Background: Complete revascularization has demonstrated better outcomes in patients with acute myocardial infarction (AMI) and multivessel disease. However, in the case of left main (LM) culprit lesion AMI with multivessel disease, there is limited evidence to suggest that complete revascularization is better. Methods: We reviewed 16,831 patients in the Korea Acute Myocardial Infarction Registry who were treated from July 2016 to June 2020, and 399 patients were enrolled with LM culprit lesion AMI treated with percutaneous coronary intervention. We categorized the patients as those treated with complete revascularization (n=295) or incomplete revascularization (n=104). The study endpoint was major adverse cardiac and cerebrovascular events (MACCE), a composite of all-cause death, myocardial infarction, ischemia-driven revascularization, stent thrombosis, and stroke. We performed propensity score matching (PSM) and analyzed the incidence of MACCE at 1 year. Results: After PSM, the two groups were well balanced. There was no significant difference between the two groups in MACCE at 1 year (12.1% vs. 15.2%; hazard ratio, 1.28; 95% confidence interval, 0.60–2.74; p=0.524) after PSM. The components of MACCE and major bleeding were also not significantly different. Conclusion There was no significant difference in clinical outcomes between the groups treated with complete or incomplete revascularization for LM culprit lesion AMI with multivessel disease.

Background: Complete revascularization has demonstrated better outcomes in patients with acute myocardial infarction (AMI) and multivessel disease. However, in the case of left main (LM) culprit lesion AMI with multivessel disease, there is limited evidence to suggest that complete revascularization is better. Methods: We reviewed 16,831 patients in the Korea Acute Myocardial Infarction Registry who were treated from July 2016 to June 2020, and 399 patients were enrolled with LM culprit lesion AMI treated with percutaneous coronary intervention. We categorized the patients as those treated with complete revascularization (n=295) or incomplete revascularization (n=104). The study endpoint was major adverse cardiac and cerebrovascular events (MACCE), a composite of all-cause death, myocardial infarction, ischemia-driven revascularization, stent thrombosis, and stroke. We performed propensity score matching (PSM) and analyzed the incidence of MACCE at 1 year. Results: After PSM, the two groups were well balanced. There was no significant difference between the two groups in MACCE at 1 year (12.1% vs. 15.2%; hazard ratio, 1.28; 95% confidence interval, 0.60–2.74; p=0.524) after PSM. The components of MACCE and major bleeding were also not significantly different. Conclusion There was no significant difference in clinical outcomes between the groups treated with complete or incomplete revascularization for LM culprit lesion AMI with multivessel disease.

Background: Complete revascularization has demonstrated better outcomes in patients with acute myocardial infarction (AMI) and multivessel disease. However, in the case of left main (LM) culprit lesion AMI with multivessel disease, there is limited evidence to suggest that complete revascularization is better. Methods: We reviewed 16,831 patients in the Korea Acute Myocardial Infarction Registry who were treated from July 2016 to June 2020, and 399 patients were enrolled with LM culprit lesion AMI treated with percutaneous coronary intervention. We categorized the patients as those treated with complete revascularization (n=295) or incomplete revascularization (n=104). The study endpoint was major adverse cardiac and cerebrovascular events (MACCE), a composite of all-cause death, myocardial infarction, ischemia-driven revascularization, stent thrombosis, and stroke. We performed propensity score matching (PSM) and analyzed the incidence of MACCE at 1 year. Results: After PSM, the two groups were well balanced. There was no significant difference between the two groups in MACCE at 1 year (12.1% vs. 15.2%; hazard ratio, 1.28; 95% confidence interval, 0.60–2.74; p=0.524) after PSM. The components of MACCE and major bleeding were also not significantly different. Conclusion There was no significant difference in clinical outcomes between the groups treated with complete or incomplete revascularization for LM culprit lesion AMI with multivessel disease.

