• Journal of Chest Surgery
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• v.57 no.3
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• pp.242-251
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• 2024

Background: This study compared the outcomes of surgical aortic valve replacement (AVR) in patients aged 50 to 70 years based on the type of prosthetic valve used. Methods: We compared patients who underwent mechanical AVR to those who underwent bioprosthetic AVR at our institution between January 2000 and March 2019. Competing risk analysis and the inverse probability of treatment weighting (IPTW) method based on propensity score were employed for comparisons. Results: A total of 1,580 patients (984 patients with mechanical AVR; 596 patients with bioprosthetic AVR) were enrolled. There was no significant difference in early mortality between the mechanical AVR and bioprosthetic AVR groups (0.9% vs. 1.7%, p=0.177). After IPTW adjustment, the risk of all-cause mortality was significantly higher in the bioprosthetic AVR group than in the mechanical AVR group (hazard ratio [HR], 1.39; 95% confidence interval [CI], 1.07-1.80; p=0.014). Competing risk analysis revealed lower risks of stroke (sub-distributional hazard ratio [sHR], 0.44; 95% CI, 0.28-0.67; p<0.001) and anticoagulation-related bleeding (sHR, 0.35; 95% CI, 0.23-0.53; p<0.001) in the bioprosthetic AVR group. Conversely, the risk of aortic valve (AV) reintervention was higher in the bioprosthetic AVR group (sHR, 6.14; 95% CI, 3.17-11.93; p<0.001). Conclusion: Among patients aged 50 to 70 years who underwent surgical AVR, those receiving mechanical valves showed better survival than those with bioprosthetic valves. The mechanical AVR group exhibited a higher risk of stroke and anticoagulation-related bleeding, while the bioprosthetic AVR group showed a higher risk of AV reintervention.

• Journal of Preventive Medicine and Public Health
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• v.44 no.5
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• pp.218-225
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• 2011

Objectives: This study investigated the relationship between the blood mercury concentration and cardiovascular risk factors in elderly Korean individuals living in coastal areas. Methods: The sample consisted of 477 adults (164 males, 313 females) aged 40 to 65 years who visited a Busan health promotion center from June to September in 2009. The relationship between blood mercury concentration and cardiovascular risk factors including metabolic syndrome, cholesterol profiles, blood pressure, body mass index (BMI), waist circumference and waist-to-hip ratio (WHR), was investigated. Variables related to blood mercury concentration were further evaluated using multiple regression analysis. Results: The blood mercury concentration of the study population was 7.99 (range, 7.60 to 8.40) ${\mu}g$/L. In males, the blood mercury concentration was 9.74 (8.92 to 10.63) ${\mu}g$/L, which was significantly higher than that in females (7.21, [6.80 to 7.64] ${\mu}g$/L). The blood mercury concentration of the study population was related to several cardiovascular risk factors including low-density lipoprotein (LDL) cholesterol (p=0.044), high-density lipoprotein (HDL) cholesterol (p=0.034), BMI (p = 0.006), waist circumference (p = 0.031), and WHR (p < 0.001). In males, the blood mercury concentration was significantly correlated with WHR in the multiple regression analysis. Conclusions: In males, the blood mercury concentration was related to waist-to-hip ratio, which is a central obesity index and cardiovascular risk factor. Our finding suggests that cardiovascular disease risk in males was increased by mercury exposure via an obesity-related mechanism.

• Journal of Korean Academy of Nursing
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• v.35 no.8
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• pp.1500-1507
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• 2005

Purpose. The purpose of this study was to identify subgroups of the physical and behavioral risk profiles for cardiovascular disease among industrial workers, and to examine predicting factors for the subgroups. Sample and Method. Health records of 2,616 male and female workers aged 19-56 years who were employed in an airplane manufacturing industry were analyzed. Data were analyzed using the Latent class cluster analysis. Results. Four different clusters (two high-risk groups, one low-risk group, and one normal group) were found and these clusters were significantly different by age, gender, and work type (p < .05 ). The two high-risk groups had higher chances of drinking alcohol, elevated BMI, FBS, total cholesterol, having hypertension, and were significantly older, and had relatively high chances of being day workers rather than other groups. The low-risk group had higher chances of drinking alcohol, higher BMI and total cholesterols compared to normal group, and highest portions of current smokers and shift workers in the four clusters and their mean BP was within prehypertension criteria. Conclusion. Industrial nurses should guide the lifestyle behaviors and risk factors of the high risk groups for CVD and need to intervene early for behavioral change for the low-risk group who are young and shift workers. Age, and work environment should be considered in planning for targeted preventive interventions for industrial workers.

