1.Clinical safety and effectiveness of the Genoss drug-eluting stent in real-world clinical practice
Young Jin YOUN ; Jun-Won LEE ; Sung Gyun AHN ; Seung-Hwan LEE ; Junghan YOON ; Jae Hyoung PARK ; Sang-Yong YOO ; Woong Chol KANG ; Nam Ho LEE ; Ki Hwan KWON ; Joon Hyung DOH ; Sang-Wook LIM ; Yang Soo JANG ; Dong Woon JEON ; Jung Ho HEO ; Woong Gil CHOI ; Sungsoo CHO ; Bong-Ki LEE ; Hyonju JEONG ; Bum-Kee HONG ; Hyun-Hee CHOI
The Korean Journal of Internal Medicine 2023;38(5):683-691
Background/Aims:
The Genoss DES™ is a novel, biodegradable, polymer-coated, sirolimus-eluting stent with a cobalt- chromium stent platform and thin strut. Although the safety and effectiveness of this stent have been previously investigated, real-world clinical outcomes data are lacking. Therefore, the aim of this prospective, multicenter trial was to evaluate the clinical safety and effectiveness of the Genoss DES™ in all-comer patients undergoing percutaneous coronary intervention.
Methods:
The Genoss DES registry is a prospective, single-arm, observational trial for evaluation of clinical outcomes after Genoss DES™ implantation in all-comer patients undergoing percutaneous coronary intervention from 17 sites in South Korea. The primary endpoint was a device-oriented composite outcome of cardiac death, target vessel-related myocardial infarction (MI), and clinically driven target lesion revascularization (TLR) at 12 months.
Results:
A total of 1,999 patients (66.4 ± 11.1 years of age; 72.8% male) were analyzed. At baseline, 62.8% and 36.7% of patients had hypertension and diabetes, respectively. The implanted stent number, diameter, and length per patient were 1.5 ± 0.8, 3.1 ± 0.5 mm, and 37.0 ± 25.0 mm, respectively. The primary endpoint occurred in 1.8% patients, with a cardiac death rate of 1.1%, target vessel-related MI rate of 0.2%, and clinically driven TLR rate of 0.8%.
Conclusions
In this real-world registry, the Genoss DES™ demonstrated excellent safety and effectiveness at 12 months among all-comer patients undergoing percutaneous coronary intervention. These findings suggest that the Genoss DES™ may be a viable treatment option for patients with coronary artery disease.
3.Comparison of Factors Associated With Direct Versus Transferred-in Admission to Government-Designated Regional Centers Between Acute Ischemic Stroke and Myocardial Infarction in Korea
Dae-Hyun KIM ; Seok-Joo MOON ; Juneyoung LEE ; Jae-Kwan CHA ; Moo Hyun KIM ; Jong-Sung PARK ; Byeolnim BAN ; Jihoon KANG ; Beom Joon KIM ; Won-Seok KIM ; Chang-Hwan YOON ; Heeyoung LEE ; Seongheon KIM ; Eun Kyoung KANG ; Ae-Young HER ; Cindy W YOON ; Joung-Ho RHA ; Seong-Ill WOO ; Won Kyung LEE ; Han-Young JUNG ; Jang Hoon LEE ; Hun Sik PARK ; Yang-Ha HWANG ; Keonyeop KIM ; Rock Bum KIM ; Nack-Cheon CHOI ; Jinyong HWANG ; Hyun-Woong PARK ; Ki Soo PARK ; SangHak YI ; Jae Young CHO ; Nam-Ho KIM ; Kang-Ho CHOI ; Juhan KIM ; Jae-Young HAN ; Jay Chol CHOI ; Song-Yi KIM ; Joon-Hyouk CHOI ; Jei KIM ; Min Kyun SOHN ; Si Wan CHOI ; Dong-Ick SHIN ; Sang Yeub LEE ; Jang-Whan BAE ; Kun Sei LEE ; Hee-Joon BAE
Journal of Korean Medical Science 2022;37(42):e305-
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.
