Publications by authors named "Joon Ho Ahn"

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.

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Background: Fractional flow reserve (FFR)-guided or angiography-guided complete revascularization has not been evaluated in patients with acute myocardial infarction (AMI) with multivessel disease and reduced left ventricular ejection fraction (LVEF). This study sought to evaluate the impact of FFR-guided percutaneous coronary intervention (PCI) for patients with AMI with multivessel disease according to left ventricular systolic function.

Methods: We performed a prespecified analysis of the FRAME-AMI (Fractional Flow Reserve Versus Angiography-Guided Strategy in Acute Myocardial Infarction With Multivessel Disease) trial, which randomly allocated 562 patients to undergo either FFR-guided PCI (FFR ≤0.

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Background: Atherosclerosis progresses through endothelial dysfunction, vascular inflammation, endothelial-to-mesenchymal transition (EndMT), and plaque instability. While ANGPTL4 (angiopoietin-like 4) is known for its metabolic functions, its role in endothelial homeostasis remains unclear.

Methods: We investigated the protective effects of ANGPTL4 on endothelial inflammation, vascular integrity, and EndMT using mice, human umbilical vein endothelial cells, human aortic endothelial cells, and induced pluripotent stem cell-derived endothelial cells.

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Aims: Rapid myocardial revascularization in patients with acute myocardial infarction (AMI) is essential to improve clinical outcomes. There is still room for improvement in the timely diagnosis of AMI. This study aimed to develop an artificial intelligence (AI) model using electrocardiograms (ECGs) for detecting AMI needing revascularization.

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Background: Despite advancements in percutaneous coronary intervention (PCI), stent-related complications continue to occur, emphasizing the necessity for stent optimization. This study employed optical coherence tomography (OCT) to investigate the safety and efficacy of overexpanding the biodegradable polymer everolimus-eluting stent (SYNERGY; Boston Scientific, Marlborough, Massachusetts, USA) stent in large coronary arteries.

Methods: This single-center observational study enrolled patients with ischemic heart disease requiring stent placement in large coronary arteries (≥4.

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Objective: The impact of renal function on revascularization outcomes in patients with acute myocardial infarction and multivessel disease remains unclear. This study compared long-term outcomes of complete (CR) and incomplete revascularization (IR) in patients with estimated glomerular filtration rate (eGFR) ≥60 or <60 mL/min/1.73 m METHODS: Using data from the Korea Acute Myocardial Infarction Registry-National Institute of Health, 5962 patients (mean age: 65.

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Objective: This study aimed to identify the factors contributing to post-traumatic growth (PTG) among nurses who experienced patient death during the coronavirus disease-2019 (COVID-19) pandemic and to evaluate the necessity of grief support is required.

Methods: An online survey was conducted to assess the experiences of nurses at Ulsan University Hospital who lost patients during the past year of the pandemic. In total, 211 nurses were recruited.

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Aims: The long-term effects of early left ventricular (LV) unloading after venoarterial extracorporeal membrane oxygenation (VA-ECMO) remain unclear.

Methods And Results: The EARLY-UNLOAD trial was a single-centre, investigator-initiated, open-label, randomized clinical trial involving 116 patients with cardiogenic shock (CS) undergoing VA-ECMO. The patients were randomly assigned to undergo either early routine LV unloading by transseptal left atrial cannulation within 12 h after randomization or the conventional approach, which permitted rescue transseptal cannulation in case of an increased LV afterload.

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Background And Objectives: The optimal timing for complete revascularization (CR) in patients with acute myocardial infarction (AMI) and multivessel disease (MVD) remain uncertain.

Methods: This post-hoc analysis of the FRAME-AMI trial included AMI patients with MVD ( = 549). They were classified into immediate ( = 329) and staged CR ( = 220) groups.

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Article Synopsis
  • * Results showed that during the first week, STEMI patients had a significantly higher mortality rate (4.62%) compared to NSTEMI patients (1.79%), but this trend reversed after the second week for men and the tenth week for women.
  • * The research highlights the need for further studies to develop advanced risk prediction models based on time-point mortality outcomes, as different baseline variables influenced mortality rates over time.
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Introduction: Elevated low-density lipoprotein cholesterol (LDL-C) is a major residual risk factor among patients with acute coronary syndrome (ACS). In the absence of sufficient real-world evidence, this observational (noninterventional) study investigated the effectiveness and safety of evolocumab in patients with hyperlipidemia treated with evolocumab for ACS in a real-world clinical setting in Korea.

Methods: Between January 2022 and February 2023, patients from 10 hospitals in Korea who initiated evolocumab within 24 weeks of an ACS event were enrolled.

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  • The study investigated the effects of clopidogrel and ticagrelor on bleeding and ischemia risks in elderly East Asian patients with diabetes and acute myocardial infarction who underwent percutaneous coronary intervention.
  • It analyzed data from 838 patients over 75 years old, ultimately comparing 466 patients after matching for treatment type.
  • Findings suggested that there was no significant difference in the incidence of severe bleeding or ischemia between those treated with ticagrelor versus clopidogrel, indicating the need for larger trials to find the best antiplatelet therapy for this group.
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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%.

