• Title/Summary/Keyword: Early stroke

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The Association of CHADS-P2A2RC Risk Score With Clinical Outcomes in Patients Taking P2Y12 Inhibitor Monotherapy After 3 Months of Dual Antiplatelet Therapy Following Percutaneous Coronary Intervention

  • Pil Sang Song;Seok-Woo Seong;Ji-Yeon Kim;Soo Yeon An;Mi Joo Kim;Kye Taek Ahn;Seon-Ah Jin;Jin-Ok Jeong;Jeong Hoon Yang;Joo-Yong Hahn;Hyeon-Cheol Gwon;Woo Jin Jang;Hyuck Jun Yoon;Jang-Whan Bae;Woong Gil Choi;Young Bin Song
    • Korean Circulation Journal
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    • v.54 no.4
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    • pp.189-200
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    • 2024
  • Background and Objectives: Concerns remain that early aspirin cessation may be associated with potential harm in subsets at high risk of ischemic events. This study aimed to assess the effects of P2Y12 inhibitor monotherapy after 3-month dual antiplatelet therapy (DAPT) vs. prolonged DAPT (12-month or longer) based on the ischemic risk stratification, the CHADS-P2A2RC, after percutaneous coronary intervention (PCI). Methods: This was a sub-study of the SMART-CHOICE trial. The effect of the randomized antiplatelet strategies was assessed across 3 CHADS-P2A2RC risk score categories. The primary outcome was a major adverse cardiac and cerebral event (MACCE), a composite of all-cause death, myocardial infarction, or stroke. Results: Up to 3 years, the high CHADS-P2A2RC risk score group had the highest incidence of MACCE (105 [12.1%], adjusted hazard ratio [HR], 2.927; 95% confidence interval [CI], 1.358-6.309; p=0.006) followed by moderate-risk (40 [1.4%], adjusted HR, 1.786; 95% CI, 0.868-3.674; p=0.115) and low-risk (9 [0.5%], reference). In secondary analyses, P2Y12 inhibitor monotherapy reduced the Bleeding Academic Research Consortium (BARC) types 2, 3, or 5 bleeding without increasing the risk of MACCE as compared with prolonged DAPT across the 3 CHADS-P2A2RC risk strata without significant interaction term (interaction p for MACCE=0.705 and interaction p for BARC types 2, 3, or 5 bleeding=0.055). Conclusions: The CHADS-P2A2RC risk score is valuable in discriminating high-ischemic-risk patients. Even in such patients with a high risk of ischemic events, P2Y12 inhibitor monotherapy was associated with a lower incidence of bleeding without increased risk of ischemic events compared with prolonged DAPT.

Investigation of the location of Jagiso eunchon in Goheung-hyeon and review the characteristics of Undae-ri kiln (고흥현 자기소(磁器所) 은촌(犾村)의 위치 탐색과 운대리 가마터 성격 검토)

  • SUNG Yungil
    • Korean Journal of Heritage: History & Science
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    • v.56 no.4
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    • pp.72-92
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    • 2023
  • As described above, the location of Jagiso eunchon in Goheung-hyeon and the nature of Undae-ri kiln site were examined. Goheung-hyeon's administrative agency was moved to Joyang-hyeon, which is now Joseong-myeon, Boseong-gun in 1395. Therefore, Goheung-hyeon Jagiso Eunchon in Sejongsillok Jiriji corresponding to 1424~1432 should be found in the west of Joseong-myeon, Boseong, where the administrative agency was moved in 1395. Among the four boundaries of Goheung-hyeon recorded in the 『Sejongsillok』 Jiriji, it is recorded as 2-ri by the sea in the south and 8-ri by Nakan in the east. If the current Goheung-hyeon is Goheung-hyeon's administrative agency in the Sejongsillok Jiriji Records Compilation Period, it cannot be the boundary the south and east mentioned above. This is because it cannot be 2-ri from the current Goheung-eup to the sea in the south, and Nakan is close to the north, not the east, as recorded. However, it has already been suggested that Joyanghyeonseong(朝陽縣城), located in Gonae Village, Ucheon-ri, Josung-myeon, Boseonggun is an Goheunghyeon's administrative agency. And if the four-way boundary of Goheung-hyeon was converted into the current distance unit based on this place(Joyanghyeonseong, 朝陽縣城), an approximate result could be obtained even if it did not exactly match. Therefore, it is highly likely that Goheung-hyeon's administrative agency, which was moved to Joyang-hyeon, Boseong in 1395, is Gonae Village, Ucheon-ri, JoSeong-myeon, Boseong. Jagiso eunchon(犾村) in Goheung-hyeon can be interpreted as a "dog-shouting village." It is thought to be a meaning structure of "animal + sound". A place name thought to have the same structure was identified in Jeongheung-ri, west of Ucheon-ri, Joseongmyeon, Boseong. It is the name of a village called Hoeum-dong(虎吟洞), and it is interpreted as the sound of a tiger or the bark of a tiger, which is the same as the meaning structure of Eunchon. However, there is Gaesan Village in the south of Hoeum-dong, and a Buncheong ware kiln site was identified around it. At this kiln site, a fragment of carved Buncheong ware engraved with the character "Eon", which corresponds to the right stroke of the character "Seom (贍)" in the name "Naeseom (內贍)" was identified. A small amount of Buncheong ware and Joseon celadon pieces were also identified. It can be seen that the Buncheong ware paid to the government was made by checking the Buncheong ware with the government name engraved on it. On the west side of Joyanghyeonseong Fortress in Ucheon-ri, joseong-myeon, Boseong, which was the administrative agency of Goheung-hyeon and the area around the Gaesan Buncheong ware kiln site in Jeongheung-ri, where the Buncheong ware paid to the government was, is thought to be Jagiso Eunchon, Goheung-hyeon. Jagiso and Dogiso are located in the four directions based on the administrative agency. Naturally, the location of Jagiso and Dogiso is also determined on where the administrative agency of Hyeon is. Since the Goheung-hyeon's administrative agency in the early Joseon Dynasty was moved to Ucheon-ri, joseong-myeon, Boseong-myeon, it is necessary to naturally find Jagiso and Dogiso in Boseong. In addition, regarding the nature of the kiln site in Undae-ri, the aspects of the excavated relics were considered. As a result, it is believed that the Undae-ri kiln site functioned as a jagiso in Heungyang-hyeon from February 1441 to the 1470s. If so, the "Ye" Buncheong ware, which was collected around Undae-ri kiln No. 7, could be naturally understood.