Background: Monocyte to High Density Lipoprotein Ratio (MHR) is a new marker that has been associated with major adverse cardiovascular outcomes among STEMI patients. We sought to strengthen the association between MHR and mortality and major adverse cardiovascular events (MACEs) among STEMI patients who underwent primary percutaneous coronary intervention. Methods: Studies were included if they satisfied the following criteria:1) Observational Studies; 2) Adult patients with ST-elevation Myocardial Infarction (STEMI) who underwent primary percutaneous intervention (PCI); and 3) Reported data on mortality and major adverse cardiovascular events. Using MEDLINE, Clinical Key, Science Direct, Scopus, and Cochrane Central Register of Controlled Trials databases, a search for eligible studies was conducted until September 2017. Our primary outcome of interest was all-cause cardiovascular (CV) mortality. We also investigated the association between MHR and major adverse cardiovascular events (MACEs). Results: We identified 3 studies involving 2793 STEMI patients, showing that in STEMI patients who underwent primary PCI, a high admission MHR is associated with a significantly higher in-hospital mortality [RR 4.71, (95% CI 2.36 to 9.39, p < 0.00001] and in-hospital MACE [RR 1.90, (95% CI 1.44 to 2.50), p < 0.00001]. This significant association was not observed in long term mortality or MACE. Conclusion: A high admission MHR among STEMI patients who underwent primary PCI is associated with a higher in-hospital mortality and MACE. This novel marker can be used as an inexpensive and readily available tool for risk stratification.

Background: Peripheral artery disease (PAD) is the most underdiagnosed, underestimated and undertreated of the atherosclerotic vascular diseases despite its poor prognosis. There may be racial or contextual differences in the Asia-Pacific region as to epidemiology, availability of diagnostic and therapeutic modalities, and even patient treatment response. The Asian Pacific Society of Atherosclerosis and Vascular Diseases (APSAVD) thus coordinated the development of an Asia-Pacific Consensus Statement (APCS) on the Management of PAD. Objectives: The APSAVD aimed to accomplish the following: 1) determine the applicability of the 2016 AHA/ ACC guidelines on the Management of Patients with Lower Extremity Peripheral Artery Disease to the Asia-Pacific region; 2) review Asia-Pacific literature; and 3) increase the awareness of PAD. Methodology: A Steering Committee was organized to oversee development of the APCS, appoint a Technical Working Group (TWG) and Consensus Panel (CP). The TWG appraised the relevance of the 2016 AHA/ACC PAD Guideline and proposed recommendations which were reviewed by the CP using a modified Delphi technique. Results: A total of 91 recommendations were generated covering history and physical examination, diagnosis, and treatment of PAD-3 new recommendations, 31 adaptations and 57 adopted statements. This Asia-Pacific Consensus Statement on the Management of PAD constitutes the first for the Asia-Pacific Region. It is intended for use by health practitioners involved in preventing, diagnosing and treating patients with PAD and ultimately the patients and their families themselves.

Community health workers, as in many other countries, are the front liners in the delivery of primary health care at the grassroots level, both in urban and rural communities in the Philippines. The term CHWs embraces a variety of community health aides who are selected, trained and are working in the communities from which they come. According to the World Health Organization (WHO), CHWs should be: (1) members of the communities where they work, (2) selected by the communities, (3) answerable to the communities for their activities, (4) supported by the health system but not necessarily as part of its organization, and (5) should have shorter training than professional workers. 1In the Philippines, CHWs refer mainly to Barangay Health Workers (BHWs) although CHWs can also include Barangay Nutrition Scholars (BNSs), Rural Health Midwives (RHMs) and Mother Leaders (MLs). In some areas of the country, there are MLs who perform the same roles as BHWs. Mostly females, BHWs are volunteers who are supposed to be accredited by the Local Health Board (LHB) and who have been trained to provide primary health care services in the community in accordance with the guidelines promulgated by the Department of Health (DOH). 2 The number of health workers in the community is set by the DOH. It is determined by the ideal ratio of BHWs relative to the number of households, provided that the total number of BHWs nationwide shall not exceed one percent (1%) of the total population. 2 BHWs, usually of age 20 to 45 years, play significant roles in providing primary health care in the communities they serve. 1 A study conducted in Camarines Sur in the Luzon island in the Philippines reported that majority of BHWs

Dyslipidemia is a cardiovascular risk factor that is increasing in prevalence in the country. The need to treat and manage elevated cholesterol levels, both pharmacologic and non-pharmacologic, is of utmost importance. Different medical societies and groups bonded together to formulate the 2020 Philippine Clinical Practice Guidelines for dyslipidemia. The group raised nine clinical questions that are important in dyslipidemia management. A technical working group analyzed the clinical questions dealing with non-pharmacologic management, primary prevention for both non-diabetic and individuals with diabetes, familial hypercholesterolemia, secondary prevention, adverse events of statins and the use of other lipid parameters as measurement of risk for cardiovascular disease. Randomized controlled trials and metaanalyses were included in the GRADE-PRO analysis to come up with the statements answering the clinical questions. The statements were presented to a panel consisting of government agencies, members of the different medical societies, and private institutions, and the statements were voted upon to come up with the final statements of the 2020 practice guidelines. The 2020 CPG is aimed for the Filipino physician to confidently care for the individual with dyslipidemia and eventually lower his risk for cardiovascular disease.