Rahul Potluri

ACALM Study Unit / Aston University · Aston Medical School

http://emjreviews.com/therapeutic-area/cardiology/big-data-and-cardiology-time-for-mass-analytics/

http://jrs.sagepub.com/content/108/10/382.full

Introduction: Angioplasty has changed the management of acute coronary syndrome (ACS). However, in patients with previous coronary artery bypass grafting (CABG), the role of angioplasty in the management of ACS is widely debated. Lack of clear guidelines leads to subjective and often stereotypical assessments based on clinician preferences. We sou...

https://doi.org/10.2217/fon-2018-0160

Background It is unclear how COVID-19 pandemic affected care and outcomes among patients who are diagnosed with ST-elevation myocardial infarction (STEMI) in the USA. Methods We analyzed the data from National Inpatient Sample from 2016 to 2020 and assessed the impact of COVID-19 infection and the COVID-19 pandemic (year 2020) on in-hospital morta...

Background Coronary artery aneurysms (CAA) are reported in up to 5% of patients undergoing coronary angiography. Treatment of CAAs with covered stents has been reported in several case reports, however there is limited evidence available on the effectiveness and safety of this interventional practice. Purpose To evaluate the current practice and o...

Chest pain is one of the most common reasons for patients to present to healthcare professionals. One of the main challenges with the management of chest pain is the wide differential diagnosis, ranging from minor chest trauma to potentially life threatening acute myocardial infarction. In a patient-centered health service pathway, the aim is to as...

Background: Despite the availability of tests to diagnose acute myocardial infarction (AMI), cases are still missed. Methods: We systematically reviewed the literature to determine how missed AMI has been defined, the reported rates of misdiagnosed AMI, the outcomes patients with misdiagnosed AMI have, what diagnosis was initially suspected in m...

Non-alcoholic fatty liver disease (NAFLD) is common and strongly associated with the metabolic syndrome. Though NAFLD may progress to end-stage liver disease, the top cause of mortality in NAFLD is cardiovascular disease (CVD). Most of the data on liver-related mortality in NAFLD derives from specialist liver centres. It is not clear if the higher...

Non-alcoholic fatty liver disease (NAFLD) is common and strongly associated with the metabolic syndrome. Though NAFLD may progress to end-stage liver disease, the top cause of mortality in NAFLD is cardiovascular disease (CVD). Most of the data on liver-related mortality in NAFLD derives from specialist liver centres. It is not clear if the higher...

Laboratory studies have suggested oncogenic roles of lipids, as well as anticarcinogenic effects of statins. Here we assess the potential effect of statin therapy on cancer risk using evidence from human genetics. We obtained associations of lipid-related genetic variants with the risk of overall and 22 site-specific cancers for 367,703 individuals...

Laboratory studies have suggested oncogenic roles of lipids, as well as anticarcinogenic effects of statins. Here we assess the potential effect of statin therapy on cancer risk using evidence from human genetics. We obtained associations of lipid-related genetic variants with the risk of overall and 22 site-specific cancers for 367,703 individuals...

Laboratory studies have suggested oncogenic roles of lipids, as well as anticarcinogenic effects of statins. Here we assess the potential effect of statin therapy on cancer risk using evidence from human genetics. We obtained associations of lipid-related genetic variants with the risk of overall and 22 site-specific cancers for 367,703 individuals...

Heart 2020;106:A97-A98.

BACKGROUND The Coronavirus disease 2019(COVID-19) outbreak has caused havoc across the world. Subsequently, research on COVID-19 has focused on number of cases and deaths and predicted projections have focused on these parameters. We propose that the number of tests performed is a very important denominator in understanding the COVID-19 data. OBJE...

The Coronavirus disease 2019(COVID-19) outbreak has caused havoc across the world. Subsequently, research on COVID-19 has focused on number of cases and deaths and predicted projections have focused on these parameters. We propose that the number of tests performed is a very important denominator in understanding the COVID-19 data. We analysed the...

