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Research Articles

Research Articles













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31 Jul 2024

​Cardiocerebral infarction (CCI), which is naturally accompanying with acute myocardial infarction (AMI) and acute ischemic stroke (AIS), is a rare but severe presentation. However, there are few data on CCI, and the treatment options are uncertain. We investigated the characteristics and outcomes of CCI compared with AMI or AIS alone.

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10 Jul 2024

​Projecting a significant rise in cardiovascular disease (CVD) mortality in Asia by 2050, a multi-national study published in The Lancet by NUS Yong Loo Lin School of Medicine, with our NUHCS cardiologists and researchers in collaboration with important stakeholders across Asia, aims to reshape our understanding of the future CVD burden in Asia.

This first large-scale projection across Asia analysed data points, and highlighted the need for targeted and effective interventions. It also provides valuable insights into regional risk factors and health roadmaps, and emphasizes the promise of new treatments to improve overall metabolic health - offering hope for effective CVD prevention.

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01 Jul 2024

​Found to be associated with adverse cardiovascular events and an increased death risk, Ischaemia with No Obstructive Coronary Arteries (INOCA) - a medical condition where the heart does not get enough blood flow but with no obstruction in the coronary arteries - has been increasingly common in the Western population, but prevalence in the Asian population remain elusive and uncertain.

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15 Jun 2024

Published in Elsevier's IJC Heart and Vasculature Journal, a study led by a team of NUHCS cardiologists and NUS Yong Loo Lin School of Medicine doctors found Yeo's Index - a novel measure of the severity of rheumatic mitral stenosis (MS) conceptualised by A/Prof Yeo Tiong-Cheng, Senior Consultant, Dept of Cardiology, NUHCS - to be highly effective in identifying severe and very severe MS in patients with rheumatic MS, even when other heart valve issues are present.

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27 May 2024

​How can Artificial Intelligence (AI) help with Cardiovascular Disease (CVD) prevention?

A team of medical professionals, including our NUHCS team of cardiologists, leveraged data informatics capabilities at NUHS to create a real-time dashboard - CardioSight, to capture and showcase data on cardiovascular risk factors at both individual and geographical level, to better identify at-risk patients of CVD and mitigate their health risks.

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07 May 2024

​Despite being the recommended first-line of treatment for patients with Obstructive Sleep Apnea (OSA), Continuous Positive Airway Pressure (CPAP) still poses challenges for some patients. The Mandibular Advancement Device (MAD) has been proven to be an alternative treatment for patients with moderate-to-severe OSA and hypertension, in effectively reducing their blood pressure.

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30 Apr 2024

​Despite revascularisation - procedures to restore blood flow to your heart - and the use of Intra-Aortic Balloon Pumps (IABP), the mortality rate for heart attacks complicated by Cardiogenic Shock (CS) remains high.

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30 Apr 2024

Despite revascularisation - procedures to restore blood flow to your heart- and the use of Intra-Aortic Balloon Pumps (IABP), the mortality rate for heart attacks complicated by Cardiogenic Shock (CS) remains high.


Recognizing the need to identify mortality predictors and evaluate the effectiveness of advanced mechanical circulatory support devices, our NUHCS team of cardiologists conducted a retrospective study on patients who experienced AMI-CS and had an IABP implanted.

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24 Apr 2024

​Outcomes of patients in the Asia-Pacific region with Cardiogenic Shock (CS) following Acute Myocardial Infarction (AMI, or heart attack) remain unfavourable, with a high in-hospital death rate - raising the need for a unified but simple and practical approach in its management. Illuminating and clarifying decision-making protocols in the management of AMI-CS for clinical practitioners in the region is crucial in helping to unlock optimal and personalised patient outcomes in care delivery.

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08 Apr 2024

​Recent research by cardiology experts, including our NUHCS team of cardiologists offers hope for heart regeneration by studying how cardiac muscle cells, called cardiomyocytes, can revert to a less mature state, allowing them to potentially proliferate and thus repair the heart. This process, known as Cardiomyocyte Dedifferentiation (CMDD), involves a key gene named Asparagine Synthetase (Asns) which helps cardiomyocytes survive and multiply, which is essential for heart repair. These findings could lead to new treatments for heart disease by harnessing the power of CMDD.

