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Successful Endovascular Aortic Repair in a Young Female with Takayasu's Arteritis Presenting with Uncontrolled Hypertension.

Sang Hun PARK ; Hae Chang JEONG ; Keun Ho PARK ; Doo Sun SIM ; Young Joon HONG ; Ju Han KIM ; Youngkeun AHN ; Myung Ho JEONG

Journal of Lipid and Atherosclerosis.2013;2(2):97-102. doi:10.12997/jla.2013.2.2.97

A 21-year-old female presented with uncontrolled hypertension. Neck, abdomen, chest computed tomography angiogram showed moderate stenosis in the left common carotid artery and the left subclavian artery, and multiple severe stenosis in the transitional area between the descending thoracic aorta and the abdominal aorta. Transthoracic echocardiography and aortography revealed that the pressure gradient between the descending thoracic aorta and the abdominal aorta was 80 mmHg. She underwent angioplasty with stent implantation. After stent implantation, claudication improved significantly, and the pressure gradient decreased to 18 mmHg. The blood pressure was normalized with single anti-hypertensive medication, and no adverse clinical event occurred during five-year follow-up.
Abdomen ; Angioplasty ; Aorta, Abdominal ; Aorta, Thoracic ; Aortography ; Arteritis ; Blood Pressure ; Carotid Artery, Common ; Constriction, Pathologic ; Echocardiography ; Female* ; Follow-Up Studies ; Humans ; Hypertension* ; Neck ; Stents ; Subclavian Artery ; Takayasu Arteritis* ; Thorax ; Young Adult

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Successful Percutaneous Coronary Intervention in a Young Male Systemic Lupus Erythematosus Patient with Acute Myocardial Infarction.

Zhe Hao PIAO ; Myung Ho JEONG ; Hae Chang JEONG ; Shi Hyun RHEW ; Ki Hong LEE ; Keun Ho PARK ; Doo Sun SIM ; Young Joon HONG ; Ju Han KIM ; Youngkeun AHN ; Jeong Gwan CHO ; Jong Chun PARK

Journal of Lipid and Atherosclerosis.2013;2(2):91-95. doi:10.12997/jla.2013.2.2.91

Acute myocardial infarction is a rare but potentially lethal complication of systemic lupus erythematosus. There are several proposed mechanisms for acute myocardial infarction in lupus patients: atherosclerosis and endothelial injury leading to plaque rupture, coronary vasculitis and inflammation of the vessel wall causing aneurismal dilatation or spasm, and acute thrombosis and embolism. We report a-37-year-old man with systemic lupus erythematosus who developed myocardial infarction twice. Potential mechanisms for acute myocardial infarction for this patient are discussed in this report.
Atherosclerosis ; Dilatation ; Embolism and Thrombosis ; Humans ; Inflammation ; Lupus Erythematosus, Systemic* ; Male* ; Myocardial Infarction* ; Percutaneous Coronary Intervention* ; Rupture ; Spasm ; Vasculitis

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Transcatheter Aortic Valve Implantation Using CoreValve by Transaortic Approach.

Kyeong Hyeon CHUN ; Young Guk KO ; Ji Young SHIM ; Sak LEE ; Byung Chul CHANG ; Jae Kwang SHIM ; Young Ran KWAK ; Myeong Ki HONG

Journal of Lipid and Atherosclerosis.2013;2(2):85-90. doi:10.12997/jla.2013.2.2.85

INTRODUCTION: Transcatheter aortic valve implantation (TAVI) is now considered as an alternative treatment option for severe aortic stenosis (AS) patients who cannot undergo surgical aortic valve replacement (AVR). CASE REPORT: We describe the first Korean case of transaortic TAVI with mini-sternotomy using CoreValve. A 83-year-old woman with severe AS and recent history of non-ST elevation myocardial infarction was referred to our institution for TAVI intervention. There was no amenable peripheral vascular access for transfemoral or trans-subclavian approach. Considering the relatively high procedural risk of transapical approach in this patient, we performed transaortic TAVI with mini-sternotomy. CONCLUSION: The present case suggests transaortic approach may be an effective and safe strategy for TAVI in high risk severe AS patients without eligible femoral or subclavian access routes.
Aged, 80 and over ; Aortic Valve Stenosis ; Aortic Valve* ; Female ; Heart Valve Prosthesis Implantation ; Humans ; Myocardial Infarction ; Vascular Access Devices

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The Correlation Between Achilles Tendon Thickness and Cardiovascular Risk Factors.