The Coronavirus disease 2019(COVID-19) outbreak has caused havoc across the world. Subsequently, research on COVID-19 has focused on number of cases and deaths and predicted projections have focused on these parameters. We propose that the number of tests performed is a very important denominator in understanding the COVID-19 data. We analysed the...

Laboratory studies have suggested oncogenic roles of lipids, as well as anticarcinogenic effects of statins. We here assess the potential effect of statin therapy on cancer risk in Mendelian randomization analyses. We obtained genetic associations with the risk of overall and 22 site-specific cancers for 367,703 individuals in UK Biobank. In total,...

Background: Non-alcoholic fatty liver disease (NAFLD) is common and strongly associated with the metabolic syndrome. Though NAFLD may progress to end-stage liver disease, the top cause of mortality in NAFLD is cardiovascular disease (CVD). Most of the data on liver-related mortality in NAFLD derives from specialist liver centres. We aimed to assess...

Introduction Patients presenting to hospital with a cardiac arrest are associated with significant mortality in the United Kingdom. The evidence for the weekend affect involving cardiac arrests is unclear and we investigated this further with ACALM big data. Methods Anonymous information on patients presenting to hospital with a cardiac arrest was...

Background: The efficacy and safety of aspirin for primary prevention of cardiovascular disease (CVD) remain debatable. Objectives: The purpose of this study was to examine the clinical outcomes with aspirin for primary prevention of CVD after the recent publication of large trials adding >45,000 individuals to the published data. Methods: Ran...

Background Married patients with Acute Coronary Syndrome (ACS) have significantly improved mortality compared to single patients while the worst outcomes are seen among divorcees. The impact of gender, marital status and outcomes in patients with cardiovascular disease has been poorly studied. Using big data, we addressed this further by studying p...

Introduction Spontaneous coronary artery dissection (SCAD) is recognised as an infrequent presentation of acute coronary syndromes (ACS). Using a large comprehensive UK ACS registry, we examined the incidence, demographic profile and long-term survival of ACS patients with SCAD. Methods We compared ACS patients with SCAD versus without SCAD admitt...

Background Sarcoidosis is a chronic systemic disease associated with cardiovascular manifestations. Although various inflammatory conditions have become recognized as non-traditional risk factors for cardiovascular disease (CVD), the risk profiles in sarcoidosis remain uncharacterised due to its rarity. Using a big data approach we evaluated the bu...

Background Catheter ablation in patients with atrial fibrillation/flutter is associated with a risk of stroke and major bleeding. We examined the safety and efficacy of uninterrupted anticoagulation with Edoxaban in patients undergoing atrial fibrillation/flutter ablation. Methods A retrospective analysis of 228 patients undergoing a catheter abla...

Background Both primary and secondary pulmonary hypertension (PH) are independently associated with morbidity and mortality. Compared to primary PH, the underlying pathology in secondary PH remains diverse as seen in the WHO classification. As such, variation in long-term outcomes remains unclear. We examined the differences in clinical characteris...

Background Atrial Fibrillation (AF) is the most common cardiac arrhythmia and is an independent risk factor for mortality. However, the impact of race has not been fully explored. We evaluated the frequency, clinical characteristics, and long-term survival in South Asian and Caucasian White patients with AF using a ‘big data’ approach. Methods Usi...

Introduction Patients presenting to hospital with a cardiac arrest are associated with significant mortality in the United Kingdom. There is widely debated evidence to support a ‘’weekend-effect’’ with mortality rates elevated for patients admitted to hospital on the weekend. However, cardiac arrest teams are on call in every acute hospital 24 hour...

Background: The relationship between respiratory diseases and individual cardiovascular diseases, and the impact of cardiovascular diseases on mortality in patients with respiratory disease, are unclear. Objectives: This study sought to determine the relationship between chronic obstructive pulmonary disease (COPD), asthma and interstitial lung...

