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  • Ovid Technologies (Wolters Kluwer Health)  (7)
  • 1
    Online Resource
    Online Resource
    Abstract 11320: Long-Term Stent-Related and Patient-Related Outcomes of Second-Generation Everolimus-Eluting Xience V Stents versus Zotarolimus-Eluting Resolute Stents in Real-World Practice: Three Year Results From the Multicenter Prospective EXCELLENT and RESOLUTE-Korea Registries
    Ovid Technologies (Wolters Kluwer Health) ; 2014
    In:  Circulation Vol. 130, No. suppl_2 ( 2014-11-25)
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 130, No. suppl_2 ( 2014-11-25)
    Abstract: Background: Long term outcomes are imperative to confirm safety of drug-eluting stents. There have been two randomized controlled trials comparing everolimus-eluting stents (EES) and Resolute zotarolimus-eluting stents (ZES-R). To date, long-term clinical outcomes of these stents were limited to only one report which has recently reported 4-year comparisons of these stents. Therefore, more evidences are needed regarding long-term clinical outcomes of the second generation stents. This study compared the long-term clinical outcomes of EES with ZES-R in “all-comer” cohorts up to 3-year follow-up. Methods: The EXCELLENT and RESOLUTE-Korea registries prospectively enrolled 3,056 patients treated with EES and 1,998 with ZES-R. Target lesion failure and patient-related composite events were compared in crude and propensity score matched analyses. Results: Of 5054 patients, 3830 patients (75.8%) had off label indication (2217 with EES and 1613 with ZES-R). The stent-related outcome (189 [6.2%] vs. 127 [6.4%] , p=0.812) and the patient-related outcome (420 [13.7%] vs. 250 [12.5%] , p=0.581) did not differ between EES and ZES-R respectively at 3 year, which was corroborated by similar results from the propensity score-matched cohort (HR 0.92, 95% CI 0.70-1.20, p=0.523 and 0.85, 95% CI 0.70-1.02, p=0.081, for stent and patient related outcomes, respectively). The rate of definite or probable stent thrombosis up to 3 years (22 [0.7%] vs. 10 [0.5%] , p=0.370) was also similar. The rate of stent thrombosis was very low and comparable between the two stents (3 [0.1%] vs. 1 [0.1%] , p=0.657). In multivariate analysis, chronic renal failure (adjusted HR 3.615, 95% CI 2.440-5.354, p 〈 0.001) and off label indication (adjusted HR 1.782, 95% CI 1.169-2.718, p=0.007) were the strongest predictors of target lesion failure. Conclusion: In this robust real world registry with unrestricted use of EES and ZES-R, both stents showed comparable safety and efficacy at 3-year follow-up. Overall incidences of target lesion failure and definite stent thrombosis, including very late stent thrombosis, were low, even in the patients with off label indications, suggesting excellent long term safety and sustained efficacy of both types of second generation drug-eluting stents.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/circ.130.suppl_2.11320
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2014
    detail.hit.zdb_id: 1466401-X
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  • 2
    Online Resource
    Online Resource
    Clinical features of idiopathic restrictive cardiomyopathy : A retrospective multicenter cohort study over 2 decades
    Ovid Technologies (Wolters Kluwer Health) ; 2017
    In:  Medicine Vol. 96, No. 36 ( 2017-09), p. e7886-
    Details
    In: Medicine, Ovid Technologies (Wolters Kluwer Health), Vol. 96, No. 36 ( 2017-09), p. e7886-
    Type of Medium: Online Resource
    ISSN: 0025-7974
    URL: Article
    DOI: 10.1097/MD.0000000000007886
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2017
    detail.hit.zdb_id: 2049818-4
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  • 3
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    β‐Blockers and 1‐Year Postdischarge Mortality for Heart Failure and Reduced Ejection Fraction and Slow Discharge Heart Rate
