BACKGROUND Patients with coronary artery disease and impaired renal function are at higher risk for both bleeding and ischemic adverse events after percutaneous coronary intervention (PCI). OBJECTIVES This study assessed the efficacy and safety of a prasugrel-based de-escalation strategy in patients with impaired renal function. METHODS We conducted a post hoc analysis of the HOST-REDUCE-POLYTECH-ACS study. Patients with available estimated glomerular filtration rate (eGFR) (n = 2,311) were categorized into 3 groups. (high eGFR: >90 mL/min; intermediate eGFR: 60 to 90 mL/min; and low eGFR: <60 mL/min). The end points were bleeding outcomes (Bleeding Academic Research Consortium type 2 or higher), ischemic outcomes (cardiovascular death, myocardial infarction, stent thrombosis, repeated revascularization, and ischemic stroke), and net adverse clinical event (including any clinical event) at 1-year follow-up. RESULTS Prasugrel de-escalation was beneficial regardless of baseline renal function (P for interaction = 0.508). The relative reduction in bleeding risk from prasugrel de-escalation was higher in the low eGFR group than in both the intermediate and high eGFR groups (relative reductions, respectively: 64% (HR: 0.36; 95% CI: 0.15-0.83) vs 50% (HR: 0.50; 95% CI: 0.28-0.90) and 52% (HR: 0.48; 95% CI: 0.21-1.13) (P for interaction = 0.646). Ischemic risk from prasgurel de-escalation was not significant in all eGFR groups (HR: 1.18 [95% CI: 0.47-2.98], HR: 0.95 [95% CI: 0.53-1.69], and HR: 0.61 [95% CI: 0.26-1.39]) (P for interaction = 0.119). CONCLUSIONS In patients with acute coronary syndrome receiving PCI, prasugrel dose de-escalation was beneficial regardless of the baseline renal function. (c) 2023 The Authors. Published by Elsevier on behalf of the American College of Cardiology Foundation. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

Purpose:This study aimed to assess the effectiveness and safety of a fixed-dose combination of rosuvastatin and valsartan (Rovatitan®) in Korean patients with concomitant hypertension and hyperlipidemia. Patients and Methods:A total of 1008 eligible patients with concomitant hypertension and hyperlipidemia were enrolled and treated for 12 weeks. Both upward and downward drug dose titrations were allowed based on the investigator's discretion. This study evaluated the effectiveness of the study drug, defined by the percentage of patients achieving the blood pressure (BP) and low-density lipoprotein cholesterol (LDL-C) treatment targets. Additionally, regression analyses were conducted to evaluate the factors associated with the effectiveness and safety of the study drug. Of the 1008 patients enrolled in the study, 911 were analyzed for clinical effectiveness. Results:At 12 weeks, 84.6% and 75.9% of patients treated with the study drug achieved their BP and LDL-C targets, respectively, and 64.8% of patients achieved both targets simultaneously. Furthermore, the percentage of patients who achieved their BP and LDL-C treatment targets demonstrated a trend across the respective risk groups; the higher the risk group, the lower the success of attaining the respective target. This trend was also observed regardless of the prior antihypertensive and/or lipid-lowering treatments. According to regression analysis, poor metabolic profiles, including a higher body mass index (BMI) and higher BP and LDL-C levels at baseline, were significantly associated with treatment failure for BP. Among the 1005 patients included in the safety analysis, 17 patients (1.7%) experienced serious adverse events; however, none were considered related to the study drug. Conclusion:The study drug used for the treatment of concomitant hypertension and hyperlipidemia in a real-world setting was effective and was well tolerated. Therefore, the study drug is suggested as a good alternative to increase patient convenience and compliance, particularly in those taking multiple medications.

