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  1. Article ; Online: Differences in Attitudes and Barriers Towards Advance Care Planning Amongst Ischemic Heart Disease Patients: A Cross-Sectional Study.

    Ng, Alyssa / Khoo, Athena Ming-Gui / Lau, Jerrald / Ang, Chermaine / Sim, Hui-Wen / Tan, Ker-Kan

    The American journal of hospice & palliative care

    2024  , Page(s) 10499091241231881

    Abstract: Objectives: Perceptions towards advanced care planning (ACP) amongst individuals with Ischemic Heart Disease before or after a life-threatening Acute Myocardial Infarction event is underexamined and could impact the appropriate timing for ACP advocacy. ... ...

    Abstract Objectives: Perceptions towards advanced care planning (ACP) amongst individuals with Ischemic Heart Disease before or after a life-threatening Acute Myocardial Infarction event is underexamined and could impact the appropriate timing for ACP advocacy. This cross-sectional study assessed awareness and intentions regarding ACP in individuals with Ischemic Heart Disease, both before and after an Acute Myocardial Infarction, and explored the motivating effect of a near-fatal Acute Myocardial Infarction event on its engagement.
    Methods: This study was conducted from 24 August 2021 through 13 March 2023, whereby patients were administered a one-time questionnaire with no follow-up required. Patients with either chronic Ischemic Heart Disease (group A) or a recent Acute Myocardial Infarction event (group B) were recruited from the outpatient National University Heart Centre, Singapore.
    Results: 101 patients (n = 51 for Group A, n = 50 for Group B) were recruited. Mean age (SD) was 59 (10.5) years and 84 were male (83.2%). Between both groups, patients in group B reported significantly higher scores on 'Lack of information' and 'Self-efficacy' domains, and had no ACP awareness nor plans of doing an ACP compared to group A. ACP awareness was the sole significant predictor of intentions of doing an ACP in the final regression model (
    Conclusions: Interestingly, this study suggests that surviving a potentially life-threatening heart condition did not result in higher intention of doing an ACP. Thus, advocacy of ACP in the community should simply start by raising awareness levels widely and may not need to be focused on individuals' state of health.
    Language English
    Publishing date 2024-02-07
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1074344-3
    ISSN 1938-2715 ; 1049-9091
    ISSN (online) 1938-2715
    ISSN 1049-9091
    DOI 10.1177/10499091241231881
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  2. Article ; Online: Sirolimus nanoparticles: (Delivering) a new hope in stentless percutaneous coronary intervention?

    Loh, Joshua P / Sim, Hui Wen

    Cardiovascular revascularization medicine : including molecular interventions

    2019  Volume 20, Issue 3, Page(s) 179–180

    MeSH term(s) Drug-Eluting Stents ; Nanoparticles ; Percutaneous Coronary Intervention ; Registries ; Sirolimus
    Chemical Substances Sirolimus (W36ZG6FT64)
    Language English
    Publishing date 2019-01-06
    Publishing country United States
    Document type Editorial ; Comment
    ZDB-ID 2212113-4
    ISSN 1878-0938 ; 1553-8389
    ISSN (online) 1878-0938
    ISSN 1553-8389
    DOI 10.1016/j.carrev.2019.01.004
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  3. Article ; Online: Rotational Atherectomy for Underexpanded Undilatable Stents: Is Ablating Away Stent Regret the Best Option?

    Loh, Joshua P / Sim, Hui Wen

    Cardiovascular revascularization medicine : including molecular interventions

    2019  Volume 20, Issue 11, Page(s) 939–940

    MeSH term(s) Atherectomy, Coronary ; Coronary Artery Disease ; Emotions ; Humans ; Stents
    Language English
    Publishing date 2019-09-07
    Publishing country United States
    Document type Editorial ; Comment
    ZDB-ID 2212113-4
    ISSN 1878-0938 ; 1553-8389
    ISSN (online) 1878-0938
    ISSN 1553-8389
    DOI 10.1016/j.carrev.2019.09.005
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  4. Article: Enhanced Thrombin Generation Is Associated with Worse Left Ventricular Scarring after ST-Segment Elevation Myocardial Infarction: A Cohort Study.

