A5004239077- Lipoproteins and Cardiovascular Health
- Health Systems, Economic Evaluations, Quality of Life
- Diabetes, Cardiovascular Risks, and Lipoproteins
- Cardiovascular Function and Risk Factors
- Acute Ischemic Stroke Management
- Chronic Disease Management Strategies
- Cerebrovascular and Carotid Artery Diseases
- Health disparities and outcomes
- Acute Myocardial Infarction Research
- Cardiac, Anesthesia and Surgical Outcomes
- Pharmaceutical Economics and Policy
- Pharmaceutical Practices and Patient Outcomes
- Cancer, Lipids, and Metabolism
- Antiplatelet Therapy and Cardiovascular Diseases
- Geriatric Care and Nursing Homes
- Primary Care and Health Outcomes
- Cardiovascular Disease and Adiposity
- Hip and Femur Fractures
- Cardiac Valve Diseases and Treatments
- Meta-analysis and systematic reviews
- Streptococcal Infections and Treatments
- Trace Elements in Health
- Nutritional Studies and Diet
- Atrial Fibrillation Management and Outcomes
- Venous Thromboembolism Diagnosis and Management
University of Nottingham
2018-2025
Primary Health Care
2022-2024
King's College London
2023
University of Southampton
2022-2023
NIHR Southampton Biomedical Research Centre
2023
Nottingham Biomedical Research Centre
2019
National Institute for Health Research
2019
Korle Bu Teaching Hospital
2018
Objective To assess low-density lipoprotein cholesterol (LDL-C) response in patients after initiation of statins, and future risk cardiovascular disease (CVD). Methods Prospective cohort study 165 411 primary care patients, from the UK Clinical Practice Research Datalink, who were free CVD before statin initiation, had at least one pre-treatment LDL-C within 12 months before, post-treatment 24 after, initiation. Based on current national guidelines, <40% reduction baseline was classified...
Data about variations in stroke incidence and subsequent major adverse outcomes are essential to inform secondary prevention prioritizing resources those at the greatest risk of end points. We aimed describe age, sex, socioeconomic differences rates first nonfatal outcomes.The cohort study used linked Clinical Practice Research Datalink Hospital Episode Statistics data from United Kingdom. The rate (IR) ratio (composite cardiovascular events, recurrent stroke, disease-related, all-cause...
Although obesity is a well-recognised risk factor for cardiovascular disease (CVD), the impact of long-term body mass index (BMI) changes in overweight or obese adults, on heart failure, CVD and mortality has not been quantified.This population-based cohort study used routine UK primary care electronic health data linked to secondary death-registry records. We identified adults who were obese, free from had repeated BMI measures. Using group-based trajectory modelling, we examined...
Abstract Background The association between metabolic syndrome and increased cardiovascular disease (CVD) risk is well‐established. However, in patients with incident CVD, the relationship obesity, health, subsequent CVD mortality outcomes are less This study investigated body mass index (BMI), health of morbidity events. Methods cohort identified 130 685 from nationwide Clinical Practice Research Datalink (CPRD GOLD) Hospital Episode Statistics (HES) databases United Kingdom. Patients were...
Purpose To use unsupervised machine learning to identify phenotypic clusters with increased risk of arrhythmic mitral valve prolapse (MVP). Materials and Methods This retrospective study included patients MVP without hemodynamically significant regurgitation or left ventricular (LV) dysfunction undergoing late gadolinium enhancement (LGE) cardiac MRI between October 2007 June 2020 in 15 European tertiary centers. The end point was a composite sustained tachycardia, (aborted) sudden death,...
BackgroundThe vast majority of individuals with familial hypercholesterolaemia in the general population remain unidentified worldwide. Recognising patients most likely to have condition, enable targeted specialist assessment and treatment, could prevent major coronary morbidity mortality. We aimed evaluate a clinical case-finding algorithm, case ascertainment tool (FAMCAT), compare it currently recommended methods for detection primary care.MethodsIn this external validation study, FAMCAT...
Familial hypercholesterolaemia (FH) is a common inherited disorder, causing lifelong elevated low-density lipoprotein cholesterol (LDL-C). Most individuals with FH remain undiagnosed, precluding opportunities to prevent premature heart disease and death. Some machine-learning approaches improve detection of in electronic health records, though clinical impact under-explored. We assessed performance an array for enhancing FH, their utility, within large primary care population. A...
Abstract Background The association between obesity, major adverse cardiovascular events (MACE), and mortality in patients with incident stroke is not well established. We assessed the relationship body mass index (BMI) MACE stroke. Methods population‐based cohort study identified 30 702 individuals from Clinical Practice Research Datalink (CPRD GOLD) Hospital Episode Statistics (HES) databases United Kingdom. Individuals were aged ≥18 years 1‐1‐1998 31‐12‐2017, a BMI recorded within 24...
