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Coronary Artery Disease: HELP
Articles from Malaysia
Based on 75 articles published since 2008
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These are the 75 published articles about Coronary Artery Disease that originated from Malaysia during 2008-2019.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3
1 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.

2 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.

3 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.

4 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.

5 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 / Anonymous3471055. ·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.

6 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

7 Clinical Trial Renal outcome following on- and off-pump coronary artery bypass graft surgery. 2008

Ooi, Joanna S M / Abdul Rahman, Mohd R / Shah, Shamsul A / Dimon, Mohd Z. ·Division of Cardiothoracic Anesthesia, Heart and Lung Center, Hospital University Kebangsaan Malaysia, University Kebangsaan Malaysia, Kuala Lumpur, Malaysia. joanna@mail.hukm.ukm.my ·Asian Cardiovasc Thorac Ann · Pubmed #18984756.

ABSTRACT: A prospective study was carried out to compare the outcomes of patients with preexisting non-dialysis-dependent renal dysfunction who underwent coronary artery bypass grafting with or without cardiopulmonary bypass. Elective off-pump coronary artery bypass was performed in 29 patients with renal dysfunction. Their results were compared with those of a similar group of 35 patients who underwent the conventional on-pump coronary artery grafting. There was a significant deterioration in creatinine clearance in the on-pump group on days 1, 2, and 4 after surgery, while creatinine clearance in the off-pump group remained close to the baseline level. Both groups had improved to the preoperative creatinine clearance values on follow-up at 4 weeks. It was concluded that off-pump surgery provided better renal protection than the conventional on-pump technique in patients with preexisting non-dialysis-dependent renal dysfunction.

8 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.

9 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 / Anonymous2461128. ·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.).

10 Article The effect of mobile messaging apps on cardiac patient knowledge of coronary artery disease risk factors and adherence to a healthy lifestyle. 2018

Tang, Yea Hung / Chong, Mei Chan / Chua, Yan Piaw / Chui, Ping Lei / Tang, Li Yoong / Rahmat, Norsiah. ·Department of Nursing Science, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia. · Faculty of Education, Institute of Educational Leadership, University of Malaya, Kuala Lumpur, Malaysia. ·J Clin Nurs · Pubmed #29777560.

ABSTRACT: AIMS: To determine the effect mobile messaging apps on coronary artery disease patient knowledge of and adherence to a healthy lifestyle. BACKGROUND: Due to the increasing incidence of coronary artery disease in recent years, interventions targeting coronary artery disease risk factors are urgent public priorities. The use of mobile technology in healthcare services and medical education is relatively new with promising future prospects. DESIGN: This study used a quasiexperimental design that included pre- and posttest for intervention and control groups. METHODS: The study was conducted from January-April 2017 with both intervention and control groups, in a teaching hospital in Klang Valley. Convenience sampling was used with inclusive criteria in choosing the 94 patients with coronary artery disease (intervention group: 47 patients; control group: 47 patients). The pretest was conducted as a baseline measurement for both groups before they were given standard care from a hospital. However, only the intervention group was given a daily information update via WhatsApp for 1 month. After 1 month, both groups were assessed with a posttest. RESULTS: The split-plot ANOVA analysis indicates that there is a significant and positive effect of the intervention on coronary artery disease patients' knowledge on coronary artery disease risk factors [F(1, 92) = 168.15, p < 0.001] with a large effect size ( CONCLUSION: This study concluded that WhatsApp was an effective health intervention in increasing coronary artery disease patient's knowledge and subsequently increasing their adherence to healthy lifestyles. RELEVANCE TO CLINICAL PRACTICE: In clinical setting, mobile messaging apps are useful in information delivery and efficient patient monitory.

11 Article Pharmacometabolomics analysis of plasma to phenotype clopidogrel high on treatment platelets reactivity in coronary artery disease patients. 2018

Amin, Arwa M / Sheau Chin, Lim / Teh, Chin-Hoe / Mostafa, Hamza / Mohamed Noor, Dzul Azri / Abdul Kader, Muhamad Ali S K / Kah Hay, Yuen / Ibrahim, Baharudin. ·School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia. Electronic address: arwa.amin.m@gmail.com. · School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia. · Bruker Sdn Bhd, Malaysia. · School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia; Cardiology Department, Hospital Pulau Pinang, Penang, Malaysia. ·Eur J Pharm Sci · Pubmed #29526765.

ABSTRACT: Dual antiplatelet therapy (DAPT) of clopidogrel and aspirin is crucial for coronary artery disease (CAD) patients undergoing percutaneous coronary intervention (PCI). However, some patients may endure clopidogrel high on treatment platelets reactivity (HTPR) which may cause thromboembolic events. Clopidogrel HTPR is multifactorial with some genetic and non-genetic factors contributing to it. We aimed to use nuclear magnetic resonance (

12 Article Measurement of coronary bifurcation angle with coronary CT angiography: A phantom study. 2018

Givehchi, Sogol / Safari, Mohammad Javad / Tan, Sock Keow / Md Shah, Mohammad Nazri Bin / Sani, Fadhli Bin Mohamed / Azman, Raja Rizal / Sun, Zhonghua / Yeong, Chai Hong / Ng, Kwan Hoong / Wong, Jeannie Hsiu Ding. ·Department of Biomedical Imaging, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia. · Department of Biomedical Imaging, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia; University of Malaya Research Imaging Centre (UMRIC), Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia. · Department of Medical Radiation Sciences, Curtin University, Perth 6845, Australia. · Department of Biomedical Imaging, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia; University of Malaya Research Imaging Centre (UMRIC), Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia. Electronic address: jeannie_wong80@um.edu.my. ·Phys Med · Pubmed #29373248.

