Displaying publications 1 - 20 of 47 in total

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  1. The role of the general practitioner in the diagnosis and management of acute myocardial infarction
    Toh CC
    Med J Malaya, 1969 Dec;24(2):85-8.
    PMID: 4244148
    Matched MeSH terms: Myocardial Infarction/diagnosis*
  2. Fulltext Coronary artery spasm (CAS) simulating inferior ST elevation myocardial infarction (STEMI)
    Liew CK, Leong WS
    Med J Malaysia, 2012 Feb;67(1):108-10.
    PMID: 22582559 MyJurnal
    Coronary arteries vasospasm (CAS) is commonly seen in invasive cardiology laboratory during diagnostic catheterization or coronary intervention. Though the incidence of Printzmetal angina is uncommon, coronary vasospasm resulting in acute myocardial infarct is rare, especially if there is no significant atherosclerotic plaque within the coronary vasculature.
    Matched MeSH terms: Myocardial Infarction/diagnosis*
  3. Delays in thrombolytic therapy in acute myocardial infarction: an audit from the east coast of peninsular Malaysia
    Loke YK, Hwang SL, Tan MH
    Ann Acad Med Singap, 1997 May;26(3):285-9.
    PMID: 9285018
    The objectives of this study were to evaluate the time delays between the onset of symptoms and admission to hospital and provision of thrombolytic therapy in patients with suspected acute myocardial infarction; and to examine the accuracy of the clinical diagnosis and the therapeutic decision on thrombolysis in these patients. An observational study of 96 patients with suspected myocardial infarction was undertaken over a period of 15 months in the Coronary Care Unit of Hospital Kuala Terengganu. Seventy per cent of the patients arrived in the hospital within 6 hours of the onset of symptoms. After arrival in the emergency room, it took a median time of 85 minutes before the administration of thrombolytic therapy. Of the 67 patients who were given thrombolysis, 46 were treated within 6 hours of the onset of symptoms. About a quarter of patients said that they had delayed seeking treatment at the hospital. Treatment delays occurring in the hospital were mainly due to admission procedures as well as late diagnosis. Eighty-one patients had confirmed myocardial infarction of whom 59 received thrombolytic therapy. Eight patients receiving thrombolytic therapy had no confirmation of myocardial infarctions. Improvements in diagnostic accuracy and reduction of delays in the provision of thrombolytic therapy could be achieved by better training of health care staff as well as by further streamlining of admission procedures.
    Matched MeSH terms: Myocardial Infarction/diagnosis
  4. Progression in sensing cardiac troponin biomarker charge transductions on semiconducting nanomaterials
    Fathil MF, Md Arshad MK, Ruslinda AR, Nuzaihan M N M, Gopinath SC, Adzhri R, et al.
    Anal Chim Acta, 2016 Sep 07;935:30-43.
    PMID: 27543013 DOI: 10.1016/j.aca.2016.06.012
    A real-time ability to interpret the interaction between targeted biomolecules and the surface of semiconductors (metal transducers) into readable electrical signals, without biomolecular modification involving fluorescence dyes, redox enzymes, and radioactive labels, created by label-free biosensors has been extensively researched. Field-effect transistor (FET)- and capacitor-based biosensors are among the diverse electrical charge biosensing architectures that have drawn much attention for having charge transduction; thus, enabling the early and rapid diagnosis of the appropriate cardiac biomarkers at lower concentrations. These semiconducting material-based transducers are very suitable to be integrated with portable electronic devices for future online collection, transmission, reception, analysis, and reporting. This overview elucidates and clarifies two major electrical label-free systems (FET- and capacitor-based biosensors) with cardiac troponin (cTn) biomarker-mediated charge transduction for acute myocardial infarction (AMI) diagnosis. Advances in these systems are highlighted by their progression in bridging the laboratory and industry; the foremost technologies have made the transition from benchtop to bedside and beyond.
    Matched MeSH terms: Myocardial Infarction/diagnosis*
  5. Cardiac arrhythmias in acute myocardial infarction
    Ng WH, Goh TH, Ishak E, Ahmad Z
    Med J Malaysia, 1979 Dec;34(2):131-5.
