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Article: Out-of-hospital cardiac arrest in Singapore: Can we do better?

Chin, Chee Tang / Keng, Felix Yung Jih

Annals of the Academy of Medicine, Singapore

2022 Volume 51, Issue 6, Page(s) 327–328

MeSH term(s)	Cardiopulmonary Resuscitation ; Humans ; Out-of-Hospital Cardiac Arrest/epidemiology ; Out-of-Hospital Cardiac Arrest/therapy ; Singapore/epidemiology
Language	English
Publishing date	2022-07-04
Publishing country	Singapore
Document type	Editorial
ZDB-ID	604527-3
ISSN	0304-4602
ISSN	0304-4602
DOI	10.47102/annals-acadmedsg.2022184
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Article ; Online: Cerebrovascular infarct associated with intracoronary adenosine: a possible rare fractional flow reserve complication.

Keh, Yann Shan / Pang, Yu Zhi / Chin, Chee Tang

Singapore medical journal

2021 Volume 63, Issue 11, Page(s) 699–700

MeSH term(s)	Humans ; Adenosine/adverse effects ; Fractional Flow Reserve, Myocardial ; Coronary Circulation ; Coronary Stenosis/diagnostic imaging ; Vasodilator Agents/adverse effects ; Coronary Angiography ; Coronary Vessels
Chemical Substances	Adenosine (K72T3FS567) ; Vasodilator Agents
Language	English
Publishing date	2021-06-18
Publishing country	India
Document type	Letter
ZDB-ID	604319-7
ISSN	2737-5935 ; 0037-5675
ISSN (online)	2737-5935
ISSN	0037-5675
DOI	10.11622/smedj.2021085
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Zs.B 589: Show issues

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Article ; Online: Unique characteristics of Asians with hypertension: what is known and what can be done?

Loo, Germaine / Puar, Troy / Foo, Roger / Ong, Tiong Kiam / Wang, Tzung-Dau / Nguyen, Quang Ngoc / Chin, Chee Tang / Chin, Calvin W L

Journal of hypertension

2024

Abstract: Hypertension remains the leading modifiable risk factor for cardiovascular disease worldwide. Over the past 30 years, the prevalence of hypertension has been increasing in East and Southeast Asia to a greater extent as compared with other Western ... ...

Abstract	Hypertension remains the leading modifiable risk factor for cardiovascular disease worldwide. Over the past 30 years, the prevalence of hypertension has been increasing in East and Southeast Asia to a greater extent as compared with other Western countries. Asians with hypertension have unique characteristics. This can be attributed to increased impact of obesity on Asians with hypertension, excessive salt intake and increased salt sensitivity, loss of diurnal rhythm in blood pressure and primary aldosteronism. The impact of hypertension on cardiovascular (particularly strokes) and chronic kidney disease is greater in Asians. These unique characteristics underpinned by the diverse socioeconomic backgrounds pose its own challenges in the diagnosis and management of hypertension in Asia.
Language	English
Publishing date	2024-03-01
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	605532-1
ISSN	1473-5598 ; 0263-6352 ; 0952-1178
ISSN (online)	1473-5598
ISSN	0263-6352 ; 0952-1178
DOI	10.1097/HJH.0000000000003706
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Zs.A 1885: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Secondary Prevention Therapies in Real-World Patients with Myocardial Infarction: Eligibility Based on Randomized Trials Supporting European and American Guidelines.

Mas-Llado, Caterina / Rossello, Xavier / González-Del-Hoyo, Maribel / Pocock, Stuart / de Werf, Frans Van / Chin, Chee Tang / Danchin, Nicolas / Lee, Stephen W-L / Medina, Jesús / Huo, Yong / Bueno, Héctor

The American journal of medicine

2023 Volume 137, Issue 2, Page(s) 137–146.e10

Abstract: Objective: We aimed to evaluate the applicability of the eligibility criteria of randomized controlled trials (RCTs) cited in guideline recommendations in a real-world cohort of patients receiving secondary prevention after acute myocardial infarction ... ...

