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).…
28th July 2025, A/Prof Chee L Khoo
We are all aware of the four pillars of treatment in the guideline directed medical treatment (GDMT) of patients with heart failure with reduced ejection fraction (HFrEF) – SGLT2 inhibitors (SGLT2i), angiotensin receptor neprilysin inhibitor (ARNI), beta blockers and mineralocorticoid receptor antagonist (MRA). When we come to heart failure with preserved ejection fraction (HRpEF), the pillar of treatment is rather lonely – SGLT2i only.…
11th June 2025, A/Prof Chee L Khoo
Atrial fibrillation (AF) is associated with 1.5 – 2-X risk of death (1,2), 2.4-X risk of stroke (2), 5-X risk of heart failure (HF) (2), 1.5-X risk of myocardial infarction (MI) (3), 2-X risk of sudden cardiac death (4), 1.6-X risk of chronic kidney disease (CKD) (2), 1.5-X risk of cognitive impairment or dementia (5) and 1.3-X risk of peripheral artery disease (PAD) (2).…
27th May 2025, A/Prof Chee L Khoo
Hypertriglyceridaemia (HTG) causes and contribute to a number of serious medical conditions including pancreatitis, cardiovascular disease, MAFLD and worsening of type 2 diabetes. The efficacy and treatment options are complicated. Apart from treating any secondary causes, our treatment options are quite limited. Marine-derive omega-3 fish oils, fenofibrate and the new icosapent ethyl are all we have in our tool kit.…
24th May 2025, A/Prof Chee L Khoo
One of the problems keeping up to date in primary care is not being aware of new guidelines that has been released. Well, the joint National Heart Foundation and Cardiac Society of ANZ released the new Australian clinical guideline for diagnosing and managing acute coronary syndromes (ACS) just a month ago (1).…
14th May 2025, NIA Diagnostic Imaging
Coronary artery calcium (CAC) scoring is a well-established, non-invasive imaging technique for assessing cardiovascular risk by identifying and quantifying calcified plaque in the coronary arteries. The CAC score, a direct marker of subclinical atherosclerosis, highly predicts future cardiovascular events, making it an essential tool for clinicians in assessing risk, even in asymptomatic individuals. (4, 5)
CAC scoring facilitates early identification of at-risk individuals by providing an objective assessment of coronary artery disease (CAD) burden, allowing for more targeted and proactive cardiovascular health care.…
27th April 2025, A/Prof Chee L Khoo
We recently looked at the LDL-C levels needed to stabilise plaque progression and the LDL-C levels needed to cause plaque regression. Plaque stabilisation and regression leads to reduction in cardiovascular events. Dyslipidaemia (especially LDL-C) is also associated with cognitive impairment and dementia and reducing those numbers with statin therapy reduces the risk.…
30th March 2025, A/Prof Chee L Khoo
While invasive coronary angiogram is still the gold standard in deciding whether revascularisation is indicated, invasive coronary angiogram has its limitations. That’s why intravascular ultrasound (IVUS) was invented. Well, it’s been 25-30 years since then and we have yet to have IVUS widely available for clinical use. We have additional miniaturised imaging techniques (see below later) since then and they are also not in clinical use as such.…
14th March 2025, A/Prof Chee L Khoo
First it’s good then it’s not. We explored the role of colchicine in reducing cardiovascular disease (CVD) back in May 2024 when we looked at the LoDoCo2 trial. At the time, it was hailed as a significant development and colchicine made it into a couple of cardiology guidelines shortly after. Well, a couple of trials later, they are not so sure anymore.…
10th February 2025, A/Prof Chee L Khoo
We perform cardiovascular (CV) risk assessments in our consulting rooms everyday. We assess lipid profiles, smoking history, family history and activity levels in our patients routinely and try to quantify the likelihood they may have a cardiovascular event. Over the years at GPVoice we have tried to expand beyond the traditional risk factors as more data come to hand.…
A/Prof Chee L Khoo, 23rd January 2025
We explored the benefits (or lack of) of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) back in early December 2024 when we look at the indications and criteria to initiate icosapent ethyl in patients with residual hypertriglyceridaemia for cardiovascular benefit. Now, omega-3 fatty acid (O3FA) supplements often contain a combination of EPA and DHA.…