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Coronary Artery Disease: HELP
Articles from Malaysia
Based on 100 articles published since 2010
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These are the 100 published articles about Coronary Artery Disease that originated from Malaysia during 2010-2020.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4
1 Review Sudden Cardiac Death (SCD) - risk stratification and prediction with molecular biomarkers. 2019

Osman, Junaida / Tan, Shing Cheng / Lee, Pey Yee / Low, Teck Yew / Jamal, Rahman. ·UKM Medical Molecular Biology Institute (UMBI), Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia. · UKM Medical Molecular Biology Institute (UMBI), Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia. lowteckyew@ppukm.ukm.edu.my. ·J Biomed Sci · Pubmed #31118017.

ABSTRACT: Sudden cardiac death (SCD) is a sudden, unexpected death that is caused by the loss of heart function. While SCD affects many patients suffering from coronary artery diseases (CAD) and heart failure (HF), a considerable number of SCD events occur in asymptomatic individuals. Certain risk factors for SCD have been identified and incorporated in different clinical scores, however, risk stratification using such algorithms is only useful for health management rather than for early detection and prediction of future SCD events in high-risk individuals. In this review, we discuss different molecular biomarkers that are used for early detection of SCD. This includes genetic biomarkers, where the majority of them are genomic variants for genes that encode for ion channels. Meanwhile, protein biomarkers often denote proteins that play roles in pathophysiological processes that lead to CAD and HF, notably (i) atherosclerosis that involves oxidative stress and inflammation, as well as (ii) cardiac tissue damage that involves neurohormonal and hemodynamic regulation and myocardial stress. Finally, we outline existing challenges and future directions including the use of OMICS strategy for biomarker discovery and the multimarker panels.

2 Review Pharmacotherapeutic management of gout in patients with cardiac disease. 2018

Chan, Chun Wai / Yap, Ying Nee. ·a Department of Family Medicine , School of Medicine, International Medical University , Seremban , Negeri Sembilan Darul Khusus , Malaysia. · b School of Medicine , International Medical University , Kuala Lumpur , Malaysia. ·Expert Opin Pharmacother · Pubmed #30345832.

ABSTRACT: INTRODUCTION: Hyperuricemia has been identified as an independent risk factor for coronary artery disease (CAD). Uric acid lowering therapy could potentially lower the risk of CAD. Conventional treatments have been effective in treating acute gout flares in most patients, but certain options, like NSAIDs could increase the risk of CAD. AREAS COVERED: This review covers the aspect of cardiac safety with traditional and new medications used in treating both acute flares and chronic gout according to the most recent international guidelines. EXPERT OPINION: All NSAIDs, not just selective Cox 2 inhibitors, have associated with them different degrees of cardiac risk; therefore, NSAIDs should be avoided when treating patients with underlying CAD. Interleukin-1 inhibitors appear to be safe alternatives for treating cardiac patients who are contraindicated to conventional treatment. Presently, there is a paucity of evidence concerning whether treatment of hyperuricemia could lower the risk of CAD and this must be explored further. It is also important to explore the cardiac safety of plegloticase to better ascertain its safety in CAD patients.

3 Review Computer aided diagnosis of Coronary Artery Disease, Myocardial Infarction and carotid atherosclerosis using ultrasound images: A review. 2017

Faust, Oliver / Acharya, U Rajendra / Sudarshan, Vidya K / Tan, Ru San / Yeong, Chai Hong / Molinari, Filippo / Ng, Kwan Hoong. ·Department of Engineering and Mathematics, Sheffield Hallam University, United Kingdom. · Department of Electronic & Computer Engineering, Ngee Ann Polytechnic, Singapore; Department of Biomedical Engineering, School of Science and Technology, SIM University, Singapore; Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, Kuala Lumpur, Malaysia. · Department of Electronic & Computer Engineering, Ngee Ann Polytechnic, Singapore. · Department of Biomedical Imaging, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia. · Department of Electronics and Telecommunications, Politecnico di Torino, Turin, Italy. · Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, Kuala Lumpur, Malaysia. Electronic address: ngkh@ummc.edu.my. ·Phys Med · Pubmed #28010920.

ABSTRACT: The diagnosis of Coronary Artery Disease (CAD), Myocardial Infarction (MI) and carotid atherosclerosis is of paramount importance, as these cardiovascular diseases may cause medical complications and large number of death. Ultrasound (US) is a widely used imaging modality, as it captures moving images and image features correlate well with results obtained from other imaging methods. Furthermore, US does not use ionizing radiation and it is economical when compared to other imaging modalities. However, reading US images takes time and the relationship between image and tissue composition is complex. Therefore, the diagnostic accuracy depends on both time taken to read the images and experience of the screening practitioner. Computer support tools can reduce the inter-operator variability with lower subject specific expertise, when appropriate processing methods are used. In the current review, we analysed automatic detection methods for the diagnosis of CAD, MI and carotid atherosclerosis based on thoracic and Intravascular Ultrasound (IVUS). We found that IVUS is more often used than thoracic US for CAD. But for MI and carotid atherosclerosis IVUS is still in the experimental stage. Furthermore, thoracic US is more often used than IVUS for computer aided diagnosis systems.

4 Review A Review of Coronary Artery Disease Research in Malaysia. 2016

Ang, C S / Chan, K M J. ·Clinical Research Centre, Hospital Seberang Jaya, Pulau Pinang, Malaysia. KMJohnChan@yahoo.com. · Sarawak Heart Centre, Department of Cardiothoracic Surgery, 94300 Kota Samarahan, Kuching, Sarawak, Malaysia. ·Med J Malaysia · Pubmed #27801387.

ABSTRACT: Coronary artery disease is the major cause of mortality and morbidity in Malaysia and worldwide. This paper reviews all research and publications on coronary artery disease in Malaysia published between 2000-2015. 508 papers were identified of which 146 papers were selected and reviewed on the basis of their relevance. The epidemiology, etiology, risk factors, prevention, assessment, treatment, and outcomes of coronary artery disease in the country are reviewed and summarized. The clinical relevance of the studies done in the country are discussed along with recommendations for future research.

5 Review Radiation dose and diagnostic image quality associated with iterative reconstruction in coronary CT angiography: A systematic review. 2016

Abdullah, Kamarul Amin / McEntee, Mark F / Reed, Warren / Kench, Peter L. ·Discipline of Medical Radiation Sciences, Faculty of Health Sciences, The University of Sydney, Lidcombe, New South Wales, Australia. · Faculty of Health Sciences, Universiti Sultan Zainal Abidin, Terengganu, Malaysia. ·J Med Imaging Radiat Oncol · Pubmed #27241506.

ABSTRACT: The aim of this systematic review is to evaluate the radiation dose reduction achieved using iterative reconstruction (IR) compared to filtered back projection (FBP) in coronary CT angiography (CCTA) and assess the impact on diagnostic image quality. A systematic search of seven electronic databases was performed to identify all studies using a developed keywords strategy. A total of 14 studies met the criteria and were included in a review analysis. The results showed that there was a significant reduction in radiation dose when using IR compared to FBP (P < 0.05). The mean and standard deviation (SD) difference of CTDIvol and dose-length-product (DLP) were 14.70 ± 6.87 mGy and 186 ± 120 mGy.cm respectively. The mean ± SD difference of effective dose (ED ) was 2.9 ± 1.7 mSv with the range from 1.0 to 5.0 mSv. The assessment of diagnostic image quality showed no significant difference (P > 0.05). The mean ± SD difference of image noise, signal-noise ratio (SNR) and contrast-noise ratio (CNR) were 1.05 ± 1.29 HU, 0.88 ± 0.56 and 0.63 ± 1.83 respectively. The mean ± SD percentages of overall image quality scores were 71.79 ± 12.29% (FBP) and 67.31 ± 22.96% (IR). The mean ± SD percentages of coronary segment analysis were 95.43 ± 2.57% (FBP) and 97.19 ± 2.62% (IR). In conclusion, this review analysis shows that CCTA with the use of IR leads to a significant reduction in radiation dose as compared to the use of FBP. Diagnostic image quality of IR at reduced dose (30-41%) is comparable to FBP at standard dose in the diagnosis of CAD.