    Sia, Ching-Hui / Tan, Sock-Hwee / Chan, Siew-Pang / Marchesseau, Stephanie / Sim, Hui-Wen / Carvalho, Leonardo / Chen, Ruth / Amin, Nor Hanim Mohd / Fong, Alan Yean-Yip / Richards, Arthur Mark / Yip, Christina / Chan, Mark Y

    Pharmaceuticals (Basel, Switzerland)

    2022  Volume 15, Issue 6

    Abstract: Acute myocardial infarction (AMI) is associated with heightened thrombin generation. There are limited data relating to thrombin generation and left ventricular (LV) scarring and LV dilatation in post-MI LV remodeling. We studied 113 patients with ST- ... ...

    Abstract Acute myocardial infarction (AMI) is associated with heightened thrombin generation. There are limited data relating to thrombin generation and left ventricular (LV) scarring and LV dilatation in post-MI LV remodeling. We studied 113 patients with ST-segment elevation myocardial infarction (STEMI) who had undergone primary percutaneous coronary intervention (PPCI) (
    Language English
    Publishing date 2022-06-06
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2193542-7
    ISSN 1424-8247
    ISSN 1424-8247
    DOI 10.3390/ph15060718
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  5. Article: Clinical Characteristics and Long-Term Outcomes of Patients With Differing Haemoglobin Levels Undergoing Semi-Urgent and Elective Percutaneous Coronary Intervention in an Asian Population.

    Soh, Rodney Yu-Hang / Sia, Ching-Hui / Djohan, Andie Hartanto / Lau, Rui-Huai / Ho, Pei-Ying / Neo, Jonathan Wen-Hui / Ho, Jamie Sin-Ying / Sim, Hui-Wen / Yeo, Tiong-Cheng / Tan, Huay-Cheem / Chan, Mark Yan-Yee / Loh, Joshua Ping-Yun

    Frontiers in cardiovascular medicine

    2022  Volume 9, Page(s) 687555

    Abstract: Introduction: This study aimed to investigate the impact of anaemia on long-term clinical outcomes in patients who underwent semi-urgent and elective percutaneous coronary intervention (PCI) in an Asian population. Although the effects of anaemia on ... ...

    Abstract Introduction: This study aimed to investigate the impact of anaemia on long-term clinical outcomes in patients who underwent semi-urgent and elective percutaneous coronary intervention (PCI) in an Asian population. Although the effects of anaemia on outcomes in Asian patients are well studied for acute coronary syndrome, its impact on Asian patients undergoing semi-urgent and elective PCI is unclear.
    Methods: This was a retrospective cohort study of patients who underwent semi-urgent and elective PCI from January 1, 2014, to December 31, 2015, at a tertiary academic centre. A total of 1,685 patients were included. They were stratified into three groups: normal (≥12 g/dL), intermediate (10-11.9 g/dL), and low (<10 g/dL) haemoglobin levels. Demographics, risk factors, and end-points including the 5-point major adverse cardiac and cerebrovascular events (MACCE) (all-cause death, subsequent stroke, myocardial infarction, congestive cardiac failure, and target lesion revascularisation), cardiovascular death, and bleeding events were analysed.
    Results: Patients in intermediate and low haemoglobin level groups were older with more comorbidities. Compared to the normal haemoglobin level group, low haemoglobin level group patients were associated with an increased risk of composite endpoints of all-cause death, subsequent stroke, myocardial infarction, congestive cardiac failure, and target lesion revascularisation [adjusted hazard ratio (aHR) 1.89, 95% confidence interval (CI):1.22, 2.92;
    Conclusion: In our Asian cohort, patients with anaemia undergoing PCI were associated with a higher comorbid burden. Despite adjustments for comorbidities, these patients had higher mortality and worse cardiovascular outcomes following contemporary PCI.
    Language English
    Publishing date 2022-03-18
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2781496-8
    ISSN 2297-055X
    ISSN 2297-055X
    DOI 10.3389/fcvm.2022.687555
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  6. Article ; Online: Percutaneous coronary intervention in patients aged 80 years old and above: a systematic review and meta-analysis.

