Imperial College London

Professor Sir Steve Bloom FMedSci, FRS

Faculty of MedicineDepartment of Medicine

Departmental Academic REF2014 Lead
 
 
 
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Contact

 

+44 (0)20 3313 3242s.bloom Website

 
 
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Assistant

 

Ms Keda Price-Cousins +44 (0)20 3313 3242

 
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Location

 

Commonwealth BuildingHammersmith Campus

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Summary

 

Publications

Publication Type
Year
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2934 results found

Abbara A, Clarke S, Islam R, Prague JK, Comninos A, Narayanaswamy S, Papadopoulou DA, Roberts RE, Izzi-Engbeaya CN, Ratnasabapathy R, Nesbitt A, Vimalesvaran S, Salim R, Lavery SA, Bloom SR, Huson L, Trew GH, Dhillo WSet al., 2017, Reply: Clinical trial registry alone is not adequate: on the perception of possible endpoint switching and P-hacking., Hum Reprod, Pages: 1-3

JOURNAL ARTICLE

Abbara A, Clarke S, Islam R, Prague JK, Comninos AN, Narayanaswamy S, Papadopoulou D, Roberts R, Izzi-Engbeaya C, Ratnasabapathy R, Nesbitt A, Vimalesvaran S, Salim R, Lavery SA, Bloom SR, Huson L, Trew GH, Dhillo WSet al., 2017, A second dose of kisspeptin-54 improves oocyte maturation in women at high risk of ovarian hyperstimulation syndrome: a Phase 2 randomized controlled trial, HUMAN REPRODUCTION, Vol: 32, Pages: 1915-1924, ISSN: 0268-1161

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Alamshah A, Spreckley E, Norton M, Kinsey-Jones JS, Amin A, Ramgulam A, Cao Y, Johnson R, Saleh K, Akalestou E, Malik Z, Gonzalez-Abuin N, Jomard A, Amarsi R, Moolla A, Sargent PR, Gray GW, Bloom SR, Murphy KGet al., 2017, L-phenylalanine modulates gut hormone release and glucose tolerance, and suppresses food intake through the calcium-sensing receptor in rodents, INTERNATIONAL JOURNAL OF OBESITY, Vol: 41, Pages: 1693-1701, ISSN: 0307-0565

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Baran DA, Visveswaran GK, Seliem A, Divita M, Wasty N, Cohen Met al., 2017, Differential responses to larger volume intra-aortic balloon counterpulsation: Hemodynamic and clinical outcomes, Catheterization and Cardiovascular Interventions, ISSN: 1522-1946

© 2017 Wiley Periodicals, Inc. Objectives: Examine hemodynamic and clinical correlates of use of an intra-aortic balloon pump catheter in a single center. Background: The intra-aortic balloon pump catheter (IABC) has been used for 50 years but the clinical benefit is still debated. We reviewed 76 patients with right heart catheter measurements prior to IABC to assess response and outcomes. Methods: All patients who received IABC with a 50cc balloon for at least 1 hour were included in this retrospective chart review study. Demographics, comorbidities, lab values, and hemodynamic parameters were recorded at baseline and 15 h postinsertion. Results: Seventy-six patients had paired measurements of cardiac output. 60 patients had a higher cardiac output with IABC treatment (responder group) and 16 did not (nonresponders). In the 60 patients in the responder group, cardiac output and index significantly increased from baseline 3.6±1.3 L/min to 5.2±1.8 L/min, and 1.8±0.5 L/min/m 2 to 2.6±0.8 L/min/m 2 respectively following IABC placement (P & #60;0.0001 for both comparisons). Various hemodynamic variables were examined and the best predictor of response to IABC was a cardiac power index of 0.3 or less. Regardless of response, in hospital survival was similar between groups. Conclusions: The majority of patients improve their cardiac output with IABC but survival was unchanged. Further work into the pathophysiology of cardiogenic shock is needed.