Background:: Myocardial inflammation often complicates leptospirosis, a re-emerging global zoonosis. Leptospirosis associated myocardial dysfunction is equivocal and the pattern of cardiac involvement may not differ from that of sepsis associated myocarditis. Methods:: We prospectively compared cardiac involvement in 113 intensive care unit pati...

Background/Introduction: Both the United Kingdom (UK) and Canada have publically funded health care systems; however, the evolution of ST-myocardial infarction (STEMI) care, with respect to the use of primary percutaneous coronary intervention (PPCI) and thrombolysis, has differed significantly across the two countries. Whether these differences in...

Background/Introduction: Inter-country comparisons can serve as natural experiments to assess the effectiveness of alternative systems of care for homogenous patient populations. Purpose: We evaluated differences in clinical characteristics, reperfusion strategies employed, and clinical outcomes of patients hospitalized with an ST-elevation myocar...

Background: Patients with rheumatoid arthritis (RA) suffer from increased cardiovascular morbidity and mortality compared to the general population, and importantly, growing evidence links systemic inflammation with accelerated atherogenesis. The extent to which inflammation underlies this cardiovascular risk is debated and other factors such as tr...

Background Atherosclerosis is a chronic inflammatory condition and growing evidence links systemic inflammation with accelerated atherogenesis. Infectious disease is a common cause of inflammation and it’s impact on atherosclerotic disease is less studied. Using a big data approach we studied the risk of atherosclerotic disease and outcome followin...

Increased mortality associated with weekend patient admissions is a global and pervasive phenomenon. Particularly in the UK, this has recently been the subject of intense media, political and scientific scrutiny (1,2). The “weekend effect” has often been highlighted with farfetched conclusions regarding the likely causes. Specifically, it has been...

Abstract BACKGROUND: There is concern that the development of heart failure and atrial fibrillation has a detrimental influence on clinical outcomes. The aim of this study was to assess all-cause mortality and length of hospital stay in patients with chronic and new-onset concomitant AF and HF. METHODS: Using the ACALM registry, we analysed adults...

Health-centred research has changed hugely over the last ten years, from the importance of computing software to the NHS becoming more involved in research. The expectations of grant-awarding bodies, ethics committees and publishers have evolved and increased in many senses. This new edition is designed for trainee clinicians, not only those prepar...

Introduction: Chronic total occlusions (CTO) in patients with ischemic heart disease (IHD) have been variably reported but their clinical profiles and outcomes remain largely unknown. Accordingly, using the Algorithm for Comorbidities, Associations, Length of stay and Mortality (ACALM) registry from the UK, we examined risk factors, predictors and...

Background: Although modifiable cardiovascular risk factors account for a large proportion of acute coronary syndromes (ACS) the extent to which they are managed is variable. The reasons for this are multifactorial and sociodemographic factors, such as marital status, could play an important role in their management and in outcomes after ACS. We ai...

Introduction: Hyperlipidaemia is a well-established cardiovascular risk factor, and some laboratory and epidemiological evidence suggests it is also a risk factor for cancer. However, the effect of hyperlipidaemia and of cholesterol-lowering drugs on cancer risk remains equivocal. We have previously demonstrated an association between hyperlipidaem...

Background and purpose: Heart failure affects over 900,000 people in the United Kingdom (UK) and costs nearly 2% of the National Health Service (NHS) budget. Traditional risk factors for heart failure have been thoroughly investigated, however the impact of cardiovascular risk factors/disease on length of stay (LOS) and mortality in heart failure p...

https://www.youtube.com/watch?v=mWItcF96ixw

Background Ischaemic heart disease (IHD) is the leading cause of mortality worldwide. Although modifiable cardiovascular risk factors, such as hypertension, diabetes and hyperlipidaemia, account for a large proportion of IHD the extent to which they are controlled is variable. The reasons for this undermanagement of risk factors is multifactorial a...