6 Review Folic acid and diseases - supplement it or not? 2016

Liew, Siaw-Cheok. ·Clinical Skills and Simulation Centre, International Medical University, Kuala Lumpur, Malaysia. ·Rev Assoc Med Bras (1992) · Pubmed #27008500.

ABSTRACT: INTRODUCTION: folic acid is a water soluble vitamin, which is synthetically-produced and found in fortified foods and supplements. Folate is found naturally in plants, such as the dark green leafy vegetables. Folate is not synthesized de novo by humans, therefore the daily requirements are met from the dietary intake of folic acid supplements or food rich in this vitamin. Folate deficiency could lead to numerous common health problems. Hyperhomocysteinemia and the possibility of malignancy developments are the long term consequences of this deficit albeit contradictory findings on these claims. METHODS: the articles included in this review focused on recent updated evidence-based reports and meta-analyses on the associations of the serum folate/folic acid and the various diseases found globally. RESULTS: the benefit of folic acid supplementation in the pre-conception period for the prevention of neural tube defects (NTDs) was well established and it was suggested that counseling sessions should be given to women with previous pregnancies affected by NTDs. However, supplementation of folic acid and its medicinal effects in the treatment of other diseases were contradictory and unclear. CONCLUSION: more detailed investigations into the health benefits of folic acid are needed before it could be recommended for supplementation, treatment or prevention of some of the diseases discussed in this review.

7 Review Molecular imaging of plaques in coronary arteries with PET and SPECT. 2014

Sun, Zhong-Hua / Rashmizal, Hairil / Xu, Lei. ·Discipline of Medical Imaging, Department of Imaging and Applied Physics, Curtin University, Perth, Western Australia 6845, Australia. · Department of Medical Imaging, Faculty of Health Sciences, University Technology MARA (UiTM), Selangor 42300, Malaysia. · Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029, China. ·J Geriatr Cardiol · Pubmed #25278976.

ABSTRACT: Coronary artery disease remains a major cause of mortality. Presence of atherosclerotic plaques in the coronary artery is responsible for lumen stenosis which is often used as an indicator for determining the severity of coronary artery disease. However, the degree of coronary lumen stenosis is not often related to compromising myocardial blood flow, as most of the cardiac events that are caused by atherosclerotic plaques are the result of vulnerable plaques which are prone to rupture. Thus, identification of vulnerable plaques in coronary arteries has become increasingly important to assist identify patients with high cardiovascular risks. Molecular imaging with use of positron emission tomography (PET) and single photon emission computed tomography (SPECT) has fulfilled this goal by providing functional information about plaque activity which enables accurate assessment of plaque stability. This review article provides an overview of diagnostic applications of molecular imaging techniques in the detection of plaques in coronary arteries with PET and SPECT. New radiopharmaceuticals used in the molecular imaging of coronary plaques and diagnostic applications of integrated PET/CT and PET/MRI in coronary plaques are also discussed.

8 Review Coronary CT angiography: Diagnostic value and clinical challenges. 2013

Sabarudin, Akmal / Sun, Zhonghua. ·Akmal Sabarudin, Diagnostic Imaging and Radiotherapy Program, School of Diagnostic and Applied Health Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur 50300, Malaysia. ·World J Cardiol · Pubmed #24392192.

ABSTRACT: Coronary computed tomography (CT) angiography has been increasingly used in the diagnosis of coronary artery disease due to improved spatial and temporal resolution with high diagnostic value being reported when compared to invasive coronary angiography. Diagnostic performance of coronary CT angiography has been significantly improved with the technological developments in multislice CT scanners from the early generation of 4-slice CT to the latest 320- slice CT scanners. Despite the promising diagnostic value, coronary CT angiography is still limited in some areas, such as inferior temporal resolution, motion-related artifacts and high false positive results due to severe calcification. The aim of this review is to present an overview of the technical developments of multislice CT and diagnostic value of coronary CT angiography in coronary artery disease based on different generations of multislice CT scanners. Prognostic value of coronary CT angiography in coronary artery disease is also discussed, while limitations and challenges of coronary CT angiography are highlighted.

9 Review Coronary CT angiography: Dose reduction strategies. 2013

Sabarudin, Akmal / Sun, Zhonghua. ·Akmal Sabarudin, Diagnostic Imaging and Radiotherapy Program, School of Diagnostic and Applied Health Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur 50300, Malaysia. ·World J Cardiol · Pubmed #24392191.

ABSTRACT: With the introduction of 64- and post-64 slice computed tomography (CT) technology, coronary CT angiography has been increasingly used as a less invasive modality for the diagnosis of coronary artery disease. Despite its high diagnostic value and promising results compared to invasive coronary angiography, coronary CT angiography is associated with high radiation dose, leading to potential risk of radiation-induced cancer. A variety of dose-reduction strategies have been reported recently to reduce radiation dose with effective outcomes having been achieved. This article presents an overview of the various methods currently used for radiation dose reduction.

10 Review Evaluation of functional severity of coronary artery disease and fluid dynamics' influence on hemodynamic parameters: A review. 2013

Govindaraju, Kalimuthu / Badruddin, Irfan Anjum / Viswanathan, Girish N / Ramesh, S V / Badarudin, A. ·Department of Mechanical Engineering, University of Malaya, Kuala Lumpur, Malaysia. grajukm@gmail.com ·Phys Med · Pubmed #22704601.

ABSTRACT: Coronary Artery Disease (CAD) is responsible for most of the deaths in patients with cardiovascular diseases. Diagnostic coronary angiography analysis offers an anatomical knowledge of the severity of the stenosis. The functional or physiological significance is more valuable than the anatomical significance of CAD. Clinicians assess the functional severity of the stenosis by resorting to an invasive measurement of the pressure drop and flow. Hemodynamic parameters, such as pressure wire assessment fractional flow reserve (FFR) or Doppler wire assessment coronary flow reserve (CFR) are well-proven techniques to evaluate the physiological significance of the coronary artery stenosis in the cardiac catheterization laboratory. Between the two techniques mentioned above, the FFR is seen as a very useful index. The presence of guide wire reduces the coronary flow which causes the underestimation of pressure drop across the stenosis which leads to dilemma for the clinicians in the assessment of moderate stenosis. In such condition, the fundamental fluid mechanics is useful in the development of new functional severity parameters such as pressure drop coefficient and lesion flow coefficient. Since the flow takes place in a narrowed artery, the blood behaves as a non-Newtonian fluid. Computational fluid dynamics (CFD) allows a complete coronary flow simulation to study the relationship between the pressure and flow. This paper aims at explaining (i) diagnostic modalities for the evaluation of the CAD and valuable insights regarding FFR in the evaluation of the functional severity of the CAD (ii) the role of fluid dynamics in measuring the severity of CAD.