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Brooks L, Viardot A, Tsakmaki A, Stolarczyk E, Howard JK, Cani PD, Everard A, Sleeth ML, Psichas A, Anastasovskaj J, Bell JD, Bell-Anderson K, Mackay CR, Ghatei MA, Bloom SR, Frost G, Bewick GAet al., 2017, Fermentable carbohydrate stimulates FFAR2-dependent colonic PYY cell expansion to increase satiety, MOLECULAR METABOLISM, Vol: 6, Pages: 48-60, ISSN: 2212-8778

JOURNAL ARTICLE

Buenaventura T, Kanda N, Jones B, Correa IR, Bloom SR, Rutter GA, Tomas Aet al., 2017, Characterisation of glucagon-like peptide-1 (GLP-1) receptor trafficking and its significance for pancreatic beta cell function, DIABETIC MEDICINE, Vol: 34, Pages: 53-53, ISSN: 0742-3071

JOURNAL ARTICLE

Cegla J, Jones BJ, Gardiner JV, Hodson DJ, Marjot T, McGlone ER, Tan TM, Bloom SRet al., 2017, RAMP2 Influences Glucagon Receptor Pharmacology via Trafficking and Signaling, ENDOCRINOLOGY, Vol: 158, Pages: 2680-2693, ISSN: 0013-7227

JOURNAL ARTICLE

Cegla J, Jones BJ, Howard J, Kay R, Creaser CS, Bloom SR, Tan TMet al., 2017, The preanalytical stability of glucagon as measured by liquid chromatography tandem mass spectrometry and two commercially available immunoassays, ANNALS OF CLINICAL BIOCHEMISTRY, Vol: 54, Pages: 293-296, ISSN: 0004-5632

JOURNAL ARTICLE

Christakis I, Scott R, Minnion J, Cuenco J, Tan T, Palazzo F, Bloom Set al., 2017, Measuring the Pharmacokinetic Properties of Drugs with a Novel Surgical Rat Model, JOURNAL OF INVESTIGATIVE SURGERY, Vol: 30, Pages: 162-169, ISSN: 0894-1939

JOURNAL ARTICLE

Comninos AN, Wall MB, Demetriou L, Shah AJ, Clarke SA, Narayanaswamy S, Nesbitt A, Izzi-Engbeaya C, Prague JK, Abbara A, Ratnasabapathy R, Salem V, Nijher GM, Jayasena CN, Tanner M, Bassett P, Mehta A, Rabiner EA, Honigsperger C, Silva MR, Brandtzaeg OK, Lundanes E, Wilson SR, Brown RC, Thomas SA, Bloom SR, Dhillo WSet al., 2017, Kisspeptin modulates sexual and emotional brain processing in humans, JOURNAL OF CLINICAL INVESTIGATION, Vol: 127, Pages: 709-719, ISSN: 0021-9738

JOURNAL ARTICLE

Cork SC, Eftekhar A, Mirza KB, Gardiner JV, Bloom SR, Toumazou Cet al., 2017, Extracellular pH monitoring for use in closed-loop vagus nerve stimulation., J Neural Eng

OBJECTIVE: Vagal nerve stimulation (VNS) has shown potential benefits for obesity treatment; however current devices lack physiological feedback, which limit their efficacy. Changes in extracellular pH (pH<sub>e</sub>) have shown to be correlated with neural activity, but have traditionally been measured with glass microelectrodes, which limit their in vivo applicability. APPROACH: Iridium oxide has previously been shown to be sensitive to fluctuations in pH and is biocompatible. Iridium oxide microelectrodes were inserted into the subdiaphragmatic vagus nerve of anaesthetised rats. Introduction of the gut hormone cholecystokinin (CCK) or distension of the stomach was used to elicit vagal nerve activity. MAIN RESULTS: iridium oxide microelectrodes have sufficient pH sensitivity to readily detect changes in pH<sub>e</sub> associated with both CCK and gastric distension. What's more, custom made Matlab script was able to use these changes in pH<sub>e</sub> to automatically trigger an implanted VNS device. SIGNIFICANCE: This is the first study to show pH<sub>e</sub> changes in peripheral nerves in vivo. Furthermore, the demonstration that iridium oxide microelectrodes are sufficiently pH sensitive as to measure changes in pH<sub>e</sub> associated with physiological stimuli means they have the potential to be integrated into closed-loop neurostimulating devices.