Abstract	Objective: We aimed to evaluate the applicability of the eligibility criteria of randomized controlled trials (RCTs) cited in guideline recommendations in a real-world cohort of patients receiving secondary prevention after acute myocardial infarction from the EPICOR registries. Methods: Recommendations provided by American and European guidelines for acute myocardial infarction were classified into general (applying to all patients) and specific (applying to patients with left ventricular dysfunction or heart failure). Randomized controlled trials cited in these recommendations were selected, and their entry criteria were applied to our international cohort of 18,117 patients. Results: There were 91.5% patients eligible for beta blockers (84.6% for general, and 5.9% for specific recommendations), 97.7% eligible for renin-angiotensin system inhibitor (angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers [ACEI/ARB]) recommendations (69.9% for general, 27.9% for specific) and 4.1% eligible for mineralocorticoid receptor antagonists (only specific recommendations). The percentages of patients with eligibility criteria who were discharged with a prescription of the recommended therapies were 80%-85% for beta blockers, 70%-75% for ACEI/ARB, and 29% for mineralocorticoid receptor antagonists. There were large regional variations in the percentage of eligible patients and in those receiving the medications (eg, 95% in Northern Europe and 57% in Southeast Asia for beta blockers). Conclusion: Most real-world acute myocardial infarction patients are eligible for secondary prevention therapy in both general and specific guideline recommendations, and the percentage of those on beta blockers and ACEI/ARB at hospital discharge is high. There are large regional variations in the proportion of patients receiving recommended therapies. Local targeted interventions are needed for quality improvement.
MeSH term(s)	Humans ; United States ; Secondary Prevention ; Mineralocorticoid Receptor Antagonists/therapeutic use ; Randomized Controlled Trials as Topic ; Myocardial Infarction/drug therapy ; Myocardial Infarction/prevention & control ; Angiotensin-Converting Enzyme Inhibitors/therapeutic use ; Angiotensin Receptor Antagonists/therapeutic use ; Adrenergic beta-Antagonists/therapeutic use
Chemical Substances	Mineralocorticoid Receptor Antagonists ; Angiotensin-Converting Enzyme Inhibitors ; Angiotensin Receptor Antagonists ; Adrenergic beta-Antagonists
Language	English
Publishing date	2023-10-12
Publishing country	United States
Document type	Journal Article
ZDB-ID	80015-6
ISSN	1555-7162 ; 1873-2178 ; 0002-9343 ; 1548-2766
ISSN (online)	1555-7162 ; 1873-2178
ISSN	0002-9343 ; 1548-2766
DOI	10.1016/j.amjmed.2023.09.021
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Article ; Online: Impact of standard modifiable cardiovascular risk factors on 2-year all-cause mortality: Insights from an international cohort of 23,489 patients with acute coronary syndrome.

González-Del-Hoyo, Maribel / Rossello, Xavier / Peral, Vicente / Pocock, Stuart / Van de Werf, Frans / Chin, Chee Tang / Danchin, Nicolas / Lee, Stephen W-L / Medina, Jesús / Huo, Yong / Bueno, Héctor

American heart journal

2023 Volume 264, Page(s) 20–30

Abstract: Background: Controversial findings have been reported in the literature regarding the impact of the absence of standard modifiable cardiovascular risk factors (SMuRFs) on long-term mortality risk in patients with acute coronary syndrome (ACS). While the ...

Abstract	Background: Controversial findings have been reported in the literature regarding the impact of the absence of standard modifiable cardiovascular risk factors (SMuRFs) on long-term mortality risk in patients with acute coronary syndrome (ACS). While the prognostic additive value of SMuRFs has been well described, the prognostic role of prior cardiovascular disease (CVD) by sex is less well-known in patients with and without SMuRFs. Methods: EPICOR and EPICOR Asia are prospective, observational registries conducted between 2010 and 2014, which enrolled ACS patients in 28 countries across Europe, Latin America, and Asia. Association between SMuRFs (diabetes, dyslipidaemia, hypertension, and smoking) and 2-year postdischarge mortality was evaluated using adjusted Cox models stratified by geographical region. Results: Among 23,489 patients, the mean age was 60.9 ± 11.9 years, 24.3% were women, 4,582 (20.1%) presented without SMuRFs, and 16,055 (69.5%) without prior CVD. Patients with SMuRFs had a higher crude 2-year postdischarge mortality (HR 1.86; 95% CI, 1.56-2.22; P < .001), compared to those without SMuRFs. After adjustment for potential confounding, the association between SMuRFs and 2-year mortality risk was substantially attenuated (HR 1.17, 95% CI 0.98-1.41; P = .087), regardless of the type of ACS. The risk conferred by prior CVD was added to the underlying risk of SMuRFs to provide risk-specific phenotypes (eg, women with SMuRFs and with prior CVD were at higher risk of dying than women without SMuRFs and without CVD; HR 1.67, 95% CI 1.34-2.06). Conclusions: In this large-scale international ACS cohort the absence of SMuRFs was not associated with a lower adjusted 2-year postdischarge mortality risk. Patients with both SMuRFs and prior CVD had a higher mortality irrespective of their sex.
MeSH term(s)	Humans ; Female ; Middle Aged ; Aged ; Male ; Acute Coronary Syndrome/complications ; Cardiovascular Diseases/complications ; Prospective Studies ; Aftercare ; Risk Factors ; Patient Discharge ; Heart Disease Risk Factors
Language	English
Publishing date	2023-06-04
Publishing country	United States
Document type	Journal Article
ZDB-ID	80026-0
ISSN	1097-6744 ; 0002-8703
ISSN (online)	1097-6744
ISSN	0002-8703
DOI	10.1016/j.ahj.2023.05.023
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Ui IV Zs.15: Show issues

