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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Real-World Eligibility and Cost-Effectiveness Analysis of Empagliflozin for Heart Failure in Korea
Eui-Soon Kim, Sun-Kyeong Park, Jong-Chan Youn, Hye Sun Lee, 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, Jin Joo Park, Dong-Ju Choi,
Journal of Korean Medical Science.2024;[Epub] CrossRef
Eligibility and Cost-Utility Analysis of Dapagliflozin in Patients with Heart Failure Across the Whole Spectrum of Ejection Fraction in South Korea
Eui-Soon Kim, Sun-Kyeong Park, Daniel Sung-ho Cho, Jong-Chan Youn, Hye Sun Lee, 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, Jin Joo
American Journal of Cardiovascular Drugs.2024; 24(2): 313. 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
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

Calcium channel blockers for hypertension: old, but still useful: Eun Mi Lee; Cardiovasc Prev Pharmacother. 2023;5(4):113-125. Published online October 30, 2023; DOI: https://doi.org/10.36011/cpp.2023.5.e16

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Abstract PDF

Calcium channel blockers (CCBs) constitute a heterogeneous class of drugs that can be divided into dihydropyridines (DHPs) and non-DHPs. DHP-CCBs are subcategorized into four generations based on the duration of activity and pharmacokinetics, while non-DHP-CCBs are subcategorized into phenylethylamine and benzodiazepine derivatives. DHP-CCBs are vascular-selective and function as potent vasodilators, whereas non-DHP-CCBs are cardiac-selective and are useful for treating tachyarrhythmia, but reduce cardiac contractility and heart rate. Traditional DHP-CCBs (nifedipine) mainly block L-type calcium channels, whereas novel CCBs block N-type (amlodipine) and/or T-type channels (efonidipine) in addition to L-type channels, leading to organ-protective effects. DHP-CCBs have a potent blood pressure–lowering effect and suppress atherosclerosis and coronary vasospasm. Diltiazem, a non-DHP-CCB, is highly effective for vasospasm control. CCBs reduce left ventricular hypertrophy and arterial stiffness. Amlodipine, a DHP-CCB, reduces blood pressure variability. L/N- and L/T-type CCBs combined with renin-angiotensin system blockers reduce proteinuria and improve kidney function compared with L-type CCBs. According to large-scale trials, DHP-CCBs reduce cardiovascular events in patients with isolated systolic hypertension, as well as in elderly and high-risk patients. Accordingly, CCBs are indicated for hypertension in elderly patients, isolated systolic hypertension, angina pectoris, and coronary vasospasm. Non-DHP-CCBs are contraindicated in high-grade heart block, bradycardia (<60 beats per minute [bpm]), and heart failure with reduced ejection fraction (HFrEF). DHP-CCBs should be used with caution in patients with tachyarrhythmia, HFrEF, and severe leg edema, and non-DHP-CCBs should be used carefully in those with constipation. Each CCB has distinct pharmacokinetics and side effects, underscoring the need for meticulous consideration in clinical practice.

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Special Article

Methods for Evaluating the Accuracy of Diagnostic Tests: Chi-Yeon Lim; Cardiovasc Prev Pharmacother. 2021;3(1):15-20. Published online January 31, 2021; DOI: https://doi.org/10.36011/cpp.2021.3.e2

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Abstract PDF

The accuracy of a diagnostic test should be evaluated before it is used in clinical situations. The sensitivity, specificity, and the trade-off between the 2 need to be considered. Sensitivity and specificity in diagnostic tests depend on the selection of cut-off values, and appropriate cut-off values can be arrived at by analyzing the receiver operating characteristic curve. In actual clinical setting, it is often difficult to obtain an appropriate gold standard for diagnosis, and in this case, consent is required as well. In this article, we summarize the basic concepts and methods for evaluating the performance of diagnostic tests.