BACKGROUND Clopidogrel was superior to aspirin monotherapy in secondary prevention after percutaneous coronary intervention (PCI).OBJECTIVES The purpose of this study was to evaluate the benefits of clopidogrel across high-risk subgroupsMETHODS This was a post hoc analysis of the HOST-EXAM (Harmonizing Optimal Strategy for Treatment of coronary artery diseases-EXtended Antiplatelet Monotherapy) trial that randomly assigned patients who were event free for 6 to 18 months post-PCI on dual antiplatelet therapy (DAPT) to clopidogrel or aspirin monotherapy. Two clinical risk scores were used for risk stratification: the DAPT score and the Thrombolysis In Myocardial Infarction Risk Score for Secondary Prevention (TRS 2(degrees)P) (the sum of age >= 75 years, diabetes, hypertension, current smoking, peripheral artery disease, stroke, coronary artery bypass grafting, heart failure, and renal dysfunction). The primary composite endpoint was a composite of all-cause death, nonfatal myocardial infarction, stroke, readmission because of acute coronary syndrome, and major bleeding (Bleeding Academic Research Consortium type >= 3) at 2 years after randomization.RESULTS Among 5,403 patients, clopidogrel monotherapy showed a lower rate of the primary composite endpoint than aspirin monotherapy (HR: 0.73; 95% CI: 0.59-0.90). The benefit of clopidogrel over aspirin was consistent regardless of TRS 2(degrees)P (high TRS 2(degrees)P [>= 3] group: HR: 0.65 [95% CI: 0.44-0.96]; and low TRS 2(degrees)P [<3] group: HR: 0.77 [95% CI: 0.60-0.99]) (P for interaction = 0.454) and regardless of DAPT score (high DAPT score [>= 2] group: HR: 0.68 [95% CI: 0.46-1.00]; and low DAPT score [<2] group: HR: 0.75 [95% CI: 0.59-0.96]) (P for interaction = 0.662). The association was similar for the individual outcomes.CONCLUSIONS The beneficial effect of clopidogrel over aspirin monotherapy was consistent regardless of clinical risk or relative ischemic and bleeding risks compared with aspirin monotherapy.

The authors performed this study to investigate the efficacy and safety of a rosuvastatin (RSV)/amlodipine (AML) polypill compared with those of atorvastatin (ATV)/AML polypill. We included 259 patients from 21 institutions in Korea. Patients were randomly assigned to 1 of 3 treatment groups: RSV 10 mg/AML 5 mg, RSV 20 mg/AML 5 mg, or ATV 20 mg /AML 5 mg. The primary endpoint was the efficacy of the RSV 10.20 mg/AML 5 mg via percentage changes in LDL‐C after 8 weeks of treatment, compared with the ATV 20 mg /AML 5 mg. There was a significant difference in the mean percentage change of LDL‐C at 8 weeks between the RSV 10 mg/AML 5 mg and the ATV 20 mg/AML 5 mg (full analysis set [FAS]: −7.08%, 95% CI: −11.79 to −2.38, p = .0034, per‐protocol analysis set [PPS]: −6.97%, 95% CI: −11.76 to −2.19, p = .0046). Also, there was a significant difference in the mean percentage change of LDL‐C at 8 weeks between the RSV 20 mg/AML 5 mg and the ATV 20 mg/AML 5 mg (FAS: −10.13%, 95% CI: −15.41 to −4.84, p = .0002, PPS: −10.96%, 95% CI: −15.98 to −5.93, p < .0001). There was no significant difference in the adverse events rates between RSV 10 mg/AML 5 mg, RSV 20 mg/AML 5 mg, and ATV 20 mg/AML 5 mg. In conclusion, while maintaining safety, RSV 10 mg/AML 5 mg and the RSV 20 mg/AML 5 mg more effectively reduced LDL‐C compared with the ATV 20 mg /AML 5 mg (Clinical trial: NCT03951207).

Objective This study aimed to compare the mean pulse rate (PR) and mean blood pressure (BP) between patients with obstructive sleep apnea (OSA) and those with simple snoring (SS) during a 24-hour period, and to investigate the correlation between apnea-hypopnea index (AHI), PR, and BP in sleep-related breathing disorder (SRBD) patients with and without hypertension, diabetes mellitus (DM), and cardiovascular diseases (CVDs). Methods Ninety SRBD patients underwent full-night polysomnography, and ambulatory BP and PR were monitored for 24 hours. Participants were classified into OSA (AHI ≥ 5) and control (SS) (AHI < 5) groups, and BP and PR were compared. Participants were also divided into groups with and without hypertension, CVDs, or DM to analyze the correlation between AHI, BP, and PR in each group. Results Mean PRs during the daytime period and during the whole 24-hour period in the OSA group were significantly higher than those in the SS group after controlling for potential confounders. No significant difference was observed in mean BP between the groups. Partial correlation analysis after controlling for confounders showed significant correlation between AHI and PR during daytime and the 24-hour period in participants without hypertension, DM, or CVDs, but not in participants with these conditions. Conclusion The significant differences and correlations only in PR (not in BP) found in this study suggest that PR could be an early marker for SRBD in individuals without comorbidities, and that an increased sympathetic tone could be responsible for future occurrence of CVD.

