Korean Circulation Journal最新文献_第6页

Association Between Vasoactive Inotropic Score and Clinical Outcomes in Patients With Fulminant Myocarditis. 暴发性心肌炎患者血管活性性肌力评分与临床结果的关系

IF 3 3区医学

Korean Circulation Journal Pub Date : 2025-05-28 DOI: 10.4070/kcj.2024.0445

David Hong, Minjung Bak, Hyukjin Park, Hyung Yoon Kim, Seonhwa Lee, In-Cheol Kim, Junho Hyun, So Ree Kim, Mi-Na Kim, Kyung-Hee Kim, Jeong Hoon Yang

{"title":"Association Between Vasoactive Inotropic Score and Clinical Outcomes in Patients With Fulminant Myocarditis.","authors":"David Hong, Minjung Bak, Hyukjin Park, Hyung Yoon Kim, Seonhwa Lee, In-Cheol Kim, Junho Hyun, So Ree Kim, Mi-Na Kim, Kyung-Hee Kim, Jeong Hoon Yang","doi":"10.4070/kcj.2024.0445","DOIUrl":"https://doi.org/10.4070/kcj.2024.0445","url":null,"abstract":"Background and objectives: This study aimed to evaluate the prognostic value of the vasoactive inotropic score (VIS) in patients with fulminant myocarditis according to the application of venoarterial-extracorporeal membrane oxygenation (VA-ECMO).Methods: This study retrospectively analyzed 417 patients with biopsy-proven or clinically suspected fulminant myocarditis from 7 hospitals in Korea. The primary outcome was a composite of all-cause death, heart transplantation, or the use of left ventricular assist device (LVAD) at 1 year.Results: The median VIS was 19.9, and 217 (52.0%) patients received VA-ECMO. The primary outcome occurred in 105 patients (26.7%). All-cause death, heart transplantation, and the implantation of LVAD occurred in 81 (20.7%), 30 (8.7%), and 1 (0.3%) patients, respectively. VIS was associated with the risk of the primary outcome in both patients treated with VA-ECMO (hazard ratio [HR], 1.017 for every 10-point increase; 95% confidence interval [CI], 1.007-1.028; p=0.001) and patients without VA-ECMO (HR, 1.128 for every 10-point increase; 95% CI, 1.079-1.179; p<0.001), but the effect was greater in patients without who did not receive VA-ECMO (interaction p<0.001). Furthermore, the predictive performance of VIS for the primary outcome was significantly lower in patients with VA-ECMO than in those without VA-ECMO (C-index, 0.555 vs. 0.780; p value for C-index comparison, 0.002).Conclusions: In patients with fulminant myocarditis, the prognostic value of VIS was more prominent in patients without VA-ECMO than in patients with VA-ECMO. These findings suggest that the prognostic value of VIS is weakened under the influence of VA-ECMO.Trial registration: ClinicalTrials.gov Identifier: NCT05933902.","PeriodicalId":17850,"journal":{"name":"Korean Circulation Journal","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144591571","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}

引用次数: 0

Sex-Specific Differences in Management and Outcomes of Cardiogenic Shock Patients With and Without Ischemic Cardiomyopathy. 伴有和不伴有缺血性心肌病的心源性休克患者的治疗和结局的性别差异。

IF 3 3区医学

Korean Circulation Journal Pub Date : 2025-05-28 DOI: 10.4070/kcj.2024.0440

Ik Hyun Park, Chang Hoon Kim, Woo Jin Jang, Ju-Hyeon Oh, Wang Soo Lee, Jeong Hoon Yang, Hyeon-Cheol Gwon

