1.Development of Korean Standardized Heart Failure Registry: Experience From Integration of KorAHF and KorHF III
Eui-Soon KIM ; Huijin LEE ; Jong-Chan YOUN ; Byung-Su YOO ; Hae-Young LEE ; Ju-Hee LEE ; Dong-Hyuk CHO ; Mi-Hyang JUNG ; Hye Sun LEE ; Hyun-Jai CHO
International Journal of Heart Failure 2026;8(1):1-11
Heart failure (HF) prevalence and associated socio-economic costs have risen rapidly in Korea, creating urgent demand for a national, standardized prospective registry to support quality monitoring, outcome comparison, and real-world evidence. Standardized data definitions are essential for valid comparisons across studies and healthcare settings. We created a unified national HF cohort by integrating the two largest Korean registries, KorAHF (2011–2014;n=5,625) and KorHF III (2018–2023; n=7,351), yielding 12,976 hospitalized HF patients. Because heterogeneous variable definitions impeded direct comparisons, we implemented a harmonization pipeline across demographic, clinical, imaging, biomarker, therapeutic, and outcome domains, aligned with international standards and reinforced by systematic data quality checks.A multidisciplinary panel then conducted a structured decision process to produce the Korean HF Standard Dataset, a tiered and interoperable variable set spanning six domains: demographics, presentation at admission, in-hospital events and comorbidities, discharge status, outpatient follow-up, and readmission events. This integrated platform and standardized variables enable precise identification of HF patient phenotypes and prognostic factors, establishing an evidence-based foundation for disease management. This supports an analysis of temporal changes in treatment patterns and outcomes, generates data to inform future clinical practice guidelines, and provides a practical basis for planning large, continuous, prospective HF registries. Furthermore, it also facilitates pragmatic, registry-based randomized clinical trials and unmet-needs assessments that can guide national health policy. Establishing a foundation for future linkage with national health databases, this platform will allow for enhanced accuracy, comparability, and representativeness, powering quality improvement initiatives and population-level monitoring of Korea’s growing HF burden.
2.Asparaginase-Associated Pancreatitis and Pancreatic Pseudocyst Managed with Endoscopic Cystogastrostomy in Adult Acute Lymphoblastic Leukemia
Gyewon PARK ; Eun Sun KIM ; Hyuk Soon CHOI ; Bora KEUM ; Yoon Tae JEEN ; Hoon Jai CHUN ; Hong Sik LEE ; Jae Min LEE
Korean Journal of Pancreas and Biliary Tract 2025;30(1):31-35
Anticancer treatment for acute lymphocytic leukemia is based on drugs such as methotrexate, 6-mercaptopurine, vincristine, and asparaginase. Asparaginase-related pancreatitis is known to have an incidence of up to 18%, and is a major cause of discontinuation of anticancer treatment for leukemia due to acute onset and chronic complications. There were various cases of treatment of peripancreatic fluid retention caused by anticancer drugs in leukemia patients. Use of lumen-apposing metal stents (LAMS) for walled-off necrosis (WON) drainage has recently increased. The electrocautery-enhanced delivery system allowed simpler and faster stent placement, streamlining the overall procedure and potentially reducing procedure time. Therefore, favorable outcomes have been reported with the use of LAMS for endoscopic drainage of various conditions. In this paper, we discuss a case in which hot-system LAMS was performed to treat L-asparaginase-induced acute pancreatitis and pancreatic pseudocyst in an adult patient with acute lymphoblastic leukemia.
