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  • Ovid Technologies (Wolters Kluwer Health)  (17)
  • Hong, Sung-Jin  (17)
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  • Ovid Technologies (Wolters Kluwer Health)  (17)
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  • 1
    Online Resource
    Online Resource
    Neointima characteristics as a prognostic marker for drug-coated balloon angioplasty in patients with in-stent restenosis: an optical coherence tomography study
    Ovid Technologies (Wolters Kluwer Health) ; 2020
    In:  Coronary Artery Disease Vol. 31, No. 8 ( 2020-12), p. 694-702
    Details
    In: Coronary Artery Disease, Ovid Technologies (Wolters Kluwer Health), Vol. 31, No. 8 ( 2020-12), p. 694-702
    Abstract: Research has shown that the prognosis of in-stent restenosis (ISR) lesions after drug-coated balloon (DCB) angioplasty can differ in relation to in-stent neointimal characteristics. However, changes in neointima characteristics after DCB have not been studied. This study sought to investigate changes in neointima characteristics after DCB for ISR. Methods From the Yonsei Optical Coherence Tomography (OCT) registry, data on DCBs performed in patients with ISR were collected. Neointima characteristics were categorized as homogeneous, heterogeneous, layered neointima, and neoatherosclerosis in each OCT procedure. Homogeneous and layered neointima were classified as a favorable neointima, while heterogeneous neointima and neoatherosclerosis were classified as an unfavorable neointima. The data of 67 ISR patients were analyzed. Results The median duration between initial and follow-up OCT was 9.6 months. Patients with homogeneous and layered neointima on the initial OCT before DCB mostly appeared as homogeneous (66.7 and 68.2%, respectively) on the follow-up OCT, whereas most of the patients with heterogeneous neointima on the initial OCT remained unaltered (70%). Patients with unfavorable neointima at either the initial ( P  = 0.023) or the follow-up OCT ( P  = 0.037) had a worse major adverse cardiovascular event-free survival than the other patients. Patients who showed unfavorable neointima at both the initial and the follow-up OCT had the worst event-free survival ( P  = 0.038). Conclusions The follow-up OCT neointimal characteristics after DCB for ISR was associated with initial OCT characteristics. Sustained unfavorable neointima in serial OCT imaging may reflect poor prognosis in patients with ISR treated with DCB.
    Type of Medium: Online Resource
    ISSN: 0954-6928
    URL: Article
    DOI: 10.1097/MCA.0000000000000946
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2020
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  • 2
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    Optical Coherence Tomography for Coronary Bioresorbable Vascular Scaffold Implantation : A Randomized Controlled Trial
    Ovid Technologies (Wolters Kluwer Health) ; 2020
    In:  Circulation: Cardiovascular Interventions Vol. 13, No. 1 ( 2020-01)
    Details
    In: Circulation: Cardiovascular Interventions, Ovid Technologies (Wolters Kluwer Health), Vol. 13, No. 1 ( 2020-01)
    Abstract: We investigated whether optical coherence tomography (OCT) guidance would reduce nonoptimal bioresorbable vascular scaffold (BVS) deployment. Methods: This was a randomized controlled trial. Patients who required percutaneous coronary intervention for ischemic heart disease were recruited from 2 centers in Korea. The enrolled patients were randomly assigned to receive either OCT-guided BVS (Absorb; Abbott Vascular) implantation or angiography-guided BVS implantation using an optimized technique. The primary outcome was nonoptimal deployment, which was a composite outcome of the following parameters assessed by OCT: a minimal scaffold area 〈 5 mm 2 , residual area stenosis 〉 20%, incomplete apposition of the scaffold struts 〉 5%, major edge dissection, or scaffold disruption. The secondary outcome was a procedural complication defined by the occurrence of no reflow, coronary perforation, or flow-limiting dissection. Results: Between September 2016 and January 2018, 88 patients (90 lesions) were assigned to OCT guidance, while 88 patients (89 lesions) were assigned to angiography guidance. The recruitment was prematurely terminated in March 2018 because the manufacturer stopped supplying BVS. Postprocedural OCT data were available for 88 lesions with OCT guidance and for 88 lesions with angiography guidance. There was nonoptimal BVS deployment postprocedurally in 35.2% of patients in the OCT-guidance group and in 38.6% in the angiography-guidance group (absolute difference, −3.7% [95% CI, −19.0% to 11.6%]; P =0.64). There were no procedural complications in either group. Conclusions: OCT-guided BVS implantation did not reduce the incidence of nonoptimal deployment compared to that of angiography-guided BVS implantation (using optimized techniques). Clinical Trial Registration: URL: https://www.clinicaltrials.gov . Unique identifier: NCT02894697.