Min Seob KWAK ; Se Jung YOON ; Yun Hyeong CHO ; Suk Min HONG ; Jong Kwan PARK ; Seungjin OH ; Dong Woon JEON ; Joo Young YANG

Journal of Lipid and Atherosclerosis.2013;2(2):77-83. doi:10.12997/jla.2013.2.2.77

BACKGROUND: Achilles tendon thickness (ATT) has been associated with increased cardiovascular risk in patients with familial hypercholesterolemia (FH). The aim of this study is to establish the correlation among ATT, obesity and established cardiovascular risk factors such as diabetes mellitus, hypertension, coronary artery disease, peripheral artery disease, smoking, and dyslipidemia. METHODS: In total, 19 patients (male 31.5%, mean age 60.0+/-12.5) with dyslipidemia and 96 control (male 64.6%, mean age 62.3+/-8.5) were enrolled. ATT was measured by ultrasonography. Anterioposterior diameter which represents the ATT was measured bilaterally, 4 cm above the insertion of Achilles tendon to the tuber calcite. Dyslipidemia was defined as elevated total cholesterol, triglyceride, or LDL cholesterol, or low levels of HDL cholesterol. RESULTS: There was no significant differences including ATT between the two groups (for ATT, dyslipidemia group, 0.44+/-0.04 vs control, 0.45+/-0.02 cm, p=0.783). There was no significant correlation between ATT and other cardiovascular risk factors except weight (r=0.34, p=0.007) and body mass index (r=0.63, p<0.001). Dyslipidemia was not significantly correlated with ATT (r=0.02, p=0.783). Use of statin was not significantly correlated with ATT (r=0.04, p=0.605). CONCLUSION: ATT was not significantly increased in patients with dyslipidemia. Lipid accumulation of Achilles tendon was not found in patients with dyslipidemia in this study.
Achilles Tendon* ; Atherosclerosis ; Body Mass Index ; Calcium Carbonate ; Cholesterol ; Cholesterol, HDL ; Cholesterol, LDL ; Coronary Artery Disease ; Diabetes Mellitus ; Dyslipidemias ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; Hyperlipoproteinemia Type II ; Hypertension ; Obesity ; Peripheral Arterial Disease ; Risk Factors* ; Smoke ; Smoking ; Triglycerides ; Ultrasonography

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Serum Ferritin Level is an Independent Predictor of Insulin Resistance in Non-diabetic Men Aged Between 30-69 Years: Korean National Health and Nutrition Examination Survey 2008-2010.

Bo Kyung KOO ; Sang Wan KIM ; Ka Hee YI ; Min Kyong MOON

Journal of Lipid and Atherosclerosis.2013;2(2):69-76. doi:10.12997/jla.2013.2.2.69

OBJECTIVE: We investigated predictors of insulin resistance in Korean population from the Korean National Health and Nutrition Examination Surveys. METHODS: Adults aged between 30-69 years without anemia were selected for the analysis. Fat mass was measured by dual-energy X-ray absorptiometry, and 24-hour nutritional information was obtained by interview from study subjects. Insulin resistance and beta cell function were calculated from homeostatic model assessment. RESULTS: 6,256 men and 8,003 women were included in the the study. Among participants, 9.8 (standard error [SE] 0.4) % of men and 6.8 (SE 0.4) % of women had diabetes mellitus (DM); moreover, serum ferritin level was higher in the DM patients compared to the non-DM subjects both in men and women (p<0.001). Serum ferritin levels correlated significantly with insulin resistance (age and body mass index adjusted p<0.001) in men, but not in women. Serum ferritin levels also correlated with total body fat (p=0.009), triglyceride levels (p<0.001), alanine aminotransferase (ALT) levels (p<0.001) and leukocyte count (p<0.001), but not with iron or fat intake. Multivariate analysis showed that serum ferritin level was an independent predictor of insulin resistance even after adjusting body fat, ALT levels, triglyceride levels and leukocyte count (beta=0.027, p=0.027). Beta cell function was not associated with ferritin levels both in men and women. CONCLUSION: Elevated serum ferritin was a risk factor for DM by increasing insulin resistance rather than affecting beta cell function. Serum ferritin level was an independent predictor of insulin resistance even after adjusting body fat or systemic inflammation in men.
Absorptiometry, Photon ; Adipose Tissue ; Adult ; Alanine Transaminase ; Anemia ; Body Mass Index ; Diabetes Mellitus ; Female ; Ferritins* ; Humans ; Inflammation ; Insulin Resistance* ; Insulin* ; Iron ; Leukocyte Count ; Male ; Multivariate Analysis ; Nutrition Surveys* ; Risk Factors ; Triglycerides

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The Inflammation Markers According to the Presence of Coronary Artery Disease in Patients with Peripheral Artery Disease.

