Designed and structured as an educational platform for all members of the interventional community to benefit, the inaugural edition of the official course of the Asia Pacific Society of Interventional Cardiology (APISC) gathered a total of 1,508 active participants. It displayed the combined efforts of both Asian Interventional Cardiovascular Therapeutics (AICT) and Asia Premier Cardiovascular Course (AsiaPCR) in providing training needs for healthcare practitioners within the interventional cardiology community.
Held at the Suntec City Convention Centre, Singapore, AICT-AsiaPCR 2019 was the first of its kind as the new official course of the Asian Pacific Society of Interventional Cardiology. It was set to showcase the Asia Pacific regions’ clinical research and innovation in interventional cardiology.
During the opening ceremony, opening statements were made by Jean Fajadet, PCR vice – chairman, and Professor Tan Huay Cheem, Organizing Chairman of AICT-AsiaPCR. Both drew special attention to the benefits of the meeting in creating a legacy and the collaboration between Asia Pacific and European regions in transmitting knowledge and expertise for the common goal of better patient care.
An opening speech delivered by the Guest – of – Honor, Senior Minister Tharman Shanmugaratnam, he addressed the importance of the conference in spreading and exchange of knowledge and technical experience. He also highlighted the need for support in research and innovation as well as public health programs for improving population health.
The event included live demonstrations direct from the operating theatre from the National University Heart Centre, Singapore and National Taiwan University Hospital. This meeting also gave doctors and researchers the opportunity to showcase their research and cases in an interactive manner through peer – to – peer learning approach.
AICT-AsiaPCR provided medical technology companies an opportunity to showcase their latest technology in interventional cardiology, allowing physicians to try their hand at the equipment and learn from the new techniques available.
Interview with Professor Tan Huay Cheem, Organizing Chairman of the AICT-AsiaPCR 2019 (Asian Interventional Cardiovascular Therapeutics-Asia Premier Cardiovascular Course), Director and Senior Consultant, National University Heart Centre, Singapore.
- What was the main motivation for the collaboration between AICT and AsiaPCR?
There is tremendous synergy for the two organizations to come together to forge a common legacy. There are techniques and knowledge that maybe different in various parts of the world, and devices that may be available in only certain parts of the world. Yet we all are in the business of taking care of patients. If we can have two meetings coming together in a common platform where we can share our knowledge and expertise, values, and cultural understanding it will be beneficial for everyone. As we become more globalized, medicine has transcended national boundaries and protectionism is a thing of the past. We are all trying to learn from each other and gain more technical knowledge. Which is for educating and aim of better trained doctors and healthcare professionals with the final aim of betterment of care for patients.
- What is some important take – aways you hope to achieve from the attendees to this conference?
We want them to go home with the understanding that the treatment has be to evidence – based approach, and systematic approach to the type of blockage that they are dealing with. Employing some of the latest technology, and in terms of data and clinical trials to support the efficacy and safety. Hopefully they can acquire new skills which they can take back and translate into direct care for patients. Finally, to create a network between practitioners from Asia Pacific and Europe can enable them to work together for future collaborations in research. Another aspect would be to help create a network for young doctors to train and connect with leaders that could help further their fellowship training.
- Having been in the field of interventional cardiology for more than 20 years how has it changed or evolved over the years?
Interventional cardiology is an ever-evolving field, from the time where balloon angioplasty being the only option in 1977. In a matter of 40 years, we are doing things that we couldn’t have possibly imagined when I was a fellow. Some of these techniques include left main stenting, chronic total occlusion of this level of complexity, bifurcation lesions, and multi – vessel coronary artery disease. With all the tools and technology available now, looking back when I was a trainee back in 1994 and all the incredible things that have happened.
We have gone further from coronary to structural and peripheral intervention. This field is non-stop, and the work never ends, there is so much more to be done.
It is not just devices; it is also drugs and innovation. New drugs can make the old procedure safer as well. What we are seeing now is a treatment modality that is more efficacious, with lower chance of complications, lower chance of reintervention needs, lower chance of death. Safety of the procedure now is improving with less than 1% chance of stent thrombosis, which was one of the most dreaded complications in the past. Chance of patients going for emergency by – pass operation was 1% before now it is almost unheard of. As such the safety and efficacy has been enhanced.
- What kind of difficulties did you and the interventional cardiology community face as the technology evolve and change?
The challenge for us was to integrate all these information and technological tools available and use them in a thoughtful and prudent fashion. To make use of them for the best outcome for the patient. Amid the vast number of tools and treatments physicians need to be educated for them to apply the techniques and technology in a careful and thoughtful manner.
- Cardiovascular disease is the number one cause of death annually, in your opinion what is the cause of this and how can these numbers be reduced.
Cardiovascular disease (CVD) is indeed the number 1 killer in the world. When discussing CVD, it is not just coronary artery disease, it includes cerebrovascular disease, and peripheral artery disease. Which means blockage of arteries in the brain, or legs that could lead to stroke, heart attacks or amputations. However, they all share a common pathophysiology, which is the accumulation of plaques within the arteries. CVD is a lifestyle disease, and clearly our lifestyle has changed that contributed to this burden of disease. These changes in lifestyle has brought about risk factors that are responsible for this, which include high cholesterol, diabetes, hypertension, obesity, and lack of exercise.
