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Major Trauma induced Left Ventricular Thrombus after Acute Myocardial Infarction.

Dong Wook LEE ; Ju Hee HA ; Jun Ho KIM ; Ki Beom PARK ; Jae Joon LEE ; Han Il CHOI ; Jin Hee KIM

Journal of Lipid and Atherosclerosis.2016;5(2):163-167. doi:10.12997/jla.2016.5.2.163

Left Ventricular Thrombus (LVT) formation after acute myocardial infarction is a serious complication. And the most feared complication of LVT is the systemic thromboembolic events, especially to the brain. Nowadays patients with acute myocardial infarction are treated with primary PCI and more aggressive anticoagulation therapies, resulting in the lower incidence of LVT. Early detection of LVT is very important, and echocardiography is the definitive test for detecting intracardiac thrombus. However, the need for serial echocardiography remains controversial. In this case report, we describe a 55-year-old man with major trauma induced LVT after acute myocardial infarction who underwent successful therapy.
Brain ; Echocardiography ; Humans ; Incidence ; Middle Aged ; Myocardial Infarction* ; Thrombosis*

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Characteristics of Young Korean Metabolically Healthy Obese Patient: Based on Retrospective Analysis of Republic of Korea Navy Soldiers' Medical Examination.

Seonggyu BYEON ; Ji Hwan LEE ; Seung Eun LEE

Journal of Lipid and Atherosclerosis.2016;5(2):155-162. doi:10.12997/jla.2016.5.2.155

OBJECTIVE: The aim of this study was to evaluate the characteristics of the young Korean obese but metabolically healthy subjects and to identify the factors associated with metabolic health status among them. METHODS: We reviewed the medical record of South-Korea Navy soldiers at 1st marine division with routine medical examination. Within this population, we selected obese subjects whose body mass index (BMI) were more than 25 kg/m². The clinical characteristics between obese subjects with metabolically healthy and unhealthy factors were retrospectively compared. RESULTS: Of the 1,522 subjects with medical record, 319 (20.9%) subjects were identified as obese. Among them, 60 subjects (18.8%) were classified as metabolically unhealthy, whereas 259 (81.2%) subjects were metabolically healthy. Multivariate analysis revealed that higher BMI (odds ratio, OR 1.26, 95% confidence interval, CI, 1.07-1.49), higher alanine transaminase (ALT) (OR 1.03, 95% CI 1.01-1.06), and drinking alcohol (OR 3.65, 95% CI 1.02-13.02) were associated with metabolically unhealthy status in obese subjects. Meanwhile, regular physical activity was associated with metabolically healthy status in obese subjects. (OR 0.33, 95% CI 0.17-0.62) CONCLUSION: This study found that higher BMI, higher ALT, and drinking alcohol were related to metabolically unhealthy status in young Korean obese subjects; meanwhile, regular physical activity was related to metabolically healthy status.
Alanine Transaminase ; Body Mass Index ; Drinking ; Healthy Volunteers ; Humans ; Medical Records ; Metabolic Diseases ; Military Personnel ; Motor Activity ; Multivariate Analysis ; Obesity ; Republic of Korea* ; Retrospective Studies*

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Impaired Antioxidant Ability of HDL and More Oxidized LDL are associated with Male Patients with Atrial Fibrillation.

Suk Jeong KIM ; Dong Gu SHIN ; Jae Ryong KIM ; Kyung Hyun CHO

Journal of Lipid and Atherosclerosis.2016;5(2):145-154. doi:10.12997/jla.2016.5.2.145

