Jin Sup Park

Jo J, et al. Korean Circ J. 2026 ;56:e89. https://doi.org/10.4070/kcj.2025.0478

Cho SW, et al. Korean Circ J. 2025 Jul;56:e3. https://doi.org/10.4070/kcj.2025.0107

Background: There is limited data on the impact of body mass index (BMI) on distal radial access (DRA). Using a large-scale prospective registry, the influence of obesity on DRA outcomes was evaluated, including cannulation and complications. Methods: Using data from the prospective, multicenter KODRA (Korean Prospective Registry for Evaluation the Safety and Efficacy of Distal Radial Approach) registry data, 4,638 patients who planned palpation-guided distal radial artery puncture were enrolled into two groups, both with body mass index (BMI) information available: obese (n = 2,205; BMI ≥ 25 kg/m²) and non-obese (n = 2,433). The primary endpoint was the success rate of distal radial artery cannulation. Secondary endpoints included cannulation time, crossover rate, and DRA-related complications. Results: The mean age was 66.6 ± 11.7 years and 67.2% were men. No significant difference existed in the success rate of distal radial artery cannulation between the two groups (94.5% in the obese group vs. 94.3% in the non-obese group, p = 0.787). This tendency in cannulation success rate and cannulation time was consistently observed in multiple sensitivity analyses, including multivariable and propensity score-matched analyses. Crossover rate (6.6% vs. 6.7%, p = 0.962) and DRA-related complications (4.3% vs. 4.6%, p = 0.630) were not significantly different between groups. However, cannulation time was significantly longer in the obese group compared to the non-obese group [105 (64–180) sec vs. 100 (60–155) sec, p = 0.002]. Conclusions: In this subgroup analysis of the KODRA trial, obesity was not associated with the success rate for palpation-guided distal radial artery cannulation, crossover rate, and DRA-related complications. Keywords: radial artery obesity coronary angiography percutaneous coronary intervention

Background: We investigated the sex‐specific variations in distal radial access (DRA)–associated outcomes, as well as the factors influencing these outcomes, by utilizing a comprehensive real‐world registry. Methods: In this post‐hoc analysis of the KODRA (Korean Prospective Registry for Evaluating the Safety and Efficacy of Distal Radial Approach) trial, we selected 4608 patients who underwent successful coronary procedures, including percutaneous coronary intervention or coronary angiography, via DRA. Primary end points were overall DRA site outcomes including bleeding, radial artery occlusion, tenderness, hand edema, numbness, perforation, and dissection. We performed both propensity score matching and multivariable logistic regression to evaluate sex‐specific differences in DRA‐associated outcomes. Moreover, a multivariable analysis using logistic regression was also performed to evaluate the independent associated factors of DRA site outcomes. Results: The mean age was 66.5±11.8 years, and 67.8% (3125 men and 1483 women) were male among 4608 enrolled patients. The incidence of overall DRA site outcomes was significantly higher in women than in men (7.5% versus 4.1%, P 12 inhibitor, and unfractionated heparin dose. Conclusions: This subgroup analysis of the KODRA trial by sex showed that overall DRA site outcomes following coronary procedures via DRA were more common in women than in men. However, no major bleeding was observed in either men or women. Registration: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT04080700.

Jin IT, et al. Korean Circ J. 2024 Nov;55:e17. https://doi.org/10.4070/kcj.2024.0239

Jeong H, et al. J Korean Acad Nurs. 2024 May;54:e8. https://doi.org/10.4040/jkan.23136