    Lin, Norman H / Ho, Jamie S-Y / Djohan, Andie Hartanto / Ho, Vanda Wen-Teng / Teo, Yao Neng / Teo, Yao Hao / Syn, Nicholas L / Aye, Yin Nwe / Soh, Rodney Y H / Yeo, Tiong-Cheng / Sim, Hui-Wen / Tan, Huay-Cheem / Chan, Mark Y / Sia, Ching-Hui

    AsiaIntervention

    2022  Volume 8, Issue 2, Page(s) 123–131

    Abstract: Background: Ischaemic heart disease remains the main cause of death in the world. With increasing age, frailty and comorbidities, senior patients aged 80 years old and above who undergo percutaneous coronary intervention (PCI) are at higher risk of ... ...

    Abstract Background: Ischaemic heart disease remains the main cause of death in the world. With increasing age, frailty and comorbidities, senior patients aged 80 years old and above who undergo percutaneous coronary intervention (PCI) are at higher risk of mortality and other complications.
    Aims: We aimed to examine the overall outcomes for this group of patients.
    Methods: Four databases (PUBMED, EMBASE, SCOPUS and CENTRAL) were searched. Studies with patients aged 80 years old and above who underwent PCI for all indications were included. Pooled outcomes of all-cause death, cardiac death, in-hospital death, subsequent stroke/transient ischaemic attack (TIA), subsequent myocardial infarction (MI), subsequent congestive cardiac failure (CCF), and overall major adverse cardiac events (MACE) were obtained for meta-analysis.
    Results: From 2,566,004 patients, the pooled cumulative incidence of death was 19.22%, cardiac death was 7.78%, in-hospital death was 7.16%, subsequent stroke/TIA was 1.54%, subsequent MI was 3.58%, subsequent CCF was 4.74%, and MACE was 17.51%. The mortality rate of all patients was high when followed up for 3 years (33.27%). ST-elevation myocardial infarction patients had more outcomes of in-hospital death (14.24% vs 4.89%), stroke/TIA (1.93% vs 0.12%), MI (3.68 vs 1.55%) and 1-year mortality (26.16% vs 13.62%), when compared to non-ST-elevation myocardial infarction patients.
    Conclusions: There was a high mortality rate at 1 year and 3 years post-PCI in the overall population of senior patients aged 80 years old and above, regardless of indication. This necessitates further studies to explore the implications of these observations.
    Language English
    Publishing date 2022-10-06
    Publishing country France
    Document type Journal Article ; Review
    ISSN 2491-0929
    ISSN (online) 2491-0929
    DOI 10.4244/AIJ-D-21-00040
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  7. Article: Symptomatic intracerebral hemorrhage after non-emergency percutaneous coronary intervention: Incidence, risk factors, and association with cardiovascular outcomes.

    Lim, Mervyn Jun Rui / Zheng, Yilong / Soh, Rodney Yu-Hang / Foo, Qi Xuan Joel / Djohan, Andie Hartanto / Nga Diong Weng, Vincent / Ho, Jamie Sin-Ying / Yeo, Tseng Tsai / Sim, Hui-Wen / Yeo, Tiong-Cheng / Tan, Huay-Cheem / Chan, Mark Yan-Yee / Loh, Joshua Ping-Yun / Sia, Ching-Hui

    Frontiers in cardiovascular medicine

    2022  Volume 9, Page(s) 936498

    Abstract: Objective: To investigate the incidence, risk factors, and association with cardiovascular outcomes of patients who developed symptomatic intracerebral hemorrhage (ICH) after non-emergency percutaneous coronary intervention (PCI).: Methods: We ... ...