• Journal of Korean Academy of Nursing
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• v.45 no.6
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• pp.857-867
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• 2015

Purpose: The purpose of this study was to investigate individual and organizational level of cardiovascular disease (CVD) risk factors associated with CVD risk in Korean blue-collar workers working in small sized companies. Methods: Self-report questionnaires and blood sampling for lipid and glucose were collected from 492 workers in 31 small sized companies in Korea. Multilevel modeling was conducted to estimate effects of related factors at the individual and organizational level. Results: Multilevel regression analysis showed that workers in the workplace having a cafeteria had 1.81 times higher CVD risk after adjusting for factors at the individual level (p =.022). The explanatory power of variables related to organizational level variances in CVD risk was 17.1%. Conclusion: The results of this study indicate that differences in the CVD risk were related to organizational factors. It is necessary to consider not only individual factors but also organizational factors when planning a CVD risk reduction program. The factors caused by having cafeteria in the workplace can be reduced by improvement in the CVD-related risk environment, therefore an organizational-level intervention approach should be available to reduce CVD risk of workers in small sized companies in Korea.

• Journal of Korean Academy of Nursing
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• v.38 no.1
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• pp.64-73
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• 2008

Purpose: This study examined the effects of a nutrition education program on self-efficacy, diet behavior pattern and cardiovascular risk factors for patients with cardiovascular disease (CVD). Method: Sixty-four CVD subjects (37 experimental, 27 control) were recruited from a cardiac center, at a university hospital located in D city, Korea. All subjects attended a first heart camp where pretest measures were performed, and a second heart camp at 6 months for the posttest measures. During the 6 month study period, the experimental group was required to attend five monthly nutrition education sessions, while the control group received only routine outpatient follow-ups. Data were analyzed by $x^2$-test and independent t-test using the SPSSWIN 11.5 program. Result: Group comparisons revealed that the experimental group had significantly more improved self-efficacy, frequency of food selection, gustation of salt, systolic blood pressure, and serum total-cholesterol compared to the control group. Conclusion: A nutrition education program may be effective in improving self-efficacy, diet behavior pattern and cardiovascular risk factors for patients with cardiovascular disease.

• Korean Journal of Psychosomatic Medicine
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• v.14 no.2
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• pp.81-87
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• 2006

A lot of studies have investigated the role of psychosocial and behavioral risk factors in the etiology and pathogenesis of cardiovascular disease. On the basis of prospective population studies that found a relationship between Type A behavior and cardiac morbidity and mortality independent of traditional risk factors, Type A behavior was declared a risk factor for the development of coronary heart disease. Additionally, recently proposed, a new personality construct, Type D personality have been reported to be associated with the increased risk for cardiovascular morbidity and mortality. In Korea, however, there were few studies about these issues. This article attempts to provide an overview of accumulating evidences on the Type A behavioral pattern and Type D personality related with cardiovascular disease to offer new directions for research.

• Research in Community and Public Health Nursing
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• v.21 no.4
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• pp.409-418
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• 2010

Purpose: This study aimed to estimate the effects of a regular walking exercise program on metabolic syndrome, cardiovascular risk factors, and depressive symptoms among the elderly with diabetic mellitus (DM) based on the Theory of Reasoned Action (TRA). Methods: This study has randomized and stratified experimental design with experimental and control groups. We developed a regular walking exercise program suitable for the elderly with DM based on the guidance of AAHPERD. The experimental group participated in the regular walking exercise program, which contains walking exercise 3 times a week and 50 minutes each time for 3 months and education on controlling diet and preventing complications once a week and 20 minutes each time for 4 weeks. Post-test was conducted after 3 months to estimate metabolic syndrome, cardiovascular risk factors, and depressive symptoms. Results: The regular walking exercise program was effective for decreasing the waist size, the level of fasting blood glucose (FBG) and triglyceride (TG), cardiovascular risk factors and the severity of depressive symptoms among the elderly with DM. Conclusion: The incidence of complications would be decreased by applying a regular walking exercise program.

