Cardiovascular Prevention and Pharmacotherapy

Special Article

Update on the Pharmacotherapy of Heart Failure with Reduced Ejection Fraction: Eui-Soon Kim, Jong-Chan Youn, Sang Hong Baek; Cardiovasc Prev Pharmacother. 2020;2(4):113-133. Published online October 31, 2020; DOI: https://doi.org/10.36011/cpp.2020.2.e17

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Heart failure (HF) is an important cardiovascular disease because of the increasing prevalence, high morbidity and mortality, and rapid expansion of health care costs. Over the past decades, efforts have been made to modify the prognosis of patients with HF. Regarding HF with reduced ejection fraction (HFrEF), several drugs have shown to improve mortality and morbidity, based on large-scale randomized controlled trials, leading to a critical paradigm shift in its pharmacological treatment. The paradigm of HFrEF pathophysiology has shifted from cardiorenal disease to hemodynamic changes, and neurohormonal activation is currently considered the prime pathophysiological mechanism of HFrEF. This review summarizes evidence on the pharmacological management of HFrEF derived from major randomized controlled trials, which have accomplished improvements in survival benefits.

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Korean Society of Heart Failure Guidelines for the Management of Heart Failure: Treatment
Jong-Chan Youn, Darae Kim, Jae Yeong Cho, Dong-Hyuk Cho, Sang Min Park, Mi-Hyang Jung, Junho Hyun, Hyun-Jai Cho, Seong-Mi Park, Jin-Oh Choi, Wook-Jin Chung, Byung-Su Yoo, Seok-Min Kang
Korean Circulation Journal.2023; 53(4): 217. CrossRef
Korean Society of Heart Failure Guidelines for the Management of Heart Failure: Treatment
Jong-Chan Youn, Darae Kim, Jae Yeong Cho, Dong-Hyuk Cho, Sang Min Park, Mi-Hyang Jung, Junho Hyun, Hyun-Jai Cho, Seong-Mi Park, Jin-Oh Choi, Wook-Jin Chung, Byung-Su Yoo, Seok-Min Kang
International Journal of Heart Failure.2023; 5(2): 66. CrossRef
Post-transplantation outcomes of sensitized patients receiving durable mechanical circulatory support
Jong-Chan Youn, Xiaohai Zhang, Keith Nishihara, In-Cheol Kim, Sang Hong Baek, Osamu Seguchi, Evan P. Kransdorf, David H. Chang, Michelle M. Kittleson, Jignesh K. Patel, Robert M. Cole, Jaime D. Moriguchi, Danny Ramzy, Fardad Esmailian, Jon A. Kobashigawa
The Journal of Heart and Lung Transplantation.2022; 41(3): 365. CrossRef
Treatment of heart failure with a preserved ejection fraction
Yuran Ahn, Jong-Chan Youn
Journal of the Korean Medical Association.2022; 65(1): 18. CrossRef
Multimodal Imaging and Biomarkers in Cardiac Amyloidosis
Mi-Hyang Jung, Suyon Chang, Eun Ji Han, Jong-Chan Youn
Diagnostics.2022; 12(3): 627. CrossRef
Physician adherence and patient-reported outcomes in heart failure with reduced ejection fraction in the era of angiotensin receptor-neprilysin inhibitor therapy
In-Cheol Kim, Jong-Chan Youn, Se Yong Jang, Sang Eun Lee, Hyun-Jai Cho, Jin-Oh Choi, Ju-Hee Lee, Kyung-Hee Kim, Sun Hwa Lee, Kye Hun Kim, Jong Min Lee, Byung-Su Yoo, Byung-Su Yoo, Se Yong Jang, Jong Min Lee, In-Cheol Kim, Jin-Oh Choi, Hyun-Jai Cho, Sang E
Scientific Reports.2022;[Epub] CrossRef
A dose–response relationship of renin–angiotensin system blockers and beta-blockers in patients with acute heart failure syndrome: a nationwide prospective cohort study
Kyung An Kim, Eui-Soon Kim, Jong-Chan Youn, Hye Sun Lee, Soyoung Jeon, Hae-Young Lee, Hyun-Jai Cho, Jin-Oh Choi, Eun-Seok Jeon, Sang Eun Lee, Min-Seok Kim, Jae-Joong Kim, Kyung-Kuk Hwang, Myeong-Chan Cho, Shung Chull Chae, Seok-Min Kang, Dong-Ju Choi, Byu
European Heart Journal - Cardiovascular Pharmacotherapy.2022; 8(6): 587. CrossRef
Characteristics, outcomes, and predictors of de novo malignancy after heart transplantation
Jong-Chan Youn, Darae Kim, In-Cheol Kim, Hye Sun Lee, Jin-Oh Choi, Eun-Seok Jeon, Keith Nishihara, Evan P. Kransdorf, David H. Chang, Michelle M. Kittleson, Jignesh K. Patel, Danny Ramzy, Fardad Esmailian, Jon A. Kobashigawa
Frontiers in Cardiovascular Medicine.2022;[Epub] CrossRef
Pathophysiology of Heart Failure with Preserved Ejection Fraction
Jong-Chan Youn, Yuran Ahn, Hae Ok Jung
Heart Failure Clinics.2021; 17(3): 327. CrossRef
Heart failure risk in younger adults needing more attention
Jong-Chan Youn, Sang Hong Baek
International Journal of Cardiology.2021; 344: 135. CrossRef

