Publications by authors named "Seung-woon Rha"

Background: Complete revascularization has demonstrated better outcomes in patients with acute myocardial infarction (AMI) and multivessel disease. However, in the case of left main (LM) culprit lesion AMI with multivessel disease, there is limited evidence to suggest that complete revascularization is better.

Methods: We reviewed 16,831 patients in the Korea Acute Myocardial Infarction Registry who were treated from July 2016 to June 2020, and 399 patients were enrolled with LM culprit lesion AMI treated with percutaneous coronary intervention.

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Background: Coronary artery spasm (CAS) is a cause of variant angina. However, the understanding of CAS patterns in the presence of mild-to-moderate coronary artery stenosis is limited. This study aimed to evaluate the incidence and patterns of CAS in patients with insignificant coronary artery stenosis using intracoronary acetylcholine (ACH) provocation test.

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Background: Data on the clinical impact of beta-blockers (BBs) in patients with myocardial infarction (MI) who had non-reduced left ventricular ejection fraction (LVEF) after percutaneous coronary intervention are limited.

Methods: From 2016 to 2020, we evaluated a cohort of 12,101 myocardial infarction patients with a non-reduced LVEF (≥40%) from the Korean Acute Myocardial Infarction Registry V. Patients were divided into two groups based on their BB (carvedilol, bisoprolol, or nebivolol) treatment at discharge: with beta-blocker treatment (BB,  = 9,468) and without beta-blocker treatment (non-BB,  = 2,633).

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To compare the long-term prognostic effect of complete percutaneous coronary intervention (PCI) on cardiovascular events in chronic total occlusion (CTO) patients with the multi-vessel disease (MVD) compared with medical therapy (MT). We enrolled 441 patients with CTO and MVD who underwent PCI. The study population was divided into the CTO-PCI (n = 231) and the CTO-MT (n = 210) groups.

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Article Synopsis
  • This study analyzed the clinical outcomes of patients with non-ST-segment elevation myocardial infarction (NSTEMI) and ST-segment elevation myocardial infarction (STEMI) based on their left ventricular ejection fraction (LVEF) across three categories: heart failure with reduced EF (HFrEF), mildly reduced EF (HFmrEF), and preserved EF (HFpEF).
  • The research found that in-hospital mortality rates were similar for NSTEMI and STEMI patients with HFrEF and HFmrEF, but NSTEMI patients had higher 3-year mortality rates. In the HFpEF group, STEMI patients experienced worse in-hospital outcomes compared to NSTEMI patients.
  • Overall
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  • 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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Aims: Considering the limited data regarding clinical outcomes of patients with non-ST-segment on the ECG elevation myocardial infarction (NSTEMI), this study compared the outcomes of patients undergoing percutaneous coronary intervention with newer-generation drug-eluting stents stratified by the presence/absence of complex lesions and symptom-to-balloon time (SBT; <48 h or ≥48 h).

Methods: We enrolled 4373 patients with NSTEMI from the Korea Acute Myocardial Infarction Registry-National Institute of Health dataset and stratified them into the complex group (2106 patients; SBT < 48 h, n  = 1365; SBT ≥48 h, n  = 741) and the noncomplex group (2267 patients; SBT < 48 h, n  = 1573; SBT ≥48 h, n  = 694). The primary outcome was the 3-year all-cause mortality rate.

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Background: Current guidelines recommend intervention for asymptomatic rheumatic mitral stenosis (MS) with mitral valve area ≤1.5 cm based on indicators including pulmonary arterial systolic pressure (PASP) >50 mm Hg and new-onset atrial fibrillation; however, evidence supporting this is lacking.

Methods: This single-center retrospective study included patients with rheumatic MS between 2006 and 2022.

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Article Synopsis
  • - The study compared the effectiveness and safety of a combination therapy (amlodipine + candesartan cilexetil) versus amlodipine alone in treating patients with essential hypertension who had not achieved adequate blood pressure control.
  • - Results showed that patients on the combination therapy experienced significantly greater reductions in both diastolic and systolic blood pressure compared to those on amlodipine alone.
  • - The incidence of adverse events was slightly higher in the combination therapy group, but overall, it was well-tolerated, suggesting it could be a beneficial option for patients not properly managed with amlodipine alone.
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Due to limited published data, we investigated 3-year outcomes according to left ventricular ejection fraction (LVEF) in patients older and younger than 75 years with non-ST-segment elevation myocardial infarction (NSTEMI) who underwent successful newer-generation drug-eluting stent (DES) implantation. This research analyzed the data of 4558 patients (1032 older adults [≥75 years] and 3526 younger adults [<75 years]) from the Korea Acute MI Registry-NIH. We further divided the older group based on LVEF: heart failure (HF) with reduced EF (HFrEF, ≤40%, n = 196; group A), HF with mildly reduced EF (HFmrEF, 41-49%, n = 228; group B), and HF with preserved EF (HFpEF, ≥50%, n = 608; group C).