ABSTRACT: PURPOSE: Accurate determination of the bifurcation angle and correlation with plaque buildup may lead to the prediction of coronary artery disease (CAD). This work evaluates two techniques to measure bifurcation angles in 3D space using coronary computed tomography angiography (CCTA). MATERIALS AND METHODS: Nine phantoms were fabricated with different bifurcation angles ranging from 55.3° to 134.5°. General X-ray and CCTA were employed to acquire 2D and 3D images of the bifurcation phantoms, respectively. Multiplanar reformation (MPR) and volume rendering technique (VRT) were used to measure the bifurcation angle between the left anterior descending (LAD) and left circumflex arteries (LCx). The measured angles were compared with the true values to determine the accuracy of each measurement technique. Inter-observer variability was evaluated. The two techniques were further applied on 50 clinical CCTA cases to verify its clinical value. RESULTS: In the phantom setting, the mean absolute differences calculated between the true and measured angles by MPR and VRT were 2.4°±2.2° and 3.8°±2.9°, respectively. Strong correlation was found between the true and measured bifurcation angles. Furthermore, no significant differences were found between the bifurcation angles measured using either technique. In clinical settings, large difference of 12.0°±10.6° was found between the two techniques. CONCLUSION: In the phantom setting, both techniques demonstrated a significant correlation to the true bifurcation angle. Despite the lack of agreement of the two techniques in the clinical context, our findings in phantoms suggest that MPR should be preferred to VRT for the measurement of coronary bifurcation angle by CCTA.

13 Article Application of stacked convolutional and long short-term memory network for accurate identification of CAD ECG signals. 2018

Tan, Jen Hong / Hagiwara, Yuki / Pang, Winnie / Lim, Ivy / Oh, Shu Lih / Adam, Muhammad / Tan, Ru San / Chen, Ming / Acharya, U Rajendra. ·Department of Electronics and Computer Engineering, Ngee Ann Polytechnic, Singapore. · National Heart Centre Singapore, Singapore; Duke-National University of Singapore Medical School, Singapore. · Department of Electronics and Computer Engineering, Ngee Ann Polytechnic, Singapore; Department of Biomedical Engineering, School of Science and Technology, Singapore University of Social Sciences, Singapore; Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, Malaysia. Electronic address: aru@np.edu.sg. ·Comput Biol Med · Pubmed #29358103.

ABSTRACT: Coronary artery disease (CAD) is the most common cause of heart disease globally. This is because there is no symptom exhibited in its initial phase until the disease progresses to an advanced stage. The electrocardiogram (ECG) is a widely accessible diagnostic tool to diagnose CAD that captures abnormal activity of the heart. However, it lacks diagnostic sensitivity. One reason is that, it is very challenging to visually interpret the ECG signal due to its very low amplitude. Hence, identification of abnormal ECG morphology by clinicians may be prone to error. Thus, it is essential to develop a software which can provide an automated and objective interpretation of the ECG signal. This paper proposes the implementation of long short-term memory (LSTM) network with convolutional neural network (CNN) to automatically diagnose CAD ECG signals accurately. Our proposed deep learning model is able to detect CAD ECG signals with a diagnostic accuracy of 99.85% with blindfold strategy. The developed prototype model is ready to be tested with an appropriate huge database before the clinical usage.

14 Article A Flowmeter Technique to Exclude Internal Mammary Artery Anastomosis Error in an Arrested Heart. 2018

Hashim, Shahrul A / Amin, Mohd Afiq / Nair, Ashvin / Raja Mokhtar, Raja Amin / Krishnasamy, Sivakumar / Cheng, Kenny. ·Cardiothoracic Surgery Unit, University of Malaya, Jalan Universiti, 50603 Kuala Lumpur, Malaysia. Electronic address: dr.shahrul@me.com. · Cardiothoracic Surgery Unit, University of Malaya, Jalan Universiti, 50603 Kuala Lumpur, Malaysia. ·Heart Lung Circ · Pubmed #29246681.

ABSTRACT: The revision of an internal mammary artery graft anastomosis because of a technical error can be time-consuming and complicated and may lead to complications. Here, we describe the technical details and our early experience of using a standard transit-time flowmeter to exclude technical errors and facilitate rapid decision making for anastomosis revision in an arrested heart during aortic cross-clamping in the absence of ultrasound guidance.

15 Article Rivaroxaban with or without aspirin in patients with stable coronary artery disease: an international, randomised, double-blind, placebo-controlled trial. 2018

Connolly, Stuart J / Eikelboom, John W / Bosch, Jackie / Dagenais, Gilles / Dyal, Leanne / Lanas, Fernando / Metsarinne, Kaj / O'Donnell, Martin / Dans, Anthony L / Ha, Jong-Won / Parkhomenko, Alexandr N / Avezum, Alvaro A / Lonn, Eva / Lisheng, Liu / Torp-Pedersen, Christian / Widimsky, Petr / Maggioni, Aldo P / Felix, Camilo / Keltai, Katalin / Hori, Masatsugu / Yusoff, Khalid / Guzik, Tomasz J / Bhatt, Deepak L / Branch, Kelley R H / Cook Bruns, Nancy / Berkowitz, Scott D / Anand, Sonia S / Varigos, John D / Fox, Keith A A / Yusuf, Salim / Anonymous4090973. ·Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada. Electronic address: connostu@phri.ca. · Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada. · School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada. · Institut Universitaire de Cardiologie et Pneumologie de Québec, Québec, QC, Canada. · Universidad de la Frontera, Temuco, Chile. · Department of Medicine, Turku University Central Hospital and Turku University, Turku, Finland. · Department of Medicine, National University of Ireland, Galway, Ireland. · Department of Medicine, University of Philippines, Manila, Philippines. · Yonsei University College of Medicine, Seoul, Korea. · Institute of Cardiology, Kiev, Ukraine. · Instituto Dante Pazzanese de Cardiologia & University Santo Amaro, Saõ Paulo, Brazil. · FuWai Hospital, CAMS, Beijing, China. · University of Aalborg, Aalborg, Denmark. · Charles University, Prague, Czech Republic. · ANMCO Research Center, Florence, Italy. · Universidad Tecnológica Equinoccial, Facultad de Ciencias de la Salud Eugenio, Espejo, Quito, Ecuador. · Department of Medicine, Semmelweis University, Budapest, Hungary. · Osaka International Cancer Institute, Osaka, Japan. · Universiti Teknologi Mara, Selangor, Malaysia. · Collegium Medicum Jagiellonian University, Krakow, Poland; University of Glasgow, Glasgow, UK. · Brigham and Women's Hospital Heart & Vascular Center and Harvard Medical School, Boston, MA, USA. · Department of Medicine, University of Washington Medical Centre, Seattle, WA, USA. · Bayer AG, Wuppertal, Germany. · Bayer AG, Parsippany, NJ, USA. · Monash University, Melbourne, VIC, Australia. · Department of Medicine, University of Edinburgh, Edinburgh, UK. ·Lancet · Pubmed #29132879.

