Browsing by Author "Xin Wee Chen"
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- PublicationModelling the prognostic effect of glucose and lipid profiles on stroke recurrence in Malaysia: an event-history analysis(2020)
;Xin Wee Chen ;Mohd Nazri Shafei ;Zariah Abdul Aziz ;Norsima Nazifah SidekKamarul Imran MusaBackground: Diabetes and dyslipidemia are significantly associated with stroke recurrence, yet the evidence for this relationship is conflicting. Consequently, the parameters in the glucose and lipid profiles may inform us regarding their relationship with stroke recurrence, thus enhancing the physicians’ clinical decision-making. Aim. This study sought to investigate whether glucose and lipid profiles could prognosticate stroke recurrence in Malaysia. Methods: We conducted a retrospective hospital-based study where we analyzed the first-ever stroke cases regarding about which the Malaysia National Stroke Registry was informed between 2009 and 2017, that fulfilled this study’s criteria, and that were followed for stroke recurrence. Using the Cox proportional hazard regression analysis, we estimated the adjusted hazard ratios (HRs), which reflected the prognostic effect of the primary variables (i.e., glucose and lipid profiles on the first-stroke admission) on stroke recurrence. Results: Among the 8,576 first-ever stroke patients, 394 (4.6%) experienced a subsequent first stroke recurrence event. The prognostic effect measured by univariable Cox regression showed that, when unadjusted, ten variables have prognostic value with regards to stroke recurrence. A multivariable regression analysis revealed that glucose was not a significant prognostic factor (adjusted HR 1.28; 95% CI [1.00–1.65]), while triglyceride level was the only parameter in the lipid profile found to have an independent prognostication concerning stroke recurrence (adjusted HR: 1.28 to 1.36). Conclusions: Triglyceride could independently prognosticate stroke recurrence, which suggests the role of physicians in intervening hypertriglyceridemia. In line with previous recommendations, we call for further investigations in first-ever stroke patients with impaired glucose and lipid profiles and suggest a need for interventions in these patients. - PublicationRisk Factors for COVID-19 Mortality in Malaysia(2022)
;Tengku Muhammad Hanis ;Wan Nor Arifin ;Kamarul Imran Musa ;Wan Shakira Rodzlan Hasani ;Che Muhammad Nur Hidayat Che Nawi ;Shahnon Anuar Shahrani ;Xin Wee Chen ;Mohd Azmi Suliman ;Erwan Ershad Ahmad Khan ;Wira Alfatah Ab AzizMohamad Zarudin Mat SaidBackground: Understanding the risks of COVID-19 mortality helps in the planning and prevention of the disease. This study aimed to determine the risk factors for COVID-19 mortality in Malaysia. Methods: Secondary online data provided by the Ministry of Health, Malaysia and Malaysia’s national COVID-19 immunisation programme were used: i) COVID-19 deaths data; ii) vaccination coverage data and iii) population estimate data. Quasi-Poisson regression was performed to determine the risk factors for COVID-19 mortality. Results: Four risk factors were identified: i) vaccination status (partial versus unvaccinated, incidence rate ratio [IRR]: 0.59; 95% CI: 0.54, 0.64; complete versus unvaccinated, IRR: 0.50; 95% CI: 0.45, 0.56; booster versus unvaccinated, IRR: 0.13; 95% CI: 0.05, 0.26); ii) age group (19 years old–59 years old versus above 60 years old, IRR: 0.90; 95% CI: 0.84, 0.97; 13 years old–18 years old versus above 60 years old, IRR: 0.09; 95% CI: 0.04, 0.19; 6 years old–12 years old versus above 60 years old, IRR: 0.09; 95% CI: 0.03, 0.22; below 5 years old versus above 60 years old, IRR: 0.11; 95% CI: 0.04, 0.23); iii) gender (male versus female, IRR: 1.23; 95% CI: 1.14, 1.32) and iv) comorbidity (yes versus no, IRR: 2.13; 95% CI: 1.96, 2.32). Conclusion: This study highlighted the risk factors for COVID-19 mortality and the benefit of COVID-19 vaccination, especially of booster vaccination, in reducing the risk of COVID-19 mortality in Malaysia. - PublicationThe global estimate of premature cardiovascular mortality: a systematic review and meta‑analysis of age‑standardized mortality rate(2023)
;Wan Shakira Rodzlan Hasani ;Nor Asiah Muhamad ;Tengku Muhammad Hanis ;Nur Hasnah Maamor ;Xin Wee Chen ;Mohd Azahadi Omar ;Yee Cheng Kueh ;Zulkarnain Abd Karim ;Muhammad Radzi Abu HassanKamarul Imran MusaBackground: Cardiovascular disease (CVD) is a significant cause of premature mortality worldwide, with a growing burden in recent years. Despite this, there is lack of comprehensive meta-analyses that quantify the extent of premature CVD mortality. Study addressed this gap by estimating the pooled ge-standardized mortality rate (ASMR) of premature CVD mortality. Methods: We conducted a systematic review of published CVD mortality studies that reported ASMR as an indicator for premature mortality measurement. All English articles published as of October 2022 were searched in four electronic databases: PubMed, Scopus, Web of Science (WoS), and the Cochrane Central Register of Controlled Trials (CENTRAL). We computed pooled estimates of ASMR using random-effects meta-analysis. We assessed heterogeneity from the selected studies using the I2 statistic. Subgroup analyses and meta regression analysis was performed based on sex, main CVD types, income country level, study time and age group. The analysis was performed using R software with the “meta” and “metafor” packages. Results: A total of 15 studies met the inclusion criteria. The estimated global ASMR for premature mortality from total CVD was 96.04 per 100,000 people (95% CI: 67.18, 137.31). Subgroup analysis by specific CVD types revealed a higher ASMR for ischemic heart disease (ASMR = 15.57, 95% CI: 11.27, 21.5) compared to stroke (ASMR = 12.36, 95% CI: 8.09, 18.91). Sex-specific differences were also observed, with higher ASMRs for males (37.50, 95% CI: 23.69, 59.37) than females (15.75, 95% CI: 9.61, 25.81). Middle-income countries had a significantly higher ASMR (90.58, 95% CI: 56.40, 145.48) compared to high-income countries (21.42, 95% CI: 15.63, 29.37). Stratifying by age group indicated that the age groups of 20–64 years and 30–74 years had a higher ASMR than the age group of 0–74 years. Our multivariable meta-regression model suggested significant differences in the adjusted ASMR estimates for all covariates except study time. Conclusions: This meta-analysis synthesized a comprehensive estimate of the worldwide burden of premature CVD mortality. Our findings underscore the continued burden of premature CVD mortality, particularly in middle-income countries. Addressing this issue requires targeted interventions to mitigate the high risk of premature CVD mortality in these vulnerable populations.