JOURNAL ARTICLE

Cuenco J, Minnion J, Tan T, Scott R, Germain N, Ling Y, Chen R, Ghatei M, Bloom Set al., 2017, Degradation Paradigm of the Gut Hormone, Pancreatic Polypeptide, by Hepatic and Renal Peptidases, ENDOCRINOLOGY, Vol: 158, Pages: 1755-1765, ISSN: 0013-7227

JOURNAL ARTICLE

Garg A, Rao SV, Agrawal S, Theodoropoulos K, Mennuni M, Sharma A, Garg L, Ferrante G, Meelu OA, Sargsyan D, Reimers B, Cohen M, Kostis JB, Stefanini GGet al., 2017, Meta-Analysis of Randomized Controlled Trials of Percutaneous Coronary Intervention With Drug-Eluting Stents Versus Coronary Artery Bypass Grafting in Left Main Coronary Artery Disease., Am J Cardiol, Vol: 119, Pages: 1942-1948

Few randomized controlled trials (RCTs) and observational studies had shown acceptable short-term efficacy and safety of percutaneous coronary intervention (PCI) with drug-eluting stents (DES) compared with coronary artery bypass grafting (CABG) in selected patients with left main coronary artery disease (LMCAD). We aimed to evaluate long-term outcomes of PCI using DES compared with CABG in patients with LMCAD. On November 1, 2016, we searched available databases for published RCTs directly comparing DES PCI with CABG in patients with LMCAD. Odds ratios (ORs) were used as the metric of choice for treatment effects using a random-effects model. I-squared index was used to assess heterogeneity across trials. Prespecified end points were all-cause mortality, cardiovascular mortality, myocardial infarction (MI), stroke, and repeat revascularization at maximal available follow-up. We identified 5 RCTs including a total of 4,595 patients, with a median follow-up of 60 months. The risk of all-cause mortality (OR 1.01; 95% confidence interval [CI] 0.76 to 1.34) and cardiovascular mortality (OR 1.02; 95% CI 0.73 to 1.42) were comparable between PCI with DES and CABG. Similarly, there were no statistically significant differences between PCI with DES and CABG for MI (OR 1.45; 95% CI 0.87 to 2.40) and stroke (OR 0.87; 95% CI 0.38 to 1.98). Conversely, repeat revascularization was significantly higher with PCI compared with CABG (OR 1.82; 95% CI 1.51 to 2.21). In conclusion, in patients with LMCAD, PCI with DES appears to be a viable alternative to CABG at long-term follow-up, with similar risks of ischemic adverse events (mortality, MI, and stroke) but a higher risk of repeat revascularization.

JOURNAL ARTICLE

Gibson CM, Pinto DS, Chi G, Arbetter D, Yee M, Mehran R, Bode C, Halperin J, Verheugt FWA, Wildgoose P, Burton P, van Eickels M, Korjian S, Daaboul Y, Jain P, Lip GYH, Cohen M, Peterson ED, Fox KAAet al., 2017, Recurrent Hospitalization Among Patients With Atrial Fibrillation Undergoing Intracoronary Stenting Treated With 2 Treatment Strategies of Rivaroxaban or a Dose-Adjusted Oral Vitamin K Antagonist Treatment Strategy., Circulation, Vol: 135, Pages: 323-333

BACKGROUND: Patients with atrial fibrillation who undergo intracoronary stenting traditionally are treated with a vitamin K antagonist (VKA) plus dual antiplatelet therapy (DAPT), yet this treatment leads to high risks of bleeding. We hypothesized that a regimen of rivaroxaban plus a P2Y12 inhibitor monotherapy or rivaroxaban plus DAPT could reduce bleeding and thereby have a favorable impact on all-cause mortality and the need for rehospitalization. METHODS: Stented subjects with nonvalvular atrial fibrillation (n=2124) were randomized 1:1:1 to administration of reduced-dose rivaroxaban 15 mg daily plus a P2Y12 inhibitor for 12 months (group 1); rivaroxaban 2.5 mg twice daily with stratification to a prespecified duration of DAPT of 1, 6, or 12 months (group 2); or the reference arm of dose-adjusted VKA daily with a similar DAPT stratification (group 3). The present post hoc analysis assessed the end point of all-cause mortality or recurrent hospitalization for an adverse event, which was further classified as the result of bleeding, a cardiovascular cause, or another cause blinded to treatment assignment. RESULTS: The risk of all-cause mortality or recurrent hospitalization was 34.9% in group 1 (hazard ratio=0.79; 95% confidence interval, 0.66-0.94; P=0.008 versus group 3; number needed to treat=15), 31.9% in group 2 (hazard ratio=0.75; 95% confidence interval, 0.62-0.90; P=0.002 versus group 3; number needed to treat=10), and 41.9% in group 3 (VKA+DAPT). Both all-cause death plus hospitalization potentially resulting from bleeding (group 1=8.6% [P=0.032 versus group 3], group 2=8.0% [P=0.012 versus group 3], and group 3=12.4%) and all-cause death plus rehospitalization potentially resulting from a cardiovascular cause (group 1=21.4% [P=0.001 versus group 3], group 2=21.7% [P=0.011 versus group 3], and group 3=29.3%) were reduced in the rivaroxaban arms compared with the VKA arm, but other forms of rehospitalization were not. CONCLUSIONS: Among patients with atria

