Displaying publications 1 - 20 of 23 in total

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  1. Chin CN, Quek DKL, Ong SBL
    Med J Malaysia, 1991 Mar;46(1):35-40.
    PMID: 1836036
    Sixty five patients were interviewed on an average of 42 months after a myocardial infarction. Using a semi structured interview, they were systematically questioned on their usual sexual activity just before their infarction and at the time of follow up. All were married men with a mean age of 54.4 years and had resumed a normal active life. Forty six (70%) reported a decrease in frequency of sexual intercourse (mean 6.9 times/month before infarction and 0.8 times/month at time of interview, p less than 0.01). The majority had difficulty in discussing sex with their doctors because of impaired doctor-patient communication, cultural factors and lack of privacy. Discussion concerning sex should be initiated as soon as the patient is stable and pertinent advice is the key to better sexual adjustment after myocardial infarction.
    Matched MeSH terms: Myocardial Infarction/complications*
  2. Chan BT, Abu Osman NA, Lim E, Chee KH, Abdul Aziz YF, Abed AA, et al.
    PLoS One, 2013;8(6):e67097.
    PMID: 23825628 DOI: 10.1371/journal.pone.0067097
    Dilated cardiomyopathy (DCM) is the most common myocardial disease. It not only leads to systolic dysfunction but also diastolic deficiency. We sought to investigate the effect of idiopathic and ischemic DCM on the intraventricular fluid dynamics and myocardial wall mechanics using a 2D axisymmetrical fluid structure interaction model. In addition, we also studied the individual effect of parameters related to DCM, i.e. peak E-wave velocity, end systolic volume, wall compliance and sphericity index on several important fluid dynamics and myocardial wall mechanics variables during ventricular filling. Intraventricular fluid dynamics and myocardial wall deformation are significantly impaired under DCM conditions, being demonstrated by low vortex intensity, low flow propagation velocity, low intraventricular pressure difference (IVPD) and strain rates, and high-end diastolic pressure and wall stress. Our sensitivity analysis results showed that flow propagation velocity substantially decreases with an increase in wall stiffness, and is relatively independent of preload at low-peak E-wave velocity. Early IVPD is mainly affected by the rate of change of the early filling velocity and end systolic volume which changes the ventriculo:annular ratio. Regional strain rate, on the other hand, is significantly correlated with regional stiffness, and therefore forms a useful indicator for myocardial regional ischemia. The sensitivity analysis results enhance our understanding of the mechanisms leading to clinically observable changes in patients with DCM.
    Matched MeSH terms: Myocardial Infarction/complications
  3. Yew KL, Sim KH, Ong TK
    Med J Malaysia, 2012 Aug;67(4):426-7.
    PMID: 23082457 MyJurnal
    Matched MeSH terms: Myocardial Infarction/complications
  4. Chong E, Shen L, Tan HC, Poh KK
    Med J Malaysia, 2011 Aug;66(3):249-52.
    PMID: 22111450
    Thrombolysis in Myocardial Infarction (TIMI) score has been used to predict outcomes in patients presenting with unstable angina (UA) and non-ST elevation myocardial infarction (NSTEMI). Our study assessed other clinical predictors for patients with UA/NSTEMI undergoing early percutaneous coronary intervention (PCI).
    Matched MeSH terms: Myocardial Infarction/complications*
  5. Azarisman SM, Carbone A, Shirazi M, Bradley J, Teo KS, Worthley MI, et al.
    Heart Lung Circ, 2016 Nov;25(11):1094-1106.
    PMID: 27210302 DOI: 10.1016/j.hlc.2016.03.011
    BACKGROUND: Cardiovascular magnetic resonance (CMR) advances in imaging techniques, permits the ability to accurately characterise tissue injury post myocardial infarction. Pre-contrast T1 mapping enables this through measurement of pre-contrast T1 relaxation times. We investigate the relationship between T1 characterisation of myocardial injury with global and regional diastolic function.

    METHODS: Revascularised acute myocardial infarction patients with normal left ventricular (LV) systolic function on TTE were assessed by 1.5T CMR. Acute regional diastolic wall motion abnormalities, global diastolic function measurements, acute segmental damage fraction with LGE and mean segmental pre-contrast T1 values were assessed on matching short axis slices.