There is a dearth of studies investigating whether the combination of low-intensity statins with ezetimibe can reduce the risk of diabetes in patients requiring statin therapy. Therefore, we aimed to evaluate the effects of combination therapy on the prevention of glycated hemoglobin (HbA1c) elevation in patients without diabetes. Sixty-eight patients were randomly assigned in a 1:1 ratio to receive a combination of low-intensity rosuvastatin (5 mg/day) and ezetimibe (10 mg/day) or high-intensity rosuvastatin (20 mg/day). The primary endpoint was the absolute difference in the HbA1c levels at 12 weeks. The HbA1c level showed an overall elevation of 0.11% at 12 weeks compared to that at baseline (mean ± standard deviation: 5.78 ± 0.3%, 95% confidence interval [CI]: 5.86–6.07, p = 0.044). The HbA1c levels did not differ between the groups at 12 weeks (least square mean difference: 0.001, 95% CI: 0.164–0.16, p = 0.999). Our study found that the combination of low-intensity rosuvastatin and ezetimibe did not yield significant differences in HbA1c levels compared to high-intensity rosuvastatin alone after 12 weeks in patients without diabetes. This suggests that the combination of low-intensity rosuvastatin and ezetimibe may not be an effective strategy for preventing HbA1c elevation in patients without diabetes requiring statins.

Cardiogenic shock (CS) is a common cause of death following acute myocardial infarction (MI). This study aimed to evaluate the adjusted mortality of venoarterial extracorporeal membrane oxygenation (VA-ECMO) with intra-aortic balloon counterpulsation (IABP) for patients with MI-CS. We included 300 MI patients selected from a multinational registry and categorized into VA-ECMO + IABP (N = 39) and no VA-ECMO (medical management ± IABP) (N = 261) groups. Both groups’ 30-day and 1-year mortality were compared using the weighted Kaplan–Meier, propensity score, and inverse probability of treatment weighting methods. Adjusted incidences of 30-day (VA-ECMO + IABP vs No VA-ECMO, 77.7% vs 50.7; P = .083) and 1-year mortality (92.3% vs 84.8%; P = .223) along with propensity-adjusted and inverse probability of treatment weighting models in 30-day (hazard ratio [HR], 1.57; 95% confidence interval [CI], 0.92–2.77; P = .346 and HR, 1.44; 95% CI, 0.42–3.17; P = .452, respectively) and 1-year mortality (HR, 1.56; 95% CI, 0.95–2.56; P = .076 and HR, 1.33; 95% CI, 0.57–3.06; P = .51, respectively) did not differ between the groups. However, better survival benefit 30 days post-ECMO could be supposed (31.6% vs 83.4%; P = .022). Therefore, patients with MI-CS treated with IABP with additional VA-ECMO and those not supported with ECMO have comparable overall 30-day and 1-year mortality risks. However, VA-ECMO-supported survivors might have better long-term clinical outcomes.

Korean Circulation Journal 대한심장학회지 순환기 Park JS, et al. Korean Circ J. 2022 Feb;52:e36. https://doi.org/10.4070/kcj.2022.0022

To assess the temporal trends of bleeding episodes during half- vs. standard-dose ticagrelor in acute coronary syndrome (ACS) patients with low platelet reactivity (LPR) during standard-dose ticagrelor (90 mg bid). ACS Patients with LPR (12 reaction units) (n = 122) were randomly assigned to receive either half-dose (45 mg bid) or standard-dose ticagrelor (90 mg bid). The primary endpoint was incidence of Bleeding Academic Research Consortium (BARC) bleeding at 1 week, 1, 3 and 6 months. Dyspnea and ischemic events were also evaluated. Bleeding episodes were most commonly observed at 1 month and then decreased over time. Half-dose ticagrelor did not reduce any BARC bleeding (odds ratio [OR] 0.900, 95% confidence interval [CI] 0.563–1.440, p = 0.661). However, serious bleeding (BARC type ≥2) occurred less often in half-dose ticagrelor (OR 0.284, 95% CI 0.088–0.921, p = 0.036). The rate of moderate-to-severe dyspnea was highest at 1 month, then decreased over time. Half-dose ticagrelor did not decrease moderate-to-severe dyspnea (Borg scale ≥ 3) (OR 1.066, 95% CI 0.322–3.530, p = 0.916). The risk of ischemic events was also similar between the groups. In conclusions, compared with standard-dose ticagrelor, half-dose ticagrelor reduced serious bleeding events during early period of dual-antiplatelet therapy in ACS patients with LPR; however, the risk of any bleeding events and dyspnea did not differ according to ticagrelor dose. Clinical registration: KCT0004640.