OBJECTIVE: Atrial fibrillation (AF) is a common arrhythmia which is generally more prevalent in the elderly population. However, the new onset of AF is frequently found in young populations. In order to identify putative prognostic biomarkers for detection of young-onset AF, we purified and characterized lipoproteins in terms of oxidative and inflammatory properties. METHODS: Male patients with AF (46±7 years of age, n=19) were recruited. Their serum and individual lipoproteins were analyzed and compared with healthy controls (48±9 years of age, n=17). RESULTS: The patients with AF revealed hypertriglyceridemia, hyperuricemia with mild obesity, elevated levels of CRP, and a normal level of cholesterol. All lipoproteins from patients with AF demonstrated higher levels of TG and advanced glycated end products, and decreased particle size than controls. AF-LDL showed an increased extent of oxidation with increased atherogenic macrophage phagocytosis. AF-HDL showed impaired antioxidant ability and a lower level of apoA-I expression. CONCLUSION: These data suggest that lipoprotein properties are severely modified in young AF patients, which were correlated with increased oxidation and inflammation.
Aged ; Apolipoprotein A-I ; Apolipoproteins ; Arrhythmias, Cardiac ; Atrial Fibrillation* ; Biomarkers ; Cholesterol ; Humans ; Hypertriglyceridemia ; Hyperuricemia ; Inflammation ; Lipoproteins ; Macrophages ; Male* ; Obesity ; Particle Size ; Phagocytosis ; Triglycerides

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Serum Lipid Level in HBsAg Carriers without a History of Hepatitis based on Nationwide Health and Nutrition Examination Datasets.

Bo Kyung KOO ; Min Kyong MOON

Journal of Lipid and Atherosclerosis.2016;5(2):133-143. doi:10.12997/jla.2016.5.2.133

OBJECTIVE: We investigated serum lipid levels in asymptomatic HBsAg carriers and the general population using the Korean National Health and Nutrition Examination Survey (KNHANES). METHODS: We analyzed the data of patients aged ≥30 years from the KNHANES 2007-2014 datasets. Subjects with diabetes mellitus, triglyceride levels >1000 mg/dL, a history of heavy alcohol consumption, or lipid-lowering medication were excluded. HBsAg carriers were divided into “unknown HBsAg carrier” and “known HBsAg carrier” according to previous self-recognition of HBsAg status using a questionnaire. RESULTS: Compared with control subjects (n=24,880; male 33.9%; mean age 52±14 years), HBsAg carriers (n=1,061; male 40.6%; mean age 50±13 years) showed significantly higher AST and ALT levels, lower platelet counts and higher body mass index (BMI) (all p<0.001). HBsAg carriers revealed lower total cholesterol, LDL cholesterol and triglyceride levels (all p<0.001) compared with control subjects, irrespective of previous awareness of HBsAg positivity. Hypertriglyceridemia and low HDL cholesterolemia were less prevalent even in the “unknown HBsAg carrier” group compared with control subjects [age, sex and BMI-adjusted odds ratio, 0.566 (95% confidence interval, 0.468-0.684) and 0.822 (0.708-0.956), respectively]. CONCLUSION: In conclusion, HBsAg carriers exhibited low total cholesterol, LDL cholesterol, and triglyceride levels compared with control subjects. Hypertriglyceridemia and low HDL cholesterolemia were also less frequently detected in HBsAg carriers even after adjustments for age, sex, and BMI.
Alcohol Drinking ; Body Mass Index ; Cholesterol ; Cholesterol, HDL ; Cholesterol, LDL ; Dataset* ; Diabetes Mellitus ; Hepatitis B Surface Antigens* ; Hepatitis B virus ; Hepatitis* ; Humans ; Hypertriglyceridemia ; Male ; Nutrition Surveys ; Odds Ratio ; Platelet Count ; Triglycerides

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A Case of Bilateral Renal Infarction of Unknown Cause in a Previously Healthy Young Male.