    RESULTS: Forty-four patients were analysed. Mean LVEF was 62.1±9.4%. No difference between NSTEMI (22/44) and STEMI in mean pre-contrast T1 values of infarcted (1025.0±109.2 vs 1011.0±81.6ms, p=0.70), adjacent (948.3±45.3 vs 941.1±46.6ms, p=0.70) and remote (888.8±52.8 vs 881.2±54.5ms, p=0.66) segments was detected. There was no correlation between pre-contrast T1 of infarcted segments with global diastolic dysfunction (E/A, r(2)=0.216, p=0.06; S/D, r(2)=0.243, p=0.053; E/E', r(2)=0.240, p=0.072), but there was significantly positive, moderate correlation with circumferential diastolic strain rate, (r(2)=0.579, p<0.01) with excellent agreement and reproducibility.

    CONCLUSION: Cardiac magnetic resonance evaluation of pre-contrast T1 values revealed no difference between NSTEMI and STEMI patients in terms of tissue characterisation post-myocardial infarction. However, pre-contrast T1 of infarcted tissue is significantly correlated with regional diastolic circumferential strain rate.

    Matched MeSH terms: Myocardial Infarction/complications
  6. Tan I, Delilkan AE
    Med J Malaysia, 1993 Dec;48(4):397-402.
    PMID: 8183162
    From January 1980 to August 1992, there were 125 deaths occurring in the operating theatre at the University Hospital Kuala Lumpur. Out of these 125, six were judged to have been mainly 'due to anaesthesia.' In the same time period, there were a total of 155,000 anaesthetics given in the hospital. This gives an anaesthetic death rate (in the operating theatre) of six out of 155,000 or 0.39:10,000.
    Matched MeSH terms: Myocardial Infarction/complications
  7. Ng WH
    Med J Malaysia, 1982 Mar;37(1):66-9.
    PMID: 7121350
    Mortality in the early phase of acute myocardial infarction occurs both during the pre-hospital period and after admission to the Coronary Care Unit. This report is an analysis of deaths that occurred in the Coronary Care Unit within a 3 year period. Forty percent of 304 patients (13 percent) unth. acute myocardial infarction died in the Coronary Care Unit, Fifty percent of the deaths were due to cardiac arrhythmias and 45 percent attributable to myocardial pump failure. Mean delay in hospital admission from onset of symptoms was 15 hours. Factors affecting early mortality and their prevention are discussed.
    Matched MeSH terms: Myocardial Infarction/complications
  8. Chin K, Yusof K
    Med J Malaysia, 1987 Jun;42(2):93-6.
    PMID: 3503197
    The clinical course of 68 patients who had temporary transvenous pacing for complete heart block in acute myocardial infarction is reviewed. There were 59 male and 9 female patients, of which 32 were Indians, 20 were Malays and 16 Chinese. 48 patients had inferior infarct, 16 patients developed anterior infarct and 4 patients presented with combined anteriorinferior infarction. The overall mortality for complete heart block in this study is 44%. The mortality pattern is 25% for inferior infarct; 87% for anterior infarct and 100% for combined anterior and inferior infarct.
    Matched MeSH terms: Myocardial Infarction/complications*
  9. Liam CK, Liao CM, Kannan P
    Singapore Med J, 1994 Aug;35(4):411-3.
    PMID: 7899906
    A patient had recurrent acute nocturnal pulmonary oedema following an anterior myocardial infarction despite a normal maximal stress electrocardiogram. He had a history of chronic heavy snoring and other symptoms to suggest a diagnosis of obstructive sleep apnoea (OSA) which was supported by an overnight sleep study. The recurrent acute pulmonary oedema was most likely due to a combination of poor left ventricular function and obstructive sleep apnoea.
    Matched MeSH terms: Myocardial Infarction/complications
  10. Ling KH, Ng KS
    Singapore Med J, 2018 10;59(10):558-559.
    PMID: 30386861 DOI: 10.11622/smedj.2018130
    Matched MeSH terms: Myocardial Infarction/complications*
  11. Wahab NA, Zainudin S, AbAziz A, Kamaruddin NA
    Med Princ Pract, 2015;24(1):96-8.
    PMID: 25428406 DOI: 10.1159/000369021
    OBJECTIVE: The aim of this case study is to emphasize the importance of α-blockade in managing a rare complication of an untreated pheochromocytoma.