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28 Feb 2024

​Cardiovascular Diseases (CVD) and Cancer stand as the two leading causes of morbidity and deaths worldwide. This report delves into the interplay of heart failure and cancer in women, emphasising that women with cancer often have additional health issues and existing cardiovascular risk factors, as supported by other multiple studies.

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23 Feb 2024

​Possibly the first systematic review of its kind investigating the connection between migraine and Atrial Fibrillation (AF) in the general population, the findings result from a cross-disciplinary team effort from NUHCS, NUS Medicine, Monash University and Royal Free London NHS Foundation Trust, are presented in a review article published by the Singapore Medical Journal.

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01 Feb 2024

​With ischaemic heart disease and cerebrovascular diseases being the cause of nearly a quarter of all deaths in Singapore in 2021, and not knowing the most effective treatment post-heart attack, it calls for a pressing need to investigate the complex interplay of cardiovascular and neurological diseases. An interdisciplinary team, StroCar, was formed to take on a multidisciplinary approach to analyse the mysteries of cardiocerebral diseases and its impact on heart-brain interactions to alter the trajectory of these diseases.

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27 Jan 2024

​Highlighted in a recent research article published on Springer Publishing, a multidisciplinary team - featuring Dr Sia Ching Hui, NUHCS, with orthopaedic experts from NUHS and specialists from NUS Medicine - revealed Diabetic Foot Ulcers (DFU) as a potential marker for cardiovascular complications in diabetic patients.

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01 Jan 2024

​Unilateral vs Bilateral Femoral Cannulation - in Peripheral Venoarterial ECMO - which reduces limb ischemia risk?

Adj Prof Graeme MacLaren, Head of Division of Cardiothoracic ICU (CTICU) & Senior Consultant, Department of Cardiac, Thoracic & Vascular Surgery (CTVS), NUHCS, and Adj A/Prof K.R. Ramanathan, Senior Consultant, Dept. of CTVS, NUHCS, share results from a retrospective cohort study based on the Extracorporeal Life Support Registry that bilateral cannulation is revealed to produce better outcomes.

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31 Dec 2023

​A review led by NUHCS' team of cardiologists looked into the evaluation of cardioemobolic stroke - a type of stroke thought to be caused by heart disease, which accounts for approximately 1 in 4 stroke cases.

This paper highlights the crucial role of diagnosis through tailored multimodal heart imaging methods in accurately identifying causes, to prevent cardioembolic stroke incidences amd recurrences.

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22 Nov 2023

​A Platform for Interdisciplinary study of Cardiovascular, Metabolic and Neurovascular diseases (PICMAN) project was conducted to explore metabolic inflexibility, where the body is unable to effectively switch between different energy sources for fuel, and microbial mechanisms linked to diabetes - all in a bid to mitigate risk of Cardiovascular Disease (CVD) in the population.

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06 Nov 2023

​Am I at a higher risk of Cardiovascular Disease (CVD) if I take calcium supplements?

Calcium supplementation was thought to pose an increased risk and previous meta-analysis based on data from randomised controlled trials (RCTs) and observational studies have contradictory findings.

However, a recent meta-analysis of 12 RCTs done by our team of NUHCS cardiologists and NUHS doctors has yielded interesting findings.

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29 Sep 2023

​What is the Smoker's Paradox?

The term "Smoker's Paradox" points to the puzzling observation in some studies that individuals who smoke and experience ST-segment elevation myocardial infarction (STEMI), treated with primary percutaneous coronary intervention (PCI), tend to exhibit improved survival rates and results, even though smoking is well-known to be a cause of cardiovascular disease (CVD) and a significant risk factor for STEMI.

Challenging this notion, Dr Sia Ching Hui, Consultant, Dept. of Cardiology, NUHCS, was part of a team of three to discuss the evidence behind the Smoker's Paradox. Smoking is still associated with worse patient outcomes, therefore smoking cessation is still one of the most effective ways to reduce cardiovascular risk and improve overall health.

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07 Sep 2023

​Mitral Stenosis (MS), a valvular heart disease caused by the narrowing of the mitral valve, can lead to life-threatening complications if not detected early.

A step forward in navigating the challenges and complexities of MS assessment, Yeo's Index - a simple, novel approach conceptualised by A/Prof Yeo Tiong Cheng, Senior Consultant, Dept. of Cardiology, NUHCS, has demonstrated robust performance in terms of diagnostic accuracy and reliability over traditional methods, according to a recent study.

