Imperial College London
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Prof. Diana Gorog

Faculty of Medicine, National 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
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282 results found

Gue YX, Anwar M, Gorog DA, 2018, A rare cause of myocardial infarction with non-obstructive coronary arteries-case report of ST-segment elevationmyocardial infarction caused by a mediastinal mass, EUROPEAN HEART JOURNAL-CASE REPORTS, Vol: 2

Journal article

Spinthakis N, Farag M, Rocca B, Gorog DAet al., 2018, More, more, more: Reducing thrombosis in acute coronary syndromes beyond dual antiplatelet therapy - current data and future directions, Journal of the American Heart Association : Cardiovascular and Cerebrovascular Disease, Vol: 7, ISSN: 2047-9980

Common to the pathogenesis of acute coronary syndromes (ACS) is the formation of arterial thrombus, which results from platelet activation and triggering of the coagulation cascade.1 To attenuate the risk of future thrombotic events, patients with ACS are treated with dual antiplatelet therapy (DAPT), namely, the combination of aspirin with a P2Y12 inhibitor, such as clopidogrel, ticagrelor, or prasugrel. Despite DAPT, some ≈10% of ACS patients experience recurrent major adverse cardiovascular events over the subsequent 30 days,2 driving the quest for more effective inhibition of thrombotic pathways. In this review, we provide an overview of studies to date and those ongoing that aim to deliver more effective combinations of antithrombotic agents to patients with recent ACS. We have chosen to confine the review to ACS patients without atrial fibrillation because those with atrial fibrillation have a clear indication for combination therapy that includes oral anticoagulation and should, we feel, be treated as a separate cohort.In this article, we discuss the limitations of the currently available clinical trial data and future directions, with suggestions for how practice might change to reduce the risk of coronary thrombosis in those at greatest risk, with minimal impact on bleeding.

Journal article

Spinthakis N, Farag M, Akhtar Z, Gorog DAet al., 2018, Is there a Role for Oral Triple Therapy in Patients with Acute Coronary Syndromes without Atrial Fibrillation?, CURRENT VASCULAR PHARMACOLOGY, Vol: 16, Pages: 427-436, ISSN: 1570-1611

Journal article

Geisler T, Gorog DA, 2018, Controversies in the Cath Lab: Navigating Contemporary Conundrums Before, During and After Intervention, CURRENT VASCULAR PHARMACOLOGY, Vol: 16, Pages: 416-417, ISSN: 1570-1611

Journal article

Farag M, Spinthakis N, Srinivasan M, Gorog DAet al., 2018, Should STEMI Patients Receive Opiate Analgesia? The Morphine Paradox, CURRENT VASCULAR PHARMACOLOGY, Vol: 16, Pages: 477-483, ISSN: 1570-1611

Journal article

Vimalesvaran K, Dockrill SJ, Gorog DA, 2018, Role of rivaroxaban in the management of atrial fibrillation: insights from clinical practice, VASCULAR HEALTH AND RISK MANAGEMENT, Vol: 14, Pages: 13-21, ISSN: 1176-6344

Journal article

Spinthakis N, Farag M, Gorog DA, Prasad A, Mahmood H, Gue Y, Wellsted D, Nabhan A, Srinivasan Met al., 2017, Percutaneous coronary intervention with drug-eluting stent versus coronary artery bypass grafting: A meta-analysis of patients with left main coronary artery disease, INTERNATIONAL JOURNAL OF CARDIOLOGY, Vol: 249, Pages: 101-106, ISSN: 0167-5273

Journal article

Farag M, Spinthakis N, Srinivasan M, Sullivan K, Wellsted D, Gorog DAet al., 2017, OPIATE USE IS ASSOCIATED WITH REDUCED ANTIPLATELET DRUG EFFECT AND RAISED TROPONIN IN PPCI, Annual Conference of the British-Cardiovascular-Intervention-Society, Publisher: BMJ PUBLISHING GROUP, Pages: A2-A2, ISSN: 1355-6037

