Publications
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UK HFpEF Collaborative Group, 2024, Rationale and design of the United Kingdom Heart Failure with Preserved Ejection Fraction Registry., Heart, Vol: 110, Pages: 359-365
OBJECTIVE: Heart failure with preserved ejection fraction (HFpEF) is a common heterogeneous syndrome that remains imprecisely defined and consequently has limited treatment options and poor outcomes. METHODS: The UK Heart Failure with Preserved Ejection Fraction Registry (UK HFpEF) is a prospective data-enabled cohort and platform study. The study will develop a large, highly characterised cohort of patients with HFpEF. A biobank will be established. Deep clinical phenotyping, imaging, multiomics and centrally held national electronic health record data will be integrated at scale, in order to reclassify HFpEF into distinct subgroups, improve understanding of disease mechanisms and identify new biological pathways and molecular targets. Together, these will form the basis for developing diagnostics and targeted therapeutics specific to subgroups. It will be a platform for more effective and efficient trials, focusing on subgroups in whom targeted interventions are expected to be effective, with consent in place to facilitate rapid recruitment, and linkage for follow-up. Patients with a diagnosis of HFpEF made by a heart failure specialist, who have had natriuretic peptide levels measured and a left ventricular ejection fraction >40% are eligible. Patients with an ejection fraction between 40% and 49% will be limited to no more than 25% of the cohort. CONCLUSIONS: UK HFpEF will develop a rich, multimodal data resource to enable the identification of disease endotypes and develop more effective diagnostic strategies, precise risk stratification and targeted therapeutics. TRIAL REGISTRATION NUMBER: NCT05441839.
Kallis C, Kaura A, Samuel NA, et al., 2023, The relationship between cardiac troponin in people hospitalised for exacerbation of COPD and major adverse cardiac events (MACE) and COPD readmissions, The International Journal of Chronic Obstructive Pulmonary Disease, Vol: 18, Pages: 2405-2416, ISSN: 1176-9106
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). People hospitalised with a COPD exacerbation were included, and peak troponin levels were standardised relative to the 99th percentile (upper limit of normal). We used Cox Proportional Hazard models adjusting for age, sex, laboratory results and clinical risk factors, and implemented logarithmic transformation (base-10 logarithm). The primary outcome was risk of MACE within 90 days from peak troponin measurement. Secondary outcome was risk of COPD readmission within 90 days from peak troponin measurement.Results: There were 2487 patients included. Of these, 377 (15.2%) patients had a MACE event and 203 (8.2%) were readmitted within 90 days from peak troponin measurement. A total of 1107 (44.5%) patients had an elevated troponin level. Of 1107 patients with elevated troponin at exacerbation, 256 (22.8%) had a MACE event and 101 (9.0%) a COPD readmission within 90 days from peak troponin measurement. Patients with troponin above the upper limit of normal had a higher risk of MACE (adjusted HR 2.20, 95% CI 1.75– 2.77) and COPD hospital readmission (adjusted HR 1.37, 95% CI 1.02– 1.83) when compared with patients without elevated troponin.Conclusion: An elevated troponin level at the time of COPD exacerbation may be a useful tool for predicting MACE in COPD patients. T
Al Saikhan L, Park C, Tillin T, et al., 2023, Does 3D-speckle tracking echocardiography improve prediction of major cardiovascular events in a multi-ethnic general population? A Southall and Brent Revisited (SABRE) cohort study, PLOS ONE, Vol: 18, ISSN: 1932-6203
Zaman S, Padayachee Y, Shah M, et al., 2023, Smartphone-based remote monitoring in heart failure with reduced ejection fraction: retrospective cohort study of secondary care use and costs, JMIR Cardio, Vol: 7, ISSN: 2561-1011
BACKGROUND: Despite effective therapies, the economic burden of heart failure with reduced ejection fraction (HFrEF) is driven by frequent hospitalizations. Treatment optimization and admission avoidance rely on frequent symptom reviews and monitoring of vital signs. Remote monitoring (RM) aims to prevent admissions by facilitating early intervention, but the impact of noninvasive, smartphone-based RM of vital signs on secondary health care use and costs in the months after a new diagnosis of HFrEF is unknown. OBJECTIVE: The purpose of this study is to conduct a secondary care health use and health-economic evaluation for patients with HFrEF using smartphone-based noninvasive RM and compare it with matched controls receiving usual care without RM. METHODS: We conducted a retrospective study of 2 cohorts of newly diagnosed HFrEF patients, matched 1:1 for demographics, socioeconomic status, comorbidities, and HFrEF severity. They are (1) the RM group, with patients using the RM platform for >3 months and (2) the control group, with patients referred before RM was available who received usual heart failure care without RM. Emergency department (ED) attendance, hospital admissions, outpatient use, and the associated costs of this secondary care activity were extracted from the Discover data set for a 3-month period after diagnosis. Platform costs were added for the RM group. Secondary health care use and costs were analyzed using Kaplan-Meier event analysis and Cox proportional hazards modeling. RESULTS: A total of 146 patients (mean age 63 years; 42/146, 29% female) were included (73 in each group). The groups were well-matched for all baseline characteristics except hypertension (P=.03). RM was associated with a lower hazard of ED attendance (hazard ratio [HR] 0.43; P=.02) and unplanned admissions (HR 0.26; P=.02). There were no differences in elective admissions (HR 1.03, P=.96) or outpatient use (HR 1.40; P=.18) between the 2 groups. These differences were sustai