11 Clinical Trial Risk and timing of clinical events according to diabetic status of patients treated with everolimus-eluting bioresorbable vascular scaffolds versus everolimus-eluting stent: 2-year results from a propensity score matched comparison of ABSORB EXTEND and SPIRIT trials. 2018

Campos, Carlos M / Caixeta, Adriano / Franken, Marcelo / Bartorelli, Antonio L / Whitbourn, Robert J / Wu, Chiung-Jen / Li Paul Kao, Hsien / Rosli, Mohd Ali / Carrie, Didier / De Bruyne, Bernard / Stone, Gregg W / Serruys, Patrick W / Abizaid, Alexandre / Anonymous2150905. ·Department of Cardiology, Hospital Israelita Albert Einstein, São Paulo, Brazil. · Centro Cardiologico Monzino, IRCCS, Milan, Italy. · Department of Cardiology, St Vincent's Hospital, Fitzroy, Victoria, Australia. · Department of Cardiology, Chang Gung Memorial Hospital, Niao-Sung Hsiang, Taiwan. · Department of Cardiology, National Taiwan University Hospital, Taipei, Taiwan. · Department of Cardiology, Institute Jantung Negara, Kuala Lumpur, Malaysia. · Department of Cardiology, Hôpital de Rangueil CHU, Toulouse, France. · Department of Cardiology, Cardiovascular Center Aalst, Belgium. · Department of Interventional Cardiology, Columbia University Medical Center, New York. · Cardiovascular Research Foundation, New York. · International Centre for Circulatory Health, NHLI, Imperial College London, United Kingdom. · Department of Interventional Cardiology, Instituto Dante Pazzanese de Cardiologia, São Paulo, Brazil. ·Catheter Cardiovasc Interv · Pubmed #28471086.

ABSTRACT: OBJECTIVES: to compare the occurrence of clinical events in diabetics treated with the Absorb bioresorbable vascular scaffold (Absorb BVS; Abbott Vascular, Santa Clara, CA) versus everolimus-eluting metal stents (EES; XIENCE V; Abbott Vascular, Santa Clara, CA) BACKGROUND: There are limited data dedicated to clinical outcomes of diabetic patients treated with bioresorbable scaffolds (BRS) at 2-year horizon. METHODS: The present study included 812 patients in the ABSORB EXTEND study in which a total of 215 diabetic patients were treated with Absorb BVS. In addition, 882 diabetic patients treated with EES in pooled data from the SPIRIT clinical program (SPIRIT II, SPIRIT III and SPIRIT IV trials) were used for comparison by applying propensity score matching using 29 different variables. The primary endpoint was ischemia driven major adverse cardiac events (ID-MACE), including cardiac death, myocardial infarction (MI), and ischemia driven target lesion revascularization (ID-TLR). RESULTS: After 2 years, the ID-MACE rate was 6.5% in the Absorb BVS vs. 8.9% in the Xience group (P = 0.40). There was no difference for MACE components or definite/probable device thrombosis (HR: 1.43 [0.24,8.58]; P = 0.69). The occurrence of MACE was not different for both diabetic status (insulin- and non-insulin-requiring diabetes) in all time points up to the 2-year follow-up for the Absorb and Xience groups. CONCLUSION: In this largest ever patient-level pooled comparison on the treatment of diabetic patients with BRS out to two years, individuals with diabetes treated with the Absorb BVS had a similar rate of MACE as compared with diabetics treated with the Xience EES. © 2017 Wiley Periodicals, Inc.

12 Clinical Trial Serum concentrations of MCP-1 and IL-6 in combination predict the presence of coronary artery disease and mortality in subjects undergoing coronary angiography. 2017

Tajfard, Mohammad / Latiff, Latiffah A / Rahimi, Hamid Reza / Moohebati, Mohsen / Hasanzadeh, Mehdi / Emrani, Ahmad Sarreshtehdar / Esmaeily, Habibollah / Taghipour, Ali / Mirhafez, Sayed Reza / Ferns, Gordon A / Mardan-Nik, Maryam / Mohammadzadeh, Elham / Avan, Amir / Hanachi, Parichehr / Ghayour-Mobarhan, Majid. ·Department of Health Education and Health Promotion, School of Health, Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. · Department of Community Health, Faculty of Medicine and Health Sciences, University Putra Malaysia, Seri Kembangan, Malaysia. · Department of Community Health, Faculty of Medicine and Health Sciences, University Putra Malaysia, Seri Kembangan, Malaysia. latiffah.latiff@gmail.com. · Department of Modern Sciences and Technologies, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. · Cardiovascular Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. · Department of Biostatistics & Epidemiology, School of Health, Management & Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. · Department of Basic Medical Sciences, Neyshabur University of Medical Sciences, Neyshabur, Iran. · Division of Medical Education, Brighton & Sussex Medical School, Falmer, Brighton, Sussex, BN1 9PH, UK. · Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. · Department of Biology, Biochemistry Unit, Alzahra University, Tehran, IR, Iran. · Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. ghayourm@mums.ac.ir. ·Mol Cell Biochem · Pubmed #28534120.

ABSTRACT: Cytokines play a key role in the pathogenesis of coronary artery disease (CAD). The aim of current study was to investigate the relationship between the serum concentrations of 12 cytokines with mortality and extent of CAD in individuals undergoing angiography and healthy controls. 342 CAD patients were recruited and divided into 2 groups: those with ≥50% occlusion in at least one coronary artery [Angiography (+)] or <50% obstruction in coronary arteries [Angiography (-)]. Also 120 healthy subjects were enrolled as control group. Lipid profile, fasting blood glucose, body mass index, and blood pressure were evaluated in all the subjects. An Evidence Investigator

13 Article Drug-coated balloon treatment in coronary artery disease: Recommendations from an Asia-Pacific Consensus Group. 2019

Her, Ae-Young / Shin, Eun-Seok / Bang, Liew Houng / Nuruddin, Amin Ariff / Tang, Qiang / Hsieh, I-Chang / Hsu, Jung-Cheng / Kiam, Ong Tiong / Qiu, ChunGuang / Qian, Jie / Ahmad, Wan Azman Wan / Ali, Rosli Mohd. ·Kangwon National University School of Medicine. · Ulsam Medical Center. sesim1989@gmail.com. · Queen Elizabeth Hospital II. · National Heart Institute Malaysia. · Beiging University ShouGang Hospital. · ChangGung Memorial Hospital. · FarEastern Memorial Hospital. · Sarawak Heart Centre. · the first affiliated hospital of Zhengzhou university, No. 1 Jianshe East Road, 450003 Zhengzhou, China. · Beijing FuWai Hospital. · University Malaya Medical Center. · Cardiac Vascular Sentral Kuala Lumpur. ·Cardiol J · Pubmed #31565793.

ABSTRACT: Coronary artery disease (CAD) is currently the leading cause of death globally, and the prevalence of this disease is growing more rapidly in the Asia-Pacific region than in Western countries. Although the use of metal coronary stents has rapidly increased thanks to the advancement of safety and efficacy of newer generation drug eluting stent (DES), patients are still negatively affected by some the inherent limitations of this type of treatment, such as stent thrombosis or restenosis, including neoatherosclerosis, and the obligatory use of dual antiplatelet therapy (DAPT) with unknown optimal duration. Drug-coated balloon (DCB) treatment is based on a leave-nothing-behind concept and therefore it is not limited by stent thrombosis and long-term DAPT; it directly delivers an anti-proliferative drug which is coated on a balloon after improving coronary blood flow. At present, DCB treatment is recommended as the first-line treatment option in metal stent-related restenosis linked to DES and bare metal stent. For de novo coronary lesions, the application of DCB treatment is extended further, for conditions such as small vessel disease, bifurcation lesions, and chronic total occlusion lesions, and others. Recently, several reports have suggested that fractional flow reserve guided DCB application was safe for larger coronary artery lesions and showed good long-term outcomes. Therefore, the aim of these recommendations of the consensus group was to provide adequate guidelines for patients with CAD based on objective evidence, and to extend the application of DCB to a wider variety of coronary diseases and guide their most effective and correct use in actual clinical practice.