Conference paper

Niespialowska-Steuden M, Markides V, Farag M, Jones D, Hussain W, Wong T, Gorog DAet al., 2017, Catheter ablation for AF improves global thrombotic profile and enhances fibrinolysis, Journal of Thrombosis and Thrombolysis, Vol: 44, Pages: 413-426, ISSN: 0929-5305

Patients with atrial fibrillation (AF) are atincreased risk of thrombotic events despite oral anticoagulation(OAC). Radiofrequency catheter ablation (RFCA) canrestore and maintain sinus rhythm (SR) in patients with AF.To assess whether RFCA improves thrombotic status. 80patients (71% male, 64±12y) with recently diagnosed AF,on OAC and scheduled to undergo RFCA or DC cardioversion(DCCV) were recruited. Thrombotic status was assessedusing the point-of-care global thrombosis test (GTT), before,and 4–6 weeks after DCCV and 3 months after RFCA. TheGTT first measures the time taken for occlusive thrombusformation (occlusion time, OT), while the second phase ofthe test measures the time taken to spontaneously dissolvethis clot through endogenous thrombolysis (lysis time, LT).3 months after RFCA, there was a significant reduction inLT (1994s [1560; 2475] vs. 1477s [1015; 1878]) in thosewho maintained SR, but not in those who reverted to AF. Atfollow-up, LT was longer in those in AF compared to thosein SR (AF 2966s [2038; 3879] vs. SR 1477s [1015; 1878]).RFCA resulted in no change in OT value, irrespective of hythm outcome. Similarly, there was no change in OT orLT in response to DCCV, irrespective of whether SR wasrestored. Successful restoration and maintenance of SR followingRFCA of AF is associated with improved globalthrombotic status with enhanced fibrinolysis. Larger studiesare required to confirm these early results and investigatewhether improved thrombotic status translates into fewerthromboembolic events.

Journal article

Lip GYH, Collet JP, de Caterina R, Fauchier L, Lane DA, Larsen TB, Marin F, Morais J, Narasimhan C, Olshansky B, Pierard L, Potpara T, Sarrafzadegan N, Sliwa K, Varela G, Vilahur G, Weiss T, Boriani G, Rocca B, Gorenek B, Savelieva I, Sticherling C, Kudaiberdieva G, Chao T-F, Violi F, Nair M, Zimerman L, Piccini J, Storey R, Halvorsen S, Gorog D, Rubboli A, Chin A, Scott-Millar Ret al., 2017, Antithrombotic therapy in atrial fibrillation associated with valvular heart disease: a joint consensus document from the European Heart Rhythm Association (EHRA) and European Society of Cardiology Working Group on Thrombosis, endorsed by the ESC Working Group on Valvular Heart Disease, Cardiac Arrhythmia Society of Southern Africa (CASSA), Heart Rhythm Society (HRS), Asia Pacific Heart Rhythm Society (APHRS), South African Heart (SA Heart) Association and Sociedad Latinoamericana de Estimulacion Cardiaca y Electrofisiologia (SOLEACE), EUROPACE, Vol: 19, Pages: 1757-+, ISSN: 1099-5129

Journal article

Gorog DA, Fayad ZA, Fuster V, 2017, Arterial Thrombus Stability Does It Matter and Can We Detect It?, JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, Vol: 70, Pages: 2036-2047, ISSN: 0735-1097

Journal article

Adamski P, Sikora J, Laskowska E, Buszko K, Ostrowska M, Umińska JM, Sikora A, Skibińska N, Sobczak P, Adamska U, Rość D, Kubica A, Paciorek P, Marszałł MP, Navarese EP, Gorog DA, Kubica Jet al., 2017, Comparison of bioavailability and antiplatelet action of ticagrelor in patients with ST-elevation myocardial infarction and non-ST-elevation myocardial infarction: A prospective, observational, single-centre study., PLoS ONE, Vol: 12, ISSN: 1932-6203