Background: Complete revascularization has demonstrated better outcomes in patients with acute myocardial infarction (AMI) and multivessel disease. However, in the case of left main (LM) culprit lesion AMI with multivessel disease, there is limited evidence to suggest that complete revascularization is better. Methods: We reviewed 16,831 patients in the Korea Acute Myocardial Infarction Registry who were treated from July 2016 to June 2020, and 399 patients were enrolled with LM culprit lesion AMI treated with percutaneous coronary intervention. We categorized the patients as those treated with complete revascularization (n=295) or incomplete revascularization (n=104). The study endpoint was major adverse cardiac and cerebrovascular events (MACCE), a composite of all-cause death, myocardial infarction, ischemia-driven revascularization, stent thrombosis, and stroke. We performed propensity score matching (PSM) and analyzed the incidence of MACCE at 1 year. Results: After PSM, the two groups were well balanced. There was no significant difference between the two groups in MACCE at 1 year (12.1% vs. 15.2%; hazard ratio, 1.28; 95% confidence interval, 0.60–2.74; p=0.524) after PSM. The components of MACCE and major bleeding were also not significantly different. Conclusion There was no significant difference in clinical outcomes between the groups treated with complete or incomplete revascularization for LM culprit lesion AMI with multivessel disease.

Purpose: The purpose of this study was to evaluate the fracture strength of zirconia crowns of varying margin thicknesses. Materials and Methods: A model of the maxillary right first molar (Nissin, Kyoto, Japan) was prepared to create an abutment, which was fabricated into a metal die via a 3D metal printer. CAD software (exocad GmbH, Darmstadt, Germany) was used to design the crowns. A total of eight groups were generated: initially separated by margin thickness (0.1 mm and 0.8 mm), and then further divided by horizontal margin widths of 0.1 mm, 0.2 mm, 0.3 mm, and 0.4 mm. Zirconia crowns were designed for each group’s working models (N=10). Crown fracture strength was assessed using a universal testing machine (Shimadzu, Kyoto, Japan), applying a compressive load until fracture and recording the maximum load. A scanning electron microscope was employed to observe fracture patterns. Fracture strength results were analyzed using one-way ANOVA, with the Tukey HSD test applied for post-hoc analysis (α=0.05). Results: Zirconia crown fracture strength significantly improved with increased horizontal margin width (P<0.001). However, margin thickness had no statistically significant effect on fracture strength (P=0.513). Conclusion Optimizing the horizontal margin width of zirconia crowns enhances their durability and performance.

Purpose: The purpose of this study was to evaluate the fracture strength of zirconia crowns of varying margin thicknesses. Materials and Methods: A model of the maxillary right first molar (Nissin, Kyoto, Japan) was prepared to create an abutment, which was fabricated into a metal die via a 3D metal printer. CAD software (exocad GmbH, Darmstadt, Germany) was used to design the crowns. A total of eight groups were generated: initially separated by margin thickness (0.1 mm and 0.8 mm), and then further divided by horizontal margin widths of 0.1 mm, 0.2 mm, 0.3 mm, and 0.4 mm. Zirconia crowns were designed for each group’s working models (N=10). Crown fracture strength was assessed using a universal testing machine (Shimadzu, Kyoto, Japan), applying a compressive load until fracture and recording the maximum load. A scanning electron microscope was employed to observe fracture patterns. Fracture strength results were analyzed using one-way ANOVA, with the Tukey HSD test applied for post-hoc analysis (α=0.05). Results: Zirconia crown fracture strength significantly improved with increased horizontal margin width (P<0.001). However, margin thickness had no statistically significant effect on fracture strength (P=0.513). Conclusion Optimizing the horizontal margin width of zirconia crowns enhances their durability and performance.

Purpose: The purpose of this study was to evaluate the fracture strength of zirconia crowns of varying margin thicknesses. Materials and Methods: A model of the maxillary right first molar (Nissin, Kyoto, Japan) was prepared to create an abutment, which was fabricated into a metal die via a 3D metal printer. CAD software (exocad GmbH, Darmstadt, Germany) was used to design the crowns. A total of eight groups were generated: initially separated by margin thickness (0.1 mm and 0.8 mm), and then further divided by horizontal margin widths of 0.1 mm, 0.2 mm, 0.3 mm, and 0.4 mm. Zirconia crowns were designed for each group’s working models (N=10). Crown fracture strength was assessed using a universal testing machine (Shimadzu, Kyoto, Japan), applying a compressive load until fracture and recording the maximum load. A scanning electron microscope was employed to observe fracture patterns. Fracture strength results were analyzed using one-way ANOVA, with the Tukey HSD test applied for post-hoc analysis (α=0.05). Results: Zirconia crown fracture strength significantly improved with increased horizontal margin width (P<0.001). However, margin thickness had no statistically significant effect on fracture strength (P=0.513). Conclusion Optimizing the horizontal margin width of zirconia crowns enhances their durability and performance.

