[{"title":"Consensus Statement on Cardiac Rehabilitation for Patients Living with Heart Failure","imageObject":{"title":""},"imageSecond":{"title":""},"blurb":"\u003Cp style=\"text-align:justify\"\u003EThe World Health Organization (WHO) definition of cardiac rehabilitation (CR) is \u201cThe sum of activities required to influence favourably the underlying cause of the disease, as well as to provide the best possible physical, mental and social conditions, so that the patients may, by their own efforts, preserve or resume when lost as normal a place as possible in the community\u201d.\u003C\/p\u003E\r\n","content":"\u003Cp\u003E\u003Cimg alt=\"\" src=\"management.file\/img\/202406031941452177.jpg\" style=\"height:990px; width:700px\" \/\u003E\u003C\/p\u003E\r\n\r\n\u003Cp\u003E\u00a0\u003C\/p\u003E\r\n\r\n\u003Cp\u003E\u003Cspan style=\"font-size:14px\"\u003E\u003Cstrong\u003ESTATEMENT OF INTENT\u003C\/strong\u003E\u003C\/span\u003E\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003EThe Consensus Statement on Cardiac Rehabilitation for Patients Living with Heart Failure is meant to provide guidance for the evidence-based clinical management of heart failure rehabilitation. It is based on the best available evidence at the time of the consensus development. Adherence to the consensus may not necessarily guarantee the best outcome in every case. Every healthcare provider is responsible for the management of their unique patient based on the clinical presentation and the management options available.\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003EEvery care has been taken to ensure that the information is correct at the time of publication. However, in the event of errors or omissions, corrections will be published in the web version of this document, which will always serve as the definitive version.\u003C\/p\u003E\r\n\r\n\u003Cp\u003E\u003Cstrong\u003E\u003Cspan style=\"font-size:14px\"\u003ETARGET AUDIENCE\u003C\/span\u003E\u003C\/strong\u003E\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003EThis consensus is meant for all healthcare professionals involved in managing patients with heart failure, which includes cardiologists, rehabilitation physicians, internal medicine physicians, physiotherapists, dietitians, nurse educators, pharmacists, heart failure specialist nurses, exercise therapists, and also for patients.\u003C\/p\u003E\r\n\r\n\u003Cp\u003E\u003Cstrong\u003E\u003Cspan style=\"font-size:14px\"\u003EDOWNLOAD YOUR COPY\u003C\/span\u003E\u003C\/strong\u003E\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003E\u003Cspan style=\"font-size:14px\"\u003EClick on \u003Ca href=\"management.file\/doc\/202406031514797214.pdf\" target=\"_blank\"\u003Elink\u003C\/a\u003E to download the full copy in PDF (1MB).\u003C\/span\u003E\u003C\/p\u003E\r\n","video":{"title":""},"document":{"title":""},"file":{"imageObject":"202406031449371271.jpg","document":"202406031514797214.pdf"},"files":{"library":["202406031941452177.jpg"]},"id":"412","fid":"237","url":"consensus-statement-on-cardiac-rehabilitation-for-patients-living-with-heart-failure2"},{"title":"Clinical Practice Guidelines Management of Heart Failure 2023 (5th Edition)","imageObject":{"title":""},"imageSecond":{"title":""},"blurb":"\u003Cp style=\"text-align:justify\"\u003EHeart failure is a condition associated with significant morbidity and mortality. In recent years, there have been advancements in both treatment and diagnostics, to enable all stakeholders in healthcare to improve the management of this condition.\u003C\/p\u003E\r\n","content":"\u003Cp\u003E\u003Cstrong\u003E\u003Cspan style=\"font-size:14px\"\u003E\u00a0\u003Cimg alt=\"\" src=\"management.file\/img\/202404241189379391.png\" style=\"height:928px; width:700px\" \/\u003E\u003C\/span\u003E\u003C\/strong\u003E\u003C\/p\u003E\r\n\r\n\u003Cp\u003E\u00a0\u003C\/p\u003E\r\n\r\n\u003Cp\u003E\u003Cspan style=\"font-size:14px\"\u003E\u003Cstrong\u003ESTATEMENT OF INTENT\u003C\/strong\u003E\u003C\/span\u003E\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003E\u003Cspan style=\"font-size:14px\"\u003EThis clinical practice guideline (CPG) is meant to be a guide for clinical practice, based on the best available evidence at the time of development. Adherence to these guidelines may not necessarily guarantee the best outcome in every case. Every healthcare provider is responsible for the management of his\/her patient based on the clinical picture presented by the patient and the management options available locally.\u003C\/span\u003E\u003C\/p\u003E\r\n\r\n\u003Cp\u003E\u003Cstrong\u003E\u003Cspan style=\"font-size:14px\"\u003EPERIOD OF VALIDITY\u003C\/span\u003E\u003C\/strong\u003E\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003E\u003Cspan style=\"font-size:14px\"\u003EThis CPG is issued in 2023 and will be reviewed in 5 years or sooner if new evidence becomes available.\u003C\/span\u003E\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003E\u00a0\u003C\/p\u003E\r\n\r\n\u003Cp\u003E\u003Cstrong\u003E\u003Cspan style=\"font-size:14px\"\u003EDOWNLOAD YOUR COPY\u003C\/span\u003E\u003C\/strong\u003E\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003E\u003Cspan style=\"font-size:14px\"\u003EClick on \u003Ca href=\"https:\/\/www.malaysianheart.org\/management.file\/doc\/202312233178002312.pdf\"\u003Elink\u003C\/a\u003E to download the full copy in PDF (6MB). \u003C\/span\u003E\u003C\/p\u003E\r\n","video":{"title":""},"document":{"title":""},"file":{"imageObject":"202404240419211713.png"},"files":{"documents":["202312233178002312.pdf","202404249444761317.pdf"],"library":["202404248437193910.jpg","202404241189379391.png"]},"id":"307","fid":"237","url":"clinical-practice-guidelines-management-of-heart-failure-2023-5th-edition"},{"title":"Cardiovascular Disease (CVD) Position Paper","imageObject":{"title":""},"imageSecond":{"title":""},"blurb":"\u003Cp style=\"text-align:justify\"\u003ECardiovascular disease (CVD) is an important healthcare challenge for Malaysia in modern times. More citizens are being diagnosed with CVD than has been recorded in the past, with symptoms emerging earlier in life, and many presenting with life-threatening acute coronary syndrome (ACS) aged below 50 years. It is an alarming trend, mainly attributed to the rising prevalence of established CVD risk factors, and an increasingly ageing population.\u003C\/p\u003E\r\n","content":"\u003Cp\u003E\u003Cimg alt=\"\" src=\"management.file\/img\/202312233337130221.jpg\" style=\"height:990px; width:700px\" \/\u003E\u003C\/p\u003E\r\n\r\n\u003Cp\u003E\u003Cimg alt=\"\" src=\"management.file\/img\/202312233133987102.jpg\" style=\"height:990px; width:700px\" \/\u003E\u003C\/p\u003E\r\n\r\n\u003Cp\u003EClick this \u003Ca href=\"management.file\/doc\/202312231133720341.pdf\"\u003Elink\u003C\/a\u003E to download document in PDF.\u003C\/p\u003E\r\n","video":{"title":""},"document":{"title":""},"file":{"imageObject":"202404241719941133.png"},"files":{"gallery":[],"library":["202312233133987102.jpg","202312233337130221.jpg"],"documents":["202312231133720341.pdf"]},"id":"308","fid":"237","url":"cardiovascular-disease-cvd-position-paper"},{"title":"\n\nClinical Practice\nGuidelines Management of Dyslipidaemia 2023 (6th Ed.)\n\n","imageObject":{"title":""},"imageSecond":{"title":""},"blurb":"\u003Cp style=\"text-align:justify\"\u003E\u003Cspan style=\"font-size:11pt\"\u003E\u003Cspan style=\"font-size:12.0pt\"\u003EDyslipidemia remains one of the most deadly of the established cardiovascular risk factors. Compared to cigarette smoking, hypertension and diabetes, dyslipidemia is often only diagnosed when patients develop their first acute vascular event, such as a heart attack or stroke. Therefore, with the advent of such new therapeutics now available, with accompanying safety and efficacy clinical data, this CPG is timely to enable all healthcare professionals to optimise the management of their patients with dyslipidemia.\u003C\/span\u003E\u003C\/span\u003E\u003C\/p\u003E\r\n","content":"\u003Cp\u003E\u003Cimg alt=\"\" src=\"management.file\/img\/202404249431053714.png\" style=\"height:939px; width:700px\" \/\u003E\u003C\/p\u003E\r\n\r\n\u003Cp\u003E\u00a0\r\n\u003Cp\u003E\u00a0\u003C\/p\u003E\r\n\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003E\u003Cspan style=\"color:#3498db\"\u003E\u003Cstrong\u003E\u003Cspan style=\"font-size:11pt\"\u003E\u003Cspan style=\"font-size:12.0pt\"\u003ESTATEMENT OF INTENT\u003C\/span\u003E\u003C\/span\u003E\u003C\/strong\u003E\u003C\/span\u003E\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003E\u003Cspan style=\"font-size:11pt\"\u003E\u003Cspan style=\"font-size:12.0pt\"\u003EThese guidelines are developed to be a guide for best clinical practice in the management of dyslipidemia, based on the best available evidence at the time of development. Speci\u001fc attempts were made to use local data and publications to ensure local relevance. Adherence to this guideline does not necessarily lead to the best clinical outcome in individual patient care. Every health care provider is responsible for the management of his\/her unique patient based on the clinical presentation and management options available locally.\u003C\/span\u003E\u003C\/span\u003E\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003E\u00a0\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003E\u003Cspan style=\"color:#3498db\"\u003E\u003Cstrong\u003E\u003Cspan style=\"font-size:11pt\"\u003E\u003Cspan style=\"font-size:12.0pt\"\u003EREVIEW OF THE GUIDELINE\u003C\/span\u003E\u003C\/span\u003E\u003C\/strong\u003E\u003C\/span\u003E\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003E\u003Cspan style=\"font-size:11pt\"\u003E\u003Cspan style=\"font-size:12.0pt\"\u003EThis guideline is issued in 2023 and will be reviewed in about 5 years or earlier if important new evidence becomes available.\u003C\/span\u003E\u003C\/span\u003E\u003C\/p\u003E\r\n\r\n\u003Cp\u003E\u00a0\u003C\/p\u003E\r\n\r\n\u003Cp\u003E\u003Cspan style=\"font-size:11pt\"\u003E\u003Cspan style=\"font-size:12.0pt\"\u003EClick this \u003Ca href=\"management.file\/doc\/202312237439134019.pdf\"\u003Elink\u003C\/a\u003E to download document in PDF (15MB).\u003C\/span\u003E\u003C\/span\u003E\u003C\/p\u003E\r\n","video":{"title":""},"document":{"title":""},"file":{"imageObject":"202312233417981403.png"},"files":{"documents":["202312237439134019.pdf"],"library":["202404249431053714.png"]},"id":"309","fid":"237","url":"clinical-practice-guidelines-management-of-dyslipidaemia-2023-6th-ed"},{"title":"Management of Non-ST Elevation Myocardial Infarction (NSTE-ACS)","imageObject":{"title":""},"imageSecond":{"title":""},"content":"\u003Cp\u003E\u003Cimg alt=\"\" src=\"management.file\/img\/202404241918337433.png\" style=\"height:966px; width:700px\" \/\u003E\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003ENon-ST Elevation Acute Coronary Syndrome (NSTE-ACS) accounted for 55.4% of all Acute Coronary\u003Cbr \/\u003E\r\nSyndrome (ACS) reported from the National Cardiovascular Disease Database (NCVD) - ACS Registry between 2016 and 2017. NSTE-ACS including the non-ST elevation myocardial infarction and unstable angina is the dominant clinical manifestation of ACS in Malaysia hence ensuring the standardised and current clinical management for our clinicians is paramount for the safety of our patients.\u003C\/p\u003E\r\n\r\n\u003Cp\u003E\u00a0\u003C\/p\u003E\r\n\r\n\u003Cp\u003E\u003Cstrong\u003EStatement of intent:\u003C\/strong\u003E\u003C\/p\u003E\r\n\r\n\u003Cp\u003EThis Guidelines was developed to be a guide for best clinical practice in the management of Non- ST Elevation Acute Coronary Syndrome (NSTE-ACS). This is a combination of both Unstable Angina (UA) and Non-ST Elevation Myocardial Infarction (NSTEMI). It is based on the best evidence currently available. Adherence to this Guidelines does not necessarily lead to the best clinical outcome in individual patient care. Thus, every health care provider is responsible for the management of his\/her unique patient, based on the clinical presentation and management options available locally.\u003C\/p\u003E\r\n\r\n\u003Cp\u003E\u003Cbr \/\u003E\r\n\u003Cstrong\u003EReview of the guideline:\u003C\/strong\u003E\u003C\/p\u003E\r\n\r\n\u003Cp\u003EThis Guideline was issued in 2021 and will be reviewed in 2026 or earlier if important new evidence becomes available.\u003C\/p\u003E\r\n\r\n\u003Cp\u003EClick on the link below to download the full copy in PDF:\u003C\/p\u003E\r\n\r\n\u003Cp\u003E\u003Ca href=\"management.file\/doc\/202307125211986267.pdf\" target=\"_blank\"\u003E\u003Cimg alt=\"\" src=\"management.file\/img\/202307129642551681.jpg\" style=\"height:73px; width:451px\" \/\u003E\u003C\/a\u003E\u003C\/p\u003E\r\n\r\n\u003Cp\u003E\u00a0\u003C\/p\u003E\r\n","video":{"title":""},"document":{"title":""},"file":{"imageObject":"202307120971826150.png","document":"202307125211986267.pdf"},"files":{"library":["202307129642551681.jpg","202404241918337433.png"]},"blurb":"","id":"243","fid":"237","url":"management-of-non-st-elevation-myocardial-infarction-nste-acs"},{"title":"MYHF CPG App","imageObject":{"title":""},"imageSecond":{"title":""},"content":"\u003Cp\u003EMYHFCPG provides cardiologist and clinicians, guidance to management of heart failure with the clinical practise guidelines, steps and therapies.\u00a0This clinical practice guidelines (CPG) is meant to be a guide for clinical practice, based on the best available evidence at the time of development. Adherence to these guidelines may not necessarily guarantee the best outcome in every case. Every healthcare provider is responsible for the management of his\/her patient based on the clinical picture presented by the patient and the management options available locally.\u003C\/p\u003E\r\n\r\n\u003Cp\u003EThe objectives of this CPG are to:\u003C\/p\u003E\r\n\r\n\u003Cul\u003E\r\n\t\u003Cli\u003EUpdate the current management of HF based on recent evidence with respect to:\u003C\/li\u003E\r\n\t\u003Cli\u003EPrevention\u003C\/li\u003E\r\n\t\u003Cli\u003EDiagnosis\u003C\/li\u003E\r\n\t\u003Cli\u003ETreatment : pharmacotherapy, device and surgical therapy\u003C\/li\u003E\r\n\t\u003Cli\u003ERehabilitation\u003C\/li\u003E\r\n\t\u003Cli\u003EEnd of life and palliative care\u003C\/li\u003E\r\n\t\u003Cli\u003ERecognise and manage HF in special populations:\u003C\/li\u003E\r\n\t\u003Cli\u003EAdult congenital heart disease\u003C\/li\u003E\r\n\t\u003Cli\u003EGeriatric population\u003C\/li\u003E\r\n\t\u003Cli\u003EPregnant women\u003C\/li\u003E\r\n\t\u003Cli\u003EDevelop a structured multidisciplinary strategy for the management of patients with HF both in the primary and secondary care setting.