Browsing by Author "Khung Keong Yeo"
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- PublicationComparative overview of ST-elevation myocardial infarction epidemiology, demographics, management, and outcomes in five Asia-Pacific countries: a meta-analysis(Oxford University Press, 2020)
;Paul Jie Wen Tern ;Aaron Kwun Hang Ho ;Rehena Sultana ;Youngkeun Ahn ;Wael Almahmeed ;David Brieger ;Derek P Chew ;Alan Yean Yip Fong ;Jinyong Hwang ;Yongcheol Kim ;Issei Komuro ;Koji Maemura ;Rosli Mohd-Ali ;David Kwang Leng Quek ;Christopher Reid ;Jack Wei Chieh Tan ;Wan Azman Wan-Ahmad ;Satoshi YasudaKhung Keong YeoThe aim of this study is to gain insight into the differences in demographics of ST-elevation myocardial infarction (STEMI) patients in Asia-Pacific, as well as inter-country variation in treatment and mortality outcomes. Systematic review of published studies and reports from known registries in Australia, Japan, Korea, Singapore, and Malaysia that began data collection after the year 2000. Supplementary self-report survey questionnaire on public health data answered by representative cardiologists working in these countries. Twenty studies comprising of 158 420 patients were included in the meta-analysis. The mean age was 61.6 years. Chronic kidney disease prevalence was higher in Japan, while dyslipidaemia was low in Korea. Use of aspirin, P2Y12 inhibitors, and statins were high throughout, but ACEi/ARB and β-blocker prescriptions were lower in Japan and Malaysia. Reperfusion strategies varied greatly, with high rates of primary percutaneous coronary intervention (pPCI) in Korea (91.6%), whilst Malaysia relies far more on fibrinolysis (72.6%) than pPCI (9.6%). Similarly, mortality differed, with 1-year mortality from STEMI was considerably greater in Malaysia (17.9%) and Singapore (11.2%) than in Korea (8.1%), Australia (7.8%), and Japan (6.2%). The countries were broadly similar in development and public health indices. Singapore has the highest gross national income and total healthcare expenditure per capita, whilst Malaysia has the lowest. Primary PCI is available in all countries 24/7/365. Despite broadly comparable public health systems, differences exist in patient profile, in-hospital treatment, and mortality outcomes in these five countries. Our study reveals areas for improvements. The authors advocate further registry-based multi-country comparative studies focused on the Asia-Pacific region. - PublicationStatin intolerance: an updated, narrative review mainly focusing on muscle adverse effects(Taylor & Francis Group, 2020)
;Jian-Jun Li ;Hui-Hui Liu ;Na-Qiong Wu ;Khung Keong Yeo ;Kathryn Tan ;Junya Ako ;Rungroj Krittayaphong ;Ru San Tan ;Philip E Aylward ;Sang Hong Baek ;Jamshed Dalal ;Alan Yean Yip Fong ;Yi-Heng Li ;Richard C O’Brien ;Tien Siang Eric Lim ;Si Ya Natalie Koh ;Daniel J Scherer ;Hayato Tada ;Vernon Kang ;Julie ButtersStephen J NichollsIntroduction: Statins have been established as the standard of care for dyslipidemia and preventing cardiovascular diseases while posing few safety concerns. However, misconceptions about statin intolerance lead to their underuse, indicating a need to improve the understanding of the safety of this treatment. Areas covered: We searched PubMed and reviewed literatures related to statin intolerance published between February 2015 and February 2020. Important large-scale or landmark studies published before 2015 were also cited as key evidence. Expert opinion: Optimal lowering of low-density lipoprotein cholesterol with statins substantially reduces the risk of cardiovascular events. Muscle adverse events (AEs) were the most frequently reported AEs by statin users in clinical practice, but they usually occurred at a similar rate with statins and placebo in randomized controlled trials and had a spurious causal relationship with statin treatment. We proposed a rigorous definition for identifying true statin intolerance and present the criteria for defining different forms of muscle AEs and an algorithm for their management. True statin intolerance is uncommon, and every effort should be made to exclude false statin intolerance and ensure optimal use of statins. For the management of statin intolerance, statin-based approaches should be prioritized over non-statin approaches.