Association and Prognostic Implications of "No-Reflow Phenomenon" and Hypercoagulability in Patients With ST-Segment Elevation Myocardial Infarction.

Background: Following percutaneous coronary intervention (PCI), the "no-reflow phenomenon" is associated with a worse outcome. However, it remains unclear how to prevent and treat this phenomenon during PCI.

Objectives: This study aimed to evaluate the association between thrombogenicity profiles and "no-reflow phenomenon" during primary PCI in patients with ST-segment elevation myocardial infarction (STEMI).

The Clinical Impact of Intravascular Imaging-Guided Percutaneous Coronary Intervention in Acute Myocardial Infarction Patients with High Thrombus Burden.

Despite the established clinical efficacy following intravascular imaging (IVI)-guided percutaneous coronary intervention (PCI) than angiography-guided PCI, evidence regarding prognostic benefits of IVI-guided PCI in acute myocardial infarction (AMI) patients with high thrombus burden remains limited. Using the nationwide registries of KAMIR-NIH and KAMIR-V, we evaluated the prognostic impact of IVI-guided PCI in AMI patients with high thrombus burden. A total of 4,074 patients with AMI and TIMI thrombus grades 4 or 5 who underwent aspiration thrombectomy were selected, of whom 892 patients (21.

Immediate versus staged complete revascularisation during index admission in patients with ST-segment elevation myocardial infarction and multivessel disease (OPTION-STEMI): a multicentre, non-inferiority, open-label, randomised trial.

Background: The optimal timing of complete revascularisation for patients with ST-segment elevation myocardial infarction (STEMI) and multivessel coronary artery disease remains unclear. We aimed to assess whether immediate complete revascularisation was non-inferior to staged complete revascularisation during the index admission.

Methods: We conducted an open-label, randomised, non-inferiority trial at 14 hospitals in South Korea.

Prognostic differences between persistent HFrEF and HFrecEF following acute myocardial infarction.

Background: Acute myocardial infarction (AMI) often leads to heart failure with reduced ejection fraction (HFrEF), with some patients showing recovery of left ventricular ejection fraction (HFrecEF) over time. This study aimed to evaluate the prognostic differences between persistent HFrEF and HFrecEF.

Methods: This prospective cohort study included AMI patients with reduced LVEF (<40%) at admission.

Renal hyperfiltration as risk factor of major adverse cardiovascular events in patients with acute myocardial infarction.

The potential interaction between the heart and kidneys is thought to contribute to the development of renal hyperfiltration (RHF). However, the clinical implications of RHF remain unclear in patients with acute myocardial infarction (AMI). A total of 9561 AMI patients with estimated glomerular filtration rate (eGFR) ≥ 60 mL/min/1.

Long-term benefit of vasodilating beta-blockers in acute myocardial infarction patients with mildly reduced left ventricular ejection fraction.

Beta-blockers have been considered the cornerstone of treatment for patients with acute myocardial infarction (AMI). However, long-term benefits of vasodilating beta-blockers remain uncertain. This study aimed to investigate the long-term clinical benefits of vasodilating beta-blockers compared to conventional beta-blockers in AMI patients with mildly reduced ejection fraction (mrEF).

Prognostic impact of changes in left ventricular ejection fraction and wall motion score index in patients with myocardial infarction.

Background: The prognostic significance of changes in left ventricular ejection fraction (LVEF) and wall motion score index (WMSI) in patients with myocardial infarction remains unclear.

Methods: This study evaluated whether changes in LVEF and WMSI can predict clinical outcomes and LV remodeling in post-AMI patients. Using data from the Korea Acute Myocardial Infarction Registry-National Institutes of Health (KAMIR-NIH), 3,510 AMI patients who underwent percutaneous coronary intervention (PCI) were retrospectively analyzed.

Epigenetic Modulation of Vascular Smooth Muscle Cell Phenotype Switching in Early-Onset Acute Myocardial Infarction.

Background: The epigenetic mechanisms underlying early-onset acute myocardial infarction (AMI) remain insufficiently characterized. The present study aims to elucidate the pathophysiology of early-onset AMI by investigating its epigenetic features as molecular indicators.

Methods: A comparative differential methylation analysis was performed on whole blood samples from 298 patients with early-onset AMI with clinical follow-up and 247 controls using targeted bisulfite sequencing.

Diabetic Status and Thrombogenicity: Association and Prognostic Implications After Percutaneous Coronary Intervention.

Background: A heightened prothrombotic environment, combined with premature and more aggressive atherosclerosis, contributes to the elevated cardiovascular risk in patients with diabetes mellitus (DM).

Objectives: The aim of this study was to evaluate the association between DM status and thrombogenicity and their prognostic implications in patients with significant coronary artery disease.

Methods: A total of 2,501 patients with coronary artery disease undergoing percutaneous coronary intervention, with on-admission glycated hemoglobin and thrombogenicity indexes (measured by thromboelastography).

Angiotensin-Converting Enzyme Inhibitors versus Angiotensin Receptor Blockers in Older Patients with acute Myocardial Infarction after a Successful Stent Implantation.

Background: This study aimed to evaluate the long-term clinical outcomes of patients with acute myocardial infarction (AMI) who underwent successful stent implantation and were subsequently treated with angiotensin-converting enzyme inhibitors (ACEI) or angiotensin receptor blockers (ARB).

Methods: Among 13,104 patients enrolled in the Korean AMI registry, 2,763 older patients aged 70 years or older, who were prescribed either ACEI or ARB at discharge, were included in this study. Propensity score matching (PSM) was performed to adjust for baseline confounders.

Potent P2Y inhibitors in patients with acute myocardial infarction and cardiogenic shock.

