Publications by authors named "Jung Won Suh"

Aim To assess an optimal long-term antiplatelet strategy in patients at both high ischaemic and bleeding risks after percutaneous coronary intervention (PCI). Methods and results Patients both at high ischaemic and bleeding risks were eligible for inclusion. We excluded patients with any ischaemic and major bleeding complications during the mandatory period of dual antiplatelet therapy (DAPT).

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Calcium channel blockers (CCBs) are frequently co-administered with clopidogrel in cardiovascular disease. Although an inhibitory drug interaction exists between them, comprehensive large-scale studies for its validation are lacking. We investigated interactions between CCBs and clopidogrel using a large-scale national registry of patients who underwent percutaneous coronary intervention (PCI).

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Article Synopsis
  • Patients undergoing complex high-risk PCI are still at high risk for adverse events despite standard dual antiplatelet therapy (DAPT).
  • The TAILORED-CHIP trial aims to compare a tailored antiplatelet strategy with an early escalation and late de-escalation approach against conventional DAPT.
  • The study's primary focus is on the net clinical outcome, measuring serious events like death, heart attack, stroke, and significant bleeding within 12 months after the procedure.
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  • The study examined the effects of proton pump inhibitors (PPIs) on patients who underwent percutaneous coronary intervention (PCI) while taking clopidogrel for antiplatelet therapy, particularly focusing on their clinical outcomes and PRU levels.
  • Among 13,160 patients, those using PPIs had higher PRU levels but did not show a significant increase in serious cardiovascular events when compared to non-users, with primary outcomes occurring in a similar proportion.
  • However, for patients carrying certain genetic variations (CYP2C19 loss-of-function alleles), PPI use was associated with an increased risk of adverse outcomes, highlighting complex interactions between medication and genetics.
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Electrocardiogram (ECG) changes after primary percutaneous coronary intervention (PCI) in ST-segment elevation myocardial infarction (STEMI) patients are associated with prognosis. This study investigated the feasibility of predicting left ventricular (LV) dysfunction in STEMI patients using an artificial intelligence (AI)-enabled ECG algorithm developed to diagnose STEMI. Serial ECGs from 637 STEMI patients were analyzed with the AI algorithm, which quantified the probability of STEMI at various time points.

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Background: Hypertensive disorders of pregnancy (HDP) pose significant risks to both maternal and fetal health, contributing to global morbidity and mortality. Management of HDP is complex, particularly because of concerns regarding potential negative effects on utero-placental circulation and limited therapeutic options due to fetal safety. Our study investigates whether blood pressure monitoring through a mobile health (mHealth) application can aid in addressing the challenges of blood pressure management in pregnant individuals with HDP.

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Importance: The appropriate follow-up surveillance strategy for patients with acute coronary syndrome (ACS) who have undergone percutaneous coronary intervention (PCI) remains unknown.

Objective: To assess clinical outcomes in patients with and without ACS who have undergone high-risk PCI according to a follow-up strategy of routine stress testing at 12 months after PCI vs standard care alone.

Design, Setting, And Participants: The POST-PCI (Pragmatic Trial Comparing Symptom-Oriented vs Routine Stress Testing in High-Risk Patients Undergoing Percutaneous Coronary Intervention) trial was a randomized clinical trial that compared follow-up strategies of routine functional testing vs standard care alone 12 months after high-risk PCI.

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Article Synopsis
  • In a study of patients aged 60 and older with patent foramen ovale (PFO) and cryptogenic stroke from South Korea, researchers aimed to determine if PFO closure helps reduce the risk of recurrent strokes compared to medical therapy alone.
  • The study included 437 patients, with 37% undergoing PFO closure; results showed that PFO closure significantly lowered the risk of subsequent ischemic strokes or TIAs over a follow-up period of about 3.9 years.
  • The findings suggest that elderly patients with high-risk PFO have a substantial recurrence rate of strokes, which PFO closure can effectively reduce.
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Background: Carriers of loss-of-function alleles have increased adverse events after percutaneous coronary intervention, but limited data are available for older patients. We aimed to evaluate the prognostic impact of genotypes on clinical outcomes in older patients after percutaneous coronary intervention.