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Robert B. Moreland, Linda Brubaker, Lana Tinawi, Alan J. Wolfe, Graeme N. Forrest, Rajvinder Khasriya, Nazema Siddiqui
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Diagnostic MicroRNA Signatures to Support Classification of Pulmonary Hypertension
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Diagnostic Accuracy of Clinical Diagnostic Scoring Systems for Childhood Tuberculosis: A Systematic Review and Meta-analysis
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Open Forum Infectious Diseases.2024;[Epub] CrossRef
Novel diagnostic biomarkers for pancreatic cancer: assessing methylation status with epigenetic-specific peptide nucleic acid and KRAS mutation in cell-free DNA
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Frontiers in Oncology.2024;[Epub] CrossRef

Original Article

Variation in blood viscosity based on the potential cause of stroke of undetermined etiology: Jinyoung Oh, Youngchan Jung, Jin Kim, Sun Ki Min, Sang Won Han, Jong Sam Baik; Cardiovasc Prev Pharmacother. 2023;5(4):144-150. Published online October 25, 2023; DOI: https://doi.org/10.36011/cpp.2023.5.e14

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Background
This study investigated potential differences in blood viscosity (BV) among patients with stroke of undetermined etiology, negative evaluation (SUDn), specifically those with potential atherothrombosis (SUDn-AT) and those with possible embolism (SUDn-E).
Methods
This single-center study employed a retrospective observational design. The participants were patients over 20 years old with the SUDn stroke subtype who were admitted within 5 days of symptom onset. These patients were categorized as SUDn-AT or SUDn-E. Patients in the SUDn-AT group had nonsignificant stenosis (<50%) of a major brain artery relevant to their symptoms and exhibited one or more signs of systemic atherosclerosis, including atherosclerosis of at least one major brain artery other than those clinically relevant, coronary artery disease, and/or peripheral artery disease. For the SUDn-E group, the SUDn criteria from the TOAST (Trial of Org 10172 in Acute Stroke Treatment) classification system were strictly applied.
Results
The final analysis included 153 patients, with 104 (68%) classified as SUDn-E and the remaining 32% as SUDn-AT. Patients in the SUDn-AT group had a higher systolic BV (P=0.012) and diastolic BV (P=0.020) than those in the SUDn-E group. Multivariable logistic regression analysis revealed that age (odds ratio [OR], 1.08; 95% confidence interval [CI], 1.03–1.13; P=0.003), systolic BV (OR, 3.11; 95% CI, 1.41–6.85; P=0.005), and diastolic BV (OR, 1.08; 95% CI, 1.02–1.14; P=0.009) were associated with SUDn-AT.
Conclusions
Within the TOAST system, two SUDn entities may be distinguishable, with potentially different underlying etiologies: atherothrombosis and embolic stroke of undetermined source.

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Association of Cerebral Artery Stenosis with Blood Viscosity in Patients with Transient Ischemic Attack
Young Chan Jung, Sang Won Han, Joong Hyun Park
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Diseases.2024; 12(9): 223. CrossRef

Review Articles

The crosstalk between insulin resistance and nonalcoholic fatty liver disease/metabolic dysfunction-associated fatty liver disease: a culprit or a consequence?: Dae-Jeong Koo, Won-Young Lee; Cardiovasc Prev Pharmacother. 2022;4(4):132-141. Published online October 20, 2022; DOI: https://doi.org/10.36011/cpp.2022.4.e17

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Nonalcoholic fatty liver disease (NAFLD), which has recently undergone a change in its definition and acronym to “metabolic dysfunction associated fatty liver disease (MAFLD),” is clinically significant as an increasingly prevalent independent risk factor for cardiovascular diseases. Insulin resistance is considered to be a key mechanism in the development and progression of NAFLD/MAFLD, and fatty liver disease itself may exacerbate insulin resistance. In this review, we describe the mechanisms underlying the interaction between insulin resistance and fatty liver, and we summarize the therapeutic attempts based on those mechanisms.

