EMBARGOED TILL TUESDAY, 3 AUGUST 04, 2PM

Transcription

1 Media Invite EMBARGOED TILL TUESDAY, 3 AUGUST 04, 2PM 27 July 2004 Dear Editors, 1 ST SINGAPORE INTERNATIONAL CARDIOVASCULAR THERAPEUTICS CONFERENCE The Heart Institute, National Healthcare Group (NHG) together with hospitals from China, India and United States of America are organising the 1 st Singapore International Cardiovascular Therapeutics (SICT) Conference from Thursday, 5 August 2004 Saturday, 7 August 2004 at the Suntec City Convention Centre. Dr Balaji Sadasivan, Minister of State for Health and Environment, is the Guest-of- Honour for the official opening of the conference at Suntec City. The National University Hospital (NUH) and a total of five overseas hospitals from China, India, United States of America will be transmitting live demonstration of Percutaneous Coronary Intervention (PCI) procedures to Suntec City, where the conference is being held; to showcase basic and advanced techniques in interventional cardiology. HEART DISEASES Coronary heart disease, which affects males and females above 55 and 65 years respectively, was the second principal cause of death in Singapore in The coronary arteries supply blood to the heart muscles. When the coronary arteries are narrowed, usually by a process known as atherosclerosis (the hardening and thickening of the artery walls), the heart s blood supply may become insufficient, especially during periods of physical exertion or stress. Atherosclerosis, a global disease and the main cause of heart disease, affects both the heart and vessels in the body. As atherosclerosis is a progressive degenerative disease, the incidence rate of coronary artery disease is certain to increase with the ageing population in Singapore. INCREASE IN NUMBER OF PATIENTS WHO UNDERWENT PERCUTANEOUS CORONARY INTERVENTION PROCEDURES Coronary artery narrowings may be treated using medications that reduce the heart's demand for blood, or by procedures aimed at increasing the heart's blood supply. The two most common methods to increase blood supply are coronary artery bypass surgery and PCI (ballooning and stenting). In Singapore, the number of patients who underwent PCI procedures in 1999 increased from 2450 to 3225 in Page 1 of 9

2 HIGHLIGHTS OF THE 1 ST SINGAPORE INTERNATIONAL CARDIOVASCULAR THERAPEUTICS CONFERENCE Several new advancements in interventional cardiology will be showcased at the congress New endothelial progenitor cell antibody coated stent to be implanted in NUH patient for the first time in Asia This new stent is unlike the currently available drug-eluting stents coated with anticancer drug to reduce the risk of cell multiplication in the vessel wall (the fundamental mechanism for renarrowing of the coronary arteries). During balloon and stenting procedures, there is obligatory injury to the inner lining of the vessel wall. This will provoke a healing and reparative process, which is characterized by multiplication of smooth muscle cells in the vessel wall. Most of the healing is controlled and non-excessive. However, in 20% to 30% of patients, excessive multiplication of smooth muscle cells can lead to renarrowing of the inner diameter of the vessel, causing lack of blood flow. This new stent is coated with antibody to endothelial progenitor cell (EPC), a type of stem cell that is released by the bone marrow in response to the vessel wall. By having antibody coated to the stent, circulating EPCs in the blood are rapidly captured onto the stent surface and provide a natural lining of endothelium to the injured segment. The advantage of the newly formed endothelial cells are that they provide an immediate protective cover to the vessel lining and at the same time reduce the rate of smooth muscle cell multiplication, hence reduce rate of restenosis (recurrent blockage of blood vessel necessitating readmission or repeat procedure). The healing process is hence a biological and natural process without the use of drugs. New Bifurcating Stent to be implanted in NUH patient for the first time in Asia One of the challenges of PCI is the treatment of narrowings that occur at the branching site of vessels. The risk has been that stenting of the main artery may result in closure or narrowing of the side branches because of shifting of fatty deposits into the branches. Hence, there is a need for dedicated stent specifically designed to treat this type of disease. The new bifurcating stent is designed to ensure the patency of the side branch vessel while treating disease in the main vessel. It also allows for easy stent delivery into the side branches should the need arises for treating these branched diseases. Percutaneous Coronary Intervention in Post-Coronary Artery Bypass Surgery Patients Post-Coronary Artery Bypass Surgery patients commonly have failure or renarrowing of the saphenous vein grafts approximately 10 years after the operation. A repeat surgical operation is generally not advisable because of the high risk of mortality associated with it. PCI is the preferred option and has been very effective in treating this unique condition. The major challenge facing interventional cardiologists has been that plaques that are found within the saphenous vein grafts are more likely to be dislodged and trapped in distal small vessels during the procedure (15%) compared to normal coronary arteries that Page 2 of 9