ABSTRACT: BACKGROUND: Coronary artery disease is a major cause of morbidity and mortality worldwide, and is a consequence of acute thrombotic events involving activation of platelets and coagulation proteins. Factor Xa inhibitors and aspirin each reduce thrombotic events but have not yet been tested in combination or against each other in patients with stable coronary artery disease. METHODS: In this multicentre, double-blind, randomised, placebo-controlled, outpatient trial, patients with stable coronary artery disease or peripheral artery disease were recruited at 602 hospitals, clinics, or community centres in 33 countries. This paper reports on patients with coronary artery disease. Eligible patients with coronary artery disease had to have had a myocardial infarction in the past 20 years, multi-vessel coronary artery disease, history of stable or unstable angina, previous multi-vessel percutaneous coronary intervention, or previous multi-vessel coronary artery bypass graft surgery. After a 30-day run in period, patients were randomly assigned (1:1:1) to receive rivaroxaban (2·5 mg orally twice a day) plus aspirin (100 mg once a day), rivaroxaban alone (5 mg orally twice a day), or aspirin alone (100 mg orally once a day). Randomisation was computer generated. Each treatment group was double dummy, and the patients, investigators, and central study staff were masked to treatment allocation. The primary outcome of the COMPASS trial was the occurrence of myocardial infarction, stroke, or cardiovascular death. This trial is registered with ClinicalTrials.gov, number NCT01776424, and is closed to new participants. FINDINGS: Between March 12, 2013, and May 10, 2016, 27 395 patients were enrolled to the COMPASS trial, of whom 24 824 patients had stable coronary artery disease from 558 centres. The combination of rivaroxaban plus aspirin reduced the primary outcome more than aspirin alone (347 [4%] of 8313 vs 460 [6%] of 8261; hazard ratio [HR] 0·74, 95% CI 0·65-0·86, p<0·0001). By comparison, treatment with rivaroxaban alone did not significantly improve the primary outcome when compared with treatment with aspirin alone (411 [5%] of 8250 vs 460 [6%] of 8261; HR 0·89, 95% CI 0·78-1·02, p=0·094). Combined rivaroxaban plus aspirin treatment resulted in more major bleeds than treatment with aspirin alone (263 [3%] of 8313 vs 158 [2%] of 8261; HR 1·66, 95% CI 1·37-2·03, p<0·0001), and similarly, more bleeds were seen in the rivaroxaban alone group than in the aspirin alone group (236 [3%] of 8250 vs 158 [2%] of 8261; HR 1·51, 95% CI 1·23-1·84, p<0·0001). The most common site of major bleeding was gastrointestinal, occurring in 130 [2%] patients who received combined rivaroxaban plus aspirin, in 84 [1%] patients who received rivaroxaban alone, and in 61 [1%] patients who received aspirin alone. Rivaroxaban plus aspirin reduced mortality when compared with aspirin alone (262 [3%] of 8313 vs 339 [4%] of 8261; HR 0·77, 95% CI 0·65-0·90, p=0·0012). INTERPRETATION: In patients with stable coronary artery disease, addition of rivaroxaban to aspirin lowered major vascular events, but increased major bleeding. There was no significant increase in intracranial bleeding or other critical organ bleeding. There was also a significant net benefit in favour of rivaroxaban plus aspirin and deaths were reduced by 23%. Thus, addition of rivaroxaban to aspirin has the potential to substantially reduce morbidity and mortality from coronary artery disease worldwide. FUNDING: Bayer AG.

16 Article Manifestation of Coronary Atherosclerosis in Klang Valley, Malaysia: An Autopsy Study. 2018

Rahimi, Razuin / Singh, Mansharan Kaur Chainchel / Noor, Norizal Mohd / Omar, Effat / Noor, Shahidan Md / Mahmood, Mohd Shah / Abdullah, Nurliza / Nawawi, Hapizah Mohd. ·The Centre for Pathology Diagnostic and Research Laboratories (CPDRL), Faculty of Medicine, Universiti Teknologi MARA. · Department of Forensic Medicine, Hospital Sungai Buloh. · Institute of Pathology, Laboratory and Forensic Medicine (I-PPerForM), Universiti Teknologi MARA. · National Institute of Forensic Medicine, Hospital Kuala Lumpur. ·J Atheroscler Thromb · Pubmed #29118310.

ABSTRACT: AIMS: The present study aimed to determine the epidemiological aspects of medico-legal autopsies and manifestation of coronary atherosclerosis. METHODS: This was a cross sectional study involving 222 cases recruited from National Institute of Forensic Medicine (NIFM) Hospital Kuala Lumpur (HKL) and Department of Forensic Medicine Hospital Sungai Buloh (HSgB) for a period of 15 months, from December 2012 to April 2014. Sociodemographic and autopsy findings, including the cause and manner of death were documented. RESULTS: Male and female subjects aged 18-70 years were recruited. Males contributed to 86% of the total subjects and comprised 61% of young adults. Road traffic accidents were the primary cause of death, contributing almost 50% of the subjects. One third of the cases comprised of death due to natural causes, wherein almost 75% of the subjects within this category succumbed to sudden cardiac death. Coronary artery disease (CAD) contributed to 60% of the sudden cardiac death (SCD). Single and double-vessel diseases were the most common pattern of atherosclerosis. In almost 80% of CAD cases, atherosclerosis affected the left anterior descending artery (LAD). CONCLUSION: Cardiovascular diseases were the most significant natural cause of sudden death with a staggering figure of 75%. CAD was the single most commonly encountered pathology within the SCD. Most cases presented with single and double-vessel diseases, observed in all subjects, as well as the young adult population.

17 Article Is coronary arteritis a feature in secondary haemophagocytic lymphohistiocytosis? 2018

See, Beng Teong / Yip, Ke Xin / Ang, Hak Lee. ·a Faculty of Medicine, Department of Paediatrics , University of Malaya , Kuala Lumpur , Malaysia. · b Department of Paediatrics , University of Malaya Medical Center , Kuala Lumpur , Malaysia. ·Paediatr Int Child Health · Pubmed #28222654.

