Imperial College London

Prof. Diana Gorog

Faculty of MedicineNational Heart & Lung Institute

Honorary Senior Research Fellow
 
 
 
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Contact

 

+44 (0)20 7034 8934d.gorog

 
 
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Location

 

Royal BromptonRoyal Brompton Campus

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Summary

 

Publications

Publication Type
Year
to

200 results found

Becker RC, Gorog DA, 2021, International COVID-19 biomarkers colloquium, JOURNAL OF THROMBOSIS AND THROMBOLYSIS, Vol: 52, Pages: 983-984, ISSN: 0929-5305

Journal article

Singh S, Gorog DA, Mahon CF, Rawal B, Semple TR, Nicol ED, Arachchillage DRJ, Price S, Desai S, Ridge CA, Padley SPG, Mirsadraee Set al., 2021, Optimal Management of Thrombotic Complications in Patients With Coronavirus Disease 2019 Reply, CRITICAL CARE MEDICINE, Vol: 49, Pages: E1190-E1191, ISSN: 0090-3493

Journal article

Kubica J, Adamski P, Gorog DA, Kubica A, Jilma B, Budaj A, Siller-Matula JM, Gurbel PA, Alexopoulos D, Badarienė J, Dąbrowski P, Dudek D, Giannitsis E, Horszczaruk G, Jaguszewski M, James S, Jeong Y-H, Kryjak M, Niezgoda P, Ostrowska M, Patti G, Romanek J, Di Somma S, Specchia G, Tantry U, Gąsior M, Tycińska A, Wojakowski W, Buszko K, Gil R, Gruchała M, Kasprzak J, Kleinrok A, Legutko J, Lesiak M, Navarese EPet al., 2021, Low-dose ticagrelor with or without acetylsalicylic acid in patients with acute coronary syndrome: Rationale and design of the ELECTRA-SIRIO 2 trial., Cardiol J

Journal article

Navarese EP, Kereiakes DJ, Gorog DA, Lansky AJ, Andreotti Fet al., 2021, When a meta-analysis equals a single large-scale trial with meaningful follow-up, EUROPEAN HEART JOURNAL, Vol: 42, Pages: 3884-3885, ISSN: 0195-668X

Journal article

Cenko E, Badimon L, Bugiardini R, Claeys MJ, De Luca G, de Wit C, Derumeaux G, Dorobantu M, Duncker DJ, Eringa EC, Gorog DA, Hassager C, Heinzel FR, Huber K, Manfrini O, Milicic D, Oikonomou E, Padro T, Trifunovic-Zamaklar D, Vasiljevic-Pokrajcic Z, Vavlukis M, Vilahur G, Tousoulis Det al., 2021, Cardiovascular disease and COVID-19: a consensus paper from the ESC Working Group on Coronary Pathophysiology & Microcirculation, ESC Working Group on Thrombosis and the Association for Acute CardioVascular Care (ACVC), in collaboration with the European Heart Rhythm Association (EHRA)., Cardiovasc Res

The cardiovascular system is significantly affected in coronavirus disease-19 (COVID-19). Microvascular injury, endothelial dysfunction and thrombosis resulting from viral infection or indirectly related to the intense systemic inflammatory and immune responses are characteristic features of severe COVID-19. Pre-existing cardiovascular disease and viral load are linked to myocardial injury and worse outcomes. The vascular response to cytokine production and the interaction between SARS-CoV-2 and ACE2 receptor may lead to a significant reduction in cardiac contractility and subsequent myocardial dysfunction. In addition, a considerable proportion of patients who have been infected with SARS-CoV-2 do not fully recover and continue to experience a large number of symptoms and post-acute complications in the absence of a detectable viral infection. This conditions often referred to as "post-acute COVID-19" may have multiple causes. Viral reservoirs or lingering fragments of viral RNA or proteins contribute to the condition. Systemic inflammatory response to COVID-19 has the potential to increase myocardial fibrosis which in turn may impair cardiac remodelling. Here we summarize the current knowledge of cardiovascular injury and post-acute sequelae of COVID-19. As the pandemic continues and new variants emerge, we can advance our knowledge of the underlying mechanisms only by integrating our understanding of the pathophysiology with the corresponding clinical findings. Identification of new biomarkers of cardiovascular complications, and development of effective treatments for COVID-19 infection are of crucial importance.

