Publications by authors named "Han-Joon Bae"

10 Publications

  • Page 1 of 1

Mortality among ischemic and nonischemic heart failure patients with a primary implantable cardioverter-defibrillator.

J Arrhythm 2021 Dec 29;37(6):1537-1545. Epub 2021 Oct 29.

Division of Cardiology Department of Internal Medicine Severance Cardiovascular Hospital Yonsei University College of Medicine Seoul Republic of Korea.

Background: The efficacy of implantable cardioverter defibrillators (ICDs) for primary prevention is controversial in patients with nonischemic heart failure (HF). We evaluated the mortality and predictors of mortality in patients with prophylactic ICD implantation for ischemic and nonischemic HF.

Methods: From 2008 to 2017, 1097 patients (667, nonischemic HF and 430, ischemic HF) who underwent prophylactic ICD implantation, were identified from the Korean National Health Insurance Service database. We used propensity score overlap weighting to correct the differences between two groups.

Results: Those with ischemic HF were older (67.0 ± 10.1 vs 61.8 ± 14.2 years), more often male (71.4% vs 63.7%), and had more comorbidities than patients with nonischemic HF. During a median follow-up of 37.3 months (interquartile range [IQR], 14.2-53.8 months), all-cause mortality was higher in unweighted patients with ischemic HF than in those with nonischemic HF (10.9 vs 6.4 per 100 person-years; hazard ratio [HR], 1.74; 95% confidence interval [CI], 1.38-2.20;  < .001). However, after weighting, the annual all-cause mortality rate was similar in both groups (9.5 vs 8.8 per 100 person-years), with no significant difference in the risk of all-cause mortality (HR, 1.08; 95% CI, 0.68-1.71;  = .755). Older age and chronic kidney disease were independent predictors of all-cause mortality in both groups. There was no significant difference in cardiac and noncardiac mortality between the weighted nonischemic and ischemic HF groups.

Conclusions: The all-cause, cardiac, and noncardiac mortality rates were similar between patients with nonischemic and ischemic HF who underwent prophylactic ICD implantation.
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http://dx.doi.org/10.1002/joa3.12651DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8637096PMC
December 2021

Ventricular Arrhythmia Associated With Magnesium and Vitamin D Deficiencies in a Patient With Rheumatoid Arthritis.

Authors:
Han Joon Bae

Cureus 2021 Oct 30;13(10):e19143. Epub 2021 Oct 30.

Internal Medicine, Cardiology, Daegu Catholic University Hospital, Daegu, KOR.

Prolongation of QT associated with electrolyte changes can lead to ventricular arrhythmias. Correction and supply of calcium, magnesium, and potassium are essential to managing this condition. In this report, we present a case of QT prolongation due to magnesium and vitamin D deficiency in a patient with rheumatoid arthritis.
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http://dx.doi.org/10.7759/cureus.19143DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8628484PMC
October 2021

Electrocardiographic Manifestations in Patients with COVID-19: Daegu in South Korea.

Korean Circ J 2021 Oct;51(10):851-862

Division of Cardiology, Daegu Catholic University College of Medicine, Daegu, Korea.

Background And Objectives: As the coronavirus disease 2019 (COVID-19) spreads worldwide, cardiac injury in patients infected with COVID-19 becomes a significant concern. Thus, this study investigates the impact of several electrocardiogram (ECG) parameters and disease severity in COVID-19 patients.

Methods: Seven medical centers in Daegu admitted 822 patients with COVID-19 between February and April 2020. This study examined 267 patients among them who underwent an ECG test and evaluated their biochemical parameters like C-reactive protein (CRP), log N-terminal pro-B-type Natriuretic Peptide (NT-proBNP), cardiac enzyme, and ECG parameters (heart rate, PR interval, QRS interval, T inversion, QT interval, and Tpe [the interval between peak to end in a T wave]).

Results: Those patients were divided into 3 groups of mild (100 patients), moderate (89 patients), and severe (78 patients) according to clinical severity score. The level of CRP, log NT-proBNP, and creatinine kinase-myocardial band were significantly increased in severe patients. Meanwhile, severe patients exhibited prolonged QT intervals (QTc) and Tpe (Tpe-c) compared to mild or moderate patients. Moreover, deceased patients (58; 21.7%) showed increased dispersion of QTc and Tpe-c compared with surviving patients (78.2±41.1 vs. 40.8±24.6 ms and 60.2±37.3 vs. 40.8±24.5 ms, both p<0.05, respectively). The QTc dispersion of more than 56.1 ms could predict the mortality in multivariate analysis (odd ratio, 11.55; 95% confidence interval, 3.746-42.306).