14 Article A new machine learning technique for an accurate diagnosis of coronary artery disease. 2019

Abdar, Moloud / Książek, Wojciech / Acharya, U Rajendra / Tan, Ru-San / Makarenkov, Vladimir / Pławiak, Paweł. ·Département d'informatique, Université du Québec à Montréal, Montréal, Québec, Canada. · Institute of Telecomputing, Faculty of Physics, Mathematics and Computer Science, Cracow University of Technology, 31-155 Krakow, Poland; Department of Biocybernetics and Biomedical Engineering, Faculty of Electrical Engineering, Automatics, Computer Science, and Biomedical Engineering, AGH University of Science and Technology, 30-059 Krakow, Poland. · Department of Electronics and Computer Engineering, Ngee Ann Polytechnic, Singapore; Department of Biomedical Engineering, School of Science and Technology, Singapore School of Social Sciences, Singapore; School of Medicine, Faculty of Health and Medical Sciences, Taylor's University, 47500 Subang Jaya, Malaysia. · Department of Cardiology, National Heart Centre Singapore, Singapore; Duke-NUS Medical School, Singapore. · Institute of Telecomputing, Faculty of Physics, Mathematics and Computer Science, Cracow University of Technology, 31-155 Krakow, Poland. Electronic address: plawiak@pk.edu.pl. ·Comput Methods Programs Biomed · Pubmed #31443858.

ABSTRACT: BACKGROUND AND OBJECTIVE: Coronary artery disease (CAD) is one of the commonest diseases around the world. An early and accurate diagnosis of CAD allows a timely administration of appropriate treatment and helps to reduce the mortality. Herein, we describe an innovative machine learning methodology that enables an accurate detection of CAD and apply it to data collected from Iranian patients. METHODS: We first tested ten traditional machine learning algorithms, and then the three-best performing algorithms (three types of SVM) were used in the rest of the study. To improve the performance of these algorithms, a data preprocessing with normalization was carried out. Moreover, a genetic algorithm and particle swarm optimization, coupled with stratified 10-fold cross-validation, were used twice: for optimization of classifier parameters and for parallel selection of features. RESULTS: The presented approach enhanced the performance of all traditional machine learning algorithms used in this study. We also introduced a new optimization technique called N2Genetic optimizer (a new genetic training). Our experiments demonstrated that N2Genetic-nuSVM provided the accuracy of 93.08% and F1-score of 91.51% when predicting CAD outcomes among the patients included in a well-known Z-Alizadeh Sani dataset. These results are competitive and comparable to the best results in the field. CONCLUSIONS: We showed that machine-learning techniques optimized by the proposed approach, can lead to highly accurate models intended for both clinical and research use.

15 Article FEV1 and total Cardiovascular mortality and morbidity over an 18 years follow-up Population-Based Prospective EPIC-NORFOLK Study. 2019

Ching, Siew-Mooi / Chia, Yook-Chin / Lentjes, Marleen A H / Luben, Robert / Wareham, Nicholas / Khaw, Kay-Tee. ·Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia. sm_ching@upm.edu.my. · Malaysian Research Institute on Ageing, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia. sm_ching@upm.edu.my. · Department of Medical Sciences, School of Healthcare and Medical Sciences, Sunway University, Bandar Sunway, Malaysia. sm_ching@upm.edu.my. · Department of Medical Sciences, School of Healthcare and Medical Sciences, Sunway University, Bandar Sunway, Malaysia. · Department of Public Health and Primary Care, Institute of Public Health, School of Clinical Medicine (K-TK and RL) and the Medical Research Council Epidemiology Unit (NW), University of Cambridge, Cambridge, United Kingdom. · Department of Public Health and Primary Care, Institute of Public Health, School of Clinical Medicine (K-TK and RL) and the Medical Research Council Epidemiology Unit (NW), University of Cambridge, Cambridge, United Kingdom. kk101@medschl.cam.ac.uk. ·BMC Public Health · Pubmed #31053065.

ABSTRACT: BACKGROUND: Our study aimed to determine the association between forced expiratory volume in one second (FEV1) and subsequent fatal and non-fatal events in a general population. METHODS: The Norfolk (UK) based European Prospective Investigation into Cancer (EPIC-Norfolk) recruited 25,639 participants between 1993 and 1997. FEV1 measured by portable spirometry, was categorized into sex-specific quintiles. Mortality and morbidity from all causes, cardiovascular disease (CVD) and respiratory disease were collected from 1997 up to 2015. Cox proportional hazard regression analysis was used with adjustment for socio-economic factors, physical activity and co-morbidities. RESULTS: Mean age of the population was 58.7 ± 9.3 years, mean FEV1 for men was 294± 74 cL/s and 214± 52 cL/s for women. The adjusted hazard ratios for all-cause mortality for participants in the highest fifth of the FEV1 category was 0.63 (0.52, 0.76) for men and 0.62 (0.51, 0.76) for women compared to the lowest quintile. Adjusted HRs for every 70 cL/s increase in FEV1 among men and women were 0.77 (p < 0.001) and 0.68 (p < 0.001) for total mortality, 0.85 (p<0.001) and 0.77 (p<0.001) for CVD and 0.52 (p <0.001) and 0.42 (p <0.001) for respiratory disease. CONCLUSIONS: Participants with higher FEV1 levels had a lower risk of CVD and all-cause mortality. Measuring the FEV1 with a portable handheld spirometry measurement may be used as a surrogate marker for cardiovascular risk. Every effort should be made to identify those with poorer lung function even in the absence of cardiovascular disease as they are at greater risk of total and CV mortality.

16 Article Sudden cardiac death in a young adult man due to spontaneous coronary artery dissection. 2019

Subramaniam, K / Siew, S F / Mahmood, M S. ·National Institute of Forensic Medicine, Hospital Kuala Lumpur, 50586 Kuala Lumpur, Malaysia. forensic.hkl@moh.gov.my. ·Malays J Pathol · Pubmed #31025638.

ABSTRACT: Spontaneous coronary artery dissection is a rare event and commonly associated with pregnancy and female gender. This condition can reduce or completely obstruct the blood flow to the heart, causing a myocardial ischaemia, abnormalities in heart rhythm or sudden death. We present a case of a 28-year-old Indian male with no previous medical illness who complained sudden onset of chest pain prior to his death. Autopsy revealed a left anterior descending coronary artery dissection associated with plaque rupture. The anterior wall of left ventricle showed contraction band necrosis. There was also atheroma present in the right coronary artery which was insignificant. Histologically, dissection was associated with atherosclerosis. There was no evidence of vasculitis. The cause of death was given as coronary artery dissection due to coronary artery atherosclerosis.

17 Article Prevalence of extracranial carotid atherosclerosis in the patients with coronary artery disease in a tertiary hospital in Malaysia. 2019

Sahadevan, Mahavishnu / Chee, Kok Han / Tai, Mei-Ling Sharon. ·Division of Cardiology. · Division of Neurology, Department of Medicine, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia. ·Medicine (Baltimore) · Pubmed #30985661.

