Journal of Korean Medical Science最新文献

{"title":"Radiation-Induced Meningiomas Have an Aggressive Clinical Course: Genetic Signature Is Limited to <i>NF2</i> Alterations, and Epigenetic Signature Is H3K27me3 Loss.","authors":"Tae-Kyun Kim, Jong Seok Lee, Ji Hoon Phi, Seung Ah Choi, Joo Whan Kim, Chul-Kee Park, Hongseok Yun, Young-Soo Park, Sung-Hye Park, Seung-Ki Kim","doi":"10.3346/jkms.2025.40.e62","DOIUrl":"10.3346/jkms.2025.40.e62","url":null,"abstract":"<p><strong>Background: </strong>While the clinical course of radiation-induced meningioma (RIM) is considered to be more aggressive than that of sporadic meningioma (SM), the genetic predisposition for RIM is not established well. The present study aimed to analyze the clinical and genetic characteristics of RIMs to increase understanding of the tumorigenesis and prognosis of RIMs.</p><p><strong>Methods: </strong>We investigated a database of 24 patients who met the RIM criteria between January 2000 and April 2023. Genetic analysis through next-generation sequencing with a targeted gene panel was performed on 10 RIM samples. Clinical, radiological, and pathological parameters were evaluated with genetic analyses.</p><p><strong>Results: </strong>The median ages for receiving radiotherapy (RT) and RIM diagnosis were 8.0 and 27.5 years, respectively, with an interval of 17.5 years between RT and RIM diagnosis. RIMs tended to develop in non-skull bases and multifocal locations. Most primary pathologies included germ cell tumors and medulloblastoma. The tumor growth rate was 3.83 cm³ per year, and the median doubling time was 0.8 years. All patients underwent surgical resection of RIMs. The histological grade of RIMs was World Health Organization grade 1 (64%) or 2 (36%). RIMs showed higher incidences in young-age (63%), high-dose (75%), and extended-field (79%) RT groups. The recurrence rate was 21%. Genetic analysis revealed <i>NF2</i> one copy loss in 90% of the patients, with truncating <i>NF2</i> mutations and additional copy number aberrations in grade 2 RIMs. <i>TERT</i> promoter mutation and <i>CDKN2A/B</i> deletion were not identified. Notably, loss of H3K27me3 was identified in 26% of RIMs. H3K27me3 loss was associated with a higher prevalence of grade 2 RIMs (67%) and high recurrence rates (33%).</p><p><strong>Conclusion: </strong>The study reveals a higher prevalence of high-grade tumors among RIMs with more rapid growth and higher recurrences than SMs. Genetically, RIMs are primarily associated with <i>NF-2</i> alterations with chromosomal abnormalities in grade 2 tumors, along with a higher proportion of H3K27me3 loss.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 18","pages":"e62"},"PeriodicalIF":3.0,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12070044/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144010780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Consensus Statements on Tinnitus Treatment: A Delphi Study by the Korean Tinnitus Study Group.","authors":"Junhui Jeong, Ho Yun Lee, Oak-Sung Choo, Hantai Kim, Kyu-Yup Lee, Jae-Jin Song, Jae-Hyun Seo, Yoon Chan Rah, Jae-Jun Song, Eui-Cheol Nam, Shi Nae Park, In Seok Moon, Hyun Joon Shim","doi":"10.3346/jkms.2025.40.e75","DOIUrl":"10.3346/jkms.2025.40.e75","url":null,"abstract":"<p><strong>Background: </strong>Tinnitus is a bothersome condition associated with various mechanisms of action. Although treatment methods vary according to these mechanisms, standardized guidelines would benefit both patients and clinicians. We conducted a Delphi study, a method that collects expert opinions through multiple rounds of questionnaires, to reach a consensus on tinnitus treatment with professional experts.</p><p><strong>Methods: </strong>A two-round modified Delphi survey was conducted to develop a clinical consensus on tinnitus treatment. The experts scored each statement on a scale of 1 (highest disagreement) to 9 (highest agreement) for their level of agreement on tinnitus treatment. Consensus was defined when 75% or more of the participants scored 7-9, and 15% or less scored 1-3. To ensure reliability of the responses, the content validity ratio and Kendall's coefficient of concordance were evaluated.</p><p><strong>Results: </strong>Approximately 19 of 31 statements reached a consensus. All 3 statements reached a consensus regarding the candidates for treatment. Regarding treatment, 3 of 8 statements on medication, 2 of 2 statements on tinnitus retraining therapy/cognitive behavioral therapy, and 5 of 7 statements on auditory rehabilitation reached a positive consensus. Although all 6 statements regarding miscellaneous treatment reached a consensus, most were negatively agreed. For treatment with neuromodulation, none of the 5 statements reached a consensus.