\u003Cbr \/\u003E\r\n\t\u00a0\u003C\/li\u003E\r\n\u003C\/ul\u003E\r\n\r\n\u003Cp\u003E\u003Cstrong\u003EThis app contains the following features:\u003C\/strong\u003E\u003C\/p\u003E\r\n\r\n\u003Cul\u003E\r\n\t\u003Cli\u003EClinical Practise Guidelines (CPG)\u003C\/li\u003E\r\n\t\u003Cli\u003EInteractive Flowcharts\u003C\/li\u003E\r\n\t\u003Cli\u003EMAGGIC Risk Calculator\u003C\/li\u003E\r\n\t\u003Cli\u003EHFA-PEFF Score\u003C\/li\u003E\r\n\t\u003Cli\u003EHF Clinic\u003C\/li\u003E\r\n\t\u003Cli\u003EBookmarks\u003C\/li\u003E\r\n\t\u003Cli\u003ENews\/Notification updates\u003C\/li\u003E\r\n\t\u003Cli\u003EUser registration\u003C\/li\u003E\r\n\t\u003Cli\u003EUser account profiles\u003C\/li\u003E\r\n\u003C\/ul\u003E\r\n\r\n\u003Cp\u003E\u00a0\u003C\/p\u003E\r\n\r\n\u003Cp\u003E\u003Cstrong\u003EDownload app on:\u003C\/strong\u003E\u003C\/p\u003E\r\n\r\n\u003Cul\u003E\r\n\t\u003Cli\u003EApp Store:\u00a0\u003Ca href=\"https:\/\/apps.apple.com\/bh\/app\/myhfcpg\/id1519421076\"\u003Ehttps:\/\/apps.apple.com\/bh\/app\/myhfcpg\/id1519421076\u003C\/a\u003E\u003C\/li\u003E\r\n\t\u003Cli\u003EGoogle Play:\u00a0\u003Ca href=\"https:\/\/play.google.com\/store\/apps\/details?id=com.myhfcpg.cpg1&hl=en\"\u003Ehttps:\/\/play.google.com\/store\/apps\/details?id=com.myhfcpg.cpg1&hl=en\u003C\/a\u003E\u003C\/li\u003E\r\n\u003C\/ul\u003E\r\n\r\n\u003Cp\u003E\u003Cimg alt=\"\" src=\"management.file\/img\/202307068865419845.jpg\" \/\u003E\u003C\/p\u003E\r\n","video":{"title":""},"document":{"title":""},"file":{"imageObject":"202307128231651529.jpg"},"id":"250","fid":"237","url":"myhf-cpg-app"},{"title":"Management of Acute ST Segment Elevation Myocardial Infarction (STEMI) 2019","imageObject":{"title":""},"imageSecond":{"title":""},"content":"\u003Cp\u003EThe 1st Clinical Practice Guideline (CPG) on ST Elevation Myocardial Infarction (STEMI) was published in 2001 with a 2nd and 3rd update in 2007 and 2014 respectively. Rapid developments have taken place, especially in the area of pre-hospital care. This 4th edition was developed to provide a clear and concise approach based on current evidence with the focus being on efforts to reduce the time from first medical contact, improve pre-hospital care as well support the application of guideline-directed therapies.\u003C\/p\u003E\r\n\r\n\u003Cp\u003EThis CPG has been prepared by a panel of committee members from the National Heart Association of Malaysia (NHAM) and Ministry of Health (MOH). The committee members were multidisciplinary and comprised of cardiologists, internal medicine, family medicine, rehabilitation and emergency physicians from the government, private sector and universities. Relevant clinical trial data and published literature have been summarized and adapted to local practices. This guideline also implemented the work of our very own national STEMI network which links non-PCIcapable centres to PCI-capable centres so PCI services can be arranged in a timely manner for all patients.\u003C\/p\u003E\r\n\r\n\u003Cp\u003EIschaemic heart disease has been a significant burden to this country, and it is projected that the burden will continue to increase with the rising number of cardiovascular risk factors and an ageing population. I believe this CPG will be an invaluable guiding document for healthcare providers involved in the management of STEMI and subsequently be translated to an improved clinical outcome for patients suffering from ischaemic heart disease.\u003C\/p\u003E\r\n\r\n\u003Cp\u003E\u003Cstrong\u003EDatuk Dr. Noor Hisham Bin Abdullah\u003C\/strong\u003E\u003Cbr \/\u003E\r\n\u003Cem\u003EDirector-General of Health Malaysia\u003Cbr \/\u003E\r\nMinistry of Health Malaysia\u003C\/em\u003E\u003C\/p\u003E\r\n\r\n\u003Cp\u003E\u00a0\u003C\/p\u003E\r\n\r\n\u003Cp\u003E\u003Cstrong\u003EStatement of intent:\u003C\/strong\u003E\u003C\/p\u003E\r\n\r\n\u003Cp\u003EThis guideline was developed to be a guide for best clinical practice, based on the best available evidence at the time of development. Specific attempts were made to use local data and publications to ensure local relevance. Adherence to this guideline does not necessarily lead to the best clinical outcome in individual patient care. Every healthcare provider is responsible for the management of his\/her unique patient based on the clinical presentation and management options available locally.\u003C\/p\u003E\r\n\r\n\u003Cp\u003E\u003Cstrong\u003EReview of the guideline:\u003C\/strong\u003E\u003C\/p\u003E\r\n\r\n\u003Cp\u003EThis guideline is issued in 2019 and will be reviewed in 2024 or earlier if important new evidence becomes available.\u003C\/p\u003E\r\n\r\n\u003Cp\u003E\u00a0\u003C\/p\u003E\r\n\r\n\u003Cp\u003EClick on the link below to download full copy in PDF:\u003C\/p\u003E\r\n\r\n\u003Cp\u003E\u003Ca href=\"management.file\/doc\/202307128056413091.pdf\" target=\"_blank\"\u003E\u003Cimg alt=\"\" src=\"management.file\/img\/202307125317918836.jpg\" style=\"height:73px; width:318px\" \/\u003E\u003C\/a\u003E\u003C\/p\u003E\r\n","video":{"title":""},"document":{"title":""},"file":{"imageObject":"202307121377548619.jpg","document":"202307128056413091.pdf"},"files":{"library":["202307125317918836.jpg"]},"id":"251","fid":"237","url":"management-of-acute-st-segment-elevation-myocardial-infarction-stemi-2019"},{"title":"Management of Heart Failure 2019 (4th Edition)","imageObject":{"title":""},"imageSecond":{"title":""},"blurb":"\u003Cp style=\"text-align:justify\"\u003ECardiovascular disease is an important cause of morbidity and mortality in Malaysia. HF, the end stage of most diseases of the heart, is a common medical problem encountered in clinical practice and is an important cause of hospital admissions and readmissions. It is also an important cause of hospital expenditure.\u003C\/p\u003E\r\n","content":"\u003Cp style=\"text-align:justify\"\u003E\u003Cimg alt=\"\" src=\"management.file\/img\/202404274723521110.jpg\" style=\"height:1036px; width:700px\" \/\u003E\u003Cimg alt=\"\" src=\"management.file\/img\/202404273011127254.jpg\" style=\"height:1036px; width:700px\" \/\u003E\u003Cbr \/\u003E\r\n\u00a0\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003E\u003Cstrong\u003EStatement of intent:\u003C\/strong\u003E\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003EThis clinical practice guidelines (CPG) is meant to be a guide for clinical practice, based on the best available evidence at the time of development. Adherence to these guidelines may not necessarily guarantee the best outcome in every case. Every healthcare provider is responsible for the management of his\/her patient based on the clinical picture presented by the patient and the management options available locally.\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003E\u003Cstrong\u003EPeriod of validity:\u003C\/strong\u003E\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003EThis CPG was issued in 2019 and will be reviewed in 5 years or sooner if new evidence becomes available.\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003E\u00a0\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003EClick on \u003Ca href=\"management.file\/doc\/202312267173537079.pdf\"\u003Elink\u003C\/a\u003E to download full copy in PDF.\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003E\u00a0\u003C\/p\u003E\r\n","video":{"title":""},"document":{"title":""},"file":{"imageObject":"202312261807739359.jpg"},"files":{"documents":["202312267173537079.pdf"],"library":["202404274723521110.jpg","202404273011127254.jpg"]},"id":"310","fid":"237","url":"management-of-heart-failure-2019-4th-edition"},{"title":"CPG Slides Summary - Management of Heart Failure 2019 (4th Edition)","imageObject":{"title":""},"imageSecond":{"title":""},"blurb":"","content":"\u003Cp style=\"text-align:justify\"\u003E\u003Cstrong\u003EClinical Practice Guidelines - Management of Heart Failure 2019, 4th Edition\u003C\/strong\u003E\u00a0was launched last 12th April 2019 at the NHAM Congress 2019 Opening Ceremony. Please find below download link for the CPG summary slides set as presented by Dr Liew Houng Bang. The full document will be made available soon. Watch this space!\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003E\u003Ca href=\"management.file\/doc\/202312269803100875.pdf\" target=\"_blank\"\u003E120419 LHB HF CPG NHAM 2019 v2.pdf\u003C\/a\u003E\u003C\/p\u003E\r\n","video":{"title":""},"document":{"title":""},"files":{"library":[],"documents":["202312269803100875.pdf"]},"file":{"imageObject":"202312265460117038.jpg"},"id":"311","fid":"237","url":"cpg-slides-summary-management-of-heart-failure-2019-4th-edition"},{"title":"CPG Slides Summary - STEMI 2019 (4th Edition)","imageObject":{"title":""},"imageSecond":{"title":""},"blurb":"","content":"\u003Cp style=\"text-align:justify\"\u003E\u003Cstrong\u003EClinical Practice Guidelines - Management of ST Elevation Myocardial Infarction (STEMI) 2019, 4th Edition\u003C\/strong\u003E\u00a0was launched last 12th April 2019 at the NHAM Congress 2019 Opening Ceremony. Please find below download link for the CPG summary slides set as presented by Dr Jeyamalar Rajadurai. The full document will be made available soon. Watch this space!\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003E\u003Ca href=\"management.file\/doc\/202312262723853001.pdf\" target=\"_blank\"\u003ECPG STEMI 2019.pdf\u003C\/a\u003E\u003C\/p\u003E\r\n","video":{"title":""},"document":{"title":""},"file":{"imageObject":"202312263300817225.jpg"},"files":{"documents":["202312262723853001.pdf"]},"id":"312","fid":"237","url":"cpg-slides-summary-stemi-2019-4th-edition"},{"title":"CPG Slides Summary","imageObject":{"title":""},"imageSecond":{"title":""},"blurb":"","content":"\u003Cp style=\"text-align:justify\"\u003EClick below to download the slides set in PDF:\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003E\u003Ca href=\"management.file\/doc\/202312268315705500.pdf\" target=\"_blank\"\u003ECPG Primary and Secondary Prevention of Cardiovascular Disease 2017 (1st Edition).pdf\u003C\/a\u003E\u003C\/p\u003E\r\n","video":{"title":""},"document":{"title":""},"file":{"imageObject":"202312261805570035.jpg"},"files":{"documents":["202312268315705500.pdf"]},"id":"314","fid":"237","url":"cpg-slides-summary2"},{"title":"CPG Slides Summary","imageObject":{"title":""},"imageSecond":{"title":""},"blurb":"","content":"\u003Cp style=\"text-align:justify\"\u003EClick below to download the slides set in PDF:\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003E\u003Ca href=\"management.file\/doc\/202312267503190860.pdf\" target=\"_blank\"\u003ECPG Management of Dyslipidaemia 2017 (5th Edition).pdf\u003C\/a\u003E\u003C\/p\u003E\r\n","video":{"title":""},"document":{"title":""},"file":{"imageObject":"202312266058917300.jpg"},"files":{"documents":["202312267503190860.pdf"]},"id":"315","fid":"237","url":"cpg-slides-summary3"},{"title":"CPG Slides Summary","imageObject":{"title":""},"imageSecond":{"title":""},"blurb":"","content":"\u003Cp style=\"text-align:justify\"\u003EClick below to download the slides set in PDF:\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003E\u003Ca href=\"management.file\/doc\/202312260803783531.pdf\" target=\"_blank\"\u003ECPG Stable CAD 2018 (2nd Edition).pdf\u003C\/a\u003E\u003C\/p\u003E\r\n","video":{"title":""},"document":{"title":""},"file":{"imageObject":"202312261032750838.jpg"},"files":{"documents":["202312260803783531.pdf"]},"id":"313","fid":"237","url":"cpg-slides-summary"},{"title":"Stable Coronary Artery \u003Cbr\u003EDisease 2018 (2nd Edition)","imageObject":{"title":""},"imageSecond":{"title":""},"blurb":"","content":"\u003Cp style=\"text-align:justify\"\u003EThe previous clinical practice guidelines for the management of stable angina were issued in 2010. Since then, there have been advances in both diagnostic and therapeutic strategies in the management of this progressive disease. Therefore, it is timely for the publication of this CPG, with a title that is now evolved from stable angina to that of stable coronary artery disease (SCAD).\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003EAtherosclerosis is a systemic vascular disease, but it is in the coronary arteries where this progressive disease exerts its most serious effects which can significantly affect morbidity and mortality.\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003EClinical manifestation of SCAD, by means of stable angina, has long been the pointwhereby an individual begins to seek medical attention. However, the combination of earlier screening by an increasingly greater number of the general population at risk of coronary artery disease has seen more patients being diagnosed with the subclinical SCAD. The high prevalence of risk factors of cardiovascular disease in Malaysia, including diabetes, hypertension, dyslipidaemia and smoking, and the emergence of better diagnostic equipment have both contributed to this effect.\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003EIn both subclinical and clinically evident SCAD, there are now new drugs and non-drug interventions available, which are now more readily available compared to when this last CPG was published. In addition, new clinical evidence have emerged on these new therapies. In this respect, the publication of this CPG, which reviews published research on these new therapies and strategies, is timely.\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003EThe management of SCAD has to be tailored carefully to an individual, as the right therapeutic strategies often improves symptoms. This CPG reviews most available treatment options in Malaysia and makes recommendations on strategies that can improve both the patients\u2019 clinical outcomes and quality of life.\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003EFinally, I would like to thank Dr Jeyamalar Rajadurai and the multidisciplinary team on the expert panel who have worked hard to put this CPG together, as well as the external reviewers of this CPG. I believe this CPG will be a relevant document for every practicing healthcare professional who manages patients with SCAD.