RA was significantly smaller than conventional RA (2.57 mm vs. 2.72 mm, p < 0.001) from quantitative computed angiography of 101 patients. However, CAG via snuffbox approach by 6 French sheath was successfully performed in all 132 patients. In addition, there was significant correlation between the snuffbox and conventional RA diameter (r=0.856, p < 0.001). In 42 PCI cases, including 25 patients with acute myocardial infarction (AMI), the success rate of PCI via snuffbox approach was 97.6% (n=41). Intravascular imaging-guided PCI was performed in 8 (19.5%) patients and multi-vessel PCI in 4 (9.8%) cases. Regarding vascular complication, forearm swelling with bruising, not requiring surgery or transfusion, occurred in 2 (4.9%) PCI cases. CONCLUSIONS Left snuffbox approach is suitable for CAG and PCI compared with the conventional radial approach.

The present study sought to assess the impact of previous angina symptoms on real world clinical outcomes in patients with ST-elevation myocardial infarction (STEMI) who had undergone successful percutaneous coronary interventions using drug-eluting stents (DES). Patients were selected from 13,650 consecutive patients enrolled in the Korea Acute Myocardial Infarction-National Institute of Health (KAMIR-NIH) registry. A total of 5167 STEMI patients were divided into a previous-angina group (n= 1129) and a control group (n=4038). Major adverse cardiac and cerebrovascular events (MACCEs) that included all-cause death, recurrent myocardial infarction (re-MI), repeat PCI, coronary artery bypass graft (CABG), cerebrovascular accident (CVA). Among the 5167 patients with STEMI, MACCEs had occurred in 168 patients in the previousangina group (14.9%) and 726 patients in the control group (18.0%) (HR, 0.76, 95% CI, 0.60-0.96, p=0.019) at the two-year (800-day) for clinical outcomes. Previous angina was associated with better clinical outcomes with respect to all-cause death (HR, 0.65, 95% CI, 0.44-0.96, p=0.029) and cardiac death (HR, 0.52, 95% CI, 0.31-0.84, p=0.008). Previous angina was a negative risk factor for adverse cardiac events. A previous history of angina predisposes a patient to a favorable outcome after acute myocardial infarction (AMI) in patients with DES implantation.

Background/Aims: We aimed to evaluate the prevalence, characteristics, and clinical outcomes of spontaneous coronary artery dissection (SCAD) in young female patients with acute myocardial infarction (AMI). Methods: We identified 8,250 patients diagnosed with AMI who underwent coronary angiogram from the Chonnam National University Hospital database, Gwangju, Korea, between November 2005 and September 2017. A total of 148 female patients aged less than 60 years with a history of AMI were retrospectively studied and the characteristics and clinical outcomes were evaluated for all SCAD patients. Results: Among female patients with AMI aged less than 60 years, the prevalence of SCAD was 8.78% (13 of 148). Based on the angiographic classification, type 2 SCAD was most commonly observed on angiograms in 69.2% of the cases (nine of 13), followed by type 3 in 23.1% (three of 13), and type 1 in 7.7% (one of 13). Furthermore, the left anterior descending (LAD) artery was the most commonly affected coronary artery (76.9%, 10 of 13 cases) and the distal segments of the coronary arteries were the most common sites of SCAD (92.3%, 12 of 13). Regarding the clinical outcomes, one of 13 patients experienced repeat revascularization during the following 31 months. Conclusions The prevalence of SCAD was 8.7%, indicating that SCAD is not rare, among female patients aged less than 60 years with AMI in Korea. Type 2 SCAD was most commonly observed on angiogram. Moreover, the distal portion of the LAD was the segment most commonly affected by SCAD. The long-term clinical outcomes were favorable in patients surviving SCAD.