1.Outcomes of Deferring Percutaneous Coronary Intervention Without Physiologic Assessment for Intermediate Coronary Lesions
Jihoon KIM ; Seong-Hoon LIM ; Joo-Yong HAHN ; Jin-Ok JEONG ; Yong Hwan PARK ; Woo Jung CHUN ; Ju Hyeon OH ; Dae Kyoung CHO ; Yu Jeong CHOI ; Eul-Soon IM ; Kyung-Heon WON ; Sung Yun LEE ; Sang-Wook KIM ; Ki Hong CHOI ; Joo Myung LEE ; Taek Kyu PARK ; Jeong Hoon YANG ; Young Bin SONG ; Seung-Hyuk CHOI ; Hyeon-Cheol GWON
Korean Circulation Journal 2025;55(3):185-195
Background and Objectives:
Outcomes of deferring percutaneous coronary intervention (PCI) without invasive physiologic assessment for intermediate coronary lesions is uncertain.We sought to compare long-term outcomes between medical treatment and PCI of intermediate lesions without invasive physiologic assessment.
Methods:
A total of 899 patients with intermediate coronary lesions between 50% and 70% diameter-stenosis were randomized to the conservative group (n=449) or the aggressive group (n=450). For intermediate lesions, PCI was performed in the aggressive group, but was deferred in the conservative group. The primary endpoint was major adverse cardiac events (MACE, a composite of all-cause death, myocardial infarction [MI], or ischemia-driven any revascularization) at 3 years.
Results:
The number of treated lesions per patient was 0.8±0.9 in the conservative group and 1.7±0.9 in the aggressive group (p=0.001). At 3 years, the conservative group had a significantly higher incidence of MACE than the aggressive group (13.8% vs. 9.3%; hazard ratio [HR], 1.49; 95% confidence interval [CI], 1.00–2.21; p=0.049), mainly driven by revascularization of target intermediate lesion (6.5% vs. 1.1%; HR, 5.69; 95% CI, 2.20–14.73;p<0.001). Between 1 and 3 years after the index procedure, compared to the aggressive group, the conservative group had significantly higher incidence of cardiac death or MI (3.2% vs.0.7%; HR, 4.34; 95% CI, 1.24–15.22; p=0.022) and ischemia-driven any revascularization.
Conclusions
For intermediate lesions, medical therapy alone, guided only by angiography, was associated with a higher risk of MACE at 3 years compared with performing PCI, mainly due to increased revascularization.
2.Outcomes of Deferring Percutaneous Coronary Intervention Without Physiologic Assessment for Intermediate Coronary Lesions
Jihoon KIM ; Seong-Hoon LIM ; Joo-Yong HAHN ; Jin-Ok JEONG ; Yong Hwan PARK ; Woo Jung CHUN ; Ju Hyeon OH ; Dae Kyoung CHO ; Yu Jeong CHOI ; Eul-Soon IM ; Kyung-Heon WON ; Sung Yun LEE ; Sang-Wook KIM ; Ki Hong CHOI ; Joo Myung LEE ; Taek Kyu PARK ; Jeong Hoon YANG ; Young Bin SONG ; Seung-Hyuk CHOI ; Hyeon-Cheol GWON
Korean Circulation Journal 2025;55(3):185-195
Background and Objectives:
Outcomes of deferring percutaneous coronary intervention (PCI) without invasive physiologic assessment for intermediate coronary lesions is uncertain.We sought to compare long-term outcomes between medical treatment and PCI of intermediate lesions without invasive physiologic assessment.
Methods:
A total of 899 patients with intermediate coronary lesions between 50% and 70% diameter-stenosis were randomized to the conservative group (n=449) or the aggressive group (n=450). For intermediate lesions, PCI was performed in the aggressive group, but was deferred in the conservative group. The primary endpoint was major adverse cardiac events (MACE, a composite of all-cause death, myocardial infarction [MI], or ischemia-driven any revascularization) at 3 years.
Results:
The number of treated lesions per patient was 0.8±0.9 in the conservative group and 1.7±0.9 in the aggressive group (p=0.001). At 3 years, the conservative group had a significantly higher incidence of MACE than the aggressive group (13.8% vs. 9.3%; hazard ratio [HR], 1.49; 95% confidence interval [CI], 1.00–2.21; p=0.049), mainly driven by revascularization of target intermediate lesion (6.5% vs. 1.1%; HR, 5.69; 95% CI, 2.20–14.73;p<0.001). Between 1 and 3 years after the index procedure, compared to the aggressive group, the conservative group had significantly higher incidence of cardiac death or MI (3.2% vs.0.7%; HR, 4.34; 95% CI, 1.24–15.22; p=0.022) and ischemia-driven any revascularization.