\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003E\u003Cstrong\u003EDatuk Dr. Noor Hisham Bin Abdullah\u003C\/strong\u003E\u003Cbr \/\u003E\r\n\u003Cem\u003EDirector-General of Health Malaysia\u003Cbr \/\u003E\r\nMinistry of Health Malaysia\u003C\/em\u003E\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003E\u003Cstrong\u003EStatement of intent:\u003C\/strong\u003E\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003EThis guideline was developed to be a guide for best clinical practice, based on the best available evidence at the time of development. Specific attempts were made to use local data and publications to ensure local relevance. Adherence to this guideline does not necessarily lead to the best clinical outcome in individual patient care. Every health care provider is responsible for the management of his\/her unique patient based on the clinical presentation and management options available locally.\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003E\u003Cstrong\u003EReview of the Guideline:\u003C\/strong\u003E\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003EThis guideline is issued in 2018 and will be reviewed in 2023 or earlier if important new evidence becomes available.\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003EClick on the link below to download the full document in PDF:\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003E\u003Ca href=\"management.file\/doc\/202312265184107803.pdf\" target=\"_blank\"\u003ECPG booklet 2018 2nd Edition (Final).pdf\u003C\/a\u003E\u003C\/p\u003E\r\n","video":{"title":""},"document":{"title":""},"file":{"imageObject":"202312261408573108.jpg"},"files":{"documents":["202312265184107803.pdf"]},"id":"316","fid":"237","url":"stable-coronary-artery-br-disease-2018-2nd-edition"},{"title":"Management of\u003Cbr\u003E Dyslipidaemia 2017 (5th Edition)","imageObject":{"title":""},"imageSecond":{"title":""},"blurb":"","content":"\u003Cp style=\"text-align:justify\"\u003EDyslipidaemia remains a significant problem in Malaysia, with the National Health and Morbidity survey in 2015 reporting an estimated 47% of the adult population having hypercholesterolaemia. In the main, dyslipidaemia is asymptomatic but its associations with serious vascular conditions such as acute myocardial infarction and stroke is well known.\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003EThe previous edition of the National Clinical Practice Guidelines (CPGs) were launched in 2011. Since then, the evidence base on this subject has grown and new treatments now available. In addition, more clinical information on dyslipidaemia has emerged from Malaysia and in region. Therefore, this edition, which is the 5th Edition of the CPG on the Management of Dyslipidaemia, is timely.\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003EAccessing this CPG, and others endorsed by the Ministry of Health, by healthcare providers is now easier, with the advent of modern telecommunications \u2013 downloading a soft copy of this CPG should be a seamless affair. I anticipate the readership of this and other such CPGs to grow and the information provided be useful for healthcare providers in their day to day management of patients.\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003EI would like to congratulate the multidisciplinary team for working together for many months to produce this CPG. Members of the this CPG Expert Panel consist of experts from both the private and public sectors, from primary to tertiary care centres, and from across the country. Under the capable and enthusiastic leadership of Dr Robaayah Zambahari, supported by Dr Jeyamalar Rajadurai, the Expert Panel regularly met to ensure the most recent and relevant information are incorporated into this CPG. I also thank members of the Panel of External Reviewers for their efforts.\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003EFinally, I hope elements of this CPG will be put into practice on a daily basis, to tackle the problem of dyslipidaemia in this country, and eventually result in a drop in mortality and morbidity associated with vascular disease. I am sure this 5th Edition of the CPG on the Management of Dyslipidaemia (2017) will go a long way towards achieving this.\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003E\u003Cbr \/\u003E\r\n\u003Cstrong\u003EDatuk Dr. Noor Hisham Bin Abdullah\u003C\/strong\u003E\u003Cbr \/\u003E\r\n\u003Cem\u003EDirector-General of Health Malaysia\u003Cbr \/\u003E\r\nMinistry of Health Malaysia\u003C\/em\u003E\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003E\u003Cbr \/\u003E\r\n\u003Cstrong\u003EStatement of intent:\u003C\/strong\u003E\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003EThis guideline was developed to be a guide for best clinical practice in the management of dyslipidaemia, based on the best available evidence at the time of development. Specific attempts were made to use local data and publications to ensure local relevance. Adherence to this guideline does not necessarily lead to the best clinical outcome in individual patient care. Every health care provider is responsible for the management of his\/her unique patient based on the clinical presentation and management options available locally.\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003E\u003Cstrong\u003EReview of the Guideline:\u003C\/strong\u003E\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003EThis guideline is issued in 2017 and will be reviewed in about 5 years or earlier if important new evidence becomes available.\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003E\u003Cstrong\u003EDownload the full document below:\u003C\/strong\u003E\u003C\/p\u003E\r\n\r\n\u003Cp\u003E\u003Ca href=\"management.file\/doc\/202401026470124810.pdf\" target=\"_blank\"\u003E\u003Cimg alt=\"\" src=\"management.file\/img\/202401021476016797.jpg\" style=\"height:73px; width:320px\" \/\u003E\u003C\/a\u003E\u003C\/p\u003E\r\n","video":{"title":""},"document":{"title":""},"files":{"documents":["202401026470124810.pdf"]},"file":{"imageObject":"202401027706548101.jpg"},"id":"341","fid":"237","url":"management-of-br-dyslipidaemia-2017-5th-edition"},{"title":"Primary & Secondary Prevention of Cardiovascular Disease 2017","imageObject":{"title":""},"imageSecond":{"title":""},"blurb":"","content":"\u003Cp style=\"text-align:justify\"\u003ECardiovascular Diseases (CVD) has been the leading cause of death in Malaysian since the early 1980s. The National Burden of Disease Study in early 2000s showed that coronary artery disease (CAD) and cerebrovascular disease (CVA) are the top two causes of death for both men and women. What is of concern is that the age of onset of CVD in Malaysia is younger compared to our neighbors and some western nations.\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003EEqually of concern is that the incidence of the major risk factors contributing to CVD has shown an increasing trend over the last 3 decades. The Ministry of Health (MOH) in conjunction with the Academy of Medicine and Professional Non-Governmental Organisations had since the mid-1990s had published Clinical Practice Guidelines (CPGs) on the Management of major risk factors for CVD. This is followed by CPGs on the Management of Acute Myocardial Infarction, Heart Failure and Cerebrovascular Accidents. More recently, in 2010, the MOH launched the National Strategic Plan for Non-Communicable Disease (NSP-NCD) in response to the global challenge in combatting NCD in general and CVD in particular. This document is now being updated by the MOH to reflect latest developments in the field and more current global targets set by the World Health Organisation (WHO).\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003EWhat has been missing thus far is an integrated approach to combat CVD at both the primary and secondary prevention levels. This is where this pioneering\u00a0\u003Cstrong\u003ECPG on Prevention of CVD\u003C\/strong\u003E\u00a0is a most welcome addition to compliment earlier initiatives to confront the scourge of CVD. The integrated approach adopted in this CPG engaging a wide spectrum of health care professionals (from dieticians to clinicians) is most commendable. It is my wish that this CPG is widely available and adopted by all health care professionals involved in the management of CVD. I strongly believe that, God Willing, compliance to the recommendation made in this CPG will go a long way to improve the quality of care we offer to reverse the rising tide of this preventable disease.\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003E\u00a0\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003E\u003Cstrong\u003EDatuk Dr. Noor Hisham Bin Abdullah\u003C\/strong\u003E\u003Cbr \/\u003E\r\n\u003Cem\u003EDirector-General of Health Malaysia\u003Cbr \/\u003E\r\nMinistry of Health Malaysia\u003C\/em\u003E\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003E\u003Cbr \/\u003E\r\n\u003Cstrong\u003EStatement of intent:\u003C\/strong\u003E\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003EThis guideline was developed to be a guide for best clinical practice in the prevention of cardiovascular disease, based on the best available evidence at the time of development. Specific attempts were made to use local data and publications to ensure local relevance. Adherence to this guideline does not necessarily lead to the best clinical outcome in individual patient care as this depends on other clinical factors like co-morbidities, acceptance of patients towards recommended therapy etc. Every health care provider is responsible to individualise the management of his\/her unique patient based on the clinical presentation and management options available locally.\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003E\u003Cstrong\u003EReview of the Guideline:\u003C\/strong\u003E\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003EThis guideline is issued in 2017 and will be reviewed in 2022 or earlier if important new evidence becomes available.\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003E\u00a0\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003E\u003Cstrong\u003EDownload the full document below:\u003C\/strong\u003E\u003C\/p\u003E\r\n\r\n\u003Cp\u003E\u003Ca href=\"management.file\/doc\/202401027178664601.pdf\" target=\"_blank\"\u003E\u003Cimg alt=\"\" src=\"management.file\/img\/202401021476016797.jpg\" style=\"height:73px; width:320px\" \/\u003E\u003C\/a\u003E\u003C\/p\u003E\r\n","video":{"title":""},"document":{"title":""},"file":{"imageObject":"202401026774961701.jpg"},"files":{"library":["202401021476016797.jpg"],"documents":["202401027178664601.pdf"]},"id":"340","fid":"237","url":"primary-secondary-prevention-of-cardiovascular-disease-2017"},{"title":"Prevention, Diagnosis & Management\u003Cbr\u003E of Infective Endocarditis 2017","imageObject":{"title":""},"imageSecond":{"title":""},"blurb":"","content":"\u003Cp style=\"text-align:justify\"\u003EInfective endocarditis (IE) is an uncommon and potentially lethal infection affecting patients at risk. Despite advances in medicine, IE still causes significant morbidity and mortality. This is due to the changing epidemiology of the disease, the wide spectrum of presentation extending from the neonate to the elderly, diagnostic difficulties, delayed surgical interventions and embolic complications. The advances in cardiothoracic surgery and cardiology over the years with the increasing use of prosthetic material, valves and intracardiac devices have also contributed to the challenges in managing IE in these patients.\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003ESome important evolution in management strategies would be the development of an Endocarditis Team with multidisciplinary expertise in cardiology, cardiothoracic surgery, infectious disease and other subspecialties as indicated. This is encouraged to enable early diagnosis, optimise treatment and prevent complications in these patients. It also allows for smoother and more efficient referrals to specialised centres.\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003EPreviously, surgical intervention was delayed because of the high-risk and mortality but, recently published data have also shown that early surgical interventions in these patients decrease embolic complications and improve outcomes. There have also been changes with regards to antimicrobial prophylaxis. The evidence currently shows that routine antimicrobial prophylaxis prior to dental procedures is not indicated for all cardiac patients and should be limited to high-risk cardiac patients only. Maintaining a good oral and skin hygiene routine is highly recommended in the prevention of IE.\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003EWith these recent developments in the prevention, diagnosis and management of IE, it is timely that we develop local clinical practice guidelines to update all respective healthcare providers with regards to the new management strategies. I congratulate the committee for the effort and hope that these guidelines would serve to decrease the incidence of IE and its associated morbidity and mortality.\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003E\u00a0\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003E\u003Cstrong\u003EDatuk Dr. Noor Hisham Bin Abdullah\u003C\/strong\u003E\u003Cbr \/\u003E\r\n\u003Cem\u003EDirector-General of Health Malaysia\u003Cbr \/\u003E\r\nMinistry of Health Malaysia\u003C\/em\u003E\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003E\u00a0\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003E\u003Cstrong\u003EStatement of intent:\u003C\/strong\u003E\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003EThese clinical practice guidelines are meant to be a guide for clinical practice. It is based on the best available evidence, knowledge and clinical experience at the time of development. These guidelines do not guarantee the best outcome in every case and the responsibility lies on the individual healthcare provider to manage his\/her patient based on the clinical manifestations of the patient and the management options available locally.\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003E\u003Cstrong\u003EPeriod of validity:\u003C\/strong\u003E\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003EThese clinical practice guidelines were issued in 2017 and will be reviewed in 4 years (2021) or earlier depending on the availability of new evidence. NHAM will inform either the Chairperson of this current CPG committee or the National Advisor of the related specialties when the time for updating this CPG is due. Prior to commencement of updating this CPG, a discussion to determine the need for an update, including the scope of the CPG updates should be done. If there is a need for an update, as with this current committee, a multidisciplinary team will be formed for the specific purpose of updating this CPG.