Christopher Tuck
A5072141675- Acute Myocardial Infarction Research
- Cardiac Imaging and Diagnostics
- Coronary Interventions and Diagnostics
- Atrial Fibrillation Management and Outcomes
- Total Knee Arthroplasty Outcomes
- Orthopaedic implants and arthroplasty
- Cardiac Valve Diseases and Treatments
- Knee injuries and reconstruction techniques
- Ethics in Clinical Research
- Infective Endocarditis Diagnosis and Management
- Heart Failure Treatment and Management
- Osteoarthritis Treatment and Mechanisms
- Bone health and treatments
- Cardiac electrophysiology and arrhythmias
- Meta-analysis and systematic reviews
- Hip and Femur Fractures
- Mobile Health and mHealth Applications
- Cardiomyopathy and Myosin Studies
- Child and Adolescent Health
- Cardiovascular Function and Risk Factors
- Cardiac Health and Mental Health
- Delphi Technique in Research
- Frailty in Older Adults
- Health Policy Implementation Science
- ECG Monitoring and Analysis
University of Edinburgh
2014-2025
British Heart Foundation
2022-2025
Center for Children
2023
Medical Research Council
2022
National Institute for Health Research
2022
University of Otago
2022
London School of Hygiene & Tropical Medicine
2022
Christchurch Hospital
2022
British Heart Foundation Centre for Cardiovascular Science
2018
Heart Foundation
2018
High-sensitivity cardiac troponin assays permit use of lower thresholds for the diagnosis myocardial infarction, but whether this improves clinical outcomes is unknown. We aimed to determine introduction a high-sensitivity I (hs-cTnI) assay with sex-specific 99th centile diagnostic threshold would reduce subsequent infarction or cardiovascular death in patients suspected acute coronary syndrome.In stepped-wedge, cluster-randomised controlled trial across ten secondary tertiary care hospitals...
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...
Background: Aortic stenosis is accompanied by progressive left ventricular hypertrophy and fibrosis. We investigated the natural history of these processes in asymptomatic patients their potential reversal post-aortic valve replacement (AVR). Methods: Asymptomatic symptomatic with aortic underwent repeat echocardiography magnetic resonance imaging. Changes peak aortic-jet velocity, mass index, diffuse fibrosis (indexed extracellular volume), (late gadolinium enhancement [LGE]) were...
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...
Major disparities between women and men in the diagnosis, management, outcomes of acute coronary syndrome are well recognized.The aim this study was to evaluate impact implementing a high-sensitivity cardiac troponin I assay with sex-specific diagnostic thresholds for myocardial infarction suspected syndrome.Consecutive patients were enrolled stepped-wedge, cluster-randomized controlled trial across 10 hospitals. Myocardial injury defined as concentration >99th centile 16 ng/l 34 men. The...
The optimal timing of aortic valve replacement in asymptomatic patients with stenosis is uncertain. Replacement fibrosis, as assessed by midwall (nonischemic) late gadolinium enhancement (LGE) on cardiac magnetic resonance (CMR) imaging, an irreversible marker left ventricular decompensation stenosis. Once established, it progresses rapidly and associated poor long-term prognosis a dose-dependent manner.The objective this multicenter prospective randomized controlled trial to determine...
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 Objective To evaluate whether a progressive course of outpatient physiotherapy offers superior outcomes to single review and home exercise based intervention when targeted at patients with predicted poor outcome after total knee arthroplasty. Design Parallel group randomised controlled trial. Setting 13 secondary tertiary care centres in the UK providing postoperative physiotherapy. Participants 334 participants osteoarthritis who were defined as risk arthroplasty, on Oxford score,...
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.
There is an increasing demand by non-commercial funders that trialists should provide access to trial data once the primary analysis completed. This has take into account concerns about identifying individual participants, and legal regulatory requirements. Using good practice guideline laid out work funded Medical Research Council Hubs for Trials Methodology (MRC HTMR), we anonymised a dataset from recently completed trial. this example, present practical guidance on how anonymise dataset,...
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...
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...
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
There is a concern that bisphosphonates may impair fracture healing because of their inhibitory effects on bone turnover. Here we evaluated the early bisphosphonate therapy and functional outcome following distal radius. The (FAB) trial was double-blind, randomized, placebo-controlled involving 15 trauma centers in United Kingdom. We enrolled 421 bisphosphonate-naive patients aged ≥50 years with radiographically confirmed radius randomized them 1:1 ratio to receive alendronic acid 70 mg once...
Frailty is increasingly present in patients with acute myocardial infarction. The electronic Index (eFI) a validated method of identifying vulnerable older the community from routine primary care data. Our aim was to assess relationship between eFI and outcomes hospitalised
Importance Type 2 myocardial infarction occurs owing to multiple factors associated with oxygen supply-demand imbalance, which may confer different risks of adverse outcomes. Objective To evaluate the prevalence and outcomes imbalance among patients type infarction. Design, Setting, Participants In this secondary analysis a stepped-wedge, cluster randomized clinical trial conducted at 10 tertiary care hospitals in Scotland, 6096 an adjudicated diagnosis 1 or from June 10, 2013, March 3,...