Publications by authors named "Yuen-Kwun Wong"

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  • A study assessed whether vitamin D deficiency contributes to atrial fibrillation and ischemic stroke in younger individuals using data from over 3,900 participants in Hong Kong and over 392,000 from the UK Biobank.
  • Results indicated that higher genetically-predicted vitamin D levels were linked to a lower risk of these conditions, with an odds ratio suggesting a significant protective effect.
  • The findings highlighted that vitamin D may specifically reduce the risk of young-onset ischemic stroke in men, suggesting further research is needed to understand how vitamin D deficiency affects sex disparities in atrial fibrillation.
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  • The study examined how mislabeled drug allergies, particularly to NSAIDs, affect stroke patients compared to the general population in Hong Kong from 2008 to 2014.
  • Patients with stroke had a higher prevalence of allergy labels for cardiovascular and diagnostic agents, impacting their treatment options and medication prescriptions.
  • Notably, those labeled with NSAID allergies were less likely to receive important medications like aspirin, faced higher mortality rates, and most could be delabeled successfully through testing.
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  • Cerebral small vessel disease (SVD) can lead to various cerebrovascular issues, but research on sex differences in SVD is limited.
  • This study analyzed data from over 20,000 patients with acute ischemic stroke to examine whether the presence and severity of cerebral microbleeds (CMB) and other SVD markers differ between males and females.
  • Results showed that males had more frequent CMB while females had fewer lacunes but higher severe white matter hyperintensities, indicating distinct SVD characteristics based on sex.
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  • This study investigated how variations in renal function affect clinical outcomes in patients with atrial fibrillation (AF) who experienced transient ischemic attacks (TIA) or ischemic strokes.
  • Researchers analyzed data from 3,809 patients over a mean follow-up of 2.5 years, measuring renal function through the estimated glomerular filtration rate (eGFR) and observing outcomes such as recurrent strokes and bleeding events.
  • The findings indicated that higher variability in eGFR was linked to an increased risk of recurrent ischemic strokes and other serious health complications.
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  • Recent trials on cholesterol-lowering treatments have generally found that statins do not significantly increase the risk of recurrent intracerebral hemorrhage (ICH), but these results may not apply to ICH survivors who face a much higher inherent risk.
  • This study aims to investigate how LDL-C levels and statin use impact ICH risk specifically among ICH survivors and whether these effects differ based on the underlying cause of the hemorrhage.
  • The analysis involved 502 ICH survivors, focusing on their LDL-C levels and medical history to understand the relationship between cholesterol management and the likelihood of recurrent ICH.
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Background: Previous studies suggest that aromatase inhibitors (AIs) increase the risk of adverse cardiovascular events and cardiac arrhythmias in patients with breast cancer, but it is unclear whether AIs also increase the risk of new-onset atrial fibrillation (AF).

Objectives: The purpose of this study was to investigate whether the use of AIs was associated with an increased risk of new-onset AF in patients with breast cancer.

Methods: We performed a retrospective analysis involving 5,707 patients with breast cancer (mean age 63.

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Background: Major intracerebral hemorrhage (ICH) trials have largely been unable to demonstrate therapeutic benefit in improving functional outcomes. This may be partly due to the heterogeneity of ICH outcomes based on their location, where a small strategic ICH could be debilitating, thus confounding therapeutic effects. We aimed to determine the ideal hematoma volume cutoff for different ICH locations in predicting ICH outcomes.

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  • Cerebral microbleeds increase the risk of both ischemic stroke and intracranial hemorrhage, complicating treatment choices for patients with atrial fibrillation on various antithrombotic therapies.
  • A study analyzed 7,839 patients, finding that microbleeds significantly raised the relative risk of intracranial hemorrhage (2.74 times) and ischemic stroke (1.29 times), particularly with combination therapies of anticoagulants and antiplatelets.
  • For patients on combination therapy, those with multiple microbleeds faced a higher absolute risk of intracranial hemorrhage compared to ischemic stroke, indicating a need for more research to develop effective preventive strategies.
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Background: Intracerebral hemorrhage (ICH) survivors are at high risk for recurrent stroke and cardiovascular events. Blood pressure (BP) control represents the most potent intervention to lower these risks, but optimal treatment targets in this patient population remain unknown. We sought to determine whether survivors of ICH achieving more intensive BP control than current guideline recommendations (systolic BP <130 mmHg and diastolic BP <80 mmHg) were at lower risk of major adverse cardiovascular and cerebrovascular events and mortality.

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Background: Long-term antiplatelet agents including the potent P2Y12 antagonist ticagrelor are indicated in patients with a previous history of acute coronary syndrome. We sought to compare the effect of ticagrelor with that of aspirin monotherapy on vascular endothelial function in patients with prior acute coronary syndrome.

Methods: This was a prospective, single center, parallel group, investigator-blinded randomized controlled trial.

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  • Vitamin D plays a crucial role in vascular repair, and its deficiency is linked to type 2 diabetes and hypertension, raising questions about its potential protective effects against cardiovascular diseases in high-risk patients.* -
  • This study utilized a two-sample Mendelian randomization approach, analyzing genetic variants to infer the causal relationship between vitamin D levels and cardiovascular events among hypertensive-diabetic individuals.* -
  • Results indicated that lower genetically predicted vitamin D levels were associated with a higher risk of cardiovascular events, suggesting that increased vitamin D exposure may help protect against conditions like myocardial infarction and other cardiovascular issues.*
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Aims: The aim of this study is to describe the implementation of the current guidance for stroke prevention and treatment option in atrial fibrillation (AF) and to evaluate mortality and morbidity in relation to therapeutic decisions, including persistence with treatment at 1 year in Asia-Pacific regions.