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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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Article Synopsis
  • - The study investigates the relationship between the high-sensitivity C-reactive protein to high-density lipoprotein cholesterol (hsCRP/HDL-C) ratio (CHR) and long-term health outcomes in patients with coronary artery disease (CAD) after undergoing percutaneous coronary intervention (PCI).
  • - Researchers categorized 3,260 CAD patients who had PCI into three groups based on their CHR levels and found that higher CHR was linked with increased risks of all-cause mortality, cardiac mortality, and major adverse cardiac events.
  • - The analysis indicated that patients in the highest CHR group faced significantly higher risks (2.127 times for all-cause mortality and 3.575 times for cardiac mortality) compared to those
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  • Cigarette smoking significantly increases the risk of major adverse cardiovascular events (MACE) in patients with chronic total occlusion (CTO), especially those who undergo percutaneous coronary intervention (PCI).
  • A study involving 681 patients found that smokers experienced MACE at a rate of 29.5% compared to 18.5% in nonsmokers over a 5-year period.
  • The research highlights the need for targeted interventions for smokers in Asian populations, as smoking plays a crucial role in worsening cardiovascular outcomes, regardless of treatment type.
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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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Statin is crucial for acute myocardial infarction (AMI) patients. However, the risk of new-onset diabetes mellitus (NODM) associated with statin is a concern. This study aimed to determine the incremental diabetogenic effects of statins according to their intensity and dose in AMI patients undergoing percutaneous coronary intervention (PCI).

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Background: We assessed left ventricular ejection fraction (LVEF) to compare the effects of renin-angiotensin system inhibitors (RASI) in patients with non-ST-segment elevation myocardial infarction (NSTEMI).

Methods: We categorized 4558 patients with NSTEMI as either RASI users (3752 patients) or non-users (806 patients). The 3-year patient-oriented composite outcome (POCO), which included all-cause death, recurrent myocardial infarction, any repeat revascularization, or hospitalization for heart failure (HF), was the primary outcome.

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Background: Diabetes mellitus (DM) is a significant factor in increased mortality rates among patients with acute myocardial infarction (AMI), but research on its impact on the long-term outcomes in patients with MI with nonobstructive coronary arteries (MINOCA) is limited. Thus, a comparison of the 3-year clinical outcomes between the DM and non-DM groups among patients with MINOCA was undertaken.

Methods: From the Korea AMI Registry-National Institute of Health dataset, 10,774 AMI patients were enrolled.

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Iliac artery angioplasty with stenting is an effective alternative treatment modality for aortoiliac occlusive diseases. Few randomized controlled trials have compared the efficacy and safety between self-expandable stent (SES) and balloon-expandable stent (BES) in atherosclerotic iliac artery disease. In this randomized, multicenter study, patients with common or external iliac artery occlusive disease were randomly assigned in a 1:1 ratio to either BES or SES.

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Article Synopsis
  • This study evaluated the prevalence and impact of newly diagnosed diabetes on elderly patients (≥65 years) undergoing percutaneous coronary intervention (PCI) from 2004 to 2021, where 2456 patients were followed for an average of five years.
  • It found that newly diagnosed diabetes affected 8.1% to 10.9% of these patients, significantly increasing their risk for major adverse cardiovascular events (MACE) compared to those with previously identified diabetes (25.28% vs. 19.15%).
  • The research concluded that newly diagnosed diabetes is an independent predictor of increased risks for MACE, cardiac death, and repeat revascularization, highlighting the need for greater attention to this group of elderly patients post
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Background And Objectives: The K-ELUVIA study aimed to investigate the clinical effectiveness and safety of Eluvia™, a polymer-coated, paclitaxel-eluting stent, for femoropopliteal artery disease using data from a prospective Korean multicenter registry.

Methods: A total of 105 patients with femoropopliteal artery disease who received endovascular treatment (EVT) with Eluvia™ stents at 7 Korean sites were enrolled in a prospective cohort and followed for 2 years. The primary endpoint was the 2-year clinical patency.

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Background: Outpatient monitoring of pulmonary congestion in heart failure (HF) patients may reduce hospitalization rates. This study tested the feasibility of non-invasive high-frequency bioelectrical impedance analysis (HF-BIA) for estimating lung fluid status.

Methods: This prospective study included 70 participants: 50 with acute HF (HF group) and 20 without HF (control group).

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Background 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.

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Background And Objectives: Ultimaster™, a third-generation sirolimus-eluting stent using biodegradable polymer, has been introduced to overcome long term adverse vascular events, such as restenosis or stent thrombosis. In the present study, we aimed to evaluate the 12-month clinical outcomes of Ultimaster™ stents in Korean patients with coronary artery disease.

Methods: This study is a multicenter, prospective, observational registry across 12 hospitals.

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