Background: Although potent P2Y inhibitors, such as ticagrelor and prasugrel, are standard treatment in patients with acute myocardial infarction (AMI), evidence for their efficacy and safety compared with clopidogrel is limited in patients with AMI complicated by cardiogenic shock.

Methods: Among 28,949 patients from the nationwide pooled registry of KAMIR-NIH and KAMIR-V, a total of 1482 patients (5.1%) with AMI and cardiogenic shock who underwent percutaneous coronary intervention of the culprit vessel were selected.

Predictive value and optimal cut-off level of high-sensitivity troponin T in patients with acute pulmonary embolism.

Background/aims: Elevated troponin levels predict in-hospital mortality and influence decisions regarding thrombolytic therapy in patients with acute pulmonary embolism (PE). However, the usefulness of high-sensitivity troponin T (hsTnT) regarding PE remains uncertain. We aimed to establish the optimal cut-off level and compare its performance for precise risk stratification.

Discontinuation of β-blocker therapy in stabilised patients after acute myocardial infarction (SMART-DECISION): rationale and design of the randomised controlled trial.

Introduction: There is a lack of evidence to support the effectiveness of prolonged β-blocker therapy after stabilisation of patients with acute myocardial infarction (AMI) without heart failure (HF) or left ventricular systolic dysfunction.

Methods And Analysis: The SMart Angioplasty Research Team: DEcision on Medical Therapy in Patients with Coronary Artery DIsease or Structural Heart Disease Undergoing InterventiON (SMART-DECISION) trial is a multicentre, prospective, open-label, randomised, non-inferiority trial designed to determine whether discontinuing β-blocker therapy after ≥1 year of maintenance in stabilised patients after AMI is non-inferior to continuing it. Patients eligible for participation are those without HF or left ventricular systolic dysfunction (ejection fraction >40%) who have been continuing β-blocker therapy for ≥1 year after AMI.

2024 Korean Society of Myocardial Infarction/National Evidence-Based Healthcare Collaborating Agency Guideline for the Pharmacotherapy of Acute Coronary Syndromes.

Many countries have published clinical practice guidelines for appropriate clinical decisions, optimal treatment, and improved clinical outcomes in patients with acute coronary syndrome. Developing guidelines that are specifically tailored to the Korean environment is crucial, considering the treatment system, available medications and medical devices, racial differences, and level of language communication. In 2017, the Korean Society of Myocardial Infarction established a guideline development committee.

Optimal timing of revascularization for patients with non-ST segment elevation myocardial infarction and severe left ventricular dysfunction.

Optimal timing of revascularization for patients who presented with non-ST segment elevation myocardial infarction (NSTEMI) and severe left ventricular (LV) dysfunction is unclear. A total of 386 NSTEMI patients with severe LV dysfunction from the nationwide, multicenter, and prospective Korea Acute Myocardial Infarction Registry V (KAMIR-V) were enrolled. Severe LV dysfunction was defined as LV ejection fraction ≤ 35%.

Clinical Impact of Self-Recognition of Recurrent Acute Myocardial Infarction: From KRMI-RCC.

: Self-recognition of recurrent myocardial infarction (re-MI) may be essential for reducing prehospital time contrast to awareness of re-MI symptoms. However, data on the current status and clinical impact of self-recognition of re-MI are limited in the contemporary period. Thus, this study aimed to increase this body of knowledge.

Different diabetogenic effect of statins according to intensity and dose in patients with acute myocardial infarction: a nationwide cohort study.

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).

Long-term prognostic implications of brachial-ankle pulse wave velocity in patients undergoing percutaneous coronary intervention.

Objective: The long-term clinical effect of arterial stiffness in high-risk disease entities remains unclear. The prognostic implications of brachial-ankle pulse wave velocity (baPWV) were assessed using a real-world registry that included patients who underwent percutaneous coronary intervention (PCI).

Methods: Arterial stiffness was measured using baPWV before discharge.

Very early vs delayed invasive strategy in high-risk NSTEMI patients without hemodynamic instability: Insight from the KAMIR-NIH.

Background: High-risk non-ST-elevation myocardial infarction (NSTEMI) patients' optimal timing for percutaneous coronary intervention (PCI) is debated despite the recommendation for early invasive revascularization. This study aimed to compare outcomes of NSTEMI patients without hemodynamic instability undergoing very early invasive strategy (VEIS, ≤ 12 hours) versus delayed invasive strategy (DIS, >12 hours).

Methods: Excluding urgent indications for PCI including initial systolic blood pressure under 90 mmHg, ventricular arrhythmia, or Killip class IV, 4,733 NSTEMI patients were recruited from the Korea Acute Myocardial Infarction Registry-National Institutes of Health (KAMIR-NIH).

Long-term clinical outcomes of image-guided percutaneous coronary intervention in acute myocardial infarction from the Korea Acute Myocardial Infarction Registry.

Imaging modalities for percutaneous coronary intervention (PCI), such as intravascular ultrasound (IVUS) or optical coherence tomography (OCT), have increased in the current PCI era. However, their clinical benefits in acute myocardial infarction (AMI) have not been fully elucidated. This study investigated the long-term outcomes of image-guided PCI in patients with AMI using data from the Korean Acute Myocardial Infarction Registry.

Platelet-fibrin clot strength and platelet reactivity predicting cardiovascular events after percutaneous coronary interventions.

Background And Aims: Platelet-fibrin clot strength (PFCS) is linked to major adverse cardiovascular event (MACE) risk. However, the association between PFCS and platelet reactivity and their prognostic implication remains uncertain in patients undergoing percutaneous coronary intervention (PCI).

Methods: In PCI-treated patients (n = 2512) from registry data from January 2010 to November 2018 in South Korea, PFCS using thromboelastography and platelet reactivity using VerifyNow were measured.