    PMID: 548713
    Matched MeSH terms: Myocardial Infarction/diagnosis*
  6. ST. segment displacement in myocardial infarction
    Fah NT
    Med J Malaysia, 1977 Jun;31(4):309-15.
    PMID: 927238
    Matched MeSH terms: Myocardial Infarction/diagnosis*
  7. Fulltext Using neural networks and just nine patient-reportable factors of screen for AMI
    Bulgiba AM, Fisher MH
    Health Informatics J, 2006 Sep;12(3):213-25.
    PMID: 17023409 DOI: 10.1177/1460458206066665
    The study investigated the effect of different input selections on the performance of artificial neural networks in screening for acute myocardial infarction (AMI) in Malaysian patients complaining of chest pain. We used hospital data to create neural networks with four input selections and used these to diagnose AMI. A 10-fold cross-validation and committee approach was used. All the neural networks using various input selections outperformed a multiple logistic regression model, although the difference was not statistically significant. The neural networks achieved an area under the ROC curve of 0.792 using nine inputs, whereas multiple logistic regression achieved 0.739 using 64 inputs. Sensitivity levels of over 90 per cent were achieved using low output threshold levels. Specificity levels of over 90 per cent were achieved using threshold levels of 0.4-0.5. Thus neural networks can perform as well as multiple logistic regression models even when using far fewer inputs.
    Matched MeSH terms: Myocardial Infarction/diagnosis*
  8. Overlapping technique for hybrid percutaneous coronary intervention strategy utilising drug eluting stent and ABSORB bioresorbable vascular scaffold
    Yew KL
    Int J Cardiol, 2015 Jan 15;178:e8-e10.
    PMID: 25205484 DOI: 10.1016/j.ijcard.2014.08.085
    Matched MeSH terms: Myocardial Infarction/diagnosis*
  9. Fulltext Severe Plasmodium falciparum infection mimicking acute myocardial infarction
    Sulaiman H, Ismail MD, Jalalonmuhali M, Atiya N, Ponnampalavanar S
    Malar J, 2014;13:341.
    PMID: 25176417 DOI: 10.1186/1475-2875-13-341
    This case report describes a case of presumed acute myocardial infarction in a returned traveler who was later diagnosed to have severe malaria. Emergency coronary angiography was normal and subsequent peripheral blood film was positive for Plasmodium falciparum.
    Matched MeSH terms: Myocardial Infarction/diagnosis*
  10. Regional assessment of LV wall in infarcted heart using tagged MRI and cardiac modelling
    Jahanzad Z, Liew YM, Bilgen M, McLaughlin RA, Leong CO, Chee KH, et al.
    Phys Med Biol, 2015 May 21;60(10):4015-31.
    PMID: 25919317 DOI: 10.1088/0031-9155/60/10/4015
    A segmental two-parameter empirical deformable model is proposed for evaluating regional motion abnormality of the left ventricle. Short-axis tagged MRI scans were acquired from 10 healthy subjects and 10 postinfarct patients. Two motion parameters, contraction and rotation, were quantified for each cardiac segment by fitting the proposed model using a non-rigid registration algorithm. The accuracy in motion estimation was compared to a global model approach. Motion parameters extracted from patients were correlated to infarct transmurality assessed with delayed-contrast-enhanced MRI. The proposed segmental model allows markedly improved accuracy in regional motion analysis as compared to the global model for both subject groups (1.22-1.40 mm versus 2.31-2.55 mm error). By end-systole, all healthy segments experienced radial displacement by ~25-35% of the epicardial radius, whereas the 3 short-axis planes rotated differently (basal: 3.3°; mid:  -1° and apical:  -4.6°) to create a twisting motion. While systolic contraction showed clear correspondence to infarct transmurality, rotation was nonspecific to either infarct location or transmurality but could indicate the presence of functional abnormality. Regional contraction and rotation derived using this model could potentially aid in the assessment of severity of regional dysfunction of infarcted myocardium.
    Matched MeSH terms: Myocardial Infarction/diagnosis*
  11. Diagnostics on acute myocardial infarction: Cardiac troponin biomarkers
    Fathil MF, Md Arshad MK, Gopinath SC, Hashim U, Adzhri R, Ayub RM, et al.
    Biosens Bioelectron, 2015 Aug 15;70:209-20.