JOURNAL ARTICLE

Glaysher MA, Mohanaruban A, Prechtl CG, Goldstone AP, Miras AD, Lord J, Chhina N, Falaschetti E, Johnson NA, Al-Najim W, Smith C, Li JV, Patel M, Ahmed AR, Moore M, Poulter N, Bloom S, Darzi A, Le Roux C, Byrne JP, Teare JPet al., 2017, A randomised controlled trial of a duodenal-jejunal bypass sleeve device (EndoBarrier) compared with standard medical therapy for the management of obese subjects with type 2 diabetes mellitus., BMJ Open, Vol: 7

INTRODUCTION: The prevalence of obesity and obesity-related diseases, including type 2 diabetes mellitus (T2DM), is increasing. Exclusion of the foregut, as occurs in Roux-en-Y gastric bypass, has a key role in the metabolic improvements that occur following bariatric surgery, which are independent of weight loss. Endoscopically placed duodenal-jejunal bypass sleeve devices, such as the EndoBarrier (GI Dynamics, Lexington, Massachusetts, USA), have been designed to create an impermeable barrier between chyme exiting the stomach and the mucosa of the duodenum and proximal jejunum. The non-surgical and reversible nature of these devices represents an attractive therapeutic option for patients with obesity and T2DM by potentially improving glycaemic control and reducing their weight. METHODS AND ANALYSIS: In this multicentre, randomised, controlled, non-blinded trial, male and female patients aged 18-65 years with a body mass index 30-50 kg/m2 and inadequately controlled T2DM on oral antihyperglycaemic medications (glycosylated haemoglobin (HbA1c) 58-97 mmol/mol) will be randomised in a 1:1 ratio to receive either the EndoBarrier device (n=80) for 12 months or conventional medical therapy, diet and exercise (n=80). The primary outcome measure will be a reduction in HbA1c by 20% at 12 months. Secondary outcome measures will include percentage weight loss, change in cardiovascular risk factors and medications, quality of life, cost, quality-adjusted life years accrued and adverse events. Three additional subgroups will investigate the mechanisms behind the effect of the EndoBarrier device, looking at changes in gut hormones, metabolites, bile acids, microbiome, food hedonics and preferences, taste, brain reward system responses to food, eating and addictive behaviours, body fat content, insulin sensitivity, and intestinal tissue gene expression. TRIAL REGISTRATION NUMBER: ISRCTN30845205, ClinicalTrials.gov Identifier NCT02459561.

JOURNAL ARTICLE

Hameed S, Patterson M, Dhillo WS, Rahman SA, Ma Y, Holton C, Gogakos A, Yeo GSH, Lam BYH, Polex-Wolf J, Fenske W, Bell J, Anastasovska J, Samarut J, Bloom SR, Bassett JHD, Williams GR, Gardiner JVet al., 2017, Thyroid Hormone Receptor Beta in the Ventromedial Hypothalamus Is Essential for the Physiological Regulation of Food Intake and Body Weight, CELL REPORTS, Vol: 19, Pages: 2202-2209, ISSN: 2211-1247

JOURNAL ARTICLE

Howard JW, Kay RG, Jones B, Cegla J, Tan T, Bloom S, Creaser CSet al., 2017, Development of a UHPLC-MS/MS (SRM) method for the quantitation of endogenous glucagon and dosed GLP-1 from human plasma, BIOANALYSIS, Vol: 9, Pages: 733-751, ISSN: 1757-6180

JOURNAL ARTICLE

Jones BJ, Scopelliti R, Tomas A, Bloom SR, Hodson DJ, Broichhagen Jet al., 2017, Potent Prearranged Positive Allosteric Modulators of the Glucagon-like Peptide-1 Receptor, CHEMISTRYOPEN, Vol: 6, Pages: 501-505, ISSN: 2191-1363