This corrects the article on p. 304 in vol. 52, PMID: 35129316.

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. Conclusions 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.

Importance:Data on P2Y12 inhibitor monotherapy after short-duration dual antiplatelet therapy (DAPT) in patients undergoing percutaneous coronary intervention are limited.Objective:To determine whether P2Y12 inhibitor monotherapy after 3 months of DAPT is noninferior to 12 months of DAPT in patients undergoing PCI.Design, Setting, and Participants:The SMART-CHOICE trial was an open-label, noninferiority, randomized study that was conducted in 33 hospitals in Korea and included 2993 patients undergoing PCI with drug-eluting stents. Enrollment began March 18, 2014, and follow-up was completed July 19, 2018.Interventions:Patients were randomly assigned to receive aspirin plus a P2Y12 inhibitor for 3 months and thereafter P2Y12 inhibitor alone (n = 1495) or DAPT for 12 months (n = 1498).Main Outcomes and Measures:The primary end point was major adverse cardiac and cerebrovascular events (a composite of all-cause death, myocardial infarction, or stroke) at 12 months after the index procedure. Secondary end points included the components of the primary end point and bleeding defined as Bleeding Academic Research Consortium type 2 to 5. The noninferiority margin was 1.8%.Results:Among 2993 patients who were randomized (mean age, 64 years; 795 women [26.6%]), 2912 (97.3%) completed the trial. Adherence to the study protocol was 79.3% of the P2Y12 inhibitor monotherapy group and 95.2% of the DAPT group. At 12 months, major adverse cardiac and cerebrovascular events occurred in 42 patients in the P2Y12 inhibitor monotherapy group and in 36 patients in the DAPT group (2.9% vs 2.5%; difference, 0.4% [1-sided 95% CI, -∞% to 1.3%]; P = .007 for noninferiority). There were no significant differences in all-cause death (21 [1.4%] vs 18 [1.2%]; hazard ratio [HR], 1.18; 95% CI, 0.63-2.21; P = .61), myocardial infarction (11 [0.8%] vs 17 [1.2%]; HR, 0.66; 95% CI, 0.31-1.40; P = .28), or stroke (11 [0.8%] vs 5 [0.3%]; HR, 2.23; 95% CI, 0.78-6.43; P = .14) between the 2 groups. The rate of bleeding was significantly lower in the P2Y12 inhibitor monotherapy group than in the DAPT group (2.0% vs 3.4%; HR, 0.58; 95% CI, 0.36-0.92; P = .02).Conclusions and Relevance:Among patients undergoing percutaneous coronary intervention, P2Y12 inhibitor monotherapy after 3 months of DAPT compared with prolonged DAPT resulted in noninferior rates of major adverse cardiac and cerebrovascular events. Because of limitations in the study population and adherence, further research is needed in other populations.Trial Registration:ClinicalTrials.gov Identifier: NCT02079194.