\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003E\u003Cstrong\u003EDownload the full document below:\u003C\/strong\u003E\u003C\/p\u003E\r\n\r\n\u003Cp\u003E\u003Ca href=\"management.file\/doc\/202401024160817174.pdf\" target=\"_blank\"\u003E\u003Cimg alt=\"\" src=\"management.file\/img\/202401021476016797.jpg\" style=\"height:73px; width:320px\" \/\u003E\u003C\/a\u003E\u003C\/p\u003E\r\n","video":{"title":""},"document":{"title":""},"file":{"imageObject":"202401024877046111.jpg"},"files":{"documents":["202401024160817174.pdf"]},"id":"342","fid":"237","url":"prevention-diagnosis-management-br-of-infective-endocarditis-2017"},{"title":"Prevention of Cardiovascular Disease\u003Cbr\u003E in Women 2016 (2nd Edition)","imageObject":{"title":""},"imageSecond":{"title":""},"blurb":"","content":"\u003Cp style=\"text-align:justify\"\u003ECardiovascular disease, till this day, remains the primary cause of mortality globally. Although it affects both genders, a greater emphasis appears to be placed on male patients, who appear to develop the disease at an earlier age compared to females. However, it is also known the incidence of cardiovascular disease in females rapidly rises to match males after menopause. From the National Cardiovascular Disease Registry in Malaysia (2011-2013), it was demonstrated that female patients had a higher in-hospital and 30-day mortality for acute coronary syndrome compared to male patients. Such statistics demand a greater focus being placed, not only on the diagnosis and treatment, but critically on the prevention of cardiovascular disease in women in our\u003Cbr \/\u003E\r\ncountry.\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003EMalaysia has a rising prevalence of cardiovascular risk factors in the population. Diabetes, hypertension and dyslipidaemia afflict both gender groups. Coupled with smoking and other non-communicable cardiovascular risk factors, it is important to place equal emphasis on both gender groups in the effort to prevent cardiovascular disease. The Ministry of Health is committed towards reducing the rates of non-communicable diseases, including those leading to cardiovascular disease, and these Guidelines form an important reference point to all stakeholders.\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003EThe advent of newer diagnostic and therapeutic strategies has also provided the opportunity to improve prevention of cardiovascular disease, including in women. Techniques such as multislice computed tomography of the coronary arteries and cardiac magnetic resonance imaging provide the clinician greater options for disease detection, yet each has its limitations. Contemporary strategies such as these will enhance the capacity of the clinician to improve both primary and secondary prevention of cardiovascular disease, augmenting established strategies such as the exercise stress test. Research in cardiovascular medicine has accelerated in recent years, and with such a rapidly expanding evidence base, these updated Guidelines are timely.\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003EI am therefore grateful to the writing committee chaired by Tan Sri Dato\u2019 Seri Robaayah, who has no doubt put countless hours into the preparation of this Clinical Practice Guidelines, which is now in its second edition. While publication becomes a useful companion for clinicians, I hope it inspires more women to the field of cardiovascular medicine.\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003E\u00a0\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003E\u003Cstrong\u003EDatuk Dr. Noor Hisham Bin Abdullah\u003Cbr \/\u003E\r\nMD, MS, AM, FAMM\u003C\/strong\u003E\u003Cbr \/\u003E\r\n\u003Cem\u003EDirector-General of Health Malaysia\u003Cbr \/\u003E\r\nMinistry of Health Malaysia\u003C\/em\u003E\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003E\u00a0\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003E\u003Cstrong\u003EStatement of intent:\u003C\/strong\u003E\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003EThis guideline was developed to be a guide for best clinical practice in the management of cardiovascular diseases in women, based on the best available evidence at the time of development. Specific attempts were made to use local data and publications to ensure local relevance. Adherence to these guidelines does not necessarilylead to the best clinical outcome in individual patient care. Every health care provider is responsible for the management of his\/her unique patient based on the clinical presentation and management options available locally.\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003E\u003Cstrong\u003EReview of the guideline:\u003C\/strong\u003E\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003EThe guideline is issued in 2016 and will be reviewed in 2021 or earlier if important new evidence becomes available. This is an update to the Clinical Practice Guidelines on Prevention of Heart Disease in Women published in 2008. This CPG supercedes the previous CPG.\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003E\u003Cstrong\u003EDownload the full document below:\u003C\/strong\u003E\u003C\/p\u003E\r\n\r\n\u003Cp\u003E\u003Ca href=\"management.file\/doc\/202401024118244706.pdf\" target=\"_blank\"\u003E\u003Cimg alt=\"\" src=\"management.file\/img\/202401021476016797.jpg\" style=\"height:73px; width:320px\" \/\u003E\u003C\/a\u003E\u003C\/p\u003E\r\n","video":{"title":""},"document":{"title":""},"file":{"imageObject":"202401024241176840.jpg"},"files":{"documents":["202401024118244706.pdf"]},"id":"344","fid":"237","url":"prevention-of-cardiovascular-disease-br-in-women-2016-2nd-edition"},{"title":"Heart Disease in \u003Cbr\u003EPregnancy 2016 (2nd Edition)","imageObject":{"title":""},"imageSecond":{"title":""},"blurb":"","content":"\u003Cp style=\"text-align:justify\"\u003EMalaysia, with a crude birth rate of 16.9 per 1000 population and an annual population growth rate of 1.3%, has also seen a significant growth in attendances at the Ministry of Health\u2019s antenatal clinics \u2013 from 5.7 million in 2013 to 6.1 million in 2014. Allied to the well documented rising prevalence of cardiovascular risk factors in the country over the last two decades, and the improved access of the population to healthcare facilities, it is reasonable to consider that there are greater numbers of pregnant women who are diagnosed or who are at risk of heart disease in Malaysia.\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003EThe Clinical Practice Guidelines on the management of heart disease in pregnancy in Malaysia was first published in 2001, so this 2nd edition is timely. These guidelines areintended to be an updated resource which is useful to all clinical practitioners and all those who are involved in the care of pregnant women. It incorporates updated knowledge on heart disease, contemporary diagnostic tools and strategies, and also on treatment options available, now over a decade since the first national guidelines was published on this subject.\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003EThe management of pregnant women in heart disease can be complex and often involves a multidisciplinary team, and particularly if the patient newly diagnosed with heart disease at the time of pregnancy. A multidisciplinary team is involved in the care of the pregnant women right through her pregnancy, and even beyond that. In recognition of this, I am proud to see the effort and coordination by the chairperson, Dr Robaayah Zambahari, to assemble an expert panel drawn from various clinical disciplines from different healthcare provider agencies. Their dedication and commitment have resulted in this comprehensive set of guidelines on how to manage heart disease in pregnancy in this modern era. I would like to thank all those who contributed to the publication of these guidelines, which I am certain will be a document often referred to, so that pregnant women with heart disease will be managed optimally to ensure the best possible outcomes for both mother and child.\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003E\u00a0\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003E\u003Cstrong\u003EDatuk Dr. Noor Hisham Bin Abdullah\u003Cbr \/\u003E\r\nMD, MS, AM, FAMM\u003C\/strong\u003E\u003Cbr \/\u003E\r\n\u003Cem\u003EDirector-General of Health Malaysia\u003Cbr \/\u003E\r\nMinistry of Health Malaysia\u003C\/em\u003E\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003E\u00a0\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003E\u003Cstrong\u003EStatement of intent:\u003C\/strong\u003E\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003EThis guideline was developed to be a guide for best clinical practice in the management of cardiovascular diseases in pregnancy, based on the best available evidence at the time of development. Specific attempts were made to use local data and publications to ensure local relevance. Adherence to this guideline does not necessarily lead to the best clinical outcome in individual patient care. Every health care provider is responsible for the management of his\/her unique patient based on the clinical presentation and management options available locally.\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003E\u003Cstrong\u003EReview of the guideline:\u003C\/strong\u003E\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003EThis guideline is issued in 2016 and will be reviewed in about 5 years or earlier if important new evidence becomes available.\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003E\u003Cstrong\u003EDownload the full document below:\u003C\/strong\u003E\u003C\/p\u003E\r\n\r\n\u003Cp\u003E\u003Ca href=\"management.file\/doc\/202401022316740118.pdf\" target=\"_blank\"\u003E\u003Cimg alt=\"\" src=\"management.file\/img\/202401021476016797.jpg\" style=\"height:73px; width:320px\" \/\u003E\u003C\/a\u003E\u003C\/p\u003E\r\n","video":{"title":""},"document":{"title":""},"files":{"library":[],"documents":["202401022316740118.pdf"]},"file":{"imageObject":"202401023047826113.jpg"},"id":"343","fid":"237","url":"heart-disease-in-br-pregnancy-2016-2nd-edition"},{"title":"Management of Heart Failure (2014)","imageObject":{"title":""},"imageSecond":{"title":""},"blurb":"","content":"\u003Cp style=\"text-align:justify\"\u003EHeart Disease is an important cause of morbidity and mortality in Malaysia. Most patients who survive a myocardial infarction or develop hypertension, will eventually develop heart failure. With ageing of the population, the prevalence of heart failure is expected to increase. Thus the publication of this Clinical Practice Guidelines on Heart Failure by the National Heart Association of Malaysia, Academy of Medicine and Ministry of Health is important and timely.\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003E\u003Cbr \/\u003E\r\nThis Guidelines updates all health care providers on the latest developments in the field of Heart failure. This is the 3rd edition of the Clinical Practice Guidelines. As in previous editions, it uses an evidence based approach and grades each recommendation accordingly thus allowing the physician in charge to apply the latest technology, knowledge and standard of care in the management of his or her patient. It provides a choice of therapy and thus allows the healthcare provider to adapt this to the local situation wherever possible.\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003E\u003Cbr \/\u003E\r\nFor this Clinical Practice Guidelines to be a success, it must be acceptable to our local setting and must be used widely.\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003ELastly, I would like to commend the Expert Committee for their hard work and effort in updating the guidelines for the benefit of all practicing physicians.\u003Cbr \/\u003E\r\n\u00a0\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003E\u003Cstrong\u003EDatuk Dr. Noor Hisham Bin Abdullah\u003Cbr \/\u003E\r\nMD, MS, AM, FAMM\u003C\/strong\u003E\u003Cbr \/\u003E\r\n\u003Cem\u003EDirector General of Health Malaysia\u003Cbr \/\u003E\r\nMinistry of Health Malaysia\u003C\/em\u003E\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003E\u00a0\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003E\u003Cstrong\u003EStatement of intent:\u003C\/strong\u003E\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003EThis clinical practice guidelines (CPG) is meant to be a guide for clinical practice, based on the best available evidence at the time of development. Adherence to these guidelines may not necessarily guarantee the best outcome in every case. Every health care provider is responsible for the management of his\/her patient based on the clinical picture presented by the patient and the management options available locally.\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003EPeriod of validity\u003Cbr \/\u003E\r\nThis CPG was issued in 2014 and will be reviewed in 5 years or sooner if new evidence becomes available.\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003E\u003Cstrong\u003EDownload the full document below:\u003C\/strong\u003E\u003C\/p\u003E\r\n\r\n\u003Cp\u003E\u003Ca href=\"management.file\/doc\/202401028415617480.pdf\" target=\"_blank\"\u003E\u003Cimg alt=\"\" src=\"management.file\/img\/202401021476016797.jpg\" style=\"height:73px; width:320px\" \/\u003E\u003C\/a\u003E\u003C\/p\u003E\r\n","video":{"title":""},"document":{"title":""},"file":{"imageObject":"202401025061874841.jpg"},"files":{"documents":["202401028415617480.pdf"]},"id":"345","fid":"237","url":"management-of-heart-failure-2014"},{"title":"Consensus Statement on the\u003Cbr\u003E Utilisation of Cardiac Computed \u003Cbr\u003ETomography (2nd edition)","imageObject":{"title":""},"imageSecond":{"title":""},"blurb":"","content":"\u003Cp style=\"text-align:justify\"\u003ECardiovascular disease remains the world'd biggest killer with coronary artery disease (CAD) being the largest contributor. In Malaysia, it has surpassed infective diseases as the leading cause of death, making it the most important non-communicable disease that the nation has to combat against.