Hee Jin CHOI ; Hyeonju JEONG ; Hye Min CHOI ; Dong Jin OH

Journal of Lipid and Atherosclerosis.2016;5(1):93-97. doi:10.12997/jla.2016.5.1.93

We report a rare case of bilateral renal infarction resulting in acute renal failure in a previously healthy 26-year-old soldier. The patient presented with an abdominal pain and bilateral costovertebral angle tenderness. Laboratory studies showed elevated serum creatinine, mild leukocytosis, and increased lactate dehydrogenase. Contrast-enhanced computed tomography showed multiple perfusion defects in both kidneys with wedge-shaped infarction in right kidney. Kidney biopsy performed in the left kidney revealed microinfarction. Comprehensive work-up did not reveal any specific causes or risk factors except smoking, and the infarction was considered to be idiopathic. He emphasized that he received extremely strenuous military training several days before he came to the hospital. He was treated with low molecular weight heparin with significant improvement in renal function. Further studies are needed for the characterization of idiopathic renal infarction in previously healthy individuals and evaluating the mechanisms including strenuous physical activity on the renal blood flow.
Abdominal Pain ; Acute Kidney Injury ; Adult ; Biopsy ; Creatinine ; Heparin, Low-Molecular-Weight ; Humans ; Infarction* ; Kidney ; L-Lactate Dehydrogenase ; Leukocytosis ; Male* ; Military Personnel ; Motor Activity ; Perfusion ; Renal Circulation ; Risk Factors ; Smoke ; Smoking

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Re-mobilization of Lost Coronary Stent From the Axillary Artery to the Femoral Artery.

Jeong Seok LEE ; Hack Lyoung KIM ; Jae Bin SEO ; Woo Hyun LIM ; Eun Gyu KANG ; Woo Young CHUNG ; Sang Hyun KIM ; Zoo Hee JO ; Myung A KIM

Journal of Lipid and Atherosclerosis.2016;5(1):87-92. doi:10.12997/jla.2016.5.1.87

Stent migration and loss are rare but can be devastating complications during percutaneous coronary intervention (PCI) for coronary artery disease. We report a unique case of wandering stent from the right coronary artery to the femoral artery via the axillary artery. Initially, the stent was stripped from the delivery catheter and embolized to axillary artery during emergent PCI. An intra-aortic balloon pump might have forced retrograde movement of the stent to axillary artery which have subsequently remobilized to the femoral artery. After stabilization, the stent was successfully removed by a percutaneous approach using a snare. Immediate retrieval of wandering stent is recommended for the prevention of secondary embolization.
Axillary Artery* ; Catheters ; Coronary Artery Disease ; Coronary Vessels ; Drug-Eluting Stents ; Embolism ; Femoral Artery* ; Percutaneous Coronary Intervention ; SNARE Proteins ; Stents*

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Quantitative Measurement of Effect of Short-term Life Style Modification on Lipid Profiles in Korean Patients with Hyperlipidemia.

Young KIM ; Moonki JUNG ; Chee Jeong KIM

Journal of Lipid and Atherosclerosis.2016;5(1):79-86. doi:10.12997/jla.2016.5.1.79

OBJECTIVE: Effects of life style modifications on lipid profiles have been well established. However, data is scarce in Korean patients. We tried to quantify the effect of life style modifications on lipid profiles in relatively large number of Korean hyperlipidemic patients. METHODS: This study enrolled 1037 consecutive hyperlipidemic patients (total cholesterol or triglyceride levels ≥200 mg/dL) from 2003 to 2013. They were consisted of patients with hypercholesterolemia (n=308), borderline hypercholesterolemia (n=302), mixed hyperlipidemia (n=107), borderline mixed hyperlipidemia (n=156), and hypertriglyceridemia (n=164). Blood lipid levels were measured before and after life style modification for 2-4 months. RESULTS: Life style modification showed a small but significant reduction of body weight in all groups. It reduced low density lipoprotein (LDL) cholesterol by 9.1% (p=0.000), 5.9% (p=0.000), and 4.8% (p=0.003) in patients with hypercholesterolemia, borderline hypercholesterolemia, and mixed hyperlipidemia, respectively. LDL cholesterol was elevated in hypertriglyceridemic patients by 35% (p=0.000). Triglyceride levels decreased in patients with hypertriglyceridemia by 22% (p=0.000) and increased in hypercholesterolemic patients. There were no different effects of life style modification between men and women. CONCLUSION: Life style modification made significant improvement in lipid profiles in Korean patients. The degree of improvement from this study may provide useful data for the management of Korean hyperlipidemic patients.
Body Weight ; Cholesterol ; Cholesterol, LDL ; Diet Therapy ; Female ; Humans ; Hypercholesterolemia ; Hyperlipidemias* ; Hypertriglyceridemia ; Life Style* ; Lipoproteins ; Male ; Triglycerides

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Economic Evaluation of Rosuvastatin and Atorvastatin for the Treatment of Dyslipidemia from a Korean Health System Perspective.