    CLINICAL PRESENTATION AND INTERVENTION: A 41-year-old man with previous bilateral pheochromocytoma presented with chest pain. He was suffering from cardiac failure and persistent hypotension requiring an inotrope. Cardiac markers, an electrocardiogram and an echocardiogram confirmed acute myocardial infarct with poor ejection fraction and global hypokinesia. An (18)F-fluorodeoxyglucose PET/CT scan showed progressive left suprarenal and organ of Zuckerkandl pheochromocytomas. Blood pressure stabilisation proved challenging but was achieved by titrating an incremental dose of α-blocker against a tapering inotropic dose.

    CONCLUSION: This case showed the efficacy of an α-blocker despite persistent hypotension in a patient with pheochromocytoma-induced cardiomyopathy.

    Matched MeSH terms: Myocardial Infarction/complications
  12. Ong SB, Katwadi K, Kwek XY, Ismail NI, Chinda K, Ong SG, et al.
    Expert Opin Ther Targets, 2018 03;22(3):247-261.
    PMID: 29417868 DOI: 10.1080/14728222.2018.1439015
    INTRODUCTION: New treatments are required to improve clinical outcomes in patients with acute myocardial infarction (AMI), for reduction of myocardial infarct (MI) size and preventing heart failure. Following AMI, acute ischemia/reperfusion injury (IRI) ensues, resulting in cardiomyocyte death and impaired cardiac function. Emerging studies have implicated a fundamental role for non-coding RNAs (microRNAs [miRNA], and more recently long non-coding RNAs [lncRNA]) in the setting of acute myocardial IRI. Areas covered: In this article, we discuss the roles of miRNAs and lncRNAs as potential biomarkers and therapeutic targets for the detection and treatment of AMI, review their roles as mediators and effectors of cardioprotection, particularly in the settings of interventions such as ischemic pre- and post-conditioning (IPC & IPost) as well as remote ischemic conditioning (RIC), and highlight future strategies for targeting ncRNAs to reduce MI size and prevent heart failure following AMI. Expert opinion: Investigating the roles of miRNAs and lncRNAs in the setting of AMI has provided new insights into the pathophysiology underlying acute myocardial IRI, and has identified novel biomarkers and therapeutic targets for detecting and treating AMI. Pharmacological and genetic manipulation of these ncRNAs has the therapeutic potential to improve clinical outcomes in AMI patients.
    Matched MeSH terms: Myocardial Infarction/complications
  13. Aziz F, Malek S, Ibrahim KS, Raja Shariff RE, Wan Ahmad WA, Ali RM, et al.
    PLoS One, 2021;16(8):e0254894.
    PMID: 34339432 DOI: 10.1371/journal.pone.0254894
    BACKGROUND: Conventional risk score for predicting short and long-term mortality following an ST-segment elevation myocardial infarction (STEMI) is often not population specific.

    OBJECTIVE: Apply machine learning for the prediction and identification of factors associated with short and long-term mortality in Asian STEMI patients and compare with a conventional risk score.

    METHODS: The National Cardiovascular Disease Database for Malaysia registry, of a multi-ethnic, heterogeneous Asian population was used for in-hospital (6299 patients), 30-days (3130 patients), and 1-year (2939 patients) model development. 50 variables were considered. Mortality prediction was analysed using feature selection methods with machine learning algorithms and compared to Thrombolysis in Myocardial Infarction (TIMI) score. Invasive management of varying degrees was selected as important variables that improved mortality prediction.