Methods And Results: We recruited 4664 patients consecutive in- and outpatients with AF who presented to cardiologists in five countries under the Asia-Pacific Heart Rhythm Society (APHRS) in whom 1-year follow-up was completed for 4003 (65.5% male; mean age 68.

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  • - Cardiovascular disease (CVD) is the top global cause of death, making risk assessment vital for identifying at-risk individuals and guiding effective medical therapy.
  • - Traditional risk prediction models for recurrent CVD events are limited, prompting a focus on various biomarkers that could enhance risk stratification and improve secondary prevention strategies.
  • - The review highlights several biomarkers like B-type natriuretic peptide and high-sensitivity cardiac troponin I, which show promise in better predicting cardiovascular risks among patients with a history of CVD, but further research is required to validate their clinical use.
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Background And Purpose: Experimental studies showed vitamin D (Vit-D) could promote vascular regeneration and repair. Prior randomized studies had focused mainly on primary prevention. Whether Vit-D protects against ischemic stroke and myocardial infarction recurrence among subjects with prior ischemic insults was unknown.

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Background Recent trials have shown that low-density lipoprotein cholesterol (LDL-C) <1.80 mmol/L (<70 mg/dL) is associated with a reduced risk of major adverse cardiovascular events in White patients with ischemic stroke with atherosclerosis. However, it remains uncertain whether the findings can be generalized to Asian patients, or that similar LDL-C targets should be adopted in patients with stroke without significant atherosclerosis.

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Background: High blood pressure is a major risk factor for cardiovascular disease. Visit-to-visit blood pressure variability (BPV) has recently been shown to predict cardiovascular outcomes. We investigated the predictive value of BPV for major adverse cardiovascular events (MACE) among patients with coronary artery disease (CAD), with and without type 2 diabetes mellitus (T2DM).

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Studies have shown the brain's rich-club organization may underpin brain function and be associated with various brain disorders. In this study, we aimed to investigate the relation between poststroke brain functions and functional recovery versus the rich-club organization of the structural brain network of patients after first-time acute ischemic stroke. A cohort of 16 acute ischemic stroke patients (11 males) was recruited.

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Background: Balancing the risks of recurrent ischaemic stroke and intracranial haemorrhage is important for patients treated with antithrombotic therapy after ischaemic stroke or transient ischaemic attack. However, existing predictive models offer insufficient performance, particularly for assessing the risk of intracranial haemorrhage. We aimed to develop new risk scores incorporating clinical variables and cerebral microbleeds, an MRI biomarker of intracranial haemorrhage and ischaemic stroke risk.

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Background And Purpose: The current coronavirus disease 2019 (COVID-19) pandemic represents a global public health crisis, disrupting emergency healthcare services. We determined whether COVID-19 has resulted in delays in stroke presentation and affected the delivery of acute stroke services in a comprehensive stroke center in Hong Kong.

Methods: We retrospectively reviewed all patients with transient ischemic attack and stroke admitted via the acute stroke pathway of Queen Mary Hospital, Hong Kong, during the first 60 days since the first diagnosed COVID-19 case in Hong Kong (COVID-19: January 23, 2020-March 24, 2020).

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Background: High-sensitivity troponin I (hs-Tnl) and B-type natriuretic peptide (BNP) are promising prognostic markers for coronary artery disease (CAD). This prospective cohort study investigated whether a combination of these cardiac biomarkers with conventional risk factors would add incremental value for the prediction of secondary major adverse cardiovascular events (MACEs) in patients with CAD, with and without type 2 diabetes mellitus (T2DM).

Methods: Baseline plasma level of hs-Tnl and BNP was measured in 2275 Chinese patients with stable CAD.

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Background: The prognostic implication of statin in tolerance (SI) in those with stable CAD remains unclear. We hypothesized that SI is of higher prognostic significance in stable CAD patients with elevated high-sensitive cardiac troponin I (hs-cTnI).

Methods: A total of 952 stable CAD patients from the prospective Hong Kong CAD study who had complete clinical data, biomarker measurements and who were prescribed statin therapy were studied.

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Article Synopsis
  • Cerebral microbleeds are small brain hemorrhages that may indicate heightened stroke risk, raising concerns about future intracranial hemorrhage versus recurrent ischemic stroke in patients receiving antithrombotic medications.
  • This study pooled data from various cohort studies, focusing on adult patients with recent ischemic strokes or transient ischemic attacks, to determine the relationship between the presence and patterns of cerebral microbleeds and the risks of future strokes or hemorrhages.
  • Analyzing data from 20,322 patients over multiple years, researchers found that patients with cerebral microbleeds had a 1.35 times higher risk of experiencing adverse outcomes compared to those without microbleeds, highlighting the significance of monitoring these markers in clinical
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Objective- In patients with stable coronary artery disease, conventional risk factors provide limited incremental predictive value for cardiovascular events. We sought to investigate whether a panel of cardiometabolic biomarkers alone or combined with conventional risk factors would exhibit incremental value in the prediction of cardiovascular events. Approach and Results- In the discovery cohort, we measured serum adiponectin, A-FABP (adipocyte fatty acid-binding protein), lipocalin-2, FGF (fibroblast growth factor)-19 and 21, plasminogen activator inhibitor-1, and retinol-binding protein-4 in 1166 Chinese coronary artery disease patients.

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Different cerebral small vessel disease (SVD) lesion types have been shown to disrupt structural brain network individually. Considering that they often coexist, we investigated the relation between their collective effect using the recently proposed total SVD score and structural brain network on MRI in 95 patients with first transient ischemic attack (TIA) or ischemic stroke. Fifty-nine patients with and 36 without any SVD lesions were included.

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