Publications by authors named "Kian Keong Poh"
Background: Severe aortic stenosis (AS) stratified by sex has been increasingly studied in the European population. Sex-specific outcomes in Asian patients with AS remain poorly defined. Hence, we aimed to study the clinical characteristics and impact of sex in moderate-to-severe AS, undergoing both invasive and conservative interventions in an Asian cohort over 10 years.
View Article and Find Full Text PDFObjectives: This analysis evaluated the cost-effectiveness of inclisiran plus standard of care (SoC; comprising statins, ezetimibe, and fenofibrate) in primary hypercholesterolemia or mixed dyslipidemia from a Singapore healthcare system perspective. Inclisiran + SoC was separately compared with SoC, alirocumab + SoC, and evolocumab + SoC.
Methods: A lifetime Markov model in the United Kingdom (UK) was adapted to the Singapore setting.
Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are increasingly used for anti-obesity indications. However, little is known of the comparative effect of GLP-1 RAs and their glycemic impact across the different routes of administration, diabetic statuses and durations of prescription. PubMed, EMBASE and CENTRAL were searched from inception to 13 February 2024.
View Article and Find Full Text PDFYeo's index, the product of the mitral leaflet separation index and dimensionless index of mitral valve (MV), was recently described to accurately identify severe rheumatic mitral stenosis (MS). We assess the association between Yeo's index and clinical outcomes in patients with rheumatic MS. We studied 297 patients with rheumatic MS.
View Article and Find Full Text PDFIntroduction: Real-world data are needed to understand the effectiveness of new therapeutic options for low-density lipoprotein cholesterol (LDL-C) reduction in Asia-Pacific clinical practice. Description of evolocumab use among adults with establisHed Atherosclerotic cardiovascuLar diseasE or hypercholesterolemia in ASia-Pacific region (HALES) was performed to better understand characteristics of and clinical decision-making for adults with established atherosclerotic cardiovascular disease/hypercholesterolemia after local evolocumab approval.
Methods: The HALES observational study, conducted at 33 sites (Hong Kong, Thailand, South Korea, Singapore, Taiwan, and Australia) comprised (1) chart review of patients who received evolocumab, a proprotein convertase subtilisin/kexin type 9 inhibitor (PCSK9i), and (2) physician/patient survey and one-time data collection of patients with high cardiovascular risk initiating evolocumab or initiating/continuing non-PCSK9i lipid-lowering therapy.
Article Synopsis
- Surgical weight loss (SWL) has been shown to improve heart function as measured by specific imaging techniques, but its effects compared to non-surgical methods in overweight Asian individuals were previously unstudied.
- A study involved 66 patients who completed a 16-week lifestyle intervention program and revealed significant weight loss, but only a non-significant improvement in heart strain metrics.
- In contrast, participants who underwent bariatric surgery exhibited notable improvements in heart function, confirming that surgical weight loss is a strong independent factor for enhancing heart strain parameters.
Background And Purpose: Tenecteplase is a thrombolytic agent with pharmacological advantages over alteplase and has been shown to be noninferior to alteplase for acute ischemic stroke in randomized trials. However, evidence pertaining to the safety and efficacy of tenecteplase in patients from different ethnic groups is lacking. The aim of this systematic review and metaanalysis was to investigate ethnicity-specific differences in the safety and efficacy of tenecteplase versus alteplase in patients with acute ischemic stroke.
View Article and Find Full Text PDFArticle Synopsis
- The study aimed to determine if the HFPEF score could predict heart failure outcomes in patients with hypertrophic cardiomyopathy (HCM) who have preserved left ventricular ejection fraction (LVEF).
- A total of 955 patients were analyzed, with those scoring higher on the HFPEF scale tending to have more severe symptoms and comorbidities, showing lower LVEF and impaired heart function.
- Findings indicated that a high HFPEF score is linked to poorer survival rates and higher rates of heart failure hospitalizations, particularly influencing outcomes based on factors like female sex, Asian ethnicity, and existing heart conditions.
Article Synopsis
- Net atrioventricular compliance (C) impacts the accuracy of mitral valve area (MVA) assessment in patients with rheumatic mitral stenosis (MS).
- In a study with 244 patients, it was found that MVA measurements using different methods showed poor concordance with the most accurate assessment, TEE 3DMVA, particularly in those with abnormal C.
- The research indicated that patients with a 2D planimetry MVA of ≤1.5 cm and a pressure half-time (PHT) of ≤130 ms are likely to have abnormal C, making MVA by PHT an unreliable measure in these cases.