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Article: A case of aortic regurgitation and hypotension.

Chan, Laura Lihua / Chin, Chee Tang

The International journal of angiology : official publication of the International College of Angiology, Inc

2013 Volume 22, Issue 4, Page(s) 263–266

Abstract: Takayasu arteritis is a chronic inflammatory large vessel vasculitis affecting the aorta and its main branches. It can present in various forms, and thereby may lead to a delay in diagnosis. We present a patient with Takayasu arteritis, diagnosed at our ... ...

Abstract	Takayasu arteritis is a chronic inflammatory large vessel vasculitis affecting the aorta and its main branches. It can present in various forms, and thereby may lead to a delay in diagnosis. We present a patient with Takayasu arteritis, diagnosed at our center when she presented with severe aortic regurgitation. We also review the current knowledge base with respect to Takayasu arteritis.
Language	English
Publishing date	2013-08-18
Publishing country	United States
Document type	Case Reports
ZDB-ID	1144390-x
ISSN	1061-1711
ISSN	1061-1711
DOI	10.1055/s-0033-1348886
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Zs.A 3635: Show issues

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Article ; Online: Role of Invasive Strategy for Non-ST-Elevation Myocardial Infarction in Patients With Chronic Kidney Disease: A Systematic Review and Meta-Analysis.

Fong, Khi Yung / Low, Chloe Hui Xuan / Chan, Yiong Huak / Ho, Kay Woon / Keh, Yann Shan / Chin, Chee Tang / Chin, Chee Yang / Fam, Jiang Ming / Wong, Ningyan / Idu, Muhammad / Wong, Aaron Sung Lung / Lim, Soo Teik / Koh, Tian Hai / Tan, Jack Wei Chieh / Yeo, Khung Keong / Yap, Jonathan

The American journal of cardiology

2023 Volume 205, Page(s) 369–378

Abstract: Patients with chronic kidney disease (CKD) have traditionally been excluded from randomized trials. We aimed to compare percutaneous coronary intervention versus conservative management, and early intervention (EI; within 24 hours of admission) versus ... ...

Abstract	Patients with chronic kidney disease (CKD) have traditionally been excluded from randomized trials. We aimed to compare percutaneous coronary intervention versus conservative management, and early intervention (EI; within 24 hours of admission) versus delayed intervention (DI; after 24 to 72 hours of admission) in patients with non-ST-segment elevation myocardial infarction (NSTEMI) and concomitant CKD. An electronic literature search was performed to search for studies comparing invasive management to conservative management or EI versus DI in patients with NSTEMI with CKD. The primary outcome was all-cause mortality; secondary outcomes were acute kidney injury (AKI) or dialysis, major bleeding, and recurrent MI. Hazard ratios (HRs) for the primary outcome and odds ratios for secondary outcomes were pooled in random-effects meta-analyses. Eleven studies (140,544 patients) were analyzed. Invasive management was associated with lower mortality than conservative management (HR 0.62, 95% confidence interval 0.57 to 0.67, p <0.001, I
MeSH term(s)	Humans ; Non-ST Elevated Myocardial Infarction/complications ; Non-ST Elevated Myocardial Infarction/therapy ; Acute Kidney Injury/epidemiology ; Acute Kidney Injury/etiology ; Conservative Treatment ; Hospitalization ; Renal Insufficiency, Chronic/complications ; Renal Insufficiency, Chronic/epidemiology ; ST Elevation Myocardial Infarction
Language	English
Publishing date	2023-08-26
Publishing country	United States
Document type	Meta-Analysis ; Systematic Review ; Journal Article
ZDB-ID	80014-4
ISSN	1879-1913 ; 0002-9149
ISSN (online)	1879-1913
ISSN	0002-9149
DOI	10.1016/j.amjcard.2023.07.178
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Article ; Online: Impact of Diabetes on Myocardial Fibrosis in Patients With Hypertension: The REMODEL Study.