Conclusions: COVID-19 infections could involve cardiac injuries, especially cardiac repolarization abnormalities. A prolonged QTc dispersion could be an independent predictable factor of mortality.
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http://dx.doi.org/10.4070/kcj.2021.0116DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8484995PMC
October 2021

Association between in-stent neointimal characteristics and native coronary artery disease progression.

PLoS One 2021 23;16(4):e0247359. Epub 2021 Apr 23.

Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea.

Background And Aims: The prognosis of stented lesions differs according to in-stent neointimal characteristics on optical coherence tomography (OCT). In particular, patients who show in-stent heterogeneous neointima are associated with a higher incidence of target lesion revascularization (TLR) compared with those who show in-stent non-heterogeneous neointima. However, the relationship between in-stent neointimal characteristics and native coronary atherosclerosis progression has not been clearly elucidated. The study aimed to investigate the relationship between in-stent neointimal characteristics and progression of native atherosclerosis.

Methods: The neointimal characteristics of 377 patients with 377 drug-eluting stents (DESs) were quantitatively and qualitatively assessed using OCT. The OCT-based neointima was categorized as homogeneous (n = 207), heterogeneous (n = 93), and layered (n = 77). The relationship of non-target lesion revascularization (non-TLR) with neointimal characteristics was evaluated after OCT examination of the stents.

Results: After a median follow-up duration of 40.0 months, patients with heterogeneous neointima showed significantly higher non-TLR rates than those with homogeneous neointima and tended to have higher non-TLR rates than those with layered neointima (heterogeneous vs. homogeneous:14.0% vs. 8.7%, p = 0.046; heterogeneous vs. layered neointima:14.0% vs. 7.8%, p = 0.152). Multivariate analysis showed that the independent determinants for non-TLR were heterogeneous neointima (HR: 2.237, 95% CI: 1.023-4.890, p = 0.044) and chronic kidney disease (hazard ratio [HR]: 8.730, 95% CI: 2.175-35.036, p = 0.002).

Conclusions: The heterogeneous neointima in DES-treated lesions was associated with a higher incidence of non-TLR and target lesion failure. This finding suggests that the neointimal pattern may reflect the progression of the native lesion.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0247359PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8064742PMC
September 2021

Long Term Clinical Outcomes in Patients with Moderate Aortic Stenosis.

Heart Surg Forum 2020 May 28;23(3):E358-E365. Epub 2020 May 28.

Division of Cardiology, Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, Republic of Korea.

Background: While the surgical correction of moderate aortic stenosis (AS) can be deferred with a watchful waiting according to the present guideline, the clinical outcomes for moderate AS with comorbidity have not extensively been studied. We aimed to explore the factors that would contribute to the outcomes of moderate AS with at least five years of follow-up duration.

Methods: Medical records review identified patients with moderate aortic valve (AV) stenosis from January 2008 and December 2012. Echocardiographic data were gathered, and the final 5-year clinical outcomes, defined as the composite of cardiovascular (CV) death, admission for heart failure (HF) aggravation, and AV replacement, were evaluated.

Results: Among 148 patients (mean age, 69.3 years; mean AV area, 1.24 cm2), 79 had adverse outcomes (16 CV deaths, 32 AV replacements, and 31 HF cases), during a mean follow-up of 5.6 years. The event group showed worse dyspnea of NYHA III-IV and a higher frequency of diabetes mellitus (DM). They had a higher frequency of moderate or moderate-to-severe functional mitral regurgitation (MR) and smaller AV area. In the multivariate analysis, DM (HR 2.29, 95% CI 1.03-5.10), moderate or moderate-to-severe MR (HR 4.84, 95% CI 1.66-10.07), and NYHA III-IV (HR 3.84, 95% CI 1.72-8.56) independently were associated with adverse outcomes.

Conclusions: The symptomatic patients with moderate AS had higher events than expected, and early intervention should be considered in case of concomitant MR and DM.
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http://dx.doi.org/10.1532/hsf.2971DOI Listing
May 2020

Assessment of Culprit Lesion of Optical Coherence Tomography in Patients With Acute Myocardial Infarction: a Case Report.

