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

Sunday, December 17, 2006

..........Angioplasty at a Glance!


The artery on the left has a severe narrowing/blockage. The middle artery shows a balloon being inflated to open up the clogged artery and the third shows a deflated balloon being pulled out leaving a widely open artery. This procedure called angioplasty introduced in 1977 revolutionized the way we treat and approach patients with coronary artery disease.

Are Drug Eluting Stents Safe? FEAR NOT!


Stents are the Cardiovascular Interventionalist's "Best Friend". It was Andreas Gruntzig, a Swiss radiologist who first demonstrated in 1977 that occluded coronary artery can be opened with the use of a balloon. A few years later came the use of a "metallic mesh" called stents to complement the plain balloon angioplasty. With widespread acceptance, we soon realized that the use of stents is limited by restenosis (reocclusion of the artery). A phenomenon (Restenosis) secondary to remodelling that usually occurs between 6 months to 1yr from implantation. A second generation stent called "Drug Eluting Stent" (DES) was developed and indeed made a significant impact in reducing restenosis by as much as 50% vs bare metal stent.

Latey however, we have been bombarded with negative news regarding the increased incidence of stent thrombosis (blood clotting) causing an acute myocardial infarction >6months after DES implantation called Late Stent Thrombosis (LST) or even >1-3yrs after implantation called Very Late Stent Thrombosis (VLST). Current indications suggest that these events were limited to those who stopped the use of an antiplatelet drug called Plavix. This incidence is very small yet it is a cause for concern. Overall however, this hardware (DES) is still considered safe and effective and I can almost guaranty its continued use in the years to come.

Our existing guideline dictates the use of plavix for a minimum of 6 months after implant. To date, we don't really know the exact duration of plavix therapy however, current data do suggest that continued use of this drug for at east 3-4 years perhaps indefinitely after implantation maybe warranted until further information is available.

The US FDA is currently convening a panel of experts to study this phenomenon and certainly a new set of guidelines with be forth coming in the near future. Again, let me reiterate that the use of DES is not only safe but also effective albeit, with minor glitch that needs further refinements in terms of guidelines for our coronary patients.
Additional studies are definitely needed to answer the two major questions we have today. These questions include the safe duration for Plavix therapy post implantation and how to identify these subset of patients at risk for this dreaded complication. I shall continue to update this blog, most importantly on this issue as soon as a new set of guidelines are available.