Introduction: Heart failure (HF) is a major healthcare problem contributing to hospital admission stays and spending. Psychiatric co-morbidities are being increasingly identified amongst HF patients but their impact on length of hospital stay (LOS) has not been studied in the UK. We investigated the impact of psychiatric co-morbidities on LOS in a...

Introduction: The incidence of cardiogenic shock (CS) is thought to have reduced with the advent of PCI (Percutaneous Coronary Intervention) as the treatment of choice for patients with ACS (Acute Coronary Syndrome), however mortality rates remain in the region of 50%. We aim to investigate trends in the incidence of CS and associated mortality in...

Introduction: Atrial fibrillation (AF) is the most common arrhythmia and is associated with serious sequelae. Some evidence exists that patients admitted out of hours (OOH), during evenings and weekends, have higher mortality rates although this has not been studied amongst AF patients in the UK. We studied the impact of OOH admissions on mortality...

Introduction: Heart failure (HF) confers significant mortality worldwide. Increased mortality rates for patients admitted to hospital on weekends are widely reported. The impact of weekend discharge on mortality rates has been seldom studied, especially in HF patients. Purpose: To investigate impact of weekend discharge on mortality in HF patients....

Introduction: Cardiovascular disease (CVD) and cancer are the leading causes of death in the UK, although the link between them is yet to be fully characterised. We aimed to establish the prevalence of cardiovascular risk factors and diseases as well as their association with all-cause mortality in patients with the four most common cancers in the...

Introduction: Heart Failure (HF) is a major contributor to mortality and morbidity worldwide. In the UK HF is a considerable and growing burden on healthcare with patients having repeated admissions to hospital. The impact of readmissions to hospital on mortality and survival amongst HF patients has been seldom studied. Purpose: To investigate the...

Background: Atrial fibrillation (AF) and heart failure (HF) frequently co-exist conferring considerable morbidity and mortality, yet current treatment options remain limited, creating a paradox whereby those most in need have the fewest therapeutic choices. Purpose: To investigate the association between HF and AF and their impact on mortality from...

Introduction: Hyperlipidaemia is a well-established cardiovascular risk factor but the effect of hyperlipidaemia and treatment with cholesterol-lowering drugs on cancer remain equivocal. We aimed to investigate the impact of comorbid hyperlipidaemia on mortality amongst patients with the four most prevalent cancer types in the United Kingdom (Lung,...

Introduction Tobacco smoking contributes significantly to the global health burden and its negative impact on cardiovascular morbidity and mortality in particular have been well documented. Smoking is affected by sociodemographic factors though with rates varying according to sex, social class and ethnicity. However, the impact of ethnicity on mort...

Background Classical risk factors for cardiovascular disease such as hypertension and diabetes, and their association with myocardial infarction (MI), have been thoroughly investigated. However, more research is needed to investigate the correlation between these risk factors and the impact on length of stay (LOS) and mortality in patients presenti...

Introduction Heart failure (HF) is a major healthcare problem contributing significantly to hospital admission stays and NHS spending. Reducing length of hospital stay (LOS) in HF is paramount in reducing this burden and is influenced by factors relating to the condition, sociodemographics and comorbidities. Psychiatric comorbidities are being incr...

Introduction Studies have shown that one in four psychiatric patients also suffer from a cardiovascular co-morbidity, and in recent years the links between cardiovascular disease and psychiatric conditions have been on the rise. We decided to investigate the prevalence of psychiatric co-morbidities and tendencies in patients with NIHF over a 14 yea...

Introduction Ischaemic heart disease is the leading cause of mortality worldwide. The development of surgical and percutaneous interventions has improved survival rates, but the influence of sociodemographic factors on outcomes following MI and their potential use as predictors of such outcomes, are increasingly recognised. Conclusive studies show...

