Publications by authors named "Nicholas Ws Chew"

Patients with liver fibrosis and type 2 diabetes mellitus (T2DM) have an increased risk of cardiovascular events. However, long-term prognosis of liver fibrosis and T2DM after acute myocardial infarction (AMI) remain to be investigated. This study compared clinical characteristics and prognosis of AMI patients with T2DM and evidence of liver fibrosis.

View Article and Find Full Text PDF

Background: The Pooled Cohort Equations (PCE) were created in 2013 to assess ASCVD risk in primary prevention. In 2023 the American Heart Association published the PREVENT equations to assess the risk of cardiovascular disease in primary prevention. The comparative performance of PCE and PREVENT for predicting 10-year ASCVD risk has not been evaluated in an external large-scale epidemiologic cohort.

View Article and Find Full Text PDF

Aims: This study aimed to assess how diabetes influences the quality of care and longer-term outcomes in contemporary STEMI cohorts.

Methods: We analysed 283,658 adults hospitalised with STEMI from the United Kingdom Myocardial Ischaemia National Audit Project (MINAP) registry between 2005 and 2019. This was linked with Office of National Statistics data to provide out of hospital mortality outcomes.

View Article and Find Full Text PDF

Purpose: Coronary CT angiography (CCTA) is well established for the diagnostic evaluation and prognostication of coronary artery disease (CAD). The growing burden of CAD in Asia and the emergence of novel CT-based risk markers highlight the need for an automated platform that integrates patient data with CCTA findings to provide tailored, accurate cardiovascular risk assessments. This study aims to develop an artificial intelligence (AI)-driven platform for CAD assessment using CCTA in Singapore's multiethnic population.

View Article and Find Full Text PDF

Background & Aims: Though probiotics, prebiotics and synbiotics have been shown to confer health benefits, their effects on cardiometabolic risk factors remain unclear. Therefore, we conducted an umbrella review to examine their effectiveness on anthropometric, cardiometabolic and inflammatory markers.

Methods: We conducted an umbrella review on eligible systematic reviews with meta-analysis (SRMA) published from journals' inception till 13 January 2023 retrieved from seven electronic databases (CINAHL, EMBASE, ProQuest, PubMed, Scopus, The Cochrane Library, and Web of Science).

View Article and Find Full Text PDF

Background: A plethora of weight management apps are available, but many individuals, especially those living with overweight and obesity, still struggle to achieve adequate weight loss. An emerging area in weight management is the support for one's self-regulation over momentary eating impulses.

Objective: This study aims to examine the feasibility and effectiveness of a novel artificial intelligence-assisted weight management app in improving eating behaviors in a Southeast Asian cohort.

View Article and Find Full Text PDF

Background: During the covid-19 pandemic there was a marked rise in the number of cardiovascular deaths. Obesity is a well-known modifiable risk factor for cardiovascular disease and has been identified as a factor which leads to poorer covid-19 related outcomes. In this study we aimed to analyse the impact of covid-19 on obesity-related cardiovascular deaths compared to trends seen 20 years prior.

View Article and Find Full Text PDF
Article Synopsis
  • - The study analyzed cardiovascular mortality trends from 1999 to 2019 in cancer patients vs non-cancer patients in the US, identifying that a significant portion of cardiovascular deaths occurred in those with a history of cancer (572,222 out of 17.9 million).
  • - Cardiovascular age-adjusted mortality rates decreased more in cancer patients (-51.6%) compared to non-cancer patients (-38.3%), with the most significant reductions seen in colorectal, prostate, and breast cancers.
  • - While many social disparities in mortality rates lessened over time, urban-rural inequalities increased, particularly among cancer patients, highlighting the need for healthcare reforms to address these disparities in access to cardio-oncology services.
View Article and Find Full Text PDF

Objectives: In critically ill patients with COVID-19, distinct hyperinflammatory and hypoinflammatory phenotypes have been described, with different outcomes and responses to therapy. We investigated if similar phenotypes exist in non-severe illness.

Methods: Consecutive patients with polymerase chain reaction (PCR) confirmed SARS-CoV-2 were examined.

View Article and Find Full Text PDF

Background And Aims: Fatty liver is the commonest liver condition globally and traditionally associated with NAFLD. A consensus meeting was held in Chicago to explore various terminologies. Herein, we explore the proposed changes in nomenclature in a population data set from the US.

