1.Impact of Complete Revascularization for Acute Myocardial Infarction In Multivessel Coronary Artery Disease Patients With Diabetes Mellitus
Jeehoon KANG ; Sungjoon PARK ; Minju HAN ; Kyung Woo PARK ; Jung-Kyu HAN ; Han-Mo YANG ; Hyun-Jae KANG ; Bon-Kwon KOO ; Hyo-Soo KIM
Korean Circulation Journal 2024;54(10):603-615
Background and Objectives:
The clinical benefits of complete revascularization (CR) in acute myocardial infarction (AMI) patients are unclear. Moreover, the benefit of CR is unknown in AMI with diabetes mellitus (DM) patients. We sought to compare the prognosis of CR and incomplete revascularization (IR) in patients with AMI and multivessel disease, according to the presence of DM.
Methods:
A total of 2,150 AMI patients with multivessel coronary artery disease were analyzed. CR was defined based on the angiographic image. The primary endpoint of this study was the patient-oriented composite outcome (POCO) defined as a composite of allcause death, any myocardial infarction, and any revascularization within 3 years.
Results:
Overall, 3-year POCO was significantly lower in patients receiving angiographic CR (985 patients, 45.8%) compared with IR (1,165 patients, 54.2%). When divided into subgroups according to the presence of DM, CR reduced 3-year clinical outcomes in the nonDM group but not in the DM group (POCO: 11.7% vs. 23.2%, p<0.001, any revascularization:7.2% vs. 10.8%, p=0.024 in the non-DM group, POCO: 24.3% vs. 27.8%, p=0.295, any revascularization: 13.3% vs. 11.3%, p=0.448 in the DM group, for CR vs. IR). Multivariate analysis showed that CR significantly reduced 3-year POCO (hazard ratio, 0.52; 95% confidence interval, 0.36–0.75) only in the non-DM group.
Conclusions
In AMI patients with multivessel disease, CR may have less clinical benefit in DM patients than in non-DM patients.
2.The Clinical Outcomes of Cervical Spine Chordoma: A Nationwide Multicenter Retrospective Study
Hangeul PARK ; Yunhee CHOI ; Sungjoon LEE ; Sun-Ho LEE ; Eun-Sang KIM ; Sun Woo JANG ; Jin Hoon PARK ; Yunseong CHO ; Giwuk JANG ; Yoon HA ; Yun-Sik DHO ; Heon YOO ; Sung Uk LEE ; Seung-Ho SEO ; Ki-Jeong KIM ; Seil SOHN ; Chun Kee CHUNG
Neurospine 2024;21(3):942-953
Objective:
Chordoma, a rare malignant tumor originating from embryonal notochord remnants, exhibits high resistance to conventional treatments, making surgical resection imperative. However, the factors influencing prognosis specifically for cervical spine chordoma have not been clearly identified. We investigate the prognosis of cervical spine chordoma with factors influential in a nationwide multicenter retrospective study.
Methods:
This study included all patients diagnosed with cervical spine chordoma at 7 tertiary referral centers from January 1998 to March 2023, excluding those with clivus and thoracic spine chordomas extending into the cervical spine. Local recurrence (LR) was identified through follow-up magnetic resonance imaging, either as reappearance in completely resected tumors or regrowth in residual tumors. The study assessed LR and overall survival, analyzing factors influencing LR and death.
Results:
Forty-five patients with cervical spine chordoma had a mean age of 46.4 years. Over a median follow-up of 52 months, LR and distant metastasis were observed in 21 (46.7%) and 4 patients (8.9%), respectively, and 16 patients (36%) were confirmed dead. The 5-year and 10-year cumulative LR rates were 51.3% and 60%, respectively, while the 5-year and 10-year survival rates were 82% and 53%. Age was the only significant factor affecting mortality (hazard ratio, 1.04; 95% confidence interval, 1.04–1.07; p=0.015). Notably, the degree of resection and adjuvant therapy did not statistically significantly impact local tumor control and mortality.
Conclusion
This study, the largest multicenter retrospective analysis of cervical spine chordoma in Korea, identified age as the only factor significantly affecting patient survival.