• Korean Journal of Health Education and Promotion
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• v.31 no.4
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• pp.37-49
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• 2014

Objectives: The aim of this study was to evaluate the effects of a lifestyle modification program for Korean adults with cardiovascular disease risk factors on their health behaviors and health status. Methods: A total of 448 adults with abdominal obesity and additional cardiovascular disease risk factors(high blood pressure, low HDL-cholesterol, high triglyceride or high blood glucose) were randomly assigned to either an intensive intervention group (IIG, n=216) or a minimal intervention group(MIG, n=232). Participants in the IIG received lifestyle modification program which consisted of health counseling with nutrition assessment, health booklet and health diary, while those in MIG received minimal information. Results: The participants in the IIG significantly improved dietary habits(p<.05), retrained eating(p<.001), external eating(p<.01) behaviors, leisure time physical activity(p<.05), dietary self-efficacy(p<.01), exercise self-efficacy(p<.01) and MetS score(p<.001) after 3 months. In addition, the participants in the IIG showed more improvement in dietary habits(p<.05) compared with those in the MIG. Conclusion: The lifestyle modification program was effective in improving some health behaviors, behavioral determinants and cardiovascular risk factors for a short term.

• Journal of Chest Surgery
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• v.57 no.2
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• pp.195-204
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• 2024

Background: Extracorporeal membrane oxygenation (ECMO) is an intervention for severe heart and lung failure; however, it poses the risk of complications, including gastrointestinal bleeding (GIB). Comprehensive analyses of GIB in patients undergoing ECMO are limited, and its impact on clinical outcomes remains unclear. Methods: This retrospective study included 484 patients who received venovenous and venoarterial ECMO between January 2015 and December 2022. Data collected included patient characteristics, laboratory results, GIB details, and interventions. Statistical analyses were performed to identify risk factors and assess the outcomes. Results: GIB occurred in 44 of 484 patients (9.1%) who received ECMO. Multivariable analysis revealed that older age (odds ratio [OR], 1.04; 95% confidence interval [CI], 1.01-1.06; p=0.0130) and need to change the ECMO mode (OR, 3.74; 95% CI, 1.75-7.96; p=0.0006) were significant risk factors for GIB, whereas no association was found with antiplatelet or systemic anticoagulation therapies during ECMO management. Half of the patients with GIB (22/44, 50%) underwent intervention, with endoscopy as the primary modality (19/22, 86.4%). Patients who underwent ECMO and developed GIB had higher rates of mortality (40/44 [90.9%] vs. 262/440 [59.5%]) and ECMO weaning failure (38/44 [86.4%] vs. 208/440 [47.3%]). Conclusion: GIB in patients undergoing ECMO is associated with adverse outcomes, including increased risks of mortality and weaning failure. Even in seemingly uncomplicated cases, it is crucial to avoid underestimating the significance of GIB.

• The Journal of Internal Korean Medicine
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• v.28 no.4
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• pp.808-815
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• 2007

Objectives : This study investigated stroke lesions and their relationship with warning signs and risk factors in stroke patients. Methods : Three hundred fifty-three stroke patients were recruited at the Department of Cardiovascular and Neurologic Diseases (stroke center) of Kyung Hee University Oriental hospital from October 2005 to July 2007. We evaluated their stroke lesions with brain MRI, their warning signs, and risk factors. Results : 353 subjects were included in the final analysis. The frequency of diabetes was found more in presence of brain stem lesion than without. The cortex lesion showed a close relationship with smoking, drinking and the frequency of one side paralysis or weakness. These were more common in males than in females. Conclusions : We observed stroke lesions and their characteristics in stroke patients. The subjects' brain lesions seemed affectedby the risk factors. A concrete conclusion can hardly be drawn from this study; additional research is necessary.