4.Percutaneous Left Atrial Appendage Occlusion Yields Favorable Neurological Outcomes in Patients with Non-Valvular Atrial Fibrillation
Oh-Hyun LEE ; Young Dae KIM ; Jung-Sun KIM ; Nak-Hoon SON ; Hui-Nam PAK ; Boyoung JOUNG ; Cheol-Woong YU ; Hyun-Jong LEE ; Woong-Chol KANG ; Eun-Seok SHIN ; Rak-kyeong CHOI ; Do-Sun LIM ; Yo Han JUNG ; Hye-Yeon CHOI ; Kyung-Yul LEE ; Bang-Hoon CHO ; Sang Won HAN ; Joong Hyun PARK ; Han-Jin CHO ; Hyung Jong PARK ; Hyo Suk NAM ; Ji Hoe HEO ; Chak-yu SO ; Gary Shing-Him CHEUNG ; Yat-yin LAM ; Xavier FREIXA ; Apostolos TZIKAS ; Yangsoo JANG ; Jai-Wun PARK
Korean Circulation Journal 2021;51(7):626-638
Background and Objectives:
Prior studies have shown that stroke patients treated with percutaneous left atrial appendage occlusion (LAAO) for non-valvular atrial fibrillation (NVAF) experience better outcomes than similar patients treated with warfarin. We investigated the impact of percutaneous left atrial appendage closure on post-stroke neurological outcomes in NVAF patients, compared with non-vitamin K antagonist oral anticoagulant (NOAC) therapy.
Methods:
Medical records for 1,427 patients in multiple registries and for 1,792 consecutive patients at 6 Korean hospitals were reviewed with respect to LAAO or NOAC treatment.Stroke severity in patients who experienced ischemic stroke or transient ischemic attack after either treatment was assessed with modified Rankin Scale (mRS) scoring at hospital discharge and at 3 and 12 months post-stroke.
Results:
mRS scores were significantly lower in LAAO patients at 3 (p<0.01) and 12 months (p<0.01) post-stroke, despite no significant differences in scores before the ischemic cerebrovascular event (p=0.22). The occurrences of disabling ischemic stroke in the LAAO and NOAC groups were 36.7% and 44.2% at discharge (p=0.47), 23.3% and 44.2% at 3 months post-stroke (p=0.04), and 13.3% and 43.0% at 12 months post-stroke (p=0.01), respectively.Recovery rates for disabling ischemic stroke at discharge to 12 months post-stroke were significantly higher for LAAO patients (50.0%) than for NOAC patients (5.6%) (p<0.01).
Conclusions
Percutaneous LAAO was associated with more favorable neurological outcomes after ischemic cerebrovascular event than NOAC treatment.
5.Percutaneous Left Atrial Appendage Occlusion Yields Favorable Neurological Outcomes in Patients with Non-Valvular Atrial Fibrillation
Oh-Hyun LEE ; Young Dae KIM ; Jung-Sun KIM ; Nak-Hoon SON ; Hui-Nam PAK ; Boyoung JOUNG ; Cheol-Woong YU ; Hyun-Jong LEE ; Woong-Chol KANG ; Eun-Seok SHIN ; Rak-kyeong CHOI ; Do-Sun LIM ; Yo Han JUNG ; Hye-Yeon CHOI ; Kyung-Yul LEE ; Bang-Hoon CHO ; Sang Won HAN ; Joong Hyun PARK ; Han-Jin CHO ; Hyung Jong PARK ; Hyo Suk NAM ; Ji Hoe HEO ; Chak-yu SO ; Gary Shing-Him CHEUNG ; Yat-yin LAM ; Xavier FREIXA ; Apostolos TZIKAS ; Yangsoo JANG ; Jai-Wun PARK
Korean Circulation Journal 2021;51(7):626-638
Background and Objectives:
Prior studies have shown that stroke patients treated with percutaneous left atrial appendage occlusion (LAAO) for non-valvular atrial fibrillation (NVAF) experience better outcomes than similar patients treated with warfarin. We investigated the impact of percutaneous left atrial appendage closure on post-stroke neurological outcomes in NVAF patients, compared with non-vitamin K antagonist oral anticoagulant (NOAC) therapy.