Purpose: The aim of this study was to evaluate the blood pressure-lowering and cholesterol-lowering effects of a fixed-dose combination therapy using candesartan (CND)/rosuvastatin (RSV) compared with CND or RSV monotherapy in patients with hypertension and hypercholesterolemia. Methods: This study was a 12-week, randomized, double-blind, placebo-controlled, multicenter study. A total of 394 patients were screened. After a 4-week run-in period, 219 of these patients with hypertension and primary hypercholesterolemia were randomized. Patients received 1 of 3 regimens for 8 weeks: (1) CND 32 mg/RSV 20 mg, (2) RSV 20 mg, or (3) CND 32 mg. The primary outcome variables were changes in the systolic blood pressure (SBP) and diastolic blood pressure (DBP) and the percentage changes in LDL-C from baseline to the drug treatment at 8 weeks. The secondary outcome variables were percentage changes of total cholesterol, triglycerides, HDL-C, non-HDL-C, apolipoprotein B, apolipoprotein A-I, high-sensitivity C-reactive protein, and glucose metabolic indices, including percentage changes of the homeostasis model assessment of insulin resistance (HOMA-IR), adiponectin, and hemoglobin Air. Tolerability of combination therapy was compared with other monotherapy groups. Findings: The percentage changes of LDL-C were-48.6% (from 157.2 to 80.1 mg/dL) in the RSV group and -49.8% (from 160.2 to 78.9 mg/dL) in the CND/RSV group from baseline to the end of 8 weeks of treatment. Mean SBP and DBP were significantly decreased in the CND/RSV and CND groups after 8 weeks (P < 0.001 for all); however, no significant differences were found between the 2 groups. Total cholesterol levels, triglycerides, non-HDL-C, and apolipoprotein B were significantly reduced in the CND/RSV and RSV groups, with no significant differences between the groups compared with the CND group (P < 0.001 for all). The percentage changes of HOMA-IR, adiponectin, and hemoglobin A(1c) had no significant differences between the combination groups and monotherapy groups. However, in a 2-sample t test, HOMA-IR was significantly decreased in the CND/RSV group compared with the RSV group in nondiabetic patients (mean [SD] percentage change of HOMA-IR,-8.7% [37.6%] vs 17.1% [53.1%]; P = 0.048). There were no significant differences in metabolic indices between the diabetic groups. Adverse events in the CND/RSV group were similar to those in the monotherapy group. (C) 2019 Elsevier Inc. All rights reserved.

The POST (the effects of postconditioning on myocardial reperfusion in patients with ST-Segment elevation myocardial infarction) study showed that ischemic postconditioning did not improve myocardial reperfusion in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI). However, it has not been determined whether postconditioning is effective in women. This study sought to evaluate the impact of sex differences on ischemic postconditioning during the primary PCI. We analyzed clinical outcomes at 1 year in the 537 men and 163 women with STEMI, who were randomized to the postconditioning or to the conventional PCI group. Women were older, had higher rates of hypertension, were less likely to be current smokers, and had longer symptom-to-reperfusion time. The rate of major adverse cardiac events (MACE: a composite of death, myocardial infarction, severe heart failure, stent thrombosis, or target vessel revascularization) at 1 year was higher in women compared to men (9.8% vs. 5.4%, p = 0.044). MACE was significantly higher in women compared to men in the postconditioning group (12.2% vs. 5.4%, p = 0.042), but not in the conventional PCI group (7.9% vs. 5.4%, p = 0.391). However, women was not an independent predictor after adjusting baseline risk factors, angiographic and procedural parameters (HR 2.67, 95% CI 0.68–10.5, p = 0.158). Despite women having more adverse clinical characteristics, their prognosis was similar to men in the conventional group. Although women showed a higher rate of the MACE compared to men, women were not an independent predictor in the postconditioning group.

Background and Objectives Diffuse long coronary artery disease (DLCAD) still has unfavorable clinical outcomes after successful percutaneous coronary intervention (PCI). Therefore, we aimed to evaluate the effectiveness and safety of Resolute™ zotarolimus-eluting stent (R-ZES; Resolute™ Integrity) for patients with DLCAD. Methods From December 2011 to December 2014, 1,011 patients who underwent PCI using R-ZES for CAD with longer than 25 mm lesion were prospectively enrolled from 21 hospitals in Korea. We assessed the clinical outcome of major adverse cardiac events (MACE) defined as the composite of cardiac death, non-fatal myocardial infarction (MI), and clinically-driven target vessel revascularization at 12 months. Results Mean age was 63.8±10.8 years, 701 (69.3%) patients were male, 572 (87.0%) patients had hypertension, 339 (33.8%) patients had diabetes, 549 (54.3%) patients diagnosed with acute MI and 545 (53.9%) patients had multi-vessel disease (MVD). A total of 1,697 stents were implanted into a total of 1,472 lesions. The mean diameter was 3.07±0.38 mm and the length was 28.27±6.97 mm. Multiple overlapping stents were performed in 205 (13.8%) lesions. A 12-month clinical follow-up was available in 1,004 patients (99.3%). The incidences of MACE and definite stent thrombosis at 12-month were 3.0% and 0.3% respectively. On multivariate Cox-regression analysis, multiple overlapping stents implantation, previous congestive heart failure, MVD, and age ≥75 years were independent predictors of one-year MACE. Conclusions Our study shows that R-ZES has an excellent 1-year clinical outcome in Korean patients with DLCAD.

