Objectives To compare left ventricular ejection fraction (LVEF) determined from 64-row multi-dete... more Objectives To compare left ventricular ejection fraction (LVEF) determined from 64-row multi-detector computed tomography (64-row MDCT) with those determined from two dimensional echocardiography (2D echo) and cardiac magnetic resonance imaging (CMR). Methods Thirty-two patients with coronary artery disease underwent trans-thoracic 2D echo, CMR and contrast-enhanced 64-row MDCT for assessment of LVEF within 48 hours of each other. 64-row MDCT LVEF was derived using the Syngo Circulation software; CMR LVEF was by Area Length Ejection Fraction (ALEF) and Simpson method and 2D echo LVEF by Simpson method.Results The LVEF was 49.13 ± 15.91% by 2D echo, 50.72 ± 16.55% (ALEF method) and 47.65 ± 16.58%(Simpson method) by CMR and 50.00 ± 15.93% by 64-row MDCT. LVEF measurements by 64-row MDCT correlated well with LVEF measured with CMR using either the ALEF method (Pearson correlation r = 0.94, P ＜0.01) or Simpson method (r = 0.92, P＜0.01). It also correlated well with LVEF measured using 2...
CASE REPORT A 47 year old lady had an acute severe episode of retrosternal chest pain, radiating ... more CASE REPORT A 47 year old lady had an acute severe episode of retrosternal chest pain, radiating to left arm and was diagnosed to have anteroseptal MI in a district hospital. The only cardiovascular risk factor was hypertension. Her vital signs were stable, Killips Class I. Thrombolysis with streptokinase and double antiplatelets acetylsalicylate 300mg and clopidogrel 300mg stat were administered. As her chest pain and ST elevation in the ECG persisted after the completion of the thrombolysis, she was transferred to a nearby tertiary hospital with cardiac facility the next morning with the presumption of failed thrombolysis.
... Cardiac Services in Sarawak, Malaysia. Kui-Hian Sim FRACP,; Alan Yean Yip Fong MRCP. Article ... more ... Cardiac Services in Sarawak, Malaysia. Kui-Hian Sim FRACP,; Alan Yean Yip Fong MRCP. Article first published online: 4 MAY 2007. ... How to Cite. Sim, K.-H. and Yip Fong, AY (2007), Cardiac Services in Sarawak, Malaysia. American Heart Hospital Journal, 5: 100–102. ...
Sex differences in acute coronary syndrome (ACS) have been well studied in major registries and c... more Sex differences in acute coronary syndrome (ACS) have been well studied in major registries and clinical trials in Western populations. Limited studies have examined the sex differences in ACS using a large number of Asian women as the subjects. The aim was to study the sex differences in ACS using the NCVD-ACS (National Cardiovascular Disease Database-Acute Coronary Syndrome) registry. We analyzed 13,591 ACS patients, of which 75.8% were men and 24.2% were women, from March 2006 to February 2010. Data were collected on demographic characteristics, risk factors, anthropometrics, treatments, procedures, mortalities, and complications. The results were compared among 3 cohorts of ACS (ST-segment elevation myocardial infarction [STEMI], non-STEMI, and unstable angina). Women were older and more likely to have diabetes, hypertension, previous heart failure, and cerebral vascular accidents than men were. Women were less likely to receive in-hospital administration of aspirin, beta-blocke...
... Cardiac Services in Sarawak, Malaysia. Kui-Hian Sim FRACP,; Alan Yean Yip Fong MRCP. Article ... more ... Cardiac Services in Sarawak, Malaysia. Kui-Hian Sim FRACP,; Alan Yean Yip Fong MRCP. Article first published online: 4 MAY 2007. ... How to Cite. Sim, K.-H. and Yip Fong, AY (2007), Cardiac Services in Sarawak, Malaysia. American Heart Hospital Journal, 5: 100–102. ...
AIMS: e-HEALING is a worldwide, internet-based registry designed to capture post marketing clinic... more AIMS: e-HEALING is a worldwide, internet-based registry designed to capture post marketing clinical data on the use of the Genous EPC capturing R stent. Rapid restoration of a healthy endothelial layer after stent placement by capturing circulating endothelial progenitor cells may reduce both stent thrombosis (ST) and in-stent-restenosis. METHODS AND RESULTS: We planned a 5,000 patient registry with >/=1 lesion suitable for stenting. The 12-month primary outcome was target vessel failure (TVF), defined as target vessel-related cardiac death or myocardial infarction (MI) and target vessel revascularisation. Secondary outcomes were the composite of cardiac death, MI or target lesion revascularisation (TLR), and individual outcomes including ST. A total of 4,939 patients received >/=1 Genous stent between 2005 and 2007. Baseline characteristics showed a median age of 63 years, 79% males, 25% diabetics, and 37% with prior MI. A total of 49% of lesions treated were ACC/AHA type B2 ...
