https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/114 Sat, 04 Apr 2026 08:36:00 GMT 2026-04-04T08:36:00Z https://scholarworks.korea.ac.kr/kumedicine/handle/2021.sw.kumedicine/64066 Title: COMPARISON OF EFFECTS OF BLOOD PRESSURE, BLOOD GLUCOSE AND LIPID VARIABILITY ON CARDIOVASCULAR PROGNOSIS IN DIABETIC PATIENTS Authors: Joo, Hyung Joon; Chung, Se Hwa; Kim, Yong Hyun; Kim, Eung Ju Abstract: Objective: Metabolic abnormalities such as dyslipidemia, glucose and high blood pressure are common in diabetic patients. Variabilities in these measures have been reported as a potential residual cardiovascular risk factors. This study aimed to analyze the relationship between variabilities of blood pressure, blood glucose, total cholesterol and triglyceride levels (metabolic variability parameters) and their effects on cardiovascular prognosis in diabetic patients. Design and method: A total of 22,310 diabetic patients aged 40 years or older who had their blood pressure, blood glucose, total cholesterol, and triglyceride levels measured three or more times for three years after January 1, 2017 at three tertiary general hospitals were selected. They were divided into high/low groups based on their systolic blood pressure (SBP), blood glucose, total cholesterol (TC) and triglyceride coefficient of variation (CV) over a 3-year period. The incidence of major adverse cardiovascular events (MACE), a composite of cardiovascular death, myocardial infarction, and stroke, was compared between groups, and significant risk factors for MACE were estimated by multivariable Cox regression analysis. Results: The number of measurements for 3 years was 15.1 times for SBP, 7.8 times for TC, 6.9 times for triglyceride, and 8.6 times for glucose. The correlation between the CV of SBP and the CV of glucose was highest, and the correlation between the CV of SBP and the CV of triglycerides was the lowest. All groups with high CV had a higher incidence of MACE than those with low CV (2.5% vs 6.0% for SBP CV groups, 3.0% vs 5.5% for TC CV groups, 3.8% vs 4.7% for triglyceride CV groups, 2.7% vs 5.8% for glucose CV groups). Multivariable Cox regression analysis suggested male, creatinine, prior myocardial infarction, SCORE2, SBP CV, TC CV, mean TC, and mean triglyceride as independent risk predictors for MACE in diabetic patients (HR 1.087 (95% CI 1.068 – 1.107) for SBP CV, 1.023 (1.016 – 1.031) for TC CV). Conclusions: Metabolic variability parameters, especially SBP CV and TC CV are important residual risk factors for cardiovascular events in diabetic patients. Mon, 01 Jan 202306 00:00:00 GMT https://scholarworks.korea.ac.kr/kumedicine/handle/2021.sw.kumedicine/64066 202306-01-01T00:00:00Z https://scholarworks.korea.ac.kr/kumedicine/handle/2021.sw.kumedicine/64064 Title: COMPARISON OF CLINICAL BENEFITS BETWEEN TELMISARTAN AND OTHER ANGIOTENSIN RECEPTOR BLOCKERS IN HYPERTENSION PATIENTS WITH COMBINATION THERAPY: MULTICENTER REAL-WORLD STUDY Authors: Joo, Hyung Joon; Yum, Yunjin; Kim, Yong Hyun; Kim, Eung Ju Abstract: Objective: Background Telmisartan have potent blood pressure lowering effect as well as the other pleiotrophic effects including PPAR-??/?? dual activation. In large clinical studies, telmisartan demonstrated the comparable clinical benefits with angiotensin converting enzyme inhibitor. However, there were few studies of direct comparison between telmisartan and the other angiotensin receptor blockers (ARBs). This study aimed to compare the cardiovascular and renal protective effect between telmisartan and the other ARBs in patients with the advanced hypertension who required two or more anti-hypertensive drugs. Design and method: This study used the Observation Medical Outcomes Partnership-Common Data Model database of three tertiary hospitals in Korea. 19,247 Patients were prescribed at least two antihypertensive drugs including ARBs, were selected from January 1, 2017 to December 31, 2019. 3,437 patients in the telmisartan group and 15,810 patients in the other ARB group were matched 1:1 through propensity score matching. Major adverse cardiovascular event (MACE), heart failure (HF) hospitalization and new-onset dialysis were compared for 3,386 patients in each group. Result: Before the matching, there was a higher proportion of patients with a history of myocardial infarction (MI) in the telmisartan group compared to the other ARB group. After the matching, average on-treatment blood pressure was similar between two groups. Over a three-year period, the incidence of MACE and HF hospitalization did not differ significantly between the two groups. Compared to the other ARB group, the telmisartan group had a lower incidence of new-onset dialysis (1.3% vs 1.9%, p-value = 0.04). However, this difference was not statistically significant in the multivariable Cox regression model. Conclusions: Telmisartan has similar cardiovascular and renal protective effects to other ARBs in patients with advanced hypertension who are taking at least two anti-hypertensive medications. Mon, 01 Jan 202306 00:00:00 GMT https://scholarworks.korea.ac.kr/kumedicine/handle/2021.sw.kumedicine/64064 202306-01-01T00:00:00Z