JOURNAL ARTICLE

Keetarut K, Zacharopoulou-Otapasidou S, Bloom S, Majumdar A, Patel PSet al., 2017, An evaluation of the feasibility and validity of a patient-administered malnutrition universal screening tool ('MUST') compared to healthcare professional screening in an inflammatory bowel disease (IBD) outpatient clinic., J Hum Nutr Diet

BACKGROUND: Malnutrition is common in inflammatory bowel disease (IBD) and is associated with poor health outcomes. Despite this, screening for malnutrition in the outpatient-setting is not routine and research in the area is limited. The present study aimed to evaluate whether agreement between malnutrition screening completed by patients and healthcare professionals (HCPs) could be achieved by comparing patient self-administered 'MUST' ('MUST'-P) with HCP administered 'MUST' ('MUST'-HCP) in a single tertiary IBD outpatient clinic. METHODS: We conducted a feasibility and validity study on adult outpatients with IBD. We collected anthropometric, nutritional and clinical data from patients. All patients completed 'MUST'-P using a self-administered questionnaire, followed by 'MUST'-HCP. 'MUST'-P was timed and feedback on ease-of-use was obtained. The risk of malnutrition was classified as low (score = 0), medium (score = 1) and high (score ≥ 2) and agreement was tested using kappa statistics (κ). RESULTS: Eighty patients were recruited (Crohn's disease: n = 49, ulcerative colitis: n = 29, unclassified: n = 2), with a mean (SD) age of 39.9 (15.1) years (51.2% were males). Seventy-one (92%) of patients found 'MUST'-P either easy or very easy. The mean (SD) time to complete 'MUST'-P was 3.1  (1.8) min (range 1-10 min). Sixty-eight (85%) of patients were at low risk of malnutrition when screened by the HCP. There was moderate agreement (κ = 0.486, P < 0.001) between 'MUST'-P and 'MUST'-HCP, with 100% agreement in scoring for medium- and high-risk categories. CONCLUSIONS: The results of the present study suggests that self-screening using 'MUST' could be effectively used in an IBD outpatient clinic to identify those at medium and high risk of malnutrition. The patient friendly version of 'MUST' ('MUST'-P) was considered quick and easy to use by patient

JOURNAL ARTICLE

Law JM, Morris DE, Izzi-Engbeaya C, Salem V, Coello C, Robinson L, Jayasinghe M, Scott R, Gunn R, Rabiner E, Tan T, Dhillo W, Bloom S, Budge H, Symonds Met al., 2017, Thermal imaging is a non-invasive alternative to PET-CT for measurement of brown adipose tissue activity in humans., J Nucl Med

Background: Obesity and its metabolic consequences are a major cause of morbidity and mortality. Brown adipose tissue (BAT) utilises glucose and free fatty acids to produce heat, thereby increasing energy expenditure. Effective evaluation of human BAT stimulators is constrained by current standard BAT assessment methods as positron emission tomography-computed tomography (PET-CT) requires exposure to high doses of ionising radiation. Infrared thermography (IRT) is a potential non-invasive, safe alternative, although direct corroboration with PET-CT has not previously been established. Methods: IRT and 18F-FDG PET-CT data from 8 healthy male participants subjected to water jacket cooling were directly compared. Thermal images (TIs) were geometrically transformed to overlay PET-CT-derived maximum intensity projection (MIP) images from each subject and the areas of greatest intensity of temperature and glucose-uptake within the supraclavicular regions compared. Relationships between supraclavicular temperatures from IRT (TSCR) and the maximum rate of glucose uptake (MR(gluc)) from PET-CT were determined. Results: Glucose uptake on MR(gluc)MIP was positively correlated with change in TSCR relative to a reference region (r2 = 0.721; P = 0.008). Spatial overlap between areas of maximal MR(gluc)MIP and maximal TSCR was 29.5±5.1%. Prolonged cooling to 60 minutes was associated with further TSCR rise compared with cooling to 10 minutes. Conclusion: The supraclavicular hotspot identified on IRT closely corresponds to the area of maximal uptake on PET-CT-derived MR(gluc)MIP images. Greater increases in relative TSCR were associated with raised glucose uptake. IRT should now be considered a suitable method for measuring BAT activation, especially in populations where PET-CT is not feasible, practical or repeatable. This work is licensed under a Creative Commons Attribution 4.0 International License http://creativecommons.org/licenses/by/4.0/.