\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003E\u003Cbr \/\u003E\r\nCardiac computed tomography (CCT) has been utilised in the last 20 years as one of the imaging modality used to diagnose CAD. Its tremendous growth in technology has seen its application grow from coronary calcium imaging and noninvasive coronary angiography to more functional cardiac and non-coronary work. With these advancements, Malaysia has to keep abreast with the contemporary use and application of this modality to be in parallel with the rest of the world.\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003E\u003Cbr \/\u003E\r\nThis consensus statement is one of the ways that Malaysians especially the medical professionals involved in the care of patients with cardiovascular diseases will be able to understand and apply the use of this imaging modality in our setting. I would like to thank the National Heart Association of Malaysia, its sister society the Society of Cardiac Imaging Malaysia and the College of Radiology for their efforts to make this second edition come to fruition. Together, we can now utilise it in our fight against cardiovascular disease.\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003E\u003Cbr \/\u003E\r\n\u003Cstrong\u003EDatuk Dr. Noor Hisham Bin Abdullah\u003Cbr \/\u003E\r\nMD, MS, AM, FAMM\u003C\/strong\u003E\u003Cbr \/\u003E\r\n\u003Cem\u003EDirector General of Health Malaysia\u003Cbr \/\u003E\r\nMinistry of Health Malaysia\u003C\/em\u003E\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003E\u00a0\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003E\u003Cstrong\u003ETarget Audience:\u003C\/strong\u003E\u003Cbr \/\u003E\r\nThis update on the existing Consensus Statement on the Utilisation of Cardiac CT (2008) aims to mainly cater for physicians (cardiologists and radiologists) and radiographers involved in providing cardiovascular computed tomography services.\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003E\u003Cstrong\u003EDownload the full document below:\u003C\/strong\u003E\u003C\/p\u003E\r\n\r\n\u003Cp\u003E\u003Ca href=\"management.file\/doc\/202401021607001994.pdf\" target=\"_blank\"\u003E\u003Cimg alt=\"\" src=\"management.file\/img\/202401021476016797.jpg\" style=\"height:73px; width:320px\" \/\u003E\u003C\/a\u003E\u003C\/p\u003E\r\n","video":{"title":""},"document":{"title":""},"file":{"imageObject":"202401024160971009.jpg"},"files":{"documents":["202401021607001994.pdf"]},"id":"347","fid":"237","url":"consensus-statement-on-the-br-utilisation-of-cardiac-computed-br-tomography-2nd-edition"},{"title":"Malaysian Consensus Statement on \u003Cbr\u003Ethe Utilisation of Cardiac Magnetic \u003Cbr\u003EResonance 2015","imageObject":{"title":""},"imageSecond":{"title":""},"blurb":"","content":"\u003Cp style=\"text-align:justify\"\u003ECardiovascular diseases are undoubtedly the leading cause of death worldwide and certainly in Malaysia. In dealing with the increasing cardiovascular disease burden, it is paramount that contemporary clinical cardiology practice mirrors the ever-growing scientific medical knowledge. Cardiac magnetic resonance (CMR) being the latest addition to the clinical armamentarium of cardiovascular imaging is certainly no different. The importance of CMR is such that today it has already become the gold standard clinical test in some cardiac diseases.\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003E\u003Cbr \/\u003E\r\nAs much as CMR is clinically needed, it has not taken off as expected. Formal institutional services were already available in Sarawak General Hospital since 2003 and 12 years on, we are still challenged by the limited availability of trained physicians, technicians and CMR capable MRI scanners. At the time of writing, there were only just over 20 practicing trained experts scattered in a handful of tertiary or quaternary care institutions throughout Malaysia.\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003E\u003Cbr \/\u003E\r\nI laud the combined efforts of these CMR specialists representing all the healthcare institutions of the country from the Ministry of Health to university hospitals and private hospitals having taken the challenging effort to come up with this inaugural consensus statement. It is hoped that this consensus statement will be useful beyond just being a reference, generating interest and awareness for this recent imaging modality amongst physicians and patients with cardiac diseases and setting the academic platform for future collaboration with the two stakeholder societies i.e. the National Heart Association of Malaysia and the College of Radiology Malaysia.\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003E\u00a0\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003EIn time, it is hoped that these efforts will translate to an increase in allocation of resources leading to the growth of CMR services, thus providing an avenue for the experts to ensure the most updated CMR practices in Malaysia in the years to come. Lastly, I thank the National Heart Association of Malaysia, its sister society the Society of Cardiac Imaging Malaysia, and the College of Radiology for spearheading this important initiative. This indeed is an exciting and evolving modality to improve cardiovascular healthcare in our country.\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003E\u003Cbr \/\u003E\r\n\u003Cstrong\u003EDatuk Dr. Noor Hisham Bin Abdullah\u003Cbr \/\u003E\r\nMD, MS, AM, FAMM\u003C\/strong\u003E\u003Cbr \/\u003E\r\n\u003Cem\u003EDirector General of Health Malaysia\u003Cbr \/\u003E\r\nMinistry of Health Malaysia\u003C\/em\u003E\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003E\u00a0\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003E\u003Cstrong\u003EDisclaimer:\u003C\/strong\u003E\u003Cbr \/\u003E\r\nThe content and recommendations made in this consensus statement are based on currently available scientific data and best clinical practice recommendations from internationally recognised bodies. Its use is for the sole purpose of physicians (cardiologists\/radiologists) and radiographers trained to use this modality within Malaysia. Clinical judgement is to prevail in all decisions and should not replace individual responsibility, especially with regards to the safety of users and patients\/clients.\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003E\u003Cstrong\u003EDownload the full document below:\u003C\/strong\u003E\u003C\/p\u003E\r\n\r\n\u003Cp\u003E\u003Ca href=\"management.file\/doc\/202401028660387141.pdf\" target=\"_blank\"\u003E\u003Cimg alt=\"\" src=\"management.file\/img\/202401021476016797.jpg\" style=\"height:73px; width:320px\" \/\u003E\u003C\/a\u003E\u003C\/p\u003E\r\n","video":{"title":""},"document":{"title":""},"file":{"imageObject":"202401026810641378.jpg"},"files":{"documents":["202401028660387141.pdf"]},"id":"346","fid":"237","url":"malaysian-consensus-statement-on-br-the-utilisation-of-cardiac-magnetic-br-resonance-2015"},{"title":"Appropriate Use Criteria for\u003Cbr\u003E Investigations and Revascularization\u003Cbr\u003E in CAD 2015 (1st edition)","imageObject":{"title":""},"imageSecond":{"title":""},"blurb":"","content":"\u003Cp style=\"text-align:justify\"\u003ECardiovascular Disease remains an important cause of mortality in Malaysia, accounting for 20-25% of all deaths in public hospitals. In Malaysia, patients with coronary artery disease (CAD) present at a mean age of 59 \u00b1 12 years, 6 years younger than those in the Global Registry of Acute Coronary Events (GRACE). More importantly, Malaysian patients have high prevalence of cardiovascular risk factors.\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003E\u003Cbr \/\u003E\r\nThe Ministry of Health (MOH) welcomes and supports the initiatives taken by National Heart Association of Malaysia (NHAM) to introduce the Appropriate Use Criteria (AUC) for management of CAD. This AUC document has been developed as a supplement to the Clinical Practice Guidelines (CPG) on the Management of Stable Coronary Artery Disease (CAD), Management of Unstable Angina\/Non ST Elevation Myocardial Infarction (UA\/NSTEMI), Management of ST Elevation Myocardial Infarction (STEMI) and Percutaneous Coronary Intervention (PCI). The development of this AUC aims to ensure that procedures are performed for appropriate indications, improve the physician\u2019s decision-making and educate patients on the expected benefits of the individual procedures. It combines the latest scientific evidence and the clinical judgement of a number of experts in utilizing tests and treatment options in a variety of clinical scenarios that are encountered in daily practice. Its rating is based on an average patient presenting to an average physician who would recommend or perform the procedure in an average hospital.\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003E\u003Cbr \/\u003E\r\nI congratulate the panel and NHAM for the development and publication of this AUC on management of CAD. These efforts and contributions would definitely bring a great impact on the future management of cardiovascular disease in this nation. Last but not the least, I believe that the ultimate objective of any healthcare provider is not solely to save lives \u2013 but rather to save the future that one life can bring. Our goal is not restricted to the idea of restoring the physical capacity of our patients \u2013 but we hope to walk the extra mile for the patients\u2019 continuous, consistent, long-term well-being.\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003E\u003Cbr \/\u003E\r\n\u003Cstrong\u003EDatuk Dr. Noor Hisham Abdullah\u003C\/strong\u003E\u003Cbr \/\u003E\r\n\u003Cem\u003EDirector General of Health Malaysia\u003Cbr \/\u003E\r\nMinistry of Health Malaysia\u003C\/em\u003E\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003E\u00a0\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003E\u003Cstrong\u003EPeriod of validity\u003C\/strong\u003E\u003Cbr \/\u003E\r\nThis AUC document was issued in 2015 and will be reviewed in 5 years or sooner as necessary\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003E\u003Cstrong\u003EDownload the full document below:\u003C\/strong\u003E\u003C\/p\u003E\r\n\r\n\u003Cp\u003E\u003Ca href=\"management.file\/doc\/202401027890146061.pdf\" target=\"_blank\"\u003E\u003Cimg alt=\"\" src=\"management.file\/img\/202401021476016797.jpg\" style=\"height:73px; width:320px\" \/\u003E\u003C\/a\u003E\u003C\/p\u003E\r\n","video":{"title":""},"document":{"title":""},"file":{"imageObject":"202401021987001466.jpg"},"files":{"documents":["202401027890146061.pdf"]},"id":"348","fid":"237","url":"appropriate-use-criteria-for-br-investigations-and-revascularization-br-in-cad-2015-1st-edition"},{"title":"Clinical Practice Guidelines Management \u003Cbr\u003EOf Acute ST Segment Elevation Myocardial \u003Cbr\u003EInfarction (STEMI) 2014 - (3rd edition)","imageObject":{"title":""},"imageSecond":{"title":""},"blurb":"","content":"\u003Ch2 style=\"text-align:justify\"\u003E\u003Cstrong\u003EMESSAGE FROM THE DIRECTOR GENERAL OF HEALTH\u003C\/strong\u003E\u003C\/h2\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003EST segment myocardial infarction (STEMI) is the most deadly among the clinical presentations of acute coronary syndrome (ACS). Unlike many medical conditions, STEMI is associated with high mortality and morbidity in its early stages, including sudden death. The National Cardiovascular Disease (NCVD) ACS Registry revealed that there was a 10% mortality for patients who were admitted to hospital with STEMI in 2006-2008.\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003ESince the publication of the 2nd Edition of the Malaysian Clinical Practice Guidelines (CPG) for the management of STEMI in 2007, there have been advances in the way STEMI is managed by the medical community, and more specialised centres providing leading-edge care for this condition. Therefore, it is timely for the publication of this 3rd edition of the Malaysian\u003Cbr \/\u003E\r\nCPG for STEMI.\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003EIt is testament to the commitment of the team of experts involved who are continuing to pursue the update of this and other CPGs. The pace of innovation in medicine has relentless in recent years, especially so in the area of cardiovascular medicine, in terms of both medical and interventional management.\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003EThere is a continual effort to not only update the CPGs but also improve the process of selecting and evaluating evidence. In addition, the incorporation of local data will make Malaysian CPGs more relevant document in the local context. I envisage many young physicians, generalists and allied health professionals will use these CPGs as a useful reference.\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003EI acknowledge that this is not an insignificant effort given other clinical and leadership responsibilities of all those directly involved, and thank the team of authors and reviewers for their time and valuable contributions. I believe this CPG will be an invaluable document for healthcare providers involved in the management of STEMI and subsequently to improve health outcomes associated with this deadly condition.\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003E\u00a0\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003E\u003Cem\u003EDatuk Dr. Noor Hisham bin Abdullah\u003C\/em\u003E\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003E\u003Cstrong\u003EThe Director General of Health, Ministry of Health Malaysia\u003C\/strong\u003E\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003E\u003Cem\u003EThis document is an update and supersedes the previous CPG on STEMI (2007)\u003C\/em\u003E\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003E\u00a0\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003E\u003Cstrong\u003EDownload the full document below:\u003C\/strong\u003E\u003C\/p\u003E\r\n\r\n\u003Cp\u003E\u003Ca href=\"management.file\/doc\/202401021941640270.pdf\" target=\"_blank\"\u003E\u003Cimg alt=\"\" src=\"management.file\/img\/202401021476016797.jpg\" style=\"height:73px; width:320px\" \/\u003E\u003C\/a\u003E\u003C\/p\u003E\r\n","video":{"title":""},"document":{"title":""},"files":{"library":[],"documents":["202401021941640270.pdf"]},"file":{"imageObject":"202401020722193416.jpg"},"id":"349","fid":"237","url":"clinical-practice-guidelines-management-br-of-acute-st-segment-elevation-myocardial-br-infarction-stemi-2014-3rd-edition"},{"title":"Clinical Practice Guidelines-Management\u003Cbr\u003E of Stable Angina Pectoris","imageObject":{"title":""},"imageSecond":{"title":""},"blurb":"","content":"\u003Cp style=\"text-align:justify\"\u003ECoronary artery disease (CAD) comprises a broad spectrum of manifestation rangingfrom asymptomatic atherosclerosis to stable angina pectoris (SAP), acute coronarysyndrome (ACS), myocardial infarction (MI) and congestive heart failure (CHF). Themanagement of SAP has not been extensively studied in large randomised clinicaltrials.In Malaysia, these patients may be managed by cardiologists, physicians and primarycare doctors. The CPG on Management of SAP was developed to help guide cliniciansin the management of this group of patients. No previous guideline was available inMalaysia prior to this.