Methods And Results: The study included 1201 older patients (aged ≥75 years) who underwent percutaneous coronary intervention and received clopidogrel-based dual antiplatelet therapy in South Korea.

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This study evaluated the association of atherogenic index of plasma (AIP) with platelet reactivity and clinical outcomes according to acute myocardial infarction (AMI). The composite of 3-year adverse outcomes of all-cause death, myocardial infarction, and cerebrovascular accident was evaluated in 10,735 patients after successful percutaneous coronary intervention with drug-eluting stents. AIP was defined as the base 10 logarithm of the ratio of triglyceride to high-density lipoprotein cholesterol concentration.

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Background: Although age and body mass index (BMI) significantly affect platelet reactivity units and clinical outcomes after percutaneous coronary intervention, there are limited data on the relationship between high on-treatment platelet reactivity (HPR) and clinical outcomes on age and BMI differences. Thus, we investigated the association of HPR with clinical outcomes according to age and BMI.

Methods And Results: The study analyzed 11 714 patients who underwent platelet function tests after percutaneous coronary intervention.

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Background: Complex percutaneous coronary intervention (C-PCI) and high platelet reactivity (HPR) have been proposed as representative risk factors for the high ischemic phenotype. Uncertainty remains regarding the relative prognostic importance of these factors.

Objectives: This study aimed to investigate the prognostic implication of HPR according to procedural complexity.

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Background: The optimal surveillance strategy after percutaneous coronary intervention (PCI) for high-risk patients with multivessel or left main coronary artery disease (CAD) remains uncertain.

Objectives: This study aims to determine the prognostic role of routine functional testing in patients with multivessel or left main CAD who underwent PCI.

Methods: The POST-PCI (Pragmatic Trial Comparing Symptom-Oriented Versus Routine Stress Testing in High-Risk Patients Undergoing Percutaneous Coronary Intervention) trial randomized high-risk PCI patients to routine functional testing at 1 year or standard care alone during follow-up.

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This study aimed to compare and evaluate the efficacy of the blood pressure (BP) control and cholesterol-lowering effects and safety of combination therapy with telmisartan, rosuvastatin, and ezetimibe versus rosuvastatin and ezetimibe double therapy or telmisartan single therapy in dyslipidemia patients with hypertension. After a wash-out/therapeutic lifestyle change period of ≥4 weeks, a total of 100 eligible patients were randomized and received one of three treatments for 8 weeks: (1) telmisartan 80 mg/rosuvastatin 20 mg/ezetimibe 10 mg (TRE), (2) rosuvastatin 20 mg/ezetimibe 10 mg (RE), or (3) telmisartan 80 mg (T). The primary endpoint was the efficacy evaluation of TRE by comparing changes in mean sitting systolic blood pressure (msSBP) and mean percentage change in low-density lipoprotein-C (LDL-C) from baseline after 8 weeks of treatment.

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Background: Coronary artery disease patients undergoing percutaneous coronary intervention (PCI) often exhibit reduced left ventricular ejection fraction (LVEF). However, the impact of LV dysfunction status in conjunction with platelet reactivity on clinical outcomes has not been previously investigated.

Methods: From the multicenter PTRG-DES (Platelet function and genoType-Related long-term prognosis in DES-treated patients) consortium, the patients were classified as preserved-EF (PEF: LVEF ≥ 50%) and reduced-EF (REF: LVEF< 5 0%) group by echocardiography.

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Article Synopsis
  • - Stent thrombosis (ST) is a serious complication after coronary artery procedures, and the link between P2Y12 reaction unit (PRU) levels and ST is still not fully understood.
  • - Analysis of 11,714 patients from the PTRG-DES registry found that higher PRU and aspirin reaction unit levels are independent predictors of early stent thrombosis (EST), which occurred in 51 patients.
  • - The risk of major cardiovascular events within a year was significantly greater for those who had EST (38.2%) compared to those who did not (3.9%), highlighting the importance of monitoring platelet activity after drug-eluting stent procedures.
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Background: East Asians (EAs), compared to white Caucasians (W), have a lower risk of ischemic heart disease and a higher risk of bleeding with antithrombotic medications. The underlying mechanisms are incompletely understood.