Journal article

Gorog DA, Navarese EP, Andreotti F, 2021, Should we consider low LDL-cholesterol a marker of in-hospital bleeding in patients with acute coronary syndrome undergoing percutaneous coronary intervention?, EUROPEAN HEART JOURNAL, Vol: 42, Pages: 3187-3189, ISSN: 0195-668X

Journal article

Bhatt DL, Kaski JC, Delaney S, Alasnag M, Andreotti F, Angiolillo DJ, Ferro A, Gorog DA, Lorenzatti AJ, Mamas M, McNeil J, Nicolau JC, Steg PG, Tamargo J, Tan D, Valgimigli Met al., 2021, Results of an international crowdsourcing survey on the treatment of non-ST segment elevation ACS patients at high-bleeding risk undergoing percutaneous intervention, INTERNATIONAL JOURNAL OF CARDIOLOGY, Vol: 337, Pages: 1-8, ISSN: 0167-5273

Journal article

Jasiewicz M, Siedlaczek M, Kasprzak M, Gorog DA, Jilma B, Siller-Matula J, Obońska K, Dobosiewicz R, Pstrągowski K, Kubica Jet al., 2021, Elevated serum transaminases in patients with acute coronary syndromes: Do we need a revision of exclusion criteria for clinical trials?, Cardiol J

BACKGROUND: Elevations of hepatic transaminase (serum alanine transaminase [ALT] and serum aspartate aminotransferase [AST]) levels in patients with acute coronary syndrome (ACS), although transient, may result in exclusions from clinical efficacy trials due to suspected liver disease. The aim of this study was to evaluate the concentrations of serum transaminases in ACS and relate these to currently accepted AST/ALT exclusion criteria from clinical trials. METHODS: 100 consecutive patients with ACS were prospectively examined. Blood samples for AST, ALT, total bilirubin and troponin I concentration were obtained at the time of admission and after 6, 12 and 24 hours. RESULTS: Eighty percent of patients had elevated AST, and 47% ALT; 43% of patients characterized AST concentration > 3 × upper limit of normal (ULN) in at least one measurement, while 8% of patients presented ALT concentration > 3 × ULN. AST presented higher concentrations when compared to ALT, resulting in a high De-Ritis ratio at every time point. No significant or high correlations were found between the concentrations of serum transaminases, De-Ritis ratio and troponin I. Two different cut-off values of troponin I were adopted to define the amount of infarcted myocardium that distinguished 28-31% of individuals with "large infarction". Among these patients, approximately 93% presented AST concentrations > 3 × ULN. CONCLUSIONS: Hepatic transaminases are often elevated in ACS, with the majority of patients with more extensive myocardial injury presenting high concentrations of AST. In the setting of ACS, current transaminase thresholds for liver dysfunction used in clinical trials may lead to excessive and inadequate exclusions of patients with larger infarcts from such trials.

Journal article

Farag M, Kiberu Y, Reddy SA, Shoaib A, Egred M, Krishnan U, Fares M, Peverelli M, Gorog DA, Elmahdy W, Berman M, Osman Met al., 2021, Preoperative Atrial Fibrillation is associated with long-term morTality in patients undergoing suRgical AortiC valvE Replacement, JOURNAL OF CARDIAC SURGERY, Vol: 36, Pages: 3561-3566, ISSN: 0886-0440

Journal article

Farag M, Peverelli M, Spinthakis N, Gue YX, Egred M, Gorog DAet al., 2021, Spontaneous Reperfusion in Patients with Transient ST-Elevation Myocardial Infarction-Prevalence, Importance and Approaches to Management, CARDIOVASCULAR DRUGS AND THERAPY, ISSN: 0920-3206

Journal article

Davidson SM, Lukhna K, Gorog DA, Salama AD, Castillo AR, Giesz S, Golforoush P, Kalkhoran SB, Lecour S, Imamdin A, do Carmo HRP, Bovi TG, Perroud MW, Ntsekhe M, Sposito AC, Yellon DMet al., 2021, RIC in COVID-19-a Clinical Trial to Investigate Whether Remote Ischemic Conditioning (RIC) Can Prevent Deterioration to Critical Care in Patients with COVID-19 (Jun, 10.1007/s10557-021-07221-y, 2021), CARDIOVASCULAR DRUGS AND THERAPY, ISSN: 0920-3206