3 are diseased. The blockage of the small downstream vessels results in heart attacks and sometimes death in these patients. Modern PCI employs the use of covered stent, a stent covered with a membrane made of polytetrafluoroethylene (PTFE) material, together with distal protection devices, which render the procedure safe and frequently successful. Newer technology of proximal protection device, where the artery is completely blocked up before the narrowing and all dislodged materials are sucked out before blockage of the artery blood vessel, has also been developed and will be showcased. Percutaneous Coronary Intervention in Acute Myocardial Infarction ( Heart Attack ) Another area, which has undergone tremendous changes, is the treatment of patients with heart attacks. PCI is an effective treatment in the treatment of these patients and is a routine service at NUH. Heart attack is caused by the formation of blood clot on top of an atheromatous plaque (cholesterol and fatty deposits) in the coronary artery. The conventional strategy has been the implantation of a stent across the narrowing. However, studies have shown that the thrombus that is formed may be dislodged and can plug the distal small capillaries causing impaired flow and unsuccessful outcomes. Various mechanical strategies, primarily two treatment approaches adopted at NUH, have been used to reduce this complication. They are the use of (1) thrombectomy device to suck out the thrombus and (2) distal protection devices to act as a protective barrier beyond the narrowing to prevent thrombus from going downstream. Results and experience of these 2 approaches will be discussed at the conference. Drug Eluting Stents in Complex Disease (Chronic Total Occlusion, Restenosis). Early studies of drug-eluting stents, which has been viewed as breakthrough transformational technology, has been largely limited to short- and medium-length disease (<20mm) in medium-sized to large arteries (>2.5mm diameter). More and more studies have been done which showed that drug-eluting stents are equally effective in complicated situations such as completely occluded vessel (called chronic total occlusion), in-stent restenosis (where patient has renarrowing in a previously stented segment, small vessels (<2.5mm in diameter) and long narrowing (>20mm in length). There have been no early reports of untoward adverse effects associated with the use of drug-eluting stents. The longest follow-up now of this new technology is 4 years. In situations where the likelihood of renarrowing after stent implantation is high, the use of drug-eluting stent is both warranted and cost-effective. Page 3 of 9

4 THE NATIONAL HEALTHCARE GROUP The National Healthcare Group (NHG) manages: Four hospitals - Alexandra Hospital, National University Hospital, Tan Tock Seng Hospital and the Institute of Mental Health/Woodbridge Hospital; The Johns Hopkins-NUH International Medical Centre; two National Centres - National Neuroscience Institute and National Skin Centre; The NHGP chain of nine polyclinics - Ang Mo Kio, Bukit Batok. Choa Chu Kang, Clementi, Hougang, Jurong, Toa Payoh, Woodlands, Yishun; Three specialty institutes - The Cancer Institute, The Eye Institute and The Heart Institute; and Four Business Divisions - NHG College, NHG Diagnostics, NHG Gulf, NHG Pharmacy and NetCare Internet Service. Our vision is "Adding years of healthy life to the people of Singapore. THE HEART INSTITUTE, NATIONAL HEALTHCARE GROUP The Heart Institute, National Healthcare Group (THI, NHG) provides cardiac services in NHG institutions like NUH, TTSH and AH. It brings together the combined resources, expertise and capabilities in the area of cardiology, cardiothoracic and vascular surgery of the whole NHG cluster to better meet the needs of the growing number of patients with heart diseases. The cardiac units within the NHG group of hospitals also work closely with NHG Polyclinics and General Practitioners Members of NHG Partners to ensure seamless and quality care for patients with heart problems. This is co-ordinated with undergraduate and postgraduate teaching, training of specialised groups involved in the care of patients, combined with high level research to seek state of the art treatment. Page 4 of 9

