Publications by authors named "Riyaz Patel"

Article Synopsis
  • A study analyzed data from over 10,000 patients with acute coronary syndrome (ACS) from 2010 to 2017 to explore the impact of reduced kidney function (eGFR) on treatment and mortality rates.
  • It found that lower eGFR levels were strongly linked to a decrease in invasive treatments like coronary angiography; patients with eGFR <30 were significantly less likely to receive these procedures compared to those with higher eGFR.
  • Additionally, there was a clear connection between lower eGFR and higher 30-day mortality rates, indicating that kidney function plays a critical role in treatment outcomes for ACS patients.
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Background: Cardiac troponin is commonly raised in patients presenting with malignancy. The prognostic significance of raised troponin in these patients is unclear.

Objectives: We sought to investigate the relation between troponin and mortality in a large, well characterised cohort of patients with a routinely measured troponin and a primary diagnosis of malignancy.

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Article Synopsis
  • - This study focused on classifying patients with heart failure (HF) and preserved or mildly reduced ejection fraction into specific phenogroups to improve targeted treatment options.
  • - Researchers analyzed data from over 2,000 patients across five UK hospitals using advanced machine learning techniques and found three distinct phenogroups, each with different clinical traits and survival outcomes.
  • - The findings revealed that survival rates declined from the first phenogroup to the third, highlighting the importance of phenogroup membership in predicting survival better than traditional factors, though it did not predict hospitalisation for HF.
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Objective: The COVID-19 pandemic was associated with a reduction in the incidence of myocardial infarction (MI) diagnosis, in part because patients were less likely to present to hospital. Whether changes in clinical decision making with respect to the investigation and management of patients with suspected MI also contributed to this phenomenon is unknown.

Methods: Multicentre retrospective cohort study in three UK centres contributing data to the National Institute for Health Research Health Informatics Collaborative.

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Background: Myeloproliferative neoplasms (MPNs) are a group of disorders of clonal haemopoiesis associated with an inherent risk of arterial and venous thrombotic complications. The prevalence of thrombotic complications and the impact of cardiovascular risk factors (CVRFs) in contemporary patient cohorts within the current era of MPN treatments have not been completely defined.

Objectives: We aim to characterise the cardiovascular risk of patients with MPN by identifying the prevalence of CVRFs and describing the pattern of thrombotic events.

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Background: Primary dyslipidaemias, including familial hypercholesterolaemia, are underdiagnosed genetic disorders that substantially increase risk for premature coronary artery disease in adults. Early identification of primary dyslipidaemias via lipid clinic referral optimises patient management and enables cascade screening of relatives. Improving the identification of primary dyslipidaemias, and understanding disparities in ascertainment and management, is an NHS priority.

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Background: No single biomarker currently risk stratifies chronic obstructive pulmonary disease (COPD) patients at the time of an exacerbation, though previous studies have suggested that patients with elevated troponin at exacerbation have worse outcomes. This study evaluated the relationship between peak cardiac troponin and subsequent major adverse cardiac events (MACE) including all-cause mortality and COPD hospital readmission, among patients admitted with COPD exacerbation.

Methods: Data from five cross-regional hospitals in England were analysed using the National Institute of Health Research Health Informatics Collaborative (NIHR-HIC) acute coronary syndrome database (2008-2017).

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Objective: To clarify the performance of polygenic risk scores in population screening, individual risk prediction, and population risk stratification.

Design: Secondary analysis of data in the Polygenic Score Catalog.

Setting: Polygenic Score Catalog, April 2022.

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Introduction: Older adults are more vulnerable to COVID-19 infections; however, little is known about which comorbidity patterns are related to a higher risk of COVID-19 infection. This study investigated the role of long-term conditions or comorbidity patterns on COVID-19 infection and related hospitalisations.

Methods: This study included 4,428 individuals from Waves 8 (2016-2017) and 9 (2018-2019) of the English Longitudinal Study of Ageing (ELSA) who also participated in the ELSA COVID-19 Substudy in 2020.

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Objective: The aim of the study was to assess the clinical effectiveness of the national cardiovascular disease (CVD) prevention programme-National Health Service Health Check (NHSHC) in reduction of CVD risk.

Design: Prospective cohort study.

Setting: 147 primary care practices in Leicestershire and Northamptonshire in England, UK.

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Recently, there has been growing interest in the early discharge strategy for low-risk patients who have undergone primary percutaneous coronary intervention (PCI) to treat ST-segment elevation myocardial infarction (STEMI). So far findings have suggested there are multiple advantages of shorter hospital stays, including that it could be a safe way to be more cost- and resource-efficient, reduce cases of hospital-acquired infection and boost patient satisfaction. However, there are remaining concerns surrounding safety, patient education, adequate follow-up and the generalisability of the findings from current studies which are mostly small-scale.