    RESULTS: Model performance using a complete and reduced variable produced an area under the receiver operating characteristic curve (AUC) from 0.73 to 0.90. The best machine learning model for in-hospital, 30 days, and 1-year outperformed TIMI risk score (AUC = 0.88, 95% CI: 0.846-0.910; vs AUC = 0.81, 95% CI:0.772-0.845, AUC = 0.90, 95% CI: 0.870-0.935; vs AUC = 0.80, 95% CI: 0.746-0.838, AUC = 0.84, 95% CI: 0.798-0.872; vs AUC = 0.76, 95% CI: 0.715-0.802, p < 0.0001 for all). TIMI score underestimates patients' risk of mortality. 90% of non-survival patients are classified as high risk (>50%) by machine learning algorithm compared to 10-30% non-survival patients by TIMI. Common predictors identified for short- and long-term mortality were age, heart rate, Killip class, fasting blood glucose, prior primary PCI or pharmaco-invasive therapy and diuretics. The final algorithm was converted into an online tool with a database for continuous data archiving for algorithm validation.

    CONCLUSIONS: In a multi-ethnic population, patients with STEMI were better classified using the machine learning method compared to TIMI scoring. Machine learning allows for the identification of distinct factors in individual Asian populations for better mortality prediction. Ongoing continuous testing and validation will allow for better risk stratification and potentially alter management and outcomes in the future.

    Matched MeSH terms: ST Elevation Myocardial Infarction/complications
  14. Bulgiba AM, Razaz M
    Int J Cardiol, 2005 Jun 22;102(1):87-93.
    PMID: 15939103
    The aim of the study was to use data from an electronic medical record system (EMR) to look for factors that would help us diagnose acute myocardial infarction (AMI) with the ultimate aim of using these factors in a decision support system for chest pain. We extracted 887 records from the electronic medical record system (EMR) in Selayang Hospital, Malaysia. We cleaned the data, extracted 69 possible variables and performed univariate and multivariate analysis. From the univariate analysis we find that 22 variables are significantly associated with a diagnosis of AMI. However, multiple logistic regression reveals that only 9 of these 22 variables are significantly related to a diagnosis of AMI. Race (Indian), male sex, sudden onset of persistent crushing pain, associated sweating and a history of diabetes mellitus are significant predictors of AMI. Pain that is relieved by other means and history of heart disease on treatment are important predictors of a diagnosis other than AMI. The degree of accuracy is high at 80.5%. There are 13 factors that are significant in the univariate analysis but are not among the nine significant factors in the multivariate analysis. These are location of pain, associated palpitations, nausea and vomiting; pain relieved by rest, pain aggravated by posture, cough, inspiration and exertion; age more than 40, being a smoker and abnormal chest wall and face examination. We believe that these findings can have important applications in the design of an intelligent decision support system for use in medical care as the predictive capability can be further refined with the use of intelligent computational techniques.
    Matched MeSH terms: Myocardial Infarction/complications
  15. Saha N, Toh CC, Ghosh MB
    J Med Genet, 1973 Dec;10(4):340-5.
    PMID: 4204387
    Matched MeSH terms: Myocardial Infarction/complications
  16. Si LY, Ali SAM, Latip J, Fauzi NM, Budin SB, Zainalabidin S
    Life Sci, 2017 Dec 15;191:157-165.
    PMID: 29066253 DOI: 10.1016/j.lfs.2017.10.030
    AIMS: Obesity increase the risks of hypertension and myocardial infarction (MI) mediated by oxidative stress. This study was undertaken to investigate the actions of roselle aqueous extract (R) on cardiotoxicity in obese (OB) rats and thereon OB rats subjected to MI.

    MAIN METHODS: Male Sprague-Dawley rats were fed with either normal diet or high-fat diet for 8weeks. Firstly, OB rats were divided into (1) OB and (2) OB+R (100mg/kg, p.o, 28days). Then, OB rats were subjected to MI (ISO, 85mg/kg, s.c, 2days) and divided into three groups: (1) OB+MI, (2) OB+MI+R and (3) OB+MI+enalapril for another 4weeks.

    KEY FINDINGS: Roselle ameliorated OB and OB+MI's cardiac systolic dysfunction and reduced cardiac hypertrophy and fibrosis. The increased oxidative markers and decreased antioxidant enzymes in OB and OB+MI groups were all attenuated by roselle.

    SIGNIFICANCE: These observations indicate the protective effect of roselle on cardiac dysfunction in OB and OB+MI rats, which suggest its potential to be developed as a nutraceutical product for obese and obese patients with MI in the future.