    Ovid Technologies (Wolters Kluwer Health) ; 2019
    In:  Journal of the American Heart Association Vol. 8, No. 4 ( 2019-02-19)
    Details
    In: Journal of the American Heart Association, Ovid Technologies (Wolters Kluwer Health), Vol. 8, No. 4 ( 2019-02-19)
    Abstract: Many hospitalized patients with heart failure and reduced ejection fraction ( HF r EF ) have a slow heart rate at discharge, and the effect of β‐blockers may be reduced in those patients. We sought to examine the variable effect of β‐blockers on clinical outcomes according to the discharge heart rate of hospitalized HF r EF patients. Methods and Results The KorAHF (Korean Acute Heart Failure) registry consecutively enrolled 5625 patients hospitalized for acute heart failure. In this analysis, we included patients with HF r EF (left ventricular ejection fraction ≤40%). Slow heart rate was defined as 〈 70 beats per minute regardless of the use of β‐blockers. The primary outcome was 1‐year all‐cause postdischarge death according to heart rate. Among 2932 patients with HF r EF , 840 (29%) had a slow heart rate and 56% received β‐blockers at discharge. Patients with slow heart rates were older and had lower 1‐year mortality than those with high heart rates ( P 〈 0.001). A significant interaction between discharge heart rate and β‐blocker use was observed ( P 〈 0.001 for interaction). When stratified, only patients without a β‐blocker prescription and with a high heart rate showed higher 1‐year mortality. In a Cox‐proportional hazards regression analysis, β‐blocker prescription at discharge was associated with 24% reduced risk for 1‐year mortality in patients with high heart rates (hazard ratio: 0.76; 95% CI, 0.61–0.95) but not in those with slow heart rates (hazard ratio: 1.02; 95% CI, 0.68–1.55). Conclusions Many patients with acute heart failure have slow discharge heart rates, and β‐blockers may have a limited effect on HF r EF and slow discharge heart rate. Clinical Trial Registration URL : http://www.clinicaltrial.gov . Unique identifier: NCT 01389843.
    Type of Medium: Online Resource
    ISSN: 2047-9980
    URL: Article
    DOI: 10.1161/JAHA.118.011121
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2019
    detail.hit.zdb_id: 2653953-6
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  • 4
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    Abstract 21002: Comparison of Clinical Outcomes of Patients With Acute Heart Failure and Recovered Ejection Fraction versus Preserved or Reduced Ejection Fraction
    Ovid Technologies (Wolters Kluwer Health) ; 2017
    In:  Circulation Vol. 136, No. suppl_1 ( 2017-11-14)
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 136, No. suppl_1 ( 2017-11-14)
    Abstract: Introduction: Recent studies showed that patients with chronic heart failure with recovered ejection fraction (HFrecEF) have better clinical outcomes than those with preserved ejection fraction (HFpEF). However, there is lack of data about HF prognosis according to EF change in acute heart failure (AHF). Therefore, the aim of this study was to investigate the prognosis of HFrecEF compared to HFpEF in patients with AHF. Methods: A total of 5,625 cohort patients with AHF enrolled in Korean AHF registry (KorAHF). Of them, 2,632 patients underwent follow-up echocardiography with measurement of EF. They were divided into three groups according to EF change: HF with reduced EF (HFrEF) (n=1,522, 68.6±14.5 years, 818 males), HFpEF (n=281, 72.6±13.5 years, 115 males), and HFrecEF (n=829, 67.6±14.2 years, 341 males). HFrEF was defined as AHF patients with EF 〈 50%, HFpEF as EF 〉 =50%, and HFrecEF as EF 〉 =50% with previous EF 〈 50%. Primary end-point was all-cause mortality at 1-year follow up. Results: Patients were older (72.6±13.5 vs. 67.6±14.2 vs. 