Publications by authors named "Seung-Hyuk Choi"

Introduction: There is a lack of evidence to support the effectiveness of prolonged β-blocker therapy after stabilisation of patients with acute myocardial infarction (AMI) without heart failure (HF) or left ventricular systolic dysfunction.

Methods And Analysis: The SMart Angioplasty Research Team: DEcision on Medical Therapy in Patients with Coronary Artery DIsease or Structural Heart Disease Undergoing InterventiON (SMART-DECISION) trial is a multicentre, prospective, open-label, randomised, non-inferiority trial designed to determine whether discontinuing β-blocker therapy after ≥1 year of maintenance in stabilised patients after AMI is non-inferior to continuing it. Patients eligible for participation are those without HF or left ventricular systolic dysfunction (ejection fraction >40%) who have been continuing β-blocker therapy for ≥1 year after AMI.

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Introduction And Objectives: Recent randomized controlled trials support the use of intravascular imaging-guided percutaneous coronary intervention (PCI) to improve patient prognosis. However, the subsequent risk of clinical events in patients with coronary artery disease is not determined solely by lesion characteristics or how these lesions are treated. The current study investigated whether the effects of intravascular imaging in complex PCI vary according to atherothrombotic risks.

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Introduction And Objectives: There are 2 options to achieve revascularization in ischemic cardiomyopathy: percutaneous coronary intervention (PCI) or coronary artery bypass graft (CABG). While the benefits of PCI for ischemic cardiomyopathy are unclear, achieving complete revascularization with PCI could improve outcomes comparable to CABG.

Methods: A total of 1496 patients with left ventricular ejection fraction (LVEF) <50% and multivessel disease who underwent either PCI or CABG were selected from a single-center cohort registry.

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Background: Coronary computed tomography angiography-derived fractional flow reserve (FFR) is a per-vessel index reflecting cumulative hemodynamic burden while coronary events occur in focal lesions.

Objectives: The authors sought to evaluate the additive prognostic value of the local gradient of FFR (FFR gradient) in addition to FFR to predict future coronary events.

Methods: The current study included 245 patients (634 vessels) who underwent coronary computed tomography angiography within 6 to 36 months before the index angiography, of which 209 vessels had future coronary events and 425 vessels did not.

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Introduction And Objectives: This study investigated the safety and efficacy of antiplatelet therapy in patients with intermediate coronary artery stenosis who underwent deferred revascularization due to their fractional flow reserve (FFR).

Methods: A nationwide cohort study was conducted using the Korean National Health Insurance Service database. A total of 4657 patients with intermediate coronary artery stenosis who underwent deferred revascularization due to their FFR were identified from 2013 to 2020.

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Background: Sarcopenia is an aging-related condition characterized by loss of skeletal muscle mass and is an indicator of subclinical atherosclerosis. The relationship between reduced muscle mass and long-term clinical outcomes in patients with advanced coronary artery disease who have undergone coronary artery bypass grafting (CABG) is not fully understood. This study is sought to evaluate the prognostic implications of sarcopenia screening in patients undergoing CABG.

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Introduction And Objectives: The current study aimed to evaluate the causal association between hemodynamically significant stenosis and the occurrence of ischemic myocardium using an experimental animal model of coronary artery stenosis.

Methods: In Yorkshire swine (n = 10), coronary stenosis in the left anterior descending artery was induced using a customized vascular occluder to create varying degrees of occlusion severity (40%-99%). Serial changes in coronary pressure and flow velocity were measured in the left anterior descending artery before and after the implantation of the vascular occluder.

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Background: Survival rates following percutaneous coronary intervention (PCI) show variability across studies, particularly regarding sex-specific outcomes. Relative survival analysis, which considers survival patterns in sex-and age-matched general populations, could help explain this variability.

Methods: In a 2011 nationwide South Korean PCI cohort study with 48,783 patients, all-cause death was assessed as the primary outcome over 5 years.

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Background And Aims: Despite the increasing popularity of electronic cigarettes (E-cigarettes), the prognostic impact of switching to E-cigarettes in smokers with coronary artery disease who have undergone percutaneous coronary intervention (PCI) remains unclear.