3.The Clinical Outcomes of Cervical Spine Chordoma: A Nationwide Multicenter Retrospective Study
Hangeul PARK ; Yunhee CHOI ; Sungjoon LEE ; Sun-Ho LEE ; Eun-Sang KIM ; Sun Woo JANG ; Jin Hoon PARK ; Yunseong CHO ; Giwuk JANG ; Yoon HA ; Yun-Sik DHO ; Heon YOO ; Sung Uk LEE ; Seung-Ho SEO ; Ki-Jeong KIM ; Seil SOHN ; Chun Kee CHUNG
Neurospine 2024;21(3):942-953
Objective:
Chordoma, a rare malignant tumor originating from embryonal notochord remnants, exhibits high resistance to conventional treatments, making surgical resection imperative. However, the factors influencing prognosis specifically for cervical spine chordoma have not been clearly identified. We investigate the prognosis of cervical spine chordoma with factors influential in a nationwide multicenter retrospective study.
Methods:
This study included all patients diagnosed with cervical spine chordoma at 7 tertiary referral centers from January 1998 to March 2023, excluding those with clivus and thoracic spine chordomas extending into the cervical spine. Local recurrence (LR) was identified through follow-up magnetic resonance imaging, either as reappearance in completely resected tumors or regrowth in residual tumors. The study assessed LR and overall survival, analyzing factors influencing LR and death.
Results:
Forty-five patients with cervical spine chordoma had a mean age of 46.4 years. Over a median follow-up of 52 months, LR and distant metastasis were observed in 21 (46.7%) and 4 patients (8.9%), respectively, and 16 patients (36%) were confirmed dead. The 5-year and 10-year cumulative LR rates were 51.3% and 60%, respectively, while the 5-year and 10-year survival rates were 82% and 53%. Age was the only significant factor affecting mortality (hazard ratio, 1.04; 95% confidence interval, 1.04–1.07; p=0.015). Notably, the degree of resection and adjuvant therapy did not statistically significantly impact local tumor control and mortality.
Conclusion
This study, the largest multicenter retrospective analysis of cervical spine chordoma in Korea, identified age as the only factor significantly affecting patient survival.
4.The Clinical Outcomes of Cervical Spine Chordoma: A Nationwide Multicenter Retrospective Study
Hangeul PARK ; Yunhee CHOI ; Sungjoon LEE ; Sun-Ho LEE ; Eun-Sang KIM ; Sun Woo JANG ; Jin Hoon PARK ; Yunseong CHO ; Giwuk JANG ; Yoon HA ; Yun-Sik DHO ; Heon YOO ; Sung Uk LEE ; Seung-Ho SEO ; Ki-Jeong KIM ; Seil SOHN ; Chun Kee CHUNG
Neurospine 2024;21(3):942-953
Objective:
Chordoma, a rare malignant tumor originating from embryonal notochord remnants, exhibits high resistance to conventional treatments, making surgical resection imperative. However, the factors influencing prognosis specifically for cervical spine chordoma have not been clearly identified. We investigate the prognosis of cervical spine chordoma with factors influential in a nationwide multicenter retrospective study.
Methods:
This study included all patients diagnosed with cervical spine chordoma at 7 tertiary referral centers from January 1998 to March 2023, excluding those with clivus and thoracic spine chordomas extending into the cervical spine. Local recurrence (LR) was identified through follow-up magnetic resonance imaging, either as reappearance in completely resected tumors or regrowth in residual tumors. The study assessed LR and overall survival, analyzing factors influencing LR and death.
Results:
Forty-five patients with cervical spine chordoma had a mean age of 46.4 years. Over a median follow-up of 52 months, LR and distant metastasis were observed in 21 (46.7%) and 4 patients (8.9%), respectively, and 16 patients (36%) were confirmed dead. The 5-year and 10-year cumulative LR rates were 51.3% and 60%, respectively, while the 5-year and 10-year survival rates were 82% and 53%. Age was the only significant factor affecting mortality (hazard ratio, 1.04; 95% confidence interval, 1.04–1.07; p=0.015). Notably, the degree of resection and adjuvant therapy did not statistically significantly impact local tumor control and mortality.