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Nonalcoholic fatty liver disease and heart failure with preserved ejection fraction: a focus on risk factors and management
Joonpyo Lee, Mi-Seung Shin
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Insulin Resistance, Non-Alcoholic Fatty Liver Disease and Type 2 Diabetes Mellitus: Clinical and Experimental Perspective
Inha Jung, Dae-Jeong Koo, Won-Young Lee
Diabetes & Metabolism Journal.2024; 48(3): 327. CrossRef
A Comprehensive Review of Pathophysiological Link Between Non-alcoholic Fatty Liver Disease, Insulin Resistance, and Metabolic Syndrome
Eudith Januario, Aly Barakat, Abhivanditha Rajsundar, Zahra Fatima, Varda Nanda Palienkar, Arjun V Bullapur, Sunchandandeep Singh Brar, Punam Kharel, Mishal Mohammed Koyappathodi Machingal, Amena Backosh
Cureus.2024;[Epub] CrossRef

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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3 Citations

Abstract PDF

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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Efficacy, side effects, adherence, affordability, and procurement of dietary supplements for treating hypercholesterolemia: a narrative review
Isabel von Känel-Cordoba, Katharina Wirnitzer, Katja Weiss, Pantelis T. Nikolaidis, Asli Devrim-Lanpir, Lee Hill, Thomas Rosemann, Beat Knechtle
Journal of Health, Population and Nutrition.2024;[Epub] CrossRef
The Link between Magnesium Supplements and Statin Medication in Dyslipidemic Patients
Roxana Nartea, Brindusa Ilinca Mitoiu, Ioana Ghiorghiu
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The effects of L-carnitine in reducing hepatotoxicity of statins in rats
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Special Article

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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Factor modification in the association between high-density lipoprotein cholesterol and liver cancer risk in a nationwide cohort
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Review Articles

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
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Jong Il Park, Hwa Young Lee, Hyunah Kim, Jisan Lee, Jiwon Shinn, Hun-Sung Kim
Journal of Korean Medical Science.2021;[Epub] CrossRef
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Endocrinology and Metabolism.2020; 35(3): 541. CrossRef

Decision-making for recurrent atrial fibrillation after catheter ablation: Jum Suk Ko, Sung Soo Kim, Hyung Ki Jeong, Nam Ho Kim; Cardiovasc Prev Pharmacother. 2023;5(4):102-112. Published online October 27, 2023; DOI: https://doi.org/10.36011/cpp.2023.5.e15

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Abstract PDF

Catheter ablation for atrial fibrillation (AF), especially pulmonary vein (PV) isolation, is widely used for rhythm control. However, AF recurrence remains a challenge, affecting 20% to 50% of cases. This review focuses on AF recurrence after catheter ablation. AF recurrence can be categorized into early recurrence (ER) within 3 months after index procedure, late recurrence (LR) within 1 year, and very LR (VLR) occurring beyond 1 year. ER has emerged as a significant predictor of LR, contrary to the traditional understanding. LR is primarily caused by PV reconnection, while VLR more involves non-PV triggers or substrates. Managing AF recurrence includes antiarrhythmic drugs, steroids, colchicine, and repeat ablation. Antiarrhythmic drugs reduce ER but have a limited impact on LR. Steroids have been shown to reduce ER, but not long-term recurrence. Colchicine, an anti-inflammatory agent, shows promise in reducing both ER and LR, although further research is necessary. Whether to perform early repeat ablation after ER remains uncertain, as not all patients require immediate intervention. In conclusion, AF recurrence after ablation remains a complex issue. Understanding the underlying mechanisms is essential for personalized management. Tailored approaches, considering individual characteristics, are crucial for long-term success. Future research should focus on improving therapeutic strategies for AF recurrence.

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Meta-analysis of Pulsed Field Ablation Versus Thermal Ablation for Pulmonary Vein Isolation in AF: A Broad Overview Focusing on Efficacy, Safety and Outcomes
Mohammad Iqbal, William Kamarullah, Raymond Pranata, Iwan Cahyo Santosa Putra, Giky Karwiky, Chaerul Achmad, Young Hoon Kim
Arrhythmia & Electrophysiology Review.2024;[Epub] CrossRef
Beyond Clinical Factors: Harnessing Artificial Intelligence and Multimodal Cardiac Imaging to Predict Atrial Fibrillation Recurrence Post-Catheter Ablation
Edward T. Truong, Yiheng Lyu, Abdul Rahman Ihdayhid, Nick S. R. Lan, Girish Dwivedi
Journal of Cardiovascular Development and Disease.2024; 11(9): 291. CrossRef