Journal article

Kubica J, Adamski P, Niezgoda P, Kubica A, Podhajski P, Baranska M, Uminska JM, Pietrzykowski L, Ostrowska M, Siller-Matula JM, Badariene J, Bartus S, Budaj A, Dobrzycki S, Fidor L, Gasior M, Gessek J, Gierlotka M, Gil R, Goracy J, Grzelakowski P, Hajdukiewicz T, Jaguszewski M, Janion M, Kasprzak J, Kern A, Klecha A, Kleinrok A, Kochman W, Krakowiak B, Legutko J, Lesiak M, Nosal M, Piotrowski G, Przybylski A, Roleder T, Skonieczny G, Sobieszek G, Tycinska A, Wojciechowski D, Wojakowski W, Wojcik J, Zielinska M, Zurakowski A, Specchia G, Gorog DA, Navarese EPet al., 2021, A new approach to ticagrelor-based de-escalation of antiplatelet therapy after acute coronary syndrome. A rationale for a randomized, double-blind, placebo-controlled, investigator-initiated, multicenter clinical study, CARDIOLOGY JOURNAL, Vol: 28, Pages: 607-614, ISSN: 1897-5593

Journal article

Davidson SM, Lukhna K, Gorog DA, Salama AD, Castillo AR, Giesz S, Golforoush P, Kalkhoran SB, Lecour S, Imamdin A, do Carmo HRP, Bovi TG, Perroud MW, Ntsekhe M, Sposito AC, Yellon DMet al., 2021, RIC in COVID-19-a Clinical Trial to Investigate Whether Remote Ischemic Conditioning (RIC) Can Prevent Deterioration to Critical Care in Patients with COVID-19, CARDIOVASCULAR DRUGS AND THERAPY, ISSN: 0920-3206

Journal article

ten Berg J, Sibbing D, Rocca B, Van Belle E, Chevalier B, Collet J-P, Dudek D, Gilard M, Gorog DA, Grapsa J, Grove EL, Lancellotti P, Petronio AS, Rubboli A, Torracca L, Vilahur G, Witkowski A, Mehilli Jet al., 2021, Management of antithrombotic therapy in patients undergoing transcatheter aortic valve implantation: a consensus document of the ESC Working Group on Thrombosis and the European Association of Percutaneous Cardiovascular Interventions (EAPCI), in collaboration with the ESC Council on Valvular Heart Disease, EUROPEAN HEART JOURNAL, Vol: 42, Pages: 2265-2269, ISSN: 0195-668X

Journal article

Ajjan RA, Kietsiriroje N, Badimon L, Vilahur G, Gorog DA, Angiolillo DJ, Russell DA, Rocca B, Storey RFet al., 2021, Antithrombotic therapy in diabetes: which, when, and for how long?, EUROPEAN HEART JOURNAL, Vol: 42, Pages: 2235-2259, ISSN: 0195-668X

Journal article

Jenner WJ, Gorog DA, 2021, Incidence of thrombotic complications in COVID-19 On behalf of ICODE: The International COVID-19 Thrombosis Biomarkers Colloquium, JOURNAL OF THROMBOSIS AND THROMBOLYSIS, Vol: 52, Pages: 999-1006, ISSN: 0929-5305

Journal article

Vandenbriele C, Gorog DA, 2021, Screening for venous thromboembolism in patients with COVID-19, JOURNAL OF THROMBOSIS AND THROMBOLYSIS, Vol: 52, Pages: 985-991, ISSN: 0929-5305

Journal article

Navarese EP, Lansky AJ, Kereiakes DJ, Kubica J, Gurbel PA, Gorog DA, Valgimigli M, Curzen N, Kandzari DE, Bonaca MP, Brouwer M, Umińska J, Jaguszewski MJ, Raggi P, Waksman R, Leon MB, Wijns W, Andreotti Fet al., 2021, Cardiac mortality in patients randomised to elective coronary revascularisation plus medical therapy or medical therapy alone: a systematic review and meta-analysis., Eur Heart J