Introduction Cardiovascular disease is increasingly being associated with novel risk factors including psychiatric diseases. Although a high prevalence of cardiovascular comorbidities has been demonstrated in psychiatric patients, the impact of these on mortality are yet to be studied. Objectives We aimed to investigate the prevalence of cardiovasc...

Introduction Hyperlipidaemia is a well -established cardiovascular risk factor but the effect of hyperlipidaemia and treatment with cholesterol-lowering drugs on cancer remain equivocal. We aimed to investigate the impact of comorbid diagnosis of hyperlipidaemia amongst patients with the four most prevalent cancer types in the United Kingdom (Lung,...

Introduction Atrial fibrillation (AF) is the most common cardiac arrhythmia and is associated with serious sequelae such as stroke and a significant mortality rate. Timely and optimal treatment of this condition can minimise these complications. There is evidence that patients with a range of conditions admitted out-of-hours (during evenings and we...

Introduction Heart Failure (HF) is common in the western world, has multiple causes and confers significant morbidity and mortality. It is thought a significant proportion of HF patients also have atrial fibrillation (AF) although data from a large population in the UK are lacking. We studied the prevalence of AF in patients with HF in the North We...

Introduction Heart failure is common and one of the top contributors to mortality in the United Kingdom. There is some highly controversial evidence to support a ‘‘weekend-effect’’ with mortality rates elevated for patients admitted or discharged from hospital on the weekend. The impact of weekend discharge on mortality rates of heart failure patie...

Background Atrial Fibrillation (AF) and Heart Failure (HF) frequently co-exist conferring considerable morbidity and mortality, yet current treatment options remain limited. Recent meta-analyses of patients with concomitant AF and HF have suggested no prognostic benefit of beta-blockers or digoxin, creating a paradox whereby those most in need have...

Introduction Percutaneous Coronary Intervention (PCI) has changed the management of acute coronary syndrome (ACS). However, the role of PCI in patients with previous coronary artery bypass grafting (CABG) is widely debated. Lack of clear guidelines leads to subjective assessments based on clinician preferences. We sought to investigate if PCI affec...

Background: Heart failure (HF) is a major healthcare problem contributing significantly to hospital admission stays and National Health Service (NHS) spending. Reducing length of hospital stay (LoS) in HF is paramount in reducing this burden and is influenced by factors relating to the condition, sociodemographics and comorbidities. Psychiatric co...

The introduction of Percutaneous Coronary Intervention (PCI), commonly referred to as angioplasty, has drastically improved outcomes for patients with Acute Coronary Syndrome (ACS). However, in certain groups of patients with ACS uncertainty remains regarding the long-term benefits versus hazards of angioplasty. There is no clear consensus on the u...

DOI: 10.1111/1471-0528.14109

Aims: Angioplasty has changed the management of acute coronary syndromes (ACS). However, in patients with chronic anaemia the evidence for angioplasty in ACS is less well known. We sought to investigate the role of angioplasty in patients with anaemia presenting with ACS, and how it affected mortality. Method: Anonymous information on patients with...

Aims: In patients with significant chronic kidney disease (CKD) the evidence for angioplasty in acute coronary syndrome (ACS) is less well known. We sought to investigate if angioplasty affected mortality and outcomes in patients with CKD, presenting with ACS. Method: Anonymous information on patients with ACS, attending a large multi-ethnic genera...

Objectives To assess the effect of “day” of hospital discharge on mortality and survival. Design Retrospective analysis of anonymous routinely collected hospital admissions data from ACALM Study. Setting Several participating NHS hospitals in the North of England from 1st January 2000 to 31st March 2013. Participants All patients aged 18 and ove...

Objectives To assess the effect of “day” of hospital discharge on mortality and survival. Design Retrospective analysis of anonymous routinely collected hospital admissions data from ACALM Study. Setting Several participating NHS hospitals in the North of England from 1st January 2000 to 31st March 2013. Participants All patients aged 18 and ove...