ABSTRACT: Haemophagocytic lymphohistiocytosis (HLH) is rare. Although Kawasaki disease (KD) has been reported as a precursor to HLH, coronary arteritis occurring at the onset of secondary HLH, not in association with KD, has not been reported. An 8-year-old girl presented with virus-induced secondary HLH associated with a giant aneurysm and ectasia of the coronary arteries which was detected incidentally at onset of the disease. She did not fulfill the criteria for diagnosis of KD. The coronary lesions improved after 6 months of treatment with dexamethasone and etoposide. Echocardiography early in the course of HLH is a useful tool to detect the unusual finding of coronary arteritis which may carry significant clinical sequelae.

18 Article Oxidative status and reduced glutathione levels in premature coronary artery disease and coronary artery disease. 2017

Musthafa, Qurratu Aini / Abdul Shukor, Muhd Faizan / Ismail, Noor Akmal Shareela / Mohd Ghazi, Azmee / Mohd Ali, Rosli / M Nor, Ika Faizura / Dimon, Mohd Zamrin / Wan Ngah, Wan Zurinah. ·a Department of Biochemistry, Faculty of Medicine , Universiti Kebangsaan Malaysia Medical Centre , Cheras , Malaysia. · b National Heart Institute of Malaysia , Kuala Lumpur , Malaysia. · c Department of Medicine , UiTM Private Specialist Centre , Selangor , Malaysia. ·Free Radic Res · Pubmed #28899235.

ABSTRACT: Identifying patients at risk of developing premature coronary artery disease (PCAD) which occurs at age below 45 years old and constitutes approximately 7-10% of coronary artery disease (CAD) worldwide remains a problem. Oxidative stress has been proposed as a crucial step in the early development of PCAD. This study was conducted to determine the oxidative status of PCAD in comparison to CAD patients. PCAD (<45 years old) and CAD (>60 years old) patients were recruited with age-matched controls (n = 30, each group). DNA damage score, plasma malondialdehyde (MDA) and protein carbonyl content were measured for oxidative damage markers. Antioxidants such as erythrocyte glutathione (GSH), oxidised glutathione (GSSG), and glutathione peroxidase activity (GPx), superoxide dismutase (SOD) and catalase (CAT) were also determined. DNA damage score and protein carbonyl content were significantly higher in both PCAD and CAD when compared to age-matched controls while MDA level was increased only in PCAD (p<.05). In contrast, GSH, GSH/GSSG ratio, α-tocotrienol isomer, and GPx activity were significantly decreased, but only in PCAD when compared to age-matched controls. The decrease in GSH was associated with PCAD (OR = 0.569 95%CI [0.375 - 0.864], p = .008) and cut-off values of 6.69 μM with areas under the ROC curves (AUROC) 95%CI: 0.88 [0.80-0.96] (sensitivity of 83.3%; specificity of 80%). However, there were no significant differences in SOD and CAT activities in all groups. A higher level of oxidative stress indicated by elevated MDA levels and low levels of GSH, α-tocotrienol and GPx activity in patients below 45 years old may play a role in the development of PCAD and has potential as biomarkers for PCAD.

19 Article None 2017

Amin, Arwa M / Sheau Chin, Lim / Teh, Chin-Hoe / Mostafa, Hamza / Mohamed Noor, Dzul Azri / Sk Abdul Kader, Muhamad Ali / Kah Hay, Yuen / Ibrahim, Baharudin. ·School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia. Electronic address: arwa.amin.m@gmail.com. · School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia. · Bruker (Malaysia) Sdn Bhd. · School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia; Cardiology Department, Hospital Pulau Pinang, Penang, Malaysia. ·J Pharm Biomed Anal · Pubmed #28873361.

ABSTRACT: Clopidogrel high on treatment platelets reactivity (HTPR) has burdened achieving optimum therapeutic outcome. Although there are known genetic and non-genetic factors associated with clopidogrel HTPR, which explain in part clopidogrel HTPR, yet, great portion remains unknown, often hindering personalizing antiplatelet therapy. Nuclear magnetic resonance (

20 Article Cost of elective percutaneous coronary intervention in Malaysia: a multicentre cross-sectional costing study. 2017

Lee, Kun Yun / Ong, Tiong Kiam / Low, Ee Vien / Liow, Siow Yen / Anchah, Lawrence / Hamzah, Syuhada / Liew, Houng Bang / Ali, Rosli Mohd / Ismail, Omar / Ahmad, Wan Azman Wan / Said, Mas Ayu / Dahlui, Maznah. ·Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia. · Department of Cardiology, Sarawak Heart Centre, Sarawak, Malaysia. · Pharmaceutical Services Division, Ministry of Health, Petaling Jaya, Malaysia. · Department of Pharmacy, Clinical Research Centre, Queen Elizabeth 2 Hospital, Kota Kinabalu, Malaysia. · Department of Pharmacy, Sarawak Heart Centre, Sarawak, Malaysia. · Administrative Office, Penang General Hospital, Pulau Pinang, Malaysia. · Division of Cardiology, Clinical Research Centre, Queen Elizabeth 2 Hospital, Kota Kinabalu, Malaysia. · Department of Cardiology, National Heart Institute, Kuala Lumpur, Malaysia. · Division of Cardiology, Penang General Hospital, Penang, Malaysia. · Division of Cardiology, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia. · Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Julius Centre University of Malaya, 50603 Kuala Lumpur, Malaysia. ·BMJ Open · Pubmed #28552843.