Sook Young KIM ; Won Yu KANG ; Jun Ho SHIN ; Bo Ram YOUN ; Il Hyung JUNG ; Dong In NAM ; Chung KANG ; Hong Ju AN ; Sang Seon LEE ; Ho Yeong SONG ; Hoon KANG ; Sang Cheol CHO ; Sun Ho HWANG ; Wan KIM

Journal of Lipid and Atherosclerosis.2013;2(2):61-67. doi:10.12997/jla.2013.2.2.61

OBJECTIVE: Prevalence of coronary artery disease (CAD) has been reported to be high in patients with atherosclerotic peripheral artery disease (PAD) in lower extremities. Various inflammatory markers have been known to be associated with CAD. The aim of study was to explore the role of inflammatory makers for CAD in patients with PAD. METHODS: A total of 346 PAD patients (71.51+/-9.41 years, 337 males) who underwent percutaneous transluminal angioplasty from June 2006 to April 2012 were included in this study. Patients were divided into the Group I (PAD with CAD: n=151, 149 males) and the Group II (PAD without CAD: n=195, 188 males). RESULTS: Among 346 patients, 149 patients had CAD (43.6%). The prevalence of diabetes mellitus (DM) (p=0.023) and smoking (p=0.010) were significantly higher in the group I when compared withthe group II. The level of high sensitivity C-reactive protein (hs-CRP) increased (p<0.001) significantly in the group I compared with the group II. By multiple logistic regression analysis, smoking (odds ratio [OR]=1.991, 95% confidence interval [CI]: 1.162-3.411; p=0.012), DM (OR=1.922, 95% CI: 1.145-3.228; p=0.015), hs-CRP (> or =3.0 mg/dL) (OR=2.595, 95% CI: 1.548-4.350, p<0.001), and age (OR=0.645; 95% CI, 0.454-0.915; p=0.014) were independent predictors for the development of CAD in PAD patients. CONCLUSION: 43.6% of patients with PAD also had CAD, and the predictors of CAD were smoking, DM, and high level of hs-CRP.
Angioplasty ; C-Reactive Protein ; Coronary Artery Disease* ; Coronary Vessels* ; Diabetes Mellitus ; Humans ; Inflammation* ; Logistic Models ; Lower Extremity ; Peripheral Arterial Disease* ; Prevalence ; Smoke ; Smoking

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Management of Hypertriglyceridemia for Prevention of Cardiovascular Diseases.

Chee Jeong KIM

Journal of Lipid and Atherosclerosis.2013;2(2):53-60. doi:10.12997/jla.2013.2.2.53

Hypertriglyceridemia has been considered as a risk factor for cardiovascular diseases. However, triglyceride levels are influenced by many clinical and lipid risk factors. When triglyceride levels are adjusted by these variables, the effect of hypertriglyceridemia as a cardiovascular risk factor becomes minimal or negligible. Therefore, the association of hypertriglyceridemia with cardiovascular diseases is uncertain. The effect of triglyceride-lowering drugs on cardiovascular diseases is also unclear. These drugs failed to reduce cardiovascular events in relatively high risk patients with variable lipid profiles. However, subgroup analysis showed the cardioprotective effects in selected patients. It is clinically important whether a patient with hypertriglyceridemia should be treated with drug therapy or not. This paper discusses this issue based on limited data of published reports.
Cardiovascular Diseases* ; Drug Therapy ; Humans ; Hypertriglyceridemia* ; Risk Factors ; Triglycerides

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Survival Rates in Peripheral Artery Disease.

Shin Yi JANG ; Seung Woo PARK ; Young Wook KIM ; Duk Kyung KIM

Journal of Lipid and Atherosclerosis.2017;6(1):39-45. doi:10.12997/jla.2017.6.1.39

OBJECTIVE: The aim of this study was to analyze the long-term survival of subjects with peripheral artery disease (PAD). METHODS: The data included 415 Korean PAD patients aged ≥20 years hospitalized from 1994 through 2004 at a single tertiary center in Korea. Death data were obtained from all participants between 1994 and 2009. RESULTS: The mean of age was 64.4±9.3 years in PAD. The proportion of peripheral vascular bypass operation (re-vascularized) was about 50%. The proportion of males was 90.6% in PAD. Five- and 10- year survival rates were 79.2% and 60.5% in PAD, respectively. The 5- and 10- year survival rates were 83.0% and 64.1% in re-vascularized group, and 75.5% and 56.3% in non-revascularized group (p<0.05). For PAD, the adjusted hazard ratios (HRs) were 1.75 (95% confidence interval (CI) 1.17-2.68) in over 65 years, 1.53 (95% CI 1.05-2.27) in diabetes, and 2.21 (95% CI 1.51-3.23) in chronic kidney disease (CKD). Interestingly, HRs in PAD were 0.55 (95% CI 0.34-0.84) in overweight and 0.45 (95% CI 0.25-0.76) in obesity. CONCLUSIONS: The 5- and 10- year survival rates were 79.2% and 60.5% in PAD. The survival rate in re-vascularized group was higher than that in non-revascularized group. Independent predictors of mortality were age, diabetes, and CKD in PAD. Obesity showed improved survival rates.
Humans ; Korea ; Male ; Mortality ; Obesity ; Overweight ; Peripheral Arterial Disease* ; Renal Insufficiency, Chronic ; Survival Rate*

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Association between Metabotropic Glutamate Receptor 1 Polymorphism and Cardiovascular Disease in Korean Adults.