ABSTRACT: There is limited information regarding the prevalence of extracranial carotid atherosclerosis in the patients with coronary artery disease (CAD) undergoing coronary artery bypass graft (CABG) surgery in South East Asia. The primary objective was to assess the prevalence of extracranial carotid stenosis, raised carotid intima media thickness (CIMT), and plaques in the patients with CAD undergoing elective CABG. The secondary objective was to evaluate the risk factors for extracranial carotid atherosclerosis.A total of 119 consecutive patients with CAD undergoing elective CABG in a tertiary hospital in Malaysia were recruited. Data on the demographic characteristics and risk factors were collected. The ultrasound carotid Doppler findings comprising of raised CIMT, plaques, and stenosis in the extracranial carotid vessels were recorded.The mean age of the patients was 64.26 ± 10.12 (range 42-89). Most of the patients were men (73.1%). The patients consisted of 44 (37%) Malays, 26 (21.8%) Chinese, and 49 (41.2%) Indians.A total of 67 (56.3%) patients had raised CIMT, 89 (74.8%) patients had plaques, and 10 (8.4%) patients had stenosis in the internal and common carotid arteries. The mean age of patients with plaques was higher compared to those without plaques (66.00 ± 9.63 vs 59.10 ± 9.92, P = .001). The body mass index (BMI) of patients with stenosis was higher compared to those without stenosis (28.35 ± 4.92 vs 25.75 ± 3.16, P = .02).The patients with plaques were more likely to be older, whereas the patients with carotid stenosis were more likely to have higher BMI.

18 Article Heterozygous familial hypercholesterolaemia in a pair of identical twins: a case report and updated review. 2019

Mohd Nor, Noor Shafina / Al-Khateeb, Alyaa Mahmood / Chua, Yung-An / Mohd Kasim, Noor Alicezah / Mohd Nawawi, Hapizah. ·Institute for Pathology, Laboratory and Forensic Medicine (I-PPerForM), Universiti Teknologi MARA (UiTM), Sungai Buloh Campus, Jalan Hospital, 47000, Sungai Buloh, Selangor, Malaysia. · Departments of Paediatric, Biochemistry and Chemical Pathology, Faculty of Medicine, Universiti Teknologi MARA (UiTM), 47000, Sungai Buloh, Selangor, Malaysia. · Institute for Pathology, Laboratory and Forensic Medicine (I-PPerForM), Universiti Teknologi MARA (UiTM), Sungai Buloh Campus, Jalan Hospital, 47000, Sungai Buloh, Selangor, Malaysia. hapizah.nawawi@gmail.com. · Departments of Paediatric, Biochemistry and Chemical Pathology, Faculty of Medicine, Universiti Teknologi MARA (UiTM), 47000, Sungai Buloh, Selangor, Malaysia. hapizah.nawawi@gmail.com. ·BMC Pediatr · Pubmed #30975109.

ABSTRACT: BACKGROUND: Familial hypercholesterolaemia (FH) is the most common inherited metabolic disease with an autosomal dominant mode of inheritance. It is characterised by raised serum levels of total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-c), leading to premature coronary artery disease. Children with FH are subjected to early and enhanced atherosclerosis, leading to greater risk of coronary events, including premature coronary artery disease. To the best of our knowledge, this is the first report of a pair of monochorionic diamniotic identical twins with a diagnosis of heterozygous FH, resulting from mutations in both LDLR and ABCG8 genes. CASE PRESENTATION: This is a rare case of a pair of 8-year-old monochorionic diamniotic identical twin, who on family cascade screening were diagnosed as definite FH, according to the Dutch Lipid Clinic Criteria (DLCC) with a score of 10. There were no lipid stigmata noted. Baseline lipid profiles revealed severe hypercholesterolaemia, (TC = 10.5 mmol/L, 10.6 mmol/L; LDL-c = 8.8 mmol/L, 8.6 mmol/L respectively). Their father is the index case who initially presented with premature CAD, and subsequently diagnosed as FH. Family cascade screening identified clinical FH in other family members including their paternal grandfather who also had premature CAD, and another elder brother, aged 10 years. Genetic analysis by targeted next-generation sequencing using MiSeq platform (Illumina) was performed to detect mutations in LDLR, APOB100, PCSK9, ABCG5, ABCG8, APOE and LDLRAP1 genes. Results revealed that the twin, their elder brother, father and grandfather are heterozygous for a missense mutation (c.530C > T) in LDLR that was previously reported as a pathogenic mutation. In addition, the twin has heterozygous ABCG8 gene mutation (c.55G > C). Their eldest brother aged 12 years and their mother both had normal lipid profiles with absence of LDLR gene mutation. CONCLUSION: A rare case of Asian monochorionic diamniotic identical twin, with clinically diagnosed and molecularly confirmed heterozygous FH, due to LDLR and ABCG8 gene mutations have been reported. Childhood FH may not present with the classical physical manifestations including the pathognomonic lipid stigmata as in adults. Therefore, childhood FH can be diagnosed early using a combination of clinical criteria and molecular analyses.

