Trend of prevalence and incidence of systemic lupus erythematosus in South Korea, 2005 to 2015: a nationwide population-based study

Background/Aims@#The aim of this study was to evaluate the trend of incidence and prevalence of systemic lupus erythematosus (SLE) in South Korea from 2005 to 2015. @*Methods@#From 2005 to 2015, individuals with SLE were identified from the National Health Insurance database, which records information on almost all Koreans. SLE was defined according to the International Classification of Diseases, 10th revision (ICD-10), code M32. The incidence was calculated per 100,000 person-years. The prevalence was calculated per 100,000 people and stratified by year, age group, sex, region, and income. @*Results@#The annual prevalence of SLE increased slightly from 21.25/100,000 people in 2005 to 35.45/100,000 people in 2015. In contrast, the annual incidence of SLE decreased slightly from 5.42/100,000 person-years in 2005 to 3.6/100,000 person-years in 2015. The prevalence and incidence of SLE were 10- and 6-fold higher in women than in men, respectively. The peak age of prevalence and incidence was 30 to 39 years in 2005; in 2015, the peak age of prevalence was 30 to 49 years and of incidence was 20 to 49 years. Regional variation was observed in both incidence and prevalence of SLE. Jeju province showed the highest prevalence of SLE (44.54/100,000 person-years), and Gwangju province showed the highest incidence of SLE (6.98/100,000 person-years) in 2015. The income status did not affect the prevalence or incidence of SLE except in patients without income who received medical aid. @*Conclusions@#The incidence of SLE has declined, but the prevalence has increased in Korea in recent years. Peak age of SLE trend to right shift in Korea.

Effectiveness and Safety of Biolimus A9™-Eluting stEnt in Patients with AcUTe Coronary sYndrome; A Multicenter, Observational Study (BEAUTY Study)

PURPOSE: This study sought to determine the 1-year clinical effectiveness and safety of a biodegradable, polymer-containing Biolimus A9™-eluting stent (BES) in Korean patients with acute coronary syndrome (ACS). MATERIALS AND METHODS: A total of 1000 ACS patients with 1251 lesions who underwent implantation of BESs at 22 centers in Korea were enrolled between May 2011 and July 2013. We assessed major adverse cardiac events (MACE) defined as the composite of cardiac death, non-fatal myocardial infarction (MI), and clinical-driven target vessel revascularization at 12 months. RESULTS: Patient mean age was 62.6±11.4 years. 72.8% of the patients were male, 28.5% had diabetes, 32.8% had multi-vessel disease (MVD), and 47.9% presented with acute MI (AMI). The mean global registry of acute coronary events risk score of all patients was 103.0±27.6. The number of stents per patient was 1.3±0.6. The incidences of MACE and definite stent thrombosis at 12 months were 3.9% and 0.2%, respectively. On multivariate Cox-regression analysis, age ≥65 years was identified as an independent predictors of 1-year MACE (hazard ratio=2.474; 95% confidence interval=1.202−5.091). Subgroup analyses revealed no significant differences in the incidence of MACE between patients with and without diabetes (4.3% vs. 3.7%, p=0.667), between those who presented with and without AMI (4.4% vs. 3.4%, p=0.403), and between those with and without MVD (4.6% vs. 3.5%, p=0.387). CONCLUSION: Our study demonstrated excellent 1-year clinical outcomes of BES implantation in patients at low-risk for ACS.

Clinical Outcomes in Patients with Intermediate Coronary Stenoses: MINIATURE Investigators (Korea MultIceNter TrIal on Long-Term Clinical Outcome According to the Plaque Burden and Treatment Strategy in Lesions with MinimUm Lumen ARea lEss Than 4 mm2 Usin

BACKGROUND AND OBJECTIVES: We evaluated the two-year clinical outcomes in patients with angiographically intermediate lesions according to the plaque burden and treatment strategy. SUBJECTS AND METHODS: We prospectively enrolled patients with angiographically intermediate lesions (diameter stenosis 30-70%) with an intravascular ultrasound (IVUS) minimum lumen area (MLA) <4 mm2 with 50-70% plaque burden of 16 Korean percutaneous coronary intervention centers. Patients were divided into medical therapy group (n=85) and zotarolimus-eluting stent group (ZES; Resolute) group (n=74). We evaluated the incidences of two-year major adverse cardiovascular events (MACE). RESULTS: A two-year clinical follow-up was completed in 143 patients and MACE occurred in 12 patients. There were no significant differences in the incidences of death (1.3% vs. 3.0%, p=0.471), target vessel-related non-fatal myocardial infarction (0.0% vs. 0.0%, p=1.000) and target vessel revascularizations (7.8% vs. 4.5%, p=0.425) between medical and ZES groups. Independent predictors of two-year MACE included acute myocardial infarction {odds ratio (OR)=2.87; 95% confidence interval (CI) 1.43-6.12, p=0.014}, diabetes mellitus (OR=2.46; 95% CI 1.24-5.56, p=0.028) and non-statin therapy (OR=2.32; 95% CI 1.18-5.24, p=0.034). CONCLUSION: Medical therapy shows comparable results with ZES, and myocardial infarction, diabetes mellitus and non-statin therapy were associated with the occurrence of two-year MACE in patients with intermediate lesion with IVUS MLA <4 mm2 with 50-70% of plaque burden.