Vitamin K antagonists have been shown to prevent stroke in patients with atrial fibrillation. How... more Vitamin K antagonists have been shown to prevent stroke in patients with atrial fibrillation. However, many patients are not suitable candidates for or are unwilling to receive vitamin K antagonist therapy, and these patients have a high risk of stroke. Apixaban, a novel factor Xa inhibitor, may be an alternative treatment for such patients.
To compare the assessment of global and regional left ventricular (LV) function using 64-slice mu... more To compare the assessment of global and regional left ventricular (LV) function using 64-slice multislice computed tomography (MSCT), 2D echocardiography (2DE) and cardiac magnetic resonance (CMR). Thirty-two consecutive patients (mean age, 56.5+/-9.7 years) referred for evaluation of coronary artery using 64-slice MSCT also underwent 2DE and CMR within 48h. The global left ventricular function which include left ventricular ejection fraction (LVEF), left ventricular end diastolic volume (LVdV) and left ventricular end systolic volume (LVsV) were determine using the three modalities. Regional wall motion (RWM) was assessed visually in all three modalities. The CMR served as the gold standard for the comparison between 64-slice MSCT with CMR and 2DE with CMR. Statistical analysis included Pearson correlation coefficient, Bland-Altman plots and kappa-statistics. The 64-slice MSCT agreed well with CMR for assessment of LVEF (r=0.92; p<0.0001), LVdV (r=0.98; p<0.0001) and LVsV (r=0.98; p<0.0001). In comparison with 64-slice MSCT, 2DE showed moderate correlation with CMR for the assessment of LVEF (r=0.84; p<0.0001), LVdV (r=0.83; p<0.0001) and LVsV (r=0.80; p<0.0001). However in RWM analysis, 2DE showed better accuracy than 64-slice MSCT (94.3% versus 82.4%) and closer agreement (kappa=0.89 versus 0.63) with CMR. 64-Slice MSCT correlates strongly with CMR in global LV function however in regional LV function 2DE showed better agreement with CMR than 64-slice MSCT.
Most studies investigating the benefits of statins have focused on North American and European po... more Most studies investigating the benefits of statins have focused on North American and European populations. This study focuses on evaluating the lipid-lowering effects of rosuvastatin and atorvastatin in Asian patients. The DIrect Statin COmparison of LDL-C Values: an Evaluation of Rosuvastatin therapY (DISCOVERY)-Asia study is one of nine independently powered studies assessing the efficacy of starting doses of statins in achieving target lipid levels in different countries worldwide. DISCOVERY-Asia was a 12-week, randomised, open-label, parallel-group study conducted in China, Hong Kong, Korea, Malaysia, Taiwan, and Thailand. A total of 1482 adults with primary hypercholesterolaemia and high cardiovascular risk (> 20%/10 years, type 2 diabetes, or a history of coronary heart disease) were randomised in a 2 : 1 ratio to receive rosuvastatin 10 mg once daily (o.d.) or atorvastatin 10 mg o.d. The percentage of patients achieving the 1998 European Joint Task Force low-density lipoprotein cholesterol (LDL-C) goal of < 3.0 mmol/L at 12 weeks was significantly higher in the rosuvastatin group (n = 950) compared with the atorvastatin group (n = 471) (79.5 vs. 69.4%, respectively; p < 0.0001). Similar results were observed for 1998 European goals for total cholesterol (TC), and the 2003 European goals for LDL-C and TC. LDL-C and TC levels were reduced significantly more with rosuvastatin compared with atorvastatin. Both drugs were well-tolerated and the incidence and type of adverse events were similar in each group. The trial registry summary is available at http://www.clinicaltrials.gov/; ClinicalTrials.gov Identifier: NCT00241488 This 12-week study showed that the starting dose of rosuvastatin 10 mg o.d. was significantly more effective than the starting dose of natorvastatin 10 mg o.d. at enabling patients with primary hypercholesterolaemia to achieve European goals for LDL-C and TC in a largely Asian population in real-life clinical practice. The safety profile of rosuvastatin 10 mg is similar to that of atorvastatin 10 mg in the Asian population studied here, and is consistent with the known safety profile of rosuvastatin in the white population.