    Matched MeSH terms: Myocardial Infarction/complications*
  17. Lee YY, Tee MH, Zurkurnai Y, Than W, Sapawi M, Suhairi I
    Singapore Med J, 2008 Apr;49(4):304-10.
    PMID: 18418522
    This study was primarily aimed to determine the failure rate of thrombolysis with streptokinase in acute myocardial infarction using electrocardiogram criteria and its association between various independent variables and outcome parameters.
    Matched MeSH terms: Myocardial Infarction/complications
  18. Krackhardt F, Kočka V, Waliszewski M, Toušek P, Janek B, Trenčan M, et al.
    Medicine (Baltimore), 2020 Feb;99(8):e19119.
    PMID: 32080086 DOI: 10.1097/MD.0000000000019119
    Stent designs with ultrathin struts may further increase the procedural success of challenging lesion subsets. The objective of this study was to assess the safety and efficacy of ultrathin strut, polymer-free sirolimus eluting stent (PF-SES) implantations in a large scale, unselected patient population.Adult patients underwent percutaneous coronary interventions (PCI) with a thin-strut PF-SES. Data from two all-comers observational studies having the same protocol (ClinicalTrials.gov Identifiers: NCT02629575 and NCT02905214) were pooled. The accumulated target lesion revascularization (TLR) rate at 9-12 months was the primary endpoint. All dual antiplatelet therapy strategies according to the applicable guidelines were permissible.In total, 7243 patients were prospectively enrolled for PCI with PF-SES in stable coronary artery disease or acute coronary syndrome (ACS). Major risk factors in the overall cohort were diabetes (37.3%), ST elevation myocardial infarction (18.1%) and non-ST myocardial infarction (24.6%). The follow-up rate was 88.6% in the overall population. The TLR rate in the overall cohort was 2.2% whereas definite/probable stent thrombosis (ST) occurred in 0.7%. In patients with in-stent restenosis lesions, the major adverse cardiac events rate was 6.4% whereas the corresponding rate for isolated left main coronary artery (LMCA) disease was highest with 6.7% followed by patients with culprit lesions in vein bypasses (VB, 7.1%). The mortality rate in patients treated in VB lesions was highest with 5.4%, followed by the isolated LMCA subgroup (3.4%) and ACS (2.6%).PCI with PF-SES in an unselected patient population, is associated with low clinical event and ST rates. Furthermore, PF-SES angioplasty in niche indications demonstrated favorable safety and efficacy outcomes with high procedural success rates.
    Matched MeSH terms: ST Elevation Myocardial Infarction/complications; Non-ST Elevated Myocardial Infarction/complications
  19. Wong KT, Tan CT
    PMID: 22427144 DOI: 10.1007/82_2012_205
    The clinicopathological features of human Nipah virus and Hendra virus infections appear to be similar. The clinical manifestations may be mild, but if severe, includes acute encephalitic and pulmonary syndromes with a high mortality. The pathological features in human acute henipavirus infections comprise vasculopathy (vasculitis, endothelial multinucleated syncytia, thrombosis), microinfarcts and parenchymal cell infection in the central nervous system, lung, kidney and other major organs. Viral inclusions, antigens, nucleocapsids and RNA are readily demonstrated in blood vessel wall and numerous types of parenchymal cells. Relapsing henipavirus encephalitis is a rare complication reported in less than 10% of survivors of the acute infection and appears to be distinct from the acute encephalitic syndrome. Pathological evidence suggests viral recrudescence confined to the central nervous system as the cause.
    Matched MeSH terms: Myocardial Infarction/complications
  20. Tavintharan S, Ning Cheung, Su Chi Lim, Tay W, Shankar A, Shyong Tai E, et al.
    Diab Vasc Dis Res, 2009 Apr;6(2):80-6.
    PMID: 20368197 DOI: 10.1177/1479164109336043
    We describe the prevalence and risk factors for PAD in Asian Malays with diabetes. A population-based study of 3,280 (78.7% response) Malay persons aged 40-80 years in Singapore was conducted. ABI was measured in all participants with a history of diabetes (N=634). PAD was defined to be present if ABI
    Matched MeSH terms: Myocardial Infarction/complications
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