Article Synopsis
- The study investigates the unclear incidence of cognitive impairment or dementia in patients after coronary artery bypass grafting (CABG) and identifies associated risk factors.* -
- A systematic search of 23 studies involving 2,620 patients revealed that the incidence of cognitive issues was notably high, especially within the first month and after one year post-surgery, with rates of 35.96% and 39.13%, respectively.* -
- Hypertension was found to be a significant risk factor for cognitive impairment shortly after CABG, highlighting the need for further research to develop strategies to mitigate these cognitive issues post-surgery.*
Introduction: Early in the coronavirus disease 2019 (COVID-19) pandemic, a low incidence of cardiovascular complications was reported in Singapore. Little was known about the trend of cardiovascular complications as the pandemic progressed. In this study, we examined the evolving trends in electrocardiographic and cardiovascular manifestations in patients hospitalised with COVID-19.
View Article and Find Full Text PDFArticle Synopsis
- Current guidelines for managing asymptomatic severe aortic stenosis (AS) patients are unclear due to insufficient data on their natural history.
- A systematic review and meta-analysis of 46 studies with 9,545 patients indicated that almost half experienced significant cardiovascular events within 5 years, with many developing symptoms or requiring surgery.
- The findings highlight the need for better understanding and management strategies for these patients, given their poor long-term cardiovascular outcomes.
Article Synopsis
- - Yeo's index is a new metric for assessing the severity of rheumatic mitral valve stenosis (MS), based on mitral leaflet separation and dimensionless index comparisons, and its effectiveness was tested against TEE's 3D mitral valve area (MVA).
- - In a study with 111 patients, Yeo's index showed the strongest correlation (r = 0.775) with TEE 3DMVA, outperforming traditional echocardiographic methods like 2D planimetry, continuity equation (CE), and pressure half-time (PHT).
- - The study concluded that Yeo's index is a reliable tool for identifying severe MS and could be particularly effective when used alongside 2D
Article Synopsis
- Yeo's Index is a new measurement for determining the severity of rheumatic mitral stenosis (MS), based on mitral leaflet separation and a dimensionless index.
- In a study involving 237 patients, it was found that Yeo's index ≤ 0.26 cm had a high sensitivity (93%) and specificity (87.5%) for identifying severe MS, while a threshold of ≤ 0.15 cm was effective for very severe MS, with sensitivity and specificity values of 83.6% and 94.3%, respectively.
- The index's effectiveness was consistent across patients with isolated MS and those with mixed valve disease, and the presence of atrial fibrillation did not affect its accuracy.
Article Synopsis
- INOCA, or ischaemia with no obstructive coronary arteries, poses a diagnostic and treatment challenge, linked to higher risks of death and cardiovascular issues, along with increased healthcare costs.
- While awareness of INOCA is growing in Western populations, its prevalence and recognition in Asian populations are still unclear.
- The review highlights barriers to diagnosing and managing INOCA, offering strategies to improve the situation.
Article Synopsis
- - The study investigates sex differences in patients with hypertrophic cardiomyopathy (HCM), focusing on Asian populations, as this aspect is less understood in this demographic.
- - Out of 295 patients, men comprised 72%, with women being older and having more health issues like hypertension; women also showed signs of obstructive physiology more frequently.
- - Findings suggest women are more likely to develop progressive heart failure requiring hospitalization, while men face a higher risk of all-cause mortality.
Cardiovascular disease (CVD) is the leading cause of death worldwide, accounting for over one-third of all deaths in Singapore. An analysis of age-standardized mortality rates (ASMR) for CVD in Singapore revealed a deceleration in the initial rapid decline in ASMR. A decrease in smoking prevalence may have contributed to the initial rapid decline in ASMR.
View Article and Find Full Text PDFClimate change is an existential threat to humanity. While the healthcare sector must manage the health-related consequences of climate change, it is a significant contributor to greenhouse gas emissions, responsible for up to 4.6% of global emission, aggravating global warming.
View Article and Find Full Text PDFIntroduction: With the advent of endovascular thrombectomy (ET), patients with acute ischaemic strokes (AIS) with large vessel occlusion (LVO) have seen vast improvements in treatment outcomes. Left ventricular diastolic dysfunction (LVDD) has been shown to herald poorer prognosis in conditions such as myocardial infarction. However, whether LVDD is related to functional recovery and outcomes in ischaemic stroke remains unclear.
View Article and Find Full Text PDFIntroduction: Prolonged cardiac monitoring after cryptogenic stroke or embolic stroke of undetermined source (ESUS) is necessary to identify atrial fibrillation (AF) that requires anticoagulation. Wearable devices may improve AF detection compared to conventional management. We aimed to review the evidence for the use of wearable devices in post-cryptogenic stroke and post-ESUS monitoring.
View Article and Find Full Text PDF