Yoonjin SHIN ; Jaehyun PARK ; Sungho WON ; Yangha KIM

Journal of Lipid and Atherosclerosis.2017;6(1):29-38. doi:10.12997/jla.2017.6.1.29

OBJECTIVE: The mGluR1 (metabotropic glutamate receptor 1) gene, a G protein–coupled receptor, is known to mediate perceptions of umami tastes. Genetic variation in taste receptors may influence dietary intake, and in turn have an impact on nutritional status and risk of chronic disease. We investigated the association of mGluR1 rs2814863 polymorphism with lipid profiles and cardiovascular disease (CVD) risk, together with their modulation by macronutrient intake in Korean adults. METHODS: The subjects consisted of 8,380 Koreans aged 40-69 years participating in the Anseong and Ansan Cohort Study, which was a part of the Korean Genome Epidemiology Study (KoGES). Data was collected using self-administered questionnaires, anthropometric measurements, and blood chemical analysis. RESULTS: Carriers of C allele at mGluR1 rs2814863 was associated with decreased high density lipoprotein cholesterol (HDL-C) and increased triglyceride as compared to carriers of TT. Also, carriers of the C allele showed higher fat intake and lower carbohydrate intake than those with carriers of TT. After adjustment for multiple testing using false-discovery rate method, the significant difference of HDL-C, triglyceride, dietary fat, and carbohydrate across genotypes disappeared. Gene-diet interaction effects between rs2814863 and macronutrients intake were not significantly associated with HDL-C and triglyceride levels. However, carriers of C allele demonstrated significantly higher odds of CVD {odds ratio=1.13, 95% CI=1.02-1.25} compared with carriers of TT. CONCLUSIONS: Our findings support significant associations between the mGluR1 rs2814863 genotype and CVD-related variables in Korean adults. However, these associations are not modified by macronutrient intake.
Adult* ; Alleles ; Blood Chemical Analysis ; Cardiovascular Diseases* ; Cholesterol, HDL ; Chronic Disease ; Cohort Studies ; Dietary Fats ; Epidemiology ; Genes, vif ; Genetic Variation ; Genome ; Genotype ; Gyeonggi-do ; Humans ; Methods ; Nutritional Status ; Polymorphism, Single Nucleotide ; Receptors, Glutamate ; Receptors, Metabotropic Glutamate* ; Triglycerides

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Long-term Survival Rates for Patients with Aortic Aneurysm.

Shin Yi JANG ; Duk Kyung KIM

Journal of Lipid and Atherosclerosis.2017;6(1):22-28. doi:10.12997/jla.2017.6.1.22

OBJECTIVE: The aim of this study was to determine factors affecting the long-term survival of subjects with aortic aneurysm (AA). METHODS: We included 294 Korean patients aged ≥30 years who were hospitalized from 1994 through 2004. Diagnosis was confirmed in 267A subjects (75.8% with abdominal only AA (AAA) and 24.2% with thoracic AA (TAA)) by computed tomography angiography in Samsung Medical Center, Seoul, Korea. AA repair direct operation or percutaneous endovascular AA repair (Revascularized group) was performed in 60.3% of the total patients. Death data were obtained from all participants between 1994 and 2009. RESULTS: The mean age of AA subjects was 68.7 (±8.1) years. The proportion of males was 82%. Five- and 10-year survival rates were 89.8% and 82.6%, respectively. The 5- and 10-year survival rates were 92.3% and 84.9% in revascularized group and 86.4% and 79.5% in non-revascularized group, respectively. Adjusted hazard ratios were 1.11 {95% confidence interval (CI) 1.04-1.21} in ages and 3.07 (95% CI 1.26-7.90) in smoking for AA. CONCLUSIONS: Age and smoking contributed to death in Korean AA patients. In addition, the 10-year survival rate for AA patients in Korea was over 80%.
Angiography ; Aortic Aneurysm* ; Diagnosis ; Humans ; Korea ; Male ; Seoul ; Smoke ; Smoking ; Survival Rate*

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