    Type of Medium: Online Resource
    ISSN: 1941-7640 , 1941-7632
    URL: Article
    DOI: 10.1161/CIRCINTERVENTIONS.119.008383
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2020
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  • 3
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    Ten-Year Clinical Outcomes of Late-Acquired Stent Malapposition After Coronary Stent Implantation
    Ovid Technologies (Wolters Kluwer Health) ; 2020
    In:  Arteriosclerosis, Thrombosis, and Vascular Biology Vol. 40, No. 1 ( 2020-01), p. 288-295
    Details
    In: Arteriosclerosis, Thrombosis, and Vascular Biology, Ovid Technologies (Wolters Kluwer Health), Vol. 40, No. 1 ( 2020-01), p. 288-295
    Abstract: The goal of this study was to determine the impact of late-acquired stent malapposition (LASM) on long-term clinical outcomes in patients treated with coronary stent implantation. Approach and Results: We investigated major adverse cardiac event during 10 years after 6-month intravascular ultrasound examination using our previous studies database. A total of 732 patients treated with bare-metal stent (54 LASM versus 678 non-LASM) and 529 patients treated with first-generation drug-eluting stent (82 LASM versus 447 non-LASM), who did not have clinical event or censoring at the time of follow-up intravascular ultrasound, were included for the present analysis. major adverse cardiac event was defined as the composite of cardiac death, target vessel–related myocardial infarction, target lesion revascularization and stent thrombosis. Multivariable adjustment and inverse probability weight were performed to consider baseline differences. After multivariable adjustment, LASM was related to a greater risk of major adverse cardiac event (hazard ratio, 1.666 [95% CI, 1.041–2.665]; P =0.0333) and very-late stent thrombosis (hazard ratio, 3.529 [95% CI, 1.153–10.798]; P =0.0271) than non-LASM in patients treated with first-generation drug-eluting stent, but not in those treated with bare-metal stent. Results were consistent after inverse probability weight. Among patients with LASM of first-generation drug-eluting stent, no late stent thrombosis occurred in patients who continued to receive dual antiplatelet therapy. Conclusions: The relationship between LASM and major adverse cardiac event might depend on the type of implanted stents during the long-term follow-up, highlighting the clinical significance of polymers and drugs in drug-eluting stent system.
    Type of Medium: Online Resource
    ISSN: 1079-5642 , 1524-4636
    URL: Article
    DOI: 10.1161/ATVBAHA.119.313602
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2020
    detail.hit.zdb_id: 1494427-3
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  • 4
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    Association between angiographic and intravascular ultrasound optimizations after new-generation drug-eluting stent implantation and clinical outcomes
    Ovid Technologies (Wolters Kluwer Health) ; 2021
    In:  Coronary Artery Disease Vol. 32, No. 6 ( 2021-09), p. 541-548
    Details
    In: Coronary Artery Disease, Ovid Technologies (Wolters Kluwer Health), Vol. 32, No. 6 ( 2021-09), p. 541-548
    Abstract: Uncertainty remains regarding the associations of angiographic optimization and intravascular ultrasound (IVUS) optimization after new-generation drug-eluting stent (DES) implantation. Methods From four randomized trials comparing outcomes between IVUS and angiography-guidance for long or chronic total occlusion (CTO) lesions, 1396 patients who underwent IVUS-guided new-generation DES implantation were enrolled. Of these, 1112 patients (80%) met angiographic optimization criteria (postprocedural diameter stenosis, ≤20%) and were further classified into the matched (same results for angiographic optimization and IVUS optimization) and the mismatched group (opposite results for angiographic optimization and IVUS optimization) according to the meeting of IVUS optimization criteria (minimal stent area, ≥5.5 mm 2 or ≥80% of mean reference lumen area). The major adverse clinical events (MACE) were compared. Results Of 1112 patients with angiographic optimization, 675 patients met the IVUS optimization criteria (61%; matched), but 437 patients (39%; mismatched) failed to meet IVUS optimization criteria (false-positive rate = 76%). On multivariate analyses, age 〉 60 years, reference vessel diameter ≤2.7 mm, left circumflex artery and lesion length ≥33 mm were significant predictors for the mismatched. When comparing the 12-month MACE rates, the mismatched group (6.8%) showed a significantly higher rate than the matched group (1.5%; hazard ratio = 2.62; 95% confidence interval = 1.20–5.72; P = 0.012), mainly driven by a higher target-vessel revascularization rate (6.4 vs 1.4%; P = 0.021). Conclusion Despite meeting angiographic optimization criteria in long or CTO lesions, more than one-third of the patients with IVUS-guided new-generation DES implantation failed to meet the IVUS optimization criteria and had worse clinical outcomes. Therefore, IVUS optimization should be considered for patients who had predictors of mismatch.