Auton A, Zaman S, Padayachee Y, et al., 2023, Smartphone-based remote monitoring for chronic heart failure: mixed methods analysis of user experience from patient and nurse perspectives, JMIR Nursing, Vol: 6, ISSN: 2562-7600
BACKGROUND: Community-based management by heart failure specialist nurses (HFSNs) is key to improving self-care in heart failure with reduced ejection fraction. Remote monitoring (RM) can aid nurse-led management, but in the literature, user feedback evaluation is skewed in favor of the patient rather than nursing user experience. Furthermore, the ways in which different groups use the same RM platform at the same time are rarely directly compared in the literature. We present a balanced semantic analysis of user feedback from patient and nurse perspectives of Luscii, a smartphone-based RM strategy combining self-measurement of vital signs, instant messaging, and e-learning. OBJECTIVE: This study aims to (1) evaluate how patients and nurses use this type of RM (usage type), (2) evaluate patients' and nurses' user feedback on this type of RM (user experience), and (3) directly compare the usage type and user experience of patients and nurses using the same type of RM platform at the same time. METHODS: We performed a retrospective usage type and user experience evaluation of the RM platform from the perspective of both patients with heart failure with reduced ejection fraction and the HFSNs using the platform to manage them. We conducted semantic analysis of written patient feedback provided via the platform and a focus group of 6 HFSNs. Additionally, as an indirect measure of tablet adherence, self-measured vital signs (blood pressure, heart rate, and body mass) were extracted from the RM platform at onboarding and 3 months later. Paired 2-tailed t tests were used to evaluate differences between mean scores across the 2 timepoints. RESULTS: A total of 79 patients (mean age 62 years; 35%, 28/79 female) were included. Semantic analysis of usage type revealed extensive, bidirectional information exchange between patients and HFSNs using the platform. Semantic analysis of user experience demonstrates a range of positive and negative perspectives. Positive impacts includ
Kaura A, Yap CH, Shah ASV, et al., 2023, The diagnostic and prognostic value of left ventricular ejection fraction corrected for myocardial remodelling, Annual Conference of the British-Cardiovascular-Society (BCS), Publisher: BMJ PUBLISHING GROUP, Pages: A205-A206, ISSN: 1355-6037
Kaura A, O'Gallagher K, Townend J, et al., 2023, Using high-sensitivity troponin for mortality prediction after coronary artery bypass graft surgery, Annual Conference of the British-Cardiovascular-Society (BCS), Publisher: BMJ PUBLISHING GROUP, Pages: A226-A227, ISSN: 1355-6037
Kallis C, Kaura A, Samuel N, et al., 2023, The Relationship Between Cardiac Troponin in Hospitalised Exacerbating Chronic Obstructive Pulmonary Disease (COPD) Patients With Major Adverse Cardiac Events (MACE) and COPD Readmissions, International Conference of the American-Thoracic-Society (ATS), Publisher: AMER THORACIC SOC, ISSN: 1073-449X
Esdaile H, Hill N, Mayet J, et al., 2023, Glycaemic control in people with diabetes following acute myocardial infarction, Diabetes Research and Clinical Practice, Vol: 199, ISSN: 0168-8227
Diabetes is a highly prevalent disease associated with considerable cardiovascular end organ damage and mortality. Despite significant changes to the management of acute myocardial infarction over the last two decades, people with diabetes remain at risk of complications and mortality following a myocardial infarct for a multitude of reasons, including increased coronary atherosclerosis, associated coronary microvascular dysfunction, and diabetic cardiomyopathy. Dysglycaemia causes significant endothelial dysfunction and upregulation of inflammation within the vasculature and epigenetic changes mean that these deleterious effects may persist despite subsequent efforts to tighten glycaemic control. Whilst clinical guidelines advocate for the avoidance of both hyper- and hypoglcyaemia in the peri-infarct period, the evidence base is lacking, and currently there is no consensus on the benefits of glycaemic control beyond this period. Glycaemic variability contributes to the glycaemic milieu and may have prognostic importance following myocardial infarct. The use of continuous glucose monitoring means that glucose trends and parameters can now be captured and interrogated, and its use, along with newer medicines, may provide novel opportunities for intervention after myocardial infarction in people with diabetes.