Pua, Chee Jian / Loo, Germaine / Kui, Michelle / Moy, Wai Lun / Hii, An-An / Lee, Vivian / Chin, Chee-Tang / Bryant, Jennifer A / Toh, Desiree-Faye / Lee, Chi-Hang / Cook, Stuart A / Richards, A Mark / Le, Thu-Thao / Chin, Calvin W L

Circulation. Cardiovascular imaging

2023 Volume 16, Issue 7, Page(s) 545–553

Abstract: Background: Compared with patients with hypertension only, those with hypertension and diabetes (HTN/DM) have worse prognosis. We aimed to characterize morphological differences between hypertension and HTN/DM using cardiovascular magnetic resonance; ... ...

Abstract	Background: Compared with patients with hypertension only, those with hypertension and diabetes (HTN/DM) have worse prognosis. We aimed to characterize morphological differences between hypertension and HTN/DM using cardiovascular magnetic resonance; and compare differentially expressed proteins associated with myocardial fibrosis using high throughput multiplex assays. Methods: Asymptomatic patients underwent cardiovascular magnetic resonance: 438 patients with hypertension (60±8 years; 59% males) and 167 age- and sex-matched patients with HTN/DM (60±10 years; 64% males). Replacement myocardial fibrosis was defined as nonischemic late gadolinium enhancement on cardiovascular magnetic resonance. Extracellular volume fraction was used as a marker of diffuse myocardial fibrosis. A total of 184 serum proteins (Olink Target Cardiovascular Disease II and III panels) were measured to identify unique signatures associated with myocardial fibrosis in all patients. Results: Despite similar left ventricular mass ( Conclusions: Adverse cardiac remodeling was observed in patients with HTN/DM. The novel proteomic signatures and associated biological activities of increased immune and inflammatory response may partly explain these observations.
MeSH term(s)	Male ; Humans ; Female ; Contrast Media ; Proteomics ; Ventricular Function, Left/physiology ; Gadolinium ; Hypertension/diagnosis ; Diabetes Mellitus ; Cardiomyopathies/complications ; Fibrosis
Chemical Substances	Contrast Media ; Gadolinium (AU0V1LM3JT)
Language	English
Publishing date	2023-07-11
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2435045-X
ISSN	1942-0080 ; 1941-9651
ISSN (online)	1942-0080
ISSN	1941-9651
DOI	10.1161/CIRCIMAGING.123.015051
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Zs.A 6743: Show issues

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Article ; Online: Markers of Focal and Diffuse Nonischemic Myocardial Fibrosis Are Associated With Adverse Cardiac Remodeling and Prognosis in Patients With Hypertension: The REMODEL Study.

Iyer, Nithin R / Le, Thu-Thao / Kui, Michelle S L / Tang, Hak-Chiaw / Chin, Chee-Tang / Phua, Soon-Kieng / Bryant, Jennifer A / Pua, Chee-Jian / Ang, Briana / Toh, Desiree-Faye / Aw, Tar-Choon / Lee, Chi-Hang / Cook, Stuart A / Ugander, Martin / Chin, Calvin W L

Hypertension (Dallas, Tex. : 1979)

2022 Volume 79, Issue 8, Page(s) 1804–1813

Abstract: Background: The prognostic significance of focal and diffuse myocardial fibrosis in patients with cardiovascular risk factors is unclear.: Methods: REMODEL (Response of the Myocardium to Hypertrophic Conditions in the Adult Population) is an ... ...

