Dr. Edgar H. Tan, a consistent honor student graduated Bachelor of Science major in Biology cum laude from Silliman University in 1982. A Faculty Silver Medal Awardee and graduated cum laude when he earned his Medical Degree from Cebu Doctors' College of Medicine in April of 1986.

He spent one year of post graduate internship at the prestigious Philippine General Hospital from May 1, 1986 to April 30, 1987 and subsequently passed his Philippine Medical Licensure Exam rank #15 in August of 1987. He pursued further training in Internal Medicine from 1989-1993 under the New York Medical College Program where he served as the Administrative Chief Medical Resident for one year. He subsequently did his Fellowship Training in Clinical/Invasive Cardiology under the consortium of Metropolitan & New York Medical College Program from 1993-1996. After his medical training in New York he practiced Internal Medicine/Invasive Cardiology in the State of South Carolina from 1996-1997 with privileges at Marlboro Park Hospital Bennettsville SC & McLeod Regional Medical Center in Florence SC. He holds an active medical license in the State of South Carolina from 1996 up to the present. He decided to come back to Cebu and practice his profession starting February 1998. His foresight at keeping his US medical license active inspite of practicing medicine outside the US has come handy for US expats currently in the Philippines wanting medical care recognized by US HMO's.

Dr. Tan is board certified by the American Board of Internal Medicine, American Board of Cardiovascular Disease and Philippine College of Physicians. He is also trained and certified in the field of Nuclear Cardiology. He is a Fellow of the American College of Physicians, American College of Cardiology and Philippine College of Physicians. His extensive background comes handy by making available the highest standard of US quality medical care right in the heart of Cebu City.

He is affiliated with Cebu Doctors' University Hospital, where he is currently the Section Head of Cardiology Department. He is also affiliated with UCMed and Perpetual Succour Hospital. His practice includes General Internal Medicine & Adult Clinical/Interventional Cardiology. He has admitting privileges at the University of Cebu Medical Center, Cebu Doctors' University Hospital & Perpetual Succour Hospital.

His office is located at Cebu Doctors' University Hospital Medical Arts Building 1, Suite 203-B, OsmeƱa Blvd. Cebu City Philippines. His office hours are 9am-12pm Mon-Sat. and 2pm to 5pm except Wed. and Sat. Tel: (032) 412-5136.

Email:EdgarTan62@yahoo.com or EdgarTanMD@gmail.com

Saturday, February 03, 2007

On Drug-Eluting Stents- What the FDA has to Say?

This is an update following a two-day US FDA expert panel meeting in December 7 & 8, 2006 regarding clotting risks with these devices. After a rigorous review of available data, it has been concluded that Drug-Eluting Stents are SAFE and EFFECTIVE for the indication for which the approval for its use was based. Simply put, the panel agreed that it is safe to to continue using DES as labelled. While the panelists agreed that there is a slight increased risk of stent thrombosis in DES, the overall risk of myocardial infarction and death is not more than that seen in bare-metal stents.

The ACC/AHA/SCAI recommendation is for 12 months of dual antiplatelet therapy (aspirin plus Plavix [clopidogrel]), which the panel said should be mentioned in the label information, but the panelists shied away from changing the label to require at least 12 months of Atherosclerosis is a progressive disease hence, my personal bias has always been to continue the use of dual antiplatelet therapy indefinitely and the current changing of the guideline extending the duration of antiplatelet regimen post DES implantation has somehow proven me right. It has been my practice long before this issue of stent thrombosis came into the spotlight because I believe that dual antiplatelet is our best defense against heart attack to date. . .

This is purely my personal opinion but I think it is just a matter of time before studies would prove its worth and becomes part of the collective recommendation from the college. While recommendations are available, it is eventually the physician and patient who will have to decide the appropriate duration of dual antiplatelet therapy given the patients unique situation and circumstance. The FDA can only recommend what is best considering the available data and does not in any way regulate physician practices. It is estimated that about 50-60% of DES implantation in the US are considered off-label use. Definitely more studies are needed to address these subgroup of patients for which there is paucity of information regarding safety and appropriate duration of antiplatelet therapy.