Background: There are limited data on the long-term outcome of platinum chromium-based everolimus-eluting stents (PtCr-EES) vs. cobalt chromium-based zotarolimus-eluting stents (CoCr-ZES). Methods and Results: A total of 3,755 patients undergoing percutaneous coronary intervention (PCI) were randomized 2: 1 to PtCr-EES or CoCr-ZES, and 96.0% of patients completed the 3-year clinical follow-up. The primary outcome was target lesion failure (TLF), defined as a composite of cardiac death, target vessel-related myocardial infarction (MI), and clinically-driven target lesion revascularization (TLR). At 3 years, TLF occurred in 5.3% and in 5.4% of the PtCr-EES and CoCr-ZES groups, respectively (hazard ratio 0.978; 95% confidence interval 0.730-1.310, P=0.919). There were no significant differences in the individual components of TLF. Routine angiographic follow-up was performed in 38.9% of the total patients. In a landmark analysis of the subgroup that had follow-up angiography, the clinically-driven TLR rate of CoCr-ZES was significantly higher than PtCr-EES group during the angiography follow-up period (P=0.009). Overall definite and probable stent thrombosis rates were very low in both groups (0.5% vs. 0.6%, P=0.677). Conclusions: PtCr-EES and CoCr-ZES had similar and excellent long-term outcomes in both efficacy and safety after PCI in an all-comer population.

Objective: There is lack of evidence for the benefit of treatment in uncomplicated, low risk grade I hypertension. As such, some of the major guidelines recommend treatment for grade I hypertensives who have underlying cardiovascular disease, or are at high risk. Design and method: From National Health Insurance Service (NHIS) Health Examination Database, subjects with grade I hypertension between 2005 and 2006 were selected and followed-up until December, 2015. The subjects had a SBP of 140–159 mmHg and/or DBP of 90–99 mmHg and were not undergoing treatment at baseline. Subjects were grouped into controlled (<140/90 mmHg; n = 99,301) and uncontrolled group (> = 140/90 mmHg; n = 49,460) according to mean of the BP recorded during follow-up health examination. All-cause death and cardiovascular outcomes including myocardial infarction (MI), ischemic stroke, hemorrhagic stroke, and end stage renal disease (ESRD) were examined by using Cox proportional hazard models with covariate adjustment method using the propensity scores. Results: Median follow-up duration was 124 months (IQR: 116–131). Compared to subjects with uncontrolled BP, controlled group had significantly lower risk of all-cause death (HR, 0.50; 95% CI, 0.48–0.52; p < 0.0001). For non-fatal events, controlled BP was associated with the lower risk of all stroke (HR, 0.88; 95% CI, 0.82–0.93; p < 0.0001), hemorrhagic stroke (HR, 0.75; 95% CI, 0.66–0.85; p < 0.0001), ischemic stroke (HR, 0.91; 95% CI, 0.84–0.98; p = 0.0083), and ESRD (HR, 0.42; 95% CI, 0.30–0.59; p < 0.0001). There was no significant difference between the two groups for non-fatal MI. Importantly, the benefit was evident in young aged hypertensives below the age of 50. The optimal level of BP associated with the lowest risk of all-cause mortality was 120 to < 130 mmHg for SBP and 70 to < 80 mmHg for DBP. However, there was increased risk of MI for subjects with SBP of < 120 mmHg and DBP of 70 to < 80 mmHg. Conclusions: In a large cohort of treated low risk, grade I hypertensive subjects, BP below 140/90 mmHg was associated with significant reduction in the risk of mortality, stroke and ESRD, with the lowest risk of mortality in the range of 120 to < 130 mmHg and 70 to < 80 mmHg.

Hypertension and dyslipidemia are major risk factors of cardiovascular disease (CVD) events. The objective of this study was to evaluate the efficacy and safety of the co-administration of fimasartan and rosuvastatin in patients with hypertension and hypercholesterolemia.

