Publications by authors named "Yao N Teo"
Background: Guideline-directed medical therapies (GDMTs), such as beta-blockers, antiplatelet drugs, lipid-lowering drugs, and renin-angiotensin system agents, have been associated with reduced risk of mortality after acute myocardial infarction (AMI). However, this survival benefit conferred by GDMTs in nonagenarians and centenarians (≥ 90 years old) is not well-defined.
Methods: We investigated restricted mean survival times of patients ≥ 90 years of age with first-onset AMI treated with GDMTs from 2007 to 2020 in the Singapore Myocardial Infarction Registry.
Objective: To provide an updated synthesis on effects of glucagon-like peptide 1 receptor agonists (GLP-1 RAs) on weight, BMI, and waist circumference incorporating newer randomized controlled trials (RCTs), particularly in individuals with overweight or obesity.
Research Design And Methods: We systematically searched PubMed, Embase, and Cochrane Central Register of Controlled Trials (CENTRAL) for RCTs published from inception to 4 October 2024. The search was limited to RCTs evaluating the use of GLP-1 RAs for mean differences from baseline in weight, BMI, and waist circumference in adults with obesity or overweight with or without diabetes.
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 PDFIntroduction: Glucagon-like peptide-1 receptor agonists are novel medications with proven efficacy in treating type 2 diabetes mellitus, and are increasingly being used for weight loss. They may potentially have benefit in treating metabolic disorders; however, evidence is sparse with regards to treating high blood pressure (BP). We performed a systematic review, meta-analysis and meta-regression investigating the efficacy of GLP-1 RAs in lowering BP in obese or overweight patients.
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- Recent studies indicate that machine learning (ML) algorithms may be useful for predicting patient outcomes after percutaneous coronary intervention (PCI).
- The review analyzed 11 studies involving nearly 5 million patients and found that while ML models demonstrated high diagnostic accuracy, issues like poor handling of missing data and lack of external validation raise concerns about their reliability.
- Although ML models show potential as supplemental tools for traditional risk assessments, there are significant hurdles that must be overcome before they can be effectively used in clinical settings.
Introduction: Lipoprotein(a) [Lp(a)] is an established independent causal risk factor for cardiovascular disease and atherosclerosis. However, its association with young-onset ischemic stroke is not well-established. A systematic review and meta-analysis was performed to investigate the association of elevated Lp(a) with young ischemic stroke.
View Article and Find Full Text PDFBackground And Objective: While obstructive sleep apnea (OSA) and urological cancer are both strongly associated with hypoxia, controversy exists regarding their association with each other. This study aims to summarize and synthesize evidence to clarify the association between OSA and urological cancer incidence and mortality.
Methods: According to a prespecified protocol, PubMed, Embase, Cochrane Library, and Scopus were searched from inception to November 16, 2023, for observational and randomized studies reporting the association of OSA with urological cancer incidence or mortality.
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.*
Article 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
- In patients with embolic stroke of undetermined source (ESUS), identifying occult atrial fibrillation (AF) is crucial to prevent recurrent strokes, but many don't use implantable loop recorders due to cost and inconvenience.
- A study analyzed clinical and echocardiographic data from 157 ESUS patients who had ILR evaluations to develop four machine learning models for predicting AF detection.
- Results showed that the support vector machine model had a 95% confidence interval area under the curve of 0.736-0.737, demonstrating moderate accuracy in predicting AF, while highlighting important features like age and heart rate.
Background: Metformin and sodium-glucose cotransporter-2 (SGLT2) inhibitors have demonstrated cardiovascular benefits but their comparative effects on mortality in type 2 diabetes mellitus (T2DM) patients with cardiovascular disease (CVD) are unknown. Hence, we evaluated and compared lifetime benefits arising from metformin or SGLT2 inhibitors in T2DM patients with CVD.
Materials And Methods: Studies published in the PubMed, EMBASE and CENTRAL databases before 28 October 2023 were retrieved.
Background: Patients with migraines, particularly those with auras, may present with stroke. Atrial fibrillation is a known risk factor for stroke. With common pathophysiological factors between migraines and atrial fibrillation, we aimed to clarify the association between migraine and atrial fibrillation in this systematic review and meta-analysis.
View Article and Find Full Text PDFIntroduction: Multiple Cochrane Reviews have demonstrated 'hospital at home' (HaH) as a promising healthcare model to be explored, with benefits such as higher care quality, reduced readmissions, shorter lengths of stay, lower cost and greater patient satisfaction. While there have been many reviews focusing on the quantitative clinical outcomes of HaH, there is generally a lack of collation of qualitative insights from stakeholders and lessons learnt from past HaH implementation.