Review Article

Recent Technology-Driven Advancements in Cardiovascular Disease Prevention: Jisan Lee, Hun-Sung Kim, Dai-Jin Kim; Cardiovasc Prev Pharmacother. 2019;1(2):43-49. Published online October 31, 2019; DOI: https://doi.org/10.36011/cpp.2019.1.e7

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Abstract PDF Supplementary Material

Recent dramatic developments in information and communication technologies have been widely applied to medicine and healthcare. In particular, biometric sensors in wearable devices linked to smartphones are collecting vast amounts of personal health data. To best use these accumulated data, personalized healthcare services are emerging, and digital platforms are being developed and studied to enable data integration and analysis. The implementation of biometric sensors and smartphones for cardiovascular and cerebrovascular healthcare emerged from the research on the feasibility and efficacy of the devices in the clinical environment. It is important to understand the recent research trends in data generation, integration, and application to prevent and treat cardiovascular and cerebrovascular diseases. This paper describes these recent developments in treating cardiovascular diseases.

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Sex- and Age-Specific Trends in Cardiovascular Health in Korea, 2007–2018
So Mi Jemma Cho, Hokyou Lee, Hyeon Chang Kim
Korean Circulation Journal.2021; 51(11): 922. CrossRef
Lack of Acceptance of Digital Healthcare in the Medical Market: Addressing Old Problems Raised by Various Clinical Professionals and Developing Possible Solutions
Jong Il Park, Hwa Young Lee, Hyunah Kim, Jisan Lee, Jiwon Shinn, Hun-Sung Kim
Journal of Korean Medical Science.2021;[Epub] CrossRef
Lessons from Use of Continuous Glucose Monitoring Systems in Digital Healthcare
Hun-Sung Kim, Kun-Ho Yoon
Endocrinology and Metabolism.2020; 35(3): 541. CrossRef

Original Article

Aspirin Has a Neutral Effect in Preventing Future Cardiovascular Events in Vasospastic Angina: Kwan Yong Lee, Dong Il Shin, Sung Ho Her, Seung Hwan Han, Youngkeun Ahn, Dong-Soo Kim, Dong-Ju Choi, Hyuck Moon Kwon, Hyeon-Cheol Gwon, Seung-Woon Rha, Sang-Ho Jo, Sung Cil Lim, Jun-Pyo Myong, Sang Hong Baek; Cardiovasc Prev Pharmacother. 2019;1(1):30-42. Published online July 31, 2019; DOI: https://doi.org/10.36011/cpp.2019.1.e4; Correction in: Cardiovasc Prev Pharmacother 2020;2(1):31