ABSTRACT: OBJECTIVES: Limitations in the quality and access of cost data from low-income and middle-income countries constrain the implementation of economic evaluations. With the increasing prevalence of coronary artery disease in Malaysia, cost information is vital for cardiac service expansion. We aim to calculate the hospitalisation cost of percutaneous coronary intervention (PCI), using a data collection method customised to local setting of limited data availability. DESIGN: This is a cross-sectional costing study from the perspective of healthcare providers, using top-down approach, from January to June 2014. Cost items under each unit of analysis involved in the provision of PCI service were identified, valuated and calculated to produce unit cost estimates. SETTING: Five public cardiac centres participated. All the centres provide full-fledged cardiology services. They are also the tertiary referral centres of their respective regions. PARTICIPANTS: The cost was calculated for elective PCI procedure in each centre. PCI conducted for urgent/emergent indication or for patients with shock and haemodynamic instability were excluded. PRIMARY AND SECONDARY OUTCOME MEASURES: The outcome measures of interest were the unit costs at the two units of analysis, namely cardiac ward admission and cardiac catheterisation utilisation, which made up the total hospitalisation cost. RESULTS: The average hospitalisation cost ranged between RM11 471 (US$3186) and RM14 465 (US$4018). PCI consumables were the dominant cost item at all centres. The centre with daycare establishment recorded the lowest admission cost and total hospitalisation cost. CONCLUSIONS: Comprehensive results from all centres enable comparison at the levels of cost items, unit of analysis and total costs. This generates important information on cost variations between centres, thus providing valuable guidance for service planning. Alternative procurement practices for PCI consumables may deliver cost reduction. For countries with limited data availability, costing method tailored based on country setting can be used for the purpose of economic evaluations. REGISTRATION: Malaysian MOH Medical Research and Ethics Committee (ID: NMRR-13-1403-18234 IIR).

21 Article MortalitY in caRdIAc surgery (MYRIAD): A randomizeD controlled trial of volatile anesthetics. Rationale and design. 2017

Landoni, Giovanni / Lomivorotov, Vladimir / Pisano, Antonio / Nigro Neto, Caetano / Benedetto, Umberto / Biondi Zoccai, Giuseppe / Gemma, Marco / Frassoni, Samuele / Agrò, Felice Eugenio / Baiocchi, Massimo / Barbosa Gomes Galas, Filomena R / Bautin, Andrei / Bradic, Nikola / Carollo, Cristiana / Crescenzi, Giuseppe / Elnakera, Abeer M / El-Tahan, Mohamed R / Fominskiy, Evgeny / Farag, Ahmed G / Gazivoda, Gordana / Gianni, Stefano / Grigoryev, Evgeny / Guarracino, Fabio / Hanafi, Sidik / Huang, Weiqing / Kunst, Gudrun / Kunstyr, Jan / Lei, Chong / Lembo, Rosalba / Li, Zhi-Jian / Likhvantsev, Valery / Lozovskiy, Andrey / Ma, Jun / Monaco, Fabrizio / Navalesi, Paolo / Nazar, Bukamal / Pasyuga, Vadim / Porteri, Elena / Royse, Colin / Ruggeri, Laura / Riha, Hynek / Santos Silva, Fernanda / Severi, Luca / Shmyrev, Vladimir / Uvaliev, Nikolay / Wang, Cheng Bin / Wang, Chew-Yin / Winterton, Dario / Yong, Chow-Yen / Yu, Jingui / Bellomo, Rinaldo / Zangrillo, Alberto. ·Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, Milan 20132, Italy. Electronic address: landoni.giovanni@hsr.it. · Siberian Biomedical Research Center, Department of Anesthesiology and Intensive Care, Novosibirsk, Russia. · Cardiac Anesthesia and Intensive Care Unit, Monaldi Hospital A.O.R.N. "Dei Colli", Via L. Bianchi Naples, 80131, Italy. · Anesthesia Section of Cardiothoracic Surgery, Dante Pazzanese Institute of Cardiology, Sao Paulo, Brazil. · University of Bristol, School of Clinical Sciences, Bristol Heart Institute, Bristol, United Kingdom. · Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy; Department of AngioCardioNeurology, IRCCS Neuromed, Pozzilli, Italy. · Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, Milan 20132, Italy. · Anaesthesia, Intensive Care and Pain Management Department, University School of Medicine Campus Bio-Medico, Rome, Italy. · Anesthesia and Intensive Care, S. Orsola-Malpighi University Hospital, Bologna, Italy. · Anesthesia and Intensive care, Heart Institute, University of Sao Paulo, Sao Paulo, Brazil. · Department of Anesthesiology and Intensive Care, Federal Almazov North-West Medical Research Centre, Saint-Petersburg, Russia. · Department of Cardiovascular Anesthesiology and Cardiac Intensive Medicine, University Hospital Dubrava, Zagreb, Croatia. · Department of Medicine, Anesthesia and Intensive Care Unit, Padova University Hospital, Via Cesare Battisti 256, 35128 Padova, Italy. · Anestesia e Terapia Intensiva Cardiochirurgica, Humanitas Research Hospital, Rozzano, Italy. · Anesthesia and Intensive Care, Faculty of Medicine, Zagazig University, Zagazig, Egypt. · Cardiothoracic Anaesthesia & Surgical Intensive Care, King Fahd Hospital, University of Dammam, Al Khobar, Saudi Arabia. · Department of Anaesthesia and Intensive Care, Siberian Biomedical Research Center of the Ministry of Health, Novosibirsk, Russia. · Department of Anaesthesia and Intensive Care, King Abdullah Medical City in Holy Capital "KAMC-HC", Makkah, Saudi Arabia. · Department of Anesthesiology and Intensive Care, Cardiovascular Institute `Dedinje`, Belgrade, Serbia. · Deputy Director for Clinical and Scientific Affairs, Scientific Research Institute of Complex Issues of Cardiovascular Disease, Kemerovo, Russia. · Department of Anaesthesia and Critical Care Medicine, Azienda Ospedaliero-Universitaria Pisana, Via Paradisa 2, 56123 Pisa, Italy. · Department of Anaesthesiology and Intensive Care, Sarawak General Hospital, Kuching, Sarawak, Malaysia. · Department of Anesthesiology, Wuhan Asia Heart Hospital, Wuhan, China. · Department of Anaesthetics, King's College Hospital NHS Foundation Trust, London, United Kingdom. · Department of Anesthesiology and Intensive Care, First Faculty of Medicine, General University Hospital in Prague, Prague, Czech Republic. · Department of Anesthesiology and Perioperative Medicine, 1st Affiliative Hospital (Xijing Hospital), Fourth Military Medical University, Xi'an, China. · Department of Anesthesiology, The Second Xiangya Hospital of Central South University, Changsha, China. · Anesthesiology and Intensive Care Department, Moscow Clinical Regional Research Institute, Shepkina st., 61/2, Moscow, Russia. · Department of Anesthesiology and Intensive Care, Ural Institute of Cardiology, Ekaterinburg, Russia. · Center for Anesthesiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China. · Anesthesia and Intensive Care, Dipartimento Scienze Mediche e Chirurgiche, Università della Magna Graecia, Catanzaro, Italy. · Cardiothoracic ICU and Anaesthesia, MKCC, West Riffa, Bahrain. · Department of Cardiac Aneasthesia and Intensive Care, Astrakhan Federal Centre for Cardiac Surgery, Astrakhan, Russia. · Dipartimento Cardiotoracico, Azienda Ospedaliera Spedali Civili, Brescia, Italy. · Department of Surgery, Level 6 Clinical Medical Research Building, The University of Melbourne, Melbourne, Australia. · Cardiothoracic Anesthesiology and Intensive Care, Institute for Clinical and Experimental Medicine, Prague, Czech Republic. · Anesthetic Department, Hospital de Santa Maria, Lisboa, Portugal. · Anesthesia and Intensive Care, Azienda Ospedaliera San Camillo Forlanini, Roma,Italy. · Department-Anesthesia and Intensive Care, ACIBADEM City Clinic Burgas, Burgas, Bulgaria. · Anaesthesia and Intensive Care, University of Malaya, Kuala Lumpur, Malaysia. · Anaesthesia and Intensive Care, Hospital Pulau Pinang, Georgetown, Malaysia. · Department of Anesthesiology, Qilu Hospital of Shandong University, Shandong, China. · The University of Melbourne, Melbourne, Victoria, Australia. ·Contemp Clin Trials · Pubmed #28533194.

