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

Wednesday, December 10, 2008

What Now for Vytorin? In? or Out?

Not too long ago Vytorin which is a combination of simvastatin and ezitimibe was lambasted after a negative study with the ENHANCE trial showing no proof of plaque regression despite a significant reduction in LDLc. It may have been a faulty study for which I think the study investigator maybe pushing this drug too much that their baseline thickness of the carotid intima maybe considered normal to start with......how can you expect further improvement when your baseline is already almost normal? It would have been better if they looked at a longer term trial comparing reduction of LDLc with inhibition of plaque progression rather than regression. I have always deep inside me believe that this was a flawed trial right from the beginning and I have continued to use the drug most importantly to my severely hyperlipidemic patients waiting for more proofs.

In medicine, our dictum is to do no harm. We have not seen harm done on patients with vytorin...that one study showed us that it " may " not be doing what it is supposed to do. We also need to mention that Simvastatin which is the statin component of vytorin has tons of proofs for the benefit our patients get from the drug hence, it just does not make sense why additional reduction of LDLc could hurt our patients?

Recently, the SANDS trial ( Stop Atherosclerosis in Native Diabetes Study) published in the Journal of the American College of Cardiology December 2008, a 36-month study, looking at regression in carotid intima in the diabetics showed that aggressive LDL reduction with ezetimibe + a statin or statin alone noted in patients with Type 2 diabetes mellitus was associated with a similar regression in carotid intima thickness. This is surely a a positive news and a welcome respite for this drug and a good reassurance not only to the medical practitioners but patients alike who got confused with earlier study results.