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Abstract PDF

Background
The aim of this multi-center prospective registry study was to evaluate the clinical efficacy of low-dose aspirin in vasospastic angina (VA) patients for the prevention of future cardiovascular events.
Methods
A total of 1,717 patients with positive and intermediate results of an intracoronary ergonovine provocation test in the VA in Korea registry (n=2,960) were classified into 100 mg/day aspirin intake (aspirin, n=743) and no-aspirin intake (control, n=974) groups. The primary end-point was a composite of major adverse cardiac events (MACEs) including cardiac death, new-onset arrhythmia, and acute coronary syndrome.
Results
The median follow-up duration was 2.0 years (25–75th, interquartile range 0.9–3.0 years). Cumulative composite MACE in the propensity score matched-pair cohort (n=1,028) was 3.6%. There was no significant difference in composite MACE between the aspirin and control groups (3.1% vs. 4.1%; hazard ratio [HR], 1.18; 95% confidence interval [CI], 0.61–2.26; p=0.623). A sensitivity analysis of only the VA-positive population showed these results to be consistent. Even for patients with minimal organic stenosis (n=369), aspirin usage was not related to the incidence of a composite MACE (HR, 1.61; 95% CI, 0.55–4.72; p=0.380).
Conclusions
Low-dose aspirin does not protect against future cardiovascular events in VA patients, even patients who combine with minimal coronary artery stenosis.

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Characteristics of Patients with Vasospastic Angina in Korea: Data from a Large Cohort (VA-KOREA)
Sung Eun Kim, Sang-Ho Jo, Won-Woo Seo, Min-Ho Lee, Hyun-Jin Kim, Seong-Sik Cho, Kwan Yong Lee, Dong-Soo Kim, Tae-Hyun Yang, Sung-Ho Her, Seung Hwan Han, Byoung-Kwon Lee, Youngkeun Ahn, Seung-Woon Rha, Hyeon-Cheol Gwon, Dong-Ju Choi, Sang Hong Baek
Cardiovascular Prevention and Pharmacotherapy.2021; 3(3): 47. CrossRef
Welcome to the New JournalCardiovascular Prevention and Pharmacotherapy
Mi-Jeong Kim, Jang-Whan Bae, Dae Ryong Kang
Cardiovascular Prevention and Pharmacotherapy.2019; 1(1): 1. CrossRef

Review Articles

Challenges and Future in Precision Cardiovascular Medicine: Sang Hong Baek; Cardiovasc Prev Pharmacother. 2019;1(1):10-18. Published online July 31, 2019; DOI: https://doi.org/10.36011/cpp.2019.1.e3

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Abstract PDF

Cardiovascular disease (CVD) still remains the global leading cause of mortality and also impose major burdens on morbidity, quality of life, and societal costs despite of the remarkable progress of cardiovascular (CV) treatment over the past 50 years. CVD therapy improves CV outcomes in less than half of patients. Precision medicine is an attractive and advancing strategy to enhance for disease prevention, diagnosis, and tailored treatment and allocate limited resources more wisely and effectively. We are now in the middle of fourth industrial revolution by a robust confluence of biotechnology, physical science and information technologies. This approach is in its premature so far, but has begun to yield useful information that moves from the conventional ‘average response’ approach to more specific and targeted approaches governed by individual variability. This review aims to how precision medicine, genomics, and epigenetics work together to create a new era of CV precision medicine.

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Cell-free DNA in maternal blood and artificial intelligence: accurate prenatal detection of fetal congenital heart defects
Ray Bahado-Singh, Perry Friedman, Ciara Talbot, Buket Aydas, Siddesh Southekal, Nitish K. Mishra, Chittibabu Guda, Ali Yilmaz, Uppala Radhakrishna, Sangeetha Vishweswaraiah
American Journal of Obstetrics and Gynecology.2023; 228(1): 76.e1. CrossRef
Welcome to the New JournalCardiovascular Prevention and Pharmacotherapy
Mi-Jeong Kim, Jang-Whan Bae, Dae Ryong Kang
Cardiovascular Prevention and Pharmacotherapy.2019; 1(1): 1. CrossRef

Blood pressure control in hypertensive disorders of pregnancy: Helsi Rismiati, Hae-Young Lee; Cardiovasc Prev Pharmacother. 2022;4(3):99-105. Published online July 29, 2022; DOI: https://doi.org/10.36011/cpp.2022.4.e16

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Hypertension is a major cause of maternal morbidity and occurs as a complication in up to one in ten pregnancies. Hypertensive disorders of pregnancy encompass gestational hypertension, preeclampsia, chronic hypertension, and chronic hypertension with superimposed preeclampsia. However, the management of hypertensive disorders of pregnancy remains a matter of debate, particularly the blood pressure thresholds and targets for managing hypertension in pregnancy. Previously, there was no clear evidence of the effectiveness of aggressive blood pressure control in pregnancy due to the risk of fetal growth restriction. Recent clinical trials have shown that aggressive control of blood pressure in pregnant women is safe for both the mother and fetus. The purpose of this paper is to present a clinically oriented guide to the drugs of choice in patients with hypertension during pregnancy, present contrasts among different guidelines and recent clinical trials, and discuss the blood pressure thresholds and targets for hypertension during pregnancy based on recent studies.

