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15th Vietnam Congress of Cardiology, National Convention Centre,
Hanoi, 9-11 October 2016;
How to benefit from an NCVD Registry:
The NCVD Experience from Malaysia
Dr Alan Fong
MBChB(Bristol), MRCP(UK), FRCP (Edin), FACC, FESC, FAPSIC, FNHAM, FAsCC
Consultant Cardiologist, Sarawak General Hospital Heart Centre;
& Head, Clinical Research Centre, Sarawak General Hospital
Sarawak General Hospital
Background
Sarawak General Hospital
Where we are…..
Sarawak General Hospital
Sarawak Heart Centre
H
H♥
2km
Sarawak General Hospital
National Health and Morbidity Surveys.. (e.1986)
Sarawak General Hospital
The NCVD Registries (e.2006)
/>Sarawak General Hospital
NCVD PCI Registry
Report 2013-2014
Sarawak General Hospital
Snapshot from the
Annual Report of the
NCVD-ACS Registry
2011-2013
Suggested citation:
W.A. Wan Azman, K.H. Sim. (Eds). Annual Report of the
NCVD-ACS Registry, Year 2011-2013. Kuala Lumpur,
Malaysia: National Cardiovascular Disease Database, 2015.
Sarawak General Hospital
NCVD-ACS Registry Participating
Hospitals
HTF
HSB
HQEI
HQEII
HRPZ II
HSNZ
HPP
HRPB
HTAA
PJHUS
UMMC
IJN
HKL
HTAR
HS
HA
Total SDP= 19 hospitals
HTJ
HSA
HM
*Each SDP started to contribute data at different
time period
NCVD-ACS Registry, Malaysia (2011-2013)
Sarawak General Hospital
N ACS admissions = 14,763
Sarawak General Hospital
Mean age: 58.5 (12.2) years
N ACS admissions = 14,763
Sarawak General Hospital
N ACS admissions = 14,763
Sarawak General Hospital
20062010
(N=4,047)
(N=4,589)
(N=6,127)
Dyslipidaemia
33.0
39.2
36.4
37.0
37.4
Hypertension
61.0
67.0
65.6
63.2
65.0
Diabetes
43.0
46.2
46.6
45.0
45.8
Family History of
premature CVD
11.0
14.5
13.2
12.4
13.2
MI history
19.0
22.0
20.8
16.2
19.2
17.0
17.3
20.2
24.4
21.2
55.0
61.4
57.6
56.4
58.2
11.0
11.4
9.6
9.4
9.9
Chronic Lung Disease
4.0
3.6
2.8
3.1
3.2
Renal disease
7.0
8.2
7.2
7.8
7.8
Peripheral vascular
disease
1.0
1.2
0.8
0.6
0.8
Cerebrovascular disease
4.0
4.2
3.6
3.5
3.8
Heart Failure
7.0
8.6
8.6
5.3
7.2
Current Smoker
33.0
37.6
37.8
38.2
38.0
BMI > 23kgm-2
75.0
75.6
75.0
78.2
76.5
CV Risk factors
(N=16,866)
Documented CAD
New onset angina
(< 2 weeks)
Chronic angina
(onset > 2 weeks ago)
2011
2012
Hypertension 65%
Diabetes 46%
2013
20112013
(N=14,763)
Sarawak General Hospital
Presence of cumulative risk factors (Percentage),
NCVD-ACS Registry, 2011-2013
Sarawak General Hospital
Sarawak General Hospital
Type of cardiac presentation for patients with ACS (%)
by admission, NCVD-ACS Registry, 2006 - 2013
N
2006 2007 2008 2009
2010
2011
2012
2013
3,392 3,640 2,839 3,594
3,401
4,047
4,589
6,127
STEMI
42.0
46.0
54.0
47.0
53.0
50.8
52.0
50.0
NSTEMI
34.0
29.0
24.0
29.0
30.0
27.0
25.0
26.2
UA
24.0
24.0
22.0
24.0
17.0
22.2
23.3
23.8
Sarawak General Hospital
Type of cardiac presentation for patients with ACS (%)
by admission,
NCVD-ACS Registry, 2006 - 2013
Sarawak General Hospital
Age group of patients by ACS stratum
NCVD-ACS Registry, 2011-2013
Mean age (SD) for STEMI: 56.2 (12.0); NSTEMI: 60.8 (11.8) and UA: 60.8 (12.0)
Sarawak General Hospital
Age group of patients by ACS stratum
NCVD-ACS Registry, 2011-2013
NSTEMI
Sarawak General Hospital
Sarawak General Hospital
Sarawak General Hospital
Type of treatment among STEMI patients by Age Group ,
NCVD-ACS Registry, 2011-2013
Sarawak General Hospital
NCVD ACS In-Hospital Mortality and 30-day
Follow up: 2006-2010 VS 2011-2013
Outcome at discharge
Outcome
Alive
2006-2010
Died
Alive
2011
Died
Alive
2012
Died
Alive
2013
Died
Alive
2011-2013
Died
Year
N
15531
1335
3729
318
4234
355
5670
457
13633
1130
%
92
8
92.2
7.8
92.2
7.8
92.6
7.4
92.4
7.6
30-day FU
N
14429
2437
3681
366
4173
416
5586
541
13440
1323
%
86
14
91.0
9.0
91.0
9.0
91.2
8.8
91.0
9.0
Outcome at discharge is similar but 30 day outcomes improved significantly
Sarawak General Hospital
Sarawak General Hospital
Year
20062010
2011
2012
2013
20112013
Outcome at discharge
Physician Cardiologist
Centre
Centre
%
N
%
Outcome N
Alive
5163
92 10368 92
Died
454
8
881
8
2839
92.2
890
92.0
Alive
241
7.8
77
8.0
Died
3368
92.2
866
92.6
Alive
286
7.8
69
7.4
Died
5031
92.6
639
92.8
Alive
407
7.4
50
7.2
Died
11238 92.4
2395
92.4
Alive
934
7.6
196
7.6
Died
30-day FU
Physician Cardiologist
Centre
Centre
N
%
N
%
4905
87
9524
85
712
13
1725
15
2801
91.0
880
91.0
279
9.0
87
9.0
3315
90.8
858
91.8
339
9.2
77
8.2
4948
91.0
638
92.6
490
9.0
51
7.4
11064 90.8
2376
91.8
1108
9.2
215
8.2
30-day outcome is better at cardiologist centre
Sarawak General Hospital