    Abstract Objective: To investigate the incidence, risk factors, and association with cardiovascular outcomes of patients who developed symptomatic intracerebral hemorrhage (ICH) after non-emergency percutaneous coronary intervention (PCI).
    Methods: We conducted a single-institution retrospective study of patients who developed symptomatic ICH after non-emergency PCI. To identify associations between clinical variables and outcomes, Cox-proportional hazards regression models were constructed. Outcomes analyzed include (1) all-cause mortality, (2) acute ischemic stroke (AIS) or transient ischemic attack (TIA), and (3) major adverse cardiovascular events (MACE).
    Results: A total of 1,732 patients were included in the analysis. The mean (±SD) age was 61.1 (±11.3) years, and 1,396 patients (80.6%) were male. The cumulative incidence of symptomatic ICH after non-emergency PCI was 1.3% (22 patients). Age, chronic kidney disease, and prior coronary artery bypass graft surgery were independently associated with a higher risk of ICH after PCI, while hyperlipidemia was independently associated with a lower risk of ICH after PCI. ICH after PCI was independently associated with a higher risk of all-cause mortality and AIS or TIA after PCI.
    Conclusion: Patients who are older, who have chronic kidney disease, and who have had prior coronary artery bypass graft surgery should be monitored for symptomatic ICH after non-emergency PCI.
    Language English
    Publishing date 2022-09-16
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2781496-8
    ISSN 2297-055X
    ISSN 2297-055X
    DOI 10.3389/fcvm.2022.936498
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  8. Article ; Online: Inadequately low left ventricular mass in patients with significant aortic stenosis predicts favourable prognostic outcomes.

    Chew, Nicholas W S / Ngiam, Jinghao Nicholas / Tan, Benjamin Yong-Qiang / Sia, Ching-Hui / Ruan, Wen / Sim, Hui-Wen / Kong, William K F / Tay, Edgar L W / Yeo, Tiong-Cheng / Poh, Kian Keong

    The international journal of cardiovascular imaging

    2021  Volume 37, Issue 5, Page(s) 1611–1619

    Abstract: In patients with significant aortic stenosis (AS), the prognostic effect of the increase in left ventricular mass (LVM) in relation to one's hemodynamic load has been described. Inappropriately high LVM has been shown to predict adverse cardiovascular ... ...