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Combined Effects of Methyldopa and Baicalein or Scutellaria baicalensis Roots Extract on Blood Pressure, Heart Rate, and Expression of Inflammatory and Vascular Disease-Related Factors in Spontaneously Hypertensive Pregnant Rats
Michał Szulc, Radosław Kujawski, Przemysław Ł. Mikołajczak, Anna Bogacz, Marlena Wolek, Aleksandra Górska, Kamila Czora-Poczwardowska, Marcin Ożarowski, Agnieszka Gryszczyńska, Justyna Baraniak, Małgorzata Kania-Dobrowolska, Artur Adamczak, Ewa Iwańczyk-S
Pharmaceuticals.2022; 15(11): 1342. CrossRef

Original Article

Development of a predictive model for the side effects of liraglutide: Jiyoung Min, Jiwon Shinn, Hun-Sung Kim; Cardiovasc Prev Pharmacother. 2022;4(2):87-93. Published online April 27, 2022; DOI: https://doi.org/10.36011/cpp.2022.4.e12

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Abstract PDF Supplementary Material

Background
Liraglutide, a drug used for the management of obesity, has many known side effects. In this study, we developed a predictive model for the occurrence of liraglutide-related side effects using data from electronic medical records (EMRs).
Methods
This study included 237 patients from Seoul St. Mary's Hospital and Eunpyeong St. Mary's Hospital who were prescribed liraglutide. An endocrinologist obtained medical data through an EMR chart review. Model performance was evaluated using the mean of the area under the receiver operating characteristic curve (AUROC) with a 95% confidence interval (CI).
Results
A predictive model was developed for patients who were prescribed liraglutide. However, 37.1% to 75.5% of many variables were missing, and the AUROC of the developed predictive model was 0.630 (95% CI, 0.551–0.708). Patients who had previously taken antiobesity medication had significantly fewer side effects than those without previous antiobesity medication use (20.7% vs. 41.4%, P<0.003). The risk of side effect occurrence was significantly higher in patients with diabetes than in patients without diabetes by 2.389 times (odds ratio, 2.389; 95% CI, 1.115–5.174).
Conclusions
This study did not successfully develop a predictive model for liraglutide-related side effects, primarily due to issues related to missing data. When prescribing antiobesity drugs, detailed records and basic blood tests are expected to be essential. Further large-scale studies on liraglutide-related side effects are needed after obtaining high-quality data.

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The effects and side effects of liraglutide as a treatment for obesity
Jeonghoon Ha, Jin Yu, Joonyub Lee, Hun-Sung Kim
Cardiovascular Prevention and Pharmacotherapy.2022; 4(4): 142. CrossRef

Review Articles

Adverse effects of statin therapy and their treatment: Dae Young Cheon, Sang-Ho Jo; Cardiovasc Prev Pharmacother. 2022;4(1):1-6. Published online January 20, 2022; DOI: https://doi.org/10.36011/cpp.2022.4.e4

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Statins are one of the most widely used drugs worldwide as first-line drugs for the treatment of hyperlipidemia and the prevention and treatment of cardiovascular diseases. Most of the side effects of statins are known to be mild, and mainly hepatotoxicity and various muscle symptoms are known. Recently, there have been studies on concerns about an increase in the incidence of diabetes after using statins, but it was found that the benefits sufficiently outweigh the risk of side effects. Therefore, the use of statins in the appropriate group should be actively performed, and it seems that the side effects can be prevented through close physical observation and appropriate examination.