Abstract	Background: The prognostic significance of focal and diffuse myocardial fibrosis in patients with cardiovascular risk factors is unclear. Methods: REMODEL (Response of the Myocardium to Hypertrophic Conditions in the Adult Population) is an observational cohort of asymptomatic patients with essential hypertension. All participants underwent cardiovascular magnetic resonance to assess for myocardial fibrosis: nonischemic late gadolinium enhancement (LGE), native myocardial T1, postcontrast myocardial T1, extracellular volume fraction including/excluding LGE regions, interstitial volume (extracellular volume×myocardial volume), and interstitial/myocyte ratio. Primary outcome was a composite of first occurrence acute coronary syndrome, heart failure hospitalization, strokes, and cardiovascular mortality. Patients were recruited from February 2016 and followed until June 2021. Results: Of the 786 patients with hypertension (58±11 years; 39% women; systolic blood pressure, 130±14 mm Hg), 145 (18%) had nonischemic LGE. Patients with nonischemic LGE were more likely to be men, have diabetes, be current smokers, and have higher blood pressure ( Conclusions: In patients with hypertension, myocardial fibrosis on cardiovascular magnetic resonance is associated with adverse cardiac remodeling and outcomes.
MeSH term(s)	Adult ; Cardiomyopathies ; Contrast Media ; Female ; Fibrosis ; Gadolinium ; Humans ; Hypertension/complications ; Hypertension/pathology ; Magnetic Resonance Imaging, Cine ; Male ; Myocardium/pathology ; Predictive Value of Tests ; Prognosis ; Prospective Studies ; Stroke Volume ; Ventricular Remodeling
Chemical Substances	Contrast Media ; Gadolinium (AU0V1LM3JT)
Language	English
Publishing date	2022-05-23
Publishing country	United States
Document type	Journal Article ; Observational Study ; Research Support, Non-U.S. Gov't
ZDB-ID	423736-5
ISSN	1524-4563 ; 0194-911X ; 0362-4323
ISSN (online)	1524-4563
ISSN	0194-911X ; 0362-4323
DOI	10.1161/HYPERTENSIONAHA.122.19225
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Zs.A 1488: Show issues

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Article: Coronary Intravascular Lithotripsy Versus Rotational Atherectomy in an Asian Population: Clinical Outcomes in Real-World Patients.

Wong, Jie Jun / Umapathy, Sridharan / Keh, Yann Shan / Lau, Yee How / Yap, Jonathan / Idu, Muhammad / Chin, Chee Yang / Fam, Jiang Ming / Liew, Boon Wah / Chin, Chee Tang / Wong, Philip En Hou / Koh, Tian Hai / Yeo, Khung Keong

Korean circulation journal

2021 Volume 52, Issue 4, Page(s) 288–300

Abstract: Background and objectives: We compared real-world clinical outcomes of patients receiving intravascular lithotripsy (IVL) versus rotational atherectomy (RA) for heavily calcified coronary lesions.: Methods: Fifty-three patients who received IVL from ... ...

Abstract	Background and objectives: We compared real-world clinical outcomes of patients receiving intravascular lithotripsy (IVL) versus rotational atherectomy (RA) for heavily calcified coronary lesions. Methods: Fifty-three patients who received IVL from January 2017 to July 2020 were retrospectively compared to 271 patients who received RA from January 2017 to December 2018. Primary endpoints were in-hospital and 30-day major adverse cardiovascular events (MACE). Results: IVL patients had a higher prevalence of acute coronary syndrome (56.6% vs 24.4, p<0.001), multivessel disease (96.2% vs 73.3%, p<0.001) and emergency procedures (17.0% vs 2.2%, p<0.001) compared to RA. In-hospital MACE (11.3% vs 5.9%, p=0.152), MI (7.5% vs 3.3%, p=0.152), and mortality (5.7% vs 3.0%, p=0.319) were not statistically significant. 30-day MACE was higher in the IVL cohort vs RA (17.0% vs 7.4%, p=0.035). Propensity score adjusted regression using IVL was also performed on in-hospital MACE (odds ratio [OR], 1.677; 95% confidence interval [CI], 0.588-4.779) and 30-day MACE (OR, 1.910; 95% CI, 0.774-4.718). Conclusions: These findings represent our initial IVL experience in a high-risk, real-world cohort. Although the event rate in the IVL arm was numerically higher compared to RA, the small numbers and retrospective nature of this study preclude definitive conclusions. These clinical outcomes are likely to improve with greater experience and better case selection, allowing IVL to effectively treat complex calcified coronary lesions.
Language	English
Publishing date	2021-11-29
Publishing country	Korea (South)
Document type	Journal Article
ZDB-ID	2557464-4
ISSN	1738-5520
ISSN	1738-5520
DOI	10.4070/kcj.2021.0155
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