The Clinical Significance of Elevated Troponin in Patients with Acute Coronary Syndrome with Normal Electrocardiogram

BACKGROUND AND OBJECTIVES: The level of cardiac specific troponin (cTn) may be important in patients with acute coronary syndrome (ACS), but with normal electrocardiography (ECG). SUBJECTS AND METHODS: Three hundred and nineteen patients (61+/-11 years, M:F=212:107), with ACS and normal ECG, who underwent a diagnostic coronary angiogram (CAG), between July 2000 and June 2001, were analyzed according to their cTn level. The clinical characteristics, initial CAG findings and major adverse cardiac events (MACE), during a one-year clinical follow-up, were compared between positive and negative cTn groups. RESULTS: Of the enrolled patients, 191 had a negative cTn (group A, 61+/-10 years, M:F=131:60), and 128 a positive cTn (group B, 60+/-11 years, M:F=81:47), and 176 (55.2%) were shown to have significant coronary artery stenosis on CAG. There were no significant differences in risk factors between the two groups. The mean left ventricular ejection fraction was 64+/-9%, and was lower in group B than in group A (59+/-10% vs. 67+/-7%, p<0.05). cTn positivity was associated with the percentage of significant coronary artery stenosis present (88% vs. 32%, p<0.05), a smaller minimal luminal diameter (1.09+/-0.44 mm vs. 2.68+/-0.33 mm, p<0.05) and a larger diameter of stenosis (68+/-6% vs. 44+/-6%, p<0.05). A multi-vessel lesion was more common in group B than in group A (58.3% vs. 30.3%, p<0.05). During the one-year follow-up period, 36 patients developed MACE, resulting in 3 deaths, 7 acute myocardial infarctions and 34 patients with restenosis. MACE was observed in 9 patients of group A and in 27 of group B (4.7% vs. 21.1%, p<0.05). CONCLUSION: The troponin levels are valuable for the early diagnosis, and prediction of the long-term prognosis, in patients with ACS and a normal ECG.

The long-term clinical effect of cutting ballon angioplasty for coronary in-stent restenosis / 대한내과학회지

BACKGROUND: Coronary stent implantation reduced the restenosis rate after percutaneous coronary intervention (PCI) but, still coronary in-stent restenosis (ISR) remains the major problem after PCI. Cutting balloon angioplasty is one of the method for ISR treatment. The purpose of this study is prospectively comparing the effect of cutting balloon angioplasty (CBA) with plain old balloon angioplasty (POBA) for the ISR. METHODS: A total of 50 patients with ISR, who underwent PCI (randomized CBA or POBA for ISR) from January to December 2001 at Chonnam National University Hospital, were divided into two groups: Group I (n=25: 58.4+/-7.9 years, male 88%) with CBA and Group II (n=25: 58.1+/-8.7 years, male 92%) with POBA. The early luminal gain, late luminal loss, major adverse cardiac event and angiographic restenosis rate were compared. RESULTS: There were no differences in baseline clinical characteristics of sex, age, ejection fraction, cardiac enzyme, risk factors of atherosclerosis, number of coronary artery lesions, and type of ISR between the groups. The minimal luminal diameters of before and after PCI were 0.83+/-0.34 mm, 2.10+/-0.55 mm in group I and 0.93+/-0.58 mm, 2.08+/-0.79 mm in group II. There were no differences in early luminal gain. All patients underwent follow-up coronary angiogram and the restenosis rate was 32% (8/25) in group I and 28% (7/25) in group II, and late luminal loss were 0.60+/-0.40 mm in group I and 0.65+/-0.61 in group II (p=NS). The major adverse cardiac events during 6-month follow-up developed in 3 cases of group I and 4 cases of group II (p=NS). CONCLUSION: There were no differences in early and long-term clinical effects after CBA and POBA for the treatment of ISR.