Publications by authors named "Kwo-Chang Ueng"
For the primary prevention of atherosclerotic cardiovascular disease (ASCVD), the recommended treatment target for each modifiable risk factor is as follows: reducing body weight by 5-10%; blood pressure < 130/80 mmHg (systolic pressure < 120 mmHg in high-risk individuals); low-density lipoprotein cholesterol (LDL-C) < 100 mg/dL in high-risk individuals, LDL-C < 115 mg/dL in moderate-risk individuals, LDL-C < 130 mg/dL in low-risk individuals, and LDL-C < 160 mg/dL in those with a minimal; complete and persistent abstinence from cigarette smoking; hemoglobin A1C < 7.0%; fulfilling recommended amounts of the six food groups according to the Taiwan food guide; and moderate-intensity physical activity 150 min/wk or vigorous physical activity 75 min/wk. For the primary prevention of ASCVD by pharmacological treatment in individuals with modifiable risk factors/clinical conditions, statins are the first-line therapy for reducing LDL-C levels; some specific anti-diabetic drugs proven to be effective in randomized controlled trials for the primary prevention of ASCVD are recommended in patients with type 2 diabetes mellitus; pharmacological treatment is recommended to assist in weight management for obese patients with a body mass index ≥ 30 kg/m (or 27 kg/m who also have at least one ASCVD risk factor or obesity-related comorbidity); an angiotensin-converting enzyme inhibitor, a glucagon-like peptide-1 receptor agonist, a sodium-dependent glucose cotransporter-2 inhibitor, and finerenone can be used in diabetic patients with chronic kidney disease for the primary prevention of ASCVD.
View Article and Find Full Text PDFSodium-glucose cotransporter 2 (SGLT2) inhibitors are medications with anti-inflammatory effects used to treat type 2 diabetes mellitus (T2DM). Cervical cancer is the most common gynecological cancer and is characterized by elevated inflammatory status. Accordingly, this study aimed to investigate the potential association between SGLT2 inhibitor use and cervical cancer development.
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- * The guidelines address various aspects of ASCVD, including chronic coronary syndrome and cerebrovascular diseases, while promoting health education and the management of clinical risk factors like diet, exercise, and smoking.
- * A catchy slogan and a memorable acronym were proposed to reinforce lifestyle changes related to modifiable risk factors, emphasizing the importance of healthy eating, physical activity, and overall well-being for ASCVD prevention.
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- Individuals with diabetes have a higher risk of cardiovascular disease, and this study compared aspirin's effectiveness for primary prevention in an Asian diabetic population against a placebo.
- After matching 37,095 aspirin users and non-users, findings showed that while aspirin users had a lower all-cause mortality rate, they experienced significantly higher rates of serious cardiovascular events and hospitalized bleeding.
- The study concluded that, although aspirin may reduce mortality risk, it also increases the risk of adverse cardiovascular events and bleeding, questioning its role in primary prevention for diabetics in this population.
The prevalence of heart failure is increasing, causing a tremendous burden on health care systems around the world. Although mortality rate of heart failure has been significantly reduced by several effective agents in the past 3 decades, yet it remains high in observational studies. More recently, several new classes of drugs emerged with significant efficacy in reducing mortality and hospitalization in chronic heart failure with reduced ejection fraction (HFrEF) and preserved ejection fraction (HFpEF).
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- Coronary artery disease (CAD) ranges from asymptomatic individuals to those experiencing acute coronary syndromes and sudden cardiac death, highlighting its spectrum and serious nature.
- Over time, CAD is marked by the development of atherosclerotic plaques in coronary arteries, with a tendency for sudden progression to critical events despite stable periods and treatments.
- Recent changes in CAD guidelines now categorize the disease into acute and chronic coronary syndromes, recognizing its complexity and emphasizing a shift from merely addressing coronary ischemia to focusing on the broader aspects of atherosclerosis for better prevention and treatment.*
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- * Understanding the shared mechanisms between psoriatic disease and CV diseases is crucial for managing patients, especially considering screening and treatment choices to avoid complications.