5 Singapore International Cardiovascular Therapeutics Annex A 5-7 August 2004 PROGRAMME DAY 1 5 th August 2004 (Thursday) 0700 hrs Registration 0800 hrs Opening Ceremony Speech by Course Director Speech by Guest of Honour Lim Yean Teng Dr Balaji Sadasivan 0830 hrs Debate: Drug-Eluting Stents Should Be Globally Employed in PCI Protagonist: Carlo Di Mario Antagonist: James Tcheng 0900hrs 0920 hrs Session 1: Bifurcation Stenting Current Technique of Bifurcation Carlo Di Mario Stenting Transmission from NUH Chairman: Lim Yean Teng Moderators: Lim Yean Leng Carlo Di Mario, Nguyen Thach, Gao Run Lin, James Tcheng, Kazuaki Mitsudo, Kao Hsien Li Case 1: Bifurcation Stenting Operator 1: Tan Huay Cheem Operator 2: Ronald Lee Case 2: Bifurcation Stenting Operator 1: Robaayah Zambahari Operator 2: Antono Sutandar Session 2: Trans-radial Intervention 1100 hrs Transmission from NUH Chairman: Peter Yan Moderators: Chang Heng Chia, Duncan Ho Hung Kwong, Chen Ji Yan, Tan Kim Heung, Greg Barsness, Fang Wei Yi, Damras Tresukosol Case 3: Transradial Intervention cases Operator 1: Masahiko Ochiai Operator 2: Bayu Arif Permana Case 4: Transradial PCI Operator 1: Toshiya Muramatsu Operator 2: Patrick Ang Lunchtime Programme 1230 hrs Interactive Sessions: PCI Complications and Management Case I : No-reflow Case II : Perforation Case III: Device Embolization Case IV: Others Chairpersons: Richard Ng/ Kao Hsien Li Atul Mathur Rosli Mohd Ali Duncan Ho Sunao Nakamura 1230 hrs Lunchtime Symposium Sponsored by Biosensors Page 5 of 9

6 Session 3: Distal Embolic Protection 1400 hrs Transmission from Escort Heart Institute, India Case A: AngioGuard in SVG PCI Case B: Proximal Occluder in SVG PCI 1500 hrs Lecture: Stem cell for Cardiovascular Disease. A Current Status Report 1515 hrs Transmission from Nanjing First People s Hospital, China Case C: Post MI intracoronary injection of stem cells Case D: Complex PCI Chairman: Tan Huay Cheem Moderators: Lim Yean Leng, Ross Prpic, Philip Koh, Nguyen Thach, Kenneth Chin, Chen Wai Hong, Patrick Ang Ashok Seth, Praveen Chandra Nguyen Thach Session 4: Atherectomy in the Era of DES Chairman: Tan Huay Cheem Moderators: Lim Yean Leng, Ross Prpic, Philip Koh, Nguyen Thach, Kenneth Chin, Chen Wai Hong, Patrick Ang Chen Shao Liang, Tejal Patel 1615hrs Transmission from NUH Chairman: Lim Yean Leng Moderators: Sunao Nakamura, Toshiya Muramatsu, James Tcheng, Sim Kui Hian, Rosli Mohd Ali, Teguh Santoso, Atul Abhyankar 1630hrs Case 5: Rotational Atherectomy Operator 1: Carlo Di Mario Operator 2: Duncan Ho Hung Kwong Case 6: Directional Atherectomy Operator 1: Hideo Tamai Operator 2: Chen Wai Hong 1730hrs 1900hrs Evening Symposia Evening Symposium Evening Symposium The End Sponsored by Neich Medical (S) Pte Ltd Sponsored by Cordis Page 6 of 9

7 Singapore International Cardiovascular Therapeutics 5-7 August 2004 PROGRAMME DAY 2 6 th August 2004 (Friday) 0700 hrs Breakfast Symposium 0800 hrs Lecture: Percutaneous Coronary Alan Yeung Intervention 2004 and Beyond Session 5: Interventional Strategies in Acute Myocardial Infarction/ Chronic Total Occlusion 0815hrs Transmission from NUH Chairman: Tan Huay Cheem Moderators: Rajiv Agarwal, Nguyen Quang Tuan, Vinod Sharma, Ashok Seth, Melvin Tan, Nguyen Thach, In-Ho Chae Case 7: Carotid/Renal Intervention Case 8: Distal Protection/CTO Case 9: Chronic Total Occlusion Operator 1: Kao Hsien Li Operator 2: Rosli Mohd Ali Operator 1: Sunao Nakamura Operator 2: Tan Kim Heung Operator 1: Kazuaki Mitsudo Operator 2: Chen Ji Yan Session 6: Intravascular Ultrasound/ Pressure Wire 1015hrs FFR vs IVUS guided PCI: Alan Yeung Complementing or Competing Transmission from Shanghai ZhongShan Hospital, China Chairman: Lim Yean Leng Moderators: Praveen Chandra, Muhammad Munawar, Park Seung Jeung, Jayaram L, Kao Hsien Li, Tejal Patel, Toshiya Muramatsu 1030 hrs Case E: IVUS-guided PCI (in-stent Ge Jun Bo restenosis) Case F: IVUS-guided complex PCI 1130 hrs Transmission from NUH Chairman: Lim Yean Leng Moderators: Praveen Chandra, Muhammad Munawar, Park Seung Jeung, Jayaram L, Kao Hsien Li, Tejal Patel, Toshiya Muramatsu Case 10: FFR-guided PCI Operator 1: Lim Yean Teng Operator 2: Tan Ning Case 11: IVUS-guided PCI Operator 1: Alan Yeung Operator 2: Greg Barsness/ Henry Chan Page 7 of 9