Original Article

Changes in cardiovascular-related health behaviors during the COVID-19 pandemic: Eunji Kim, Chan-Hee Jung, Dae Jung Kim, Seung-Hyun Ko, Hae-Young Lee, Kyung-Yul Lee, Dae Ryong Kang, Sung Kee Ryu, Won-Young Lee, Eun-Jung Rhee, Hyeon Chang Kim; Cardiovasc Prev Pharmacother. 2023;5(1):15-23. Published online January 27, 2023; DOI: https://doi.org/10.36011/cpp.2023.5.e2

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Abstract PDF Supplementary Material

Background
The COVID-19 pandemic has been the most pressing health challenge in recent years. Meanwhile, prevention for other diseases, such as cardiovascular disease (CVD) has been less prioritized during the pandemic. COVID-19, a novel infectious disease, both had a direct impact on public health and provoked changes in health-related behaviors, including those for CVD prevention. This study sought to examine changes in CVD-related health behaviors during the COVID-19 pandemic and related sociodemographic factors.
Methods
We used data from the Cardiovascular Disease Prevention Awareness Survey conducted in Korea in June 2022. A total of 2,000 adults across Korea’s 17 provinces completed a structured questionnaire online or on a mobile device. Self-reported changes in CVD-related health behaviors were investigated. We used unadjusted and adjusted logistic regression models to explore the associations between negative changes and sociodemographic factors.
Results
In smoking, drinking, and healthcare service use, the proportion of those with positive changes surpassed the proportion of respondents who reported negative changes. In contrast, negative changes predominated for diet, exercise, and stress. Most individuals (52.6%) reported a deterioration of psychological distress. These negative changes were significantly associated with age, sex, marital status, and the presence of cardiometabolic disease.
Conclusions
The COVID-19 pandemic has affected CVD-related health behaviors. Based on these changes, CVD prevention should be encouraged with appropriate and prioritized strategies.

Citations

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Changes in cardiovascular-related health behaviors after the end of social distancing: the 2023 Cardiovascular Disease Prevention Awareness Survey
Jaeyong Lee, Eunji Kim, Won-Young Lee, Eun-Jung Rhee, Hyeon Chang Kim
Cardiovascular Prevention and Pharmacotherapy.2024; 6(2): 57. CrossRef
Cardiovascular-related health behavior changes: lessons from the COVID-19 pandemic and post-pandemic challenges
Inha Jung, Won-Young Lee
Cardiovascular Prevention and Pharmacotherapy.2023; 5(4): 99. CrossRef

Review Article

Adverse reactions to antiarrhythmic drugs: Ungjeong Do; Cardiovasc Prev Pharmacother. 2023;5(1):1-14. Published online January 16, 2023; DOI: https://doi.org/10.36011/cpp.2023.5.e1

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2 Citations

Abstract PDF

There are various types of adverse reactions to antiarrhythmic drugs (AADs). Proarrhythmia, which refers to an exacerbation of the preexisting arrhythmia or occurrence of a new arrhythmia, may occur under the therapeutic concentration of an AAD. Bradyarrhythmia is the most common type of proarrhythmia due to AADs, and prior myocardial infarction and old age are known risk factors. Atrial flutter with 1:1 atrioventricular conduction usually occurs during rhythm control of atrial fibrillation with class IC AADs. QT prolongation due to AADs, mainly class III AADs, elevates the risk of torsade de pointes by triggered activity due to early afterdepolarization. The addition of clinical factors that promote QT prolongation, such as hypokalemia, hypomagnesemia, female sex, and bradycardia, increases the risk of developing torsade de pointes. Proarrhythmic monomorphic ventricular tachycardia usually occurs as a result of slow conduction and disparity of refractoriness due to class IC AADs. In patients with preexisting left ventricular systolic dysfunction or structural heart disease, the risk of hypotension or cardiogenic shock caused by negative inotropic effects due to AADs should be considered. To prevent these major adverse reactions to AADs, we need to understand the electrophysiologic properties of AADs in detail. Furthermore, the risk of proarrhythmia could be heightened by interplay with clinical factors, such as electrolyte unbalances, heart rate, and hepatic/renal or myocardial dysfunction. Sufficient awareness about drug-drug interactions, which may affect the metabolism of AADs, will improve patient safety during the management of arrhythmia.