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The Link between Magnesium Supplements and Statin Medication in Dyslipidemic Patients
Roxana Nartea, Brindusa Ilinca Mitoiu, Ioana Ghiorghiu
Current Issues in Molecular Biology.2023; 45(4): 3146. CrossRef

Body Weight Change and Cardiovascular Disease: Effect of Weight Gain, Weight Loss, and Weight Cycling: Jung-Hwan Cho, Eun-Jung Rhee, Won-Young Lee; Cardiovasc Prev Pharmacother. 2021;3(4):73-81. Published online October 31, 2021; DOI: https://doi.org/10.36011/cpp.2021.3.e12

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Abstract PDF

Obesity is an independent risk factor for the development and progression of cardiovascular disease (CVD). Various cardiovascular outcomes are related to the association between body weight change and CVD. Metabolically healthy obese individuals could have a better prognosis in terms of cardiovascular morbidity and mortality than metabolically unhealthy obese individuals. Smoking cessation causes significant weight gain and consequent deterioration of the metabolic profile despite not impairing the cardiovascular benefits. Intentional weight loss has a consistent cardiovascular protective effect, but unintentional weight loss due to progressive catabolism and loss of muscle mass could be associated with poor cardiovascular outcomes. Obese individuals who are successful in losing weight with subsequent regain (weight cycling) could have an unfavorable cardiometabolic profile and the risk of CVD. Further studies are needed to evaluate the impact of weight changes on CVD by identifying unknown pathophysiology and to decide appropriate management and interventions for various phenotypes of weight change.

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Investigating the efficacy and feasibility of using a whole-of-diet approach to lower circulating levels of C-reactive protein in postmenopausal women: a mixed methods pilot study
Stephanie Cowan, Aimee Dordevic, Andrew J. Sinclair, Helen Truby, Surbhi Sood, Simone Gibson
Menopause.2023;[Epub] CrossRef

Special Articles

Geriatric Considerations in the Management of Elderly Patients with Cardiovascular Diseases: Doo Soo Jeon; Cardiovasc Prev Pharmacother. 2021;3(2):38-46. Published online April 30, 2021; DOI: https://doi.org/10.36011/cpp.2021.3.e6

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Abstract PDF

Cardiovascular disease (CVD) is the most frequently diagnosed disease as well as the leading cause of death in the elderly. It usually results from long-term effects of cardiovascular risk factors as well as the aging process itself. Elderly people commonly have geriatric syndrome, which is an age-specific problem that is complicated by the presence of cardiovascular, cognitive, and physical dysfunction and is accompanied by many other chronic diseases. While caring for the elderly, in addition to CVD, various inherent problems must be considered. The patient-centered approach, instead of evidence-based guidelines that are designed for young adult patients, is the most important concept when it comes to elderly patients with CVD and multiple comorbidities. This approach should be used to maintain the functionality, independence, quality of life, and dignity of these patients.

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Assessment of Quality of Life in Patients With Cardiovascular Disease Using the SF-36, MacNew, and EQ-5D-5L Questionnaires
Aikaterini Chatzinikolaou, Stergios Tzikas, Maria Lavdaniti
Cureus.2021;[Epub] CrossRef

Shifting from Pharmacotherapy to Prevention of Hypertension: Bernard Man Yung Cheung, Man-Fung Tsoi; Cardiovasc Prev Pharmacother. 2020;2(2):33-42. Published online April 30, 2021; DOI: https://doi.org/10.36011/cpp.2020.2.e8

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Hypertension is a common chronic disease affecting a large section of the general population. As hypertension is usually asymptomatic, awareness, treatment and control rates are low. Drug side-effects also affect compliance. Hypotension and electrolyte abnormalities in the elderly can be severe. Therefore, prevention is better than cure. As blood pressure rises with age, prevention should be started early. As there are many genes affecting blood pressure, genetic tests are not useful. Good antenatal care and care of preterm infants can help to prevent adult cardiovascular diseases including hypertension. Childhood obesity is an important determinant of blood pressure in childhood and adolescence. This is a window of opportunity for prevention. The current American College of Cardiology/American Heart Association guideline on hypertension defines stage 1 hypertension as a systolic blood pressure of 130–139 mmHg or a diastolic blood pressure of 80–89 mmHg. Although this makes many people in the general population hypertensive, stage 1 hypertension in young adults is already associated with increased cardiovascular and mortality risk. Fortunately, hypertension at this early stage is easy to control and weight loss is easier in young males, who can get exercise from work or exercise after work. Leisure-time physical activity seems more beneficial than occupational physical activity. Cardiovascular risk assessment and promoting a healthy lifestyle in the young are likely to forestall hypertension and future cardiovascular disease. Preventing or reversing hypertension is no longer an impossible dream.