AIMS: The value of elective coronary revascularisation plus medical therapy over medical therapy alone in managing stable patients with coronary artery disease is debated. We reviewed all trials comparing the two strategies in this population. METHODS AND RESULTS: From inception through November 2020, MEDLINE, EMBASE, Google Scholar, and other databases were searched for randomised trials comparing revascularisation against medical therapy alone in clinically stable coronary artery disease patients. Treatment effects were measured by rate ratios (RRs) with 95% confidence intervals, using random-effects models. Cardiac mortality was the pre-specified primary endpoint. Spontaneous myocardial infarction (MI) and its association with cardiac mortality were secondary endpoints. Further endpoints included all-cause mortality, any MI, and stroke. Longest follow-up data were abstracted. The study is registered with PROSPERO (CRD42021225598). Twenty-five trials involving 19 806 patients (10 023 randomised to revascularisation plus medical therapy and 9783 to medical therapy alone) were included. Compared with medical therapy alone, revascularisation yielded a lower risk of cardiac death [RR 0.79 (0.67-0.93), P < 0.01] and spontaneous MI [RR 0.74 (0.64-0.86), P < 0.01]. By meta-regression, the cardiac death risk reduction after revascularisation, compared with medical therapy alone, was linearly associated with follow-up duration [RR per 4-year follow-up: 0.81 (0.69-0.96), P = 0.008], spontaneous MI absolute difference (P = 0.01) and percentage of multivessel disease at baseline (P = 0.004). Trial sequential and sensitivity analyses confirmed the reliability of the cardiac mortality findings. All-cause mortality [0.94 (0.87-1.01), P = 0.11], any MI (P = 0.14), and stroke risk (P = 0.30) did not differ significantly between strategies. CONCLUSION: In

Journal article

Kanji R, Vandenbriele C, Arachchillage DRJ, Price S, Gorog DAet al., 2021, Optimal Tests to Minimise Bleeding and Ischaemic Complications in Patients on Extracorporeal Membrane Oxygenation, THROMBOSIS AND HAEMOSTASIS, ISSN: 0340-6245

Journal article

Gue YX, Ding WY, Lip GYH, Gorog DAet al., 2021, Assessment of endogenous fibrinolysis in clinical practice using novel tests: ready for clinical roll-out?, SN APPLIED SCIENCES, Vol: 3, ISSN: 2523-3963

Journal article

Mirsadraee S, Gorog DA, Mahon CF, Rawal B, Semple TR, Nicol ED, Arachchillage DRJ, Devaraj A, Price S, Desai SR, Ridge CA, Singh S, Padley SPGet al., 2021, Prevalence of Thrombotic Complications in ICU-Treated Patients With Coronavirus Disease 2019 Detected With Systematic CT Scanning, CRITICAL CARE MEDICINE, Vol: 49, Pages: 804-815, ISSN: 0090-3493

Journal article

Kanji R, Gue YX, Memtsas V, Gorog DAet al., 2021, Fibrinolysis in Platelet Thrombi, INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES, Vol: 22

Journal article

Gue YX, Tennyson M, Gao J, Ren S, Kanji R, Gorog DAet al., 2021, Development of a novel risk score to predict mortality in patients admitted to hospital with COVID-19 (vol 10, 21379, 2020), SCIENTIFIC REPORTS, Vol: 11, ISSN: 2045-2322

Journal article

GUE YX, ADATIA K, KANJI R, POTPARA T, LIP GYH, GOROG DAet al., 2021, Out-of-hospital cardiac arrest: A systematic review of current risk scores to predict survival, AMERICAN HEART JOURNAL, Vol: 234, Pages: 31-41, ISSN: 0002-8703

Journal article

Gorog DA, Price S, Sibbing D, Baumbach A, Capodanno D, Gigante B, Halvorsen S, Huber K, Lettino M, Leonardi S, Morais J, Rubboli A, Siller-Matula JM, Storey RF, Vranckx P, Rocca Bet al., 2021, Antithrombotic therapy in patients with acute coronary syndrome complicated by cardiogenic shock or out-of-hospital cardiac arrest: a joint position paper from the European Society of Cardiology (ESC) Working Group on Thrombosis, in association with the Acute Cardiovascular Care Association (ACCA) and European Association of Percutaneous Cardiovascular Interventions (EAPCI), EUROPEAN HEART JOURNAL-CARDIOVASCULAR PHARMACOTHERAPY, Vol: 7, Pages: 125-140, ISSN: 2055-6837