View Article and Find Full Text PDF

Objectives: In the early months of the COVID-19 pandemic in Singapore, the vast majority of infected persons were migrant workers living in dormitories who had few medical comorbidities. In 2021, with the Delta and Omicron waves, this shifted to the more vulnerable, elderly population within the local community. We examined evolving trends among the hospitalised cases of COVID-19.

View Article and Find Full Text PDF

Background: There is a growing number of trials examining the effectiveness of pharmacotherapies for obesity, however, little is known about placebo and nocebo effect in these trials. Hence, we sought to examine the effect of placebo in obesity trials, to better understand the potential factors affecting clinical endpoints in them.

Methods: Medline, Embase, and Cochrane CENTRAL were searched for articles examining weight-loss RCTs examining patients with overweight or obesity in placebo-controlled arms from inception till 25 June 2022.

View Article and Find Full Text PDF
Article Synopsis
  • Type 2 Diabetes Mellitus (T2DM) often coexists with fatty liver disease, and a shift from using the term non-alcoholic fatty liver disease (NAFLD) to metabolic associated fatty liver disease (MAFLD) raises concerns about diagnosis accuracy.
  • A study analyzing data from the NHANES survey found that the new MAFLD definition increased fatty liver diagnoses by nearly 69%, revealing significant health risks associated specifically with the MAFLD(+)/NAFLD(-) group.
  • The premature adoption of MAFLD as a definition leads to over-diagnosis and worsens patient outcomes, highlighting the need for careful consideration in diagnosing and treating fatty liver in T2DM patients.
View Article and Find Full Text PDF

Introduction: The obesity paradox, where obesity is associated with improved survival, has been described in patients undergoing haemodialysis and in those with heart failure. It was also demonstrated in patients undergoing valve replacement for aortic stenosis (AS). We explored this phenomenon in medically managed severe AS.

View Article and Find Full Text PDF

Background: Nonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disease. NAFLD is associated with dyslipidemia, and cardiovascular mortality remains the leading cause of death. While statins are the first-line therapy in hyperlipidemia, their utilization has been suboptimal.

View Article and Find Full Text PDF

Background & Aims: Cardiovascular disease contributes to a high rate of morbidity and mortality after liver transplantation (LT). However, the progression of cardiac function and cardiac remodeling in LT recipients remains poorly understood. This study sought to evaluate the progression of cardiac function and structure in LT recipients and identify independent predictors of prognosis using echocardiography.

View Article and Find Full Text PDF

Despite the elucidation of the pathways behind the development of aortic stenosis (AS), there remains no effective medical treatment to slow or reverse its progress. Instead, the gold standard of care in severe or symptomatic AS is replacement of the aortic valve. Oxidative stress is implicated, both directly as well as indirectly, in lipid infiltration, inflammation and fibro-calcification, all of which are key processes underlying the pathophysiology of degenerative AS.

View Article and Find Full Text PDF

Background/aims: Nonalcoholic fatty liver disease (NAFLD) is closely associated with diabetes. The cumulative impact of both diseases synergistically increases risk of adverse events. However, present population analysis is predominantly conducted with reference to non-NAFLD individuals and has not yet examined the impact of prediabetes.

View Article and Find Full Text PDF

Ischemic heart disease (IHD) is the leading cause of disability and mortality worldwide. Reactive oxygen species (ROS) have been shown to play key roles in the progression of diabetes, hypertension, and hypercholesterolemia, which are independent risk factors that lead to atherosclerosis and the development of IHD. Engineered biomaterial-based nanomedicines are under extensive investigation and exploration, serving as smart and multifunctional nanocarriers for synergistic therapeutic effect.

View Article and Find Full Text PDF

Background/aims: Non-alcoholic fatty liver disease (NAFLD) is associated with the development of cardiovascular disease. While existing studies have examined cardiac remodeling in NAFLD, there has been less emphasis on the development of carotid atherosclerosis and stroke. We sought to conduct a meta-analysis to quantify the prevalence, risk factors, and degree of risk increment of carotid atherosclerosis and stroke in NAFLD.

View Article and Find Full Text PDF

Current guidelines on the management of patients with aortic valvular disease have widened the use of transcatheter aortic valve implantation (TAVI) with an emphasis on avoidance of prosthesis-patient mismatch (PPM). This study sought to examine the incidence, risk factors, and all-cause mortality of PPM after TAVI. Medline and Embase databases were searched from inception to August 10, 2021.

View Article and Find Full Text PDF