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Article Synopsis
  • * Twenty patients were enrolled, and results after 8 months showed minimal in-stent late lumen loss (0.7 mm) and complete stent strut coverage, indicating successful healing.
  • * There were no adverse cardiovascular events reported within the same period, suggesting that the new stent design is safe and effective in treating coronary artery disease.
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Objectives: This study investigated the optimal timing for percutaneous coronary intervention (PCI) in patients with NSTEMI complicated by heart failure (HF).

Methods: In total, 762 patients with NSTEMI and HF in a multicenter, prospective registry in South Korea were classified according to the Killip classification (Killip class 2, n = 414 and Killip class 3, n = 348) and underwent early (within 24 h) and delayed (after 24 h) PCI. The primary outcome was all-cause mortality which was further analyzed with landmark analysis with two months as a cut-off.

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Article Synopsis
  • Current guidelines suggest complete revascularization (CR) for stable patients with ST-segment elevation myocardial infarction (STEMI) and multivessel coronary artery disease (MVD), but the best timing for the procedure is still unclear.
  • The OPTION-STEMI trial investigates whether immediate CR during a primary angioplasty is as effective as in-hospital staged CR, using fractional flow reserve (FFR) assessments for certain lesions.
  • The trial enrolled patients with significant non-infarct-related artery lesions, aiming to measure outcomes like death and myocardial infarction one year post-randomization, with results expected in mid-2025.
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  • The study examines the effects of early left ventricular unloading versus a conventional approach on 30-day mortality in patients with cardiogenic shock undergoing VA-ECMO.
  • Conducted from March 2021 to September 2022, it involved 116 patients randomly assigned to either early unloading or the conventional approach, with no significant difference in mortality rates observed between the two groups.
  • However, the early unloading group experienced a shorter time to disappearance of pulmonary congestion compared to the conventional group.
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Background: Several studies have compared clinical outcomes according to sex in patients with acute myocardial infarction (AMI). However, studies evaluating sex differences in clinical outcomes of single-vessel disease (SVD) and multi-vessel disease (MVD) in Korean patients with AMI are lacking. Therefore, this study aimed to analyze sex differences in the clinical characteristics of patients with AMI with SVD and MVD and to evaluate the impact of sex differences on the clinical outcomes in patients with AMI with SVD and MVD.

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Background: Thin-cap fibroatheroma is a rupture-prone vulnerable plaque that leads to acute coronary syndrome (ACS). However, its underlying mechanisms are not fully understood. Several studies have investigated the clinical association between angiopoietin-like protein 4 (ANGPTL4) and coronary artery disease.

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Article Synopsis
  • * Conducted with 116 patients, participants were randomly assigned to either receive routine unloading within 12 hours of VA-ECMO or the conventional method based on later monitored signs of increased afterload.
  • * The trial aims to assess the effects on 30-day mortality and other clinical outcomes, potentially influencing future practices in managing complications linked to VA-ECMO.
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Article Synopsis
  • * LVR was defined as an LV end-diastolic diameter greater than 55 mm and was found in 9.9% of the 262 patients who were monitored through echocardiography over a year.
  • * Results showed that LVR is linked to poorer outcomes, particularly in patients who had incomplete revascularization, with significantly higher risks of major adverse cardiovascular events and heart failure compared to those who had complete revascularization.
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Background: Limited data are available regarding the proper application time and long-term outcomes of extracorporeal membrane oxygenation (ECMO) in patients with cardiogenic shock. This cohort study appraised the clinical outcomes according to ECMO application without or before cardiopulmonary resuscitation (CPR) in patients with acute myocardial infarction (AMI) combined with cardiogenic shock.

Methods: Between 2011 and 2015, a total of 13,104 patients with AMI were enrolled in a nationwide AMI registry.

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Background/aims: Recurrent acute myocardial infarction (AMI) is an adverse cardiac event in patients with a first AMI. The predictors of recurrent AMI after the first AMI in patients who underwent successful percutaneous coronary intervention (PCI) have not been elucidated.

Methods: We analyzed the data collected from 9,869 patients (63.

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Background: In the cause of increase the clinical research observational evidence on type 2 myocardial infraction (T2MI), the study compared the characteristics of T2MI and T1MI with respect to major adverse cardiac events (MACE) and mortality as long-term outcomes from a large, nationwide, prospective Korean cohort registry.

Methods: From 13,105 consecutively enrolled individuals in the Korea Acute Myocardial Infarction-National Institute of Health (KAMIR-NIH) registry between October 2011 and December 2015, 11,053 acute myocardial infarction (AMI) patients were divided into the T1MI (n=10,545) and T2MI (n=508) groups. All patients completed ≥3 years of follow-up.

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Although amlodipine is recommended as the first-line therapy for the treatment of hypertension, its use is limited by its potential side effects. S-amlodipine is expected to be able to minimize side effects of amlodipine with a similar antihypertensive effect by removing the malicious R-chiral form. However, sustainable blood pressure control with S-amlodipine has not been well established yet.

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