    Type of Medium: Online Resource
    ISSN: 0954-6928
    URL: Article
    DOI: 10.1097/MCA.0000000000001007
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2021
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  • 5
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    Clinical utility of coronary computed tomography angiography in patients diagnosed with high-grade stenosis of the coronary arteries
    Ovid Technologies (Wolters Kluwer Health) ; 2019
    In:  Coronary Artery Disease Vol. 30, No. 7 ( 2019-11), p. 511-519
    Details
    In: Coronary Artery Disease, Ovid Technologies (Wolters Kluwer Health), Vol. 30, No. 7 ( 2019-11), p. 511-519
    Type of Medium: Online Resource
    ISSN: 0954-6928
    URL: Article
    DOI: 10.1097/MCA.0000000000000750
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2019
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  • 6
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    Long-term outcomes after percutaneous coronary intervention relative to bypass surgery in diabetic patients with multivessel coronary artery disease according to clinical presentation
    Ovid Technologies (Wolters Kluwer Health) ; 2020
    In:  Coronary Artery Disease Vol. 31, No. 2 ( 2020-03), p. 174-183
    Details
    In: Coronary Artery Disease, Ovid Technologies (Wolters Kluwer Health), Vol. 31, No. 2 ( 2020-03), p. 174-183
    Abstract: For diabetic patients with multivessel coronary artery disease (MVD), limited data exist on the long-term outcomes of percutaneous coronary intervention (PCI) versus coronary artery bypass graft (CABG) according to clinical presentation [stable coronary artery disease (SCAD) or non-ST-elevation acute coronary syndrome (NSTE-ACS)]. Patients and methods From a Korean multicenter registry, we analyzed 1135 diabetic patients with MVD treated with PCI ( n  = 660) or CABG ( n  = 475). After propensity score matching, 8-year major adverse cardiovascular and cerebrovascular events [MACCE; composite of all-cause death, myocardial infarction (MI), or stroke] were compared between PCI and CABG according to clinical presentation. Results After matching, MACCE was not different between PCI and CABG for SCAD patients [15.6 vs. 17.2%, hazard ratio (HR)  = 0.94, 95% confidence interval (CI)  = 0.55–1.63, P  = 0.837], whereas it was higher in PCI than in CABG for NSTE-ACS patients (31.1 vs. 22.4%, HR = 1.63, 95% CI = 1.03–2.59, P  = 0.036), mainly driven by the higher MI occurrence (HR = 2.18, 95% CI = 1.04–4.59, P  = 0.035). A significant interaction between revascularization strategy and clinical presentation was observed for MACCE ( P -interaction = 0.022). However, when PCI was further classified according to revascularization completeness, the treatment gap between PCI and CABG with respect to MI in NSTE-ACS patients was improved by complete-revascularization PCI. Conclusion Among diabetic patients with MVD, the long-term outcomes of PCI versus CABG differed according to clinical presentation. CABG may be more beneficial for NSTE-ACS patients with MVD in reducing MACCE and MI, whereas PCI was as effective as CABG for SCAD patients with MVD. Therefore, clinical presentation must be considered when choosing revascularization strategies in these patients.