Journal article

Krychtiuk KA, Speidl WS, Giannitsis E, Gigante B, Gorog DA, Jaffe AS, Mair J, Moeckel M, Mueller C, Storey RF, Vilahur G, Wojta J, Huber K, Halvorsen S, Geisler T, Morais J, Lindahl B, Thygesen Ket al., 2021, Biomarkers of coagulation and fibrinolysis in acute myocardial infarction: a joint position paper of the Association for Acute Cardio Vascular Care and the European Society of Cardiology Working Group on Thrombosis, EUROPEAN HEART JOURNAL-ACUTE CARDIOVASCULAR CARE, Vol: 10, Pages: 343-355, ISSN: 2048-8726

Journal article

Kim HK, Tantry US, Park H-W, Shin E-S, Geisler T, Gorog DA, Gurbel PA, Jeong Y-Het al., 2021, Ethnic Difference of Thrombogenicity in Patients with Cardiovascular Disease: a Pandora Box to Explain Prognostic Differences, KOREAN CIRCULATION JOURNAL, Vol: 51, Pages: 202-221, ISSN: 1738-5520

Journal article

Gue YX, Spinthakis N, Egred M, Gorog DA, Farag Met al., 2021, Non-Vitamin K Antagonist Oral Anticoagulants Versus Warfarin for Patients With Left Ventricular Thrombus: A Systematic Review and Meta-Analysis, AMERICAN JOURNAL OF CARDIOLOGY, Vol: 142, Pages: 147-151, ISSN: 0002-9149

Journal article

Gue YX, Jeong Y-H, Farag M, Spinthakis N, Gorog DAet al., 2021, Precision Treatment in ACS-Role of Assessing Fibrinolysis, JOURNAL OF CLINICAL MEDICINE, Vol: 10

Journal article

Jenner WJ, Kanji R, Mirsadraee S, Gue YX, Price S, Prasad S, Gorog DAet al., 2021, Thrombotic complications in 2928 patients with COVID-19 treated in intensive care: a systematic review, Journal of Thrombosis and Thrombolysis, Vol: 51, Pages: 595-607, ISSN: 0929-5305

A prothrombotic state is reported with severe COVID-19 infection, which can manifest in venous and arterial thrombotic events. Coagulopathy is reflective of more severe disease and anticoagulant thromboprophylaxis is recommended in hospitalized patients. However, the prevalence of thrombosis on the intensive care unit (ICU) remains unclear, including whether this is sufficiently addressed by conventional anticoagulant thromboprophylaxis. We aimed to identify the rate of thrombotic complications in ICU-treated patients with COVID-19, to inform recommendations for diagnosis and management. A systematic review was conducted to assess the incidence of thrombotic complications in ICU-treated patients with COVID-19. Observational studies and registries reporting thrombotic complications in ICU-treated patients were included. Information extracted included patient demographics, use of thromboprophylaxis or anticoagulation, method of identifying thrombotic complications, and reported patient outcomes. In 28 studies including 2928 patients, thrombotic complications occurred in 34% of ICU-managed patients, with deep venous thrombosis reported in 16.1% and pulmonary embolism in 12.6% of patients, despite anticoagulant thromboprophylaxis, and were associated with high mortality. Studies adopting systematic screening for venous thrombosis with Duplex ultrasound reported a significantly higher incidence of venous thrombosis compared to those relying on clinical suspicion (56.3% vs. 11.0%, p < 0.001). Despite thromboprophylaxis, there is a very high incidence of thrombotic complications in patients with COVID-19 on the ICU. Systematic screening identifies many thrombotic complications that would be missed by relying on clinical suspicion and should be employed, with consideration given to increased dose anticoagulant thromboprophylaxis, whilst awaiting results of prospective trials of anticoagulation in this cohort.

Journal article

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