BACKGROUND: Data from available studies suggest that the presence of ST-elevation myocardial infarction (STEMI) may be associated with delayed and attenuated ticagrelor bioavailability and effect compared with non-ST-elevation myocardial infarction (NSTEMI). METHODS: In a single-center, prospective, observational trial 73 patients with myocardial infarction (STEMI n = 49, NSTEMI n = 24) underwent a pharmacokinetic and pharmacodynamic assessment after a 180 mg ticagrelor loading dose (LD). Ticagrelor and its active metabolite (AR-C124910XX) plasma concentrations were determined with liquid chromatography tandem mass spectrometry, and their antiplatelet effect was measured with the VASP assay and multiple electrode aggregometry. RESULTS: During the first six hours after ticagrelor LD, STEMI patients had 38% and 34% lower plasma concentration of ticagrelor and AR-C124910XX, respectively, than NSTEMI (ticagrelor AUC(0-6): 2491 [344-5587] vs. 3991 [1406-9284] ng*h/mL; p = 0.038; AR-C124910XX AUC(0-6): 473 [0-924] vs. 712 [346-1616] ng*h/mL; p = 0.027). STEMI patients also required more time to achieve maximal concentration of ticagrelor (tmax: 4.0 [3.0-12.0] vs. 2.5 [2.0-6.0] h; p = 0.012). Impaired bioavailability of ticagrelor and AR-C124910XX seen in STEMI subjects was associated with diminished platelet inhibition in this group, which was most pronounced during the initial hours of treatment. CONCLUSIONS: Plasma concentrations of ticagrelor and AR-C124910XX during the first hours after ticagrelor LD were one third lower in STEMI than in NSTEMI patients. This reduced and delayed ticagrelor bioavailability was associated with weaker antiplatelet effect in STEMI. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT02602444 (November 09, 2015).

Journal article

Winter M-P, Grove EL, De Caterina R, Gorog DA, Ahrens I, Geisler T, Gurbel PA, Tantry U, Navarese EP, Siller-Matula JMet al., 2017, Advocating cardiovascular precision medicine with P2Y12 receptor inhibitors, EUROPEAN HEART JOURNAL-CARDIOVASCULAR PHARMACOTHERAPY, Vol: 3, Pages: 221-234, ISSN: 2055-6837

Journal article

Gue YX, Gorog DA, 2017, Importance of Endogenous Fibrinolysis in Platelet Thrombus Formation, International Journal of Molecular Sciences, Vol: 18, ISSN: 1422-0067

The processes of thrombosis and coagulation are finely regulated by endogenous fibrinolysismaintaining healthy equilibrium. When the balance is altered in favour of platelet activation and/orcoagulation, or if endogenous fibrinolysis becomes less efficient, pathological thrombosis can occur.Arterial thrombosis remains a major cause of morbidity and mortality in the world despite advancesin medical therapies. The role endogenous fibrinolysis in the pathogenesis of arterial thrombosis hasgained increasing attention in recent years as it presents novel ways to prevent and treat existingdiseases. In this review article, we discuss the role of endogenous fibrinolysis in platelet thrombusformation, methods of measurement of fibrinolytic activity, its role in predicting cardiovasculardiseases and clinical outcomes and future directions.

Journal article

Spinthakis N, Farag M, Gorog DA, Mahmood H, Prasad A, Srinivasan Met al., 2017, Percutaneous coronary intervention with drug-eluting stent versus coronary artery bypass grafting: a meta-analysis of patients with left main coronary artery disease, Publisher: OXFORD UNIV PRESS, Pages: 271-271, ISSN: 0195-668X

Conference paper

Farag MF, Spinthakis N, Srinivasan M, Sullivan K, Wellsted D, Gorog DAet al., 2017, Morphine use in STEMI associated with enhanced platelet reactivity and larger infarct size, and this is negated by GPI use peri-PPCI, Publisher: OXFORD UNIV PRESS, Pages: 1282-1282, ISSN: 0195-668X

Conference paper

Sabatine MS, Giugliano RP, Keech AC, Honarpour N, Wiviott SD, Murphy SA, Kuder JF, Wang H, Liu T, Wasserman SM, Sever PS, Pedersen TRet al., 2017, Evolocumab and clinical outcomes in patients with cardiovascular disease, New England Journal of Medicine, Vol: 376, Pages: 1713-1722, ISSN: 0028-4793