Chronic kidney disease (CKD) is an independent risk factor for the development of coronary artery disease, and for the progression to more severe coronary heart disease.1) CKD is also associated with adverse outcomes in those with existing cardiovascular disease.2) The most frequent cause of CKD is diabetic nephropathy. Nearly 45% of incident renal failure is attributed to diabetes and another 20% is attributed to chronic hypertension.3) Nowadays it is not uncommon for interventional cardiologists to encounter diabetic patients with associated CKD in proportion to increasing numbers of patients who need percutaneous coronary intervention (PCI). The large numbers of patients with CKD treated with PCI have been found to suffer from a markedly higher mortality of about 40% within 3-4 years after PCI.4) Patients with diabetic nephropathy undergoing PCI have increased risk of contrast-induced nephropathy (CIN), an annoying problem not to be overlooked. There is a complicated relationship between CIN, comorbidity, and mortality. Abe et al.5) reported that CIN was significantly correlated with long-term mortality in patients with CKD but not in those without CKD. During the last decade, there have been remarkable advancements in optimal medical therapy, interventional techniques and devices, which made it possible to reduce procedure-related complications in patients undergoing PCI. It was expected that these advancements would reduce the adverse effect of CKD on clinical outcomes. However, updated data sets reflecting these changes are rare. Significantly, the study performed by Kim et al.6) provides the latest data regarding the impact of CKD for clinical outcomes in patients undergoing PCI.

Objective: Arterial stiffness is a major contributor to cardiovascular disease. Recently, pulse wave velocity (PWV) is used to assess arterial stiffness. But, few studies have assessed arterial stiffness using real arterial blood pressure (BP). Design and Method: A total of 54 patients who underwent coronary angiography (CAG) via radial approach were enrolled. All patients were recorded brachial arterial (BA) BP curve via direct radial sheath during BP measurement using automated BP machine (Omron HEM 7080IT). In BA BP curve, all patients were measured the degree of changes in BP during deflation twice. ‘Baseline BP’ (bBP) is defined as the BP at first pulse during BP cuff deflation. ‘Peak BP’ (pBP) is defined as the highest BP during BP cuff deflation. ‘Stable BP’ (sBP) is defined as the lowest BP after BP cuff deflation. Difference between bBP and pBP (BPP) is calculated as ‘pBP - bBP’. Difference between pBP and sBP (PSP) is calculated as ‘pBP - sBP’. Difference Values of BPP and PSP were adjusted by BA systolic BP (SBP). Adjusted BPP (aBPP) is calculated as (pBP - bBP)/BA SBP, and adjusted PSP (aPSP) is calculated as (pBP - sBP)/BA SBP. Of 54 patients, 29 patients were measured brachial-ankle PWV (baPWV). All baPWV were performed within 5 days after CAG. Results: Mean age was 63.4 years and female was 44.4% (n = 24). Mean aBPP was 0.625 ± 0.110, and mean aPSP was 0.140 ± 0.483. The aBPP was moderately positive correlated with baPWV (r = 0.463, p = 0.011) and aPSP was also moderately positive correlation with baPWV (r = 0.493, p = 0.007). In multivariate analysis after adjustment, aBPP (p = 0.033) and aPSP (p = 0.022) were correlated with baPWV. Conclusions: The differences of BP in accordance with rise and fall of BP after re-flow of brachial artery might be predict arterial stiffness.

Purpose: The aim of this study was to evaluate the efficacy and tolerability of rosuvastatin/ezetimibe combination therapy in Korean patients with high cardiovascular risk. Methods: This was a 12-week, randomized, double-blind, placebo-controlled, multicenter study. A total of 337 patients were screened. After a 4-week run-in period, 245 of these patients with high or moderately high risk as defined by the National Cholesterol Education Program Adult Treatment Panel III guidelines were randomly assigned. Patients received 1 of 6 regimens for 8 weeks as follows: (1) rosuvastatin 5 mg, (2) rosuvastatin 5 mg/ezetimibe 10 mg, (3) rosuvastatin 10 mg, (4) rosuvastatin 10 mg/ezetimibe 10 mg, (5) rosuvastatin 20 mg, or (6) rosuvastatin 20 mg/ezetimibe 10 mg. The primary outcome variable was percentage change in the level of LDL-C at week 8 of drug treatment. Secondary outcome variables included percentage changes of other lipid variables and achievement rates of LDL-C targets. Tolerability analyses were also performed. Findings: The percentage change of LDL-C ranged from -45% to -56% (mean, -51%) in the mono therapy groups and from -58% to -63% (mean, -60%) in the combination therapy groups. The percentage change was greater in the pooled combination therapy group than in the counterpart (P < 0.001 for the pooled groups); this difference was more obvious for regimens with a lower statin dose. The percentage reductions of total cholesterol and triglycerides were greater in the combination groups than in the mono therapy groups. The LDL-C target achievement rates were 64% to 87% (mean, 73%) in the monotherapy groups and 87% to 95% (mean, 91%) in the combination groups (P = 0.01 for the pooled groups). The rates were significantly greater in patients receiving the combination therapy than in the monotherapy at lower doses of rosuvastatin. The proportions of patients with various adverse events were not significantly different between the groups. (C) 2017 Elsevier HS Journals, Inc. All rights reserved.