8 Lunchtime Interactive Sessions: Complex PCI 1230 hrs Interactive Sessions: Complex PCI Case I: Left Main Stenting Case II: Ostial Lesion Stenting Case III: Bifurcation Stenting Case IV: SVG Stenting Chairperson: Philip Koh/ Praveen Chandra Park Seung Jeung Rajiv Agarwal Chang Heng Chia Praveen Chandra 1230 hrs Lunchtime Symposium Sponsored by Boston Session 7: PCI in Diabetic Patients 1400 hrs PCI in diabetics: Asian Perspective Tan Huay Cheem 1420 hrs Transmission from Jaslok Hospital, India Chairman: Richard Ng Moderators: Subabratta Dutta, Atul Mathur, Peter Yan, Chen Ji Yan, Hideo Tamai, Suman Bhandari, Tan Kok Soon, Michael Kutryk Case G: Complex PCI in Diabetics Ashwin Mehta Case H: Complex PCI in Diabetics Session 8: Breakthrough Technology 1520 hrs Beyond DES: New endothelial progenitor cell antibody coated stent Michael Kutryk 1535 hrs Transmission from NUH Chairman: Richard Ng Moderators: Chen Wai Hong, Atul Mathur, Peter Yan, Chen Ji Yan, Hideo Tamai, Suman Bhandari, Tan Kok Soon, Michael Kutryk Case 12: New endothelial progenitor cell antibody coated stent Case 13: Cypher Select Case 14: Spider Device Stent/ Velocimed Case 15: Biolimus 1700 hrs End of Day hrs Gala Evening Operator 1: Tan Huay Cheem Operator 2: James Tcheng/Ma Ying Yan Operator 1: Park Seung Jeung Operator 2: Melvin Tan Operator 1: Lim Yean Teng Operator 2: Bambang Budiono/Li Lang Operator 1: Teguh Santoso Operator 2: Damras Tresukosol Page 8 of 9

9 Singapore International Cardiovascular Therapeutics 5-7 August 2004 PROGRAMME DAY 3 7 th August 2004 (Saturday) 0800hrs Transmission from La Jolla Scripps Medical Centre, USA Basic/Advanced PCI Lectures Chairman: Maurice Choo Moderators: Tan Huay Cheem, James Tcheng, Greg Barsness, Nguyen Thach, Alan Yeung, Ashok Seth, Masahiko Ochiai, Gao Run Lin Chairman: Maurice Choo 0915 hrs Selection of guiding catheters in Chen Wai Hong challenging situations 0930 hrs Selection of guidewires for PCI Duncan Ho Hung Kwong 0945 hrs Stent designs: Which to Choose? Praveen Chandra 1000 hrs Management of High Risk PCI Nguyen Thach (Low EF, ACS, Multivessel PCI) 1015 hrs Hemodynamics in the Greg Barsness Catheterisation Laboratory 1030 hrs Tea break 1045 hrs Basic/Advanced PCI Lectures Chairman: Lim Yean Teng 1045 hrs Role of CABG in the Era of Drug Alan Yeung Eluting Stents: Who should undergo CABG? 1100 hrs Transradial PCI: Tips & Tricks Masahiko Ochiai 1115 hrs Management of Common Chang Heng Chia Complications of PCI 1130 hrs Antiplatelet in PCI: Cooperation or James Tcheng Competition? 1145 hrs Left main intervention in DES era Teguh Santoso 1200 hrs Treatment of Chronic Total Toshiya Muramatsu Occlusion: Histology to Wire Selection 1215 hrs Drug-eluting Stent in Chronic Total Kenneth Chin Occlusion 1230 hrs Percutaneous ASD Closure: James Yip Preferred Option to Surgery? 1245 hrs Interpretation of Cerebral Kao Hsien Li Angiography and Techniques of Carotid Stenting By Cardiologists 1300 hrs PCI in SVG disease: Latest Ashok Seth update 1315 hrs End of Course Page 9 of 9