19 Article Volatile Anesthetics versus Total Intravenous Anesthesia for Cardiac Surgery. 2019

Landoni, Giovanni / Lomivorotov, Vladimir V / Nigro Neto, Caetano / Monaco, Fabrizio / Pasyuga, Vadim V / Bradic, Nikola / Lembo, Rosalba / Gazivoda, Gordana / Likhvantsev, Valery V / Lei, Chong / Lozovskiy, Andrey / Di Tomasso, Nora / Bukamal, Nazar A R / Silva, Fernanda S / Bautin, Andrey E / Ma, Jun / Crivellari, Martina / Farag, Ahmed M G A / Uvaliev, Nikolay S / Carollo, Cristiana / Pieri, Marina / Kunstýř, Jan / Wang, Chew Yin / Belletti, Alessandro / Hajjar, Ludhmila A / Grigoryev, Evgeny V / Agrò, Felice E / Riha, Hynek / El-Tahan, Mohamed R / Scandroglio, A Mara / Elnakera, Abeer M / Baiocchi, Massimo / Navalesi, Paolo / Shmyrev, Vladimir A / Severi, Luca / Hegazy, Mohammed A / Crescenzi, Giuseppe / Ponomarev, Dmitry N / Brazzi, Luca / Arnoni, Renato / Tarasov, Dmitry G / Jovic, Miomir / Calabrò, Maria G / Bove, Tiziana / Bellomo, Rinaldo / Zangrillo, Alberto / Anonymous7110983. ·From the Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute (G.L., F.M., R.L., N.D.T., M.C., M.P., A.B., A.M.S., M.G.C., A.Z.), and Vita-Salute San Raffaele University (G.L., A.Z.), Milan, Istituto di Anestesia e Rianimazione, Azienda Ospedaliera di Padova, Padua (C.C.), Anesthesia and Intensive Care Department, University Campus Bio-Medico of Rome (F.E.A.), and Anestesia e Rianimazione, Dipartimento Cardiovascolare, Azienda Ospedaliera San Camillo Forlanini (L.S.), Rome, the Department of Cardiothoracic and Vascular Anesthesia and Intensive Care, University Hospital Policlinico S. Orsola, Bologna (M.B.), Dipartimento di Scienze Mediche e Chirurgiche, Università Magna Graecia di Catanzaro, Catanzaro (P.N.), Anestesia e Terapia Intensiva Cardiochirurgica, Istituto Clinico Humanitas, Rozzano (G.C.), the Department of Anesthesia, Intensive Care and Emergency, Città della Salute e della Scienza Hospital, and the Department of Surgical Sciences, University of Turin, Turin (L.B.), and the Anesthesiology and Intensive Care Clinic, Department of Medicine, University of Udine, Udine (T.B.) - all in Italy · the Department of Anesthesiology and Intensive Care, E. Meshalkin National Medical Research Center, Novosibirsk (V.V. Lomivorotov, V.A.S., D.N.P.), the Departments of Anesthesiology and Intensive Care (V.V.P.) and Cardiac Surgery (D.G.T.), Federal Center for Cardiovascular Surgery Astrakhan, Astrakhan, the Department of Anesthesia and Intensive Care, First Moscow State Medical University (V.V.P., V.V. Likhvantsev), and the Department of Intensive Care, Moscow Regional Clinical and Research Institute (V.V. Likhvantsev), Moscow, the Department of Anesthesia and Intensive Care, Ural Institute of Cardiology, Ekaterinburg (A.L.), the Laboratory for Anesthesiology and Intensive Care, Almazov National Medical Research Center, Saint Petersburg (A.E.B.), and the Intensive Care Unit, Scientific Research Institute for Complex Issues of Cardiovascular Diseases, Kemerovo (E.V.G.) - all in Russia · the Anesthesia Section, Department of Surgery, Dante Pazzanese Institute of Cardiology (C.N.N.), the Department of Cardiopneumology, Instituto do Coração, Universidade de São Paulo, and the Intensive Care Unit, Hospital SirioLibanes (L.A.H.), and the Cardiac Surgery Section, Department of Surgery, Dante Pazzanese Institute of Cardiology (R.A.), São Paulo, Brazil · the Department of Cardiovascular Anesthesiology and Intensive Care Medicine, and the Clinical Department of Anesthesiology, Resuscitation and Intensive Care Medicine, University Hospital Dubrava, Zagreb (N.B.), and the Department of Biomedical Sciences, University North, Varaždin (N.B.) - both in Croatia · the Department of Anesthesia and Intensive Care, Cardiovascular Institute Dedinje (G.G., M.J.), and the School of Medicine, University of Belgrade (M.J.), Belgrade, Serbia · the Department of Anesthesiology and Perioperative Medicine, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi (C.L.), and the Center for Anesthesiology, Beijing Anzhen Hospital, Capital Medical University, Beijing (J.M.) - both in China · the Cardiothoracic Intensive Care Unit and Anesthesia Department, Mohammed Bin Khalifa Cardiac Center, Riffa, Bahrain (N.A.R.B.) · the Department of Anesthesiology, Hospital de Santa Maria, Lisbon, Portugal (F.S.S.) · the Department of Anesthesia, King Abdullah Medical City-Holy Capital, Makkah (A.M.G.A.F.), and the Anesthesiology Department, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam (M.R.E.-T.) - both in Saudi Arabia · Anesthesia and Intensive Care, Acibadem City Clinic-Cardiac Surgery Center, Burgas, Bulgaria (N.S.U.) · the Department of Anesthesiology, Resuscitation and Intensive Medicine, Charles University in Prague, First Faculty of Medicine and General Teaching Hospital (J.K.), and the Cardiothoracic Anesthesiology and Intensive Care, Department of Anesthesiology and Intensive Care Medicine, Institute for Clinical and Experimental Medicine (H.R.), Prague, Czech Republic · the Department of Anesthesiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia (C.Y.W.) · the Anesthesia and Surgical Intensive Care Department, Faculty of Medicine, Zagazig University Hospitals, Zagazig (A.M.E.), and the Department of Anesthesia and Surgical Intensive Care, Mansoura University, Mansoura (M.A.H.) - both in Egypt · and the School of Medicine, University of Melbourne, Melbourne, VIC, Australia (R.B.). ·N Engl J Med · Pubmed #30888743.

ABSTRACT: BACKGROUND: Volatile (inhaled) anesthetic agents have cardioprotective effects, which might improve clinical outcomes in patients undergoing coronary-artery bypass grafting (CABG). METHODS: We conducted a pragmatic, multicenter, single-blind, controlled trial at 36 centers in 13 countries. Patients scheduled to undergo elective CABG were randomly assigned to an intraoperative anesthetic regimen that included a volatile anesthetic (desflurane, isoflurane, or sevoflurane) or to total intravenous anesthesia. The primary outcome was death from any cause at 1 year. RESULTS: A total of 5400 patients were randomly assigned: 2709 to the volatile anesthetics group and 2691 to the total intravenous anesthesia group. On-pump CABG was performed in 64% of patients, with a mean duration of cardiopulmonary bypass of 79 minutes. The two groups were similar with respect to demographic and clinical characteristics at baseline, the duration of cardiopulmonary bypass, and the number of grafts. At the time of the second interim analysis, the data and safety monitoring board advised that the trial should be stopped for futility. No significant difference between the groups with respect to deaths from any cause was seen at 1 year (2.8% in the volatile anesthetics group and 3.0% in the total intravenous anesthesia group; relative risk, 0.94; 95% confidence interval [CI], 0.69 to 1.29; P = 0.71), with data available for 5353 patients (99.1%), or at 30 days (1.4% and 1.3%, respectively; relative risk, 1.11; 95% CI, 0.70 to 1.76), with data available for 5398 patients (99.9%). There were no significant differences between the groups in any of the secondary outcomes or in the incidence of prespecified adverse events, including myocardial infarction. CONCLUSIONS: Among patients undergoing elective CABG, anesthesia with a volatile agent did not result in significantly fewer deaths at 1 year than total intravenous anesthesia. (Funded by the Italian Ministry of Health; MYRIAD ClinicalTrials.gov number, NCT02105610.).

20 Article Metabolomics profiling and pathway analysis of human plasma and urine reveal further insights into the multifactorial nature of coronary artery disease. 2019

Amin, Arwa M / Mostafa, Hamza / Arif, Nor Hayati / Abdul Kader, Muhamad Ali Sk / Kah Hay, Yuen. ·School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia; Department of Clinical and Hospital Pharmacy, College of Pharmacy, Taibah University, Al Madinah Al Munawwarah, Saudi Arabia. Electronic address: arwamostafa@taibahu.edu.sa. · School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia. Electronic address: hmam12_pha084@student.usm.my. · Psychiatry Department, Hospital Pulau Pinang, Malaysia. Electronic address: nyati39@yahoo.com. · School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia; Cardiology Department, Hospital Pulau Pinang, Penang, Malaysia. Electronic address: mdali_sheikh@hotmail.com. · School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia. Electronic address: khyuen@usm.my. ·Clin Chim Acta · Pubmed #30826371.

ABSTRACT: BACKGROUND: Coronary artery disease (CAD) claims lives yearly. Nuclear magnetic resonance ( METHODS: We analysed plasma and urine samples of 50 stable CAD patients and 50 healthy controls using RESULTS: Both plasma and urine OPLS-DA models had specificity, sensitivity and accuracy of 100%, 96% and 98%, respectively. Plasma MVLR model had specificity, sensitivity, accuracy and AUROC of 92%, 86%, 89% and 0.96, respectively. The MVLR model of urine had specificity, sensitivity, accuracy and AUROC of 90%, 80%, 85% and 0.92, respectively. 35 and 12 metabolites were identified in plasma and urine metabotypes, respectively. Metabolic pathway analysis revealed that urea cycle, aminoacyl-tRNA biosynthesis and synthesis and degradation of ketone bodies pathways were significantly disturbed in plasma, while methylhistidine metabolism and galactose metabolism pathways were significantly disturbed in urine. The enrichment over representation analysis against SNPs-associated-metabolite sets library revealed that 85 SNPs were significantly enriched in plasma metabotype. CONCLUSIONS: Cardiometabolic diseases, dysbiotic gut-microbiota and genetic variabilities are largely implicated in the pathogenesis of CAD.