</p><p><strong>Conclusion: </strong>The experts reached a high level of consensus on treatment candidates, tinnitus retraining therapy/cognitive behavioral therapy, and auditory rehabilitation in this modified Delphi study. The results of this study can provide beneficial and practical information for clinicians regarding the treatment of tinnitus.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 18","pages":"e75"},"PeriodicalIF":3.0,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12070046/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144028781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Associated With Compliance and Persistence With Pharmacotherapy in Patients With Osteoporosis: A Nationwide Cohort Study in Korea.","authors":"Seong Hee Ahn, So Young Park, Mi Kyung Kwak, Yong-Chan Ha, Tae-Young Kim, Ha Young Kim","doi":"10.3346/jkms.2025.40.e72","DOIUrl":"10.3346/jkms.2025.40.e72","url":null,"abstract":"<p><strong>Background: </strong>Despite the necessity of long-term management for fracture risk reduction, adherence to osteoporosis pharmacotherapy remains poor. We investigated the factors influencing adherence to pharmacotherapy among Korean patients with osteoporosis, with a particular focus on treatment with bisphosphonates (BPs).</p><p><strong>Methods: </strong>Data from 725,313 osteoporosis patients newly prescribed BPs or selective estrogen receptor modulators (SERMs) between 2012 and 2014, obtained from the Korean National Health Insurance Service, were analyzed. Adherence was assessed based on compliance and persistence over a two-year period, with factors associated with adherence identified using multivariable logistic regression.</p><p><strong>Results: </strong>Only 14.8% of the patients who started BPs or SERMs sustained medication compliance, with 15.8% persisting with treatment over the two-year follow-up. Compared with BPs, patients receiving SERMs showed better compliance and persistence (odds ratios [ORs], 1.44 and 1.48, respectively; <i>P</i> < 0.001); while patients receiving intravenous administration showed higher compliance and persistence (ORs, 2.08 and 1.76, respectively; <i>P</i> < 0.001) compared with those taking oral medications. Patients placed on a quarterly dosing schedule showed improved compliance and persistence (ORs, 1.55 and 1.31, respectively; <i>P</i> < 0.001) compared with those on other dosing intervals. Male gender, advanced age, living outside metropolitan areas, receiving treatment in non-general hospitals, and a history of previous fractures were associated with poorer two-year adherence.</p><p><strong>Conclusion: </strong>This study underscores the complex nature of medication adherence among Korean osteoporosis patients, particularly those treated with BPs. These findings accordingly indicate that medication with more convenient administration regimens and fewer side effects, coupled with suitable follow-up durations, could contribute to enhancing treatment adherence.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 18","pages":"e72"},"PeriodicalIF":3.0,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12070043/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143970185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In This Issue on 12-May-2025.","authors":"Jin-Hong Yoo","doi":"10.3346/jkms.2025.40.e158","DOIUrl":"https://doi.org/10.3346/jkms.2025.40.e158","url":null,"abstract":"","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 18","pages":"e158"},"PeriodicalIF":3.0,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144015424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Childhood Trauma and Anhedonia-Related Symptoms: The Mediation Role of Trait Anhedonia and Circulating Proteins.","authors":"Sang Jin Rhee, Dongyoon Shin, Daun Shin, Yoojin Song, Eun-Jeong Joo, Hee Yeon Jung, Sungwon Roh, Sang-Hyuk Lee, Hyeyoung Kim, Minji Bang, Kyu Young Lee, Jihyeon Lee, Yeongshin Kim, Youngsoo Kim, Yong Min Ahn","doi":"10.3346/jkms.2025.40.e66","DOIUrl":"10.3346/jkms.2025.40.e66","url":null,"abstract":"<p><strong>Background: </strong>Though accumulating evidence suggests an association between childhood trauma and anhedonia, further analysis is needed to consider specific traumatic dimensions, both traits and state anhedonia, and the role of circulating proteins. Therefore, this study investigated the association between different types of childhood traumas and their influence on anhedonia-related symptoms, and to evaluate the influence of anhedonia traits and plasma proteins as mediators.