3rd January 2026, A/Prof Chee L Khoo
Women, in general, have a lower cardiovascular (CV) risk because of the “protection” from the oestrogen exposure from puberty onwards. Of course, that “protection” ends when a woman becomes menopausal and indeed, the prevalence of CV events very quickly approaches those of men within a few years. One of the most difficult decisions to make is when to treat elevated lipids in women.…
28th December 2025, A/Prof Chee L Khoo
We discussed the Lancet Commission’s clinical obesity 12 months ago. Clinical obesity is obesity in the presence of a clinical disease (whether complication or co-morbidity). This is why the PBS is funding semaglutide for patients with obesity and established cardiovascular (CV) disease and not obesity on its own. There are many other “diseases” associated with obesity which will be funded by the PBS in the very near future.…
25th December, 2025, A/Prof Chee L Khoo
With increasing prevalence of obesity, type 2 diabetes, hypertension and obstructive sleep apnoea, we are encountering increasing prevalence of atrial fibrillation in our practice. These are the common risk factors which we associate with a higher risk of developing AF. Surprisingly, there is one group which stands out different from the expected groups listed above.…
11th November, A/Prof Chee L Khoo
Don’t we all hate the onerous restrictions on the PBS Authority criteria to qualify for the PCSK9 therapy. The efficacy of the agents (evolocumab, alirolocumab and inclisran) is well proven in clinical trials (1-3). Only the -mabs have been shown to have cardiovascular (CV) benefits. CV outcomes is yet to be established with inclisiran.…
31st October 2025, A/Prof Chee L Khoo
We have covered the issue of lipoprotein (a) on a number of occasions in the past. We highlighted how the additional atherosclerotic harm in patients with elevated levels. Although lipoprotein (a) lowering agents are yet to hit the market, it is still important to check the levels at least once in all patients as the results may influence your LDL-C targets as well as prompt further cardiovascular investigations.…
31st October 2025, A/Prof Chee L Khoo
The role of aspirin is well established in secondary prevention of cardiovascular events. However, it’s coming up to 10 years since international guidelines specifically recommend against aspirin in primary prevention of CV events (1-3). There have been a number of landmark studies looking at the risk and benefits of aspirin in primary prevention.…
11th October 2025, A/Prof Chee L Khoo
Weekly semaglutide injectable has been around for some years now. Even with my special interest in diabetes and obesity, I am getting confused with all the clinical trials involving semaglutide in patients with obesity with or without diabetes. They all have very innovative acronyms most of them starting with “S” which makes them hard to keep track of.…
29th September 2025, A/Prof Chee L Khoo
I must admit that I have been doing this for many years on an ad hoc basis. I have been screening for helicobacter pylori (HP) infection in patients who need to be on aspirin (primary or secondary prevention of coronary artery disease). This isn’t what is recommended in any cardiovascular (CV) disease guidelines until recently but the evidence is not robust.…
29th September 2025, A/Prof Chee L Khoo
Digitalis is one of the oldest drugs in cardiovascular (CV) medicine and has generally been used in patients with heart failure (HF) and in those with atrial fibrillation (AF) or in both (1,2). In fact, up until 25 years ago, digitalis in the form of digoxin was used in around two thirds of patients with moderate to severe heart failure.…
6th September 2025, A/Prof Chee L Khoo
We all have patients at risk of thromboembolism (mainly from atrial fibrillation risks) and atherosclerotic cardiovascular disease (primarily, coronary artery disease). They may require both anti-coagulant as well as anti-platelet therapy. Sometimes, we don’t have a choice as they have high risks for both. Theoretically, they at high bleeding risks. Yet, our cardiology colleagues have to make that difficult decision to continue both.…
13th August 2025, A/Prof Chee L Khoo
We know the ongoing cost and availability of anti-obesity medications (AOM) the likes of Wegovy and Mounjaro although we have been assured that the supply issue is behind us now. Part of the problem with cost relate to the manufacturing cost of the devices. In fact, the rate limiting step to the production is the pen, which needs to be precisely manufactured and tested as it is a medical device.…
28th July 2025, A/Prof Chee L Khoo
We have explored the association between intensive endurance athletes and cardiovascular events in the past. Data on the dose–response relationship between long-term intensive endurance exercise and coronary heart disease has been rather conflicting over the years. While early studies suggest that regular endurance athletes have lower ischaemic heart disease (1), later studies reported an increased prevalence of coronary atherosclerotic plaques amongst highly trained athletes in comparison to healthy non-athletes (2–4).…