JOURNAL ARTICLE

Liu Z, Silvain J, Kerneis M, Barthélémy O, Payot L, Choussat R, Sabouret P, Cohen M, Pollack CV, Goldstein P, Zeymer U, Huber K, Vicaut E, Collet JP, Montalescot Get al., 2017, Intravenous Enoxaparin Versus Unfractionated Heparin in Elderly Patients Undergoing Primary Percutaneous Coronary Intervention, Angiology, Vol: 68, Pages: 29-39, ISSN: 0003-3197

© The Author(s) 2016. Elderly (≥75 years old) patients with ST-segment elevation myocardial infarction (STEMI) have higher ischemic and bleeding risk compared with those < 75 years old. We investigated the efficacy and safety of intravenous (IV) enoxaparin versus IV unfractionated heparin (UFH) in elderly patients undergoing primary percutaneous coronary intervention (PCI) for STEMI. A prespecified analysis of the Acute Myocardial Infarction Treated with Primary Angioplasty and Intravenous Enoxaparin or Unfractionated Heparin to Lower Ischemic and Bleeding Events at Short- and Long-term Follow-up (ATOLL) study was performed examining the 30-day outcomes in the elderly patients. Of the 165 elderly patients in the ATOLL study, 85 patients received IV enoxaparin 0.5 mg/kg and 80 patients received IV UFH. Intravenous enoxaparin did not reduce the primary end point, the main secondary efficacy end point, major bleeding, major or minor bleeding, and all-cause mortality compared with IV UFH. The rate of minor bleeding (5.9% vs 22.8%, P adjusted =.01) was significantly lower with IV enoxaparin compared with IV UFH. Intravenous enoxaparin appears to be a safe alternative to IV UFH in primary PCI of the elderly patients with STEMI.

JOURNAL ARTICLE

Magnuson EA, Li H, Wang K, Vilain K, Shafiq A, Bonaca MP, Bhatt DL, Cohen M, Steg PG, Storey RF, Braunwald E, Sabatine MS, Cohen DJet al., 2017, Cost-Effectiveness of Long-Term Ticagrelor in Patients With Prior Myocardial Infarction, JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, Vol: 70, Pages: 527-538, ISSN: 0735-1097

JOURNAL ARTICLE

Prague JK, Roberts RE, Comninos AN, Clarke S, Jayasena CN, Nash Z, Doyle C, Papadopoulou DA, Bloom SR, Mohideen P, Panay N, Hunter MS, Veldhuis JD, Webber LC, Huson L, Dhillo WSet al., 2017, Neurokinin 3 receptor antagonism as a novel treatment for menopausal hot flushes: a phase 2, randomised, double-blind, placebo-controlled trial, LANCET, Vol: 389, Pages: 1809-1820, ISSN: 0140-6736

JOURNAL ARTICLE

Tan T, Behary P, Tharakan G, Minnion J, Al-Najim W, Albrechtsen NJW, Holst JJ, Bloom SRet al., 2017, The Effect of a Subcutaneous Infusion of GLP-1, OXM, and PYY on Energy Intake and Expenditure in Obese Volunteers, JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, Vol: 102, Pages: 2364-2372, ISSN: 0021-972X

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Tharakan G, Behary P, Albrechtsen NJW, Chahal H, Kenkre J, Miras AD, Ahmed AR, Holst JJ, Bloom SR, Tan Tet al., 2017, Roles of increased glycaemic variability, GLP-1 and glucagon in hypoglycaemia after Roux-en-Y gastric bypass, EUROPEAN JOURNAL OF ENDOCRINOLOGY, Vol: 177, Pages: 455-464, ISSN: 0804-4643

JOURNAL ARTICLE

Thawabi M, Hawatmeh A, Studyvin S, Habib H, Shamoon F, Cohen Met al., 2017, Cardiac troponin and outcome in decompensated heart failure with preserved ejection fraction, Cardiovascular Diagnosis and Therapy, Vol: 7, Pages: 359-366, ISSN: 2223-3652

