Anatomic or Functional Evaluation as an Initial Test for Stable Coronary Artery Disease: A Propensity Score Analysis

Park, Gyung‐Min; Kim, Young‐Hak; Yun, Sung‐Cheol; Ahn, Jung‐Min; Choi, Hyo-In; Roh, Jae‐Hyung; Lee, Pil Hyung; Chang, Mineok; Kim, Tae Hyun; Jo, Min‐Woo; Park, Duk‐Woo; Kang, Soo–Jin; Lee, Seung-Whan; Lee, Cheol Whan; Moon, Dae Hyuk; Park, Seong-Wook; Park, Seung‐Jung

doi:10.2967/jnumed.115.169318

Cited by 9 publications

(12 citation statements)

References 30 publications

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“…In this current study, for the evaluation of clinical outcomes, the HIRA database was used until July 2016. 9) In patients with multiple events, the first event was considered to be the component of the composite outcome.…”

Section: Methodsmentioning

confidence: 99%

Trends, Characteristics, and Clinical Outcomes of Patients Undergoing Percutaneous Coronary Intervention in Korea between 2011 and 2015

et al. 2018

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Background and ObjectivesWe sought to evaluate nationwide trends, characteristics, and clinical outcomes in patients undergoing percutaneous coronary intervention (PCI) in Korea.MethodsFrom National Health Insurance claims data in Korea, 81,115 patients, who underwent PCI for the first episode of coronary artery disease between 2011 and 2015, were enrolled. Patients were categorized into angina (n=49,288) or acute myocardial infarction (AMI, n=31,887) groups and analyzed.ResultsThe mean age of patients was 64.4±12.2 years and 56,576 (69.7%) were men. Diabetes, hyperlipidemia, and hypertension were observed in 27,086 (33.4%), 30,675 (37.8%), and 45,389 (56.0%) patients, respectively. There was a 10% increase in the number of patients undergoing PCI for angina between 2011–2012 and 2014–2015 (11,105 vs. 13,261; p=0.021). However, the number of patients undergoing PCI for AMI marginally decreased between 2011–2012 and 2014–2015 (8,068 vs. 7,823; p=0.052). In procedures, drug-eluting stent was the most frequently used device (93.2%), followed by balloon angioplasty (5.5%) and bare metal stents (1.3%). The mean number of stents per patient was 1.39±0.64. At discharge, dual-anti platelet therapy, statin, beta-blockers, and angiotensin converting enzyme inhibitor or angiotensin receptor blocker were provided to 76,292 (94.1%), 71,411 (88.0%), 57,429 (70.8%), and 54,418 (67.1%) patients, respectively. The mean in-hospital and 1-year total medical costs were 8,628,768±4,832,075 and 13,128,158±9,758,753 Korean Won, respectively. In-hospital mortality occurred in 2,094 patients (2.6%).ConclusionsAppropriate healthcare strategies reflecting trends, characteristics, and clinical outcomes of PCI are needed in Korea.

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Section: Methodsmentioning

confidence: 99%

Trends, Characteristics, and Clinical Outcomes of Patients Undergoing Percutaneous Coronary Intervention in Korea between 2011 and 2015

et al. 2018

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“…In addition, owing to relatively low hard clinical event rates in patients with angina, it was difficult to make definitive conclusions as to the incremental clinical benefits of higher intensity statin therapy for hard clinical events, such as death and MI. However, our study has the advantage of well-controlled and reliable data from the nationwide database in Korea (i.e., a quasi-governmental organization) that enabled qualified analyses for the moderate- versus high-intensity statin therapies in angina patients undergoing PCI with DES [11, 16].…”

Section: Discussionmentioning

confidence: 99%

“…Death was identified by all in- and out-patient claims that indicated death. MI was defined using the hospital discharge databases of the HIRA (ICD-10 codes I21.X–22.X) [16]. In this current study, for the evaluation of clinical outcomes, the HIRA database was used until June 2016.…”

Section: Methodsmentioning

confidence: 99%

Moderate-intensity versus high-intensity statin therapy in Korean patients with angina undergoing percutaneous coronary intervention with drug-eluting stents: A propensity-score matching analysis