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The Association Between Dietary Inflammatory Index (DII) and Risk of Hypertension: A Case–Control Study
Niloofar Shoaei, Nafiseh Shokri-Mashhadi, Awat feizi, Reza Ghiasvand
High Blood Pressure & Cardiovascular Prevention.2022; 29(6): 611. CrossRef

Tafamidis for Cardiac Transthyretin Amyloidosis: Darae Kim, Jin-Oh Choi, Eun-Seok Jeon; Cardiovasc Prev Pharmacother. 2021;3(1):1-9. Published online January 31, 2021; DOI: https://doi.org/10.36011/cpp.2021.3.e1

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Transthyretin amyloid (ATTR) cardiomyopathy is a progressive disease caused by the infiltration of ATTR fibrils in the myocardium. Although it is a rare disease, ATTR cardiomyopathy is an important cause of heart failure with preserved ejection fraction, and its incidence is increasing due to improved diagnostic imaging tools. There has been a breakthrough in the field of transthyretin amyloidosis, which opens a new therapeutic door for the patients. In this review, an overview of tafamidis therapy in ATTR cardiomyopathy with recent results from clinical trials will be discussed.

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Multimodal Imaging and Biomarkers in Cardiac Amyloidosis
Mi-Hyang Jung, Suyon Chang, Eun Ji Han, Jong-Chan Youn
Diagnostics.2022; 12(3): 627. CrossRef

Logistic Regression and Least Absolute Shrinkage and Selection Operator: Hyunyong Lee, Hun-Sung Kim; Cardiovasc Prev Pharmacother. 2020;2(4):142-146. Published online October 31, 2020; DOI: https://doi.org/10.36011/cpp.2020.2.e15

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Logistic regression, a model that forms a binary dependent variable and one or more independent variable(s), is used especially in epidemiological studies. By understanding the logistic model and its applications, such as odds ratio (OR) and performance efficiency, the concept of logistic regression can be easily grasped. The purpose of this article is to 1) introduce logistic regression, including odds and OR, 2) present predictive efficiency, such as area under the curve, and 3) explain the caution of logistic regression analysis.

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Perceptron: Basic Principles of Deep Neural Networks
Eung-Hee Kim, Hun-Sung Kim
Cardiovascular Prevention and Pharmacotherapy.2021; 3(3): 64. CrossRef

Original Article

Changes in Target Achievement Rates after Statin Prescription Changes at a Single University Hospital: Seon Choe, Jiwon Shinn, Hun-Sung Kim, Ju Han Kim; Cardiovasc Prev Pharmacother. 2020;2(3):103-111. Published online July 31, 2020; DOI: https://doi.org/10.36011/cpp.2020.2.e14

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Abstract PDF

Background
We investigated the changes in low-density lipoprotein cholesterol (LDL-C) target achievement rates (<70 and <100 mg/dL) when the prescription changed from various statins to Lipilou^®, a generic formulation of atorvastatin.
Methods
This was a retrospective cohort study of patients who had been prescribed Lipilou^® for more than 3 months at Seoul National University Hospital from 2012 to 2018. For patients who were treated with a previous statin before the prescription of Lipilou^®, changes in target achievement rates of LDL-C less than 70 and less than 100 mg/dL were confirmed 3–6 months after the prescription of Lipilou^®.
Results
Among the 683 enrolled patients, when their prescription was changed to Lipilou^®, the target achievement rate of LDL-C significantly increased for LDL-C less than 70 mg/dL (from 22.1% to 66.2%, p<0.001) and less than 100 mg/dL (from 26.8% to 75.3%, p<0.001). In particular, when a moderate-low potency statin was changed to Lipilou^® (10 mg), the target achievement rates for LDL-C less than 70 mg/dL (from 28.9% to 66.7%, p<0.001) and less than 100 mg/dL (from 42.2% to 86.7%, p<0.001) significantly increased. The change from a moderate-high potency statin to Lipilou^® (20 mg) showed an increased target achievement rates for LDL-C <70 mg/dL (from 33.3% to 80.0%, p=0.008) and 100 mg/dL (from 40.0% to 73.3%, p<0.025).
Conclusions
We cannot simply conclude that Lipilou^® is superior to other statins. However, when the target LDL-C was not reached with previous statin treatments, a high target achievement rate could be achieved by changing the prescription to Lipilou^®. Physicians should always consider aggressive statin prescription changes for high target achievement rates.