- * A collaborative Task Force of clinicians from various specialties in Taiwan has been formed to create expert recommendations aimed at improving care for psoriasis patients while addressing CV comorbidities.
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- Fibrosis contributes to changes in atrial tissue structure, and this study aimed to explore how micro-ribonucleic acids (miRNAs) influence fibrotic processes under low-oxygen (hypoxic) conditions.
- Researchers used various laboratory techniques to analyze the effects of specific miRNAs on fibrotic genes and markers, particularly collagen types I and III, in cardiomyocyte cells exposed to hypoxia.
- The study found that miR-let-7a, miR-let-7e, and miR-133a directly regulate collagen production and that inhibiting the JNK pathway can enhance the effects of these miRNAs, suggesting potential new treatments for atrial fibrosis.
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- - Hypertension is a major risk factor for cardiovascular disease and overall mortality, yet the traditional blood pressure threshold for diagnosing hypertension has remained at 140/90 mmHg despite evidence suggesting lower thresholds may be more beneficial.
- - Recent studies, like SPRINT and STEP, challenge this long-standing belief and highlight the benefits of home blood pressure monitoring (HBPM), which is found to be more reliable than office measurements for tracking true blood pressure levels and related health risks.
- - The 2022 Taiwan Hypertension Guidelines redefine hypertension as blood pressure ≥ 130/80 mmHg and suggest a target of < 130/80 mmHg, advocating for HBPM using a specific protocol to improve hypertension management and enhance patient outcomes.
Oxygen pulse (OP) is a function of stroke volume and cellular oxygen extraction and OP curve pattern (OPCP) can provide continuous measurements of OP. However, measurements of these two components are difficult during incremental maximum exercise. As cardiac function is evaluated using ejection fraction (EF) according to the guidelines and EF can be obtained using first-pass radionuclide ventriculography, the aim of this study was to investigate associations of OP%predicted and OPCP with EF in patients with heart failure with reduced or mildly reduced ejection fraction (HFrEF/HFmrEF) and chronic obstructive pulmonary disease (COPD), and also in normal controls.
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- Dronedarone's use in patients with chronic kidney disease (CKD) is complicated due to issues like drug buildup and increased heart rhythm risks, making it crucial to assess its safety and effectiveness for these patients.
- A post hoc analysis of the ATHENA trial revealed that dronedarone significantly reduced cardiovascular hospitalizations and atrial fibrillation/flutter recurrences compared to placebo, particularly in patients with less severe kidney impairment.
- However, more adverse events leading to discontinuation were observed in patients with severe renal impairment, indicating that while dronedarone is generally effective across various renal functions, caution is needed for those with significant kidney issues.
Coronary artery disease (CAD) is one of the leading causes of death in Taiwan. Despite the use of current guideline-recommended therapies for secondary prevention, the residual risk of recurrent cardiovascular events remains high in CAD, warranting the need for new treatment options. Antithrombotic drugs are one of the most important medical therapies for CAD.
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- The study investigates the relationship between fever-induced Brugada ECG patterns and potential arrhythmias in patients, identifying 21 febrile patients with type 1 Brugada ECG in an emergency setting.
- Patients were classified into symptomatic (with a history of cardiac issues) and asymptomatic groups, revealing that symptomatic individuals have a higher risk of serious outcomes compared to asymptomatic ones, who generally showed no arrhythmic events during long-term follow-up.
- The findings suggest that a previous history of syncope or sudden death significantly impacts the prognosis, with careful fever management being crucial for the long-term safety of asymptomatic patients.
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- Type 2 diabetes is a growing global health issue, with projections suggesting over half a billion cases by 2030, increasing risks for heart-related complications.
- Two new types of diabetes medications have shown promise in reducing cardiovascular issues through various clinical trials.
- The Taiwan Society of Cardiology has created a consensus pathway to better integrate these therapies into patient care, supporting existing clinical guidelines.
The study evaluated the changes in polycyclic aromatic hydrocarbons (PAHs) of Oolong tea samples at each heat treatment stage of the manufacturing process, different post-treatment methods and different brewing conditions. The content of PAHs in the tea leaves was significantly increased during stir fixation (280 °C for 8 min) stage of the manufacturing process. In the subsequent heat treatment process, the PAHs content did not change much until the Oolong tea product (primary) was further roasted.