ABSTRACT: OBJECTIVE: There is initial evidence that the use of volatile anesthetics can reduce the postoperative release of cardiac troponin I, the need for inotropic support, and the number of patients requiring prolonged hospitalization following coronary artery bypass graft (CABG) surgery. Nevertheless, small randomized controlled trials have failed to demonstrate a survival advantage. Thus, whether volatile anesthetics improve the postoperative outcome of cardiac surgical patients remains uncertain. An adequately powered randomized controlled trial appears desirable. DESIGN: Single blinded, international, multicenter randomized controlled trial with 1:1 allocation ratio. SETTING: Tertiary and University hospitals. INTERVENTIONS: Patients (n=10,600) undergoing coronary artery bypass graft will be randomized to receive either volatile anesthetic as part of the anesthetic plan, or total intravenous anesthesia. MEASUREMENTS AND MAIN RESULTS: The primary end point of the study will be one-year mortality (any cause). Secondary endpoints will be 30-day mortality; 30-day death or non-fatal myocardial infarction (composite endpoint); cardiac mortality at 30day and at one year; incidence of hospital re-admission during the one year follow-up period and duration of intensive care unit, and hospital stay. The sample size is based on the hypothesis that volatile anesthetics will reduce 1-year unadjusted mortality from 3% to 2%, using a two-sided alpha error of 0.05, and a power of 0.9. CONCLUSIONS: The trial will determine whether the simple intervention of adding a volatile anesthetic, an intervention that can be implemented by all anesthesiologists, can improve one-year survival in patients undergoing coronary artery bypass graft surgery.

