Cardiovascular Prevention and Pharmacotherapy

Editorial

Welcome to the New Journal Cardiovascular Prevention and Pharmacotherapy: Mi-Jeong Kim, Jang-Whan Bae, Dae Ryong Kang; Cardiovasc Prev Pharmacother. 2019;1(1):1-2. Published online July 31, 2019; DOI: https://doi.org/10.36011/cpp.2019.1.e5

Review Articles

Asian Cohort Studies on Cardiovascular Risk Factors in Childhood: Sun Jae Jung, Hyeon Chang Kim, Il Suh; Cardiovasc Prev Pharmacother. 2019;1(1):3-9. Published online July 31, 2019; DOI: https://doi.org/10.36011/cpp.2019.1.e2

Abstract PDF: Long-term cohort studies have shown that cardiovascular risk factors measured during childhood were associated with levels of adult cardiovascular risk factors and also with the lifetime risk of cardiovascular disease (CVD). However, most of the epidemiologic evidence was from Western studies and relatively small in the Asian population. From the literature, we identified and reviewed 8 Asian cohort studies focusing on cardiovascular risk factors among children. The Asian cohort studies have confirmed that childhood risk factors can predict later levels of adult risk factors. Besides, it has been shown that childhood risk factors are associated with intermediate phenotypes, such as metabolic disturbance and degenerative vascular changes, in adulthood. These findings reaffirmed the importance of screening and managing cardiovascular risk factors from early life in Asia. However, there is little evidence on CVD incidence and mortality because there is no Asian cohort study, which observed from childhood until middle-aged or old ages. Longer follow-up data are required to measure the impact of childhood cardiovascular risk factors, especially since obesity and other cardiovascular risk factors are increasing in Asian children and adolescents.

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

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.

Role of Novel Oral Anticoagulant for Patient with Atrial Fibrillation Underwent Percutaneous Coronary Intervention: Jang-Whan Bae; Cardiovasc Prev Pharmacother. 2019;1(1):19-29. Published online July 31, 2019; DOI: https://doi.org/10.36011/cpp.2019.1.e1

Abstract PDF: Atrial fibrillation (AF) is very common arrhythmic disorder especially in elderly population, and makes higher major adverse cardiac events (MACEs) in the patients with acute coronary syndrome (ACS) or underwent percutaneous coronary intervention (PCI). Pivotal drug for AF patients to reduce systemic embolism was warfarin, and certain duration of dual antiplatelet therapy (DAPT) is important after PCI with stent. But, best regimen of antithrombotic agent after PCI in AF is unclear especially in the clinical use of novel oral anticoagulant (NOAC). This manuscript will deal those clinical studies to indicate optimal regimen and duration of NOAC use for AF patients underwent PCI. NOAC use on DAPT significantly reduces major or minor bleeding compared to warfarin in AF patients with ACS or underwent PCI. But, the duration of NOAC use is still unclear, and there is exist clear contraindication to use it in clinical field. NOAC use reduced major or minor bleeding significantly compared to warfarin, but the incidence of MACEs was similar between warfarin and NOAC. Physician should understand the advantage or disadvantage of NOAC use, and be able to tailor the regimen and duration of antithrombotics including NOAC in this higher risk patient population.

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

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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