{"title":"Sex-Specific Differences in Management and Outcomes of Cardiogenic Shock Patients With and Without Ischemic Cardiomyopathy.","authors":"Ik Hyun Park, Chang Hoon Kim, Woo Jin Jang, Ju-Hyeon Oh, Wang Soo Lee, Jeong Hoon Yang, Hyeon-Cheol Gwon","doi":"10.4070/kcj.2024.0440","DOIUrl":"10.4070/kcj.2024.0440","url":null,"abstract":"Background and objectives: Comprehensive data on sex-based differences in the management and outcomes of patients with and without ischemic cardiomyopathy (ICMP) presenting with cardiogenic shock (CS) remain limited. This study aimed to investigate whether clinical management and outcomes differ by sex among CS patients, stratified by underlying etiology.Methods: We analyzed 1,247 CS patients from the RESCUE registry, a multicenter observational cohort, stratified by sex and CS etiology: ICMP (females: 276, males: 730) and non-ICMP (females: 111, males: 130). Primary outcomes included in-hospital and 12-month mortality. Multivariable Cox proportional hazards models and propensity-score matching were used to adjust for confounding factors.Results: Among ICMP patients, females were less likely to undergo coronary angiography (p=0.001), although rates of successful revascularization were similar between sexes (p=0.982). In-hospital 30-day mortality did not differ significantly between females and males in either the ICMP cohort (37.1% vs. 29.5%; adjusted hazard ratio [HR], 0.93; 95% confidence interval [CI], 0.63-1.39; p=0.737) or the non-ICMP cohort (28.3% vs. 25.6%; adjusted HR, 1.23; 95% CI, 0.68-2.22; p=0.493). At 12 months, mortality risk remained comparable between sexes in both ICMP (46.4% vs. 37.1%; adjusted HR, 0.82; 95% CI, 0.57-1.17; p=0.274) and non-ICMP groups (40.1% vs. 41.3%; adjusted HR, 0.91; 95% CI, 0.56-1.45; p=0.685). These findings were consistent after propensity-score matching.Conclusions: There was no significant difference in management, 12-month or in-hospital mortality between females and males, irrespective of the etiology of CS.Trial registration: ClinicalTrials.gov Identifier: NCT02985008.","PeriodicalId":17850,"journal":{"name":"Korean Circulation Journal","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144333377","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}

引用次数: 0

Sex-Specific Differences in Cardiogenic Shock: Does It Still Matter? 心源性休克的性别差异：仍然重要吗？

IF 3 3区医学

Korean Circulation Journal Pub Date : 2025-05-27 DOI: 10.4070/kcj.2025.0162

Nuri Lee, Hyukjin Park

引用次数: 0

Real-World Cost-Effectiveness of Angiotensin Receptor-Neprilysin Inhibitor in Heart Failure With Reduced Ejection Fraction in Korea. 血管紧张素受体-奈普利素抑制剂治疗韩国心力衰竭伴射血分数降低的实际成本-效果

IF 3.1 3区医学

Korean Circulation Journal Pub Date : 2025-05-27 DOI: 10.4070/kcj.2024.0403

Byeong-Chan Oh, Dong-Hyuk Cho, Jimi Choi, Sun-Hong Kwon, Byung-Su Yoo

{"title":"Real-World Cost-Effectiveness of Angiotensin Receptor-Neprilysin Inhibitor in Heart Failure With Reduced Ejection Fraction in Korea.","authors":"Byeong-Chan Oh, Dong-Hyuk Cho, Jimi Choi, Sun-Hong Kwon, Byung-Su Yoo","doi":"10.4070/kcj.2024.0403","DOIUrl":"https://doi.org/10.4070/kcj.2024.0403","url":null,"abstract":"Background and objectives: Heart failure with reduced ejection fraction (HFrEF) poses a significant burden on healthcare systems worldwide. We evaluated the real-world cost-effectiveness of angiotensin receptor-neprilysin inhibitor (ARNI) compared with traditional renin-angiotensin system (RAS) blockade in patients with HFrEF in the Korean setting.Methods: A partitioned survival model was developed based on the PARADE-HF study, which evaluated the effectiveness of ARNI in Korean HFrEF patients using National Health Insurance claims data. The model estimated medical costs, hospitalizations, life-years, and quality-adjusted life-years (QALYs) over a lifetime. Cost-effectiveness was assessed using the incremental cost-effectiveness ratio (ICER).Results: The use of ARNI resulted in additional 0.54 life-years, 0.25 QALYs gained, fewer hospitalizations (25.91 vs. 26.40) per 1,000 person-years, and an added cost of $2,880 per patient. The ICER was $11,365/QALY for all patients and $9,421/QALY for elderly patients (≥75 years). At a $20,000/QALY threshold of the willingness to pay, cost-effectiveness probabilities were 68% in all patients and 88% in elderly patients.Conclusions: In the real world, ARNI demonstrated superior cost-effectiveness compared with traditional RAS blockade in patients with HFrEF, with particularly pronounced benefits in elderly patients aged ≥75 years. The favorable cost-effectiveness profile, combined with significant reductions in mortality and hospitalization, supports the broader adoption of ARNI in clinical practice, especially for elderly patients despite concerns about tolerability in this population.","PeriodicalId":17850,"journal":{"name":"Korean Circulation Journal","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144742387","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}