Park

Han

et al. 2018

PLoS ONE

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ObjectivesIt is unclear whether high-intensity statin therapy provides incremental clinical benefits over moderate-intensity statin therapy in Asian patients with angina. This study sought to compare the clinical outcomes of moderate- and high-intensity statin therapies in patients undergoing percutaneous coronary intervention (PCI) for angina in Korean patients.MethodsBased on the national health insurance claims data in South Korea, patients aged 18 years or older without a known history of coronary artery disease, who underwent PCI with drug-eluting stents due to angina between 2011 and 2015, were enrolled. According to the intensity of statin therapy, patients were categorized into moderate-intensity statin therapy (n = 23,863) and high-intensity statin therapy (n = 9,073) groups. The primary endpoint, defined as a composite of all-cause death and myocardial infarction, was compared between the two groups using a propensity-score matching analysis.ResultsDuring the follow-up period (median, 2.0 years; interquartile range, 1.1–3.1), 1,572 patients had 1,367 deaths and 242 myocardial infarctions. After propensity-score matching, there were 8,939 matched pairs. There was no significant difference in the incidence of the primary endpoint between the two groups (adjusted hazard ratio of high-intensity statin therapy, 1.093; 95% confidence interval: 0.950–1.259; p = 0.212).ConclusionsIn Korean patients undergoing PCI with drug-eluting stents for angina, the high-intensity statin therapy did not provide additional clinical benefits over the moderate-intensity statin therapy.

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“…The SPECT/CT is acquired during the same period of time as in the renal planar scintigraphy, and the volume of interest (VOI) is drawn on each kidney for the quantification of absolute radioactivity. The measurement of GFR using 99m Tc-DTPA SPECT/CT was reproducible and accurate in healthy volunteers and renal tumor patients post partial nephrectomy and useful for disease severity evaluation in urinary stone patients 6,7 . However, the necessity of manual drawing of the VOI on the whole renal parenchyma in CT images is an obstacle that prevents the wide use of this new approach.…”

Section: Introductionmentioning

confidence: 90%

“…However, the necessity of manual drawing of the VOI on the whole renal parenchyma in CT images is an obstacle that prevents the wide use of this new approach. The labor-intensive and time-consuming manual drawing usually takes about 15 min per scan by nuclear medicine physicians 6,7 .…”

Section: Introductionmentioning

confidence: 99%

Measurement of Glomerular Filtration Rate using Quantitative SPECT/CT and Deep-learning-based Kidney Segmentation

Park

Bae

Seo

et al. 2019

Sci Rep

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Quantitative SPECT/CT is potentially useful for more accurate and reliable measurement of glomerular filtration rate (GFR) than conventional planar scintigraphy. However, manual drawing of a volume of interest (VOI) on renal parenchyma in CT images is a labor-intensive and time-consuming task. The aim of this study is to develop a fully automated GFR quantification method based on a deep learning approach to the 3D segmentation of kidney parenchyma in CT. We automatically segmented the kidneys in CT images using the proposed method with remarkably high Dice similarity coefficient relative to the manual segmentation (mean = 0.89). The GFR values derived using manual and automatic segmentation methods were strongly correlated (R2 = 0.96). The absolute difference between the individual GFR values using manual and automatic methods was only 2.90%. Moreover, the two segmentation methods had comparable performance in the urolithiasis patients and kidney donors. Furthermore, both segmentation modalities showed significantly decreased individual GFR in symptomatic kidneys compared with the normal or asymptomatic kidney groups. The proposed approach enables fast and accurate GFR measurement.

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Anatomic or Functional Evaluation as an Initial Test for Stable Coronary Artery Disease: A Propensity Score Analysis

Cited by 9 publications

References 30 publications

Trends, Characteristics, and Clinical Outcomes of Patients Undergoing Percutaneous Coronary Intervention in Korea between 2011 and 2015

Trends, Characteristics, and Clinical Outcomes of Patients Undergoing Percutaneous Coronary Intervention in Korea between 2011 and 2015

Moderate-intensity versus high-intensity statin therapy in Korean patients with angina undergoing percutaneous coronary intervention with drug-eluting stents: A propensity-score matching analysis

Measurement of Glomerular Filtration Rate using Quantitative SPECT/CT and Deep-learning-based Kidney Segmentation

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