Objectives To compare left ventricular ejection fraction (LVEF) determined from 64-row multi-dete... more Objectives To compare left ventricular ejection fraction (LVEF) determined from 64-row multi-detector computed tomography (64-row MDCT) with those determined from two dimensional echocardiography (2D echo) and cardiac magnetic resonance imaging (CMR). Methods Thirty-two patients with coronary artery disease underwent trans-thoracic 2D echo, CMR and contrast-enhanced 64-row MDCT for assessment of LVEF within 48 hours of each other. 64-row MDCT LVEF was derived using the Syngo Circulation software; CMR LVEF was by Area Length Ejection Fraction (ALEF) and Simpson method and 2D echo LVEF by Simpson method.Results The LVEF was 49.13 ± 15.91% by 2D echo, 50.72 ± 16.55% (ALEF method) and 47.65 ± 16.58%(Simpson method) by CMR and 50.00 ± 15.93% by 64-row MDCT. LVEF measurements by 64-row MDCT correlated well with LVEF measured with CMR using either the ALEF method (Pearson correlation r = 0.94, P ＜0.01) or Simpson method (r = 0.92, P＜0.01). It also correlated well with LVEF measured using 2...
CASE REPORT A 47 year old lady had an acute severe episode of retrosternal chest pain, radiating ... more CASE REPORT A 47 year old lady had an acute severe episode of retrosternal chest pain, radiating to left arm and was diagnosed to have anteroseptal MI in a district hospital. The only cardiovascular risk factor was hypertension. Her vital signs were stable, Killips Class I. Thrombolysis with streptokinase and double antiplatelets acetylsalicylate 300mg and clopidogrel 300mg stat were administered. As her chest pain and ST elevation in the ECG persisted after the completion of the thrombolysis, she was transferred to a nearby tertiary hospital with cardiac facility the next morning with the presumption of failed thrombolysis.
... Cardiac Services in Sarawak, Malaysia. Kui-Hian Sim FRACP,; Alan Yean Yip Fong MRCP. Article ... more ... Cardiac Services in Sarawak, Malaysia. Kui-Hian Sim FRACP,; Alan Yean Yip Fong MRCP. Article first published online: 4 MAY 2007. ... How to Cite. Sim, K.-H. and Yip Fong, AY (2007), Cardiac Services in Sarawak, Malaysia. American Heart Hospital Journal, 5: 100–102. ...
Sex differences in acute coronary syndrome (ACS) have been well studied in major registries and c... more Sex differences in acute coronary syndrome (ACS) have been well studied in major registries and clinical trials in Western populations. Limited studies have examined the sex differences in ACS using a large number of Asian women as the subjects. The aim was to study the sex differences in ACS using the NCVD-ACS (National Cardiovascular Disease Database-Acute Coronary Syndrome) registry. We analyzed 13,591 ACS patients, of which 75.8% were men and 24.2% were women, from March 2006 to February 2010. Data were collected on demographic characteristics, risk factors, anthropometrics, treatments, procedures, mortalities, and complications. The results were compared among 3 cohorts of ACS (ST-segment elevation myocardial infarction [STEMI], non-STEMI, and unstable angina). Women were older and more likely to have diabetes, hypertension, previous heart failure, and cerebral vascular accidents than men were. Women were less likely to receive in-hospital administration of aspirin, beta-blocke...
... Cardiac Services in Sarawak, Malaysia. Kui-Hian Sim FRACP,; Alan Yean Yip Fong MRCP. Article ... more ... Cardiac Services in Sarawak, Malaysia. Kui-Hian Sim FRACP,; Alan Yean Yip Fong MRCP. Article first published online: 4 MAY 2007. ... How to Cite. Sim, K.-H. and Yip Fong, AY (2007), Cardiac Services in Sarawak, Malaysia. American Heart Hospital Journal, 5: 100–102. ...
AIMS: e-HEALING is a worldwide, internet-based registry designed to capture post marketing clinic... more AIMS: e-HEALING is a worldwide, internet-based registry designed to capture post marketing clinical data on the use of the Genous EPC capturing R stent. Rapid restoration of a healthy endothelial layer after stent placement by capturing circulating endothelial progenitor cells may reduce both stent thrombosis (ST) and in-stent-restenosis. METHODS AND RESULTS: We planned a 5,000 patient registry with >/=1 lesion suitable for stenting. The 12-month primary outcome was target vessel failure (TVF), defined as target vessel-related cardiac death or myocardial infarction (MI) and target vessel revascularisation. Secondary outcomes were the composite of cardiac death, MI or target lesion revascularisation (TLR), and individual outcomes including ST. A total of 4,939 patients received >/=1 Genous stent between 2005 and 2007. Baseline characteristics showed a median age of 63 years, 79% males, 25% diabetics, and 37% with prior MI. A total of 49% of lesions treated were ACC/AHA type B2 ...