引用次数: 0

miR-140-5p and Water Channel Aquaporin 4: Opening a New Channel for Treating Atrial Fibrillation. miR-140-5p与水通道水通道蛋白4：打开心房颤动治疗的新通道

IF 3 3区医学

Korean Circulation Journal Pub Date : 2025-05-27 DOI: 10.4070/kcj.2025.0156

Hyo-Jeong Ahn, Hyun-Jai Cho

引用次数: 0

Growth in Children with Congenital Heart Disease: Filling the Gap With Nationwide Evidence. 先天性心脏病儿童的成长：填补全国证据的空白。

IF 3 3区医学

Korean Circulation Journal Pub Date : 2025-05-27 DOI: 10.4070/kcj.2025.0139

Se Yong Jung

引用次数: 0

Exercise Training in Patients With Fontan Circulation: Moving Towards Evidence-Based Rehabilitation. Fontan循环患者的运动训练：走向循证康复。

IF 3 3区医学

Korean Circulation Journal Pub Date : 2025-05-23 DOI: 10.4070/kcj.2025.0141

Se Yong Jung

引用次数: 0

Ticagrelor Monotherapy vs. Ticagrelor With Aspirin in Bleeding and Cardiovascular Events in Acute Coronary Syndrome Patients According to Renal Function: The Subanalysis From the TICO Trial. 替格瑞洛单药治疗与替格瑞洛联合阿司匹林治疗急性冠脉综合征患者的出血和心血管事件：来自TICO试验的亚分析

IF 3 3区医学

Korean Circulation Journal Pub Date : 2025-05-22 DOI: 10.4070/kcj.2024.0232

Ji Hyun Lee, Hyeonju Jeong, Eui-Seock Hwang, Sung-Jin Hong, Chul-Min Ahn, Jung-Sun Kim, Byeong-Keuk Kim, Young-Guk Ko, Donghoon Choi, Myeong-Ki Hong, Yangsoo Jang, Yun-Hyeong Cho, Yongsung Suh