Objective To assess the incidence of hip fracture and all major osteoporotic fractures (MOF) in patients with chronic obstructive pulmonary disease (COPD) compared non-COPD to evaluate use performance risk prediction tools COPD. prevalence osteoporosis. Design Population-based cohort study. Setting UK General Practice health records from The Health Improvement Network database. Participants Patients an incident COPD diagnosis 2004 2015 matched by age, sex general practice were studied....
Abstract Background Medication reviews in primary care provide an opportunity to review and discuss the safety appropriateness of a person’s medicines. However, there is limited evidence about access impact routine medication for older adults general population, particularly UK. We aimed quantify proportion people aged 65 years over with recorded 2019 describe changes numbers types medicines prescribed following review. Methods used anonymised electronic health records from UK’s Clinical...
Background and aimsFamilial hypercholesterolaemia (FH) is a known major cause of premature heart disease. However, the risks atherosclerotic disease in other vascular regions are less known. We determined risk cardiovascular (CVD) outcomes associated with clinical FH.MethodsIn retrospective cohort study (1 January, 1999 to 22 July, 2016), we randomly-matched 14,097 UK subjects FH diagnoses or characteristics (Simon-Broome definite Dutch Lipid Clinic Score >8) 42,506 without by age, sex,...
Hierarchical clustering, a common 'unsupervised' machine-learning algorithm, is advantageous for exploring potential underlying aetiology in particularly heterogeneous diseases. We investigated embolic sources stroke of undetermined source (ESUS) using data-driven method, and explored variation recurrence between clusters.We used hierarchical k-means clustering algorithm on patients' baseline data, which assigned each individual into unique group, minimum-variance method to calculate the...
Objectives Guidance recommends statin treatment in familial hypercholesterolaemia (FH) to achieve at least a 50% reduction low-density lipoprotein cholesterol (LDL-C). We assessed prescribing rates and LDL-C goal attainment among individuals with FH primary care. Methods Using care electronic health records from the UK Clinical Practice Research Datalink, we identified adults recorded diagnosis of FH, measures prior (baseline) 12 months after initiating treatment. The percentage change was...
Patients with ischemic stroke are considered a very high risk population for subsequent cardiovascular events and guidelines recommend intensive preventive strategies. However, there is no clear recommendation that patients hemorrhagic should also be regarded as population. To compare the of morbidity/mortality between incident stroke. aged ≥18 years or 1998 2017 prior history serious vascular event were identified from UK Clinical Practice Research Datalink (CPRD GOLD) linked to Hospital...
Although familial hypercholesterolemia (FH) screening within primary care is considered cost-effective, which approach cost-effective has not been established. This study determines the cost-effectiveness of six case-finding strategies for electronic health records to identify index patients who have genetically confirmed monogenic FH in English care. A decision tree was constructed represent pathways each (FH Case Identification Tool (FAMCAT) versions 1 and 2, cholesterol screening, Dutch...
Abstract Introduction Multiple Long Term Conditions (MLTC) are a major challenge to health and social care systems around the world. There is limited research exploring wider contextual determinants that important improving for people living with MLTC. In this study, we aimed elicit prioritise of improved in Methods A three round online Delphi study was conducted England professionals, data scientists, researchers, MLTC their carers. Results Our findings suggest system which still...
Objective Familial hypercholesterolaemia (FH) is a common inherited disorder causing premature coronary heart disease (CHD) and death. We have developed the novel Hypercholesterolaemia Case Ascertainment Tool (FAMCAT 1) case-finding algorithm for application in primary care, to improve detection of FH. The performance this was further improved by including personal history CHD 2 algorithm). This study has evaluated their performance, at 95% specificity, detect genetically confirmed FH...
Evidence on sex differences in outcomes after developing coronary heart disease (CHD) has focused recurrent CHD, all-cause mortality or revascularisation. We assessed disparities subsequent major adverse cardiovascular events (MACE) adults surviving their first-time CHD.Using a population-based cohort obtained from the Clinical Practice Research Datalink (CPRD GOLD) linked to hospitalisation and death records UK, we identified 143 702 (aged ≥18 years) between 1 January 1998 31 December 2017...
Familial hypercholesterolaemia (FH) is a common inherited disorder that remains mostly undetected in the general population. Through FH case-finding and direct access to genetic testing primary care, this intervention study described lipid profile of patients found at increased risk outcomes those with positive test results. In 14 Central England practices, novel tool (Familial Hypercholetserolaemia Case Ascertainment Tool, FAMCAT1) was applied electronic health records 86 219 cholesterol...