Methods: Using a nationwide cohort from the Korean National Health Insurance database, 17 973 adults (≥20 years) identified as smokers (based on a health screening examination within 3 years before PCI) who underwent health screening within 3 years after PCI were enrolled to determine changes in smoking habits. Patients were classified as continued combustible cigarette users, successful quitters, or switchers to E-cigarettes.

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Article Synopsis
  • - This study investigates the relationship between visceral adiposity (fat stored in the abdominal cavity) and long-term mortality in patients who underwent coronary artery bypass grafting (CABG), revealing that lower levels of visceral fat are linked to a higher risk of death.
  • - A total of 2810 CABG patients were analyzed, classifying them into three groups based on their visceral fat area index (VFAI), with findings indicating that patients in the low VFAI group (least visceral fat) had a higher incidence of long-term mortality compared to those in the higher VFAI groups.
  • - The results suggest that having low visceral fat does not necessarily protect critically ill patients, contradicting the obesity paradox; thus, managing
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Background: Endovascular therapy (EVT) has become the preferred treatment modality for femoropopliteal disease. However, there is limited evidence regarding its procedural and clinical outcomes according to the affected area.

Aims: The aim of this study is to investigate clinical outcomes and device effectiveness according to treatment extent in the superficial femoral artery (SFA), popliteal artery (PA), or both.

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Because there is a lack of comparative studies assessing drug-coated balloon (DCB) and drug-eluting stent (DES) outcomes with respect to intraluminal (IL) and subintimal (SI) approaches in femoropopliteal (FP) total occlusive lesions, we compared the outcomes between DCB (including bailout stenting) and DES treatments for this lesion. A total of 487 limbs (434 patients) were divided into the IL (n = 344, DCB: n = 268, DES: n = 76) and SI (n = 143, DCB: n = 83, DES: n = 60) approach groups. The primary outcome was a major adverse limb event (MALE), defined as above-ankle amputation or repeat revascularization of the index limb.

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We investigated the long-term patterns and effects of transfusion on the clinical outcome of patients undergoing percutaneous coronary intervention (PCI) using a nationwide registry. Five-year clinical outcome of all Koreans undergoing PCI using stent in year 2011 (n = 48,786) was investigated. Primary outcome was the incidence density of transfusion.

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Article Synopsis
  • This study investigates the outcomes and complication predictors of using flared limbs (FL) versus standard limbs (SL) in endovascular aneurysm repair (EVAR) for patients with ectatic common iliac arteries and abdominal aortic aneurysms.
  • The research analyzed data from 391 patients and found that the FL group had a higher rate of intraoperative type Ib endoleaks compared to the SL group, but there was no significant difference in long-term limb events or overall survival.
  • Despite some complications associated with FL use, such as aortic sac enlargement, the study concludes that both FL and SL have similar efficacy for treating aneurysms in this context.
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Background: Whether angiotensin II receptor blockers (ARBs) can be an alternative to angiotensin-converting enzyme inhibitors (ACEIs) in patients without heart failure (HF) after acute myocardial infarction (MI) remains controversial. The aim of this study was to compare clinical outcomes between initial ARB and ACEI therapy in patients with MI without HF.

Methods: Between 2010 and 2016, a total of 31,013 patients who underwent coronary revascularization for MI with prescription of ARBs or ACEIs at hospital discharge were enrolled from the Korean nationwide medical insurance data.

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Article Synopsis
  • - The study aimed to compare the efficacy of drug-coated balloon (DCB) PCI versus drug-eluting stent (DES)-only PCI in patients with complex coronary artery lesions.
  • - A total of 126 patients received DCB-based PCI, which was compared with 234 patients who underwent DES-only PCI, focusing on the rate of target vessel failure (TVF) over 2 years.
  • - Results showed that DCB-based PCI had similar risks for TVF and other complications compared to DES-only PCI, suggesting that DCB could be a viable alternative in complex cases.
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Background: Currently, non-vitamin K-antagonist oral anticoagulant (NOAC) monotherapy has been suggested as the optimal antithrombotic therapy for atrial fibrillation (AF) beyond one year after coronary revascularization. The aim of this study was to compare the outcomes between NOAC monotherapy and NOAC plus antiplatelet combination therapy using real-world data.