Conclusion
This study, the largest multicenter retrospective analysis of cervical spine chordoma in Korea, identified age as the only factor significantly affecting patient survival.
5.Association of epicardial adipose tissue with metabolic risk factors on cardiovascular outcomes: serial coronary computed tomography angiography study
Sungjoon PARK ; Dong Eun KIM ; Su Min KIM ; JungMin CHOI ; Sang Joon PARK ; Hae-Young LEE ; Eun Ju CHUN
The Korean Journal of Internal Medicine 2024;39(2):283-294
Background/Aims:
Epicardial adipose tissue (EAT) shares pathophysiological properties with other visceral fats and potentially triggers local inflammation. However, the association of EAT with cardiovascular disease (CVD) is still debatable. The study aimed to observe the changes and associations in EAT and risk factors over time, as well as to investigate whether EAT was associated with CVD.
Methods:
A total of 762 participants from Seoul National University Hospital (SNUH) and SNUH Gangnam Center were included in this study. EAT was measured using coronary computed tomography angiography.
Results:
Baseline EAT level was positively associated with body mass index (BMI), calcium score, atherosclerotic cardiovascular disease (ASCVD) 10-year risk score, glucose, triglycerides (TG)/high-density lipoprotein (HDL), but not with total cholesterol, low-density lipoprotein (LDL). At follow-up, EAT levels increased in all groups, with low EAT groups demonstrating a significant increase in EAT per year. Change in EAT was associated with a change in BMI, TG/HDL, and glucose, while changes in LDL, calcium score, and ASCVD 10-year risk score were not associated. Although calcium score and ASCVD 10-year risk score were associated with CVD events, baseline information of EAT, baseline EAT/body surface area, or EAT change was not available.
Conclusions
Metabolic risks, e.g., BMI, TG/HDL, and glucose, were associated with EAT change per year, whereas classical CVD risks, e.g., LDL, calcium score, and ASCVD 10-year risk score, were not. The actual CVD event was not associated with EAT volume, warranting future studies combining qualitative assessments with quantitative ones.
6.Impact of Complete Revascularization for Acute Myocardial Infarction In Multivessel Coronary Artery Disease Patients With Diabetes Mellitus
Jeehoon KANG ; Sungjoon PARK ; Minju HAN ; Kyung Woo PARK ; Jung-Kyu HAN ; Han-Mo YANG ; Hyun-Jae KANG ; Bon-Kwon KOO ; Hyo-Soo KIM
Korean Circulation Journal 2024;54(10):603-615
Background and Objectives:
The clinical benefits of complete revascularization (CR) in acute myocardial infarction (AMI) patients are unclear. Moreover, the benefit of CR is unknown in AMI with diabetes mellitus (DM) patients. We sought to compare the prognosis of CR and incomplete revascularization (IR) in patients with AMI and multivessel disease, according to the presence of DM.
Methods:
A total of 2,150 AMI patients with multivessel coronary artery disease were analyzed. CR was defined based on the angiographic image. The primary endpoint of this study was the patient-oriented composite outcome (POCO) defined as a composite of allcause death, any myocardial infarction, and any revascularization within 3 years.
Results:
Overall, 3-year POCO was significantly lower in patients receiving angiographic CR (985 patients, 45.8%) compared with IR (1,165 patients, 54.2%). When divided into subgroups according to the presence of DM, CR reduced 3-year clinical outcomes in the nonDM group but not in the DM group (POCO: 11.7% vs. 23.2%, p<0.001, any revascularization:7.2% vs. 10.8%, p=0.024 in the non-DM group, POCO: 24.3% vs. 27.8%, p=0.295, any revascularization: 13.3% vs. 11.3%, p=0.448 in the DM group, for CR vs. IR). Multivariate analysis showed that CR significantly reduced 3-year POCO (hazard ratio, 0.52; 95% confidence interval, 0.36–0.75) only in the non-DM group.
Conclusions
In AMI patients with multivessel disease, CR may have less clinical benefit in DM patients than in non-DM patients.