Vitamin K antagonists have been shown to prevent stroke in patients with atrial fibrillation. How... more Vitamin K antagonists have been shown to prevent stroke in patients with atrial fibrillation. However, many patients are not suitable candidates for or are unwilling to receive vitamin K antagonist therapy, and these patients have a high risk of stroke. Apixaban, a novel factor Xa inhibitor, may be an alternative treatment for such patients.
To compare the assessment of global and regional left ventricular (LV) function using 64-slice mu... more To compare the assessment of global and regional left ventricular (LV) function using 64-slice multislice computed tomography (MSCT), 2D echocardiography (2DE) and cardiac magnetic resonance (CMR). Thirty-two consecutive patients (mean age, 56.5+/-9.7 years) referred for evaluation of coronary artery using 64-slice MSCT also underwent 2DE and CMR within 48h. The global left ventricular function which include left ventricular ejection fraction (LVEF), left ventricular end diastolic volume (LVdV) and left ventricular end systolic volume (LVsV) were determine using the three modalities. Regional wall motion (RWM) was assessed visually in all three modalities. The CMR served as the gold standard for the comparison between 64-slice MSCT with CMR and 2DE with CMR. Statistical analysis included Pearson correlation coefficient, Bland-Altman plots and kappa-statistics. The 64-slice MSCT agreed well with CMR for assessment of LVEF (r=0.92; p<0.0001), LVdV (r=0.98; p<0.0001) and LVsV (r=0.98; p<0.0001). In comparison with 64-slice MSCT, 2DE showed moderate correlation with CMR for the assessment of LVEF (r=0.84; p<0.0001), LVdV (r=0.83; p<0.0001) and LVsV (r=0.80; p<0.0001). However in RWM analysis, 2DE showed better accuracy than 64-slice MSCT (94.3% versus 82.4%) and closer agreement (kappa=0.89 versus 0.63) with CMR. 64-Slice MSCT correlates strongly with CMR in global LV function however in regional LV function 2DE showed better agreement with CMR than 64-slice MSCT.
Most studies investigating the benefits of statins have focused on North American and European po... more Most studies investigating the benefits of statins have focused on North American and European populations. This study focuses on evaluating the lipid-lowering effects of rosuvastatin and atorvastatin in Asian patients. The DIrect Statin COmparison of LDL-C Values: an Evaluation of Rosuvastatin therapY (DISCOVERY)-Asia study is one of nine independently powered studies assessing the efficacy of starting doses of statins in achieving target lipid levels in different countries worldwide. DISCOVERY-Asia was a 12-week, randomised, open-label, parallel-group study conducted in China, Hong Kong, Korea, Malaysia, Taiwan, and Thailand. A total of 1482 adults with primary hypercholesterolaemia and high cardiovascular risk (> 20%/10 years, type 2 diabetes, or a history of coronary heart disease) were randomised in a 2 : 1 ratio to receive rosuvastatin 10 mg once daily (o.d.) or atorvastatin 10 mg o.d. The percentage of patients achieving the 1998 European Joint Task Force low-density lipoprotein cholesterol (LDL-C) goal of < 3.0 mmol/L at 12 weeks was significantly higher in the rosuvastatin group (n = 950) compared with the atorvastatin group (n = 471) (79.5 vs. 69.4%, respectively; p < 0.0001). Similar results were observed for 1998 European goals for total cholesterol (TC), and the 2003 European goals for LDL-C and TC. LDL-C and TC levels were reduced significantly more with rosuvastatin compared with atorvastatin. Both drugs were well-tolerated and the incidence and type of adverse events were similar in each group. The trial registry summary is available at http://www.clinicaltrials.gov/; ClinicalTrials.gov Identifier: NCT00241488 This 12-week study showed that the starting dose of rosuvastatin 10 mg o.d. was significantly more effective than the starting dose of natorvastatin 10 mg o.d. at enabling patients with primary hypercholesterolaemia to achieve European goals for LDL-C and TC in a largely Asian population in real-life clinical practice. The safety profile of rosuvastatin 10 mg is similar to that of atorvastatin 10 mg in the Asian population studied here, and is consistent with the known safety profile of rosuvastatin in the white population.
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