Al Saikhan L, Park C, Tillin T, et al., 2023, Sex-differences in associations of LV structure and function measured by echocardiography with long-term risk of mortality and cardiovascular morbidity, FRONTIERS IN CARDIOVASCULAR MEDICINE, Vol: 10, ISSN: 2297-055X
Kaura A, Sterne JAC, Trickey A, et al., 2022, Developing informatics infrastructure to curate datasets using electronic health record data from five hospitals for translational cardiovascular research, Publisher: OXFORD UNIV PRESS, Pages: 2794-2794, ISSN: 0195-668X
Kaura A, Goswami S, Mulla A, et al., 2022, The association between age, troponin level, and mortality in patients hospitalised with acute pulmonary embolism (NIHR Health Informatics Collaborative TROP-PE study), Publisher: OXFORD UNIV PRESS, Pages: 1873-1873, ISSN: 0195-668X
Kaura A, Samuel NA, Roddick AJ, et al., 2022, The prognostic significance of troponin level in patients with malignancy (NIHR Health Informatics Collaborative TROP-MALIGNANCY study), Publisher: OXFORD UNIV PRESS, Pages: 2588-2588, ISSN: 0195-668X
Kaura A, Roddick AJ, Samuel NA, et al., 2022, The association between troponin level and mortality in patients admitted to hospital with acute stroke (NIHR Health Informatics Collaborative TROP-STROKE study), Publisher: OXFORD UNIV PRESS, Pages: 1991-1991, ISSN: 0195-668X
Benedetto U, Sinha S, Mulla A, et al., 2022, Implications of elevated troponin on time-to-surgery in non-ST elevation myocardial infarction (NIHR Health Informatics Collaborative: TROP-CABG study)., Int J Cardiol, Vol: 362, Pages: 14-19
Implications of elevated troponin on time-to-surgery in non-ST elevation myocardial infarction(NIHR Health Informatics Collaborative:TROP-CABG study). Benedetto et al. BACKGROUND: The optimal timing of coronary artery bypass grafting (CABG) in patients with non-ST elevation myocardial infarction (NSTEMI) and the utility of pre-operative troponin levels in decision-making remains unclear. We investigated (a) the association between peak pre-operative troponin and survival post-CABG in a large cohort of NSTEMI patients and (b) the interaction between troponin and time-to-surgery. METHODS AND RESULTS: Our cohort consisted of 1746 patients (1684 NSTEMI; 62 unstable angina) (mean age 69 ± 11 years,21% female) with recorded troponins that had CABG at five United Kingdom centers between 2010 and 2017. Time-segmented Cox regression was used to investigate the interaction of peak troponin and time-to-surgery on early (within 30 days) and late (beyond 30 days) survival. Average interval from peak troponin to surgery was 9 ± 15 days, with 1466 (84.0%) patients having CABG during the same admission. Sixty patients died within 30-days and another 211 died after a mean follow-up of 4 ± 2 years (30-day survival 0.97 ± 0.004 and 5-year survival 0.83 ± 0.01). Peak troponin was a strong predictor of early survival (adjusted P = 0.002) with a significant interaction with time-to-surgery (P interaction = 0.007). For peak troponin levels <100 times the upper limit of normal, there was no improvement in early survival with longer time-to-surgery. However, in patients with higher troponins, early survival increased progressively with a longer time-to-surgery, till day 10. Peak troponin did not influence survival beyond 30 days (adjusted P = 0.64). CONCLUSIONS: Peak troponin in NSTEMI patients undergoing CABG was a significant predictor of earl
Esdaile H, Mayet J, Hill N, 2022, Cardiovascular disease risk stratification in type 2 diabetes, Diabetic Medicine, Vol: 39, Pages: 1-2, ISSN: 0742-3071
