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Straits Times
28-05-2025
- Health
- Straits Times
New programme with AI tools to improve heart health among elderly set to reach 60,000 a year
Mr Teo Yong Choon, who had a heart attack in 2017, will now be assessed using two AI tools as part of the new programme when he goes for check-ups at the National Heart Centre Singapore. PHOTO: LIANHE ZAOBAO New programme with AI tools to improve heart health among elderly set to reach 60,000 a year SINGAPORE – When former engineer Teo Yong Choon woke up in the middle of the night in 2017 , breaking out in cold sweat with intermittent chest pains, he tried to sleep it off. But when the pain hit with increasing frequency the next morning, his wife persuaded him to go to the emergency department. It turned out that he was having a heart attack. Almost immediately, he was wheeled into emergency surgery and had three stents put in his heart. 'I think it was because I did not take any cholesterol medication even though my readings were high back then,' said Mr Teo. It took him six months to return to his original fitness level of being able to jog slowly for 20 minutes. Eight years on, the 71-year-old retiree has changed his diet of greasy local favourites to low-carb and higher-protein meals. He is also on medication to prevent a second heart attack. When he goes back for check-ups at the National Heart Centre Singapore (NHCS), he will now be assessed using two artificial intelligence (AI) tools. These tools will help doctors in identifying any early signs of deterioration in Mr Teo's condition and assessing whether he is at increased risk of experiencing another heart attack. The new tools are rolled out as part of a new programme launched to prevent and detect cardiovascular disease earlier in older adults at NHCS. Called Cardiovascular Ageing and Longevity Programme, or Crane, the initiative was announced at a media briefing on May 28 at the centre. It is expected to reach about 60,000 patients a year over the next three to five years. In 2023, cardiovascular disease accounted for almost one in three deaths in Singapore. The initiative encompasses three broad areas of improving clinical care, expanding its clinical research programme, and educating healthcare professionals and patients on geriatric cardiology. Associate Professor Angela Koh, director of Crane, said the AI tools can provide clinicians with more insights that enable them to intervene earlier. One tool, 3DGait, can help spot early signs of fragility by analysing the way a person stands up and then walks from a sitting position. 'If you are pre-frail, your risk of having heart disease may actually be higher,' said Prof Koh, referring to a risk state where a person is likely to actually become frail. 'If you have had a heart disease, you really want to detect pre-frailty because by doing so, you avoid the next deterioration,' said Prof Koh, who is also a senior consultant at NHCS' department of cardiology. Another tool that will help doctors make more accurate assessments is Medi-Kiosk, which can obtain not just basic health metrics such as body mass index and blood pressure but also detailed body composition data including skeletal muscle mass, visceral fat and fluid levels. 'Information like fluid status is important because water retention is an important manifestation of heart failure,' added Prof Koh. Under Crane, NHCS will also advance research in areas such as the fundamental mechanisms of cardiovascular ageing and investigate the gender differences in these mechanisms. The team will also conduct research focusing on specific groups, including geriatric cardio-oncology, regenerative cardiovascular medicine and population health strategies. Professor Yeo Khung Keong, the centre's chief executive, said: 'With our extensive expertise in cardiovascular care and research, NHCS is well poised to spearhead this transformative programme that will not only benefit our local population but also contribute to valuable insights on cardiovascular ageing to the broader medical community across Asia-Pacific.' Join ST's WhatsApp Channel and get the latest news and must-reads.