\u003Cbr \/\u003E\r\n\u00a0\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003E\u003Cstrong\u003EObjectives\u003C\/strong\u003E\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003EThese guidelines are intended to provide education and awareness on ways to:\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003E1. Identify patients with stable angina.\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003E2. Assess, risk stratify and manage these patients appropriately.\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003E\u003Cstrong\u003EClinical Questions\u003C\/strong\u003E\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003EThe clinical questions addressed in these guidelines include:\u00a0\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003E1. How does one diagnose a patient with SAP and exclude patient with unstableangina?\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003E2. Having identified patients with SAP, what appropriate tests should be done fordiagnosis and prognostication?\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003E3. Which patients should be referred for invasive procedures?\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003E4. What appropriate treatment modalities, either non-pharmacological and\/orpharmacological to be utilised?\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003E\u00a0\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003E\u003Cstrong\u003ETarget Group\u003C\/strong\u003E\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003EThis guideline is directed at all healthcare providers treating SAP \u2013 generalpractitioners, medical officers, general and family physicians and cardiologists.\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003E\u003Cstrong\u003ETarget Population\u003C\/strong\u003E\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003EThis guideline is for the management of patients with Stable Angina Pectoris. Itexcludes patients with new-onset angina, crescendo angina and rest angina.\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003E\u003Cstrong\u003EDownload the full document below:\u003C\/strong\u003E\u003C\/p\u003E\r\n\r\n\u003Cp\u003E\u003Ca href=\"management.file\/doc\/202401021013976546.pdf\" target=\"_blank\"\u003E\u003Cimg alt=\"\" src=\"management.file\/img\/202401021476016797.jpg\" style=\"height:73px; width:320px\" \/\u003E\u003C\/a\u003E\u003C\/p\u003E\r\n","video":{"title":""},"document":{"title":""},"file":{"imageObject":"202401023966141075.jpg"},"files":{"documents":["202401021013976546.pdf"]},"id":"350","fid":"237","url":"clinical-practice-guidelines-management-br-of-stable-angina-pectoris"},{"title":"Clinical Practice Guidelines-Management\u003Cbr\u003E of Pulmonary Arterial Hypertension (PAH)","imageObject":{"title":""},"imageSecond":{"title":""},"blurb":"","content":"\u003Cp style=\"text-align:justify\"\u003EPulmonary arterial hypertension (PAH) is defined as a group of diseases characterised by a progressive increase of pulmonary vascular resistance (PVR) leading to right ventricular failure and premature death. Untreated, it is a potentially devastating disease. However, the past decade has seen remarkable improvements in our understanding of the pathology associated with the condition and the development of PAH-specific therapies with the ability to alter the natural history of the disease. Indeed, the diagnosis, assessment and treatment of PAH is a rapidly evolving area, with changes occurring in the definition of the disease, screening and diagnostic techniques, staging and follow-up assessment, and a growing armamentarium of PAH-specific therapies.\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003EThese new advances provide a significant opportunity for practitioners to detect and treat patients with PAH in a timely and effective manner, thereby improving overall mortality, morbidity, and quality of life associated with this disease. Our intention is to provide clear and concise descriptions of the new pathological classification and of the recent pathogenetic insights. The diagnostic process will be discussed in order to propose a logical sequence of investigations for aetiology identification, disease assessment and follow-up. Special emphasis will be devoted to an evidence-based treatment algorithm that is unique to Malaysia, yet in-line with internationally accepted guidelines.\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003E\u003Cstrong\u003EThese guidelines provide:\u003C\/strong\u003E\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003Ea) A description of Pulmonary Arterial Hypertension (PAH) which\u00a0reflects the devastating nature of PAH that have crucial bearing on\u00a0the patient\u2019s management\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003Eb) A description of the basic pathophysiology of PAH\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003Ec) A brief discussion on the Dana Point Classification (2008) and WHO\u00a0Functional Class Classification\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003Ed) Guidance on the recognition of clinical features and diagnostic\u00a0approach of PAH.\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003Ee) An algorithm on treatment of PAH with available therapies locally\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003Ef) A guide on PAH disease monitoring in accordance with dynamic\u00a0changes with therapy or with disease progression\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003Eg) A guide on management of PAH in congenital heart disease. \u00a0\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003E\u003Cstrong\u003EDownload the full document below:\u003C\/strong\u003E\u003C\/p\u003E\r\n\r\n\u003Cp\u003E\u003Ca href=\"management.file\/doc\/202401027814714069.pdf\" target=\"_blank\"\u003E\u003Cimg alt=\"\" src=\"management.file\/img\/202401021476016797.jpg\" style=\"height:73px; width:320px\" \/\u003E\u003C\/a\u003E\u003C\/p\u003E\r\n","video":{"title":""},"document":{"title":""},"file":{"imageObject":"202401021914487760.jpg"},"files":{"documents":["202401027814714069.pdf"]},"id":"351","fid":"237","url":"clinical-practice-guidelines-management-br-of-pulmonary-arterial-hypertension-pah"},{"title":"Clinical Practice Guidelines-Management \u003Cbr\u003Eof Atrial Fibrillation 2012","imageObject":{"title":""},"imageSecond":{"title":""},"blurb":"","content":"\u003Cp style=\"text-align:justify\"\u003EAtrial fibrillation (AF) is an atrial tachyarrhythmia characterized by uncoordinated atrial activation with consequent deterioration of atrial mechanical function. The surface ECG is characterized by \u2018absolutely\u2019 irregular RR intervals and the absence of any distinct P waves. The P waves are replaced by fibrillary (F) waves.\u003Cbr \/\u003E\r\n\u003Cbr \/\u003E\r\nAtrial Flutter (AFl) in the typical form is characterized by a saw-tooth pattern of regular atrial activation called flutter (F) waves on the ECG. AFl commonly occurs with 2:1 AV block, resulting in a regular or irregular ventricular rate of 120 to 160 beats per minute (most characteristically about 150 beats per minute).\u003Cbr \/\u003E\r\n\u003Cbr \/\u003E\r\nAF is the commonest sustained cardiac arrhythmia. Information on AF in Malaysia is scarce. Hospital practice data may give a biased view of the clinical epidemiology of AF, since only one-third of patients with AF may actually have been admitted to hospital. Data from predominantly western populations suggest the estimated prevalence of AF is 0.4% to 1% in the general population. The prevalence of AF doubles with each decade of age, from 0.5% at age 50-59 years to almost 9% at age 80-89 years.\u003Csup\u003E3-4\u003C\/sup\u003E\u00a0The mortality rate of patients with AF is about double that of patients in sinus rhythm.\u003Csup\u003E2, 5\u003C\/sup\u003E\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003EIn patients with AF or AFI, the aims of treatment involve the following five objectives.\u003C\/p\u003E\r\n\r\n\u003Col style=\"list-style-type:upper-roman\"\u003E\r\n\t\u003Cli style=\"text-align:justify\"\u003ERelief of symptoms, such as palpitations, dizziness, fatigue and dyspnoea, is paramount to the patient.\u003C\/li\u003E\r\n\t\u003Cli style=\"text-align:justify\"\u003EThe prevention of serious complications, such as thromboembolism (particularly ischaemic stroke) and heart failure, is equally important.\u003C\/li\u003E\r\n\t\u003Cli style=\"text-align:justify\"\u003EOptimal management of concomitant cardiovascular disease.\u003C\/li\u003E\r\n\t\u003Cli style=\"text-align:justify\"\u003ERate control.\u003C\/li\u003E\r\n\t\u003Cli style=\"text-align:justify\"\u003ECorrection of rhythm disturbance.\u003C\/li\u003E\r\n\u003C\/ol\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003E\u003Cstrong\u003EReferences:\u003C\/strong\u003E\u003Cbr \/\u003E\r\n\u003Cbr \/\u003E\r\n(2) Kirchhof P, Auricchio A, Bax J, Crijns H, Camm J, Diener HC, Goette A, Hindricks G, Hohnloser S, Kappenberger L, Kuck KH, Lip GY, Olsson B, Meinertz T, Priori S, Ravens U, Steinbeck G, Svernhage E, Tijssen J, Vincent A, Breithardt G. Outcome parameters for trials in atrial fibrillation: executive summary. Recommendations from a consensus conference organized by the German Atrial Fibrillation Competence NETwork (AFNET) and the European Heart Rhythm Association (EHRA). Eur Heart J 2007; 28:2803-2817.\u003Cbr \/\u003E\r\n\u003Cbr \/\u003E\r\n(3)\u00a0 Stewart S, Hart CL, Hole DJ, McMurray JJ. Population prevalence, incidence, and predictors of atrial fibrillation in the Renfrew\/Paisley study. Heart 2001; 86:516-521.\u003Cbr \/\u003E\r\n\u003Cbr \/\u003E\r\n(4) Go AS, Hylek EM, Phillips KA, Chang Y, Henault LE, Selby JV, Singer DE. Prevalence of diagnosed atrial fibrillation in adults: national implications for rhythm management and stroke prevention: the AnTicoagulation and Risk Factors in Atrial Fibrillation (ATRIA) Study. JAMA 2001; 285:2370-2375.\u003Cbr \/\u003E\r\n\u003Cbr \/\u003E\r\n(5) Stewart S, Hart CL, Hole DJ, McMurray JJ. A population-based study of the long-term risks associated with atrial fibrillation: 20-year follow-up of the Renfrew\/Paisley study. Am J Med 2002; 113:359-364.\u003Cbr \/\u003E\r\n\u003Cbr \/\u003E\r\nThis CPG is intended to assist health care providers in clinical decision making by describing a range of generally acceptable approaches for the diagnosis, management, and prevention of AF.\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003E\u003Cstrong\u003EDownload the full document below:\u003C\/strong\u003E\u003C\/p\u003E\r\n\r\n\u003Cp\u003E\u003Ca href=\"management.file\/doc\/202401021159670714.pdf\" target=\"_blank\"\u003E\u003Cimg alt=\"\" src=\"management.file\/img\/202401021476016797.jpg\" style=\"height:73px; width:320px\" \/\u003E\u003C\/a\u003E\u003C\/p\u003E\r\n","video":{"title":""},"document":{"title":""},"file":{"imageObject":"202401020195147176.jpg"},"files":{"documents":["202401021159670714.pdf"]},"id":"352","fid":"237","url":"clinical-practice-guidelines-management-br-of-atrial-fibrillation-2012"},{"title":"Clinical Practice Guidelines-Management\u003Cbr\u003Eof Dyslipidemia 2011 (4th Edition)","imageObject":{"title":""},"imageSecond":{"title":""},"blurb":"","content":"\u003Cp style=\"text-align:justify\"\u003EIn 2009, cardiovascular disease (CVD) was the leading cause of death in both men and women\u003Csup\u003E1\u003C\/sup\u003E. CVD includes coronary heart disease (CHD), cerebrovascular disease and peripheral arterial disease. CHD is a spectrum ranging from stable angina to acute coronary syndromes (ACS).\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003EThe peak incidence of ACS in Malaysia was in the 51-60 year age group and the male to female ratio was 3:1\u003Csup\u003E2\u003C\/sup\u003E. The mean age in the local NCVD-ACS Registry 2006 was 58.1 years.\u003Csup\u003E3\u003C\/sup\u003E\u00a0This is younger than that noted in neighbouring countries such as Thailand (65 years)\u00a0\u003Csup\u003E4\u003C\/sup\u003E, China (63 years)\u00a0\u003Csup\u003E5\u003C\/sup\u003E\u00a0and in the western population (GRACE Registry- 66 years\u003Csup\u003E6\u003C\/sup\u003E, Canada- 68 years\u003Csup\u003E7\u003C\/sup\u003E).\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003EIn the NCVD-ACS Registry, most patients (96.8%) had at least one established cardiovascular risk factor - hypertension (72.6%), dyslipidaemia (55.9%) and\/or diabetes (55%)\u003Csup\u003E3\u003C\/sup\u003E.\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003EIn the prevention of CVD, efforts should be aimed at reducing global risks. This guideline emphasizes:\u003C\/p\u003E\r\n\r\n\u003Cul\u003E\r\n\t\u003Cli style=\"text-align:justify\"\u003Ea multifactorial approach that addresses all risk factors. This is because the benefits of modifying several risk factors simultaneously are synergistic.\u003C\/li\u003E\r\n\t\u003Cli style=\"text-align:justify\"\u003Ethat preventing CVD should be directed at global CVD burden rather than CHD alone.\u003C\/li\u003E\r\n\u003C\/ul\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003EIn the management of dyslipidaemia the following changes have been made:\u003C\/p\u003E\r\n\r\n\u003Cul\u003E\r\n\t\u003Cli style=\"text-align:justify\"\u003Eidentification of those at high risk - this includes individuals with established CVD, diabetes, multiple risk factors and established renal disease.\u003C\/li\u003E\r\n\t\u003Cli style=\"text-align:justify\"\u003Eemphasizes the importance of a family history of premature CVD and familial dyslipidaemia\u003C\/li\u003E\r\n\t\u003Cli style=\"text-align:justify\"\u003Etreatment targets.