Ryan Wereski
A5049718111- Acute Myocardial Infarction Research
- Cardiac Imaging and Diagnostics
- Coronary Interventions and Diagnostics
- COVID-19 Clinical Research Studies
- Atrial Fibrillation Management and Outcomes
- Long-Term Effects of COVID-19
- Heart Failure Treatment and Management
- Cardiac electrophysiology and arrhythmias
- COVID-19 and healthcare impacts
- Cardiovascular Function and Risk Factors
- COVID-19 and Mental Health
- Cardiovascular Effects of Exercise
- Delphi Technique in Research
- Venous Thromboembolism Diagnosis and Management
- Healthcare professionals’ stress and burnout
- Cardiac pacing and defibrillation studies
- Lipoproteins and Cardiovascular Health
- SARS-CoV-2 and COVID-19 Research
- Employment and Welfare Studies
- Streptococcal Infections and Treatments
- HIV/AIDS Research and Interventions
- Otolaryngology and Infectious Diseases
- Phagocytosis and Immune Regulation
- Cardiovascular Health and Risk Factors
- Biomarkers in Disease Mechanisms
British Heart Foundation
2020-2025
University of Edinburgh
2020-2025
Queen Elizabeth University Hospital
2019-2024
Edinburgh Royal Infirmary
2024
NHS Greater Glasgow and Clyde
2020-2024
University of Glasgow
2016-2023
Christchurch Hospital
2022
Medical Research Council
2022
National Institute for Health Research
2022
University of Otago
2022
Background: The introduction of more sensitive cardiac troponin assays has led to increased recognition myocardial injury in acute illnesses other than coronary syndrome. Universal Definition Myocardial Infarction recommends high-sensitivity testing and classification patients with based on pathogenesis, but the clinical implications implementing this guideline are not well understood. Methods: In a stepped-wedge cluster randomized, controlled trial, we implemented assay recommendations 48...
High-sensitivity cardiac troponin assays enable myocardial infarction to be ruled out earlier, but the safety and efficacy of this approach is uncertain. We investigated whether an early rule-out pathway safe effective for patients with suspected acute coronary syndrome.
Abstract Although guidelines recommend fixed cardiac troponin thresholds for the diagnosis of myocardial infarction, concentrations are influenced by age, sex, comorbidities and time from symptom onset. To improve diagnosis, we developed machine learning models that integrate at presentation or on serial testing with clinical features compute Collaboration Diagnosis Evaluation Acute Coronary Syndrome (CoDE-ACS) score (0–100) corresponds to an individual’s probability infarction. The were...
The COVID-19 pandemic is putting health professionals under increasing pressure. This population already acknowledged to be at risk of burnout.We aim provide a 'snapshot' the levels burnout, anxiety, depression and distress among healthcare workers during pandemic.We distributed an online survey via social media in June 2020 open any UK worker. primary outcome measure was symptoms burnout measured using Copenhagen Burnout Inventory. Secondary outcomes depression, subjective measures stress...
Abstract The pathophysiology and trajectory of post-Coronavirus Disease 2019 (COVID-19) syndrome is uncertain. To clarify multisystem involvement, we undertook a prospective cohort study including patients who had been hospitalized with COVID-19 (ClinicalTrials.gov ID NCT04403607 ). Serial blood biomarkers, digital electrocardiography patient-reported outcome measures were obtained in-hospital at 28–60 days post-discharge when imaging using chest computed tomography pulmonary coronary...
Although the 99th percentile is recommended diagnostic threshold for myocardial infarction, some guidelines also advocate use of higher troponin thresholds to rule in infarction at presentation. It unclear whether magnitude or change concentration can differentiate causes injury and practice.
Abstract Aims Whilst the risk factors for type 1 myocardial infarction due to atherosclerotic plaque rupture and thrombosis are established, our understanding of that predispose 2 during acute illness is still emerging. Our aim was evaluate compare infarction. Methods results We conducted a secondary analysis multi-centre randomized trial population 48 282 consecutive patients attending hospital with suspected coronary syndrome. The diagnosis index presentation all subsequent reattendances...
