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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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Diagnostic and Therapeutic Approach of Carotid and Cerebrovascular Plaque on the Basis of Vessel Imaging.

Dong Hyun LEE ; Jong Ho PARK

Journal of Lipid and Atherosclerosis.2017;6(1):15-21. doi:10.12997/jla.2017.6.1.15

Atherosclerosis, characterized by chronic systemic inflammation with plaque formation, is one of the major causes of cerebrovascular disease. Recent advances in imaging technologies can help further understand the overall process and biology of plaque formation and rupture. Thus, these imaging techniques could aid clinicians to make better decision for risk stratification, therapeutic planning, and prediction of future cerebrovascular event. Ultrasonography, magnetic resonance imaging, and positron emission tomography are the rapidly-evolving imaging modalities dealing with assessment of atherosclerotic plaque. By advances in imaging technology for evaluating plaque, we can characterize the vulnerability of plaque in-vivo, understand the composition and activity of plaque, assess therapeutic response to treatment, and ultimately predict the overall risk of future cerebrovascular episodes. In this review, we will introduce current understanding of various advanced imaging modalities and clinical application of these imaging technologies.
Atherosclerosis ; Biology ; Carotid Artery Diseases ; Cerebrovascular Disorders ; Inflammation ; Magnetic Resonance Imaging ; Plaque, Atherosclerotic ; Positron-Emission Tomography ; Rupture ; Ultrasonography

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New European Society of Cardiology/European Atherosclerosis Society Guideline for the Management of Dyslipidemia.

Chang Hee JUNG

Journal of Lipid and Atherosclerosis.2017;6(1):8-14. doi:10.12997/jla.2017.6.1.8

The management of dyslipidemia is one of the crucial components in the prevention of atherosclerotic cardiovascular disease. Recently, the task force for the management of dyslipidemias of the ESC (European Society of Cardiology) and the EAS (European Atherosclerosis Society) updated their clinical guideline for the first time in 5 years. Although the new guideline maintained the previous recommendations in almost every aspect, there were some updates and modifications in the risk categorization and therapeutic modalities. In this review, I'd like to summarize the updated recommendations and differences compared to the previous version.
Advisory Committees ; Atherosclerosis* ; Cardiovascular Diseases ; Dyslipidemias*

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Bile Acid Receptor Farnesoid X Receptor: A Novel Therapeutic Target for Metabolic Diseases.

Sungsoon FANG

Journal of Lipid and Atherosclerosis.2017;6(1):1-7. doi:10.12997/jla.2017.6.1.1

Bile acid has been well known to serve as a hormone in regulating transcriptional activity of Farnesoid X receptor (FXR), an endogenous bile acid nuclear receptor. Moreover, bile acid regulates diverse biological processes, including cholesterol/bile acid metabolism, glucose/lipid metabolism and energy expenditure. Alteration of bile acid metabolism has been revealed in type II diabetic (T2D) patients. FXR-mediated bile acid signaling has been reported to play key roles in improving metabolic parameters in vertical sleeve gastrectomy surgery, implying that FXR is an essential modulator in the metabolic homeostasis. Using a genetic mouse model, intestinal specific FXR-null mice have been reported to be resistant to diet-induced obesity and insulin resistance. Moreover, intestinal specific FXR agonism using gut-specific FXR synthetic agonist has been shown to enhance thermogenesis in brown adipose tissue and browning in white adipose tissue to increase energy expenditure, leading to reduced body weight gain and improved insulin resistance. Altogether, FXR is a potent therapeutic target for the treatment of metabolic diseases.
Adipose Tissue, Brown ; Adipose Tissue, White ; Animals ; Bile Acids and Salts ; Bile* ; Biological Processes ; Body Weight ; Energy Metabolism ; Felodipine ; Gastrectomy ; Homeostasis ; Humans ; Insulin Resistance ; Metabolic Diseases* ; Metabolism ; Mice ; Obesity ; Thermogenesis

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Intramural Hematoma with Air Density on Computed Tomography after Percutaneous Kyphoplasty.

Ji Young WOO ; Soo Yoon MOON ; Hee Su PARK ; Kyung Up KIM ; Jae Kyun CHOI ; Won Woo SEO ; Dae Gyun PARK

Journal of Lipid and Atherosclerosis.2015;4(2):141-144. doi:10.12997/jla.2015.4.2.141

Iatrogenic aortic dissection occurs in association with diverse invasive procedures. It occurs primarily as a complication of cardiac surgery or after catheterization procedure. We found a case of iatrogenic abdominal aortic dissection caused by traumatic needle injury. The patient complained of abdominal pain after balloon kyphoplasty. Abdominal computed tomography (CT) showed intramural hematoma with air density suggestive of an iatrogenic cause. The patient was managed conservatively, and no lesion progression was noted in the follow-up CT. To the best of our knowledge, this is the first case of iatrogenic aortic dissection associated with kyphoplasty.
Abdominal Pain ; Catheterization ; Catheters ; Follow-Up Studies ; Hematoma* ; Humans ; Kyphoplasty* ; Needles ; Thoracic Surgery

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Myocardial Ischemia by Aggravation of Myocardial Bridging.

