Publications by authors named "Jungkyu Han"
Importance: Antiplatelet monotherapy in the chronic maintenance period for patients with high bleeding risk (HBR) and those who have undergone complex percutaneous coronary intervention (PCI) has not yet been explored.
Objective: To compare clopidogrel vs aspirin monotherapy in patients with HBR and/or PCI complexity.
Design, Setting, And Participants: This post hoc analysis of the multicenter HOST-EXAM Extended study, an open-label trial conducted across 37 sites in South Korea, enrolled patients from 2014 to 2018 with up to 5.
Background And Objectives: The risk profiles, procedural characteristics, and clinical outcomes for women undergoing bifurcation percutaneous coronary intervention (PCI) are not well defined compared to those in men.
Methods: COronary BIfurcation Stenting III (COBIS III) is a multicenter, real-world registry of 2,648 patients with bifurcation lesions treated with second-generation drug-eluting stents. We compared the angiographic and procedural characteristics and clinical outcomes based on sex.
The impact of alcohol consumption and its restriction on clinical outcomes in patients undergoing percutaneous coronary intervention (PCI) remains elusive. We aimed to investigate the clinical outcomes in drinkers undergoing PCI. We included 77,409 patients who underwent PCI and a health check-up within one year of the PCI using a nationwide prospective database from the Korean National Health Insurance System.
View Article and Find Full Text PDFArticle Synopsis
- The optimal duration of dual antiplatelet therapy (DAPT) in patients with chronic kidney disease undergoing PCI with third-generation drug-eluting stents is still unclear.
- A study analyzed data from the HOST-IDEA trial, comparing 3- to 6-month DAPT with 12-month DAPT among patients grouped by their kidney function, indicating that those with low kidney function experienced higher adverse clinical events.
- The findings suggest that 3- to 6-month DAPT provides similar clinical outcomes to 12-month DAPT for patients, regardless of their renal function status.
Clopidogrel Versus Aspirin as Chronic Maintenance Antiplatelet Monotherapy in Patients After Percutaneous Coronary Intervention With Chronic Kidney Disease: A Post Hoc Analysis of the HOST-EXAM Trial.
J Am Heart Assoc
September 2024
Background: Clopidogrel monotherapy improved clinical outcomes compared with aspirin monotherapy during a chronic maintenance period in patients who underwent coronary stenting in the HOST-EXAM (Harmonizing Optimal Strategy for Treatment of Coronary Artery Stenosis-Extended Antiplatelet Monotherapy) trial. However, it is uncertain whether the beneficial effect of clopidogrel over aspirin is different according to the renal function.
Methods And Results: We conducted a post hoc analysis of the HOST-EXAM trial.
Background: Transcatheter aortic valve implantation (TAVI) is preferred for treating severe aortic stenosis in older, frail populations, yet the impact of frailty on economic and clinical outcomes of TAVI is not well studied.
Methods: This retrospective cohort study included 2175 TAVI patients from 2015 to 2019, using Korea's National Health Insurance Service database, stratifying patients into low, intermediate, and high-frailty groups, using the Hospital Frailty Risk Score (HFRS). Health care costs, admissions, and total length of hospitalization were analyzed using Wilcoxon-rank test 12 months pre- and post-TAVI.
Background And Aims: Patients with high bleeding risk (HBR) undergoing percutaneous coronary intervention (PCI) are at increased risk of not only bleeding, but also ischaemic events. This study aimed to determine the long-term relative risk of ischaemic and bleeding events in HBR patients.
Methods: This study was a nationwide cohort study, based on the Korean National Health Insurance Review and Assessment Service database.
Background And Objectives: The clinical benefits of complete revascularization (CR) in acute myocardial infarction (AMI) patients are unclear. Moreover, the benefit of CR is unknown in AMI with diabetes mellitus (DM) patients. We sought to compare the prognosis of CR and incomplete revascularization (IR) in patients with AMI and multivessel disease, according to the presence of DM.
View Article and Find Full Text PDFBackground: Long-term follow-up is essential to evaluate the impact of polymer degradation in drug-eluting stents (DES).
Aims: We aimed to compare durable-polymer DES (DP-DES) and biodegradable-polymer DES (BP-DES) during a 3-year follow-up to evaluate the entire period of polymer resolution (before, during, and after degradation).
Methods: The HOST REDUCE POLYTECH RCT Trial was a randomised clinical trial enrolling patients with acute coronary syndrome (ACS) and comparing the efficacy and safety of DP-DES and BP-DES.
Article Synopsis
- The study aimed to compare the clinical outcomes of two third-generation drug-eluting stents: the Coroflex ISAR and the Orsiro.
- It was conducted as part of the HOST-IDEA trial, which originally involved dual antiplatelet therapy duration but shifted to a registry format for stent comparison, ultimately including 328 patients randomized between the two stents.
- Results showed that patients with the Coroflex ISAR stent had a significantly higher rate of target lesion failure compared to those with the Orsiro stent, with revascularization being a major factor for this difference.
Background: Hypertension and dyslipidemia significantly contribute to cardiovascular disease development. Their coexistence poses challenges in managing multiple medications, influencing treatment adherence.
Objective: This study aimed to assess the efficacy and safety of a combined treatment approach using a fixed-dose combination therapy.
Aims: Evidence for the effectiveness of left ventricular (LV) unloading in patients who received venoaterial extracorporeal membrane oxygenation (VA-ECMO) for acute myocardial infarction (AMI) or non-AMI induced cardiogenic shock (CS) is limited. The aim of the present study was to compare the effect of LV unloading in AMI-induced and non-AMI-induced CS.
Methods And Results: This is a single-centre retrospective observational study of patients with CS undergoing VA-ECMO from January 2011 to March 2019.