</p><p><strong>Methods: </strong>This study included 170 patients with schizophrenia, bipolar disorder, major depressive disorder, and healthy controls aged 19-65 years. Multiple reaction monitoring was performed to quantify plasma proteins, and 464 proteins were analyzed. The association between childhood trauma dimensions, anhedonic traits, and related symptoms was analyzed with linear regression. A series of mediation analyses was performed to determine whether anhedonic traits and plasma proteins mediated the association between childhood trauma and anhedonia-related symptoms.</p><p><strong>Results: </strong>Childhood emotional neglect was significantly associated with anhedonic traits and anhedonia-related symptoms. Mediation analysis revealed that the indirect effect of anhedonic traits for childhood emotional neglect on anhedonia-related symptoms (effect = 0.037; bias-corrected CI, 0.009 to 0.070) was statistically significant. The indirect effect of plasma TNR5 for anhedonic traits on anhedonia-related symptoms was statistically significant (effect = -0.011; bias-corrected CI, -0.026 to -0.002). Serial mediation analysis revealed that the indirect effect of childhood emotional neglect on anhedonia-related symptoms via anhedonic traits and TNR5 was statistically significant (effect = 0.007; bias-corrected CI, 0.001 to 0.017).</p><p><strong>Conclusion: </strong>Anhedonic traits and plasma TNR5 protein levels serially mediated the association between childhood emotional neglect and anhedonia-related symptoms. The study highlights the importance of considering both psychopathological traits and biological correlates when investigating the association between childhood trauma and psychopathological symptoms.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 18","pages":"e66"},"PeriodicalIF":3.0,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12070042/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143997228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of Pulmonary Rehabilitation for Lung Cancer Patients in Korea: Analysis of the National Health Insurance Service Database.","authors":"Sang Hun Kim, Cho Hui Hong, Jong-Hwa Jeong, Jinmi Kim, Jeong Su Cho, Jin A Yoon, Jung Seop Eom, Byeong Ju Lee, Myung Hun Jang, Myung-Jun Shin, Yong Beom Shin","doi":"10.3346/jkms.2025.40.e150","DOIUrl":"https://doi.org/10.3346/jkms.2025.40.e150","url":null,"abstract":"<p><p>This study aimed to assess the utilization trends of pulmonary rehabilitation (PR) among lung cancer patients in Korea using the National Health Insurance Service (NHIS) database (2017 to 2021). PR was introduced and covered under the NHIS in 2016, primarily for chronic obstructive pulmonary disease, but recent evidence suggests its benefits for lung cancer patients. Data extraction was based on Korea Informative Classification of Diseases 8th revision codes C33 and C34, with PR prescriptions identified by codes MM440 and MM290. Descriptive statistical analysis was performed, and propensity score matching was used for comparison between PR and non-PR groups. Results showed a significant increase in PR utilization, with the number of patients receiving PR (MM440) rising from 1,002 in 2017 to 3,723 in 2021, indicating a 3.7-fold increase. However, the proportion of patients receiving PR remained low at 2.9% in 2021. Enhanced access to PR services and improved evaluation strategies are essential for optimizing patient outcomes.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 17","pages":"e150"},"PeriodicalIF":3.0,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12056064/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143967967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Creating a Practical Tool for Predicting Major Amputation Rate in Patients With Diabetic Hindfoot Ulcers: Focus on Ischemia and Infection.","authors":"Ye-Won Choi, Seung-Kyu Han, Seong-Ho Jeong, Eun-Sang Dhong","doi":"10.3346/jkms.2025.40.e55","DOIUrl":"https://doi.org/10.3346/jkms.2025.40.e55","url":null,"abstract":"<p><strong>Background: </strong>Patients with diabetic hindfoot ulcers typically harbor significant concerns regarding their prospects for healing or the potential for major amputation. Nonetheless, a scarcity of data addressing this prevalent and critical query exists. Thus, the aim of this study was to create an initial risk-scoring system to forecast the prognosis of individuals with diabetic hindfoot ulcers, leveraging assessments of ischemia and infection severity, which are recognized as the principal risk factors for amputation.