22 Article Fifteen new risk loci for coronary artery disease highlight arterial-wall-specific mechanisms. 2017

Howson, Joanna M M / Zhao, Wei / Barnes, Daniel R / Ho, Weang-Kee / Young, Robin / Paul, Dirk S / Waite, Lindsay L / Freitag, Daniel F / Fauman, Eric B / Salfati, Elias L / Sun, Benjamin B / Eicher, John D / Johnson, Andrew D / Sheu, Wayne H H / Nielsen, Sune F / Lin, Wei-Yu / Surendran, Praveen / Malarstig, Anders / Wilk, Jemma B / Tybjærg-Hansen, Anne / Rasmussen, Katrine L / Kamstrup, Pia R / Deloukas, Panos / Erdmann, Jeanette / Kathiresan, Sekar / Samani, Nilesh J / Schunkert, Heribert / Watkins, Hugh / Anonymous2140907 / Do, Ron / Rader, Daniel J / Johnson, Julie A / Hazen, Stanley L / Quyyumi, Arshed A / Spertus, John A / Pepine, Carl J / Franceschini, Nora / Justice, Anne / Reiner, Alex P / Buyske, Steven / Hindorff, Lucia A / Carty, Cara L / North, Kari E / Kooperberg, Charles / Boerwinkle, Eric / Young, Kristin / Graff, Mariaelisa / Peters, Ulrike / Absher, Devin / Hsiung, Chao A / Lee, Wen-Jane / Taylor, Kent D / Chen, Ying-Hsiang / Lee, I-Te / Guo, Xiuqing / Chung, Ren-Hua / Hung, Yi-Jen / Rotter, Jerome I / Juang, Jyh-Ming J / Quertermous, Thomas / Wang, Tzung-Dau / Rasheed, Asif / Frossard, Philippe / Alam, Dewan S / Majumder, Abdulla Al Shafi / Di Angelantonio, Emanuele / Chowdhury, Rajiv / Anonymous2150907 / Chen, Yii-Der Ida / Nordestgaard, Børge G / Assimes, Themistocles L / Danesh, John / Butterworth, Adam S / Saleheen, Danish. ·MRC/BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK. · Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA. · Department of Applied Mathematics, University of Nottingham Malaysia Campus, Semenyih, Malaysia. · Robertson Centre for Biostatistics, University of Glasgow, Glasgow, UK. · HudsonAlpha Institute for Biotechnology, Huntsville, Alabama, USA. · Pfizer Worldwide Research and Development, Cambridge, Massachusetts, USA. · Department of Medicine, Division of Cardiovascular Medicine, Stanford University, Stanford, California, USA. · Stanford Cardiovascular Institute, Stanford University, Stanford, California, USA. · National Heart, Lung, and Blood Institute, Population Sciences Branch, Bethesda, Maryland, USA. · NHLBI and Boston University's The Framingham Heart Study, Framingham, Massachusetts, USA. · Division of Endocrine and Metabolism, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan. · School of Medicine, National Yang-Ming University, Taipei, Taiwan. · College of Medicine, National Defense Medical Center, Taipei, Taiwan. · Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Copenhagen, Denmark. · Northern Institute for Cancer Research, Newcastle University, Newcastle-upon-Tyne, UK. · Pfizer Worldwide Research and Development, Stockholm, Sweden. · Pfizer Worldwide Research and Development, Human Genetics, Cambridge, Massachusetts, USA. · Department of Clinical Biochemistry, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark. · Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark. · William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK. · Centre for Genomic Health, Queen Mary University of London, London, UK. · Institute for Cardiogenetics, University of Lübeck, Lübeck, Germany. · DZHK (German Research Centre for Cardiovascular Research), partner site Hamburg/Lübeck/Kiel, Lübeck, Germany. · University Heart Center Lübeck, Lübeck, Germany. · Center for Genomic Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA. · Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA. · Department of Cardiovascular Sciences, University of Leicester, Leicester, UK. · NIHR Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, UK. · Deutsches Herzzentrum München, Technische Universität München, Munich, Germany. · DZHK (German Center for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany. · Radcliffe Department of Medicine, University of Oxford, Oxford, UK. · Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, UK. · Charles Bronfman Institute for Personalized Medicine, Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, New York, USA. · Departments of Genetics, Medicine, and Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA. · University of Florida College of Pharmacy, Gainesville, Florida, USA. · Department of Cellular and Molecular Medicine, Lerner Research Institute, Cleveland, Ohio, USA. · Division of Cardiology, Emory University School of Medicine, Atlanta, Georgia, USA. · Saint Luke's Mid America Heart Institute, Kansas City, Missouri, USA. · Department of Biomedical and Health Informatics, University of Missouri-Kansas City, Kansas City, Missouri, USA. · College of Medicine, University of Florida, Gainesville, Florida, USA. · Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA. · Department of Epidemiology, University of Washington, Seattle, Washington, USA. · Department of Statistics and Biostatistics, Rutgers University, Piscataway, New Jersey, USA. · Division of Genomic Medicine, National Human Genome Research Institute, US National Institutes of Health, Bethesda,Maryland, USA. · Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA. · Carolina Center for Genome Sciences, Chapel Hill, North Carolina, USA. · Human Genetics Center, School of Public Health, University of Texas Health Science Center at Houston, Houston, Texas, USA. · Human Genome Sequencing Center, Baylor College of Medicine, Houston, Texas, USA. · Division of Biostatistics and Bioinformatics, Institute of Population Health Sciences, National Health Research Institutes, Miaoli, Taiwan. · Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan. · Institute for Translational Genomics and Population Sciences, Department of Pediatrics, LABioMed at Harbor-UCLA Medical Center, Torrance, California, USA. · School of Medicine, Chung Shan Medical University, Taichung, Taiwan. · Division of Endocrinology and Metabolism, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan. · Institute for Translational Genomics and Population Sciences, Departments of Pediatrics and Medicine, LABioMed at Harbor-UCLA Medical Center, Torrance, California, USA. · Cardiovascular Center and Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan. · National Taiwan University College of Medicine, Taipei, Taiwan. · Centre for Non-Communicable Disease, Karachi, Pakistan. · School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada. · National Institute of Cardiovascular Diseases, Sher-e-Bangla Nagar, Bangladesh. · National Institute for Health Research Blood and Transplant Research Unit in Donor Health and Genomics, University of Cambridge, Cambridge, UK. · Wellcome Trust Sanger Institute, Hinxton, UK. · British Heart Foundation Cambridge Centre of Excellence, Department of Medicine, University of Cambridge, Cambridge, UK. ·Nat Genet · Pubmed #28530674.

ABSTRACT: Coronary artery disease (CAD) is a leading cause of morbidity and mortality worldwide. Although 58 genomic regions have been associated with CAD thus far, most of the heritability is unexplained, indicating that additional susceptibility loci await identification. An efficient discovery strategy may be larger-scale evaluation of promising associations suggested by genome-wide association studies (GWAS). Hence, we genotyped 56,309 participants using a targeted gene array derived from earlier GWAS results and performed meta-analysis of results with 194,427 participants previously genotyped, totaling 88,192 CAD cases and 162,544 controls. We identified 25 new SNP-CAD associations (P < 5 × 10

23 Article Enhanced status of inflammation and endothelial activation in subjects with familial hypercholesterolaemia and their related unaffected family members: a case control study. 2017

Rahman, Thuhairah / Hamzan, Nur Suhana / Mokhsin, Atiqah / Rahmat, Radzi / Ibrahim, Zubin Othman / Razali, Rafezah / Thevarajah, Malathi / Nawawi, Hapizah. ·Faculty of Medicine, Universiti Teknologi MARA (UiTM), Jalan Hospital, Sungai Buloh, Selangor, Malaysia. · Laboratory Medicine Division, Universiti Malaya Medical Center, Kuala Lumpur, Malaysia. · Faculty of Medicine, Universiti Teknologi MARA (UiTM), Jalan Hospital, Sungai Buloh, Selangor, Malaysia. hapizah@salam.uitm.edu.my. · Institute of Pathology, Laboratory and Forensic Medicine (I-PPerForM), Universiti Teknologi MARA (UiTM), Sungai Buloh, Selangor, Malaysia. hapizah@salam.uitm.edu.my. ·Lipids Health Dis · Pubmed #28438163.