{"title":"Ticagrelor Monotherapy vs. Ticagrelor With Aspirin in Bleeding and Cardiovascular Events in Acute Coronary Syndrome Patients According to Renal Function: The Subanalysis From the TICO Trial.","authors":"Ji Hyun Lee, Hyeonju Jeong, Eui-Seock Hwang, Sung-Jin Hong, Chul-Min Ahn, Jung-Sun Kim, Byeong-Keuk Kim, Young-Guk Ko, Donghoon Choi, Myeong-Ki Hong, Yangsoo Jang, Yun-Hyeong Cho, Yongsung Suh","doi":"10.4070/kcj.2024.0232","DOIUrl":"10.4070/kcj.2024.0232","url":null,"abstract":"Background and objectives: Ticagrelor monotherapy after short-term dual-antiplatelet therapy (DAPT) has not been established in chronic kidney disease (CKD) patients. This study evaluated the effects of ticagrelor monotherapy after 3-month of DAPT on renal function in acute coronary syndrome patients.Methods: From the TICO trial, the primary outcome was a composite of net adverse clinical events (NACEs), defined as a composite of major bleeding and major adverse cardiovascular and cerebrovascular events (MACCEs). The secondary outcomes were thrombolysis in myocardial infarction (TIMI) major or minor bleeding and MACCE.Results: Among patients without CKD (n=2,436), ticagrelor monotherapy after 3 months of DAPT had a lower rate of NACE (hazard ratio [HR], 0.41; 95% confidence interval [CI], 0.21-0.78; p=0.007) and TIMI bleeding (HR, 0.86; 95% CI, 0.19-0.81; p=0.011) than those of ticagrelor-based 12-month DAPT. Among CKD patients receiving ticagrelor monotherapy, lower risk of NACE (HR, 0.45; 95% CI, 0.20-1.02; p=0.055) and bleeding (HR, 0.20; 95% CI, 0.06-0.68; p=0.009) were observed. Otherwise, ticagrelor monotherapy was not significantly associated with an increased MACCE risk in those without CKD (HR, 0.62; 95% CI, 0.30-1.27; p=0.192) or with CKD (HR, 0.55; 95% CI, 0.21-1.48; p=0.237), versus 12-month DAPT.Conclusions: Regardless of renal function, ticagrelor monotherapy after 3 months of DAPT resulted in a reduced risk of not only NACE but also major or minor bleeding at 1 year compared with ticagrelor-based 12-month DAPT. Irrespective of renal function status, however, the MACCE risk was not significantly different between the two strategies.","PeriodicalId":17850,"journal":{"name":"Korean Circulation Journal","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144333379","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}

引用次数: 0

Machine Learning-Based Prediction of Long-Term Outcomes in Patients With Chronic Total Occlusion of the Coronary Artery. 基于机器学习的慢性冠状动脉全闭塞患者长期预后预测。

IF 3 3区医学

Korean Circulation Journal Pub Date : 2025-05-19 DOI: 10.4070/kcj.2025.0016

Tae Oh Kim, Hyeonyong Hae, Hwa Jung Kim, Seung-Whan Lee, Ho Jin Kim, Joon Bum Kim, Cheol-Hyun Chung, Soo-Jin Kang

{"title":"Machine Learning-Based Prediction of Long-Term Outcomes in Patients With Chronic Total Occlusion of the Coronary Artery.","authors":"Tae Oh Kim, Hyeonyong Hae, Hwa Jung Kim, Seung-Whan Lee, Ho Jin Kim, Joon Bum Kim, Cheol-Hyun Chung, Soo-Jin Kang","doi":"10.4070/kcj.2025.0016","DOIUrl":"10.4070/kcj.2025.0016","url":null,"abstract":"Background and objectives: Precise prediction of long-term outcomes in patients with chronic total occlusion (CTO) of the coronary artery is crucial for cardiovascular care. The recent development of advanced machine learning (ML) models has opened up new possibilities in medical prognostics. This study aimed to develop ML models and validate their performance in predicting long-term clinical outcomes in patients with CTO.Methods: This study retrospectively analyzed 3,248 patients listed in the Asan Medical Center CTO Registry (2003-2018). Patients underwent coronary artery bypass grafting, percutaneous coronary intervention, or optimal medical therapy and were followed up for a median period of 5.3 years. The study population was randomly split into training (n=2,598) and test (n=650) sets. Three ML algorithms-namely, L2-penalized logistic regression, artificial neural networks, and CatBoost-were employed to develop a prognostic model for 5-year cardiac death (primary endpoint) as well as 5-year all-cause mortality and target vessel revascularization (TVR) (secondary endpoints). Model performance was assessed using area under the receiver operating characteristic curves (AUCs), and feature importance was evaluated using SHapley Additive exPlanations values.Results: The three ML algorithms exhibited comparable performance in predicting 5-year cardiac death (AUC: 0.80). Additionally, these three ML algorithms successfully predicted 5-year all-cause mortality (AUC: 0.83-0.84) and TVR (AUC: 0.65-0.74), showing good predictive performance. Patient demographics and comorbidities, rather than treatment modality, were the leading predictors of outcomes.Conclusions: The ML models are reliable in predicting 5-year clinical outcomes in patients with CTO, demonstrating their potential for clinical application.","PeriodicalId":17850,"journal":{"name":"Korean Circulation Journal","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144333359","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}

