Variations in management strategies for stable coronary artery disease in the Asia-Pacific region: Insights from a multinational survey.
10.47102/annals-acadmedsg.2024340
- Author:
Lucky CUENZA
1
;
Satoshi HONDA
2
;
Khi Yung FONG
3
;
Mitsuaki SAWANO
4
;
F Aaysha CADER
5
;
Purich SURUNCHUPAKORN
6
;
Wishnu Aditya WIDODO
7
;
Mayank DALAKOTI
8
;
Jeehoon KANG
9
;
Misato CHIMURA
10
;
Mohammed AL-OMARY
11
;
Zhen-Vin LEE
12
;
Novi Yanti SARI
13
;
Thanawat SUESAT
14
;
Tanveer AHMAD
15
;
Jose Donato MAGNO
16
;
Chen Ting TAN
17
;
Badai Bhatara TIKSNADI
18
;
Uditha HEWARATHNA
19
;
Faisal HABIB
20
;
Derek Pok Him LEE
21
;
Jonathan YAP
22
Author Information
1. Philippine Heart Center, Quezon City, Philippines.
2. Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan.
3. Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
4. Yale New Haven Hospital Center for Outcomes Research and Evaluation, New Haven, Connecticut, US.
5. Kettering General Hospital, UK.
6. Central Chest Institute of Thailand, Thailand.
7. Jakarta Heart Center, Jakarta, Indonesia.
8. Department of Cardiology, National University Heart Centre, Singapore.
9. Seoul National University Hospital, South Korea.
10. Osaka University Graduate School of Medicine, Osaka, Japan.
11. John Hunter Hospital The University of Newcastle, Australia.
12. KPJ Damansara Specialist Hospital 2, Kuala Lumpur, Malaysia.
13. Mohammed Hoesin General Hospital, Indonesia.
14. Khon Kaen Hospital, Thailand.
15. United Hospital Limited, Dhaka, Bangladesh.
16. University of the Philippines-Philippine General Hospital, Philippines.
17. Sarawak Heart Centre, Malaysia.
18. Department of Cardiology and Vascular Medicine, Universitas Padjadjaran, Bandung, Indonesia.
19. Teaching Hospital Ratnapura, Sri Lanka.
20. Haji Adam Malik General Hospital University of Sumatera Utara, Indonesia.
21. Department of Medicine, Queen Elizabeth Hospital, Hong Kong.
22. Department of Cardiology, National Heart Centre Singapore, Singapore.
- Publication Type:Journal Article
- Keywords:
Asia Pacific;
cardiologists;
coronary artery disease;
coronary intervention;
survey
- MeSH:
Humans;
Coronary Artery Disease/therapy*;
Cross-Sectional Studies;
Practice Patterns, Physicians'/statistics & numerical data*;
Asia;
Health Knowledge, Attitudes, Practice;
Surveys and Questionnaires;
Male;
Practice Guidelines as Topic;
Female;
Attitude of Health Personnel;
Middle Aged;
Developing Countries
- From:Annals of the Academy of Medicine, Singapore
2025;54(5):283-295
- CountrySingapore
- Language:English
-
Abstract:
INTRODUCTION:Randomised controlled trials (RCTs) have informed guideline recommendations for the management of stable coronary artery disease (CAD). However, the real-world impact of contemporary guidelines and trials on practising physicians in the Asia-Pacific region remains uncertain. We aimed to evaluate the knowledge, attitudes and practices among cardiovascular physicians in the region regarding stable CAD management.
METHOD:An anonymised cross-sectional electronic survey was administered to cardiovascular practitioners from the Asia Pacific, assessing 3 domains: 1) baseline knowledge on recent trials and society guideline, 2) attitudes towards stable CAD, and 3) case scenarios reflecting management preferences. Correlations among knowledge, attitudes and practice scores were assessed between physicians from developed and developing countries using Pearson correlation.
RESULTS:Overall, 713 respondents from 21 countries completed the survey. The mean knowledge score was 2.90±1.18 (out of 4), with 37.3% of respondents answering all questions correctly, while 74.6% noted that guidelines have significant impact on their practice. Despite guidelines recommending optimal medical therapy, majority chose revascularisation (range 53.4- 90.6%) as the preferred strategy for the case scenarios. Practitioners from developed regions had higher knowledge scores and lower attitude scores compared to developing regions, while practice scores were similar in both groups. Weakly positive correlations were noted between knowledge, attitude and practice scores.
CONCLUSION:Variations exist in knowledge and attitudes towards guideline recommendations and correspondingly actual clinical practice in the Asia Pacific, with most practitioners choosing an upfront invasive strategy for the treatment of stable CAD. These differences reflect real-world disparities in guideline interpretation and clinical adoption.
