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￭♣ S-187 ￭
Impact of hs-CRP on outcomes in acute myocardial infarction according to LDL cholesterol level
Department of Cardiology, Keimyung University Dongsan Medical Center, Daegu, Korea
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Sang-Woong Choi, Yun-Kyeong Cho, Jae-Pil Lee, Jihyun Sohn, Hyun-Ok Cho, Hyoung-Seob Park, Hyuck-Jun Yoon, Hyungseop Kim, Chang-Wook Nam, Seung-Ho Hur, Yoon-Nyun Kim, Kwon-Bae Kim
Background: High-sensitivity C-reactive protein (hs-CRP) is a known prognostic marker in acute myocardial infarction. There were little data about the impact of hs-CRP on long-term cardiovascular outcome of patient with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI). Method: From January 1st, 2008 to December 31th, 2010, we enrolled 601 patients with AMI underwent PCI. Clinical history, laboratory findings, echocardiographic findings, angiographic findings and outcomes were reviewed retrospectively. All patients were divided by two groups; Low LDL group (LDL cholesterol < 70 mg/dL) and High LDL group (LDL cholesterol ≥ 70 mg/dL). Each group was analyzed separately. Result: High LDL group had more hypertension, previous myocardial infarction history, and higher age and body mass index at the time of diagnosis of AMI. High LDL groups used more statins after PCI than low LDL group. There was no significant difference in echocardio- graphic parameters. And there also was no difference in angiographic parameters. In high LDL group, higher hs-CRP was related to higher 3-year MACE (HR 1.111, CI 1.016-1.215, p=0.021). Other factors contributing to higher 3-year MACE were unusing statins after PCI, and lower hemo- globin at diagnosis. After multivariate analysis, hs-CRP was revealed to be an independent prognostic factor of 3-year MACE (HR 1.083, CI 1.001-1.171, p=0.047). Conclusion: In patient with AMI underwent PCI, hs-CRP could be prognostic factor of 3-year MACE in whose LDL cho- lesterol over 70 mg/dL, but otherwise not.￭ S-188 ￭
Clinical outcomes of medically treated acute aortic intramural hematoma
1Yeungnam University Hospital, 2Keimyung University Hospital, 3Daegu Catholic University Hospital,
4Daegu Fatima Hospital
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Min Kyu Kang
1, Jong Seon Park
1, Won Jong Park
1, Ung Kim
1, Sang Hee Lee
1, Dong Gu Shin
1, Young Jo Kim
1, Yoon Kyung Cho
2, Chang Wook Nam
2, Seung Ho Hur
2, Jin Bae Lee
3, Jae Geun Ryu
3, Bong Ryeol Lee
4, Byung Chun Jung
4 Background and objective: Intramural hematoma of the aorta (IMH) considered as a variant of overt aortic dissection. However, IMH prognosis is a lot better compared to that of aortic dissection. Several studies have shown IMH to be a very dynamic process that leads to reabsorption, classic dissection, or aortic rupture. The aim of this study was to evaluate the clinical outcomes of patients with acute aortic IMH which were medically treated at the presentation. Patients and Methods: We analyzed 118 consecutive medically treated patients with acute IMH diagnosed by contrast enhanced computed tomography (CT) from four large centers in Daegu City. Those patients were divided into two groups; typea A (n=44, 37.3%) and type B (n=74, 62.7%). The change of aortic diameter and hematoma size, clinical outcomes were analyzed and compared be- tween the groups. Results: In baseline characteristics, there was no significant difference between two groups. During hospitalization, progression to aortic dissection (13.6% vs 2.7%, p=0.051) and conversion to surgery (13.6% vs. 1.4%, p=0.011) were higher in type A than type B. On CT findings, pericardial effusion (27%) and pleural effusion (25%) was higher in type B than type A. Short-term follow-up CT examination (mean 10 days) didn't show any differences in the rate of hematoma absorption and aggravation between the types. During the 2 year clinical follow up, morality rate was 13.2% in type A and 9.7% in type B (p=0.587). Conclusion: Even in type A acute IMH, early medical treatment and surgi- cal conversion only in a selected, complicated cases would be a favorable treatment option.Key words: Intramural hematoma of the aorta (IMH), survival rates, morphological evolution