</p><p><strong>Methods: </strong>Ischemia severity was categorized as iS0, iS1, or iS2 based on transcutaneous partial oxygen tension values, while infection severity was classified as iN0, iN1, or iN2 according to the results of tissue and bone biopsy cultures. Risk scores were determined by summing the scores for ischemia and infection severity, yielding a range of 0 to 4. Wound healing outcomes were graded as either healed with or without major amputation. Wound healing outcomes were assessed based on the assigned risk scores.</p><p><strong>Results: </strong>With ascending risk scores, the proportion of patients subjected to major amputation also increased (<i>P</i> value for trend < 0.001). Univariable logistic regression analysis revealed a significant positive correlation between escalating risk scores and major amputation incidence. Patients with a risk score of 4 exhibited a 41-fold higher likelihood of undergoing major amputation compared to those with a risk score of 0.</p><p><strong>Conclusion: </strong>Risk scores can serve as a reliable predictor of the major amputation rate in patients with diabetic hindfoot ulcers.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 17","pages":"e55"},"PeriodicalIF":3.0,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12056059/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144007010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maternal Exposures to COVID-19 Vaccine and Adverse Birth Outcomes: National Population Study in Korea.","authors":"Kyuwon Kim, Erdenetuya Bolormaa, Eunseon Gwak, Ju-Young Shin, Nam-Kyong Choi, Young June Choe, Seung-Ah Choe","doi":"10.3346/jkms.2025.40.e63","DOIUrl":"https://doi.org/10.3346/jkms.2025.40.e63","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to estimate the association between mRNA coronavirus disease 2019 (COVID-19) vaccine exposure during pregnancy and the risks of preterm birth and congenital malformations leveraging a national population data.</p><p><strong>Methods: </strong>This retrospective cohort study utilized national data from the National Health Insurance System, linking maternal and infant records with COVID-19 vaccination registries. Newborns with congenital malformations were identified using diagnosis codes. The analysis included women aged 20-49 who gave live births between February 2022 and December 2022. Odds ratios (ORs) for preterm birth and any congenital malformation per COVID-19 vaccination during pregnancy compared to 1:4 matched unvaccinated controls, adjusted for maternal age, residential area, employment, income, disability, month of conception, pre-pregnancy obesity, smoking, and severe acute respiratory syndrome coronavirus 2 infection prior to pregnancy, were calculated. We compared the risk of two outcomes between BNT162b2 and mRNA-1273.</p><p><strong>Results: </strong>Among 106,692 women who gave birth during the study period, 8,966 (8.4%) received a COVID-19 vaccination during pregnancy. Of the newborns, 7,039 (6.6%) were preterm births and 7,658 (7.2%) had congenital malformations. COVID-19 vaccination during pregnancy was associated with a comparable risk of preterm birth (OR, 1.03; 95% confidence interval [CI], 0.77-1.36) and a similar risk of congenital malformations (0.90; 95% CI, 0.72-1.12) compared to non-vaccinees. The ORs of preterm birth (1.02; 95% CI, 0.77-1.36) and congenital malformation (0.91; 95% CI, 0.73-1.14) for mRNA-1273 were comparable to those for BNT162b2.</p><p><strong>Conclusion: </strong>COVID-19 vaccines during pregnancy poses no increased risk of preterm birth and congenital malformations compared to those not exposed to the vaccine, with similar risk levels observed between the two mRNA vaccines. This finding provides additional evidence supporting the safety of COVID-19 vaccines.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 17","pages":"e63"},"PeriodicalIF":3.0,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12056060/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144025289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nutrition Status and Comorbidities Are Important Factors Associated With Mortality During Anti-Tuberculosis Treatment.","authors":"Oh Beom Kwon, Hyung Woo Kim, Ju Sang Kim, Eung Gu Lee, Yeonhee Park, Sung Soo Jung, Jin Woo Kim, Jee Youn Oh, Sang Haak Lee, Seunghoon Kim, Sun-Hyung Kim, Jiwon Lyu, Yousang Ko, Sun Jung Kwon, Ganghee Chae, Jinsoo Min","doi":"10.3346/jkms.2025.40.e73","DOIUrl":"https://doi.org/10.3346/jkms.2025.40.e73","url":null,"abstract":"<p><strong>Background: </strong>The increasing incidence and mortality rates of tuberculosis among older individuals who suffer from multiple morbidities and are vulnerable to malnutrition are major obstacles to efforts to eradicate tuberculosis in the Republic of Korea. Herein, we identified the factors associated with mortality during anti-tuberculosis treatment in patients with pulmonary tuberculosis.