    PMID: 25841117 DOI: 10.1016/j.bios.2015.03.037
    Acute myocardial infarction or myocardial infarction (MI) is a major health problem, due to diminished flow of blood to the heart, leads to higher rates of mortality and morbidity. Data from World Health Organization (WHO) accounted 30% of global death annually and expected more than 23 million die annually by 2030. This fatal effects trigger the need of appropriate biomarkers for early diagnosis, thus countermeasure can be taken. At the moment, the most specific markers for cardiac injury are cardiac troponin I (cTnI) and cardiac troponin T (cTnT) which have been considered as 'gold standard'. Due to higher specificity, determination of the level of cardiac troponins became a predominant indicator for MI. Several ways of diagnostics have been formulated, which include enzyme-linked immunosorbent assay, chemiluminescent, fluoro-immunoassays, electrical detections, surface plasmon resonance, and colorimetric protein assay. This review represents and elucidates the strategies, methods and detection levels involved in these diagnostics on cardiac superior biomarkers. The advancement, sensitivity, and limitations of each method are also discussed. In addition, it concludes with a discussion on the point-of care (POC) assay for a fast, accurate and ability of handling small sample measurement of cardiac biomarker.
    Matched MeSH terms: Myocardial Infarction/diagnosis*
  12. Myocardial infarction in a young Indian grandmultipara
    Kannan P, Raman S, Ramani VS, Jeyamalar R
    Aust N Z J Obstet Gynaecol, 1993 Nov;33(4):424-6.
    PMID: 8179560
    Matched MeSH terms: Myocardial Infarction/diagnosis*
  13. Kounis syndrome following solenopsis (fire ant) bite
    Ng BH, Tan HX, Vijayasingham S
    Med J Malaysia, 2019 08;74(4):344-346.
    PMID: 31424048
    Anaphylaxis is rarely associated with the vasospastic acute coronary syndrome with or without the presence of underlying coronary artery disease. We report here a case of Kounis syndrome in a man with no known cardiovascular risk developed acute ST-elevation myocardial infarction complicated with complete heart block following Solenopsis (fire ant) bite.
    Matched MeSH terms: ST Elevation Myocardial Infarction/diagnosis
  14. Fulltext Inverse changes in plasma tetranectin and titin levels in patients with type 2 diabetes mellitus: a potential predictor of acute myocardial infarction?
    Rahim MAA, Rahim ZHA, Ahmad WAW, Bakri MM, Ismail MD, Hashim OH
    Acta Pharmacol Sin, 2018 Jul;39(7):1197-1207.
    PMID: 29417940 DOI: 10.1038/aps.2017.141
    An early intervention using biomarkers to predict acute myocardial infarction (AMI) will effectively reduce global heart attack incidence, particularly among high-risk patients with type 2 diabetes mellitus (T2DM). This study attempted to identify potential biomarkers by detecting changes in the levels of plasma proteins in T2DM patients following onset of AMI in comparison with those without AMI. Volunteer T2DM patients without AMI (control; n=10) and T2DM patients with AMI (n=10) were recruited. Plasma samples from these patients were evaluated via two-dimensional gel electrophoresis (2DE) to screen for proteins with level changes between the two groups. The abundance of spots on gel images was analyzed using Progenesis SameSpots and subjected to false discovery rate (FDR) analysis. Protein spots with statistically significant changes of at least 1.5 fold were selected for mass spectrometry (MS) analysis. Due to strong cardiac connections, tetranectin and titin were evaluated by enzymelinked immunosorbent assay (ELISA). The adjusted P-values and fold changes between the two groups resulted in identification of 34 protein spots with significantly altered abundance. Upon MS analysis, 17 plasma proteins were identified: tetranectin, titin, clusterin, haptoglobin, myosin-13, zinc fnger protein 445, DNA repair protein RAD50, serum albumin, apolipoprotein A-IV, caspase-6, aminoacyl tRNA synthase complex-interacting multifunctional protein 1, serotransferrin, retinol-binding protein 4, transthyretin, alpha-1-antitrypsin, apolipoprotein A-I and serum amyloid A. Comparable patterns of changes in tetranectin and titin between the control and AMI groups were confirmed using ELISA. In summary, tetranectin and titin in plasma appeared to be closely associated with the onset of AMI among T2DM patients and can be used as potential biomarkers for prediction of a cardiac event, though this requires validation in a prospective cohort study.