7.Impact of Complete Revascularization for Acute Myocardial Infarction In Multivessel Coronary Artery Disease Patients With Diabetes Mellitus
Jeehoon KANG ; Sungjoon PARK ; Minju HAN ; Kyung Woo PARK ; Jung-Kyu HAN ; Han-Mo YANG ; Hyun-Jae KANG ; Bon-Kwon KOO ; Hyo-Soo KIM
Korean Circulation Journal 2024;54(10):603-615
Background and Objectives:
The clinical benefits of complete revascularization (CR) in acute myocardial infarction (AMI) patients are unclear. Moreover, the benefit of CR is unknown in AMI with diabetes mellitus (DM) patients. We sought to compare the prognosis of CR and incomplete revascularization (IR) in patients with AMI and multivessel disease, according to the presence of DM.
Methods:
A total of 2,150 AMI patients with multivessel coronary artery disease were analyzed. CR was defined based on the angiographic image. The primary endpoint of this study was the patient-oriented composite outcome (POCO) defined as a composite of allcause death, any myocardial infarction, and any revascularization within 3 years.
Results:
Overall, 3-year POCO was significantly lower in patients receiving angiographic CR (985 patients, 45.8%) compared with IR (1,165 patients, 54.2%). When divided into subgroups according to the presence of DM, CR reduced 3-year clinical outcomes in the nonDM group but not in the DM group (POCO: 11.7% vs. 23.2%, p<0.001, any revascularization:7.2% vs. 10.8%, p=0.024 in the non-DM group, POCO: 24.3% vs. 27.8%, p=0.295, any revascularization: 13.3% vs. 11.3%, p=0.448 in the DM group, for CR vs. IR). Multivariate analysis showed that CR significantly reduced 3-year POCO (hazard ratio, 0.52; 95% confidence interval, 0.36–0.75) only in the non-DM group.
Conclusions
In AMI patients with multivessel disease, CR may have less clinical benefit in DM patients than in non-DM patients.
8.The Clinical Outcomes of Cervical Spine Chordoma: A Nationwide Multicenter Retrospective Study
Hangeul PARK ; Yunhee CHOI ; Sungjoon LEE ; Sun-Ho LEE ; Eun-Sang KIM ; Sun Woo JANG ; Jin Hoon PARK ; Yunseong CHO ; Giwuk JANG ; Yoon HA ; Yun-Sik DHO ; Heon YOO ; Sung Uk LEE ; Seung-Ho SEO ; Ki-Jeong KIM ; Seil SOHN ; Chun Kee CHUNG
Neurospine 2024;21(3):942-953
Objective:
Chordoma, a rare malignant tumor originating from embryonal notochord remnants, exhibits high resistance to conventional treatments, making surgical resection imperative. However, the factors influencing prognosis specifically for cervical spine chordoma have not been clearly identified. We investigate the prognosis of cervical spine chordoma with factors influential in a nationwide multicenter retrospective study.
Methods:
This study included all patients diagnosed with cervical spine chordoma at 7 tertiary referral centers from January 1998 to March 2023, excluding those with clivus and thoracic spine chordomas extending into the cervical spine. Local recurrence (LR) was identified through follow-up magnetic resonance imaging, either as reappearance in completely resected tumors or regrowth in residual tumors. The study assessed LR and overall survival, analyzing factors influencing LR and death.
Results:
Forty-five patients with cervical spine chordoma had a mean age of 46.4 years. Over a median follow-up of 52 months, LR and distant metastasis were observed in 21 (46.7%) and 4 patients (8.9%), respectively, and 16 patients (36%) were confirmed dead. The 5-year and 10-year cumulative LR rates were 51.3% and 60%, respectively, while the 5-year and 10-year survival rates were 82% and 53%. Age was the only significant factor affecting mortality (hazard ratio, 1.04; 95% confidence interval, 1.04–1.07; p=0.015). Notably, the degree of resection and adjuvant therapy did not statistically significantly impact local tumor control and mortality.
Conclusion
This study, the largest multicenter retrospective analysis of cervical spine chordoma in Korea, identified age as the only factor significantly affecting patient survival.