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Catheter ablation vs antiarrhythmic therapy for atrial fibrillation in heart failure with preserved ejection fraction
Marisa R. DeLuca, Bilal Ali, Yasir Tarabichi, Beni R. Verma, Saima Karim
Heart Rhythm.2024;[Epub] CrossRef
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Dabyn Lee, Hyeryun Lee, Hyungsun Jun, Jungtae Leem
The Journal of Internal Korean Medicine.2024; 45(6): 1316. CrossRef

Original Articles

Effect of the addition of thiazolidinedione to sodium-glucose cotransporter 2 inhibitor therapy on lipid levels in type 2 diabetes mellitus: a retrospective study using Korean National Health Insurance Service data: Taegyun Park, Kyungdo Han, Dongwook Shin, Jongho Park; Cardiovasc Prev Pharmacother. 2022;4(3):114-122. Published online July 29, 2022; DOI: https://doi.org/10.36011/cpp.2022.4.e15

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2 Citations

Abstract PDF

Background
Dyslipidemia is common in patients with type 2 diabetes mellitus (T2D) and contributes to an increased risk of cardiovascular disease. Previous studies have shown that treatment with thiazolidinediones (TZDs) and sodium-glucose cotransporter-2 inhibitors (SGLT2-i) may help to improve dyslipidemia in T2D patients. In this study, we investigated whether patients treated with TZD and SGLT2-i showed greater improvement in high-density lipoprotein cholesterol (HDL-C) levels than those treated with only SGLT2-i.
Methods
From the National Health Insurance Service database of Korea, we extracted all patients who first received SGTL2-i from 2014 to 2016. Propensity score matching was performed to balance the two groups: group A (SGTL2-i and TZD, regardless of other antidiabetic medications) and group B (SGTL2-i only without TZD, regardless of other antidiabetic medications). Posttreatment HDL-C levels were compared by the Student t-test.
Results
In total, 1,400 T2D patients (700 in each group) were matched by propensity score matching. There was a significant posttreatment increase in HDL-C in group A (49.54±20.03 to 51.6±12.92 mg/dL, P=0.007), but not in group B (49.14±13.52 to 49.1±2.15 mg/dL, P=0.937). Group A also showed significantly higher posttreatment HDL-C levels than group B (51.4±12.92 vs. 49.1±12.15 mg/dL, P<0.001). Regarding the secondary endpoints, posttreatment triglyceride levels were lower (P<0.001), but total cholesterol (P=0.131) and low-density lipoprotein cholesterol levels (P=0.054) were not different after treatment.
Conclusions
The combination of SGTL2-i and TZD may be more effective in ameliorating dyslipidemia in T2D patients than SGLT2-i alone. However, further studies are needed to confirm this finding.

Citations

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SGLT2 Inhibitor Use and Risk of Dementia and Parkinson Disease Among Patients With Type 2 Diabetes
Hae Kyung Kim, Geert Jan Biessels, Min Heui Yu, Namki Hong, Yong-ho Lee, Byung-Wan Lee, Eun Seok Kang, Bong-Soo Cha, Eun Jig Lee, Minyoung Lee
Neurology.2024;[Epub] CrossRef
A Green Approach: Optimization of the UPLC Method Using DoE Software for Concurrent Quantification of Pioglitazone and Dapagliflozin in a SNEDDS Formulation for the Treatment of Diabetes
Ehab M. Elzayat, Abdelrahman Y. Sherif, Mohamed W. Attwa, Mohammad A. Altamimi
ACS Omega.2024; 9(45): 45011. CrossRef

Effects of physical activity on cardiovascular outcomes and mortality in Korean patients with diabetes: a nationwide population-based cohort study: Inha Jung, Sun Joon Moon, Hyemi Kwon, Se Eun Park, Kyung-Do Han, Eun-Jung Rhee, Won-Young Lee; Cardiovasc Prev Pharmacother. 2022;4(1):42-55. Published online January 20, 2022; DOI: https://doi.org/10.36011/cpp.2022.4.e3