    Type of Medium: Online Resource
    ISSN: 0954-6928
    URL: Article
    DOI: 10.1097/MCA.0000000000000767
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2020
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  • 7
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    Ticagrelor Monotherapy Versus Ticagrelor With Aspirin in Acute Coronary Syndrome Patients With a High Risk of Ischemic Events
    Ovid Technologies (Wolters Kluwer Health) ; 2021
    In:  Circulation: Cardiovascular Interventions Vol. 14, No. 8 ( 2021-08)
    Details
    In: Circulation: Cardiovascular Interventions, Ovid Technologies (Wolters Kluwer Health), Vol. 14, No. 8 ( 2021-08)
    Abstract: In patients with acute coronary syndrome (ACS) with a high risk of ischemia, the impact of ticagrelor monotherapy after short-term dual antiplatelet therapy (DAPT) has not been clearly elucidated. Methods: This post hoc analysis of the TICO trial (Ticagrelor Monotherapy After 3 Months in the Patients Treated With New Generation Sirolimus-Eluting Stent for Acute Coronary Syndrome) compared the impact of ticagrelor monotherapy after 3-month DAPT versus ticagrelor-based 12-month DAPT in patients with high-ischemic risk ACS, defined as any of the following: number of stents implanted ≥3, total stent length 〉 60 mm, complex procedures (chronic total occlusion, left main occlusion, or bifurcation plaques remedied using the 2-stent technique), or a history of diabetes or chronic kidney disease. Ischemic (composite of death, myocardial infarction, stent thrombosis, stroke, and target vessel revascularization) and bleeding outcomes (major bleeding) were evaluated at 12 months. Results: Of the total population (N=3056), 1473 (48.2%) patients were identified as having high-ischemic risk ACS. The rate of the ischemic outcome was significantly higher in high-ischemic risk ACS patients than in nonhigh-ischemic risk ACS patients (3.9% versus 1.9%, hazard ratio, 2.14 [95% CI, 1.37–3.35], P =0.001). Furthermore, the risk of major bleeding (3.2% versus 1.5%, hazard ratio, 2.23 [95% CI, 1.36–3.68], P =0.001) and the composite ischemic and bleeding outcome (6.6% versus 3.3%, hazard ratio, 2.02 [95% CI, 1.44–2.84], P 〈 0.001) were also higher in the high-risk ACS population. In ACS patients with or without high-ischemic risk, the effect of ticagrelor monotherapy after 3-month DAPT, as compared to that of 12-month DAPT, was consistent with ischemic ( P int =0.718), bleeding ( P int =0.092), and composite outcomes ( P int =0.094) without significant interactions. Conclusions: There were no significant heterogeneities in the impact of ticagrelor monotherapy after 3-month DAPT compared with that of ticagrelor-based 12-month DAPT on clinical outcomes according to the presence of high-ischemic risk. Registration: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT02494895.
    Type of Medium: Online Resource
    ISSN: 1941-7640 , 1941-7632
    URL: Article
    DOI: 10.1161/CIRCINTERVENTIONS.121.010812
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2021
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  • 8
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    Is Routine Postdilation During Angiography-Guided Stent Implantation as Good as Intravascular Ultrasound Guidance?: An Analysis Using Data From IVUS-XPL and ULTIMATE
    Ovid Technologies (Wolters Kluwer Health) ; 2022
    In:  Circulation: Cardiovascular Interventions Vol. 15, No. 1 ( 2022-01)
    Details
    In: Circulation: Cardiovascular Interventions, Ovid Technologies (Wolters Kluwer Health), Vol. 15, No. 1 ( 2022-01)
    Abstract: There are 2 competing approaches to optimize drug-eluting stent implantation: angiography-guided routine postdilation or intravascular ultrasound (IVUS) guidance. Methods: From the pooled data of 2 randomized trials, IVUS-XPL (Impact of Intravascular Ultrasound Guidance on the Outcomes of Xience Prime Stents in Long Lesions) and ULTIMATE (Intravascular Ultrasound Guided Drug Eluting Stents Implantation in All-Comers Coronary Lesions), that compared IVUS- versus angiography-guided drug-eluting stent implantation, we compared 1037 patients (1265 lesions) with IVUS-guided postdilation, 905 patients (1170 lesions) with angiography-guided postdilation, and 383 patients (397 lesions) with angiography-guided drug-eluting stent implantation without postdilation as a reference group; all patients required ≥28 mm long stents. The primary end point was composite of cardiac death, target lesion–related myocardial infarction, or ischemia-driven target lesion revascularization