21 Article Safety and efficacy of the COMBO bio-engineered stent in an all-comer PCI cohort: 1-Year final clinical outcomes from the MASCOT post-marketing registry. 2019

Colombo, Antonio / Chandrasekhar, Jaya / Aquino, Melissa / Ong, Tiong Kiam / Sartori, Samantha / Baber, Usman / Lee, Michael / Iniguez, Andres / Hajek, Petr / Borisov, Borislav / Atzev, Borislav / Den Heijer, Peter / Coufal, Zdenek / Hudec, Martin / Mates, Martin / Snyder, Clayton / Moalem, Kamilia / Morrell, Deborah / Elmore, Francesca / Rowland, Stephen / Mehran, Roxana / Anonymous701027. ·San Raffaele Scientific Institute, Milan, Italy. · Icahn School of Medicine at Mount Sinai, New York, NY, USA. · Pusat Jantung Hospital Umum Sarawak, Sarawak, Malaysia. · Queen Elizabeth Hospital, Singapore. · Meixoeiro Hospital - University Hospital of Vigo, Vigo, Spain. · 2nd Faculty of Medicine and Motol University Hospital, Praha, Czech Republic. · MBAL St. Ivan Rilski, Stara Zagora, Bulgaria. · MBAL Puls, Blagoevgrad, Blagoevgrad, Bulgaria. · Amphia Hospital - Breda, Breda, Netherlands. · T. Bata Regional Hospital Zlin, Zlin, Czech Republic. · SuSCH Banská Bystrica, Banská Bystrica, Slovakia. · Nemocnice na Homolce, Praha 5, Czech Republic. · OrbusNeich Ltd, Fort Lauderdale, FL, USA. · Icahn School of Medicine at Mount Sinai, New York, NY, USA. Electronic address: Roxana.mehran@mountsinai.org. ·Int J Cardiol · Pubmed #30826192.

ABSTRACT: BACKGROUND: The COMBO stent (OrbusNeich Medical, Ft. Lauderdale, Florida) is a new-generation bio-engineered drug eluting stent, combining an abluminal coating of a bioabsorbable polymer matrix for sustained release of sirolimus and luminal anti-CD34 coating for endothelial progenitor cell capture and rapid endothelialization. METHODS: The Multinational Abluminal Sirolimus Coated BiO-Engineered StenT (MASCOT) registry was a prospective post-marketing study conducted from June 2014-May 2017 across 60 centers globally. Patients were eligible if COMBO stent implantation was attempted, and they received dual antiplatelet therapy (DAPT) per local guidelines. Follow-up was conducted by trained research staff at 1, 6 and 12 months by phone or clinic visit to capture clinical events and DAPT cessation events. The primary endpoint was 1-year target lesion failure (TLF), composite of cardiac death, non-fatal myocardial infarction not clearly attributable to a non-target vessel, or ischemia-driven target lesion revascularization. RESULTS: A total of 2614 patients were enrolled over the study period with 96.7% completion of 1-year follow-up. The mean age of enrolled patients was 62.9 ± 11.2 years and 23.0% were female. Diabetes mellitus was present at baseline in 33.5%. A total of 56.1% patients underwent PCI for acute coronary syndrome (ACS). The 1-year primary endpoint of TLF occurred in 3.4% patients (n = 88). Definite stent thrombosis occurred in 0.5% patients (n = 12). CONCLUSION: The MASCOT post marketing registry provides comprehensive safety and efficacy outcomes following contemporary PCI using the novel COMBO stent in an all-comer population. This platform is associated with low rates of 1-year TLF and ST. CLINICALTRIALS. GOV IDENTIFIER: NCT02183454.

22 Article Cholesterol goal achievement and lipid-lowering therapy in patients with stable or acute coronary heart disease in Singapore: results from the Dyslipidemia International Study II. 2019

Poh, Kian-Keong / Chin, Chee Tang / Tong, Khim Leng / Tan, Julian Ko Beng / Lim, Jee Seong / Yu, Weixuan / Horack, Martin / Vyas, Ami / Lautsch, Dominik / Ambegaonkar, Baishali / Brudi, Philippe / Gitt, Anselm K. ·Department of Cardiology, National University Heart Centre Singapore, National University Health System, Singapore. · Yong Loo Lin School of Medicine, National University of Singapore, Singapore. · Department of Cardiology, National Heart Centre Singapore, Singapore. · Duke-NUS Medical School, Singapore. · Department of Cardiology, Changi General Hospital, Singapore. · Mount Elizabeth Medical Centre, Singapore. · Merck Sharp & Dohme (Malaysia) Sdn Bhd, Petaling Jaya, Selangor, Malaysia. · MSD Pharma (Singapore) Pte Ltd, Singapore. · Herzzentrum Ludwigshafen, Cardiology, Stiftung Institut für Herzinfarktforschung, Ludwigshafen, Germany. · University of Rhode Island, College of Pharmacy, Department of Pharmacy Practice, Kingston, RI, USA. · Merck & Co Inc, Kenilworth, NJ, USA. · Klinikum der Stadt Ludwigshafen, Medizinische Klinik B, Ludwigshafen, Germany. ·Singapore Med J · Pubmed #30773600.

ABSTRACT: INTRODUCTION: Dyslipidaemia is a major risk factor for coronary heart disease (CHD). There is a lack of data on the extent of lipid abnormalities and lipid-lowering therapy (LLT) in Singapore. METHODS: The Dyslipidemia International Study (DYSIS) II was a multinational observational study of patients with stable CHD and hospitalised patients with an acute coronary syndrome (ACS). A full lipid profile and use of LLT were documented at baseline, and for the ACS cohort, at four months post-hospitalisation. RESULTS: 325 patients were recruited from four sites in Singapore; 199 had stable CHD and 126 were hospitalised with an ACS. At baseline, 96.5% of the CHD cohort and 66.4% of the ACS cohort were being treated with LLT. In both cohorts, low-density lipoprotein cholesterol (LDL-C) levels were lower for the treated than the non-treated patients; accordingly, a higher proportion of patients met the LDL-C goal of < 70 mg/dL (CHD: 28.1% vs. 0%, p = 0.10; ACS: 20.2% vs. 0%, p < 0.01). By the four-month follow-up, a higher proportion of the ACS patients that were originally not treated with LLT had met the LDL-C goal (from 0% to 54.5%), correlating with the increased use of medication. However, there was negligible improvement in the patients who were treated prior to the ACS. CONCLUSION: Dyslipidaemia is a significant concern in Singapore, with few patients with stable or acute CHD meeting the recommended European Society of Cardiology/European Atherosclerosis Society goal. LLT was widely used but not optimised, indicating considerable scope for improved management of these very-high-risk patients.

23 Article Relationship between serum high sensitivity C-reactive protein with angiographic severity of coronary artery disease and traditional cardiovascular risk factors. 2019

Tajfard, Mohammad / Tavakoly Sany, Seyedeh Belin / Avan, Amir / Latiff, Latiffah A / Rahimi, Hamid Reza / Moohebati, Mohsen / Hasanzadeh, Mehdi / Ghazizadeh, Hamideh / Esmaeily, Habibollah / Doosti, Hassan / Taghipour, Ali / Ghayour-Mobarhan, Majid / Ferns, Gordon A / Emamian, Marzie / Bin Abd Mutalib, Mohd Sokhini. ·Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. · Department of Health Education and Health Promotion, School of Health, Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. · Metabolic Syndrome Research Centre, Mashhad University of Medical Sciences, Mashhad, Iran. · Department of Community Health, Faculty of Medicine and Health Sciences, University Putra Malaysia, Seri Kembangan, Malaysia. · Department of Modern Sciences and Technologies, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. · Vascular and Endovascular Surgery Research Centre, Mashhad University of Medical Sciences, Mashhad, Iran. · Department of Cardiology, Ghaem Educational Hospital, Mashhad University of Medical Sciences, Mashhad, Iran. · Department of Biostatistics and Epidemiology, Faculty of Health, Mashhad University of Medical Sciences, Mashhad, Iran. · Department of Statistics, School of Health, Macquarie University, Sydney, Australia. · Brighton & Sussex Medical School, Division of Medical Education, Falmer, Brighton, Sussex BN1 9PH, UK. · Biochemistry Department, School of Medicine, Mashhad University of Medical Science, Mashhad, Iran. · Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, University Putra Malaysia, Malaysia. ·J Cell Physiol · Pubmed #30548615.