Sunghwan SUH ; Chang Hee JUNG ; Soon Jun HONG ; Jung Sun KIM ; Byung Ju SONG ; Hyun Soon SOHN ; Sung Hee CHOI

Journal of Lipid and Atherosclerosis.2016;5(1):61-77. doi:10.12997/jla.2016.5.1.61

OBJECTIVE: This study aims to analyze cost-effectiveness of two most-commonly used statins from the perspective of the Korean national health system. METHODS: The scope of the analysis included rosuvastatin (5 mg, 10 mg, and 20 mg) and atorvastatin (10 mg, 20 mg, 40 mg, and 80 mg). Effectiveness was defined as percentage (%) and absolute (mg/dL) reductions of low-density lipoprotein cholesterol (LDL-C) from the baseline. They were derived from published randomized controlled studies for rosuvastatin and atorvastatin. Effectiveness was defined as reductions in LDL-C levels per mg dose of the drugs. The annual direct medical costs including drug acquisition costs and monitoring costs over the one-year time horizon were calculated for each alternative. The average cost-effectiveness ratios (ACERs) and incremental cost-effectiveness ratios (ICERs) for each statin dose were calculated. RESULTS: The ACERs for all doses of rosuvastatin (5 mg, 10 mg, and 20 mg) were lower than those for all doses of atorvastatin (10 mg, 20 mg, 40 mg, and 80 mg). Rosuvastatin 10 mg was the most cost-effective statin for LDL-C reduction. In cost-effectiveness analyses for corresponding doses of rosuvastatin and atorvastatin, rosuvastatin was the superior strategy which suggests both higher effectiveness and lower costs than atorvastatin. However, we have to consider this analysis is highly influenced by current price of statins in each market. CONCLUSIONS: For reduction of LDL-C levels in Korean patients with dyslipidemia, rosuvastatin 10mg is the most cost-effective statin in the current Korean market.
Acer ; Atorvastatin Calcium* ; Cholesterol ; Cost-Benefit Analysis* ; Dyslipidemias* ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; Lipoproteins ; Rosuvastatin Calcium*

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Black Raspberry Improved Lipid Profiles and Vascular Endothelial Function in Patients with Metabolic Syndrome: A Subgroup Analysis of Statin Naïve Participants.

Hee Jun MYUNG ; Han Saem JEONG ; Tae Yeon HWANG ; Kyoung Ho GO ; Juwon KIM ; Woori CHO ; Yoon Kyung CHOI ; Jiae PARK ; Soon Jun HONG

Journal of Lipid and Atherosclerosis.2016;5(1):49-59. doi:10.12997/jla.2016.5.1.49