Objective: Accurate measurement of blood pressure (BP) is important in diagnosis and treatment of hypertension. Non-invasive BP, including automated oscillometric BP (NBP) measurement has become increasingly popular and is now gaining more and more acceptance by patients and clinicians. But few studies show the difference between NBP and invasive arterial blood pressure (IBP). The aim of this study was to evaluate how accurate NBP compared to IBP and what are normal values for NBP. Design and Method: The study was a prospective analysis of the findings in patients performed invasive coronary angiography. A total of 88 patients who underwent angiography via radial approach were enrolled. All patients were measured IBP to use radial sheath directly and NBP to use automated BP device (Omron HEM 7080IT). 54 of 88 patients were also measured manual BP (MBP) using mercury sphygmomanometer. All measurements of BP were performed in cardiac catheterization laboratory, twice. Degree of difference between NBP and IBP was calculated as ‘mean IBP – mean NBP’ Results: Mean age of subjects was 63.84 ± 10.34 and 39 were female. Mean IBP was 141.6/72.33 ± 21.4/9.8 mmHg, mean NBP was 137.34/74.97 ± 21.6/9.5 mmHg and mean MBP was 137.03/78.37 ± 22.0/10.8 mmHg. Mean systolic IBP was significantly higher compared with NBP and MBP (respectively p = 0.001, p = 0.002). However, mean diastolic IBP was significantly lower compared with NBP and MBP (respectively p < 0.001, p < 0.001). Difference between mean systolic NBP and mean systolic MBP was not significant (p = 0.536). Age, sex, history of hypertension, diabetes and smoking did not correlate with difference of BP by measurement methods. Conclusions: Non-invasive systolic BP was underestimated comparing to the invasive systolic BP. On the contrary, Non-invasive diastolic BP was overestimated comparing to invasive diastolic BP. In non-invasive measurements, there was no significant difference between systolic MBP and ABP.

Objective: It is difficult to quantify arterial stiffness directly in a focal area of elastic artery such as the aorta within these modalities. The purpose of this study was to determine the feasibility of assessment of aortic distensibility (AD) with analysis of Cardiac computed tomography (CCT) by comparing distensibility of the descending aorta between patients with coronary artery disease (CAD group) and without CAD (non-CAD group). Design and Method: The study was a retrospective analysis of the findings in 69 patients who performed cardiac MDCT for evaluation of chest pain symptoms (n = 34 in CAD group, n = 35 in non-CAD group). The 69 subjects was performed 64 channel cardiac MDCT and Scan data were reconstructed at 20 phases between 0% and 95% of the R-R intervals with an increment of 5%. Pixel-based measurements of arterial dimensions were performed at 1 cross-section of the descending aorta in a transverse plane at the aortic valve level. End diastole area was measured at 95% of R-R interval and end systolic area was measured at 35% of R-R interval. Aortic distensibility was calculated as follows: AD = (end systolic area - end diastolic area)/ (end diastolic area × pulse pressure). For the measurement of pulse wave velocity (PWV), carotid-femoral (cfPWV), femoral-dorsalis (fdPWV) and carotid-radial (crPWV) was measured with the subject in a supine position using automatic device. Results: Hypertension was significantly higher in CAD group than non-CAD group. Figure showed the differences of AD and PWV between CAG group and non-CAD group. The AD was significantly smaller in patients with CAD (AD; change in area/mmHg: 1.53 ± 1.11 × 10–3 in CAD vs 2.17 ± 1.18 × 10–3 in without CAD, p = 0.002). Conclusions: AD is associated with atherosclerosis of the coronary arteries. Cardiac CT enables to assess direct and noninvasive measurements of aortic distensibility.