Kaura A, Samuel NA, Roddick A, et al., 2022, PROGNOSTIC SIGNIFICANCE OF TROPONIN IN PATIENTS WITH MALIGNANCY (NIHR HEALTH INFORMATICS COLLABORATIVE TROP-MALIGNANCY STUDY), Annual Conference of the British-Cardiovascular-Society - 100 Years of Cardiology, Publisher: BMJ PUBLISHING GROUP, Pages: A135-A135, ISSN: 1355-6037
Kaura A, Sterne JAC, Trickey A, et al., 2022, DEVELOPING INFORMATICS INFRASTRUCTURE TO CURATE DATASETS USING ELECTRONIC HEALTH RECORD DATA FROM FIVE NHS HOSPITALS FOR TRANSLATIONAL CARDIOVASCULAR RESEARCH, Publisher: BMJ PUBLISHING GROUP, Pages: A27-A28, ISSN: 1355-6037
Kaura A, Goswami S, Benedetto U, et al., 2022, ASSOCIATION BETWEEN AGE, TROPONIN LEVEL AND MORTALITY IN PATIENTS PRESENTING TO HOSPITAL WITH ACUTE PULMONARY EMBOLISM (NIHR HEALTH INFORMATICS COLLABORATIVE TROP-PE STUDY), Annual Conference of the British-Cardiovascular-Society - 100 Years of Cardiology, Publisher: BMJ PUBLISHING GROUP, Pages: A129-A129, ISSN: 1355-6037
Kaura A, Roddick A, Samuel NA, et al., 2022, ASSOCIATION BETWEEN TROPONIN AND MORTALITY IN ACUTE STROKE (NIHR HEALTH INFORMATICS COLLABORATIVE TROP-STROKE STUDY), Annual Conference of the British-Cardiovascular-Society - 100 Years of Cardiology, Publisher: BMJ PUBLISHING GROUP, Pages: A129-A130, ISSN: 1355-6037
Al Saikhan L, Park C, Tillin T, et al., 2022, Relationship Between Image Quality and Bias in 3D Echocardiographic Measures: Data From the SABRE (Southall and Brent Revisited) Study, JOURNAL OF THE AMERICAN HEART ASSOCIATION, Vol: 11
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Kelshiker M, Seligman H, Howard JAMES, et al., 2022, Coronary flow reserve and cardiovascular outcomes: a systematic review and meta-analysis, European Heart Journal, Vol: 43, Pages: 1582-1593, ISSN: 0195-668X
Aims: This meta-analysis aims to quantify the association of reduced coronary flow with all3 cause mortality and major adverse cardiovascular events (MACE) across a broad range of patient groups and pathologies. Methods and Results: We systematically identified all studies between 1st January 2000 and1st August 2020, where coronary flow was measured and clinical outcomes were reported. The endpoints were all-cause mortality and MACE. Estimates of effect were calculated from published hazard ratios using a random-effects model. 79 studies, including 59,740 subjects were included. Abnormal coronary flow reserve (CFR) was associated with a higher incidence of all-cause mortality (HR 3.78, 95% CI 2.39-5.97) and a higher incidence of MACE (HR 3.42, 95% CI 2.92-3.99). Each 0.1-unit reduction in CFR was associated with a proportional increase in mortality (per 0.1 CFR unit HR 1.16, 95% CI 1.04-1.29) and MACE (per 0.1 CFR unit HR 1.08, 95% CI 1.04-1.11)). In patients with isolated coronary microvascular dysfunction, an abnormal CFR was associated with a higher incidence of mortality (HR 5.44, 95% CI 3.78-7.83) and MACE (HR 3.56, 95% CI 2.14-5.90). Abnormal CFR was also associated with a higher incidence of MACE in patients with acute coronary syndromes (HR 3.76, 95% CI 2.35-6.00), heart failure (HR 6.38, 95% CI 1.95-20.90), heart transplant (HR 3.32, 95% CI 2.34-4.71) and diabetes mellitus (HR 7.47, 95% CI 3.37-16.55). Conclusions: Reduced coronary flow is strongly associated with increased risk of all-cause mortality and MACE across a wide range of pathological processes. This finding supports recent recommendations that coronary flow should be measured more routinely in clinical practice to target aggressive vascular risk modification for individuals at higher risk
Kaura A, Trickey A, Shah A, et al., 2022, Comparing the longer-term effectiveness of a single dose of the Pfizer-BioNTech and Oxford-AstraZeneca COVID-19 vaccines across the age spectrum, EClinicalMedicine, Vol: 46, ISSN: 2589-5370