OBJECTIVE: Black raspberry (Rubus occidentalis) has been known for its anti-inflammatory and anti-oxidant effects and for improving vascular endothelial function in patients at high-risk for cardiovascular disease. We investigated short-term effects of black raspberry on lipid profiles, vascular endothelial function and circulating endothelial progenitor cells in statin naïve participants with metabolic syndrome. METHODS: Patients with metabolic syndrome (n=51) without lipid lowering medications were prospectively randomized into the black raspberry group (n=26, 750 mg/day) and placebo group (n=25) during the 12-week follow-up. Lipid profiles, brachial artery flow-mediated dilatation (baFMD) and inflammatory cytokines such as IL-6, TNF-α, C-reactive protein, adiponectin, sICAM-1, sVCAM-1 were measured at baseline and at 12-week follow-up. Central blood pressure and augmentation index were also measured at baseline and at 12-week follow-up. RESULTS: Decreases from baseline in total cholesterol levels (-22.7±34.3 mg/dL vs. 0.0±34.7mg/dL, p<0.05, respectively) and total cholesterol/HDL ratio (-0.34±0.68 vs. 0.17±0.56, p<0.05, respectively) were significantly greater in the black raspberry group when compared to the placebo group. Decreases from baseline in IL-6 (-0.5±1.4 pg/mL vs. -0.1±1.1 pg/mL, p<0.05, respectively) and TNF-α levels (-5.4±4.5 pg/mL vs. -0.8±4.0 pg/mL, p<0.05, respectively) were significantly greater in the black raspberry group. Increases from the baseline in adiponectin levels (2.9±2.1 µg/mL vs. -0.2±2.5 µg/mL, p<.05) were significant in the black raspberry group. Increases in baFMD at 12-week follow-up were significantly greater in the black raspberry group when compared to the placebo group (2.9±3.6 mm vs. 1.0±3.9 mm, p<0.05, respectively). Radial augmentation indexes were significantly decreased in the black raspberry group when compared to the placebo group (-2±10% vs. 4±13%, p<0.05). CONCLUSION: The use of black raspberry significantly decreased serum total cholesterol levels, inflammatory cytokines, and augmentation index, thereby improving vascular endothelial function in statin naïve participants with metabolic syndrome during the 12-week follow-up.
Adiponectin ; Antioxidants ; Blood Pressure ; Brachial Artery ; C-Reactive Protein ; Cardiovascular Diseases ; Cholesterol ; Cytokines ; Dilatation ; Endothelial Progenitor Cells ; Follow-Up Studies ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors* ; Interleukin-6 ; Prospective Studies ; Rubus*

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Long-term Clinical Outcomes in Acute Myocardial Infarction Patients with Left Ventricular Dysfunction.

Jiung JEONG ; Myung Ho JEONG ; Young Joon HONG ; Ju Han KIM ; Youngkeun AHN ; Jeong Gwan CHO ; Jong Chun PARK

Journal of Lipid and Atherosclerosis.2016;5(1):37-47. doi:10.12997/jla.2016.5.1.37

OBJECTIVE: The purpose of this study was to define the effect of the changes of left ventricular ejection fraction (LVEF) on long-term major adverse cardiac events (MACEs) in patients with acute myocardial infarction (AMI). METHODS: Clinical analysis was performed on 1,188 AMI patients who completed follow- up 2-dimensional (2D) echocardiography after one year and clinical follow-up for 5 years. These patients were divided into three groups according to the LVEF change ratio: group A [increased LVEF change ratio, N=626], group B [decreased LVEF change ratio<20%, N=414], group C [decreased LVEF change ratio≥20%, N=148]. RESULTS: Initial low LVEF group and normal LVEF group showed no differences in MACEs. The mean initial and follow-up LVEF were 54.4±12.2% and 60.4±12.3% in the group A, 54.6±13.0% and 47.9±12.1% in the group B, and 56.5±12.6% and 39.9±11.6% in the group C (p=0.71). Total MACEs occurred in 62 (9.9%) patients in the group A, 83 (20.0%) patients in the group B, 44 (29.7%) patients in the group C during 5-year clinical follow-up (p=0.01). Initial low EF (<45%) was not a risk factor for long-term MACEs (Odd ratio (OR), 1.686; 95% confidence index (CI), 0.861-2.862, p=0.065), but the LVEF change ratio was a strong risk factor for long-term MACEs (OR, 3.731; 95% CI, 2.039-6.828, p=0.001). MACE-free survivals of patients with initial low LVEF and patients with low LVEF during follow-up period showed no significant differences (p=0.731). CONCLUSION: Initial low LVEF is not a predictor of long-term MACEs, but the decreased LVEF ratio during follow-up period is a strong predictor of long-term MACEs.
Echocardiography ; Follow-Up Studies ; Heart Failure ; Humans ; Myocardial Infarction* ; Prognosis ; Risk Factors ; Stroke Volume ; Ventricular Dysfunction, Left*

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