Publications by authors named "Doo sun Sim"
Article Synopsis
- - The study investigates the link between myocardial bridging (MB) and coronary vasospasm (CVS), aiming to see if CVS worsens outcomes for patients with MB over the long term.
- - Researchers included 254 patients with MB, dividing them into two groups: those with CVS (168 patients) and those without (86 patients), and examined major adverse cardiovascular events (MACEs) over an average follow-up of 8.15 years.
- - Results showed that patients with CVS experienced significantly higher rates of MACEs (35.1%) compared to those without CVS (26.7%), indicating that CVS negatively impacts the clinical outcomes of MB patients, suggesting a need for further research.
Background: Despite increasing evidence on the benefits of statin therapy for acute myocardial infarction (AMI), differential outcomes in accordance with statin intensity have not been evaluated in patients with AMI and low-density lipoprotein cholesterol (LDL-C) levels < 55 mg/dL. Therefore, this study aimed to compare the clinical outcomes of high- and moderate-intensity statin therapy in this population.
Methods: A total of 752 participants with AMI and LDL-C levels < 55 mg/dL from a Korean nationwide multicenter observational cohort (2016-2020) were included and categorized into two groups: high-intensity statin group (n = 384) and moderate-intensity statin group (n = 368).
Article Synopsis
- * Results showed that during the first week, STEMI patients had a significantly higher mortality rate (4.62%) compared to NSTEMI patients (1.79%), but this trend reversed after the second week for men and the tenth week for women.
- * The research highlights the need for further studies to develop advanced risk prediction models based on time-point mortality outcomes, as different baseline variables influenced mortality rates over time.
Background And Objectives: Cigarette smoking is a major risk factor for atherosclerosis. Nicotine, a crucial constituent of tobacco, contributes to atherosclerosis development and progression. However, evidence of the association between nicotine and neointima formation is limited.
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- The study investigated the effects of clopidogrel and ticagrelor on bleeding and ischemia risks in elderly East Asian patients with diabetes and acute myocardial infarction who underwent percutaneous coronary intervention.
- It analyzed data from 838 patients over 75 years old, ultimately comparing 466 patients after matching for treatment type.
- Findings suggested that there was no significant difference in the incidence of severe bleeding or ischemia between those treated with ticagrelor versus clopidogrel, indicating the need for larger trials to find the best antiplatelet therapy for this group.
Article Synopsis
- Dyslipidemia, a key risk factor for heart attacks, has shown an increase in prevalence among Korean patients from 11.1% to 17.1% between 2011 and 2020 as this study explored trends in its management.
- Over the same period, there was a rise in statin prescriptions from 92.9% to 97.0%, with high-intensity statin use increasing dramatically and greater adoption of drugs like ezetimibe.
- Despite improvements in managing dyslipidemia, with more patients achieving lipid targets, ongoing efforts are crucial to further lower the risk of heart-related complications.*
Optimal timing of revascularization for patients who presented with non-ST segment elevation myocardial infarction (NSTEMI) and severe left ventricular (LV) dysfunction is unclear. A total of 386 NSTEMI patients with severe LV dysfunction from the nationwide, multicenter, and prospective Korea Acute Myocardial Infarction Registry V (KAMIR-V) were enrolled. Severe LV dysfunction was defined as LV ejection fraction ≤ 35%.
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- * Twenty patients were enrolled, and results after 8 months showed minimal in-stent late lumen loss (0.7 mm) and complete stent strut coverage, indicating successful healing.
- * There were no adverse cardiovascular events reported within the same period, suggesting that the new stent design is safe and effective in treating coronary artery disease.
Article Synopsis
- Researchers studied 861 patients with myocardial infarction with nonobstructive coronary arteries (MINOCA) to understand how the timing of hospitalization affects mortality rates over two years.
- * They found that patients who presented late (after 12 or 24 hours) had a significantly higher risk of death compared to those who arrived early, with adjusted hazard ratios confirming this increased risk.
- * Factors such as being female, not using emergency services, and having high creatinine levels were linked to late presentation, indicating a need for better systems to minimize delays in seeking treatment.
Background: A drug-eluting stent (DES) is a highly beneficial medical device used to widen or unblock narrowed blood vessels. However, the drugs released by the implantation of DES may hinder the re-endothelialization process, increasing the risk of late thrombosis. We have developed a tacrolimus-eluting stent (TES) that as acts as a potent antiproliferative and immunosuppressive agent, enhancing endothelial regeneration.
View Article and Find Full Text PDFBackground: The comparative efficacy and safety of adjusted- and standard-dose prasugrel in East Asian patients with acute myocardial infarction (AMI) undergoing percutaneous coronary intervention (PCI) remain unclear. This study aimed to comparatively assess the ischaemic and bleeding outcomes of adjusted-dose (maintenance dose: 3.75 mg) and standard-dose (maintenance dose: 10 mg) prasugrel in East Asian patients with AMI undergoing PCI.
View Article and Find Full Text PDFObjectives: This study investigated the optimal timing for percutaneous coronary intervention (PCI) in patients with NSTEMI complicated by heart failure (HF).
Methods: In total, 762 patients with NSTEMI and HF in a multicenter, prospective registry in South Korea were classified according to the Killip classification (Killip class 2, n = 414 and Killip class 3, n = 348) and underwent early (within 24 h) and delayed (after 24 h) PCI. The primary outcome was all-cause mortality which was further analyzed with landmark analysis with two months as a cut-off.