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Understanding and Utilizing Claim Data from the Korean National Health Insurance Service (NHIS) and Health Insurance Review & Assessment (HIRA) Database for Research
Dae-Sung Kyoung, Hun-Sung Kim
Journal of Lipid and Atherosclerosis.2022; 11(2): 103. CrossRef

Special Articles

Pragmatic Clinical Trials for Real-World Evidence: Concept and Implementation: Na-Young Jeong, Seon-Ha Kim, Eunsun Lim, Nam-Kyong Choi; Cardiovasc Prev Pharmacother. 2020;2(3):85-98. Published online July 31, 2020; DOI: https://doi.org/10.36011/cpp.2020.2.e12

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Abstract PDF

The importance of real-world evidence (RWE) has been highlighted in recent years, and the limitations of the classical randomized controlled trials, also known as explanatory clinical trials (ECTs), have been emphasized. Post-marketing observational studies have several problems, such as biases and incomparability between patient groups, and RWE can only be obtained after a certain period. Therefore, pragmatic clinical trials (PCTs) have garnered attention as an alternative to obtaining scientifically robust RWE in a relatively short time. PCTs are clinical trials that have a pragmatic concept, i.e., the opposite of ECTs and are intended to help decision makers by evaluating the effectiveness of interventions in routine clinical practice. The characteristics of PCTs are the inclusion of various patients in clinical practice, recruitment of patients in heterogeneous settings, and comparison with actual clinical treatments rather than a placebo. Thus, the results of PCTs are likely to be generalized and can have a direct impact on clinical and policy decision-making. This study aimed to describe the characteristics and definitions of PCTs compared with those of ECTs and to highlight the important considerations in the planning process of PCTs. To perform PCTs for the purpose of obtaining RWE, the contents covered in this study will be helpful.

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A scoping review of the Choice and Partnership Approach in child and adolescent mental health services
Kathleen Pajer, Carlos Pastrana, William Gardner, Aditi Sivakumar, Ann York
Journal of Child Health Care.2022; : 136749352210762. CrossRef

Competing Risk Model in Survival Analysis: Yena Jeon, Won Kee Lee; Cardiovasc Prev Pharmacother. 2020;2(3):77-84. Published online July 31, 2020; DOI: https://doi.org/10.36011/cpp.2020.2.e11

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Abstract PDF

Survival analysis is primarily used to identify the time-to-event for events of interest. However, there subjects may undergo several outcomes; competing risks occur when other events may affect the incidence rate of the event of interest. In the presence of competing risks, traditional survival analysis such as the Kaplan-Meier method or the Cox proportional hazard regression introduces biases into the estimation of survival probability. In this review, we discuss several methods that can be used to consider competing risks in survival analysis: the cumulative incidence function, the cause-specific hazard function, and Fine and Gray's Subdistribution hazard function. We also provide a guide for conducting competing risk analysis using SAS with the bone marrow transplantation dataset presented by Klein and Moeschberger (1997).

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Standard Survival Analysis Can Overestimate Incidence and Risk Factors of Event of Interest in a Prospective Cohort Study with Considerable Attrition: The Case of a Suicide High-Risk Cohort
Min Ji Kim, Maengseok Noh, Jieun Yoo, Seung Yeon Jeon, Jungjoon Moon, Seong Jin Cho, Sang Yeol Lee, Se-Hoon Shim, Shin Gyeom Kim, Won Sub Kang, Min-Hyuk Kim, Christopher Hyung Keun Park, Daun Shin, Sang Jin Rhee, Jeong Hun Yang, Yong-Min Ahn, Weon-Young L
SSRN Electronic Journal .2022;[Epub] CrossRef

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