Background: Clopidogrel was superior to aspirin monotherapy in secondary prevention after percutaneous coronary intervention (PCI).
Objectives: The purpose of this study was to evaluate the benefits of clopidogrel across high-risk subgroups METHODS: This was a post hoc analysis of the HOST-EXAM (Harmonizing Optimal Strategy for Treatment of coronary artery diseases-EXtended Antiplatelet Monotherapy) trial that randomly assigned patients who were event free for 6 to 18 months post-PCI on dual antiplatelet therapy (DAPT) to clopidogrel or aspirin monotherapy. Two clinical risk scores were used for risk stratification: the DAPT score and the Thrombolysis In Myocardial Infarction Risk Score for Secondary Prevention (TRS 2°P) (the sum of age ≥75 years, diabetes, hypertension, current smoking, peripheral artery disease, stroke, coronary artery bypass grafting, heart failure, and renal dysfunction).
Transconjunctival orbital fat repositioning is a surgical technique that resolves protruding orbital fat and sunken tear troughs through a single procedure. The procedure involves incision of the conjunctiva and dissection of the tear trough and orbicularis retaining ligaments, followed by repositioning of the sufficiently released orbital fat as a pedicle. Various techniques have been used to fixate the repositioned fat, including direct suturing of the fat to the target area (internal fixation) and suturing the repositioned fat pedicle and pulling out the suture toward the lower eyelid skin (external fixation).
View Article and Find Full Text PDFBackground And Aims: The authors investigated the impact of smoking and its cessation after percutaneous coronary intervention (PCI) on cardiovascular outcomes.
Methods: Using a nationwide database from the Korean National Health Insurance System, 74 471 patients undergoing PCI between 2009 and 2016 were classified as non-, ex-, or current smokers, depending on smoking status at the first health check-up within 1 year after PCI. The primary outcome was major adverse cardiovascular and cerebrovascular event (MACCE), a composite of all-cause death, myocardial infarction, coronary revascularization, and stroke.
Backgrounds: The HOST-EXAM Extended study reported the benefit of clopidogrel monotherapy over aspirin monotherapy in secondary prevention after percutaneous coronary intervention (PCI). This age-specific subgroup analysis of the study aimed to assess the impact of age on antiplatelet monotherapy after PCI.
Methods: We analysed data from the per-protocol population (4717 patients) with a median follow-up of 5.
Background: It is still unclear the impact of diabetes mellitus (DM) in complex coronary lesions treated with percutaneous coronary intervention (PCI) which themselves are at increased incidence of adverse events.
Methods: BIFURCAT registry encompassed patients treated with PCI for coronary bifurcation lesion from the COBIS III and the RAIN registry. The primary endpoint was the occurrence of major cardiovascular adverse event (MACE), a composite and mutual exclusive of all-cause death or myocardial infarction (MI) or target-lesion revascularization (TLR).
Background: Oxygen therapy is used in various clinical situation, but its clinical outcomes are inconsistent. The relationship between the fraction of inspired oxygen (FIO2) during transcatheter aortic valve implantation (TAVI) and clinical outcomes has not been well studied. We investigated the association of FIO2 (low vs.
View Article and Find Full Text PDFIntroduction: Low-density lipoprotein (LDL) cholesterol-lowering treatment is beneficial for the secondary or primary prevention of high-risk atherosclerotic cardiovascular disease (ASCVD). However, the prognostic implications of low LDL cholesterol levels in patients without previous ASCVD and without statin use remain elusive.
Methods: From a nationwide cohort, 2,432,471 participants without previous ASCVD or statin use were included.
Article Synopsis
- The HOST-EXAM trial found that clopidogrel monotherapy is more effective and safer than aspirin monotherapy for patients after coronary artery interventions.
- Researchers developed a Markov model to assess the cost-effectiveness of both treatments from the perspectives of South Korea, the UK, and the US, using data from the HOST-EXAM trial.
- The analysis revealed that clopidogrel had higher lifetime costs and lower quality-adjusted life-years (QALYs) in South Korea, while it actually reduced costs in the UK and US, although QALYs were still lower compared to aspirin.
Importance: Selecting the optimal antiplatelet agent in patients who have received percutaneous coronary intervention is especially important in those with diabetes due to the heightened risk of ischemic events in this population. Studies on the efficacy and safety of clopidogrel vs aspirin for long-term maintenance after percutaneous coronary intervention in patients with diabetes are lacking.
Objective: To investigate cardiovascular outcomes with clopidogrel vs aspirin in patients with and without diabetes.
Background Clopidogrel monotherapy was more effective in reducing the risk of adverse clinical events than aspirin monotherapy in patients who underwent percutaneous coronary intervention (PCI) with drug-eluting stent (DES), according to the HOST-EXAM (Harmonizing Optimal Strategy for Treatment of Coronary Artery Stenosis-Extended Antiplatelet Monotherapy) trial. However, it remains unknown whether these effects differ based on sex. Methods and Results This was a prespecified secondary analysis of HOST-EXAM in South Korea.
View Article and Find Full Text PDFAims: Dual-antiplatelet therapy (DAPT) with aspirin and a potent P2Y12 inhibitor is the standard treatment for patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI). De-escalation of the potent P2Y12 inhibtor is an appealing concept to balance the ischaemic and bleeding risks after PCI. An individual patient data meta-analysis was performed to compare de-escalation versus standard DAPT in patients with ACS.
View Article and Find Full Text PDFBackground: Patients with coronary artery disease and impaired renal function are at higher risk for both bleeding and ischemic adverse events after percutaneous coronary intervention (PCI).
Objectives: This study assessed the efficacy and safety of a prasugrel-based de-escalation strategy in patients with impaired renal function.
Methods: We conducted a post hoc analysis of the HOST-REDUCE-POLYTECH-ACS study.