68.6±14.5 years, p 〈 0.001) and more likely to be female (59.1% vs. 41.1% vs. 46.3%, p=0.058) in HFpEF group than in HFrecEF and HFrEF group. Systolic BP was lowest (136.7±31.1 vs. 128.6±29.9 vs. 131.9±29.7 mmHg, p 〈 0.001) in the HFrecEF group. In echocardiographic exam, EF was lowest in the HFrecEF group (60.0±6.4% vs. 30.4±10.1% vs. 37.8±15.8%, p 〈 0.001) and E/e’ was highest (18.7±10.9 vs. 22.0±12.0 vs. 21.2±11.3, p 〈 0.001). Ischemic etiology was less evident in the HFpEF group (22.1% vs. 40.0% vs. 39.0%, p 〈 0.001), but valvular (29.5%), hypertensive (6.8%), and tachycardic etiologies (12.8%) were more frequent in the HFpEF group. In clinical outcomes, 1-year death was highest in the HFrecEF group (13.9% vs. 18.3% vs. 16.6%, p=0.752) and rehospitalization rate was comparable between the groups (42.7% vs. 41.9% vs. 45.5%, 0.141). Kaplan-Meier survival analysis showed that 1-year mortality in the HFrecEF group was marginally higher than that in the HFpEF group (p=0.046 by log rank test). Conclusions: AHF patients in HFrecEF group had higher mortality than those in HFpEF group. Recovery from acute depressed LV function may not always warrant favorable clinical outcomes in long-term follow-up.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/circ.136.suppl_1.21002
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2017
    detail.hit.zdb_id: 1466401-X
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  • 5
    Online Resource
    Online Resource
    Characteristics, Outcomes, and Treatment of Heart Failure With Improved Ejection Fraction
    Ovid Technologies (Wolters Kluwer Health) ; 2019
    In:  Journal of the American Heart Association Vol. 8, No. 6 ( 2019-03-19)
    Details
    In: Journal of the American Heart Association, Ovid Technologies (Wolters Kluwer Health), Vol. 8, No. 6 ( 2019-03-19)
    Abstract: Many patients with heart failure ( HF ) with reduced ejection fraction ( HF r EF ) experience improvement or recovery of left ventricular ejection fraction ( LVEF ). Data on clinical characteristics, outcomes, and medical therapy in patients with HF with improved ejection fraction (HFiEF) are scarce. Methods and Results Of 5625 consecutive patients hospitalized for acute HF in the KorAHF (Registry [Prospective Cohort] for Heart Failure in Korea) study, 5103 patients had baseline echocardiography and 2302 patients had follow‐up echocardiography at 12 months. HF phenotypes were defined as persistent HF r EF ( LVEF ≤40% at baseline and at 1‐year follow‐up), HF i EF ( LVEF ≤40% at baseline and improved up to 40% at 1‐year follow‐up), HF with midrange ejection fraction (LVEF between 40% and 〈 50%), and HF with preserved ejection fraction ( LVEF ≥50%). The primary outcome was 4‐year all‐cause mortality from the time of HF i EF diagnosis. Among 1509 HF r EF patients who had echocardiography 1 year after index hospitalization, 720 (31.3%) were diagnosed as having HF i EF . Younger age, female sex, de novo HF , hypertension, atrial fibrillation, and β‐blocker use were positive predictors and diabetes mellitus and ischemic heart disease were negative predictors of HF i EF . During 4‐year follow‐up, patients with HF i EF showed lower mortality than those with persistent HF r EF in univariate, multivariate, and propensity‐score–matched analyses. β‐Blockers, but not renin–angiotensin system inhibitors or mineralocorticoid receptor antagonists, were associated with a reduced all‐cause mortality risk (hazard ratio: 0.59; 95% CI , 0.40–0.87; P =0.007). Benefits for outcome seemed similar among patients receiving low‐ or high‐dose β‐blockers (log‐rank, P =0.304). Conclusions HF i EF is a distinct HF phenotype with better clinical outcomes than other phenotypes. The use of β‐blockers may be beneficial for these patients. Clinical Trial Registration URL : https://www.clinicaltrials.gov . Unique identifier: NCT01389843.