Methods:
Medical records for 1,427 patients in multiple registries and for 1,792 consecutive patients at 6 Korean hospitals were reviewed with respect to LAAO or NOAC treatment.Stroke severity in patients who experienced ischemic stroke or transient ischemic attack after either treatment was assessed with modified Rankin Scale (mRS) scoring at hospital discharge and at 3 and 12 months post-stroke.
Results:
mRS scores were significantly lower in LAAO patients at 3 (p<0.01) and 12 months (p<0.01) post-stroke, despite no significant differences in scores before the ischemic cerebrovascular event (p=0.22). The occurrences of disabling ischemic stroke in the LAAO and NOAC groups were 36.7% and 44.2% at discharge (p=0.47), 23.3% and 44.2% at 3 months post-stroke (p=0.04), and 13.3% and 43.0% at 12 months post-stroke (p=0.01), respectively.Recovery rates for disabling ischemic stroke at discharge to 12 months post-stroke were significantly higher for LAAO patients (50.0%) than for NOAC patients (5.6%) (p<0.01).
Conclusions
Percutaneous LAAO was associated with more favorable neurological outcomes after ischemic cerebrovascular event than NOAC treatment.
6.Safety and Efficacy of a New Ultrathin Sirolimus-Eluting Stent with Abluminal Biodegradable Polymer in Real-World Practice
Young Jin YOUN ; Sang Yong YOO ; Jun Won LEE ; Sung Gyun AHN ; Seung Hwan LEE ; Junghan YOON ; Jae Hyoung PARK ; Woong Gil CHOI ; Sungsoo CHO ; Sang Wook LIM ; Yang Soo JANG ; Ki Hwan KWON ; Nam Ho LEE ; Joon Hyung DOH ; Woong Chol KANG ; Dong Woon JEON ; Bong Ki LEE ; Jung Ho HEO ; Bum Kee HONG ; Hyun Hee CHOI
Korean Circulation Journal 2020;50(4):317-327
BACKGROUND AND OBJECTIVES: Recently, Genoss drug-eluting stent (DES)™ stent comprising cobalt-chromium platform with an ultrathin strut thickness, sirolimus, and an abluminal biodegradable polymer was developed. Owing to the lack of substantial evidence for the safety and efficacy of this stent, we report 12-month results of the Genoss DES™ stent.METHODS: We analyzed subjects who were eligible for a 12-month follow-up from the ongoing Genoss DES™ registry, which is a prospective, single-arm, observational, multicenter trial to investigate the clinical outcomes after the successful Genoss DES™ stent implantation among all-comers. The primary endpoint was a device-oriented composite outcome, defined as cardiac death, target vessel-related myocardial infarction, and target lesion revascularization at 12-month follow-up.RESULTS: Among 622 subjects, the mean age of subjects was 66.5±10.4 years, 70.6% were males, 67.5% had hypertension, and 38.3% had diabetes. The implanted stent number, diameter, and length per patient were 1.5±0.8, 3.1±0.4 mm, and 36.0±23.3 mm, respectively. At 12-month clinical follow-up, the primary endpoint occurred only in 4 (0.6%) subjects.CONCLUSIONS: The novel Genoss DES™ stent exhibited excellent safety and efficacy in real-world practice.
