Publications by authors named "Hong-Sung Jin"
Importance: In patients with atherosclerotic cardiovascular disease (ASCVD), intensive lowering of low-density lipoprotein (LDL) cholesterol levels with high-intensity statins is generally recommended. However, alternative approaches considering statin-related adverse effects and intolerance are needed.
Objective: To compare the long-term efficacy and safety of an alternative LDL cholesterol-lowering strategy vs high-intensity statin strategy in patients with ASCVD in randomized clinical trials.
Article Synopsis
- - This study developed a machine learning model to personalize the duration of dual antiplatelet therapy (DAPT) after coronary stent implantation, aiming to reduce bleeding risks associated with prolonged therapy.
- - The model, tested on data from several clinical trials, indicated that 84.5% of participants could safely receive a shorter 3-month DAPT without significantly increasing the risk of major adverse cardiovascular events.
- - Validation results showed that patients on abbreviated DAPT had a lower incidence of major bleeding compared to those on the standard 12-month DAPT, highlighting the effectiveness of personalized therapy in improving patient outcomes.
Article Synopsis
- High remnant cholesterol (remnant-C) levels during cholesterol-lowering therapy are linked to an increased risk of cardiovascular events in patients with atherosclerotic cardiovascular disease (ASCVD).
- A study involving 3,348 ASCVD patients found that individuals in the high remnant-C group experienced the highest rates of cardiovascular death, major events, or non-fatal strokes over three years.
- The findings suggest that monitoring remnant-C levels could help identify patients at higher risk for adverse outcomes, making it a useful tool alongside traditional LDL cholesterol measurements.
Optical coherence tomography-guided versus angiography-guided percutaneous coronary intervention for patients with complex lesions (OCCUPI): an investigator-initiated, multicentre, randomised, open-label, superiority trial in South Korea.
Lancet
September 2024
Article Synopsis
- The OCCUPI trial aimed to determine if optical coherence tomography (OCT) guidance during percutaneous coronary intervention (PCI) provides better clinical outcomes compared to traditional angiography guidance for complex heart lesions over a year.
- Conducted across 20 hospitals in South Korea, the trial included 1,604 patients aged 19-85 and utilized randomization to assign participants to either OCT or angiography guidance during their PCI procedure.
- The main outcome measured was the rate of major adverse cardiac events, but the effectiveness of OCT guidance in reducing these events compared to angiography guidance remains uncertain, as the study was designed to assess potential clinical benefits.
Background: Dual antiplatelet therapy (DAPT) for 12 months is the standard of care after coronary stenting in patients with acute coronary syndrome (ACS). The aim of this individual patient-level meta-analysis was to summarise the evidence comparing DAPT de-escalation to ticagrelor monotherapy versus continuing DAPT for 12 months after coronary drug-eluting stent implantation.
Methods: A systematic review and individual patient data (IPD)-level meta-analysis of randomised trials with centrally adjudicated endpoints was performed to evaluate the comparative efficacy and safety of ticagrelor monotherapy (90 mg twice a day) after short-term DAPT (from 2 weeks to 3 months) versus 12-month DAPT in patients undergoing percutaneous coronary intervention with a coronary drug-eluting stent.
Background: Patients with ST-elevation myocardial infarction (STEMI) tend to be excluded or under-represented in randomized clinical trials evaluating the effects of potent P2Y12 inhibitor monotherapy after short-term dual antiplatelet therapy (DAPT).
Methods: Individual patient data were pooled from randomized clinical trials that included STEMI patients undergoing drug-eluting stent (DES) implantation and compared ticagrelor monotherapy after short-term (≤3 months) DAPT versus ticagrelor-based 12-month DAPT in terms of centrally adjudicated clinical outcomes. The co-primary outcomes were efficacy outcome (composite of all-cause death, myocardial infarction, or stroke) and safety outcome (Bleeding Academic Research Consortium type 3 or 5 bleeding) at 1 year.
Background: The impact of rosuvastatin versus atorvastatin on new-onset diabetes mellitus (NODM) among patients treated with high-intensity statin therapy for coronary artery disease (CAD) remains to be clarified. This study aimed to evaluate the risk of NODM in patients with CAD treated with rosuvastatin compared to atorvastatin in the randomized LODESTAR trial.
Methods: In the LODESTAR trial, patients with CAD were randomly assigned to receive either rosuvastatin or atorvastatin using a 2-by-2 factorial randomization.