CNA
21-05-2025
- Health
- CNA
More younger people in Singapore developing heart conditions; heart attacks remain on the rise
SINGAPORE: At the age of 37, Mr Alvin Mercado suffered his first heart attack while accompanying his young daughter at their family clinic. 'I would describe it as something like a crushing, heavy pain. And then I had this numbness running from my neck through my left hand, and I was wearing a mask - and I recall that I couldn't breathe at all,' he recounted. When he sought help from the doctor, he was immediately taken to the hospital where he was told he needed an emergency stent procedure. But that was not the end of the bad news. Nine months later in mid-2024, he suffered a second heart attack despite having already made healthier changes to his lifestyle. The IT engineer is now undergoing a cardiac rehabilitation programme. Mr Mercado is among a growing number of younger Singaporeans experiencing heart problems that could lead to more serious conditions later in life, according to doctors and cardiologists. The National Heart Centre Singapore (NHCS) now handles more than 120,000 patient consultations every year – up from 80,000 in 2006. This also comes as the number of heart attack cases in Singapore continue to go up. Data from the Singapore Myocardial Infarction Registry showed the number went up from about 8,000 in 2011 to over 12,000 a decade later. The number of heart attacks in Singapore is projected to rise almost three-fold from about 480 cases per 100,000 people this year, to around 1,400 by 2050, according to forecasts by medical researchers from the National University Health System cluster. Cardiovascular disease – or heart disease – is the top cause of death in Singapore, accounting for almost a third of deaths in 2023. WHAT ARE THE MAJOR RISK FACTORS? Dr Ching Chi Keong, senior consultant cardiologist at NHCS, told CNA that the number of people aged above 50 with hypertension, high cholesterol and diabetes has risen over the years. These are major risk factors for heart disease, the most common of which is coronary artery disease. 'Fortunately, not all patients with coronary artery disease have the severe form leading to heart attacks or sudden death, but it's prudent to control these risk factors,' Dr Ching added. For those like Mr Mercado who suffered heart attacks below the age of 40, doctors pointed to two main risk factors – a history of smoking and a family history of heart disease. Mr Mercado said he had ignored the warning signs in the weeks leading up to his first heart attack, including his family history. He had felt the same sort of 'heavy crushing pain' in his chest, numbness in his hands and cold sweat. 'These are the classic traits, but I brushed it off because it went away after 15 minutes. I brushed it off as something like a transient kind of fatigue,' he said. Dr Ching warned that these are the exact symptoms – chest pain or difficulty breathing – that could point to an undiagnosed heart condition. Pressing on with activities could lead to sudden fainting spells, he further cautioned. Meanwhile, extreme cases of arrhythmia – or an abnormal heart rhythm – affect about 2 per cent of the population or more than 100,000 people in Singapore, according to available statistics. Dr Ching said those suffering from this may feel light-headed and experience palpitations. It could lead to a stroke or heart failure. Risk factors include age, existing heart disease and other diseases like thyroid disorders, lung disease, poorly controlled hypertension, and obesity. Dr Ching advised that patients go for an electrocardiogram (ECG) when they experience an abnormal heart rate or rhythm, as this can come and go. 'For those without any symptoms, it may be appropriate or reasonable to see your doctor for a physical checkup, maybe an ECG before one goes on strenuous physical activity or training. The family physician is usually able to assess symptoms,' he said. He added that he recommends patients to wear gadgets, like smartwatches, that can record a heartbeat. This helps provide an additional point of reference for doctors. MARATHON DEATHS Dr Ching also noted recent media reports of sudden deaths of young people dying after marathons, including a 23-year-old man who died at the 2XU Compression Run last month. The case is still under police investigation. In 2011 and 2016, a 22-year-old and a 28-year-old died respectively after taking part in the Standard Chartered Singapore Marathon. Both were found to have succumbed to heart conditions. 'In these individuals who are at risk of sudden death events from physical exertion, we have (found that) coronary artery disease remains one of the major causes,' said Dr Ching. 'But there are other uncommon heart conditions that may lead to sudden cardiac death from heavy physical exertion, such as abnormal thickened heart muscles – a condition called hypertrophic cardiomyopathy.' Inadequate hydration while running a marathon can also 'cause a perfect storm' with other medical or heart conditions, leading to sudden cardiac death, added Dr Ching. MORE CPR, AED TRAINING At the Singapore Heart Foundation, more than 3,000 clients passed through its heart wellness centres in the past year – 15 per cent more than in 2021. The foundation runs rehabilitation programmes which include supervised exercise, dietary planning, and even mental health support. It is also boosting its training efforts to ensure people know how to react if they come across someone suffering a heart attack. A patient's chance of survival drops by 10 per cent for every minute that nothing is done to resuscitate them. According to the foundation, about 70 to 80 per cent of cardiac arrests happen outside of healthcare facilities – specifically at home or in public places. In 2021, nearly 6 in 10 cardiac arrest victims received bystander cardiopulmonary resuscitation (CPR) - up from 20 per cent from a decade before. But among these cases, only less than 10 per cent used an automated external defibrillator (AED). To plug this gap, the foundation conducted more outreach efforts. This led to more than 15,000 people attending CPR and AED courses from April last year to March this year. This was a nearly 80 per cent increase from the same period the previous year, said the foundation's chairman Tan Huay Cheem. "To use a defibrillator and to administer shock sounds really daunting to most people, but actually the machine can self-scan … it's kind of an idiot-proof sort of device where you can learn very quickly as long as you follow the instructions,' Professor Tan added. 'We want to encourage people to learn both CPR as well as AED, because (with this) combination, you can reduce the chance of mortality by more than 50 per cent in some of these patients.' MORE AEDS ISLANDWIDE Beyond training, the foundation is pushing for more AEDs to be installed islandwide, including in private buildings. One AED is installed in the lift lobby of every two Housing Board blocks. Each unit costs about S$2,000, with about 12,000 units currently accessible across the country. Prof Tan noted that the foundation also emphasises prevention through education – not just with adults but also at the school level with young children. 'While the disease affects mainly the elderly population, it is not to say that heart attack cannot occur in a younger person,' he said. Mr Mercado said that after suffering two heart attacks, he now wants to correct such misconceptions and remind people to be vigilant. "I thought heart attacks will only happen to people in their 50s or 60s and to old people, not me, right? And so that is something that I know I only have two choices about. One is - I don't do anything. I just cry about it. Or, I pick myself up,' he added. 'And with that grit and determination, and looking at my family, I know I have to do something about it, and so that is a turning point in my life to carry forward.'