Methods: Between 2015 and 2020, patients with AF who had received NOACs beyond one year after coronary revascularization were enrolled from Korean national insurance data.

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Importance: Data are limited regarding the effects of intravascular imaging guidance during complex percutaneous coronary intervention (PCI) in patients with diabetes.

Objective: To compare the clinical outcomes of intravascular imaging-guided vs angiography-guided complex PCI in patients with or without diabetes.

Design, Setting, And Participants: This prespecified secondary analysis of a subgroup of patients in RENOVATE-COMPLEX-PCI (Randomized Controlled Trial of Intravascular Imaging Guidance Versus Angiography-Guidance on Clinical Outcomes After Complex Percutaneous Coronary Intervention), an investigator-initiated, open-label multicenter trial, analyzed enrolled patients who underwent complex PCI at 20 sites in Korea from May 2018 through May 2021.

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Aims: This study sought to examine the difference in clinical characteristics, treatment strategy, trends in mortality, and medical costs according to the aetiologies of cardiogenic shock (CS).

Methods And Results: This was a population-based, nationwide, cohort study from the Korean National Health Insurance Service database. All CS adults (≥18 years) were admitted to an intensive care unit from January 2010 to December 2020.

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Article Synopsis
  • The study looked at patients with heart attacks and severe complications to see how different treatments affected their recovery.
  • Researchers compared two methods of treating blocked heart arteries: fixing just the main problem (culprit) versus fixing multiple issues at once.
  • They found that patients with more serious artery blockages did worse overall, but those with certain types of blockages had better outcomes when treated with multiple artery repair right away.
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Background: It is unclear whether the beneficial effects of intravascular imaging-guided stent optimization vary by clinical presentation during complex percutaneous coronary intervention (PCI).

Objectives: In this prespecified, stratified subgroup analysis from RENOVATE-COMPLEX-PCI (Randomized Controlled Trial of Intravascular Imaging Guidance versus Angiography-Guidance on Clinical Outcomes After Complex PCI), we sought to compare the outcomes between intravascular imaging vs angiography guidance according to clinical presentation.

Methods: Patients with complex coronary artery lesions were randomly assigned to undergo either intravascular imaging-guided PCI or angiography-guided PCI in a 2:1 ratio.

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Aims: This study evaluated how well serial pulse pressure (PP) and PP adjusted by the vasoactive inotropic score (VIS) predicted venoarterial extracorporeal membrane oxygenation (VA-ECMO) weaning success and clinical outcomes in acute myocardial infarction complicated by cardiogenic shock (AMI-CS) patients.

Methods And Results: A total of 213 patients with AMI-CS who received VA-ECMO between January 2010 and August 2021 were enrolled in the institutional ECMO registry. Serial PP and VIS were measured immediately, 12, 24, and 48 h after VA-ECMO insertion.

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Aims: Although culprit-only revascularization during the index procedure has been recommended in patients with acute myocardial infarction (AMI) complicated by cardiogenic shock (CS), the reduction in residual ischaemia is also emphasized to improve clinical outcomes. However, few data are available about the significance of residual ischaemia in patients undergoing mechanical circulatory supports. This study aimed to evaluate the effects of residual ischaemia on clinical outcomes in patients with AMI undergoing venoarterial-extracorporeal membrane oxygenation (VA-ECMO).

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Introduction And Objectives: There are no clinical data on the efficacy of intravascular imaging-guided percutaneous coronary intervention (PCI) compared with angiography-guided PCI in patients with acute myocardial infarction (AMI) and cardiogenic shock. The current study sought to evaluate the impact of intravascular imaging-guided PCI in patients with AMI and cardiogenic shock.

Methods: Among a total of 28 732 patients from the nationwide pooled registry of KAMIR-NIH (November, 2011 to December, 2015) and KAMIR-V (January, 2016 to June, 2020), we selected a total of 1833 patients (6.

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