    Type of Medium: Online Resource
    ISSN: 2047-9980
    URL: Article
    DOI: 10.1161/JAHA.118.011077
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2019
    detail.hit.zdb_id: 2653953-6
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  • 6
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    Online Resource
    Guideline‐Directed Medical Therapy for Patients With Heart Failure With Midrange Ejection Fraction: A Patient‐Pooled Analysis From the KorHF and KorAHF Registries
    Ovid Technologies (Wolters Kluwer Health) ; 2018
    In:  Journal of the American Heart Association Vol. 7, No. 21 ( 2018-11-06)
    Details
    In: Journal of the American Heart Association, Ovid Technologies (Wolters Kluwer Health), Vol. 7, No. 21 ( 2018-11-06)
    Abstract: Although current guidelines now define heart failure with midrange ejection fraction ( HF mr EF ) as HF with a left ventricular EF of 40% to 49%, there are limited data on response to guideline‐directed medical therapy in patients with HF mr EF . The current study aimed to evaluate the association between β‐blocker, renin‐angiotensin system blocker ( RASB ), or aldosterone antagonist ( AA ) treatment with clinical outcome in patients with HF mr EF . Methods and Results We performed a patient‐level pooled analysis on 1144 patients with HF mr EF who were hospitalized for acute HF from the Kor HF (Korean Heart Failure) and Kor AHF (Korean Acute Heart Failure) registries. The study population was divided between use of β‐blocker, RASB , or AA to evaluate the guideline‐directed medical therapy in patients with HF mr EF . Sensitivity analyses, including propensity score matching and inverse‐probability‐weighted methods, were performed. The use of β‐blocker in the discharge group showed significantly lower rates of all‐cause mortality compared with those who did not use a β‐blocker (β‐blocker versus no β‐blocker, 30.7% versus 38.2%; hazard ratio, 0.758; 95% confidence interval, 0.615–0.934; P =0.009). Similarly, the RASB use in the discharge group was associated with the lower risk of mortality compared with no use of RASB ( RASB versus no RASB , 31.9% versus 38.1%; hazard ratio, 0.76; 95% confidence interval, 0.618–0.946; P =0.013). However, there was no significant difference in all‐cause mortality between AA and no AA in the discharge group ( AA versus no AA , 34.2% versus 34.0%; hazard ratio, 1.063; 95% confidence interval, 0.858–1.317; P =0.578). Multiple sensitivity analyses showed similar trends. Conclusions For treatment of acute HFmrEF after hospitalization, β‐blocker and RASB therapies on discharge were associated with reduced risk of all‐cause mortality. Clinical Trial Registration URL : http://www.clinicaltrials.gov . Unique identifier: NCT 01389843.
    Type of Medium: Online Resource
    ISSN: 2047-9980
    URL: Article
    DOI: 10.1161/JAHA.118.009806
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2018
    detail.hit.zdb_id: 2653953-6
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  • 7
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    Predictors and Prognostic Value of Worsening Renal Function During Admission in HFpEF Versus HFrEF: Data From the KorAHF (Korean Acute Heart Failure) Registry
    Ovid Technologies (Wolters Kluwer Health) ; 2018
    In:  Journal of the American Heart Association Vol. 7, No. 6 ( 2018-03-20)
    Details
    In: Journal of the American Heart Association, Ovid Technologies (Wolters Kluwer Health), Vol. 7, No. 6 ( 2018-03-20)
    Abstract: Worsening renal function ( WRF ) is associated with adverse outcomes in patients with heart failure. We investigated the predictors and prognostic value of WRF during admission, in patients with preserved ejection fraction ( HF p EF ) versus those with reduced ejection fraction ( HF r EF ). Methods and Results A total of 5625 patients were enrolled in the KorAHF (Korean Acute Heart Failure) registry. WRF was defined as an absolute increase in creatinine of ≥0.3 mg/ dL . Transient WRF was defined as recovery of creatinine at discharge, whereas persistent WRF was indicated by a nonrecovered creatinine level. HF p EF and HF r EF were defined as a left ventricle ejection fraction ≥50% and ≤40%, respectively. Among the total population, WRF occurred in 3101 patients (55.1%). By heart failure subgroup, WRF occurred more frequently in HF r EF (57.0% versus 51.3%; P 〈 0.001 in HF r EF and HF p EF ). Prevalence of WRF increased as creatinine clearance decreased in both heart failure subgroups. Among various predictors of WRF , chronic renal failure was the strongest predictor. WRF was an independent predictor of adverse in‐hospital outcomes ( HF r EF : odds ratio; 2.75; 95% confidence interval, 1.50–5.02; P =0.001; HF p EF : odds ratio, 9.48; 95% confidence interval, 1.19–75.89; P =0.034) and 1‐year mortality ( HF r EF : hazard ratio, 1.41; 95% confidence interval , 1.12–1.78; P =0.004 versus HF p EF : hazard ratio, 1.72; 95% confidence interval, 1.23–2.42; P =0.002). Transient WRF was a risk factor for 1‐year mortality, whereas persistent WRF had no additive risk compared to transient WRF . Conclusions In patients with acute heart failure patients, WRF is an independent predictor of adverse in‐hospital and follow‐up outcomes in both HF r EF and HF p EF , though with a different effect size. Clinical Trial Registration URL : https://www.clinicaltrials.gov . Unique identifier: NCT 01389843.
    Type of Medium: Online Resource
    ISSN: 2047-9980
    URL: Article
    DOI: 10.1161/JAHA.117.007910
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2018
    detail.hit.zdb_id: 2653953-6
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