Straits Times
20-05-2025
- Health
- Straits Times
AI system for faster detection of coronary artery disease to be trialled at 3 S'pore hospitals
A total of 300 patients across the three institutions will be involved in the trial. ST PHOTO: TARYN NG AI system for faster detection of coronary artery disease to be trialled at 3 S'pore hospitals SINGAPORE – A new artificial intelligence (AI) system which will reduce the time required for a cardiac scan analysis and allow for faster diagnosis of coronary artery disease will be available at three public hospitals here as part of a year-long trial. The Singapore heart lesion analyser (Sense) will be trialled at the National Heart Centre Singapore (NHCS), the National University Hospital and Tan Tock Seng Hospital in the third quarter of 2025. A total of 300 patients across the three institutions will be involved in the trial. Sense will use sophisticated computational capabilities and algorithms to interpret cardiac imaging scans and evaluate the risk of coronary artery disease in under 10 minutes. This is a process which typically requires two to four hours of analysis by radiographers and cardiologists, said Assistant Professor Lohendran Baskaran, senior consultant with the NHCS cardiology department. 'Sometimes it can take longer because doctors are busy doing other things in between all these scans, such as seeing patients in clinic,' said Prof Lohendran. Sense automates this process, analysing CT scans to establish the amount of calcium deposits in the coronary arteries and epicardial adipose tissue – the layer of fat surrounding the heart and major coronary arteries. It has shown between 85 and 99 per cent accuracy so far, Prof Lohendran said, though he noted these results have been from the use of Sense in a controlled environment. The year-long trial of Sense at the three institutions will give a better idea of how accurate the system is in real-world settings, he said. 'Ultimately, all of this has to be reviewed, checked and confirmed by the doctor before taking it any further. This will never override a doctor's position or clinical judgment,' said Prof Lohendran. Sense is being led by the CardioVascular Systems Imaging and Artificial Intelligence ( research laboratory at NHCS, together with A*Star's Institute for Infocomm Research. whose work began in 2021, uses AI to detect and predict heart disease more quickly and accurately. Occupying a 164 sq m space at the NHCS building on Hospital Boulevard, the lab employs AI-powered machine learning software and high-performance graphics processing units (GPUs) for real-time processing of large datasets, to significantly improve the accuracy of disease prediction models. This infrastructure will allow to enhance and strengthen it AI algorithms, using the big data collected and analysed, said co-director and core technical lead Associate Professor Zhong Liang. Sense builds on an earlier project by the AI-driven national platform for CT coronary angiography for clinical and industrial applications (Apollo). Apollo aimed to improve the accuracy and speed of interpreting CT scans using AI. Over four years, it built a database of almost three million images from the CT scans of some 5,000 cardiac patients here, together with comprehensive clinical data. Sense is supported by SingHealth and A*Star's Healthcare Translation Partnership, while Apollo was awarded A*Star's Industry Alignment Fund – Pre-Positioning Programme. The lab's work will help improve understanding of coronary artery disease in Singapore, said Prof Lohendran, who is also director and core clinical lead of Factors such as the severity of disease and what part of the population is likely to have it are still poorly understood, he added. Coronary artery disease is responsible for almost a third of the cardiovascular-related deaths in Singapore. In 2023, 8,311 people here died from cardiovascular disease in the Republic, accounting for about 30 per cent of all deaths that year. Zhaki Abdullah is a correspondent at The Straits Times. He is on the health beat, in addition to occasionally covering science, environmental, tech and Muslim affairs issues. Join ST's WhatsApp Channel and get the latest news and must-reads.