ABSTRACT: Serum high-sensitivity C-reactive protein (hs-CRP) is predictive of coronary artery disease (CAD). The aim of this study was to examine the possible association of hs-CRP with presence and severity of CAD and traditional CAD risk factors. This case-control study was carried out on 2,346 individuals from September 2011 to May 2013. Of these 1,187 had evidence of coronary disease, and were subject to coronary angiography, and the remainder were healthy controls (n = 1,159). Characteristics were determined using standard laboratory techniques and serum Hs-CRP levels were estimated using enzyme-linked immunosorbent assay (ELISA) kits, and severity of CAD was assessed according to the score of obstruction in coronary artery. Serum hs-CRP levels were higher in those with severe coronary disease, who had stenosis ≥ 50% stenosis of at least one coronary artery (all p < 0.001 vs. individuals in healthy control), and correlated significantly with the score for coronary artery disease (all p < 0.01). After adjustment for conventional risk factors, regression analysis revealed that smoking habits, fasting blood glucose, total cholesterol, high-density lipoprotein, hs-CRP, blood pressure, anxiety, dietary intake of vitamin E, and cholesterol remained as independent determinants for angiographic severity of CAD. The area under the receiving operating characteristic (ROC) curve for serum hs-CRP was 0.869 (CI 95% 0.721-0.872, p < 0.001). The optimal values for the cut-off point was a serum hs-CRP of 2.78 mg/l (sensitivity 80.20%, specificity 85%) to predict severity of CAD. Increased serum hs-CRP levels are significantly associated with angiographic severity of CAD, suggesting its value as a biomarkers for predicting CAD.

24 Article Religion, Spirituality and Risk of Coronary Heart Disease: A Matched Case-Control Study and Meta-Analysis. 2019

Hemmati, Rohoullah / Bidel, Zeinab / Nazarzadeh, Milad / Valadi, Maryam / Berenji, Somayeh / Erami, Elahe / Al Zaben, Fatten / Koenig, Harold G / Sanjari Moghaddam, Ali / Teymoori, Farshad / Sabour, Siamak / Ghanbarizadeh, Saeed Reza / Seghatoleslam, Tahereh. ·Student Research Committee, Ilam University of Medical Sciences, Ilam, Iran. · Department of Cardiology, Ilam University of Medical Sciences, Ilam, Iran. · The Collaboration Center of Meta-Analysis Research, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran. zeinab.bidel@yahoo.com. · The Collaboration Center of Meta-Analysis Research, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran. · George Institute for Global Health, University of Oxford, Oxford, UK. · Division of Psychiatry, Department of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia. · Department of Psychiatry, Duke University Medical Center, Durham, NC, USA. · School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran. · Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran. · Department of Epidemiology, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran. · Department of Psychological Medicine, Center of Addiction Sciences (UMCAS), Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia. ·J Relig Health · Pubmed #30350244.

ABSTRACT: Although the association between religion/spirituality (R/S) and psychological outcomes is well established, current understanding of the association with cardiovascular disease remains limited. We sought to investigate the association between Islamic R/S and coronary heart disease (CHD), and place these findings in light of a meta-analysis. In this case-control study, 190 cases with non-fatal CHD were identified and individually matched with 383 hospital-based controls. R/S was measured by self-administered 102 items questionnaire. A tabular meta-analysis was performed of observational studies on R/S (high level versus low level) and CHD. In addition, a dose-response meta-analysis was conducted using generalized least-squares regression. Participants in the top quartile had decreased odds of CHD comparing to participants in the lowest quartile of religious belief (OR 0.20, 95% confidence interval (CI) 0.06-0.59), religious commitment (OR 0.36, CI 95% 0.13-0.99), religious emotions (OR 0.39, CI 95% 0.18-0.87), and total R/S score (OR 0.30, CI 95% 0.13-0.67). The meta-analysis study showed a significant relative risk of 0.88 (CI 95% 0.77-1.00) comparing individuals in high level versus low level of R/S. In dose-response meta-analysis, comparing people with no religious services attendance, the relative risks of CHD were 0.77 (CI 95% 0.65-0.91) for one times attendance and 0.27 (CI 95% 0.11-0.65) for five times attendance per month. R/S was associated with a significantly decreased risk of CHD. The possible causal nature of the observed associations warrants randomized clinical trial with large sample size.

25 Article Plasma Ceramides as Prognostic Biomarkers and Their Arterial and Myocardial Tissue Correlates in Acute Myocardial Infarction. 2018

de Carvalho, Leonardo P / Tan, Sock Hwee / Ow, Ghim-Siong / Tang, Zhiqun / Ching, Jianhong / Kovalik, Jean-Paul / Poh, Sock Cheng / Chin, Chee-Tang / Richards, A Mark / Martinez, Eliana C / Troughton, Richard W / Fong, Alan Yean-Yip / Yan, Bryan P / Seneviratna, Aruni / Sorokin, Vitaly / Summers, Scott A / Kuznetsov, Vladimir A / Chan, Mark Y. ·Federal University of Sao Paulo State, Sao Paulo, Brazil. · National University Heart Center, Singapore, Singapore. · Cardiovascular Research Institute, Yong Loo Lin School of Medicine, National University of Singapore, Singapore. · Albert Einstein Hospital, São Paulo, Brazil. · Bioinformatics Institute, ASTAR, Singapore. · Institute of Molecular and Cell Biology, ASTAR, Singapore. · Program in Cardiovascular and Metabolic Disorders, Duke-National University of Singapore Graduate Medical School, Singapore. · National Heart Centre Singapore, Singapore. · Christchurch Heart Institute, University of Otago Christchurch, Christchurch Hospital, Christchurch, New Zealand. · Miller School of Medicine, University of Miami, Miami, Florida. · Clinical Research Centre, Sarawak General Hospital, Kuching, Malaysia. · Department of Cardiology, Sarawak General Hospital, Kuching, Malaysia. · Department of Medicine & Therapeutics, The Chinese University of Hong Kong, Hong Kong, China. · University of Utah, Salt Lake City, Utah. · Nanyang Institute of Technology in Health & Medicine, Nanyang Technological University, Singapore. ·JACC Basic Transl Sci · Pubmed #30062203.

ABSTRACT: We identified a plasma signature of 11 C14 to C26 ceramides and 1 C16 dihydroceramide predictive of major adverse cardiovascular events in patients with acute myocardial infarction (AMI). Among patients undergoing coronary artery bypass surgery, those with recent AMI, compared with those without recent AMI, showed a significant increase in 5 of the signature's 12 ceramides in plasma but not simultaneously-biopsied aortic tissue. In contrast, a rat AMI model, compared with sham control, showed a significant increase in myocardial concentrations of all 12 ceramides and up-regulation of 3 ceramide-producing enzymes, suggesting ischemic myocardium as a possible source of this ceramide signature.

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