View Article and Find Full Text PDFBackground: Preoperative skin preparation is associated with surgical site infection (SSI). Traditional preoperative shaving fails to reduce the risk of SSI. The efficacy of 2% chlorhexidine for preoperative skin preparation in percutaneous coronary intervention (PCI) is sketchy.
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- - Atrial hypoxia leads to structural changes that promote atrial fibrillation by increasing profibrotic activity in cardiomyocytes, as shown in the study with cultured HL-1 cells exposed to low oxygen levels.
- - The exposure to hypoxia raised levels of key proteins involved in fibrosis (like COL1A, COL3A, and TGF-β1) through a signaling pathway involving hypoxia-inducible factor HIF-1α and the JNK protein.
- - Targeting the ROS/JNK signaling pathway may offer a new approach to develop therapies for preventing atrial fibrillation, as inhibiting this pathway reduced the expression of fibrosis-related proteins triggered by hypoxia.
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- A study was conducted to evaluate the effectiveness of a new once-daily extended-release carvedilol (carvedilol ER) formulation in lowering blood pressure among patients with hypertension, as opposed to the traditional twice-daily dosing.
- A total of 134 patients were randomly assigned to receive either placebo, low-dose carvedilol ER, or high-dose carvedilol ER for 8 weeks, with the main goal of measuring systolic and diastolic blood pressure changes.
- Results showed that while carvedilol ER was generally well tolerated, it did not lead to significant reductions in blood pressure compared to placebo, although higher doses showed some gradational improvement in blood pressure control.
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- The study investigated procalcitonin (PCT) as a biomarker for sepsis detection in critically ill patients by combining it with other relevant clinical factors.
- A retrospective cohort study was conducted in an ICU, analyzing 258 patients to identify independent factors and create a PCT-based scoring system for detecting sepsis with better accuracy compared to PCT alone.
- The developed scoring system demonstrated strong sepsis-detecting performance (AUROC 0.80) and was validated in an independent cohort, confirming its effectiveness in clinical settings.
The aim of this study was to examine atrial fibrillation (AF) patients' preferences regarding oral anticoagulation (OAC) characteristics and to investigate differences across 5 different countries. A multicenter discrete choice experiment was conducted in Germany, Sweden, Switzerland, Spain, and Taiwan. Study sites enrolled patients with nonvalvular AF who received continuous OAC therapy.
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- - The study investigates the role of dipeptidyl peptidase-4 (DPP-4) gene variations in contributing to coronary artery disease (CAD), with a focus on differences between men and women.
- - Researchers conducted a case-control analysis using blood samples to assess specific SNPs (rs7608798 and rs3788979) and found that one SNP (rs3788979) increased CAD risk in women, while another (rs7608798) appeared to have a protective effect.
- - These findings suggest that genetic factors influencing CAD may differ by gender, highlighting the need for further research to confirm these associations, particularly within the Taiwanese population.
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- * Clinical trials initiated after a 2008 FDA mandate on cardiovascular safety for new diabetes medications have shown that some new agents can reduce cardiovascular (CV) risks and improve outcomes compared to older treatments.
- * The Taiwan Society of Cardiology and the Diabetes Association of Republic of China have developed updated treatment guidelines aimed at managing type 2 diabetes in patients with various cardiovascular conditions and risk factors.
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- The study evaluated the effectiveness of radiofrequency ablation (RFA) in patients with resistant hypertension caused by aldosterone-producing adenoma (APA) over both short and long-term periods.
- Eight adult patients underwent RFA from 2009 to 2017, showing a 100% technical success rate with minor complications but no major issues.
- Results indicated significant improvements in blood pressure and reduced need for antihypertensive medications, with long-term follow-up (around 6.7 years) confirming lasting benefits.
The dysbiosis of human gut microbiota is strongly associated with the development of colorectal cancer (CRC). The dysbiotic features of the transition from advanced polyp to early-stage CRC are largely unknown. We performed a 16S rRNA gene sequencing and enterotype-based gut microbiota analysis study.
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