Authors:
Han Joon Bae

Heart Surg Forum 2020 02 25;23(1):E061-E062. Epub 2020 Feb 25.

Division of Cardiology, Department of Internal Medicine, Daegu Catholic University Medical Center, Daegu, Republic of Korea.

In general, patients with acute myocardial infarction (AMI) have severe stenosis secondary to a superimposed thrombus at the event. Optical coherence tomography (OCT) is a useful imaging tool for patients with AMI. This allows us to identify the site of ruptured plaque, erosion of fibrous cap, and characteristics of stenotic lesion. In this case, we present the difference of the ruptured cavity and obstructed lesion.
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http://dx.doi.org/10.1532/hsf.2679DOI Listing
February 2020

NOAC Adherence of Patients with Atrial Fibrillation in the Real World: Dosing Frequency Matters?

Thromb Haemost 2020 Feb 28;120(2):306-313. Epub 2019 Oct 28.

Division of Cardiology, Department of Internal Medicine, SM Christianity Hospital, Pohang, South Korea.

Background And Objectives:  Nonvitamin K antagonist oral anticoagulants (NOACs) require stricter medication adherence. We investigated the NOACs adherence in real-world practice.

Methods:  We screened all patients in our cardiology department the day before their outpatient appointment, over a 5-month period. We enrolled 719 consecutive patients who were taking NOACs for atrial fibrillation. The patients were contacted by phone or text to bring the remnant pills with them without any information why. Adherence was measured by the percentage of prescribed doses taken (PDT) (number of doses taken/number of doses expected to be taken from the last prescription × 100 [%]) and the Morisky Medication Adherence Scale (MMAS)-8.

Results:  All 4 NOACs (apixaban 47.8%, dabigatran 21.2%, rivaroxaban 18.4%, and edoxaban 12.6%) were prescribed. The mean duration that the patients had been taking NOACs was 7.2 ± 5.7 months. The PDT was 95.4 ± 9.1% in the once-daily dosing group and 93.4 ± 12.7% in the twice-daily group, and the difference was statistically significant ( = 0.017). The mean MMAS was 2.6 ± 0.8. The proportion of patients with a PDT < 80% was 7.8%. They had a significantly higher MMAS than the PDT ≥ 80% group (3.4 vs. 2.5;  = 0.000).

Conclusion:  Most patients who were taking NOACs had excellent adherence regardless of the dosing frequency. An MMAS ≥ 3 could be used as a simple screening tool for a poor NOAC adherence.
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http://dx.doi.org/10.1055/s-0039-1697954DOI Listing
February 2020

Five-Year Change in the Renal Function After Catheter Ablation of Atrial Fibrillation.

J Am Heart Assoc 2019 09 31;8(17):e013204. Epub 2019 Aug 31.

Yonsei University Health System Seoul Republic of Korea.

Background Although it has been reported that renal function can improve after catheter ablation of atrial fibrillation (AF), long-term changes in renal function and its relationship to rhythm outcomes have not yet been evaluated. We explored the 5-year change in estimated glomerular filtration rate (eGFR) in AF patients depending on medical therapy and catheter ablation. Methods and Results Among 1963 patients who underwent AF catheter ablation and 14 056 with AF under medical therapy in the National Health Insurance Service database, we compared 571 with AF catheter ablation (59±10 years old, 72.3% male, and 66.5% paroxysmal AF) and 1713 with medical therapy after 1:3 propensity-score matching. All participants had 5 years of serial eGFR data (Chronic Kidney Disease-Epidemiology Collaboration [CKD-EPI] method). Catheter ablation improved eGFR (P<0.001), but medical therapy did not. In 2284 matched patients, age (adjusted odds ratio [OR], 0.98 [0.97-0.99]; P<0.001) and AF catheter ablation (adjusted OR, 2.02 [1.67-2.46]; P<0.001) were independently associated with an improved eGFR. Among 571 patients who underwent AF ablation, freedom from AF/atrial tachycardia recurrence after the last AF ablation procedure was independently associated with an improved eGFR (adjusted OR, 1.44 [1.01-2.04]; P=0.043), especially in patients without diabetes mellitus (adjusted OR, 1.78 [1.21-2.63]; P=0.003, P for interaction=0.012). Although underlying renal dysfunction (<60 mL/min/1.73m) was associated with atrial structural remodeling (adjusted OR, 1.05 [1.00-1.11]; P=0.046), it did not affect the AF ablation rhythm outcome. Conclusions AF catheter ablation significantly improved renal function over a 5-year follow-up, especially in patients maintaining sinus rhythm without preexisting diabetes mellitus.
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http://dx.doi.org/10.1161/JAHA.119.013204DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6755838PMC
September 2019

Early efficacy and safety of statin therapy in Korean patients with hypercholesterolemia: Daegu and Gyeongbuk Statin Registry.