Methods: We performed a systematic literature search on four databases and included 17 papers involving the provision of acute and/or subacute care by healthcare professionals in patients' homes.
Study Objectives: In coronary artery bypass grafting (CABG), abnormal cardiac repolarization is associated with adverse cardiovascular events that can be measured via the QTc interval. We investigated the impact of obstructive sleep apnea on the change in repolarization after CABG and the association of change in repolarization with the occurrence of major adverse cardiac and cerebrovascular events.
Methods: A total of 1,007 patients from 4 hospitals underwent an overnight sleep study prior to a nonemergent CABG.
Introduction: Patent foramen ovale (PFO) occurs in 25% of the general population and in 40% of cryptogenic ischemic stroke patients. Recent trials support PFO closure in selected patients with cryptogenic stroke. We examined the outcomes of transcatheter PFO closure in a real-world study cohort with cryptogenic stroke.
View Article and Find Full Text PDFBackground: Some observational studies and randomised controlled trials (RCTs) have reported an association between calcium supplementation and increased risk of cardiovascular disease. Previous meta-analyses on the topic, based on data from RCTs and observational studies, have contradictory findings. This meta-analysis was conducted to determine the difference in associated risks of calcium supplementation with cardiovascular disease and stroke in RCTs.
View Article and Find Full Text PDFCognitive impairment (CI) shares common cardiovascular risk factors with acute myocardial infarction (AMI), and is increasingly prevalent in our ageing population. Whilst AMI is associated with increased rates of CI, CI remains underreported and infrequently identified in patients with AMI. In this review, we discuss the evidence surrounding AMI and its links to dementia and CI, including pathophysiology, risk factors, management and interventions.
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- The study compared the effectiveness of insertable cardiac monitors (ICMs) versus traditional methods in detecting atrial fibrillation (AF) in patients who have suffered from ischemic stroke.
- It involved a systematic analysis of three randomized controlled trials with a total of 1,233 patients, using various methods to evaluate AF detection rates and clinical outcomes.
- Results showed that ICMs significantly improved AF detection and increased the initiation of anticoagulation therapy, but did not affect the rates of recurrent stroke or mortality.
Background: Recent studies have shown that breast arterial calcification (BAC) detected on screening mammography is linked to cardiovascular diseases via medial calcification. However, its effect on cardiovascular outcomes remains unclear. Therefore, we conducted a meta-analysis to determine the effect of BAC on cardiovascular outcomes in patients.
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- The study investigates the effectiveness and safety of using stent retrievers (SR) versus aspiration catheters (AC) in treating acute ischaemic stroke caused by distal medium vessel occlusion (AIS-DMVO).
- A systematic review of 13 studies involving 1881 patients found that the combination of SR and primary combined techniques resulted in higher rates of functional independence and lower mortality compared to AC alone.
- While both methods had similar outcomes for successful recanalisation and safety concerns, SR alone showed a significantly higher odds of successful recanalisation compared to AC, indicating possible advantages for SR/PC techniques.
Bradyarrhythmias are commonly encountered in clinical practice. While there are several electrocardiographic criteria and algorithms for tachyarrhythmias, there is no algorithm for bradyarrhythmias to the best of our knowledge. In this article, we propose a diagnostic algorithm that uses simple concepts: (1) the presence or absence of P waves, (2) the relationship between the number of P waves and QRS complexes, and (3) the regularity of time intervals (PP, PR and RR intervals).
View Article and Find Full Text PDFIntroduction: Patent foramen ovale (PFO) is a potential source of cardiac embolism in cryptogenic ischemic stroke, but it may also be incidental. Right-to-left shunt (RLS) size may predict PFO-related stroke, but results have been controversial. In this cohort study of medically-managed PFO patients with cryptogenic stroke, we aimed to investigate the association of shunt size with recurrent stroke, mortality, newly detected atrial fibrillation (AF), and to identify predictors of recurrent stroke.
View Article and Find Full Text PDFBackground: Emerging evidence has shown higher overall cancer incidence in patients with obstructive sleep apnea. Gastrointestinal cancers, including esophageal, stomach, liver, pancreas, and colorectal cancers account for 26% of incident cancers. However, the link between gastrointestinal cancers and obstructive sleep apnea is still unclear.
View Article and Find Full Text PDFObjective: Co-prevalence and incidence of depression and/or anxiety with stroke and myocardial infarction are currently unclear. This paper explores the relationships, as these are important comorbidities affecting patient outcomes.
Methods: A systematic search across five databases (PubMed, Scopus, PsycINFO, Embase, Cochrane) was conducted for observational studies reporting co-prevalence of depression or anxiety with stroke or myocardial infarction.