Death
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Drug-Eluting Stents
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Follow-Up Studies
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Humans
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Hypertension
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Male
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Multicenter Studies as Topic
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Myocardial Infarction
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Percutaneous Coronary Intervention
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Polymers
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Prospective Studies
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Registries
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Sirolimus
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Stents
7.Safety and Efficacy of a New Ultrathin Sirolimus-Eluting Stent with Abluminal Biodegradable Polymer in Real-World Practice
Young Jin YOUN ; Sang Yong YOO ; Jun Won LEE ; Sung Gyun AHN ; Seung Hwan LEE ; Junghan YOON ; Jae Hyoung PARK ; Woong Gil CHOI ; Sungsoo CHO ; Sang Wook LIM ; Yang Soo JANG ; Ki Hwan KWON ; Nam Ho LEE ; Joon Hyung DOH ; Woong Chol KANG ; Dong Woon JEON ; Bong Ki LEE ; Jung Ho HEO ; Bum Kee HONG ; Hyun Hee CHOI
Korean Circulation Journal 2020;50(4):317-327
BACKGROUND AND OBJECTIVES:
Recently, Genoss drug-eluting stent (DES)â„¢ stent comprising cobalt-chromium platform with an ultrathin strut thickness, sirolimus, and an abluminal biodegradable polymer was developed. Owing to the lack of substantial evidence for the safety and efficacy of this stent, we report 12-month results of the Genoss DESâ„¢ stent.
METHODS:
We analyzed subjects who were eligible for a 12-month follow-up from the ongoing Genoss DESâ„¢ registry, which is a prospective, single-arm, observational, multicenter trial to investigate the clinical outcomes after the successful Genoss DESâ„¢ stent implantation among all-comers. The primary endpoint was a device-oriented composite outcome, defined as cardiac death, target vessel-related myocardial infarction, and target lesion revascularization at 12-month follow-up.
RESULTS:
Among 622 subjects, the mean age of subjects was 66.5±10.4 years, 70.6% were males, 67.5% had hypertension, and 38.3% had diabetes. The implanted stent number, diameter, and length per patient were 1.5±0.8, 3.1±0.4 mm, and 36.0±23.3 mm, respectively. At 12-month clinical follow-up, the primary endpoint occurred only in 4 (0.6%) subjects.
CONCLUSIONS
The novel Genoss DESâ„¢ stent exhibited excellent safety and efficacy in real-world practice.
8.Significant reduction in the density of premature ventricular complex with ß‑blocker medication in fast rate‑dependent premature ventricular complex
Yae Min PARK ; Chang Yun KIM ; Jungduk SEO ; Albert Youngwoo JANG ; Mi Sook CHA ; Woong Chol KANG ; Seung Hwan HAN ; Mi‑Seung SHIN ; In Suck CHOI
International Journal of Arrhythmia 2020;21(4):20-
Background:
There is little data regarding types of idiopathic premature ventricular complex (PVC) according to heart rate dependence.
Methods:
One hundred and sixty-eight patients with idiopathic PVC were enrolled in this study. Evaluation of the number of PVCs and total ventricular beats, and the density of PVC was done using 24 h Holter monitoring. Patients were divided into groups as having: fast rate-dependent (Group I), slow rate-dependent (Group II), and heart rateindependent PVC (Group III) based on the relationship between the number of hourly PVC and hourly heart rate. After ß-blocker medication, 24 h Holter monitoring was repeated.
Results:
Among the 168 subjects, 66 (39.3%) patients were in Group I, 18 (10.7%) in Group II, and 84 (50.0%) in Group III. There were no significant differences in the baseline number of PVCs and total ventricular beats, and the density of PVC among the three groups. The number of PVCs was significantly reduced in patients with Group I (14,030 ± 11,463 beats/day vs. 7401 ± 10,464 beats/day, p < 0.001), and total ventricular beat was significantly reduced in patients with Group I (109,223 ± 17,564 beats/day vs. 96,182 ± 15,594 beats/day, p < 0.001) and Group III (106,515 ± 13,468 beats/ day vs. 97,995 ± 12,960 beats/day, p < 0.001) after ß-blocker medication. The density of PVC was significantly reduced only in patients of Group I (12.9 ± 10.3% vs. 7.4 ± 10.3%, p = 0.001) after ß-blocker medication.
Conclusions
The type of PVC according to the heart rate dependence should be considered when treating idi‑ opathic PVC with ß-blockers.

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