Course Director

A/Prof Koh Tian Hai

Chairman, Organising Committee

A/Prof Lim Yean Teng

Co-chairman, Organising Committee

Fellow colleagues

Distinguished guests

Ladies and gentlemen

1 It gives me great pleasure to be here today at the opening of the 11^th Singapore Live Interventions in Vascular Endotherapy, jointly organised by

• The National Heart Centre, Singapore,
• The Paris Course on Revascularisation,
• The Transcatheter Cardiovascular Therapeutics, USA
• The Institut Jantung Negara, Malaysia (Malaysian National Heart Institute) and
• The Fu Wai Cardiovascular Institute, China

2 The Singapore LIVE course in now in its 11^th year and is a well established and premier event in the interventional cardiology calendar for the Asia-Pacific region. It serves as a platform to share knowledge, skills and experiences in the latest technologies and techniques in interventional cardiology from around the world. In past years, it had been well attended by interventional cardiologists, radiologists and colleagues from related paramedical disciplines from countries across Asia and this year is no exception. To all our foreign guests, I welcome you to Singapore.

3 Singapore is actively pursuing research into the life sciences in order to develop Singapore into a major biomedical hub. The annual Singapore LIVE course can serve as one of the vehicles to highlight cutting edge biomedical technology, and the growing opportunities that can result from biomedical research.

4 Among other things, this 11^th LIVE course will highlight the use of drug coated stents. These devices may represent the next breakthrough in PTCA technology since the initial discovery of Percutaneous Transluminal Coronary Angioplasty by Dr Andreaus Gruentzig in 1978, and the subsequent introduction of coronary stents in 1986. Re-stenosis had been the Archilles heel of PTCA, resulting in recurrent symptoms in a significant proportion of patients. It has occurred even after treatment with coronary stent implantation.

5 The Sirolimus drug coated stent had been recently been shown in a 238 patient clinical trial to demonstrate a zero percent re-stenosis rate at 6 months, compared to a 26% re-stenosis rate in the control stent arm, a very significant finding. Furthermore the number of major adverse clinical events was 3% in the drug coated stent arm at 6 months, versus 27% in the control group, a highly significant difference.

6 We obviously need to monitor the long-term benefits of these promising new developments. However, these new technologies certainly carry with them the promise that the need for repeat PTCAs for restenosis may be substantially reduced.

7 Stem cell research is another exciting new field of biomedical research. Heart failure is likely to become more common with the ageing of the population here. Research into using stem cells as a form of tissue replacement therapy for heart failure, is currently underway. If successful, myocardial regeneration is expected to produce great benefits in patients with heart failure. As is the case elsewhere, the National Medical Research Council in Singapore has been funding research in this promising area.

8 Active research is also currently carried out on the use of angiogenic substances to promote the growth of new blood vessels to improve blood supply to ischaemic areas of the heart. The induction of the growth of new blood vessels will also benefit patients with surgically un-bypassable coronary artery obstructions.

9 Improving the management of coronary heart disease is a major priority of my Ministry. Working with the National Committee on Cardiac Care, the Ministry has recently published Clinical Practice Guidelines on Hyperlipidaemia, which is a very significant risk factor for coronary heart disease. We will also be publishing Clinical Practice Guidelines for the management of other cardiac diseases over the next few years.

10 In addition, my Ministry actively supports the development of new medical capabilities through the Health Service Development Programme. For heart diseases, this programme is supporting the development of new services involving cutting-edge technology on a pilot programme basis. The Minister for Health had previously announced two projects related to cardiovascular medicine. We are funding the expansion of MRI capabilities in National University Hospital to develop a comprehensive cardiac MRI and peripheral vascular MR angiography service. We are also funding a pilot programme in both TTSH and SGH on endoscopic stenting of aortic aneurysms.

11 In addition to these, we are also funding the establishment of the Mechanical Heart Devices Programme. This programme funds the use of left venticular assist devices and other artificial mechanical heart devices for patients with severe cardiac failure or left ventricular dysfunction. These devices would maintain the function of circulation and blood pressure for a few days until the patient recovers, or serve as a ‘bridging device’ until a donor heart becomes available for heart transplantation. The programme is run out of the National Heart Centre, but is open to specialists, and their patients, from both healthcare clusters.

12 In the year 2000, ischaemic and other heart diseases accounted for 25.1% of all deaths in Singapore. The continuing rapid advances in management of heart diseases is indeed good news for medical professionals and their many patients.

13 To conclude, let me once again congratulate the National Heart Centre, Singapore, the Paris Course on Revascularisation, Transcatheter Cardiovascular Therapeutics, Institut Jantung Negara (Malaysian National Heart institute) and the Fu Wai Cardiovascular Institute for jointly organising this event. I would also like to extend a personal invitation to all our foreign guest to take some time to see this city of ours and I hope that you would bring back many fond memories of Singapore. With the interesting topics being discussed and live transmissions from the participating centres in France, USA, Malaysia and China, I am sure that you would all have an enriching experience in this course.

14 On this note, it is my pleasure to declare the 11^th Singapore Live Interventions in Vascular Endotherapy open.

15 Thank you.