Objectives: We sought to compare thrombotic profiles of EA and W patients with myocardial infarction (MI) and relate these to cardiovascular outcomes.

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Background And Aims: The optimal follow-up surveillance strategy for high-risk diabetic patients with had undergone percutaneous coronary intervention (PCI) remains unknown.

Methods: The POST-PCI (Pragmatic Trial Comparing Symptom-Oriented versus Routine Stress Testing in High-Risk Patients Undergoing Percutaneous Coronary Intervention) study was a randomized trial comparing a follow-up strategy of routine functional testing at 1 year vs. standard care alone after high-risk PCI.

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Background: Diabetes mellitus (DM) is associated with thrombogenicity, clinically manifested with atherothrombotic events after percutaneous cutaneous intervention (PCI). This study aimed to investigate association between DM status and platelet reactivity, and their prognostic implication in PCI-treated patients.

Methods: The Platelet function and genoType-Related long-term Prognosis-Platelet Function Test (PTRG-PFT) cohort was established to determine the linkage of platelet function test (PFT) with long-term prognosis during dual antiplatelet therapy including clopidogrel in patients treated with drug-eluting stent (DES).

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Article Synopsis
  • Loss-of-function (LoF) alleles of CYP2C19 are found frequently in East Asians and are associated with high platelet reactivity (HPR), leading to worse outcomes after drug-eluting stent (DES) implantation.
  • A study involving 13,160 Korean patients sought to assess the additional predictive value of combining HPR with CYP2C19 genotype for long-term prognosis after DES treatment.
  • Results showed that patients with both HPR and CYP2C19 LoF/LoF had the highest rates of major adverse cardiac and cerebrovascular events (MACCE), and using both factors together significantly enhanced risk prediction for stent thrombosis.
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Background: In South Korea, the number of people with dementia is rising at a worrisome rate, and many of them also have acute myocardial infarction (AMI), a disease with a high mortality rate.

Hypothesis: We speculated that dementia and drug compliance have significant impact on the mortality of patients with AMI.

Methods: The study derived data from the National Health Insurance Service-Senior for a retrospective cohort study.

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Background Although high platelet reactivity (HPR) on clopidogrel is associated with higher ischemic events and lower bleeding events in patients who have undergone percutaneous coronary intervention with drug-eluting stents, the differential risk of HPR in East Asian women versus men is unknown. Methods and Results We compared 11 714 patients enrolled in the PTRG-DES (Platelet Function and Genotype-Related Long-Term Prognosis in Drug-Eluting Stent-Treated Patients With Coronary Artery Disease) Consortium according to sex and the presence/absence of HPR on clopidogrel (defined as ≥252 P2Y12 reactivity units). The primary study end point was major adverse cardiac and cerebrovascular events (MACCEs; comprising all-cause mortality, myocardial infarction, cerebrovascular accident, and stent thrombosis).

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Article Synopsis
  • A study examined the long-term outcomes of patients undergoing clopidogrel therapy after receiving drug-eluting stents, focusing on CYP2C19 genotypes among East Asians.
  • They found that patients identified as intermediate or poor metabolizers had a significantly higher risk of serious cardiac events within 5 years compared to rapid or normal metabolizers.
  • The results suggested that CYP2C19 genotyping could help identify patients at greater risk after treatment, particularly among those with acute coronary syndrome, indicating a potential for personalized medication strategies.
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Background: Comparative studies of ultrathin-strut biodegradable polymer sirolimus-eluting stent (BP-SES) have reported promising results and validated its excellent outcomes in terms of safety and efficacy. However, there are limited studies comparing BP drug-eluting stents with struts of different thicknesses. We compared the long-term clinical outcomes of patients treated with an ultrathin-strut BP-SES or a thick-strut biodegradable polymer biolimus-eluting stent (BP-BES).

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Background: The long-term prognostic implication of platelet reactivity after percutaneous coronary intervention (PCI) is not clearly known.

Objectives: The impacts of platelet reactivity from the PTRG-DES consortium were assessed.

Methods: The primary endpoint was the major adverse cardiac and cerebrovascular events (MACCE) including all-cause death, myocardial infarction, stent thrombosis, or stroke.

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