9.Impact of Complete Revascularization for Acute Myocardial Infarction In Multivessel Coronary Artery Disease Patients With Diabetes Mellitus
Jeehoon KANG ; Sungjoon PARK ; Minju HAN ; Kyung Woo PARK ; Jung-Kyu HAN ; Han-Mo YANG ; Hyun-Jae KANG ; Bon-Kwon KOO ; Hyo-Soo KIM
Korean Circulation Journal 2024;54(10):603-615
Background and Objectives:
The clinical benefits of complete revascularization (CR) in acute myocardial infarction (AMI) patients are unclear. Moreover, the benefit of CR is unknown in AMI with diabetes mellitus (DM) patients. We sought to compare the prognosis of CR and incomplete revascularization (IR) in patients with AMI and multivessel disease, according to the presence of DM.
Methods:
A total of 2,150 AMI patients with multivessel coronary artery disease were analyzed. CR was defined based on the angiographic image. The primary endpoint of this study was the patient-oriented composite outcome (POCO) defined as a composite of allcause death, any myocardial infarction, and any revascularization within 3 years.
Results:
Overall, 3-year POCO was significantly lower in patients receiving angiographic CR (985 patients, 45.8%) compared with IR (1,165 patients, 54.2%). When divided into subgroups according to the presence of DM, CR reduced 3-year clinical outcomes in the nonDM group but not in the DM group (POCO: 11.7% vs. 23.2%, p<0.001, any revascularization:7.2% vs. 10.8%, p=0.024 in the non-DM group, POCO: 24.3% vs. 27.8%, p=0.295, any revascularization: 13.3% vs. 11.3%, p=0.448 in the DM group, for CR vs. IR). Multivariate analysis showed that CR significantly reduced 3-year POCO (hazard ratio, 0.52; 95% confidence interval, 0.36–0.75) only in the non-DM group.
Conclusions
In AMI patients with multivessel disease, CR may have less clinical benefit in DM patients than in non-DM patients.
10.The Clinical Outcomes of Cervical Spine Chordoma: A Nationwide Multicenter Retrospective Study
Hangeul PARK ; Yunhee CHOI ; Sungjoon LEE ; Sun-Ho LEE ; Eun-Sang KIM ; Sun Woo JANG ; Jin Hoon PARK ; Yunseong CHO ; Giwuk JANG ; Yoon HA ; Yun-Sik DHO ; Heon YOO ; Sung Uk LEE ; Seung-Ho SEO ; Ki-Jeong KIM ; Seil SOHN ; Chun Kee CHUNG
Neurospine 2024;21(3):942-953
Objective:
Chordoma, a rare malignant tumor originating from embryonal notochord remnants, exhibits high resistance to conventional treatments, making surgical resection imperative. However, the factors influencing prognosis specifically for cervical spine chordoma have not been clearly identified. We investigate the prognosis of cervical spine chordoma with factors influential in a nationwide multicenter retrospective study.
Methods:
This study included all patients diagnosed with cervical spine chordoma at 7 tertiary referral centers from January 1998 to March 2023, excluding those with clivus and thoracic spine chordomas extending into the cervical spine. Local recurrence (LR) was identified through follow-up magnetic resonance imaging, either as reappearance in completely resected tumors or regrowth in residual tumors. The study assessed LR and overall survival, analyzing factors influencing LR and death.
Results:
Forty-five patients with cervical spine chordoma had a mean age of 46.4 years. Over a median follow-up of 52 months, LR and distant metastasis were observed in 21 (46.7%) and 4 patients (8.9%), respectively, and 16 patients (36%) were confirmed dead. The 5-year and 10-year cumulative LR rates were 51.3% and 60%, respectively, while the 5-year and 10-year survival rates were 82% and 53%. Age was the only significant factor affecting mortality (hazard ratio, 1.04; 95% confidence interval, 1.04–1.07; p=0.015). Notably, the degree of resection and adjuvant therapy did not statistically significantly impact local tumor control and mortality.
Conclusion
This study, the largest multicenter retrospective analysis of cervical spine chordoma in Korea, identified age as the only factor significantly affecting patient survival.

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