Conclusions
For intermediate lesions, medical therapy alone, guided only by angiography, was associated with a higher risk of MACE at 3 years compared with performing PCI, mainly due to increased revascularization.
3.Outcomes of Deferring Percutaneous Coronary Intervention Without Physiologic Assessment for Intermediate Coronary Lesions
Jihoon KIM ; Seong-Hoon LIM ; Joo-Yong HAHN ; Jin-Ok JEONG ; Yong Hwan PARK ; Woo Jung CHUN ; Ju Hyeon OH ; Dae Kyoung CHO ; Yu Jeong CHOI ; Eul-Soon IM ; Kyung-Heon WON ; Sung Yun LEE ; Sang-Wook KIM ; Ki Hong CHOI ; Joo Myung LEE ; Taek Kyu PARK ; Jeong Hoon YANG ; Young Bin SONG ; Seung-Hyuk CHOI ; Hyeon-Cheol GWON
Korean Circulation Journal 2025;55(3):185-195
Background and Objectives:
Outcomes of deferring percutaneous coronary intervention (PCI) without invasive physiologic assessment for intermediate coronary lesions is uncertain.We sought to compare long-term outcomes between medical treatment and PCI of intermediate lesions without invasive physiologic assessment.
Methods:
A total of 899 patients with intermediate coronary lesions between 50% and 70% diameter-stenosis were randomized to the conservative group (n=449) or the aggressive group (n=450). For intermediate lesions, PCI was performed in the aggressive group, but was deferred in the conservative group. The primary endpoint was major adverse cardiac events (MACE, a composite of all-cause death, myocardial infarction [MI], or ischemia-driven any revascularization) at 3 years.
Results:
The number of treated lesions per patient was 0.8±0.9 in the conservative group and 1.7±0.9 in the aggressive group (p=0.001). At 3 years, the conservative group had a significantly higher incidence of MACE than the aggressive group (13.8% vs. 9.3%; hazard ratio [HR], 1.49; 95% confidence interval [CI], 1.00–2.21; p=0.049), mainly driven by revascularization of target intermediate lesion (6.5% vs. 1.1%; HR, 5.69; 95% CI, 2.20–14.73;p<0.001). Between 1 and 3 years after the index procedure, compared to the aggressive group, the conservative group had significantly higher incidence of cardiac death or MI (3.2% vs.0.7%; HR, 4.34; 95% CI, 1.24–15.22; p=0.022) and ischemia-driven any revascularization.
Conclusions
For intermediate lesions, medical therapy alone, guided only by angiography, was associated with a higher risk of MACE at 3 years compared with performing PCI, mainly due to increased revascularization.
4.Outcomes of Deferring Percutaneous Coronary Intervention Without Physiologic Assessment for Intermediate Coronary Lesions
Jihoon KIM ; Seong-Hoon LIM ; Joo-Yong HAHN ; Jin-Ok JEONG ; Yong Hwan PARK ; Woo Jung CHUN ; Ju Hyeon OH ; Dae Kyoung CHO ; Yu Jeong CHOI ; Eul-Soon IM ; Kyung-Heon WON ; Sung Yun LEE ; Sang-Wook KIM ; Ki Hong CHOI ; Joo Myung LEE ; Taek Kyu PARK ; Jeong Hoon YANG ; Young Bin SONG ; Seung-Hyuk CHOI ; Hyeon-Cheol GWON
Korean Circulation Journal 2025;55(3):185-195
Background and Objectives:
Outcomes of deferring percutaneous coronary intervention (PCI) without invasive physiologic assessment for intermediate coronary lesions is uncertain.We sought to compare long-term outcomes between medical treatment and PCI of intermediate lesions without invasive physiologic assessment.
Methods:
A total of 899 patients with intermediate coronary lesions between 50% and 70% diameter-stenosis were randomized to the conservative group (n=449) or the aggressive group (n=450). For intermediate lesions, PCI was performed in the aggressive group, but was deferred in the conservative group. The primary endpoint was major adverse cardiac events (MACE, a composite of all-cause death, myocardial infarction [MI], or ischemia-driven any revascularization) at 3 years.
