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.
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

Aim: We designed this study to compare the presence of depressive symptoms pre and 6 months post-MI and to identify the association of various biological and non-biological risk factors with the development of depressive symptoms post-MI. Objective: Coronary artery disease and depressive illness are the largest contributors to global mortality and disability. These disorders frequently occur together and have major health implications. We conducted this study to determine the frequency of increased depressive symptoms following Myocardial Infarction (MI) and analyze associated baseline risk factors. Study Design: Descriptive case series. Place and duration of study: Tertiary care cardiology hospital from Sept 2019 to Jan 2021. Patients and Methods: Patients presenting with a recent episode of myocardial infarction at the out-patient department of cardiology were recruited for this study. Demographic variables and baseline health status were recorded. Hospital Anxiety and Depression Scale (HADS) was applied in two instances, at first contact for depressive symptoms pre-MI and at the second instance 6 months post-MI. An increase in HADS score of 4 or more points after 6 months of MI was considered significant. Association of age, gender, smoking status, employment status, previous MI episode, depression and history of stressful life event with an increase in depression was analyzed. Results: The sample consisted of 140 patients, 88 males and 52 females. The mean age was 51.22 years (SD= ± 12.35). 60.7% (n=85) of patients had an increase in depressive symptoms scores as measured by HADS. Younger age (30 to 50 years), being a smoker and having a previous history of myocardial infarction were associated with a significant increase in depressive symptoms. Conclusion 60.7% of patients have increased depressive symptoms after myocardial infarction. Patients should be regularly screened for emerging depressive symptoms and special attention should be paid to younger patients, smokers and those who have a previous history of coronary artery disease.