\u003C\/li\u003E\r\n\u003C\/ul\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003EThe objectives of this CPG is to:\u003C\/p\u003E\r\n\r\n\u003Cul\u003E\r\n\t\u003Cli style=\"text-align:justify\"\u003Ehighlight the important advances in the management of dyslipidaemia in recent years\u003C\/li\u003E\r\n\t\u003Cli style=\"text-align:justify\"\u003Eeducate healthcare providers on the importance of risk stratification in determining the intensity of preventive efforts and treatment targets\u003C\/li\u003E\r\n\t\u003Cli style=\"text-align:justify\"\u003Eupdate healthcare providers on the management of dyslipidaemia\u003C\/li\u003E\r\n\u003C\/ul\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003E\u00a0\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003E\u003Cstrong\u003EReferences:\u003C\/strong\u003E\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003E1. Number of discharges and deaths in government hospitals. Health Informatics Centre, Planning and Development Division, Ministry of Health Malaysia, July 2010.\u003Cbr \/\u003E\r\n2. Azman W, Ramesh S V, Zambahari R et al on behalf of the ACCORD investigators. Malaysia-ACute CORonary syndromes Descriptive study (ACCORD): Evaluation of the compliance with existing guidelines in patients with Acute Coronary Syndrome (Unstable Angina and Non-ST elevation Myocardial Infarction). Personal communication.\u003Cbr \/\u003E\r\n3. WA Wan Ahmad, KH Sim (Eds). Annual Report of the NCVD-ACS Registry, Year 2006. Kuala Lumpur, Malaysia: National Cardiovascular Disease Database 2008, Assessed at\u00a0\u003Ca href=\"http:\/\/www.acrm.org.my\/\"\u003Ewww.acrm.org.my\u003C\/a\u003E\u003Cbr \/\u003E\r\n4. Chaowalit N, Yipintsoi T, Tresukosol D et al for the Thai Acute Coronary Syndrome Registry. Prognostic value of selected presenting features of acute coronary syndrome in predicting in-hospital adverse events: insight from the Thai Acute Coronary Syndrome Registry. Intern Med 2009; 48: 639-46.\u003Cbr \/\u003E\r\n5. Song XT, Chen YD, Pan WQ for the CRACE Investigators. Gender based differences in patients with acute coronary syndrome: finding from Chinese Registry of Acute Coronary Events (CRACE). Chin Med J 2007; 120:1063-7.\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003E\u003Cstrong\u003EDownload the full document below:\u003C\/strong\u003E\u003C\/p\u003E\r\n\r\n\u003Cp\u003E\u003Ca href=\"management.file\/doc\/202401025171090467.pdf\" target=\"_blank\"\u003E\u003Cimg alt=\"\" src=\"management.file\/img\/202401021476016797.jpg\" style=\"height:73px; width:320px\" \/\u003E\u003C\/a\u003E\u003C\/p\u003E\r\n","video":{"title":""},"document":{"title":""},"file":{"imageObject":"202401027917401661.jpg"},"files":{"documents":["202401025171090467.pdf"]},"id":"353","fid":"237","url":"clinical-practice-guidelines-management-br-of-dyslipidemia-2011-4th-edition"},{"title":"Clinical Practice Guidelines-Management \u003Cbr\u003Eof UA\/NSTEMI 2011 (2nd Edition)","imageObject":{"title":""},"imageSecond":{"title":""},"blurb":"","content":"\u003Cp style=\"text-align:justify\"\u003ECardiovascular Disease (CVD) is one of the main causes of mortality and morbidity in Malaysia. The estimated incidence of Acute Coronary Syndrome (ACS) is 141 per 100,000 population per year, and the in-patient mortality rate is approximately 7%. This data is derived from the National Cardiovascular Disease Database (NCVD) based on the ACS 2006 Annual report1. These figures are comparable similar to that of many developed countries. Unstable Angina\/Non ST Elevation Myocardial Infarction (UA\/NSTEMI) which falls within the spectrum of ACS, is an important cause of cardiac morbidity and mortality.\u003Cbr \/\u003E\r\n\u003Cbr \/\u003E\r\nThe last CPG on UA\/NSTEMI was published in 2002. Since then, there have been significant advances in the management of this important condition. Thus, it is timely to update this CPG to keep abreast with contemporary evidenced based state of the art management of this condition.\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003E\u003Cstrong\u003EDownload the full document below:\u003C\/strong\u003E\u003C\/p\u003E\r\n\r\n\u003Cp\u003E\u003Ca href=\"management.file\/doc\/202401027750010147.pdf\" target=\"_blank\"\u003E\u003Cimg alt=\"\" src=\"management.file\/img\/202401021476016797.jpg\" style=\"height:73px; width:320px\" \/\u003E\u003C\/a\u003E\u003C\/p\u003E\r\n","video":{"title":""},"document":{"title":""},"file":{"imageObject":"202401027071050174.jpg"},"files":{"documents":["202401027750010147.pdf"]},"id":"354","fid":"237","url":"clinical-practice-guidelines-management-br-of-ua-nstemi-2011-2nd-edition"},{"title":"Clinical Practice Guidelines-Management\u003Cbr\u003E of Percutaneous Coronary \u003Cbr\u003E\u00a0Intervention (PCI) 2009","imageObject":{"title":""},"imageSecond":{"title":""},"blurb":"","content":"\u003Cp style=\"text-align:justify\"\u003E\u003Cstrong\u003EIntroduction\u003C\/strong\u003E\u003Cbr \/\u003E\r\n\u003Cbr \/\u003E\r\nCardiovascular disease (CVD) is an important cause of morbidity and mortality in Malaysia. It accounted for about a fifth of the total burden of disease (admissions in government hospitals) in 2000. Coronary artery disease (CAD) and cerebrovascular disease accounted for 50% and 32% of the cardiovascular burden respectively. In 2006, CVD was the commonest cause of deaths in government hospitals accounting for 24.2% of total deaths.\u003Cbr \/\u003E\r\n\u003Cbr \/\u003E\r\nManagement of CAD includes aggressive risk factor modification and lifestyle changes, medical therapy and revascularisation procedures. Revascularisation is by percutaneous coronary intervention (PCI) and coronary artery bypass graft (CABG) surgery.\u003Cbr \/\u003E\r\n\u003Cbr \/\u003E\r\nIn Malaysia, there has been an increase in the number of diagnostic and interventional cardiac procedures performed over the last few years. With technical improvement in devices and skills, more complex PCI cases are now being addressed.\u003Cbr \/\u003E\r\n\u003Cbr \/\u003E\r\nThe National Cardiovascular Disease (NCVD) - PCI Registry was initiated in 2006 to obtain data and for clinical audit.\u003Cbr \/\u003E\r\n\u003Cbr \/\u003E\r\nThe objectives of this clinical practice guideline are to critically evaluate the use of PCI in the management of CAD based on currently available literature. It aims to:\u003C\/p\u003E\r\n\r\n\u003Cul\u003E\r\n\t\u003Cli style=\"text-align:justify\"\u003Eassist health care providers in clinical decision making regarding the appropriate use of coronary revascularisation procedures\u003C\/li\u003E\r\n\t\u003Cli style=\"text-align:justify\"\u003Eimprove patient outcomes following PCI\u003C\/li\u003E\r\n\t\u003Cli style=\"text-align:justify\"\u003Eimprove the standard of care in patients undergoing PCI\u003C\/li\u003E\r\n\u003C\/ul\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003EFor this purpose, this guideline is divided into 2 parts:\u003C\/p\u003E\r\n\r\n\u003Cul\u003E\r\n\t\u003Cli style=\"text-align:justify\"\u003EPart A: The role of PCI in the management of patients with CAD\u003C\/li\u003E\r\n\t\u003Cli style=\"text-align:justify\"\u003EPart B: Technical aspects of PCI as a revascularisation strategy Guidelines help in the management of patients. Not all eligible patients will have access to all the recommendations stated in this guideline. Patient care should be individualised and clinical judgement plays an important role in decision making.\u003C\/li\u003E\r\n\u003C\/ul\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003E\u003Cstrong\u003EDownload the full document below:\u003C\/strong\u003E\u003C\/p\u003E\r\n\r\n\u003Cp\u003E\u003Ca href=\"management.file\/doc\/202401026111040717.pdf\" target=\"_blank\"\u003E\u003Cimg alt=\"\" src=\"management.file\/img\/202401021476016797.jpg\" style=\"height:73px; width:320px\" \/\u003E\u003C\/a\u003E\u003C\/p\u003E\r\n","video":{"title":""},"document":{"title":""},"file":{"imageObject":"202401024011177016.jpg"},"files":{"documents":["202401026111040717.pdf"]},"id":"355","fid":"237","url":"clinical-practice-guidelines-management-br-of-percutaneous-coronary-br-intervention-pci-2009"},{"title":"Clinical Practice Guidelines-Management \u003Cbr\u003Eof Heart Failure 2007 (2nd Edition)","imageObject":{"title":""},"imageSecond":{"title":""},"blurb":"","content":"\u003Cp style=\"text-align:justify\"\u003E\u003Cstrong\u003EIntroduction\u003C\/strong\u003E\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003EHeart failure (HF) is the end stage of most diseases of the heart. The\u00a0prevalence of HF varies between 3 \u2013 20 per 1000 population, although\u00a0in persons over the age of 65 years, it could be as high as 100 per 1000\u00a0population.\u00a0\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003EThe prognosis for HF is poor, far worse than some of the common\u00a0cancers. The one year mortality rate varies between 5% to 52%\u00a0depending on the severity and the presence of co-morbidity.\u00a0In a large community based study, about 40% of individuals with HF\u00a0died within a year of initial diagnosis. About half of all deaths are\u00a0sudden and may occur at any stage of the syndrome. Heart failure is\u00a0an important cause of hospitalization accounting for about 10% of all\u00a0medical admissions in Malaysia. About 45% of patients with HF are\u00a0readmitted at least once within 12 months for acute decompensation.\u00a0\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003EMore recent epidemiological studies from the West seem to indicate\u00a0that the prognosis has improved slightly with earlier detection of the\u00a0condition and improved treatment strategies. \u00a0\u00a0\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003EThe aims of management are:\u00a0\u003C\/p\u003E\r\n\r\n\u003Cul\u003E\r\n\t\u003Cli style=\"text-align:justify\"\u003EPreventing the development of HF\u00a0\u003C\/li\u003E\r\n\u003C\/ul\u003E\r\n\r\n\u003Cul\u003E\r\n\t\u003Cli style=\"text-align:justify\"\u003EReducing the morbidity associated with the condition and\u00a0improving the quality of life of these patients\u00a0\u003C\/li\u003E\r\n\u003C\/ul\u003E\r\n\r\n\u003Cul\u003E\r\n\t\u003Cli style=\"text-align:justify\"\u003EImproving the survival of patients with HF\u00a0\u003C\/li\u003E\r\n\u003C\/ul\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003EThis guideline provides evidence based recommendations to help\u00a0health care providers in the management of their patients with HF.\u00a0Patient care should however be individualized and sound clinical\u00a0judgement plays an important role in decision making.\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003E\u003Cstrong\u003EDownload the full document below:\u003C\/strong\u003E\u003C\/p\u003E\r\n\r\n\u003Cp\u003E\u003Ca href=\"management.file\/doc\/202401020147791151.pdf\" target=\"_blank\"\u003E\u003Cimg alt=\"\" src=\"management.file\/img\/202401021476016797.jpg\" style=\"height:73px; width:320px\" \/\u003E\u003C\/a\u003E\u003C\/p\u003E\r\n","video":{"title":""},"document":{"title":""},"file":{"imageObject":"202401025907111741.jpg"},"files":{"documents":["202401020147791151.pdf"]},"id":"356","fid":"237","url":"clinical-practice-guidelines-management-br-of-heart-failure-2007-2nd-edition"},{"title":"Clinical Practice Guidelines-Prevention\u003Cbr\u003E of Cardiovascular Disease in Women\u003Cbr\u003E 2008 (1st Edition)","imageObject":{"title":""},"imageSecond":{"title":""},"blurb":"","content":"\u003Cp style=\"text-align:justify\"\u003E\u003Cstrong\u003ESummary\u003C\/strong\u003E\u003C\/p\u003E\r\n\r\n\u003Cul\u003E\r\n\t\u003Cli style=\"text-align:justify\"\u003ECardiovascular disease (CVD) is the main cause of death among women in Malaysia.\u003C\/li\u003E\r\n\t\u003Cli style=\"text-align:justify\"\u003EIn the National Health a\u00adnd Morbidity Survey (NHMS) III, the prevalence of lifestyle related diseases (hypertension, diabetes, overweight and obesity) has increased significantly. In addition, the longer life expectancy of Malaysian women (76.4 years) will further increase the CVD burden.\u003C\/li\u003E\r\n\t\u003Cli style=\"text-align:justify\"\u003EGender differences include the following:-\u003Cbr \/\u003E\r\n\t\u003Cbr \/\u003E\r\n\t- Presenting symptoms for CHD and stroke in women may be atypical.\u003Cbr \/\u003E\r\n\t- Women have a higher prevalence of CVD risk factors with increasing age.\u003Cbr \/\u003E\r\n\t- The physiological changes associated with midlife and menopause contributes to this increased prevalence of risk factors.\u003Cbr \/\u003E\r\n\t- CVD risk factors such as hypertension, diabetes and smoking confer a worse prognosis in women.\u003C\/li\u003E\r\n\t\u003Cli style=\"text-align:justify\"\u003EIncreased awareness, early and appropriate investigations and management of CVD is important.\u003C\/li\u003E\r\n\t\u003Cli style=\"text-align:justify\"\u003EAll women should know the levels and significance of their risk factors. All women above the age of 40 years, should have their CVD risk assessed and risk stratified to:-\u003Cbr \/\u003E\r\n\t\u003Cbr \/\u003E\r\n\t- High Risk\u003Cbr \/\u003E\r\n\t- At Risk\u003Cbr \/\u003E\r\n\t- Optimal Risk\u003C\/li\u003E\r\n\t\u003Cli style=\"text-align:justify\"\u003EAssessment of CVD risk involves:\u003Cbr \/\u003E\r\n\t\u003Cbr \/\u003E\r\n\t- History: Looking for symptoms of CHD or CHD Equivalents, family history of premature CHD, smoking status physical activity.\u003Cbr \/\u003E\r\n\t- Physical Examination: Height, weight, BMI, waist circumference, pulses, blood pressure.\u003Cbr \/\u003E\r\n\t- Investigations: Blood sugar, lipid profile\u003C\/li\u003E\r\n\t\u003Cli style=\"text-align:justify\"\u003EThe CVD risk factors should be identified and appropriately managed to target :-\u003Cbr \/\u003E\r\n\t\u003Cbr \/\u003E\r\n\t- High Risk - intensive risk factor reduction with pharmacological and lifestyle changes from the outset.\u003Cbr \/\u003E\r\n\t- At Risk - non pharmacological intervention with diet and physical activity. If targets not achieved, pharmacological therapy is indicated.\u003Cbr \/\u003E\r\n\t- Optimal Risk - continue with healthy lifestyle measures.\u003C\/li\u003E\r\n\u003C\/ul\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003E\u003Cstrong\u003EDownload the full document below:\u003C\/strong\u003E\u003C\/p\u003E\r\n\r\n\u003Cp\u003E\u003Ca href=\"management.file\/doc\/202401027164117210.pdf\" target=\"_blank\"\u003E\u003Cimg alt=\"\" src=\"management.file\/img\/202401021476016797.jpg\" style=\"height:73px; width:320px\" \/\u003E\u003C\/a\u003E\u003C\/p\u003E\r\n","video":{"title":""},"document":{"title":""},"file":{"imageObject":"202401026101127147.jpg"},"files":{"documents":["202401027164117210.pdf"]},"id":"357","fid":"237","url":"clinical-practice-guidelines-prevention-br-of-cardiovascular-disease-in-women-br-2008-1st-edition"},{"title":"Clinical Practice Guidelines-Management of Acute ST segment Elevation Myocardial Infarction (STEMI)2007 (2nd edtion)","imageObject":{"title":""},"imageSecond":{"title":""},"blurb":"","content":"\u003Cp style=\"text-align:justify\"\u003E\u003Cstrong\u003EMessage from the Director General Of Health\u003C\/strong\u003E\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003EIn this new millennium, there has been an exponential increase of scientific knowledge and publications. Indeed, one of the greatest challenges of modern day medical practice is to keep pace with this information and applying them into routine clinical practice.