10 Year Experience with the Malaysian ACS & PCI Registries:

1. Joint Meeting of Coronary Revascularisation (JCR), Busan. 9-10 December 2016. Session 5: 1550hrs, Room A 10 Year Experience with the Malaysian ACS & PCI Registries: translation into research and practice Dr Alan Fong MBChB(Bristol), MRCP(UK), FRCP (Edin), FACC, FESC, FAPSIC, FNHAM, FAsCC Consultant Cardiologist, Sarawak General Hospital Heart Centre; & Head, Clinical Research Centre, Sarawak General Hospital Adjunct Professor, Swinburne University of Technology

2. National Health and Morbidity Surveys.. (e.1986)

3. The NCVD Registries (e.2006) http://www.acrm.org.my/ncvd/aboutUs_overview.php

4. NCVD PCI Registry Report 2013-2014

5. Snapshot from the Annual Report of the NCVD-ACS Registry 2011-2013 Suggested citation: W.A. Wan Azman, K.H. Sim. (Eds). Annual Report of the NCVD-ACS Registry, Year 2011-2013. Kuala Lumpur, Malaysia: National Cardiovascular Disease Database, 2015.

6. NCVD-ACS Registry Participating Hospitals HTF HQEI HQEII HRPZ II HSB HSNZ HPP HRPB HTAA PJHUS UMMC IJN HKL HTAR HS HA Total SDP= 19 hospitals HTJ HSA *Each SDP started to contribute data at different time period HM NCVD-ACS Registry, Malaysia (2011-2013)

7. N ACS admissions = 14,763

8. Mean age: 58.5 (12.2) years N ACS admissions = 14,763

10. N ACS admissions = 14,763

11. Hypertension 65% Diabetes 46%

12. Presence of cumulative risk factors (Percentage), NCVD-ACS Registry, 2011-2013

13. Type of cardiac presentation for patients with ACS (%) by admission, NCVD-ACS Registry, 2006 - 2013

14. Age group of patients by ACS stratum NCVD-ACS Registry, 2011-2013 NSTEMI

17. Type of treatment among STEMI patients by Age Group , NCVD-ACS Registry, 2011-2013

18. NCVD ACS In-Hospital Mortality and 30-day Follow up: 2006-2010 VS 2011-2013 Outcome at discharge is similar but 30 day outcomes improved significantly

20. 30-day outcome is better at cardiologist centre

21. STEMI: comparison between NCVD and TIMI developmental dataset An Asian Validation of the TIMI risk score for ST-Segment Elevation Myocardial Infarction: Results and Implications for Cardiac Care in a Developing Country. Sharmini Selvarajah, Alan Fong Yean Yip, Gunavathy Selvaraj, Jamaiyah Haniff, Cuno S.P.M. Uiterwaal, Michiel L. Bots, PLoS One 2012;7(7):e40249

22. STEMI reperfusion strategies in UK and Malaysia Malaysia 2013 – approx. 70% lytic, approx 9% PPCI

23. The NCVD PCI Registry…

24. SDPs for the NCVD PCI Registry

25. Baseline Characteristics

26. Cardiovascular Risk Factors

27. Coronary stent implants!

28. Clinical outcomes

29. Primary PCI in STEMI – with vs without transfer

30. MySTEMI Network (Klang Valley)

31. ... Addressing the problems >3 billion at risk

32. A recent hit…. with global implications

33. Regional collaboration – 2016 and beyond

34. ACS – a patient from Marudi (~130km from Miri by road)

35. Summary: how the NCVD has helped us…. • Systematic collection of local data important • Better understanding of the local disease burden • Strategies to improve therapeutic protocols • Addressing the evidence gap by research • Translating research into guidelines

36. Sarawak General Hospital