Results:
The number of treated lesions per patient was 0.8±0.9 in the conservative group and 1.7±0.9 in the aggressive group (p=0.001). At 3 years, the conservative group had a significantly higher incidence of MACE than the aggressive group (13.8% vs. 9.3%; hazard ratio [HR], 1.49; 95% confidence interval [CI], 1.00–2.21; p=0.049), mainly driven by revascularization of target intermediate lesion (6.5% vs. 1.1%; HR, 5.69; 95% CI, 2.20–14.73;p<0.001). Between 1 and 3 years after the index procedure, compared to the aggressive group, the conservative group had significantly higher incidence of cardiac death or MI (3.2% vs.0.7%; HR, 4.34; 95% CI, 1.24–15.22; p=0.022) and ischemia-driven any revascularization.
Conclusions
For intermediate lesions, medical therapy alone, guided only by angiography, was associated with a higher risk of MACE at 3 years compared with performing PCI, mainly due to increased revascularization.
5.The Relationships among Various Risk Fac tors to Predict Early Preterm Birth Com pared to Late Preterm Birth
Eun Young WOO ; Gwi Taek SHIN ; Jin Young LEE ; Chanmi LIM ; Min Jung CHOI ; Suk Young KIM
Perinatology 2024;35(1):7-12
Objective:
To evaluate and assesse useful factors in predicting early preterm birth (PTB) and de termined the increased risks of early PTB for the combinations of these factors compared to late PTB.
Methods:
The 77 singleton pregnancies with PTL were enrolled. They had undergone examinations including cervical length (CL) and fetal fibronectin (fFN), polymerase chain reaction for sexually transmitted disease, and cervical culture. We first evaluated the statistical significance of the primary predictors (known risk factors before pregnancy) and secondary predictors (fFN, CL, high-sensitivity C-reactive protein [hsCRP] and cervical bacterial analysis). Next, we analyzed the various combinations of meaningful factors.
Results:
CL <2.5 cm (P=0.007; odds ratio [OR], 3.598), hsCRP ≥0.9 mg/dL (P=0.011; OR, 3.79), and fFN ≥50 ng/mL (P=0.035; OR, 2.75) were more predictive of early PTB than late PTB. The highest OR was observed for the combination of all 3 factors (P=0.039; OR, 7.75). The fFN positivity and hsCRP ≥0.9 mg/dL was in OR 6.094 (P=0.013). The CL<2.5 cm and hsCRP ≥0.9 mg/dL was in OR 5.333 (P=0.009). Finally, the CL <2.5 cm and fFN positivity was in OR 3.946 (P=0.013). The interval between diagnosis and delivery in women with all 3 factors was 8 days shorter than that for women without these factors (P=0.04).
Conclusion
Our study is the first to demonstrate the potential risks of PTB using the combination of commonly used in clinical factors, and revealed quantification by the ORs. We will be useful reference value for patients counselling for prediction of early PTB.
6.The Relationships among Various Risk Fac tors to Predict Early Preterm Birth Com pared to Late Preterm Birth
Eun Young WOO ; Gwi Taek SHIN ; Jin Young LEE ; Chanmi LIM ; Min Jung CHOI ; Suk Young KIM
Perinatology 2024;35(1):7-12
Objective:
To evaluate and assesse useful factors in predicting early preterm birth (PTB) and de termined the increased risks of early PTB for the combinations of these factors compared to late PTB.
Methods:
The 77 singleton pregnancies with PTL were enrolled. They had undergone examinations including cervical length (CL) and fetal fibronectin (fFN), polymerase chain reaction for sexually transmitted disease, and cervical culture. We first evaluated the statistical significance of the primary predictors (known risk factors before pregnancy) and secondary predictors (fFN, CL, high-sensitivity C-reactive protein [hsCRP] and cervical bacterial analysis). Next, we analyzed the various combinations of meaningful factors.