Study Objective: Although the importance of primary percutaneous coronary intervention has been emphasized for ST-segment elevation myocardial infarction (STEMI), the appropriateness of the cardiac catheterization laboratory activation remains suboptimal. This study aimed to develop a precise artificial intelligence (AI) model for the diagnosis of STEMI and accurate cardiac catheterization laboratory activation.
Methods: We used electrocardiography (ECG) waveform data from a prospective percutaneous coronary intervention registry in Korea in this study.
Background: The optimal statin treatment strategy that is balanced for both efficacy and safety has not been clearly determined in older adults with coronary artery disease (CAD).
Methods: In the post hoc analysis of the LODESTAR (low-density lipoprotein cholesterol-targeting statin therapy versus intensity-based statin therapy in patients with coronary artery disease) trial, the impact between a treat-to-target strategy versus a high-intensity statin therapy strategy was compared in older adults (aged 75 years or older). The goal of treat-to-target low-density lipoprotein cholesterol (LDL-C) level was 50-70 mg/dl.
The spread of American Bullfrog has a significant impact on the surrounding ecosystem. It is important to study the mechanisms of their spreading so that proper mitigation can be applied when needed. This study analyzes data from national surveys on bullfrog distribution.
View Article and Find Full Text PDFBackground And Objectives: The popliteal artery is generally regarded as a "no-stent zone." Limited data are available on the outcomes of drug-coated balloons (DCBs) for popliteal artery disease. This study aimed to evaluate the 12-month clinical outcomes among patients who received DCB treatment for atherosclerotic popliteal artery disease.
View Article and Find Full Text PDFBackground And Aims: In patients with acute coronary syndrome (ACS), dual antiplatelet therapy (DAPT) with aspirin and a potent P2Y12 inhibitor is recommended for 12 months after drug-eluting stent (DES) implantation. Monotherapy with a potent P2Y12 inhibitor after short-term DAPT is an attractive option to better balance the risks of ischaemia and bleeding. Therefore, this study evaluated the efficacy and safety of ticagrelor monotherapy after short-term DAPT, especially in patients with ACS.
View Article and Find Full Text PDFArticle Synopsis
- * It involved 159 patients with 339 lesions, all of whom had noninvasive coronary computed tomography angiography (CTA) prior to angiography, where FFR and OCT were used to identify ischemic lesions.
- * Findings showed that certain plaque characteristics from CTA and OCT, like low attenuation plaque and thrombus, significantly predicted which lesions were likely causing ischemia, suggesting a detailed anatomical evaluation could enhance diagnostic accuracy.
Article Synopsis
- The study investigates whether ticagrelor or clopidogrel monotherapy is as effective as dual antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI) in preventing major adverse cardiovascular events like death, myocardial infarction (MI), or stroke.
- Researchers conducted a systematic review using data from various sources, analyzing patient information from randomized trials to compare the outcomes of the different treatments.
- The analysis included data from 25,960 PCI patients, showing that the efficacy and safety of ticagrelor or clopidogrel monotherapy were evaluated against DAPT to determine their noninferiority regarding adverse clinical outcomes.
Article Synopsis
- * Researchers analyzed data from 359 TAVR patients from 2015 to 2021, matching 120 patients for outcome comparison between ICE with monitored anesthesia care (MAC) and TEE with general anesthesia (GA).
- * Results showed similar rates of the primary outcome (about 18.3% for ICE-MAC and 20.0% for TEE-GA) and other complications like paravalvular regurgitation and bleeding, indicating ICE is a safe
Background And Aims: Whether the effect of a combination strategy rather than increasing doses of one drug to lower low-density lipoprotein cholesterol (LDL-C) levels is consistent across baseline LDL-C levels remains uncertain.
Methods: In the RACING trial, which showed a non-inferiority of moderate-intensity statin with ezetimibe (rosuvastatin 10 mg with ezetimibe 10 mg) to high-intensity statin (rosuvastatin 20 mg) for the primary outcome (3-year composite of cardiovascular death, major cardiovascular event, or stroke), the heterogeneity in treatment effect according to baseline LDL-C levels was assessed for the primary and secondary outcomes (clinical efficacy and safety).
Results: Of 3780 participants, 2817 participants (74.
Aim: This study evaluated the safety and efficacy of a moderate-intensity statin with ezetimibe combination therapy versus high-intensity statin monotherapy in patients with metabolic syndrome (MetS) and atherosclerotic cardiovascular disease.