3.Asparaginase-Associated Pancreatitis and Pancreatic Pseudocyst Managed with Endoscopic Cystogastrostomy in Adult Acute Lymphoblastic Leukemia
Gyewon PARK ; Eun Sun KIM ; Hyuk Soon CHOI ; Bora KEUM ; Yoon Tae JEEN ; Hoon Jai CHUN ; Hong Sik LEE ; Jae Min LEE
Korean Journal of Pancreas and Biliary Tract 2025;30(1):31-35
Anticancer treatment for acute lymphocytic leukemia is based on drugs such as methotrexate, 6-mercaptopurine, vincristine, and asparaginase. Asparaginase-related pancreatitis is known to have an incidence of up to 18%, and is a major cause of discontinuation of anticancer treatment for leukemia due to acute onset and chronic complications. There were various cases of treatment of peripancreatic fluid retention caused by anticancer drugs in leukemia patients. Use of lumen-apposing metal stents (LAMS) for walled-off necrosis (WON) drainage has recently increased. The electrocautery-enhanced delivery system allowed simpler and faster stent placement, streamlining the overall procedure and potentially reducing procedure time. Therefore, favorable outcomes have been reported with the use of LAMS for endoscopic drainage of various conditions. In this paper, we discuss a case in which hot-system LAMS was performed to treat L-asparaginase-induced acute pancreatitis and pancreatic pseudocyst in an adult patient with acute lymphoblastic leukemia.
4.Asparaginase-Associated Pancreatitis and Pancreatic Pseudocyst Managed with Endoscopic Cystogastrostomy in Adult Acute Lymphoblastic Leukemia
Gyewon PARK ; Eun Sun KIM ; Hyuk Soon CHOI ; Bora KEUM ; Yoon Tae JEEN ; Hoon Jai CHUN ; Hong Sik LEE ; Jae Min LEE
Korean Journal of Pancreas and Biliary Tract 2025;30(1):31-35
Anticancer treatment for acute lymphocytic leukemia is based on drugs such as methotrexate, 6-mercaptopurine, vincristine, and asparaginase. Asparaginase-related pancreatitis is known to have an incidence of up to 18%, and is a major cause of discontinuation of anticancer treatment for leukemia due to acute onset and chronic complications. There were various cases of treatment of peripancreatic fluid retention caused by anticancer drugs in leukemia patients. Use of lumen-apposing metal stents (LAMS) for walled-off necrosis (WON) drainage has recently increased. The electrocautery-enhanced delivery system allowed simpler and faster stent placement, streamlining the overall procedure and potentially reducing procedure time. Therefore, favorable outcomes have been reported with the use of LAMS for endoscopic drainage of various conditions. In this paper, we discuss a case in which hot-system LAMS was performed to treat L-asparaginase-induced acute pancreatitis and pancreatic pseudocyst in an adult patient with acute lymphoblastic leukemia.
5.Asparaginase-Associated Pancreatitis and Pancreatic Pseudocyst Managed with Endoscopic Cystogastrostomy in Adult Acute Lymphoblastic Leukemia
Gyewon PARK ; Eun Sun KIM ; Hyuk Soon CHOI ; Bora KEUM ; Yoon Tae JEEN ; Hoon Jai CHUN ; Hong Sik LEE ; Jae Min LEE
Korean Journal of Pancreas and Biliary Tract 2025;30(1):31-35
Anticancer treatment for acute lymphocytic leukemia is based on drugs such as methotrexate, 6-mercaptopurine, vincristine, and asparaginase. Asparaginase-related pancreatitis is known to have an incidence of up to 18%, and is a major cause of discontinuation of anticancer treatment for leukemia due to acute onset and chronic complications. There were various cases of treatment of peripancreatic fluid retention caused by anticancer drugs in leukemia patients. Use of lumen-apposing metal stents (LAMS) for walled-off necrosis (WON) drainage has recently increased. The electrocautery-enhanced delivery system allowed simpler and faster stent placement, streamlining the overall procedure and potentially reducing procedure time. Therefore, favorable outcomes have been reported with the use of LAMS for endoscopic drainage of various conditions. In this paper, we discuss a case in which hot-system LAMS was performed to treat L-asparaginase-induced acute pancreatitis and pancreatic pseudocyst in an adult patient with acute lymphoblastic leukemia.