ABSTRACT: BACKGROUND: Familial hypercholesterolaemia (FH) leads to premature coronary artery diseases (CAD) which pathophysiologically can be measured by inflammation, endothelial activation and oxidative stress status. However, the status of these biomarkers among related unaffected relatives of FH cases and whether FH is an independent predictor of these biomarkers have not been well established. Thus, this study aims to (1) compare the biomarkers of inflammation, endothelial activation and oxidative stress between patients with FH, their related unaffected relatives (RUC) and normolipaemic subjects (NC) (2)determine whether FH is an independent predictor of these biomarkers. METHODS: One hundred thirty-one FH patients, 68 RUC and 214 matched NC were recruited. Fasting lipid profile, biomarkers of inflammation (hsCRP), endothelial activation (sICAM-1 and E-selectin) and oxidative stress [oxidized LDL (oxLDL), malondialdehyde (MDA) and F2-isoprostanes (ISP)] were analyzed and independent predictor was determined using binary logistic regression analysis. RESULTS: hsCRP was higher in FH and RUC compared to NC (mean ± SD = 1.53 ± 1.24 mg/L and mean ± SD = 2.54 ± 2.30 vs 1.10 ± 0.89 mg/L, p < 0.05). sICAM-1 and E-selectin were higher in FH compared to NC (mean ± SD = 947 ± 742 vs 655 ± 191 ng/mL, p < 0.001 and 175 ± 131 vs 21.6 ± 10.7 ng/mL, p < 0.001 respectively) while sICAM-1 concentration was higher in RUC compared to NC (mean ± SD = 945 ± 379 vs 655 ± 191 ng/mL, p < 0.01). Biomarkers of oxidation (ox-LDL, MDA and ISP) were elevated in FH compared to NC [mean ± SD = (48.2 ± 26.8 vs 27.3 ± 13.2 mU/L, p < 0.001), (2.57 ± 1.3 vs 1.20 ± 0.30 nmol/mL, p < 0.001) and (645 ± 396 vs 398 ± 20.5 pg/L, p < 0.001) respectively], but no significant differences were observed between RUC and NC (p > 0.05). FH was an independent predictor for sICAM-1 (p = 0.007), ox-LDL (p < 0.001) and MDA (p < 0.001) while RUC independently predicted for sICAM-1 (p < 0.001). CONCLUSION: The screening for FH is vital as all biomarkers associated with atherogenesis are higher in these subjects and FH also independently predict biomarkers of endothelial activation and oxidative stress. Furthermore, despite not fulfilling the diagnostic criteria for FH, related unaffected family members that may not phenotypically express the mutation may still be at risk of developing CAD as reflected from the enhanced inflammatory and endothelial activation status observed in this group. This highlights the need to not only conduct family tracing in indexed FH cases, but also assess the coronary risk among family members that do not fulfil the FH diagnostic criteria.

24 Article Statin Treatment and Clinical Outcomes of Heart Failure Among Africans: An Inverse Probability Treatment Weighted Analysis. 2017

Bonsu, Kwadwo Osei / Owusu, Isaac Kofi / Buabeng, Kwame Ohene / Reidpath, Daniel D / Kadirvelu, Amudha. ·School of Medicine and Health Sciences, Monash University, Bandar Sunway, Malaysia kwadwo.osei.bonsu@monash.edu kbonsu2880@gmail.com. · Accident and Emergency Directorate, Komfo Anokye Teaching Hospital, Kumasi, Ghana. · Directorate of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana. · Department of Medicine, School of Medical Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana. · Department of Pharmacy Practice, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana. · School of Medicine and Health Sciences, Monash University, Bandar Sunway, Malaysia. ·J Am Heart Assoc · Pubmed #28365564.

ABSTRACT: BACKGROUND: Randomized control trials of statins have not demonstrated significant benefits in outcomes of heart failure (HF). However, randomized control trials may not always be generalizable. The aim was to determine whether statin and statin type-lipophilic or -hydrophilic improve long-term outcomes in Africans with HF. METHODS AND RESULTS: This was a retrospective longitudinal study of HF patients aged ≥18 years hospitalized at a tertiary healthcare center between January 1, 2009 and December 31, 2013 in Ghana. Patients were eligible if they were discharged from first admission for HF (index admission) and followed up to time of all-cause, cardiovascular, and HF mortality or end of study. Multivariable time-dependent Cox model and inverse-probability-of-treatment weighting of marginal structural model were used to estimate associations between statin treatment and outcomes. Adjusted hazard ratios were also estimated for lipophilic and hydrophilic statin compared with no statin use. The study included 1488 patients (mean age 60.3±14.2 years) with 9306 person-years of observation. Using the time-dependent Cox model, the 5-year adjusted hazard ratios with 95% CI for statin treatment on all-cause, cardiovascular, and HF mortality were 0.68 (0.55-0.83), 0.67 (0.54-0.82), and 0.63 (0.51-0.79), respectively. Use of inverse-probability-of-treatment weighting resulted in estimates of 0.79 (0.65-0.96), 0.77 (0.63-0.96), and 0.77 (0.61-0.95) for statin treatment on all-cause, cardiovascular, and HF mortality, respectively, compared with no statin use. CONCLUSIONS: Among Africans with HF, statin treatment was associated with significant reduction in mortality.

25 Article Types of social supports predicting health-related quality of life among adult patients with CHD in the Institut Jantung Negara (National Heart Institute), Malaysia. 2017

Tye, Sue K / Kandavello, Geetha / Gan, Kah L. ·Patient Counseling Department,Institut Jantung Negara,Kuala Lumpur,Malaysia. ·Cardiol Young · Pubmed #26911553.

ABSTRACT: OBJECTIVES: The objectives of this study were to examine which types of social supports - emotional/informational support, tangible support, affectionate support, and positive interactions - are the predictors of health-related quality of life (HRQoL) in adult patients with CHD and to assess the influence of demographic variables and clinical factors on these variables. METHODS: In total, 205 adult patients with CHD from the National Heart Institute, Malaysia, were recruited. Patients were first screened by cardiology consultants to ensure they fit the inclusion criteria before filling in questionnaires, which were medical outcome studies - social support survey and AQoL-8D. Results/conclusions All social supports and their subscales were found to have mild-to-moderate significant relationships with physical dimension, psychological dimension, and overall HRQoL; however, only positive interaction, marital status, and types of diagnosis were reported as predictors of HRQoL. Surprisingly, with regard to the physical dimension of quality of life, social supports were not significant predictors, but educational level, marital status, and types of diagnosis were significant predictors. Positive interaction, affectionate support, marital status, and types of diagnosis were again found to be predictors in the aspects of the psychological dimension of quality of life. In conclusion, positive interaction and affectionate support, which include elements of fun, relaxation, love, and care, should be included in the care of adult patients with CHD.

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