Purpose: The purpose of this study was to evaluate the fracture strength of zirconia crowns of varying margin thicknesses. Materials and Methods: A model of the maxillary right first molar (Nissin, Kyoto, Japan) was prepared to create an abutment, which was fabricated into a metal die via a 3D metal printer. CAD software (exocad GmbH, Darmstadt, Germany) was used to design the crowns. A total of eight groups were generated: initially separated by margin thickness (0.1 mm and 0.8 mm), and then further divided by horizontal margin widths of 0.1 mm, 0.2 mm, 0.3 mm, and 0.4 mm. Zirconia crowns were designed for each group’s working models (N=10). Crown fracture strength was assessed using a universal testing machine (Shimadzu, Kyoto, Japan), applying a compressive load until fracture and recording the maximum load. A scanning electron microscope was employed to observe fracture patterns. Fracture strength results were analyzed using one-way ANOVA, with the Tukey HSD test applied for post-hoc analysis (α=0.05). Results: Zirconia crown fracture strength significantly improved with increased horizontal margin width (P<0.001). However, margin thickness had no statistically significant effect on fracture strength (P=0.513). Conclusion Optimizing the horizontal margin width of zirconia crowns enhances their durability and performance.

Background: Fractional flow reserve (FFR) based on computed tomography (CT) has been shown to better identify ischemia-causing coronary stenosis. However, this current technology requires high computational power, which inhibits its widespread implementation in clinical practice. This prospective, multicenter study aimed at validating the diagnostic performance of a novel simple CT based fractional flow reserve (CT-FFR) calculation method in patients with coronary artery disease. Methods: Patients who underwent coronary CT angiography (CCTA) within 90 days and invasive coronary angiography (ICA) were prospectively enrolled. A hemodynamically significant lesion was defined as an FFR ≤ 0.80, and the area under the receiver operating characteristic curve (AUC) was the primary measure. After the planned analysis for the initial algorithm A, we performed another set of exploratory analyses for an improved algorithm B. Results: Of 184 patients who agreed to participate in the study, 151 were finally analyzed.Hemodynamically significant lesions were observed in 79 patients (52.3%). The AUC was 0.71 (95% confidence interval [CI], 0.63–0.80) for CCTA, 0.65 (95% CI, 0.56–0.74) for CT-FFR algorithm A (P = 0.866), and 0.78 (95% CI, 0.70–0.86) for algorithm B (P = 0.112). Diagnostic accuracy was 0.63 (0.55–0.71) for CCTA alone, 0.66 (0.58–0.74) for algorithm A, and 0.76 (0.68–0.82) for algorithm B. Conclusion This study suggests the feasibility of automated CT-FFR, which can be performed on-site within several hours. However, the diagnostic performance of the current algorithm does not meet the a priori criteria for superiority. Future research is required to improve the accuracy.

Background: There has been no comparison of the determinants of admission route between acute ischemic stroke (AIS) and acute myocardial infarction (AMI). We examined whether factors associated with direct versus transferred-in admission to regional cardiocerebrovascular centers (RCVCs) differed between AIS and AMI. Methods: Using a nationwide RCVC registry, we identified consecutive patients presenting with AMI and AIS between July 2016 and December 2018. We explored factors associated with direct admission to RCVCs in patients with AIS and AMI and examined whether those associations differed between AIS and AMI, including interaction terms between each factor and disease type in multivariable models. To explore the influence of emergency medical service (EMS) paramedics on hospital selection, stratified analyses according to use of EMS were also performed. Results: Among the 17,897 and 8,927 AIS and AMI patients, 66.6% and 48.2% were directly admitted to RCVCs, respectively. Multivariable analysis showed that previous coronary heart disease, prehospital awareness, higher education level, and EMS use increased the odds of direct admission to RCVCs, but the odds ratio (OR) was different between AIS and AMI (for the first 3 factors, AMI > AIS; for EMS use, AMI < AIS). EMS use was the single most important factor for both AIS and AMI (OR, 4.72 vs. 3.90). Hypertension and hyperlipidemia increased, while living alone decreased the odds of direct admission only in AMI;additionally, age (65–74 years), previous stroke, and presentation during non-working hours increased the odds only in AIS. EMS use weakened the associations between direct admission and most factors in both AIS and AMI. Conclusions Various patient factors were differentially associated with direct admission to RCVCs between AIS and AMI. Public education for symptom awareness and use of EMS is essential in optimizing the transportation and hospitalization of patients with AMI and AIS.