\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003EThe publication of the Malaysian CPG on STEMI by the National Heart Association of Malaysia, Academy of Medicine and Ministry of Health Malaysia is therefore very timely. Apart from the updates in the clinical scientific knowledge, adaptations have been made for the local setting.\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003EWith this CPG, patients presenting to any of the health care institutions in the country with STEMI will be assured of the latest standards of clinical practice. However, for any CPG to be a success, it has to be utilized optimally and updated from time to time.\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003EI would like to commend to the expert panel for the time and effort taken by them in updating this CPG and for health care practitioners to translate knowledge in this CPG into routine clinical practice, for the benefit of our fellow Malaysians.\u003Cbr \/\u003E\r\n\u003Cbr \/\u003E\r\n\u003Cstrong\u003EY.Bhg Tan Sri Datuk Dr Hj Mohd Ismail Merican\u003Cbr \/\u003E\r\nDirector General of Health Malaysia\u003C\/strong\u003E\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003EFor further reading, please download the lecture slides below....\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003E\u003Cstrong\u003EDownload the full document below:\u003C\/strong\u003E\u003C\/p\u003E\r\n\r\n\u003Cp\u003E\u003Ca href=\"management.file\/doc\/202401027417131170.pdf\" target=\"_blank\"\u003E\u003Cimg alt=\"\" src=\"management.file\/img\/202401021476016797.jpg\" style=\"height:73px; width:320px\" \/\u003E\u003C\/a\u003E\u003C\/p\u003E\r\n","video":{"title":""},"document":{"title":""},"file":{"imageObject":"202401023171170174.jpg"},"files":{"documents":["202401027417131170.pdf"]},"id":"358","fid":"237","url":"clinical-practice-guidelines-management-of-acute-st-segment-elevation-myocardial-infarction-stemi-2007-2nd-edtion"},{"title":"Clinical Practice Guidelines\u003Cbr\u003E-Management of Stroke","imageObject":{"title":""},"imageSecond":{"title":""},"blurb":"","content":"\u003Cp style=\"text-align:justify\"\u003E\u003Cstrong\u003EForeword\u003C\/strong\u003E\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003EStroke is a global health problem and is the second commonest cause of death worldwide. It is also a leading cause of adult disability (WHO report 2003).\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003EStroke also caused 3 % of the world's disability burden in 1990. By 2020, stroke mortality would have almost doubled, mainly as a result of an increase in the portion of older people and inadequate control of major risk factors for stroke especially in less developed countries. Two thirds of stroke is 15 years below that in high income countries.\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003EIn Malaysia, stroke was consistently the 3rd commonest cause of death in the 1990s (SEAMIC data). In 2002 stroke was the 4th highest cause of death, following septicaemia, heart disease and cancer. Population-based studies on the incidence of stroke have been carried out almost exclusively in Caucasians in Europe, Australia and the USA. There is a steep rise in incidence with age, with three-quarters of all first strokes occurring after the age of 85 years, at least in white populations. There are virtually no comparable data from less developed countries such as Africa, South America and Asia.\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003EStroke shares major risk factors-tobacco use, unhealthy diet, physical inactivity, obesity, high blood pressure-with other cronic diseases such as coronary heart disease and some cancers. Most conventional vascular risk factor- age, cigarette smoking, diabetes, and obesity-age broadly similar for ischaemic stroke and for vascular disease in other parts of the arterial tree.\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003EFor further reading, please download the lecture slides below....\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003E\u003Cstrong\u003EDownload the full document below:\u003C\/strong\u003E\u003C\/p\u003E\r\n\r\n\u003Cp\u003E\u003Ca href=\"management.file\/doc\/202401024406771711.pdf\" target=\"_blank\"\u003E\u003Cimg alt=\"\" src=\"management.file\/img\/202401021476016797.jpg\" style=\"height:73px; width:320px\" \/\u003E\u003C\/a\u003E\u003C\/p\u003E\r\n","video":{"title":""},"document":{"title":""},"file":{"imageObject":"202401024011177647.jpg"},"files":{"documents":["202401024406771711.pdf"]},"id":"359","fid":"237","url":"clinical-practice-guidelines-brmanagement-of-stroke"},{"title":"Clinical Practice Guidelines\u003Cbr\u003E-Management of Hypertension","imageObject":{"title":""},"imageSecond":{"title":""},"blurb":"","content":"\u003Cp\u003E\u003Cstrong\u003EFOREWORD\u003C\/strong\u003E\u003C\/p\u003E\r\n\r\n\u003Cp\u003EHypertension is a major risk factor for cardiovascular, cerebrovascular and renal diseases. The third National Health and Morbidity Survey of 2006 showed that the prevalence of hypertension among adults 30 years old and above was 43%, a relative increase of 30% from that of 10 years earlier.\u003C\/p\u003E\r\n\r\n\u003Cp\u003EIt is now estimated that there are 4.8 million individuals with hypertension in Malaysia. The estimated figure worldwide is a staggering 1 billion individuals. It is however alarming to note that, according to the findings of the Third National Health and Morbidity Survey of 2006, close to two thirds of individuals with hypertension in Malaysia were unaware that they have hypertension. Although there was an increase in the treatment rate among those who have been diagnosed, the control rate is still poor. The Third National Health and Morbidity Survey revealed that among patients with\u003Cbr \/\u003E\r\nhypertension who were on drug treatment, only 26% of them achieved the target blood pressure. This finding is consistent with a separate survey conducted by the Institute of Health Management of the Ministry of Health on the outpatient management of\u00a0 hypertension in government clinics.Only 28.5% of patients treated for hypertension in government clinics achieved the target blood pressure.\u003C\/p\u003E\r\n\r\n\u003Cp\u003EAlthough the management of cardiovascular disease has moved away from the traditional single risk factor approach to a more comprehensive global cardiovascular risk approach, optimum management of individual risk factors must not be overlooked.\u003C\/p\u003E\r\n\r\n\u003Cp\u003EI hope this latest edition of the Clinical Practice Guideline (CPG) on Hypertension will help to address the current shortfalls in the detection, awareness, treatment and control rates of hypertension in Malaysia. I would like to thank all those who have worked hard to come out with this latest edition. I hope this CPG will be utilised optimally by health care professionals involved in the management of hypertension.\u003C\/p\u003E\r\n\r\n\u003Cp\u003E\u003Cbr \/\u003E\r\n\u003Cstrong\u003EYB Tan Sri Datuk Dr. Hj. Mohd. Ismail b. Merican\u003C\/strong\u003E\u003Cbr \/\u003E\r\nDirector-General of Health,\u003Cbr \/\u003E\r\nMinistry of Health, Malaysia\u003C\/p\u003E\r\n\r\n\u003Cp\u003EFor further reading, please download the lecture slides below....\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003E\u003Cstrong\u003EDownload the full document below:\u003C\/strong\u003E\u003C\/p\u003E\r\n\r\n\u003Cp\u003E\u003Ca href=\"management.file\/doc\/202401024561117707.pdf\" target=\"_blank\"\u003E\u003Cimg alt=\"\" src=\"management.file\/img\/202401021476016797.jpg\" style=\"height:73px; width:320px\" \/\u003E\u003C\/a\u003E\u003C\/p\u003E\r\n","video":{"title":""},"document":{"title":""},"file":{"imageObject":"202401020517117476.jpg"},"files":{"documents":["202401024561117707.pdf"]},"id":"360","fid":"237","url":"clinical-practice-guidelines-brmanagement-of-hypertension"},{"title":"Consensus Statement on\u003Cbr\u003E Utilization of Cardiac CT","imageObject":{"title":""},"imageSecond":{"title":""},"blurb":"","content":"\u003Cp style=\"text-align:justify\"\u003E\u003Cstrong\u003EIntroduction\u003C\/strong\u003E\u003Cbr \/\u003E\r\n\u003Cbr \/\u003E\r\nCardiovascular disease is a conglomerate of diseases that affects the heart and the arterial system in the body. It remains the number one cause of death in developed countries. In Malaysia, between the years 2000-2004, 20-25% of death in Government hospitals is due to cardiovascular diseases [1].\u003Cbr \/\u003E\r\n\u003Cbr \/\u003E\r\nCoronary artery disease (CAD) is characterised by the presence of atherosclerotic plaques in the coronary arteries. Coronary artery calcification is part of the development of these atherosclerotic plaques. These plaques progressively narrow the arterial lumen and hence impair blood flow. The reduction in coronary artery flow may be asymptomatic or symptomatic, may occur with or without exertion, and may culminate in a myocardial infarction, depending on obstruction severity and rapidity of development.\u003Cbr \/\u003E\r\n\u003Cbr \/\u003E\r\nVarious investigational modalities are available for the detection of CAD. These include electrocardiography, echocardiography and radionuclide imaging.Lately, there has been increasing awareness in newer imaging techniques such as Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) in diagnosing CAD.\u003Cbr \/\u003E\r\n\u003Cbr \/\u003E\r\nPlease download complete Consensus Statement below...\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003E\u003Cstrong\u003EDownload the full document below:\u003C\/strong\u003E\u003C\/p\u003E\r\n\r\n\u003Cp\u003E\u003Ca href=\"management.file\/doc\/202401024470711176.pdf\" target=\"_blank\"\u003E\u003Cimg alt=\"\" src=\"management.file\/img\/202401021476016797.jpg\" style=\"height:73px; width:320px\" \/\u003E\u003C\/a\u003E\u003C\/p\u003E\r\n","video":{"title":""},"document":{"title":""},"file":{"imageObject":"202401027674714011.jpg"},"files":{"documents":["202401024470711176.pdf"]},"id":"361","fid":"237","url":"consensus-statement-on-br-utilization-of-cardiac-ct"},{"title":"Consensus Statement on Cardiac Rehabilitation for Patients Living with Heart Failure","imageObject":{"title":""},"imageSecond":{"title":""},"blurb":"\u003Cp style=\"text-align:justify\"\u003EThe World Health Organization (WHO) definition of cardiac rehabilitation (CR) is \u201cThe sum of\u003Cbr \/\u003E\r\nactivities required to influence favourably the underlying cause of the disease, as well as to provide\u003Cbr \/\u003E\r\nthe best possible physical, mental and social conditions, so that the patients may, by their own\u003Cbr \/\u003E\r\nefforts, preserve or resume when lost as normal a place as possible in the community\u201d.\u003C\/p\u003E\r\n","content":"\u003Cp\u003E\u00a0\u003C\/p\u003E\r\n\r\n\u003Cp\u003E\u003Cspan style=\"font-size:14px\"\u003E\u003Cstrong\u003ESTATEMENT OF INTENT\u003C\/strong\u003E\u003C\/span\u003E\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003EThe Consensus Statement on Cardiac Rehabilitation for Patients Living with Heart Failure is meant to provide guidance for the evidence-based clinical management of heart failure rehabilitation. It is based on the best available evidence at the time of the consensus development. Adherence to the consensus may not necessarily guarantee the best outcome in every case. Every healthcare provider is responsible for the management of their unique patient based on the clinical presentation and the management options available.\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003EEvery care has been taken to ensure that the information is correct at the time of publication. However, in the event of errors or omissions, corrections will be published in the web version of this document, which will always serve as the definitive version.\u003C\/p\u003E\r\n\r\n\u003Cp\u003E\u003Cstrong\u003E\u003Cspan style=\"font-size:14px\"\u003ECONSENSUS DEVELOPMENT\u003C\/span\u003E\u003C\/strong\u003E\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003EThe consensus development group consisted of cardiologists, rehabilitation physicians, a dietician,\u003Cbr \/\u003E\r\nand an occupational therapist. A literature search was carried out using the following electronic databases: PubMed, Medline, and Cochrane Databases of Systemic Reviews. In addition, the reference lists of all relevant articles were searched to identify further studies. Reference was also made to the latest edition of other guidelines on heart failure rehabilitation available during the development of the document.\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003EThe consensus statements were formulated with agreement by the development group members. Where the evidence was insufficient, a consensus was reached by the group members. The draft consensus was submitted for external review by experts in cardiology and heart failure rehabilitation.\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003E\u00a0\u003C\/p\u003E\r\n\r\n\u003Cp\u003E\u003Cstrong\u003E\u003Cspan style=\"font-size:14px\"\u003EDOWNLOAD YOUR COPY\u003C\/span\u003E\u003C\/strong\u003E\u003C\/p\u003E\r\n\r\n\u003Cp style=\"text-align:justify\"\u003E\u003Cspan style=\"font-size:14px\"\u003EClick on \u003Ca href=\"https:\/\/www.malaysianheart.org\/management.file\/doc\/202312233178002312.pdf\" target=\"_blank\"\u003Elink\u003C\/a\u003E to download the full copy in PDF (6MB). \u003C\/span\u003E\u003C\/p\u003E\r\n","video":{"title":""},"document":{"title":""},"file":{"imageObject":"202406033473174712.png"},"files":{"library":["202406037417432173.png"],"documents":["202406033421777431.pdf"]},"id":"411","fid":"237","url":"consensus-statement-on-cardiac-rehabilitation-for-patients-living-with-heart-failure"}]
National Heart Association of Malaysia
D-13A-06, Menara Suezcap 1, KL Gateway,
No.2 Jalan Kerinchi, Gerbang Kerinchi Lestari,
59200 Kuala Lumpur, Malaysia.