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2 Citations

Abstract PDF Supplementary Material

Background
Since a sedentary lifestyle is considered a modifiable risk factor for cardiovascular disease (CVD), physical activity (PA) is recommended for type 2 diabetes mellitus (T2DM) patients to prevent CVD. We investigated the association between different levels of PA and the risk for CVD and all-cause mortality in patients with T2DM using nationwide data.
Methods
We examined health examination data and claims records of 2,745,637 participants with T2DM at baseline from the Korean National Health Insurance Service who underwent health examinations between 2009 and 2012. We excluded subjects with a history of myocardial infarction or stroke. Each participant was asked to report their weekly PA levels according to three categories: vigorous, moderate, and walking. The incidence of CVD and death was analyzed until 2017.
Results
The risk of CVD was lower in regular exercisers than in nonexercisers after adjusting for confounding variables. A dose-response trend was evident in the association between the degree of PA and CVD risk. All categories of PA were inversely associated with CVD risk and mortality. The reduction in CVD risk and all-cause mortality was more profound in patients aged ≥65 years.
Conclusions
Augmenting PA might have positive effects on the prevention of CVD and all-cause death, especially in the elderly. The benefits of PA were consistently observed in various subgroups regardless of the presence of chronic conditions. Therefore, clinicians should encourage elderly patients with T2DM to increase their daily PA.

Citations

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Incentivised physical activity intervention promoting daily steps among university employees in the workplace through a team-based competition
Ayazullah Safi, Sanjoy Deb, Adam Kelly, Matthew Cole, Natalie Walker, Mohammed Gulrez Zariwala
Frontiers in Public Health.2024;[Epub] CrossRef
Effect of physical activity on incident atrial fibrillation in individuals with varying duration of diabetes: a nationwide population study
JungMin Choi, So‑Ryoung Lee, Eue-Keun Choi, Kyung-Yeon Lee, Hyo-Jeong Ahn, Soonil Kwon, Kyung‑Do Han, Seil Oh, Gregory Y. H. Lip
Cardiovascular Diabetology.2024;[Epub] CrossRef

Special Articles

Inflammation in Metabolic Diseases and Insulin Resistance: Won-Young Lee; Cardiovasc Prev Pharmacother. 2021;3(2):31-37. Published online April 30, 2021; DOI: https://doi.org/10.36011/cpp.2021.3.e5

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2 Citations

Abstract PDF

Increased inflammation and insulin resistance are commonly observed in obesity and diabetes. Inflammatory mediators secreted by the adipose tissue contribute to the pathogenesis of diabetes and cardiovascular diseases. Free fatty acids and pro-inflammatory cytokines from adipose tissue inhibit the intracellular insulin signaling pathway, further contributing to the progression of diabetes. Meta-analysis studies show that high sensitivity C-reactive protein can be used as a predictor of future all-cause mortality, including cardiovascular and cancer mortality. In addition to the discovery of novel therapeutic methods targeting inflammatory mediators, basic lifestyle interventions, such as regular exercise, healthy eating, and proper weight control, are absolutely crucial for reducing inflammation and preventing mortality.

Citations

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Stimulation, regulation, and inflammaging interventions of natural compounds on nuclear factor kappa B (NF-kB) pathway: a comprehensive review
Gowtham Kannan, Benedict Mathews Paul, Parimelazhagan Thangaraj
Inflammopharmacology.2025; 33(1): 145. CrossRef
Links between oral microbiome and insulin resistance: Involvement of MAP kinase signaling pathway
Yi-Ru Chang, Wen-Chi Cheng, Ya-Chun Hsiao, Guan-Wei Su, Shan-Jen Lin, Yu-Shan Wei, Hsiu-Chuan Chou, Hsiu-Ping Lin, Guan-Yu Lin, Hong-Lin Chan
Biochimie.2023; 214: 134. 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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2 Citations

Abstract PDF

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.

Citations

Citations to this article as recorded by

A Comprehensive Review on Chemistry and Biology of Tafamidis in Transthyretin Amyloidosis
Monali B. Patil, Piyush Ghode, Prashant Joshi
Mini-Reviews in Medicinal Chemistry.2024; 24(6): 571. 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

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