BACKGROUNDEvolocumab is a monoclonal antibody that inhibits proprotein convertase subtilisin–kexin type 9 (PCSK9) and lowers low-density lipoprotein (LDL) cholesterol levels by approxi-mately 60%. Whether it prevents cardiovascular events is uncertain.METHODSWe conducted a randomized, double-blind, placebo-controlled trial involving 27,564 pa-tients with atherosclerotic cardiovascular disease and LDL cholesterol levels of 70 mg per deciliter (1.8 mmol per liter) or higher who were receiving statin therapy. Patients were randomly assigned to receive evolocumab (either 140 mg every 2 weeks or 420 mg monthly) or matching placebo as subcutaneous injections. The primary efficacy end point was the composite of cardiovascular death, myocardial infarction, stroke, hospitalization for un-stable angina, or coronary revascularization. The key secondary efficacy end point was the composite of cardiovascular death, myocardial infarction, or stroke. The median duration of follow-up was 2.2 years.RESULTSAt 48 weeks, the least-squares mean percentage reduction in LDL cholesterol levels with evolocumab, as compared with placebo, was 59%, from a median baseline value of 92 mg per deciliter (2.4 mmol per liter) to 30 mg per deciliter (0.78 mmol per liter) (P<0.001). Relative to placebo, evolocumab treatment significantly reduced the risk of the primary end point (1344 patients [9.8%] vs. 1563 patients [11.3%]; hazard ratio, 0.85; 95% confi-dence interval [CI], 0.79 to 0.92; P<0.001) and the key secondary end point (816 [5.9%] vs. 1013 [7.4%]; hazard ratio, 0.80; 95% CI, 0.73 to 0.88; P<0.001). The results were consistent across key subgroups, including the subgroup of patients in the lowest quartile for base-line LDL cholesterol levels (median, 74 mg per deciliter [1.9 mmol per liter]). There was no significant difference between the study groups with regard to adverse events (includ-ing new-onset diabetes and neurocognitive events), with the exceptio

Journal article

Ridker PM, Revkin J, Amarenco P, Brunell R, Curto M, Civeira F, Flather M, Glynn RJ, Gregoire J, Jukema JW, Karpov Y, Kastelein JJP, Koenig W, Lorenzatti A, Manga P, Masiukiewicz U, Miller M, Mosterd A, Murin J, Nicolau JC, Nissen S, Ponikowski P, Santos RD, Schwartz PF, Soran H, White H, Wright RS, Vrablik M, Yunis C, Shear CL, Tardif J-C, Conde D, Colquhoun D, Missault L, Gregoire J, Gao R, Urina M, Solar M, Jensen HK, Grobbee D, Savolainen M, Schiele F, Montalescot G, Edes I, Blake G, Lotan C, Maggioni A, Savonitto S, Lee CW, Leiva Pons JL, Dan G-A, Bruguera Cortada J, Mellbin L, Kahan T, Noble S, Hwang J-J, Sritara P, Tokgozoglu L, Revkin J, Tarasenko L, Borer JS, Black H, Carmena R, Furie KL, McMurray J, Neaton J, Zannad F, O'Neill B, Welty F, McNamara R, Chun H, Abbott JD, Jacoby D, McPherson C, Jadbabaie F, Pinto D, McCullough L, Silverman IE, Sansing LH, Dearborn-Tomazos J, Foody J, Schindler J, Piazza G, Chakrabarti A, Pride Y, Gelfand E, Baultrukonis D, Chaudhuri S, Frederich R, Johnson M, Mridha K, Powell C, Wang E, Wei C, Anderson P, Buonanno M, Epsley C, Evans B, Frolova M, Goetsch M, Hessinger D, Ikehara E, Ivanac K, Kizko J, Le K, McNally-Dufort C, Morocco T, Nadkarni S, Nissen T, Nye R, Pak R, Pence D, Redifer P, Schwartz W, Sattler C, Schade R, Sullivan B, Wegner J, Alvarez CA, Budassi N, Vogel DR, Avaca H, Conde DG, Estol CCCJ, Gelersztein E, Glenny JA, Hershson AR, Bruno RL, Maffei LE, Soler JMP, Zaidman CJ, Carnero GS, Colombo HR, Jure HO, Luquez HA, Ramos HR, Resk JH, Rusculleda MM, Ulla MR, Caccavo A, Farias EF, Wenetz LMM, Cabella PRF, Cuadrado JA, Chahin M, Mackinnon IJ, Zarandon RBS, Schmidberg J, Fernandez AA, Montana O, Codutti OR, Gorosito VM, Maldonado N, Sala J, De La Fuente RAL, Casabella TES, Di Gennaro JPA, Guerrero RAA, Alvarez MS, Berli M, Botta CE, Montenegro EE, Vico ML, Begg A, Lehman R, Gilfillan CP, d'Emden M, Markovic TP, Sullivan D, Aroney C, Stranks SN, Crimmins DS, Arstall M, Van Gaal W, Davis T, Aylward PE, Amerena J, Wilet al., 2017, Cardiovascular Efficacy and Safety of Bococizumab in High-Risk Patients, NEW ENGLAND JOURNAL OF MEDICINE, Vol: 376, Pages: 1527-1539, ISSN: 0028-4793