    Abstract In patients with significant aortic stenosis (AS), the prognostic effect of the increase in left ventricular mass (LVM) in relation to one's hemodynamic load has been described. Inappropriately high LVM has been shown to predict adverse cardiovascular events. However, little is known about the prognostic impact of inadequately low LVM (i-lowLVM) in patients with significant AS. I-lowLVM was defined as the measured LVM < 73% of the predicted LVM based on sex, stroke work and height from the reference adult population, used in previous established studies. For outcome analysis, the end-point was defined as all-cause mortality, aortic valve replacement and/or admission for congestive heart failure. Kaplan-Meier curves and multivariable Cox regression models were constructed to compare outcomes on follow-up. During the follow-up (4.5 ± 4.1 years), 132 patients (11.1%) had i-lowLVM, 868 (73.1%) had adequate-LVM, 188 (15.8%) had inappropriately high LVM. Outcome analysis only included patients with i-lowLVM and adequate-LVM (N = 1000). An adverse composite event occurred in 41.7% of the i-lowLVM group and 52.4% of the adequate-LVM group (p = 0.021). Event-free survival in patients with i-lowLVM and appropriate-LVM was 76% versus 68% at 2-year, 55% versus 46% at 4-year, 33% versus 27% at 6-year, 20% versus 17% at 8-year, and 17% versus 11% at 10-year follow-up, respectively (p < 0.001). Cox analysis revealed that i-lowLVM was independently associated with lower composite adverse outcome (HR 0.624, 95% CI 0.460-0.846, p = 0.002) after adjusting for sex, age, ejection fraction, ischemic heart disease, diabetes and transaortic valve mean gradient. In the separate Cox subanalyses, the presence of i-lowLVM remained a predictor of lower composite adverse outcome in the severe AS subgroup (HR 0.587, 95% CI 0.396-0.870, p = 0.008), and the LVH subgroup (HR 0.574, 95% CI 0.401-0.824, p = 0.003) after adjusting for confounders. I-lowLVM despite significant AS may represent a distinct group that is associated with improved survival outcomes independent of other prognostic covariates.
    MeSH term(s) Aortic Valve/diagnostic imaging ; Aortic Valve/surgery ; Aortic Valve Stenosis/diagnostic imaging ; Aortic Valve Stenosis/surgery ; Heart Valve Prosthesis ; Humans ; Hypertrophy, Left Ventricular/diagnostic imaging ; Hypertrophy, Left Ventricular/etiology ; Predictive Value of Tests ; Prognosis ; Stroke Volume ; Ventricular Function, Left
    Language English
    Publishing date 2021-01-16
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2055311-0
    ISSN 1875-8312 ; 1573-0743 ; 1569-5794 ; 0167-9899
    ISSN (online) 1875-8312 ; 1573-0743
    ISSN 1569-5794 ; 0167-9899
    DOI 10.1007/s10554-020-02146-3
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    Zs.A 2104: Show issues Location:
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  9. Article ; Online: Remote intensive management to improve antiplatelet adherence in acute myocardial infarction: a secondary analysis of the randomized controlled IMMACULATE trial.

    Sim, Hui Wen / Koh, Karen W L / Poh, Sock-Cheng / Chan, Siew Pang / Marchesseau, Stephanie / Singh, Devinder / Han, Yiying / Ng, Faclin / Lim, Eleanor / Prabath, Joseph F / Lee, Chi-Hang / Chen, Ruth / Carvalho, Leonardo / Tan, Sock-Hwee / Loh, Joshua P Y / Tan, Jack W C / Kuwelker, Karishma / Amanullah, R M / Chin, Chee-Tang /
    Yip, James W L / Lee, Choy-Yee / Gan, Juvena / Lo, Chew-Yong / Ho, Hee-Hwa / Hausenloy, Derek J / Tai, Bee-Choo / Richards, A Mark / Chan, Mark Y

    Journal of thrombosis and thrombolysis

    2024  Volume 57, Issue 3, Page(s) 408–417

    Abstract: This study aim to investigate if remote intensive coaching for the first 6 months post-AMI will improve adherence to the twice-a-day antiplatelet medication, ticagrelor. Between July 8, 2015, to March 29, 2019, AMI patients were randomly assigned to ... ...