6.Asparaginase-Associated Pancreatitis and Pancreatic Pseudocyst Managed with Endoscopic Cystogastrostomy in Adult Acute Lymphoblastic Leukemia
Gyewon PARK ; Eun Sun KIM ; Hyuk Soon CHOI ; Bora KEUM ; Yoon Tae JEEN ; Hoon Jai CHUN ; Hong Sik LEE ; Jae Min LEE
Korean Journal of Pancreas and Biliary Tract 2025;30(1):31-35
Anticancer treatment for acute lymphocytic leukemia is based on drugs such as methotrexate, 6-mercaptopurine, vincristine, and asparaginase. Asparaginase-related pancreatitis is known to have an incidence of up to 18%, and is a major cause of discontinuation of anticancer treatment for leukemia due to acute onset and chronic complications. There were various cases of treatment of peripancreatic fluid retention caused by anticancer drugs in leukemia patients. Use of lumen-apposing metal stents (LAMS) for walled-off necrosis (WON) drainage has recently increased. The electrocautery-enhanced delivery system allowed simpler and faster stent placement, streamlining the overall procedure and potentially reducing procedure time. Therefore, favorable outcomes have been reported with the use of LAMS for endoscopic drainage of various conditions. In this paper, we discuss a case in which hot-system LAMS was performed to treat L-asparaginase-induced acute pancreatitis and pancreatic pseudocyst in an adult patient with acute lymphoblastic leukemia.
7.Real-World Eligibility and Cost-Effectiveness Analysis of Empagliflozin for Heart Failure in Korea
Eui-Soon KIM ; Sun-Kyeong PARK ; Jong-Chan YOUN ; Hye Sun LEE ; Hae-Young LEE ; Hyun-Jai CHO ; Jin-Oh CHOI ; Eun-Seok JEON ; Sang Eun LEE ; Min-Seok KIM ; Jae-Joong KIM ; Kyung-Kuk HWANG ; Myeong-Chan CHO ; Shung Chull CHAE ; Seok-Min KANG ; Jin Joo PARK ; Dong-Ju CHOI ; Byung-Su YOO ; Jae Yeong CHO ; Kye Hun KIM ; Byung-Hee OH ; Barry GREENBERG ; Sang Hong BAEK
Journal of Korean Medical Science 2024;39(1):e8-
Background:
The US Food and Drug Administration (FDA) and European Medicines Agency (EMA) approved empagliflozin for reducing cardiovascular mortality and heart failure (HF) hospitalization in patients with both HF with reduced ejection fraction (HFrEF) and HF with preserved ejection fraction (HFpEF). However, limited data are available on the generalizability of empagliflozin to clinical practice. Therefore, we evaluated real-world eligibility and potential cost-effectiveness based on a nationwide prospective HF registry.
Methods:
A total of 3,108 HFrEF and 2,070 HFpEF patients from the Korean Acute Heart Failure (KorAHF) registry were analyzed. Eligibility was estimated by inclusion and exclusion criteria of EMPagliflozin outcomE tRial in Patients With chrOnic heaRt Failure With Reduced Ejection Fraction (EMPEROR-Reduced) and EMPagliflozin outcomE tRial in Patients With chrOnic heaRt Failure With Preserved Ejection Fraction (EMPEROR-Preserved) trials and by FDA & EMA label criteria. The cost-utility analysis was done using a Markov model to project the lifetime medical cost and quality-adjusted life year (QALY).
Results:
Among the KorAHF patients, 91.4% met FDA & EMA label criteria, while 44.7% met the clinical trial criteria. The incremental cost-effectiveness ratio of empagliflozin was calculated at US$6,764 per QALY in the overall population, which is far below a threshold of US$18,182 per QALY. The cost-effectiveness benefit was more evident in patients with HFrEF (US$5,012 per QALY) than HFpEF (US$8,971 per QALY).
Conclusion
There is a large discrepancy in real-world eligibility for empagliflozin between FDA & EMA labels and clinical trial criteria. Empagliflozin is cost-effective in HF patients regardless of ejection fraction in South Korea health care setting. The efficacy and safety of empagliflozin in real-world HF patients should be further investigated for a broader range of clinical applications.

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