Adding significant value to evaluations, Yeo's Index is unaffected by the presence of Atrial Fibrillation (AF), thus equipping cardiologists with greater confidence in clinical diagnosis and decision-making for prompt intervention of the condition, while providing an improved means for the evaluation of MS severity.

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06 Sep 2023

​A team of NUS Medicine researchers, with NUHCS and other collaborating institutions, coalesced for this umbrella review of systematic reviews and meta-analyses studies, where results show females with T2DM do indeed have a higher risk of negative cardiovascular issues than their male counterparts, and a higher risk of death,

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01 Sep 2023

​Recognised as the Singapore Medical Journal's Top Cited Paper published in 2023!

The review of 42 studies on cardiac side effects linked with different types of mRNA COVID-19, concluded that COVID-19 vaccine remains of overall benefit, while emphasising the need for continued observation of adverse reactions in booster doses.

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28 Jul 2023

​Are there any gender-related differences in the symptoms and outcomes of Asian patients with Hypertrophic Cardiomyopathy (HCM)?

Research by a tram of cardiologists at NUHCS, published in the current issue of Annals of Academy of Medicine, Singapore, provided insights into how the lack of typical symptoms in women with HCM often led to a delay in diagnosis, as well as other vital differences in female vs. male patients - with key recommendations towards improving outcomes in the understudied Asian population.

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01 Jul 2023

​Time is crucial in treating heart attacks and Percutaneous Coronary Intervention (PCI) is a minimally invasive procedure vital for the treatment of cardiac arrests. However, it may pose health risks for seniors aged 80 and above.

In a comprehensive analysis, NUHCS research team reviewed data from 132 articles across 33 regions. Despite heightened risks, evidence supports the necessity of PCI for treating unstable coronary artery diseases (CAD).

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31 May 2023

​The number of heart attacks (Acute Myocardial Infarction) in Singapore is projected to rise by three times by the year 2050, according to a joint study led by Dr Nicolas Chew, Senior Resident, Dept. of Cardiology, NUHCS, from the Cardiovascular-Metabolic Disease Translational Research Programme (CVMD TRP) at NUS Yong Loo Lin School of Medicine.

Obesity is set to the be the leading risk factor for hear attacks in three decades.

Listen to this CNA interview to find out more: Daily Cuts - Obesity-related heart attacks - CNA (channelnewsasia.com)

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22 May 2023

​This study dived into the transformative potential of Extracorporeal Cardiopulmonary Resuscitation (E-CPR) versus Conventional Cardiopulmonary Resuscitation (C-CPR), which showcased a significant reduction in in-hospital mortality, with a particular emphasis on its effectiveness in patients with in-hospital cardiac arrests.

These profound insights emphasise the paramount importance of prepared prehospital ECMO programs and infrastructure for rapid referrals, in order to enhance patient outcomes.

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31 Mar 2023

​Amid the rising prevalence of hypertension and obesity, there is an increasing spotlight on understanding the underlying mechanisms in play, to improve strategies and treatment for those affected. Published by The Obesity Society's official journal, the study sheds light on the aggravated mortality effects of hypertension among obese individuals in the US - highlighting the need for co-management of these deadly twins through better hypertension control and weight loss advocacy in healthcare, to improve the lives of those affected.

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02 Mar 2023

​Exercise-Based Cardiac Rehabilitation (EBCR) has proven to have a multitude of physiological benefits as a treatement modality for patients with heat failure, yet its uptake remains a challenge.

Diving into the "whys" and "hows" behind, NUHCS' team of cardiologists has co-written a timely research piece that distils strategies to overcome barriers in advancing EBCR and suggest innovative delivery methods - all while looking at future trends in this dynamic field.

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25 Jan 2023

​The limited knowledge in managing the rare but lethal Secondary Aorto-Enteric Fistula (SAEF) - a complication that arises after abdominal aortic surgery - has resulted in medical professionals switching to new minimally invasive treatment options, instead of the traditional surgical approach which still has high fatality rates post-surgery.

This article delves into the techniques, considerations and outcomes of a minimally invasive approach performed on a 68-year-old patient with severe internal bleeding.

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2024/08/30