© Cardiovascular Diagnosis and Therapy. Background: Cardiac troponin (cTn) has been established as an effective prognostic marker in acute heart failure (HF) with predominantly reduced ejection fraction. However, its prognostic value in heart failure with preserved ejection fraction (HFpEF) is unclear. The aim of this study is to describe the prognostic role of troponin I in patients hospitalized for HFpEF decompensation. Methods: We included 363 consecutive patients admitted for HFpEF decompensation that was not associated with acute coronary syndrome (ACS). Patients with troponin level elevation (troponin I level ≥0.04 ng/mL) were compared to patients with normal troponin level. The primary outcome was short-, intermediate-, and long-term all-cause mortality. The secondary outcomes were differences in B-type natriuretic peptide level (BNP), length of stay, and readmission rates between the two groups. Results: Nearly half of the patients in the Cohort had troponin level elevation. Troponin level elevation was significantly associated with higher 30-day (4.8% vs. 0.6%, P=0.014), 1-year (12.2% vs. 4.6%, P=0.009), and 2-year mortality (13.8% vs. 5.1%, P=0.005) when compared to a normal troponin level. Troponin level elevation was an independent predictor of mortality after adjusting for clinical and laboratory risk factors seen in HFpEF decompensation. Additionally, BNP level > 287 pg/mL, age, and history of atrial fibrillation were identified as statistically significant predictors of mortality. Conclusions: Troponin level elevation, in hospitalized patients with HFpEF decompensation, was associated with higher short-, intermediate-, and long-term mortality.

JOURNAL ARTICLE

Visveswaran GK, Cohen M, Seliem A, DiVita M, McNamara JKR, Dave A, Wasty N, Baran DAet al., 2017, A single center tertiary care experience utilizing the large volume mega 50cc intra-aortic balloon counterpulsation in contemporary clinical practice, Catheterization and Cardiovascular Interventions, Vol: 90, Pages: E63-E72, ISSN: 1522-1946

© 2017 Wiley Periodicals, Inc. Objective: Clinical outcomes and adverse events utilizing the large volume 50cc intra-aortic balloon (IAB) in contemporary clinical practice. Background: The newer large volume 50cc IAB, recently introduced into clinical practice offers improved diastolic augmentation and better left ventricular (LV) unloading compared to the older 40cc IAB. Methods: In 150 consecutive patients who received intra-aortic balloon counterpulsation (IABC) with a 50cc balloon from 2011 to 2015, we retrospectively analyzed demographic, clinical, laboratory, and hemodynamic variables, adverse events and survival to discharge from index hospitalization. Results: Median LVEF was 20%. The most common indication was cardiogenic shock (CS) in 100 patients. Median duration of IABC was 92.5 hr. 95% of patients were free of any IAB device related complications. Five patients received a transfusion for bleeding causally related to IABC. 70 of the 150 patients who received MCS with IABC with no escalation of therapy, recovered and were discharged alive. Fifteen patients were stabilized on IABC and bridged to orthotopic heart transplant. All 15 were discharged alive. Thirty-four patients were initiated on IABC and escalated to VAD and/or Impella/Tandem Heart, with 24 patients surviving to hospital discharge. Overall survival to hospital discharge for the 150 patients was 72.7%. Conclusion: IABC using a larger volume 50cc balloon appears effective as a first line percutaneous MCS strategy in a large fraction of critically ill cardiac patients with few adverse events. A large scale registry or randomized clinical trial utilizing the larger volume IAB is needed to validate our results. © 2017 Wiley Periodicals, Inc.

JOURNAL ARTICLE

Akalestou E, Christakis I, Solomou AM, Minnion JS, Rutter GA, Bloom SRet al., 2016, Proglucagon-Derived Peptides Do Not Significantly Affect Acute Exocrine Pancreas in Rats, PANCREAS, Vol: 45, Pages: 967-973, ISSN: 0885-3177

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Alamshah A, McGavigan AK, Spreckley E, Kinsey-Jones JS, Amin A, Tough IR, O'Hara HC, Moolla A, Banks K, France R, Hyberg G, Norton M, Cheong W, Lehmann A, Bloom SR, Cox HM, Murphy KGet al., 2016, L-arginine promotes gut hormone release and reduces food intake in rodents, DIABETES OBESITY & METABOLISM, Vol: 18, Pages: 508-518, ISSN: 1462-8902

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Bhatt DL, Bonaca MP, Bansilal S, Angiolillo DJ, Cohen M, Storey RF, Im K, Murphy SA, Held P, Braunwald E, Sabatine MS, Steg PGet al., 2016, Reduction in Ischemic Events With Ticagrelor in Diabetic Patients With Prior Myocardial Infarction in PEGASUS-TIMI 54, JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, Vol: 67, Pages: 2732-2740, ISSN: 0735-1097

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