The ageing process is also a risk factor, with ageing populations such as Singapore, we will see higher prevalence of CVD.
The impact of the disease is not only on the individual, it affects the family, society, and healthcare system. Besides the physical impact, we should also consider the financial, emotional, and social impacts. As such the burden of the disease is high, and the impact is tremendous. Yet we know that it is a preventable disease, risk factor control and lifestyle change must be an ongoing effort.
There are ways to prevent this, in the recent report on Cardiovascular Disease Burden in Asia Pacific we have proposed 3 strategies.
- Education of the general public, healthcare professionals, caregivers on the importance of promoting awareness of preventing CVD.
- Promote innovation with health and digital technology; mobile health application, devices and drugs. Thereby improving healthcare outcomes, reduce medical errors, making the system more efficient in terms of delivery of care
- Collaborations between patients, healthcare providers, companies, and governments to be aligned to promote cardiovascular health.
With these 3 broad strategies I believe will be the way to go to reduce cardiovascular disease.
- Now there is a lot of talk about artificial intelligence in healthcare, do you see any potential application or integration of artificial intelligence in interventional cardiology?
There’s no question that healthcare technology is changing the paradigm of medical care. Artificial intelligence being one of them, big data analytics as well as robotics. The ability to harness these technologies in a thoughtful fashion is key. We want to maintain the ‘care’ in healthcare, putting patients in the center of our treatments. Artificial intelligence will help to change some aspects of medicine, but it is never going to replace the human component. So, the doctor – patient relationship is still sacrosanct and fundamental. We certainly can use machine and technology to perform a specific task. Artificial intelligence with its neural networks is great at perform these specific tasks. For example, showing a computer to read a X – ray, it may read better than a human. But if you ask the computer to put in the patient’s story, investigation results, treatment response, or even the patient’s history or symptoms, the machine is unable to capture the nuances of the patient’s feelings and behavior.
Technology will have its place; it will always be an enabler it is never going to substitute the human – to – human interaction. To quote Dr Ali Parsa, Babylon Health CEO, “Allow doctors to be more human, by allowing machines to be more machines”.
- With the emergence of 5G networks in China, a recent report from Xinhua News highlighted the use of 5G – assisted remote to conduct orthopedic surgeries. As Singapore also prepares for 5G network by next year, do you see any integration of the 5G network into the healthcare system?
The potential of 5G network is tremendous, it is possible with 5G network to transmit cases. Right now, we are using satellite, 5G would be a cheaper option. In terms of operating robotic machines remotely is possible. The impact of 5G technology on medical care will be there. However, like all technology, it to be harnessed in a manner that will make human care a better experience for everyone. I am optimistic with 5G application and personally would want access to 5G technology and am excited to see how it can be harnessed. Already there are attempts at remote telemonitoring as well as telemedicine where doctors can monitor patients from home. The technology is already there, 5G will raise it the next level.
- We do have readers who are students who are probably aspiring healthcare professionals or doctors, do you have any words of encouragement for these students entering the healthcare profession?
Healthcare is a wonderful profession, there is no other job where you can impact a person’s life so directly. It is a very fulfilling job. If you want to make medicine or healthcare your profession, make sure it is calling rather than a means to financial gain. It takes a lot of passion to do this job well, only by doing it in a proper fashion with the right perspective will you be able to find fulfillment and meaning.
This interview was conducted by Deborah Emmanuel Seah Qing En
Professor Tan Huay Cheem MBBS, MMed (Int Med), FRCP (UK), FAMS, FACC, FAsFC, FSCAI
Professor Tan graduated from the National University of Singapore in 1987 and obtained a Masters of Medicine in Internal Medicine and Membership of Royal College of Physician (United Kingdom) in 1992, Fellowship of American College of Cardiology in 2001, Fellowship of Society of Coronary Angiography and Intervention in 2002 and Fellowship of Royal College of Physician in 2004.
Professor Tan did his Interventional Cardiology fellowship at Duke University Medical Centre, North Carolina, USA in 1995, followed by training in Vascular Ultrasonography at St Vincent’s Hospital, Sydney, Australia, and carotid stenting at Taiwan National University Hospital.
He is presently the Director, National University Heart Centre, Singapore (NUHCS); Senior Consultant Cardiologist at the National University Hospital, and Professor of Medicine with Yong Loo Lin School of Medicine, National University of Singapore. He was the past President of Singapore Cardiac Society and presently a Board member of the Singapore Heart Foundation. Professor Tan was also awarded the National Day Award for Public Service Administration in 2016 and Ministry of Health, Singapore Distinguished Senior Clinician Award 2017.
He is the current President of the Asia Pacific Society of Interventional Cardiology (APSIC) and founding member of the Asia Interventional Cardiovascular Therapeutics (AICT).
Professor Tan is regularly invited as a lecturer and faculty in many international cardiology meetings and am a Visiting Professor to 9 hospitals in China and University of Mandalay, Myanmar. He is also an active clinical researcher.