https://scholarworks.korea.ac.kr/kumedicine/handle/2021.sw.kumedicine/64077 Title: SELF-MONITORING OF BLOOD PRESSURE AND FEEDBACK USING APP IN TREATMENT OF UNCONTROLLED HYPERTENSION: SMART APP STUDY Authors: Choi, Dong-Ju; Park, Sungji; Yoon, Minjae; Jo, Sangho; Kim, Eungju; Kim, Soojoong Abstract: Objective: Self-monitoring of blood pressure (SMBP) is a reliable method used to assess blood pressure (BP) accurately. However, patients do not often know how to respond to the measured BP value. We developed a mobile application-based feedback for tailored recommendations and aimed to evaluate whether this feedback is superior to SMBP alone in terms of BP reduction and drug compliance improvement in patients with hypertension. Design and method: Self-Monitoring of and Feed-back using APP in TReatment of UnconTrolled Blood Pressure (SMART-BP) is a prospective, randomized, open-label, multicenter trial to evaluate the efficacy of SMBP-App compared with SMBP alone. In the SMBP alone group, the patients performed home BP measurement and receive the standard care, whereas in the SMBP-App group, the patients received additional recommendations from the application using feedback algorithm in response to the obtained BP value. The primary endpoints were mean home BP and adherence of antihypertensive medication. Follow-up visits were scheduled at 12 and 24 weeks after randomization. Results: Among total 173 patients (88 for SBMP-app and 85 for SMBP alone) with full-analysis set, 53% were men, and the mean age was 59.8 years. Baseline characteristics including BP were not significantly different between two groups. At 6 months, mean reduction in home systolic BP was significantly higher in SMBP-App group than SBMP alone group (-20.0±13.5 vs. -14.9±12.9, = 0.012). Also, SMBP-app group showed higher drug adherence value and proportion of adherence over 95% than in SMBP alone group (95.2% vs. 90.4%, P = 0.004; 72/88 vs. 46/85, P = 0.010). Reduction in home systolic BP at 3 months and office systolic BP at 3 months were also higher in SBMP-App, similar with primary end point. Conclusions: SMBP-App is superior to SMBP alone in terms of blood pressure reduction and improved drug adherence in patients with hypertension. Mon, 01 Jan 202306 00:00:00 GMT https://scholarworks.korea.ac.kr/kumedicine/handle/2021.sw.kumedicine/64077 202306-01-01T00:00:00Z https://scholarworks.korea.ac.kr/kumedicine/handle/2021.sw.kumedicine/63402 Title: Comparison of Contrast Media Versus Hydroxyethyl Starch for Frequency- Domain Optical Coherence Tomography Imaging in Coronary Artery Disease Authors: Kang, Dong Oh; Nam, Hyeong Soo; Kim, Sun Won; Yoo, Hongki; Kim, Jin Won Abstract: Background Contemporary high-resolution intracoronary optical coherence tomography (OCT) requires injection of flushing media for image acquisition to avoid signal attenuation by red blood cells. There is a growing need for an alternative flushing media other than iodine contrast to reduce the risk of renal dysfunction. To address this issue, we investigated the safety and feasibility of hydroxyethyl starch (HES) as a flushing media for OCT image acquisition and compared with the contrast media flushed images. Methods We prospectively enrolled 43 patients with 70 coronary lesions (46 stented and 24 pre-stented or non-culprit lesions). Paired OCT images were obtained by manual injection of iodine contrast (average 12 mL), followed by pentastarch (10% HES 260 kDa/0.45, average 15 mL). A total of 162 runs (81 pairs) were analyzed and each OCT pullback was assessed on a frame-by-frame basis by automated customized lumen contour and stent strut segmentation algorithm. The number of clear image segments (CIS) and pre-specified quantitative 2D- and 3D-morphometric measurements were compared between the paired OCT images. Results Image quality as assessed by proportion of CIS were comparable between the contrast media and pentastarch flushed images (93.3%vs. 93.7%; p=0.501). Pixel-based blood flushing capability showed no significant difference between the paired image segments (median (IQR), 0.951 (0.947-0.953) vs. 0.951 (0.949-0.952), p=0.264; Figure A-B). Quantitative 2D- and 3D-morphometric measurements of minimal stent area, minimal lumen area, segment stent volume and segment lumen volume correlated well between the paired OCT runs (all p<0.001; Figure C). Customized 3D-rendered reconstruction of paired OCT images enabled clear visualization of stent strut geometry within the stented vessels (Figure D). There were no clinically relevant complications associated with OCT imaging with pentastarch administration such as anaphylactic reaction, life-threatening arrhythmia, heart failure, or acute renal deterioration. Conclusion Intracoronary OCT using pentastarch is safe and technically feasible without affecting the optical signal intensity and overall image quality. Non-contrast imaging with pentastarch significantly reduces the obligatory iodine contrast load, therefore, could be considered as a promising strategy in high-risk patients for renal impairment. Wed, 01 Jan 20230425 00:00:00 GMT https://scholarworks.korea.ac.kr/kumedicine/handle/2021.sw.kumedicine/63402 20230425-01-01T00:00:00Z