Results:
CL <2.5 cm (P=0.007; odds ratio [OR], 3.598), hsCRP ≥0.9 mg/dL (P=0.011; OR, 3.79), and fFN ≥50 ng/mL (P=0.035; OR, 2.75) were more predictive of early PTB than late PTB. The highest OR was observed for the combination of all 3 factors (P=0.039; OR, 7.75). The fFN positivity and hsCRP ≥0.9 mg/dL was in OR 6.094 (P=0.013). The CL<2.5 cm and hsCRP ≥0.9 mg/dL was in OR 5.333 (P=0.009). Finally, the CL <2.5 cm and fFN positivity was in OR 3.946 (P=0.013). The interval between diagnosis and delivery in women with all 3 factors was 8 days shorter than that for women without these factors (P=0.04).
Conclusion
Our study is the first to demonstrate the potential risks of PTB using the combination of commonly used in clinical factors, and revealed quantification by the ORs. We will be useful reference value for patients counselling for prediction of early PTB.
7.The Relationships among Various Risk Fac tors to Predict Early Preterm Birth Com pared to Late Preterm Birth
Eun Young WOO ; Gwi Taek SHIN ; Jin Young LEE ; Chanmi LIM ; Min Jung CHOI ; Suk Young KIM
Perinatology 2024;35(1):7-12
Objective:
To evaluate and assesse useful factors in predicting early preterm birth (PTB) and de termined the increased risks of early PTB for the combinations of these factors compared to late PTB.
Methods:
The 77 singleton pregnancies with PTL were enrolled. They had undergone examinations including cervical length (CL) and fetal fibronectin (fFN), polymerase chain reaction for sexually transmitted disease, and cervical culture. We first evaluated the statistical significance of the primary predictors (known risk factors before pregnancy) and secondary predictors (fFN, CL, high-sensitivity C-reactive protein [hsCRP] and cervical bacterial analysis). Next, we analyzed the various combinations of meaningful factors.
Results:
CL <2.5 cm (P=0.007; odds ratio [OR], 3.598), hsCRP ≥0.9 mg/dL (P=0.011; OR, 3.79), and fFN ≥50 ng/mL (P=0.035; OR, 2.75) were more predictive of early PTB than late PTB. The highest OR was observed for the combination of all 3 factors (P=0.039; OR, 7.75). The fFN positivity and hsCRP ≥0.9 mg/dL was in OR 6.094 (P=0.013). The CL<2.5 cm and hsCRP ≥0.9 mg/dL was in OR 5.333 (P=0.009). Finally, the CL <2.5 cm and fFN positivity was in OR 3.946 (P=0.013). The interval between diagnosis and delivery in women with all 3 factors was 8 days shorter than that for women without these factors (P=0.04).
Conclusion
Our study is the first to demonstrate the potential risks of PTB using the combination of commonly used in clinical factors, and revealed quantification by the ORs. We will be useful reference value for patients counselling for prediction of early PTB.
8.The Relationships among Various Risk Fac tors to Predict Early Preterm Birth Com pared to Late Preterm Birth
Eun Young WOO ; Gwi Taek SHIN ; Jin Young LEE ; Chanmi LIM ; Min Jung CHOI ; Suk Young KIM
Perinatology 2024;35(1):7-12
Objective:
To evaluate and assesse useful factors in predicting early preterm birth (PTB) and de termined the increased risks of early PTB for the combinations of these factors compared to late PTB.
Methods:
The 77 singleton pregnancies with PTL were enrolled. They had undergone examinations including cervical length (CL) and fetal fibronectin (fFN), polymerase chain reaction for sexually transmitted disease, and cervical culture. We first evaluated the statistical significance of the primary predictors (known risk factors before pregnancy) and secondary predictors (fFN, CL, high-sensitivity C-reactive protein [hsCRP] and cervical bacterial analysis). Next, we analyzed the various combinations of meaningful factors.
Results:
CL <2.5 cm (P=0.007; odds ratio [OR], 3.598), hsCRP ≥0.9 mg/dL (P=0.011; OR, 3.79), and fFN ≥50 ng/mL (P=0.035; OR, 2.75) were more predictive of early PTB than late PTB. The highest OR was observed for the combination of all 3 factors (P=0.039; OR, 7.75). The fFN positivity and hsCRP ≥0.9 mg/dL was in OR 6.094 (P=0.013). The CL<2.5 cm and hsCRP ≥0.9 mg/dL was in OR 5.333 (P=0.009). Finally, the CL <2.5 cm and fFN positivity was in OR 3.946 (P=0.013). The interval between diagnosis and delivery in women with all 3 factors was 8 days shorter than that for women without these factors (P=0.04).
