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Background/aims Transradial intervention (TRI) is becoming the preferred method over transfemoral intervention (TFI) because TRI is associated with lower incidence of major bleeding and vascular complications. However, there has been limited published data regarding the clinical outcomes of TRI versus TFI in Korean patients with ST-elevation myocardial infarction (STEMI). Methods A total of 689 consecutive STEMI patients who underwent primary percutaneous coronary intervention (PCI) with drug-eluting stents (DESs) from January to December of 2009 at nine university hospitals were enrolled in this study. Mid-term angiographic and 12-month cumulative clinical outcomes of the TRI group (n = 220, 31.9%) were compared to those of the TFI group (n = 469, 28.1%). Results After propensity score matching, in-hospital complications and the 12-month major clinical outcomes during follow-up in the two groups were similar to each other. However, the incidence rates of repeat revascularization (6.4% vs. 0.5%, p = 0.003), target vessel revascularization (6.4% vs. 0.5%, p = 0.003), and major adverse cardiac events (MACE; 11.6% vs. 4.6%, p = 0.018) in the TFI group were higher than those in the TRI group during the 12-month of follow-up. Conclusions In our study, TRI in STEMI patients undergoing primary PCI with DESs was associated with lower incidence of access site hematoma, 12-month repeat revascularization, and MACE compared to TFI. Therefore, TRI might play an important role in reducing bleeding complications while improving major clinical outcomes in STEMI patients undergoing primary PCI with DESs.

Objective:With limitation of clinic and brachial BP, central BP and vascular parameters have known to be better to probe efficacy of antihypertensive drug. Because vascular parameters are measured at resting state, role of ambulatory central BP and vascular parameters to explain the difference in cl

Background and Objectives:B-type natriuretic peptide (BNP) is released from the cardiac ventricles in response to increased wall tension. Early diagnosis of congestive heart failure (CHF) and assessment of the left ventricular end diastolic pressure (LVEDP) are thought to be important in the diagnosis, treatment and follow up of patients with CHF. Subjects and Methods:Between March, 2002 and November, 2002, 50 patients, who were admitted for treatment and hemodynamic monitoring, were studied. For the BNP measurement, 3 to 5ml blood samples were collected into tubes containing EDTA. The BNP was measured with a fluorescence immunoassay kit (Triage, Biosite, San Diego, U.S.A.). Cardiac Catheterization was performed for the assessment of the LVEDP. Results: Of the 50 subjects, 34 with CHF had a mean BNP level of 483.1±77.8 pg/mL, whereas those without CHF had a level of 79.2±24.0 pg/mL. The difference between the groups was statistically significant (p=0.005). A significant positive correlation was seen between the BNP and the LVEDP (r=0.53, p=0.001). The correlation between the BNP and the left ventricular ejection fraction (LVEF) was not statistically significant (r=-0.226, p=0.198). Conclusion:The plasma BNP was significantly increased in CHF, and might reflect the LVEDP. Further study will be required to see whether the BNP is a useful parameter for the staging and treatment of CHF. (Korean Circulation J 2003;33 (8):695-700)

Background and Objectives:In this study we investigated the association between the polymorphism of apolipoprotein E and the development of myocardial infarction, and assessed whether this polymorphism pr- oduces any changes of plasma lipid level. Subjects and Methods:A total of 182 patients participated in this study and were divided into two groups; 91 patients with myocardial infarction (MI group and 91 patients with no known heart disease (control group. For both groups we analyzed the clinical parameters, the chan- ges of plasma lipid level and the degree of polymorphism of apolipoprotein E. Results:Total cholesterol, tri- glyceride and LDL cholesterol levels were significantly higher in the MI group, while the HDL cholesterol level was significantly lower. Compared with the control group, the frequency of e2 allele was significantly lower while that of e 3 allele was significantly higher in the MI group. As for the control group, the triglyce- ride level was significantly higher in the patients with e 2 allele than in those without e 2 allele, and the total cholesterol level was significantly higher in the patients with e 4 allele than in those without e 4 allele. In the MI group, the plasma lipid levels were not significantly different from those in the control group. Conclusion: We suggested that apolipoprotein E polymorphism could affect the lipid metabolism as well as the develop- ment of myocardial infarction. However further study is needed in patients with myocardial infarction. ( ( ( (Korean Circulation J 2002;32(1 :31-37

Background and Objectives：It has been suggested that the indices based on tissue doppler and color M-mode echocardiography reflect the left ventricular end-diastolic pressure. These include the early diastolic transmitral velocity (E to early myocardial velocity ratio measured by tissue doppler (E’ and the E to the wave propagation velocity (Vp ratio measured from color M-mode images. However, these indices have not been well validated in congestive heart failure patients. Subjects and Methods：Thirty one congestive heart failure patients who underwent simultaneous cardiac catheterization and echocardiography, and had normal sinus rhythm were enrolled in this study. The left ventricular end-diastolic pressure obtained from the left heart catheterization was compared with the diastolic indices using pulsed doppler, tissue doppler and color M-mode echocardiography. Results： The left ventricular end-diastolic pressure (LVEDP ranged from 3.3 to 23 mmHg. Some parameters showed a significant correlation with the LVEDP. The propagation velocity showed a significant correlation with the LVEDP (r＝-0.382, p＝0.034, and the E to propagation velocity ratio (E/Vp showed a good correlation with the LVEDP (r＝0.408, p＝0.023. In addition, the E to early diastolic velocity of the mitral annulus (E’ ratio had an insignificant correlation with the LVEDP (r＝0.322, p＝0.078. Among the patients with ischemic congestive heart failure, the E to the propagation velocity ratio (E/Vp showed a marginal correlation with the LVEDP (r＝ 0.461, p＝0.047. Conclusion：In patients with congestive heart failure, the Vp and E/Vp showed a good correlation with the LVEDP. In the subgroup of patients with ischemic congestive heart failure, only the E/Vp showed a significant correlation with the LVEDP. (Korean Circulation J 2002;32 (10 :872-877