    Matched MeSH terms: Myocardial Infarction/diagnosis
  15. Biosensing based on surface-enhanced Raman spectroscopy as an emerging/next-generation point-of-care approach for acute myocardial infarction diagnosis
    Low JSY, Thevarajah TM, Chang SW, Goh BT, Khor SM
    Crit Rev Biotechnol, 2020 Dec;40(8):1191-1209.
    PMID: 32811205 DOI: 10.1080/07388551.2020.1808582
    Cardiovascular disease is a major global health issue. In particular, acute myocardial infarction (AMI) requires urgent attention and early diagnosis. The use of point-of-care diagnostics has resulted in the improved management of cardiovascular disease, but a major drawback is that the performance of POC devices does not rival that of central laboratory tests. Recently, many studies and advances have been made in the field of surface-enhanced Raman scattering (SERS), including the development of POC biosensors that utilize this detection method. Here, we present a review of the strengths and limitations of these emerging SERS-based biosensors for AMI diagnosis. The ability of SERS to multiplex sensing against existing POC detection methods are compared and discussed. Furthermore, SERS calibration-free methods that have recently been explored to minimize the inconvenience and eliminate the limitations caused by the limited linear range and interassay differences found in the calibration curves are outlined. In addition, the incorporation of artificial intelligence (AI) in SERS techniques to promote multivariate analysis and enhance diagnostic accuracy are discussed. The future prospects for SERS-based POC devices that include wearable POC SERS devices toward predictive, personalized medicine following the Fourth Industrial Revolution are proposed.
    Matched MeSH terms: Myocardial Infarction/diagnosis*
  16. Fulltext Association of testosterone, inflammation with the severity of first acute ST-elevation myocardial infarction
    Wickramatilake CM, Mohideen MR, Pathirana C
    Indian Heart J, 2017 02 12;69(2):291.
    PMID: 28460787 DOI: 10.1016/j.ihj.2017.02.002
    Matched MeSH terms: ST Elevation Myocardial Infarction/diagnosis*
  17. Utilization of second derivative photoplethysmographic features for myocardial infarction classification
    Mahri N, Gan KB, Meswari R, Jaafar MH, Mohd Ali MA
    J Med Eng Technol, 2017 May;41(4):298-308.
    PMID: 28351231 DOI: 10.1080/03091902.2017.1299229
    Myocardial infarction (MI) is a common disease that causes morbidity and mortality. The current tools for diagnosing this disease are improving, but still have some limitations. This study utilised the second derivative of photoplethysmography (SDPPG) features to distinguish MI patients from healthy control subjects. The features include amplitude-derived SDPPG features (pulse height, ratio, jerk) and interval-derived SDPPG features (intervals and relative crest time (RCT)). We evaluated 32 MI patients at Pusat Perubatan Universiti Kebangsaan Malaysia and 32 control subjects (all ages 37-87 years). Statistical analysis revealed that the mean amplitude-derived SDPPG features were higher in MI patients than in control subjects. In contrast, the mean interval-derived SDPPG features were lower in MI patients than in the controls. The classifier model of binary logistic regression (Model 7), showed that the combination of SDPPG features that include the pulse height (d-wave), the intervals of "ab", "ad", "bc", "bd", and "be", and the RCT of "ad/aa" could be used to classify MI patients with 90.6% accuracy, 93.9% sensitivity and 87.5% specificity at a cut-off value of 0.5 compared with the single features model.
    Matched MeSH terms: Myocardial Infarction/diagnosis*
  18. Deep Deterministic Learning for Pattern Recognition of Different Cardiac Diseases through the Internet of Medical Things
    Iqbal U, Wah TY, Habib Ur Rehman M, Mujtaba G, Imran M, Shoaib M
    J Med Syst, 2018 Nov 05;42(12):252.