Conclusion
Our study is the first to demonstrate the potential risks of PTB using the combination of commonly used in clinical factors, and revealed quantification by the ORs. We will be useful reference value for patients counselling for prediction of early PTB.
9.The Relationships among Various Risk Fac tors to Predict Early Preterm Birth Com pared to Late Preterm Birth
Eun Young WOO ; Gwi Taek SHIN ; Jin Young LEE ; Chanmi LIM ; Min Jung CHOI ; Suk Young KIM
Perinatology 2024;35(1):7-12
Objective:
To evaluate and assesse useful factors in predicting early preterm birth (PTB) and de termined the increased risks of early PTB for the combinations of these factors compared to late PTB.
Methods:
The 77 singleton pregnancies with PTL were enrolled. They had undergone examinations including cervical length (CL) and fetal fibronectin (fFN), polymerase chain reaction for sexually transmitted disease, and cervical culture. We first evaluated the statistical significance of the primary predictors (known risk factors before pregnancy) and secondary predictors (fFN, CL, high-sensitivity C-reactive protein [hsCRP] and cervical bacterial analysis). Next, we analyzed the various combinations of meaningful factors.
Results:
CL <2.5 cm (P=0.007; odds ratio [OR], 3.598), hsCRP ≥0.9 mg/dL (P=0.011; OR, 3.79), and fFN ≥50 ng/mL (P=0.035; OR, 2.75) were more predictive of early PTB than late PTB. The highest OR was observed for the combination of all 3 factors (P=0.039; OR, 7.75). The fFN positivity and hsCRP ≥0.9 mg/dL was in OR 6.094 (P=0.013). The CL<2.5 cm and hsCRP ≥0.9 mg/dL was in OR 5.333 (P=0.009). Finally, the CL <2.5 cm and fFN positivity was in OR 3.946 (P=0.013). The interval between diagnosis and delivery in women with all 3 factors was 8 days shorter than that for women without these factors (P=0.04).
Conclusion
Our study is the first to demonstrate the potential risks of PTB using the combination of commonly used in clinical factors, and revealed quantification by the ORs. We will be useful reference value for patients counselling for prediction of early PTB.
10.Strategies to Improve Smoking Cessation for Participants in Lung Cancer Screening Program: Analysis of Factors Associated with Smoking Cessation in Korean Lung Cancer Screening Project (K-LUCAS)
Yeol KIM ; Jaeho LEE ; Eunju LEE ; Juntae LIM ; Yonghyun KIM ; Choon-Taek LEE ; Seung Hun JANG ; Yu-Jin PAEK ; Won-Chul LEE ; Chan Wha LEE ; Hyae Young KIM ; Jin Mo GOO ; Kui Son CHOI ; Boyoung PARK ; Duk Hyoung LEE ; Hong Gwan SEO
Cancer Research and Treatment 2024;56(1):92-103
Purpose:
Smoking cessation intervention is one of the key components of successful lung cancer screening program. We investigated the effectiveness and related factors of smoking cessation services provided to the participants in a population-based lung cancer screening trial.
Materials and Methods:
The Korean Lung Cancer Screening Project (K-LUCAS) is a nationwide, multi-center lung cancer screening trial that evaluates the feasibility of implementing population-based lung cancer screening. All 5,144 current smokers who participated in the K-LUCAS received a mandatory smoking cessation counseling. Changes in smoking status were followed up using a telephone survey in 6 months after lung cancer screening participation. The lung cancer screening’s impact on smoking cessation is analyzed by variations in the smoking cessation interventions provided in screening units.
Results:
Among 4,136 survey responders, participant’s motivation to quit smoking increased by 9.4% on average after lung cancer screening. After 6 months from the initial screening, 24.3% of participants stopped smoking, and 10.6% of participants had not smoked continuously for at least 6 months after screening. Over 80% of quitters stated that participation in lung cancer screening motivated them to quit smoking. Low-cost public smoking cessation program combined with lung cancer screening increased the abstinence rates. The smokers were three times more likely to quit smoking when the smoking cessation counseling was provided simultaneously with low-dose computed tomography screening results than when provided separately.
Conclusion
A mandatory smoking cessation intervention integrated with screening result counselling by a physician after participation in lung cancer screening could be effective for increasing smoking cessation attempts.

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