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Introduction: Older adults are usually more vulnerable to COVID-19 infections; however, little is known about which comorbidity patterns are related to a higher probability of COVID-19 infection. This study investigated the role of long-term conditions or comorbidity patterns on COVID-19 infection and related hospitalisations.

Methods: This study included 4,428 individuals from Waves 8 (2016-2017) and 9 (2018-2019) of the English Longitudinal Study of Ageing (ELSA), who also participated in the ELSA COVID-19 Substudy in 2020.

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Objectives: To evaluate implementation of digital National Early Warning Score 2 (NEWS2) in a cardiac care setting and a general hospital setting in the COVID-19 pandemic.

Design: Thematic analysis of qualitative semistructured interviews using the non-adoption, abandonment, scale-up, spread, sustainability framework with purposefully sampled nurses and managers, as well as online surveys from March to December 2021.

Settings: Specialist cardiac hospital (St Bartholomew's Hospital) and general teaching hospital (University College London Hospital, UCLH).

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Introduction: Patients with cardiovascular diseases (CVD) are at significant risk of developing critical events. Early warning scores (EWS) are recommended for early recognition of deteriorating patients, yet their performance has been poorly studied in cardiac care settings. Standardisation and integrated National Early Warning Score 2 (NEWS2) in electronic health records (EHRs) are recommended yet have not been evaluated in specialist settings.

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Background: The quality of recording and documentation of deteriorating patient management by health professionals has been challenged during the COVID-19 pandemic. Non-adherence to escalation and documentation guidelines increases risk of serious adverse events. Electronic health record (EHR)-integrated dashboards are auditing tools of patients' status and clinicians' performance, but neither the views nor the performance of health professionals have been assessed, relating to management of deteriorating patients.

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In the same way that the practice of cardiology has evolved over the years, so too has the way cardiology fellows in training (FITs) are trained. Propelled by recent advances in technology-catalyzed by COVID-19-and the requirement to adapt age-old methods of both teaching and health care delivery, many aspects, or 'domains', of learning have changed. These include the environments in which FITs work (outpatient clinics, 'on-call' inpatient service) and procedures in which they need clinical competency.

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Article Synopsis
  • The study investigates the role of specific genetic variants (SNPs) in the PPARGC1A gene on the risk of subsequent coronary heart disease (CHD) events in patients already diagnosed with the condition.* -
  • Using data from 23 studies with nearly 81,000 participants, the researchers analyzed associations between three SNPs and the occurrence of CHD death or myocardial infarction, employing a Cox proportional hazards model.* -
  • The meta-analysis found no significant links between the genetic variants and the risk of subsequent CHD events or cardiovascular diseases, except for some inverse associations observed in specific participant subgroups.*
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Background: Assessing the spectrum of disease risk associated with hypertriglyceridemia is needed to inform potential benefits from emerging triglyceride lowering treatments. We sought to examine the associations between a full range of plasma triglyceride concentration with five clinical outcomes.

Methods: We used linked data from primary and secondary care for 15 M people, to explore the association between triglyceride concentration and risk of acute pancreatitis, chronic pancreatitis, new onset diabetes, myocardial infarction and all-cause mortality, over a median of 6-7 years follow up.

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Information found in the social media may help to set up infoveillance and track epidemics, identify high-risk behaviours, or assess trends or feelings about a subject or event. We developed a dashboard to enable novice users to easily and autonomously extract and analyze data from Twitter. Eleven users tested the dashboard and considered the tool to be highly usable and useful.

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Article Synopsis
  • - The study examined the relationship between peak pre-operative troponin levels and survival rates for patients undergoing coronary artery bypass grafting (CABG) after non-ST elevation myocardial infarction (NSTEMI), involving a cohort of 1,746 patients from five UK centers.
  • - Results indicated that elevated troponin levels were a strong predictor of early survival (up to 30 days post-surgery) and demonstrated a significant interaction with the time taken to perform surgery; longer waits improved survival for patients with higher troponin readings.
  • - The findings suggest that while troponin levels can guide the timing of surgery for improving immediate outcomes, they do not affect long-term survival beyond 30 days, highlighting their potential use
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Importance: A lack of internationally agreed standards for combining available data sources at scale risks inconsistent disease phenotyping limiting research reproducibility.

Objective: To develop and then evaluate if a rules-based algorithm can identify coronary artery disease (CAD) sub-phenotypes using electronic health records (EHR) and questionnaire data from UK Biobank (UKB).

Design: Case-control and cohort study.

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Article Synopsis
  • A study analyzed data from over 13,000 patients with acute coronary syndrome (ACS) in the UK, focusing on those who experienced ventricular arrhythmias (VA) or cardiac arrest (CA) during their acute episode.
  • The findings revealed that patients with VA or CA faced a significantly higher risk of future VA and that those who had CA also experienced a 36% increase in long-term mortality risk.
  • This suggests that patients with VA or CA during ACS are at greater risk for ongoing heart rhythm issues and may need closer monitoring post-discharge.
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