Background:A single dose strategy may be adequate to confer population level immunity and protection against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, especially in low- and middle-income countries where vaccine supply remains limited. We compared the effectiveness of a single dose strategy of the Oxford-AstraZeneca or Pfizer-BioNTech vaccines against SARS-CoV-2 infection across all age groups and over an extended follow-up period.Methods:Individuals vaccinated in North-West London, UK, with either the first dose of the Oxford-AstraZeneca or Pfizer-BioNTech vaccines between January 12, 2021 to March 09, 2021, were matched to each other by demographic and clinical characteristics. Each vaccinated individual was additionally matched to an unvaccinated control. Study outcomes included SARS-CoV-2 infection of any severity, COVID-19 hospitalisation, COVID-19 death, and all-cause mortality. Findings:Amongst matched individuals, 63,608 were in each of the vaccine groups and 127,216 were unvaccinated. Between 14-84 days of follow-up after matching, there were 534 SARS-CoV-2 infections, 65 COVID-19 hospitalisations, and 190 deaths, of which 29 were categorized as due to COVID-19. The incidence rate ratio (IRR) for SARS-CoV-2 infection was 0.85 (95% confidence interval [CI], 0.69 to 1.05) for Oxford-Astra-Zeneca, and 0.69 (0.55 to 0.86) for Pfizer-BioNTech. The IRR for both vaccines was the same at 0.25 (0.09 to 0.55) and 0.14 (0.02 to 0.58) for reducing COVID-19 hospitalization and COVID-19 mortality, respectively. The IRR for all-cause mortality was 0.25 (0.15 to 0.39) and 0.18 (0.10 to 0.30) for the Oxford-Astra-Zeneca and Pfizer-BioNTech vaccines, respectively. Age was an effect modifier of the association between vaccination and SARS-CoV-2 infection of any severity; lower hazard ratios for increasing age. Interpretation: A single dose strategy, for both vaccines, was effective at reducing COVID-19 mortality and hospitalization rates. The mag
Sau A, Kaura A, Ahmed A, et al., 2022, Prognostic significance of ventricular arrhythmias in 13444 patients with acute coronary syndrome: a retrospective cohort study based on routine clinical data (NIHR Health Informatics Collaborative VA-ACS Study), Journal of the American Heart Association, Vol: 11, Pages: 1-19, ISSN: 2047-9980
Background: A minority of acute coronary syndrome (ACS) cases are associated with ventricular arrhythmias (VA) and/or cardiac arrest (CA). We investigated the effect of VA/CA at time of ACS on long-term outcomes.Methods and Results: We analysed routine clinical data from 5 NHS Trusts in the United Kingdom, collected between 2010 and 2017, by the National Institute for Health Research Health Informatics Collaborative (NIHR HIC).13,444 patients with ACS, of which 376 (2.8%) had concurrent VA, survived to hospital discharge and were followed up for a median of 3.42 years. Patients with VA or CA at index presentation had significantly increased risks of subsequent VA during follow-up (VA group: adjusted HR 4.15, 95% CI 2.42-7.09, CA group: adjusted HR 2.60 95% CI 1.23-5.48). Patients who suffered a CA in the context of ACS and survived to discharge also had a 36% increase in long-term mortality (adjusted hazard ratio 1.36 (95% 1.04-1.78)), though the concurrent diagnosis of VA alone during ACS did not affect all-cause mortality (adjusted HR 1.03, 95% CI 0.80-1.33). Conclusions: Patients who develop VA or CA during ACS, who survive to discharge, have increased risks of subsequent VA, while those who have CA during ACS also have an increase in long-term mortality. These individuals may represent a subgroup at greater risk of subsequent arrhythmic events due to intrinsically lower thresholds for developing VA.