</p><p><strong>Methods: </strong>We conducted a case-control study and extracted data from the database of a multi-center prospective observational cohort study in Korea. Among the participants with rifampicin-susceptible pulmonary tuberculosis, the survival group was defined as those who successfully completed treatment within one year, whereas the mortality group was defined as those who died during treatment. Univariable and multivariable logistic regression analyses were performed to identify factors associated with TB mortality.</p><p><strong>Results: </strong>Among 1,119 participants with pulmonary TB registered between 2019 and 2021, 799 and 59 were grouped in the survival and mortality groups, respectively. Age, positive smear results, alarming symptoms, nutrition risk score, Charlson comorbidity index score, and initial standard treatment regimen were significant based on univariable analysis and were selected for the multivariable logistic regression model. Nutrition risk score (adjusted odds ratio, 2.44; 95% confidence interval, 1.72-3.48) and Charlson comorbidity index score (adjusted odds ratio, 1.62; 95% confidence interval, 1.35-1.94) remained statistically significant in the multivariate analysis.</p><p><strong>Conclusion: </strong>Nutritional status and comorbidities at baseline were identified as important factors associated with mortality in patients with pulmonary tuberculosis.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 17","pages":"e73"},"PeriodicalIF":3.0,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12056065/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143970190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Natural History of Hypertrophic Cardiomyopathy in Korea: A Nationwide Population-Based Retrospective Cohort Study.","authors":"Shin Yi Jang, Wook Sung Kim, Sang-Chol Lee","doi":"10.3346/jkms.2025.40.e61","DOIUrl":"https://doi.org/10.3346/jkms.2025.40.e61","url":null,"abstract":"<p><strong>Background: </strong>There are few long-term large-scale epidemiologic studies on hypertrophic cardiomyopathy (HCM; 10th revision of the International Statistical Classification of Diseases and Related Health Problems codes: I42.1, I42.2). This analysis used the Korean National Health Insurance Service (KNHIS) data between 2006 and 2017 to evaluate the natural history of HCM over a decade.</p><p><strong>Methods: </strong>KNHIS data and death statistics were evaluated according to age, sex, socioeconomic position, and comorbidities. Survival rates (SRs) and adjusted hazard ratio (HR) were compared with death data of the Korean population from 2006 through 2018.</p><p><strong>Results: </strong>The mean age was 47.3 ± 14.9 years in males and 57.5 ± 15.4 years in females (<i>P</i> < 0.001). The male proportion was 58.9%. The most common cause of death was diseases of the circulatory system. The 10-year SR of HCM was higher in males (75.9% vs. 62.5%, <i>P</i> < 0.001). The adjusted HR for different age groups was significantly high in most age group: 3.67 (95% confidence interval [CI], 2.65-5.10) for 0-9 years, and it gradually increased from the 30s to the 80s group (1.39 [95% CI, 1.05-1.83] for 30-39 years and 48.2 [95% CI, 37.0-62.7] for those older than 80 years). The adjusted HR was 1.12 (95% CI, 1.07-1.17) for males, 1.40 (95% CI, 1.33-1.48) for the lower income level, and 1.18 (95% CI, 1.12-1.25) for the medium income level. In patients with comorbidities, the adjusted HRs were 1.23 (95% CI, 1.16-1.30) for diabetes, 1.45 (95% CI, 1.30-1.62) for myocardial infarction, 1.63 (95% CI, 1.52-1.76) for atrial fibrillation, 1.83 (95% CI, 1.68-1.99) for ischemic stroke, 1.66 (95% CI, 1.31-2.10) for hemorrhagic stroke, 2.42 (95% CI, 2.16-2.70) for chronic kidney disease, and 3.18 (95% CI, 2.87-3.52) for malignant neoplasm.</p><p><strong>Conclusion: </strong>HCM in Korea showed a higher prevalence and incidence in males. The 10-year SR of HCM was approximately 70% and lower in females than that in males. The risk of death from HCM increased with age and was significantly higher in males, individuals with low income levels, and patients with various comorbidities. These findings should be considered for the long-term management and allocation of healthcare resources for patients with HCM.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 17","pages":"e61"},"PeriodicalIF":3.0,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12056062/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143997364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}