Type 2 myocardial infarction is caused by oxygen supply-demand imbalance, and its diagnosis increasingly common with the advent of high-sensitivity cardiac troponin assays. Although this associated poor outcomes, widespread uncertainty confusion remain among clinicians as to how investigate manage heterogeneous group patients type infarction.
Collaboration for the Diagnosis and Evaluation of Acute Coronary Syndrome (CoDE-ACS) is a validated clinical decision support tool that uses machine learning with or without serial cardiac troponin measurements at flexible time point to calculate probability myocardial infarction (MI). How CoDE-ACS performs different points measurement compares guideline-recommended diagnostic pathways rely on fixed thresholds uncertain.
Abstract Tools for predicting COVID-19 outcomes enable personalized healthcare, potentially easing the disease burden. This collaborative study by 15 institutions across Europe aimed to develop a machine learning model risk of in-hospital mortality post-SARS-CoV-2 infection. Blood samples and clinical data from 1286 patients collected 2020 2023 four cohorts in Canada were analyzed, with 2906 long non-coding RNAs profiled using targeted sequencing. From discovery cohort combining three...
The 99th centile of cardiac troponin, derived from a healthy reference population, is recommended as the diagnostic threshold for myocardial infarction, but troponin concentrations are strongly influenced by age. Our aim was to assess performance in older patients presenting with suspected infarction.
Patients with suspected acute coronary syndrome in whom myocardial infarction has been excluded are at risk of future adverse cardiac events.
Despite poor cardiovascular outcomes, there are no dedicated, validated risk stratification tools to guide investigation or treatment in type 2 myocardial infarction. The goal of this study was derive and validate a tool for the prediction death future infarction patients with T2-risk score developed prospective multicenter cohort consecutive Cox proportional hazards models were constructed primary outcome at 1 year using variables selected priori based on clinical importance. Discrimination...
The diagnostic criteria for type 2 myocardial infarction identify a heterogenous group of patients with variable outcomes and no clear treatment implications. We aimed to determine the implications new clinical classification more objective using cardiac imaging. In prospective cohort study, underwent coronary angiography magnetic resonance imaging or echocardiography. was applied (a) spontaneous due acute pathology, (b) secondary precipitated by illness in presence obstructive artery...
COVID-19 is typically a primary respiratory illness with multisystem involvement. The prevalence and clinical significance of cardiovascular involvement in remain unclear.This prospective, observational, multicentre, longitudinal, cohort study minimal selection criteria near-consecutive approach to screening. Patients who have received hospital care for will be enrolled within 28 days discharge. Myocardial injury diagnosed according the peak troponin I relation upper reference limit (URL,...
Abstract Aims Whether a single cardiac troponin measurement can safely rule out myocardial infarction in patients presenting within few hours of symptom onset is uncertain. The study aim was to assess the performance early presenters. Methods and results In with possible infarction, diagnostic high-sensitivity I at presentation evaluated externally validated those tested ≤3, 4–12, >12 h from onset. limit-of-detection (2 ng/L), rule-out (5 sex-specific 99th centile (16 ng/L women; 34...
This secondary analysis of a randomized clinical trial evaluates the testing high-sensitivity cardiac troponin in practice.
The benefit and utility of high-sensitivity cardiac troponin (hs-cTn) in the diagnosis myocardial infarction patients with kidney impairment is unclear. Here, we describe implementation hs-cTnI testing on diagnosis, management, outcomes without impairment. Consecutive suspected acute coronary syndrome enrolled a stepped-wedge, cluster-randomized controlled trial were included this pre-specified secondary analysis. Kidney was defined as an eGFR under 60mL/min/1.73m
In patients with acute chest pain who have had myocardial infarction excluded, plasma cardiac troponin I concentrations ≥5 ng/L are associated risk of future adverse cardiovascular events. We aim to evaluate the association between and coronary plaque composition in such patients.In a prespecified secondary analysis prospective cohort study, blinded quantitative was performed on 242 CT angiograms whom excluded. Patients were stratified by peak concentration or <5 ng/L. Associations assessed...