Journal of Yeungnam Medical Science

Original articles

Cardiology and Cardiovascular Medicine
Association between clopidogrel preloading time and post-procedural troponin elevation in patients with stable angina undergoing elective percutaneous coronary intervention: a retrospective cohort study: Sungho Jo, Jeong Tae Byoun, Donghyeon Joo, Jae Young Cho, Kyeong Ho Yun; J Yeungnam Med Sci. 2026;43:34. Published online May 18, 2026; DOI: https://doi.org/10.12701/jyms.2026.43.34

1,143 View
66 Download

Abstract PDF: Background
Clopidogrel requires several hours to achieve adequate platelet inhibition. We investigated the association of clopidogrel preloading time with 30-day clinical outcomes and post-procedural troponin elevation in patients with stable angina undergoing elective percutaneous coronary intervention (PCI).
Methods
This single-center retrospective cohort study included 1,020 patients with stable angina (clopidogrel-naive) who received 300 mg clopidogrel preloading within 24 hours before elective PCI between 2012 and 2020. Patients were categorized according to clopidogrel preloading-to-balloon time ≤6 hours or >6 hours. The primary endpoint was 30-day major adverse cardiovascular events (MACE), defined as a composite of all-cause death, myocardial infarction, stroke, and any revascularization. Secondary endpoints included serial troponin T changes and troponin T elevation ≥5×, ≥25×, and ≥70× the upper reference limit. Stabilized inverse probability of treatment weighting (IPTW) was used.
Results
Thirty-day MACE occurred in five patients (0.49%) and did not differ between the ≤6-hour and >6-hour groups after IPTW (0.5% vs. 0.4%, p=0.754). Post-procedural troponin T levels at 6, 24, and 48 hours were higher in the ≤6-hour group. Patients with shorter preloading-to-balloon times showed higher peak troponin T levels, with the greatest difference at the ≤1-hour cutoff (geometric mean ratio, 2.12; 95% confidence interval, 1.53–2.95; p<0.001) and progressive attenuation at longer cutoffs. Troponin T elevation ≥5× and ≥25× was more frequent in the ≤6-hour group, whereas ≥70× elevation did not differ.
Conclusion
Clopidogrel preloading ≤6 hours before elective PCI was not associated with increased 30-day MACE but was associated with lower-threshold post-procedural troponin T elevation.

Cardiology and Cardiovascular Medicine
The performance of ASpirin-FREE therapy after successful percutaneous coronary intervention for acute coronary syndrome: the ASFREE prospective pilot study: Donghyeon Joo, Sungho Jo, Jeong Tae Byoun, Jae Young Cho, Kyeong Ho Yun; J Yeungnam Med Sci. 2026;43:25. Published online March 19, 2026; DOI: https://doi.org/10.12701/jyms.2026.43.25

2,331 View
107 Download

Abstract PDF: Background
Dual antiplatelet therapy with aspirin and a P2Y12 inhibitor is standard after percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS); however, bleeding risk remains a major concern. Early discontinuation of aspirin due to potent P2Y12 inhibition may mitigate bleeding without increasing thrombotic events.
Methods
The ASpirin-FREE therapy after successful percutaneous coronary intervention for acute coronary syndrome (ASFREE) study was an investigator-initiated, single-center, prospective, open-label, single-arm pilot study enrolling patients with ACS who underwent PCI with drug-eluting stents. All patients received a single loading dose of aspirin on the day of the PCI, followed by ticagrelor or prasugrel monotherapy. The primary efficacy endpoint was target vessel failure (TVF) at 12 months. The primary safety endpoint was definite stent thrombosis. Event rates are reported with 95% confidence intervals (CIs).
Results
In total, 228 patients were enrolled. TVF occurred in 10 patients (4.4%; 95% CI, 2.1%–7.9%). Definite stent thrombosis was observed in one patient (0.4%; 95% CI, 0.01%–2.4%), with no acute or subacute events. Major bleeding (Bleeding Academic Research Consortium type 3 or 5) occurred in two patients (0.9%; 95% CI, 0.1%–3.1%).
Conclusion
An aspirin-free strategy following a single loading dose with continuation of potent P2Y12 inhibitor monotherapy was feasible in patients with ACS undergoing PCI and was associated with low rates of thrombotic and major bleeding events. These findings should be regarded as hypothesis-generating and supporting further evaluations in adequately powered randomized controlled trials (CRIS registration: KCT0008182).

Case report

Cardiology and Cardiovascular Medicine
Fatal progressive right heart failure in a pancreatic cancer patient: Jeong Tae Byoun, Jae Young Cho; Yeungnam Univ J Med. 2020;37(2):122-127. Published online September 19, 2019; DOI: https://doi.org/10.12701/yujm.2019.00332

11,244 View
113 Download
5 Crossref

Abstract PDF

Pulmonary tumor thrombotic microangiopathy (PTTM) is a rare but fatal complication of cancer and causes pulmonary hypertension and acute/subacute right heart failure. PTTM is most commonly associated with gastric cancer and more rarely associated with pancreatic cancer. We report a case of progressive right heart failure associated with clinically diagnosed pancreatic cancer, suggesting PTTM.

Citations

Citations to this article as recorded by

Multi-omics analysis of genetic drivers linking aortic stenosis and left ventricular diastolic dysfunction in heart failure
Zeeshan Ahmed, Prithvi Govindareddy, Jayden Mathew, Naveena Yanamala, Partho P. Sengupta
BioData Mining.2026;[Epub] CrossRef
A rare, life-threatening debut of pancreatic adenocarcinoma: Pulmonary tumor thrombotic microangiopathy
Pablo Jiménez-Labaig, Soledad Fernández Solé, Susana Gómez Varela, Jorge García Calvo, Sergio Carrera Revilla, Alberto Muñoz Llarena
Current Problems in Cancer: Case Reports.2023; 10: 100238. CrossRef
Evidence of sex differences in cancer‐related cardiac complications in mouse models of pancreatic and liver cancer
Anna Gams, Alejandro Nevarez, Stephanie Perkail, Aileen Venegas, Sharon A. George, Tatiana Efimova, Igor R. Efimov
Physiological Reports.2023;[Epub] CrossRef
Prospective of Pancreatic Cancer Diagnosis Using Cardiac Sensing
Mansunderbir Singh, Priyanka Anvekar, Bhavana Baraskar, Namratha Pallipamu, Srikanth Gadam, Akhila Sai Sree Cherukuri, Devanshi N. Damani, Kanchan Kulkarni, Shivaram P. Arunachalam
Journal of Imaging.2023; 9(8): 149. CrossRef
Fatal pulmonary tumour thrombotic microangiopathy in patient with ovarian adenocarcinoma: review and a case report
Gintare Neverauskaite-Piliponiene, Kristijonas Cesas, Darius Pranys, Skaidrius Miliauskas, Lina Padervinskiene, Jolanta Laukaitiene, Giedre Baksyte, Gintare Sakalyte, Egle Ereminiene
BMC Cardiovascular Disorders.2022;[Epub] CrossRef

First
Prev
Page of 1
Next
Last

Search