Korean J Intern Med 2020 03 19;35(2):342-350. Epub 2019 Aug 19.

Division of Cardiology, Department of Internal Medicine, Keimyung University Dongsan Hospital, Daegu, Korea.

Background/aims: To date, prospective data are limited on efficacy and safety profiles of statin therapy in Korean hypercholesterolemic patients. Hence, the aim of this study was to evaluate the practice patterns of statin therapy and its efficacy and safety through the prospective Daegu and Gyeongbuk statin registry.

Methods: Statin naïve patients who were prescribed statins according to the criteria of Korean Guidelines for Management of Dyslipidemia were enrolled. Clinical and laboratory evaluations were performed at baseline and at week 8, where the efficacy was assessed with the same guidelines.

Results: Of 908 patients, atorvastatin and rosuvastatin were most frequently prescribed statins (63.1% and 29.3%, respectively). High intensity statins (atorvastatin 40 mg or rosuvastatin 20 mg) were prescribed in 24.7% of all patients and in 79.5% of high and very high risk groups. The total and low density lipoprotein (LDL) cholesterol levels decreased from 203.7 ± 43.0 to 140.6 ± 28.6 mg/dL and 134.4 ± 35.7 to 79.5 ± 21.3 mg/dL, respectively. The achievement rate of the LDL target goal was 98.6% in low risk, 95.0% in moderate risk, 88.1% in high risk, and 42.1% in very high risk patients (59.7% in overall). There was no significant difference in the efficacy between atorvastatin and rosuvastatin. Adverse events were observed in 12.0% of patients and led to 1.4% of treatment cessation.

Conclusion: The efficacy of the usual starting dose of statins in daily practice was relatively insufficient for Korean hypercholesterolemic patients with high or very high risks. Short-term adverse events of statin therapy were not common in Korean patients with a low discontinuation rate.
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http://dx.doi.org/10.3904/kjim.2018.272DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7060999PMC
March 2020

Left Ventricular End-Systolic Volume Can Predict 1-Year Hierarchical Clinical Composite End Point in Patients with Cardiac Resynchronization Therapy.

Yonsei Med J 2019 Jan;60(1):48-55

Division of Cardiology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.

Purpose: This study aimed to elucidate which echocardiographic criteria at three time points, for cardiac resynchronization therapy (CRT) response, are accurate in discriminating the hierarchical clinical composite end point (HCCEP).

Materials And Methods: We included 120 patients (age, 66.1±12.6 years; men, 54.2%) who underwent CRT implantation for heart failure (HF). Echocardiography was performed before and at 3, 6, and 12 months after CRT implantation. The 1-year HCCEP included all-cause mortality, hospitalization for HF, and New York Heart Association functional class for 12 months. CRT response criteria were decrease in left ventricular (LV) end-systolic volume (LVESV) >15%, decrease in LV end-diastolic volume >15%, absolute increase in LV ejection fraction (LVEF) ≥5%, relative increase in LVEF ≥15%, and decrease in mitral regurgitation ≥1 grade. Temporal changes in CRT response rates, accuracy of CRT response criteria at each time and cutoff value for the discrimination of improvement in HCCEP, and agreements with improvement in HCCEP were analyzed.

Results: HCCEP improvement rates were 65.8% in total group. In nonischemic group, CRT response rates according to all echocardiographic criteria significantly increased with time. In ischemic group, CRT response rate did not significantly change with time. In total group, ΔLVESV at 6 months (ΔLVESV6) had the most significant accuracy for the discrimination of HCCEP (area under the curve=0.781). The optimal cutoff value of ΔLVESV6 was 13.5% (sensitivity=0.719, specificity=0.719). ΔLVESV6 had fair agreement with HCCEP (κ=0.391, <0.001).

Conclusion: ΔLVESV6 is the most useful echocardiographic CRT response criterion for the prediction of 1-year HCCEP.
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http://dx.doi.org/10.3349/ymj.2019.60.1.48DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6298892PMC
January 2019
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