    PMID: 30397730 DOI: 10.1007/s10916-018-1107-2
    Electrocardiography (ECG) sensors play a vital role in the Internet of Medical Things, and these sensors help in monitoring the electrical activity of the heart. ECG signal analysis can improve human life in many ways, from diagnosing diseases among cardiac patients to managing the lifestyles of diabetic patients. Abnormalities in heart activities lead to different cardiac diseases and arrhythmia. However, some cardiac diseases, such as myocardial infarction (MI) and atrial fibrillation (Af), require special attention due to their direct impact on human life. The classification of flattened T wave cases of MI in ECG signals and how much of these cases are similar to ST-T changes in MI remain an open issue for researchers. This article presents a novel contribution to classify MI and Af. To this end, we propose a new approach called deep deterministic learning (DDL), which works by combining predefined heart activities with fused datasets. In this research, we used two datasets. The first dataset, Massachusetts Institute of Technology-Beth Israel Hospital, is publicly available, and we exclusively obtained the second dataset from the University of Malaya Medical Center, Kuala Lumpur Malaysia. We first initiated predefined activities on each individual dataset to recognize patterns between the ST-T change and flattened T wave cases and then used the data fusion approach to merge both datasets in a manner that delivers the most accurate pattern recognition results. The proposed DDL approach is a systematic stage-wise methodology that relies on accurate detection of R peaks in ECG signals, time domain features of ECG signals, and fine tune-up of artificial neural networks. The empirical evaluation shows high accuracy (i.e., ≤99.97%) in pattern matching ST-T changes and flattened T waves using the proposed DDL approach. The proposed pattern recognition approach is a significant contribution to the diagnosis of special cases of MI.
    Matched MeSH terms: Myocardial Infarction/diagnosis*
  19. Acute myocarditis mimicking ST-elevation myocardial infarction: A diagnostic challenge for frontline clinicians
    Ang KP, Quek ZQ, Lee CY, Lu HT
    Med J Malaysia, 2019 12;74(6):561-563.
    PMID: 31929492
    The clinical presentation of acute myocarditis is highly variable ranging from no symptoms to cardiogenic shock. Despite considerable progress, it remains a challenge for frontline physicians to discriminate between acute myocarditis and myocardial infarction, especially in the early phase. Our case serves as a reminder that acute presentation of myocarditis could resemble ST elevation myocardial infarction potentially misdirecting the therapeutic decision. The clinical presentation, electrocardiographic and laboratory findings of the patient are not specific enough to distinguish acute myocarditis from myocardial infarction. The gold standard tests such coronary angiography and cardiovascular magnetic resonance (CMR) can reliably differentiate the two entities.
    Matched MeSH terms: ST Elevation Myocardial Infarction/diagnosis*
  20. Coronary intervention door-to-balloon time and outcomes in ST-elevation myocardial infarction: a meta-analysis
    Foo CY, Bonsu KO, Nallamothu BK, Reid CM, Dhippayom T, Reidpath DD, et al.
    Heart, 2018 08;104(16):1362-1369.
    PMID: 29437704 DOI: 10.1136/heartjnl-2017-312517
    OBJECTIVE: This study aims to determine the relationship between door-to-balloon delay in primary percutaneous coronary intervention and ST-elevation myocardial infarction (MI) outcomes and examine for potential effect modifiers.

    METHODS: We conducted a systematic review and meta-analysis of prospective observational studies that have investigated the relationship of door-to-balloon delay and clinical outcomes. The main outcomes include mortality and heart failure.

    RESULTS: 32 studies involving 299 320 patients contained adequate data for quantitative reporting. Patients with ST-elevation MI who experienced longer (>90 min) door-to-balloon delay had a higher risk of short-term mortality (pooled OR 1.52, 95% CI 1.40 to 1.65) and medium-term to long-term mortality (pooled OR 1.53, 95% CI 1.13 to 2.06). A non-linear time-risk relation was observed (P=0.004 for non-linearity). The association between longer door-to-balloon delay and short-term mortality differed between those presented early and late after symptom onset (Cochran's Q 3.88, P value 0.049) with a stronger relationship among those with shorter prehospital delays.

    CONCLUSION: Longer door-to-balloon delay in primary percutaneous coronary intervention for ST-elevation MI is related to higher risk of adverse outcomes. Prehospital delays modified this effect. The non-linearity of the time-risk relation might explain the lack of population effect despite an improved door-to-balloon time in the USA.

    CLINICAL TRIAL REGISTRATION: PROSPERO (CRD42015026069).

    Matched MeSH terms: ST Elevation Myocardial Infarction/diagnosis
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