at 3 years. Results: Postintervention quantitative coronary angiography–based minimum lumen diameter was not different between the angiography guidance with postdilation versus the angiography guidance without postdilation group (2.5±0.4 mm versus 2.5±0.4 mm; P =0.367). However, it was larger in the IVUS guidance with postdilation versus the angiography guidance without postdilation group (2.6±0.5 mm versus 2.5±0.4 mm; P =0.046), and also in the IVUS guidance with postdilation versus the angiography guidance with postdilation group (2.6±0.5 mm versus 2.5±0.4 mm; P 〈 0.001). The rate of the primary end point was not different between the angiography guidance with postdilation versus the angiography guidance without postdilation group (8.6% versus 9.8%; hazard ratio, 0.86 [95% CI, 0.58–1.29]; P =0.473). However, it was lower after IVUS guidance with postdilation versus angiography guidance without postdilation (4.5% versus 9.8%; hazard ratio, 0.44 [95% CI, 0.28–0.68]; P 〈 0.001) and also after IVUS guidance with postdilation versus angiography guidance with postdilation (4.5% versus 8.6%; hazard ratio, 0.51 [95% CI, 0.35–0.74]; P 〈 0.001). Conclusions: In patients undergoing long drug-eluting stent implantation, IVUS-guided postdilation was associated with improved long-term clinical outcomes, unlike angiography-guided postdilation.
    Type of Medium: Online Resource
    ISSN: 1941-7640 , 1941-7632
    URL: Article
    DOI: 10.1161/CIRCINTERVENTIONS.121.011366
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2022
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  • 9
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    ST-segment elevation versus non-ST-segment elevation myocardial infarction in current smokers after newer-generation drug-eluting stent implantation
    Ovid Technologies (Wolters Kluwer Health) ; 2021
    In:  Medicine Vol. 100, No. 49 ( 2021-12-10), p. e28214-
    Details
    In: Medicine, Ovid Technologies (Wolters Kluwer Health), Vol. 100, No. 49 ( 2021-12-10), p. e28214-
    Type of Medium: Online Resource
    ISSN: 0025-7974 , 1536-5964
    URL: Article
    DOI: 10.1097/MD.0000000000028214
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2021
    detail.hit.zdb_id: 2049818-4
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  • 10
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    Outcomes in prediabetes vs. diabetes in patients with non-ST-segment elevation myocardial infarction undergoing percutaneous intervention
    Ovid Technologies (Wolters Kluwer Health) ; 2021
    In:  Coronary Artery Disease Vol. 32, No. 3 ( 2021-05), p. 211-223
    Details
    In: Coronary Artery Disease, Ovid Technologies (Wolters Kluwer Health), Vol. 32, No. 3 ( 2021-05), p. 211-223
    Abstract: The comparative long-term clinical outcomes between patients with prediabetes and diabetes in patients with non-ST-elevation myocardial infarction (NSTEMI) and multivessel disease (MVD) who were undergoing percutaneous coronary intervention (PCI) are not well known. We therefore compared the 2-year clinical outcomes in such patients. Methods A total of 2963 patients with NSTEMI and MVD [normoglycemia (group A, n = 629), prediabetes (group B, n = 802), and diabetes (group C, n = 1532)] were evaluated. The primary outcomes were the occurrence of major adverse cardiac events (MACE) defined as all-cause death, recurrent myocardial infarction (Re-MI), and any repeat revascularization. The secondary outcome was stent thrombosis. Results The cumulative incidence of MACE as well as for death or MI in group B and C were similar when compared to each other. However, they ( P = 0.048 and P = 0.017, respectively and P = 0.022 and P = 0.001, respectively) were significantly higher than in group A. The cumulative incidence of all-cause death in group B ( P = 0.042) and all-cause death and cardiac death in group C ( P = 0.001 and P = 0.028, respectively) were significantly higher than in group A. However, those of all-cause death, cardiac death, Re-MI, any repeat revascularization, and ST were not significantly different between groups B and C. Conclusion In this study, patients with NSTEMI and MVD who underwent successful implantation of newer-generation DES and were prediabetic had worse outcomes compared to normoglycemics and comparable to those with diabetes.
    Type of Medium: Online Resource
    ISSN: 0954-6928
    URL: Article
    DOI: 10.1097/MCA.0000000000000969
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2021
    detail.hit.zdb_id: 2042449-8
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