    Abstract This study aim to investigate if remote intensive coaching for the first 6 months post-AMI will improve adherence to the twice-a-day antiplatelet medication, ticagrelor. Between July 8, 2015, to March 29, 2019, AMI patients were randomly assigned to remote intensive management (RIM) or standard care (SC). RIM participants underwent 6 months of weekly then two-weekly consultations to review medication side effects and medication adherence coaching by a centralized nurse practitioner team, whereas SC participants received usual cardiologist face-to-face consultations. Adherence to ticagrelor were determined using pill counting and serial platelet reactivity measurements for 12 months. A total of 149 (49.5%) of participants were randomized to RIM and 152 (50.5%) to SC. Adherence to ticagrelor was similar between RIM and SC group at 1 month (94.4 ± 0.7% vs. 93.6±14.7%, p = 0.537), 6 months (91.0±14.6% vs. 90.6±14.8%, p = 0.832) and 12 months (87.4±17.0% vs. 89.8±12.5%, p = 0.688). There was also no significant difference in platelet reactivity between the RIM and SC groups at 1 month (251AU*min [212-328] vs. 267AU*min [208-351], p = 0.399), 6 months (239AU*min [165-308] vs. 235AU*min [171-346], p = 0.610) and 12 months (249AU*min [177-432] vs. 259AU*min [182-360], p = 0.678). Sensitivity analysis did not demonstrate any association of ticagrelor adherence with bleeding events and major adverse cardiovascular events. RIM, comprising 6 months of intensive coaching by nurse practitioners, did not improve adherence to the twice-a-day medication ticagrelor compared with SC among patients with AMI. A gradual decline in ticagrelor adherence over 12 months was observed despite 6 months of intensive coaching.
    MeSH term(s) Humans ; Ticagrelor/therapeutic use ; Myocardial Infarction/drug therapy ; Myocardial Infarction/chemically induced ; Platelet Aggregation Inhibitors/therapeutic use ; Blood Platelets ; Hemorrhage/chemically induced ; Treatment Outcome ; Percutaneous Coronary Intervention
    Chemical Substances Ticagrelor (GLH0314RVC) ; Platelet Aggregation Inhibitors
    Language English
    Publishing date 2024-02-01
    Publishing country Netherlands
    Document type Randomized Controlled Trial ; Journal Article
    ZDB-ID 1230645-9
    ISSN 1573-742X ; 0929-5305
    ISSN (online) 1573-742X
    ISSN 0929-5305
    DOI 10.1007/s11239-023-02931-6
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  10. Article ; Online: Low Relative Valve Load is Associated With Paradoxical Low-Flow Aortic Stenosis Despite Preserved Left Ventricular Ejection Fraction and Adverse Clinical Outcomes.

    Ngiam, Jinghao N / Chew, Nicholas W S / Pramotedham, Thanawin / Tan, Benjamin Y Q / Sim, Hui-Wen / Ruan, Wen / Sia, Ching-Hui / Kong, William K F / Yeo, Tiong-Cheng / Poh, Kian-Keong

    Heart, lung & circulation

    2021  Volume 31, Issue 1, Page(s) 128–135

    Abstract: Background: Paradoxical low-flow (LF) severe aortic stenosis (AS) despite preserved left ventricular (LV) ejection fraction (LVEF) has been shown to be distinct from normal-flow (NF) AS, with a poorer prognosis. Relative valve load (RVL) is a novel ... ...

    Abstract Background: Paradoxical low-flow (LF) severe aortic stenosis (AS) despite preserved left ventricular (LV) ejection fraction (LVEF) has been shown to be distinct from normal-flow (NF) AS, with a poorer prognosis. Relative valve load (RVL) is a novel echocardiographic haemodynamic index based on the ratio of transaortic mean pressure gradient to the global valvulo-arterial impedance (Zva) in order to estimate the contribution of the valvular afterload to the global LV load. We aimed to determine the usefulness of RVL in LF AS versus NF AS.
    Method: A total of 450 consecutive patients with medically managed severe AS (aortic valve area <1.0 cm
    Results: There were 149 (33.1%) patients with LF. Despite higher global impedance in LF (Zva 6.3±2.4 vs 3.9±0.9 mmHg/mL/m
    Conclusions: Increased systemic arterial afterload may be important in the pathophysiology of LF AS. Low RVL was an independent predictor of poor clinical outcomes in medically managed severe AS. There may be a greater role in the attenuation of systemic arterial afterload in AS to improve outcomes.
    MeSH term(s) Aortic Valve/diagnostic imaging ; Aortic Valve/surgery ; Aortic Valve Stenosis/diagnosis ; Aortic Valve Stenosis/surgery ; Humans ; Retrospective Studies ; Severity of Illness Index ; Stroke Volume ; Ventricular Function, Left
    Language English
    Publishing date 2021-06-09
    Publishing country Australia
    Document type Journal Article
    ZDB-ID 2020980-0
    ISSN 1444-2892 ; 1443-9506
    ISSN (online) 1444-2892
    ISSN 1443-9506
    DOI 10.1016/j.hlc.2021.05.075
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