引用次数: 0

Non-culprit Lesion Location and FFR-guided Revascularization in Acute Myocardial Infarction With Multivessel Disease: FRAME-AMI Substudy. 非罪魁祸首病变定位和ffr引导下的多血管疾病急性心肌梗死血运重建：FRAME-AMI亚研究

IF 3 3区医学

Korean Circulation Journal Pub Date : 2025-05-13 DOI: 10.4070/kcj.2024.0430

Ho Sung Jeon, Jung-Hee Lee, Jun-Won Lee, Young Jin Youn, Joo Myung Lee, Hyun Kuk Kim, Keun Ho Park, Eun Ho Choo, Chan Joon Kim, Seung Hun Lee, Min Chul Kim, Young Joon Hong, Joon-Hyung Doh, Sang Yeub Lee, Sang Don Park, Hyun-Jong Lee, Min Gyu Kang, Jin-Sin Koh, Yun-Kyeong Cho, Chang-Wook Nam, Bon-Kwon Koo, Bong-Ki Lee, Kyeong Ho Yun, Joo-Yong Hahn, Sung Gyun Ahn

{"title":"Non-culprit Lesion Location and FFR-guided Revascularization in Acute Myocardial Infarction With Multivessel Disease: FRAME-AMI Substudy.","authors":"Ho Sung Jeon, Jung-Hee Lee, Jun-Won Lee, Young Jin Youn, Joo Myung Lee, Hyun Kuk Kim, Keun Ho Park, Eun Ho Choo, Chan Joon Kim, Seung Hun Lee, Min Chul Kim, Young Joon Hong, Joon-Hyung Doh, Sang Yeub Lee, Sang Don Park, Hyun-Jong Lee, Min Gyu Kang, Jin-Sin Koh, Yun-Kyeong Cho, Chang-Wook Nam, Bon-Kwon Koo, Bong-Ki Lee, Kyeong Ho Yun, Joo-Yong Hahn, Sung Gyun Ahn","doi":"10.4070/kcj.2024.0430","DOIUrl":"https://doi.org/10.4070/kcj.2024.0430","url":null,"abstract":"Background and objectives: The prognosis of unrevascularized non-culprit lesions (NCLs) and the benefits of non-culprit percutaneous coronary intervention (PCI) may depend on their functional significance and location in patients with acute myocardial infarction (AMI) and multivessel coronary disease (MVD). We investigated the differential outcomes of fractional flow reserve (FFR) versus angiography-guided PCI for NCL between the left anterior descending artery (LAD) and non-LAD arteries.Methods: This was a prespecified post hoc analysis of the FRAME-AMI trial. The primary endpoint, a composite of time to death, myocardial infarction, or repeat revascularization, was matched between the two strategies according to the NCL location.Results: Among 562 patients, the proportions of NCL in the LAD and non-LAD groups were 55.0% and 45.0%, respectively. PCI rates (82.2% vs. 78.3%; p=0.242) and the primary outcome (9.4% vs. 11.5%; p=0.421) were comparable between the two groups. In the non-culprit LAD group, FFR-guided PCI was associated with a lower rate of the primary outcome compared to angiography-guided PCI (5.7% vs. 14.3%, p=0.010). In the non-culprit non-LAD group, the outcome rate did not significantly differ between FFR- and angiography-guided PCI (7.4% vs. 14.5%, p=0.081). Nevertheless, the interaction between the non-culprit location and FFR- or angiography-guided PCI did not affect the primary outcome (p=0.667).Conclusions: The NCL location did not affect the favorable outcomes of FFR-guided PCI over angiography-guided PCI in patients with AMI and MVD.","PeriodicalId":17850,"journal":{"name":"Korean Circulation Journal","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144591573","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}

引用次数: 0