Article Synopsis
- Current guidelines suggest complete revascularization (CR) for stable patients with ST-segment elevation myocardial infarction (STEMI) and multivessel coronary artery disease (MVD), but the best timing for the procedure is still unclear.
- The OPTION-STEMI trial investigates whether immediate CR during a primary angioplasty is as effective as in-hospital staged CR, using fractional flow reserve (FFR) assessments for certain lesions.
- The trial enrolled patients with significant non-infarct-related artery lesions, aiming to measure outcomes like death and myocardial infarction one year post-randomization, with results expected in mid-2025.
There are limited data on outcomes after implantation of everolimus-eluting stents (EES) in East Asian patients with small vessel coronary lesions. A total of 1,600 patients treated with XIENCE EES (Abbott Vascular, CA, USA) were divided into the small vessel group treated with one ≤2.5 mm stent (n=119) and the non-small vessel group treated with one ≥2.
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- The study compared the outcomes of patients with acute myocardial infarction (AMI) treated with either a single long stent (SLS) or overlapped double short stents (DSS) to determine which method is more effective.
- A total of 537 patients were analyzed, showing differences in patient characteristics, procedure time, and serum creatinine levels between the two stenting methods, but similar one-year rates of major adverse cardiac and cerebrovascular events (MACCEs).
- The conclusion indicates that SLS is as safe and effective as DSS for treating AMI, suggesting that SLS could be preferred if deliverability is not an issue.
Background/aims: Due to limited real-world evidence on the association between time to presentation (T2P) and outcomes following acute myocardial infarction and diabetes (AMI-DM), we investigated the characteristics of patients with AMI-DM and their outcomes based on their T2P.
Methods: 4,455 patients with AMI-DM from a Korean nationwide observational cohort (2011-2015) were divided into early and late presenters according to symptom-to-door time. The effects of T2P on three-year all-cause mortality were estimated using inverse probability of treatment weighting (IPTW) and survival analysis.
Background: Current polymer-based drug-eluting stents (DESs) have fundamental issues about inflammation and delayed re-endothelializaton of the vessel wall. Substance-P (SP), which plays an important role in inflammation and endothelial cells, has not yet been applied to coronary stents. Therefore, this study compares poly lactic-co-glycolic acid (PLGA)-based everolimus-eluting stents (PLGA-EESs) versus 2-methacryloyloxyethyl phosphorylcholine (MPC)-based SP-eluting stents (MPC-SPs) in in-vitro and in-vivo models.
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- The study examines the effects of early left ventricular unloading versus a conventional approach on 30-day mortality in patients with cardiogenic shock undergoing VA-ECMO.
- Conducted from March 2021 to September 2022, it involved 116 patients randomly assigned to either early unloading or the conventional approach, with no significant difference in mortality rates observed between the two groups.
- However, the early unloading group experienced a shorter time to disappearance of pulmonary congestion compared to the conventional group.
Background: The benefits of de-escalation of P2Y inhibition after percutaneous coronary intervention (PCI) may differ by high bleeding risk (HBR) status.
Aims: We investigated the efficacy and safety of de-escalation from ticagrelor to clopidogrel after PCI by HBR status.
Methods: This is a non-prespecified post hoc analysis of the TicAgrelor Versus CLOpidogrel in Stabilized Patients with Acute Myocardial Infarction (TALOS-AMI) trial.
Background: Several studies have compared clinical outcomes according to sex in patients with acute myocardial infarction (AMI). However, studies evaluating sex differences in clinical outcomes of single-vessel disease (SVD) and multi-vessel disease (MVD) in Korean patients with AMI are lacking. Therefore, this study aimed to analyze sex differences in the clinical characteristics of patients with AMI with SVD and MVD and to evaluate the impact of sex differences on the clinical outcomes in patients with AMI with SVD and MVD.
View Article and Find Full Text PDFBackground: Thin-cap fibroatheroma is a rupture-prone vulnerable plaque that leads to acute coronary syndrome (ACS). However, its underlying mechanisms are not fully understood. Several studies have investigated the clinical association between angiopoietin-like protein 4 (ANGPTL4) and coronary artery disease.
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- * Conducted with 116 patients, participants were randomly assigned to either receive routine unloading within 12 hours of VA-ECMO or the conventional method based on later monitored signs of increased afterload.
- * The trial aims to assess the effects on 30-day mortality and other clinical outcomes, potentially influencing future practices in managing complications linked to VA-ECMO.
Background Data on the incidence, relevant patient factors, and clinical outcomes of the misdiagnosis of ST-segment-elevation myocardial infarction (STEMI) in the modern era of percutaneous coronary intervention are limited. Methods and Results Data from KAMIR (Korea Acute Myocardial Infarction Registry) between November 2011 and June 2020 were analyzed. Out of 28 470 patients with acute myocardial infarction, 11 796 were eventually diagnosed with STEMI following a coronary angiogram.
View Article and Find Full Text PDFObjective: To compare the clinical outcomes of patients with acute myocardial infarction with renal impairment (AMI-RI) treated with either angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs) in real-world clinical settings.
Patients And Methods: A total of 4790 consecutive patients with AMI-RI between November 1, 2011, and December 31, 2015, were subdivided into ACEI (n=2845) and ARB (n=1945) treatment groups. The primary end points were major adverse cardiac and cerebrovascular events, including all-cause mortality, nonfatal myocardial infarction, any revascularization, cerebrovascular accident, rehospitalization, and stent thrombosis.