Materials And Methods: In this post-hoc subgroup analysis of the RACING trial, patients were analysed based on the presence of MetS. MetS was defined as meeting at least three of the five following criteria: (a) elevated waist circumference; (b) elevated triglycerides; (c) reduced high-density lipoprotein cholesterol; (d) elevated blood pressure; and (e) elevated fasting glucose.
We aimed to evaluate sex differences in the effects of moderate-intensity statin with ezetimibe combination therapy (rosuvastatin 10 mg plus ezetimibe) versus high-intensity statin (rosuvastatin 20 mg) monotherapy in patients with atherosclerotic cardiovascular disease (ASCVD). This was a sex-specific subgroup analysis of the RACING trial that evaluated the interaction between sex and treatment strategies for the primary outcome (composite of cardiovascular death, major cardiovascular events, or nonfatal stroke at 3 years). Of 3780 patients in the RACING trial, 954 (25.
View Article and Find Full Text PDFBackground And Objectives: We evaluated the effect of diabetes on the relationship between body mass index (BMI) and clinical outcomes in patients following percutaneous coronary intervention (PCI) with drug-eluting stent implantation.
Methods: A total of 6,688 patients who underwent PCI were selected from five different registries led by Korean Multicenter Angioplasty Team. They were categorized according to their BMI into the following groups: underweight (<18.
Aims: Using rosuvastatin, the RACING (randomized comparison of efficacy and safety of lipid-lowering with statin monotherapy versus statin/ezetimibe combination for high-risk cardiovascular diseases) trial showed the beneficial effects of combining moderate-intensity statin with ezetimibe compared with high-intensity statin monotherapy in patients with atherosclerotic cardiovascular disease. This study investigated whether the beneficial effects of combination lipid-lowering therapy extend to patients treated with atorvastatin, not rosuvastatin, in daily clinical practice.
Methods And Results: Using stabilized inverse probability of treatment weighting, a total of 31 993 patients who were prescribed atorvastatin after drug-eluting stent (DES) implantation were identified from a nationwide cohort database: 6 215 patients with atorvastatin 20 mg plus ezetimibe 10 mg (combination lipid-lowering therapy) and 25 778 patients with atorvastatin 40-80 mg monotherapy.
Dual antiplatelet therapy (DAPT), consisting of aspirin and a P2Yinhibitor, has been the principal antiplatelet therapy after drug-eluting stent (DES) implantation in patients with acute coronary syndrome (ACS) and chronic coronary disease. Particularly in patients with ACS, which presents a higher ischemic risk than chronic coronary artery disease, DAPT for up to 12 months is the recommended standard treatment. However, to decrease bleeding events related to the potency of P2Yinhibitors and a prolonged duration of DAPT, recent studies have suggested P2Yinhibitor monotherapy after short-term DAPT (1-3 months), which decreased the bleeding risk without an increased ischemic risk.
View Article and Find Full Text PDFBackground: Stopping aspirin within 1 month after implantation of a drug-eluting stent for ticagrelor monotherapy has not been exclusively evaluated for patients with acute coronary syndrome. The aim of this study was to investigate whether ticagrelor monotherapy after <1 month of dual antiplatelet therapy (DAPT) is noninferior to 12 months of ticagrelor-based DAPT for adverse cardiovascular and bleeding events in patients with acute coronary syndrome.
Methods: In this randomized, open-label, noninferiority trial, 2850 patients with acute coronary syndrome who underwent drug-eluting stent implantation at 24 centers in South Korea were randomly assigned (1:1) to receive either ticagrelor monotherapy (90 mg twice daily) after <1 month of DAPT (n=1426) or 12 months of ticagrelor-based DAPT (n=1424) between April 24, 2019, and May 31, 2022.
Objective: To compare the long term efficacy and safety of rosuvastatin with atorvastatin treatment in adults with coronary artery disease.
Design: Randomised, open label, multicentre trial.
Setting: 12 hospitals in South Korea, September 2016 to November 2019.
Aims: The aim of this study was to assess the association between triglyceride (TG) levels and cardiovascular disease (CVD) mortality concerning low-density lipoprotein cholesterol (LDL-C) and age in the general population.
Methods And Results: From the Korean National Health Insurance Service database, 15 672 028 participants aged 18-99 who underwent routine health examinations were followed up for CVD mortality. Hazard ratios for CVD mortality were calculated using Cox models after adjusting for various confounders.