31st May 2024, A/Prof Chee L Khoo
It’s coming to almost 10 years now when suddenly, we were not able to prescribe testosterone replacement therapy (TRT) to men with hypogonadism or low testosterone levels under the PBS. This came on the back of a decision by the US FDA in March 2015 to restrict the prescription of TRT (1).…
31st May 2024, A/Prof Chee L Khoo
Renin-angiotensin system (RAS) inhibitors and SGLT2 inhibitors have been the cornerstone treatment of chronic kidney disease (CKD) for many years now. They have been shown to protect kidneys and at the same time reduce adverse cardiovascular outcomes. Finerenone was recently shown to do the same. These three agents are now the guideline-directed three pillars in the treatment of CKD.…
12th May 2024, A/Prof Chee L Khoo
We are used to using colchicine for acute treatment of gout but colchicine has also proven itself a key pharmacotherapy in the treatment of cardiovascular conditions such as pericardial disease (1), post-operative atrial fibrillation (2) and coronary artery disease (3). Colchicine disrupts the inflammatory response in acute gout but the inflammatory pathways that colchicine acts on are also found in other inflammatory diseases including coronary artery disease.…
27th April 2024, A/Prof Chee L Khoo
PAD is associated with a high incidence of future lower-limb amputations, physical disability, cardiovascular outcomes, other serious health outcomes, reduced quality of life, and mortality (3–8). Some GPs are lucky to have tool that can easily perform ankle brachial index (ABI) as part of a cardiovascular assessment. It is a very simple tool that can detect peripheral arterial disease (PAD).…
31st March 2024, A/Prof Chee L Khoo
In case you have not noticed, there was some disquiet in the cardiovascular community this week on the potential harm intermittent fasting can cause. The headline presentation says “8-hour time-restricted eating linked to a 91% higher risk of cardiovascular death”. Well, any study regarding “diets” are always going to be sus.…
28th March 2024, A/Prof Chee L Khoo
We all know that high LDL-C is absolutely and adversely associated with cardiovascular mortality and morbidity. It’s been “proven” again and again in large clinical trials and meta-analyses after meta-analyses. Reducing lipids levels have also been shown to reduce cardiovascular (CV) events in secondary as well as in primary prevention. This is particularly the case in those with intermediate to high CV risks.…
10th March 2024, A/Prof Chee L Khoo
Myocardial infarction in a patient with minimal coronary artery disease (stenosis <50%) is increasingly being recognised in patients with myocardial injury but no significant coronary obstruction is demonstrated. Myocardial Infarction in Non-Obstructive Coronary Arteries (MINOCA) accounts for approximately 5-10% of all myocardial infarction. The precise pathogenesis is poorly understood. Diagnosing MINOCA is not straightforward and identifying the aetiologies and ongoing management can be challenging.…
24th February 2024, A/Prof Chee L Khoo
We all know how important it is for BP control in prevention cardiovascular, cerebrovascular and renal complications. We are also aware of the difficulty is improving medication adherence. We have a broad range of effective BP lowering medications covering diverse classes of medications. Anti-hypertensives work only if our patients take them regularly.…
24th February 2024, A/Prof Chee L Khoo
In May 2022, the US Preventative Services Task Force (USPSTF) recommended that we avoid routine aspirin for primary prevention of CVD for anyone at all (1). In particular, for those between 40–59-year-old with a 10-year CVD risk 10%, the decision to initiate aspirin for the primary prevention should be an individual one as the evidence of the net benefit of aspirin use in this group is small.…
11th February 2024, A/Prof Chee L Khoo
Hypertriglyceridaemia (HTG) often accompanies hypercholesterolaemia but that is often ignored as it is considered to be a minor villain. Older clinical trials on lipid lowering agents excluded subjects with HTG and that is partly why the significance of HTG is often ignored. The interplay between HTG and atherosclerotic cardiovascular disease (ASCVD) is real but extremely complicated.…
13th January 2024, Conjoint A/Prof Chee L Khoo
Amiodarone started life as an anti-angina drug but it’s used primarily for its anti-arrhythmic properties these days. That’s not because it is such a good anti-arrhythmic agent (AAD) but because there just aren’t that many good and safe anti-arrhythmic agents around. We are all aware of amiodarone’s thyroid effects (hypo or hyper) and we monitor them closely as long as they are on amiodarone.…
13th January 2024, Conjoint A/Prof Chee L Khoo
When we think about extreme physical activity (EPA) such as marathon running, apart from the perceived issue of wearing out knee and hip joints (that’s another issue, another day), we think about the cardiovascular risks or benefits that comes with this intense physical activity. We explored the issue of marathon running and cardiovascular risks 9 months ago here.…