Kyung Up KIM ; Jae Kyun CHOI ; Hye Mi OH ; Ji Young WOO ; Hee Su PARK ; Soo Yoon MOON ; Won Woo SEO ; Kyoo Rok HAN

Journal of Lipid and Atherosclerosis.2015;4(2):137-140. doi:10.12997/jla.2015.4.2.137

Myocardial bridging (MB) occurs when the myocardium covers a segment of a major epicardial coronary artery, resulting in a tunneled arterial segment. Although MB is generally considered benign, it has been associated with myocardial ischemia. A 70-year-old man with MB (50% luminal narrowing during systole) at the mid-left anterior descending artery (LAD) on previous coronary angiography (CAG) visited our hospital with worsening chest pain. His blood pressure (BP) was not well controlled because of poor compliance. Follow-up CAG showed that MB at the mid-LAD progressed to severe stenosis (>90% luminal narrowing during systole) and the total length of tunneled artery extended from 22.5 to 23.9 mm. His chest pain was relieved by BP control. This is the first report of myocardial ischemia secondary to progression of MB demonstrated by CAG in Korea.
Aged ; Arteries ; Blood Pressure ; Chest Pain ; Compliance ; Constriction, Pathologic ; Coronary Angiography ; Coronary Vessels ; Follow-Up Studies ; Humans ; Hypertension ; Ischemia ; Korea ; Myocardial Bridging* ; Myocardial Ischemia* ; Myocardium ; Phenobarbital

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Missing Right Coronary Artery in a Patient with Acute Inferior ST Segment Elevation Myocardial Infarction: A Case of Extremely Rare Variation of Coronary Anatomy.

Jae Hyuk LEE ; Yongsung SUH ; In Cheol YOON ; Yong Hwan JUNG ; Sung Hwa CHOI ; Yun Hyeong CHO ; Deok Kyu CHO

Journal of Lipid and Atherosclerosis.2015;4(2):131-135. doi:10.12997/jla.2015.4.2.131

We recently encountered an interesting case of acute inferior ST segment elevation myocardial infarction (STEMI). This patient had a rare anatomic variation, single coronary artery. The right coronary artery originate from the left circumflex proper artery, not from aorta, was totally obstructed with thrombi. Though it took more time to figure out the patient's coronary anatomy and the culprit lesion, we successfully performed primary percutaneous coronary intervention within the guideline-recommended time period. We performed left coronary angiography at the beginning. This strategy could be helpful in determining the culprit lesion and preventing unnecessary procedural delay in acute inferior STEMI.
Anatomic Variation ; Aorta ; Arteries ; Coronary Angiography ; Coronary Vessel Anomalies ; Coronary Vessels* ; Humans ; Myocardial Infarction* ; Percutaneous Coronary Intervention

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Increased Estimated 10-Year Risk for Cardiovascular Disease Assessed Using the Pooled Cohort Equation in Non-Diabetic Subjects According to Increasing HbA1c Levels.

Hyung Geun OH ; Eun Jung RHEE

Journal of Lipid and Atherosclerosis.2015;4(2):123-130. doi:10.12997/jla.2015.4.2.123

OBJECTIVE: In 2013, a new risk calculator known as the Pooled Cohort Equation (PCE) was introduced with the new cholesterol guideline. We aimed to calculate the 10-year atherosclerotic cardiovascular disease (ASCVD) risk using PCE in non-diabetic Korean subjects with glycated hemoglobin (HbA1c) lower than 6.5%. METHODS: A total of 17,519 participants were evaluated in a health screening program. The 10-year ASCVD risk was calculated using the PCE. Subjects with underlying diabetes or HbA1c > or =6.5% were excluded. Subjects were divided into four groups according to fasting blood glucose (FBG) and HbA1c levels: FBG <100 mg/dL, 100< or =FBG<110 mg/dL, 110< or =FBG<120 mg/dL, and FBG > or =120 mg/dL; HbA1c <5.5%, 5.5%< or =HbA1c<5.6%, 5.6%< or =HbA1c<5.8%, and HbA1c > or =5.8%. RESULTS: The mean 10-year ASCVD risk significantly increased as FBG increased from <100 mg/dL to >120 mg/dL in the four divided groups (2.6%, 3.3%, 3.8%, 4.1%; p<0.01), and as HbA1c increased from <5.5% to >5.8% (2.4%, 2.7%, 3.0%, 3.6%; p<0.01). The odds ratio for 10-year ASCVD risk > or =10% significantly increased from group I to IV according to FBG and HbA1c levels after adjusting for age, body mass index and fasting insulin level (1.187, 1.753, and 2.390 vs. 1.0 in the lowest FBG group; 1.626, 1.574, and 1.645 vs. 1.0 in the lowest HbA1c group). CONCLUSION: The 10-year ASCVD risk calculated using the PCE significantly increased as the FBG and HbA1c increased even in Korean subjects without underlying diabetes.
Blood Glucose ; Body Mass Index ; Cardiovascular Diseases* ; Cholesterol ; Cohort Studies* ; Fasting ; Hemoglobin A, Glycosylated ; Insulin ; Mass Screening ; Odds Ratio ; Prediabetic State

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