Kaura A, Mayet J, Manisty C, 2022, Sharpening focus through wider collaboration: evolving heterogeneity in the bi-directional relationship between cardiovascular disease and COVID-19, EUROPEAN HEART JOURNAL, Vol: 43, Pages: 1121-1123, ISSN: 0195-668X
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Kelshiker M, Seligman H, Howard JP, et al., 2022, CORONARY FLOW RESERVE AND CARDIOVASCULAR OUTCOMES: A SYSTEMATIC REVIEW AND META-ANALYSIS, 71st Annual Scientific Session and Expo of the American-College-of-Cardiology (ACC), Publisher: ELSEVIER SCIENCE INC, Pages: 989-989, ISSN: 0735-1097
Kaura A, Hartley A, Panoulas V, et al., 2022, Mortality risk prediction of high-sensitivity C-reactive protein in suspected acute coronary syndrome: a cohort study, PLoS Medicine, Vol: 19, ISSN: 1549-1277
BACKGROUND: There is limited evidence on the use of high-sensitivity C-reactive protein (hsCRP) as a biomarker for selecting patients for advanced cardiovascular (CV) therapies in the modern era. The prognostic value of mildly elevated hsCRP beyond troponin in a large real-world cohort of unselected patients presenting with suspected acute coronary syndrome (ACS) is unknown. We evaluated whether a mildly elevated hsCRP (up to 15 mg/L) was associated with mortality risk, beyond troponin level, in patients with suspected ACS. METHODS AND FINDINGS: We conducted a retrospective cohort study based on the National Institute for Health Research Health Informatics Collaborative data of 257,948 patients with suspected ACS who had a troponin measured at 5 cardiac centres in the United Kingdom between 2010 and 2017. Patients were divided into 4 hsCRP groups (<2, 2 to 4.9, 5 to 9.9, and 10 to 15 mg/L). The main outcome measure was mortality within 3 years of index presentation. The association between hsCRP levels and all-cause mortality was assessed using multivariable Cox regression analysis adjusted for age, sex, haemoglobin, white cell count (WCC), platelet count, creatinine, and troponin. Following the exclusion criteria, there were 102,337 patients included in the analysis (hsCRP <2 mg/L (n = 38,390), 2 to 4.9 mg/L (n = 27,397), 5 to 9.9 mg/L (n = 26,957), and 10 to 15 mg/L (n = 9,593)). On multivariable Cox regression analysis, there was a positive and graded relationship between hsCRP level and mortality at baseline, which remained at 3 years (hazard ratio (HR) (95% CI) of 1.32 (1.18 to 1.48) for those with hsCRP 2.0 to 4.9 mg/L and 1.40 (1.26 to 1.57) and 2.00 (1.75 to 2.28) for those with hsCRP 5 to 9.9 mg/L and 10 to 15 mg/L, respectively. This relationship was independent of troponin in all suspected ACS patients and was further verified in those who were confirmed to have an ACS diagnosis by clinical coding. The main limitation of our study is that we did not
Seligman H, Nijjer SS, van de Hoef TP, et al., 2022, Phasic flow patterns of right versus left coronary arteries in patients undergoing clinical physiological assessment, EUROINTERVENTION, Vol: 17, Pages: 1260-+, ISSN: 1774-024X
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Al Saikhan L, Alobaida M, Bhuva A, et al., 2021, Imaging Protocol, Feasibility, and Reproducibility of Cardiovascular Phenotyping in a Large Tri-Ethnic Population-Based Study of Older People: The Southall and Brent Revisited (SABRE) Study (vol 7,591946,2020), FRONTIERS IN CARDIOVASCULAR MEDICINE, Vol: 8, ISSN: 2297-055X
Cook CM, Howard JP, Ahmad Y, et al., 2021, Comparing invasive hemodynamic responses in adenosine hyperemia versus physical exercise stress in chronic coronary syndromes, INTERNATIONAL JOURNAL OF CARDIOLOGY, Vol: 342, Pages: 7-14, ISSN: 0167-5273
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