Journal article

Okafor ON, Farrington K, Gorog DA, 2017, Allopurinol as a therapeutic option in cardiovascular disease, PHARMACOLOGY & THERAPEUTICS, Vol: 172, Pages: 139-150, ISSN: 0163-7258

Journal article

Mittal TK, Pottle A, Nicol E, Barbir M, Ariff B, Mirsadraee S, Dubowitz M, Gorog DA, Clifford P, Firoozan S, Smith R, Dubrey S, Chana H, Shah J, Stephens N, Travill C, Kelion A, Pakkal M, Timmis Aet al., 2017, Prevalence of obstructive coronary artery disease and prognosis in patients with stable symptoms and a zero-coronary calcium score, EHJ Cardiovascular Imaging / European Heart Journal - Cardiovascular Imaging, Vol: 18, Pages: 922-929, ISSN: 2047-2412

Aims:CT calcium scoring (CTCS) and CT cardiac angiography (CTCA) are widely used in patients with stable chest pain to exclude significant coronary artery disease (CAD). We aimed to resolve uncertainty about the prevalence of obstructive coronary artery disease and long-term outcomes in patients with a zero-calcium score (ZCS).Methods and results:Consecutive patients with stable cardiac symptoms referred for CTCS or CTCS and CTCA from chest pain clinics to a tertiary cardiothoracic centre were prospectively enrolled. In those with a ZCS, the prevalence of obstructive CAD on CTCA was determined. A follow-up for all-cause mortality was obtained from the NHS tracer service. A total of 3914 patients underwent CTCS of whom 2730 (69.7%) also had a CTCA. Half of the patients were men (50.3%) with a mean age of 56.9 years. Among patients who had both procedures, a ZCS was present in 52.2%, with a negative predictive value of 99.5% for excluding ≥70% stenosis on CTCA. During a mean follow-up of 5.2 years, the annual event rate was 0.3% for those with ZCS compared with 1.2% for CS ≥1. The presence of non-calcified atheroma on CTCA in patients with ZCS did not affect the prognostic value (P = 0.98).Conclusion:In patients with stable symptoms and a ZCS, obstructive CAD is rare, and prognosis over the long-term is excellent, regardless of whether non-calcified atheroma is identified. A ZCS could reliably be used as a ‘gatekeeper’ in this patient cohort, obviating the need for further more expensive tests.

Journal article

Khan TZ, Barbir M, Pennell DJ, Gorog DAet al., 2017, CHANGES IN THROMBOTIC PARAMETERS IN PATIENTS WITH REFRACTORY ANGINA AND RAISED LIPOPROTEIN(A) TREATED WITH LIPOPROTEIN APHERESIS, 66th Annual Scientific Session and Expo of the American-College-of-Cardiology (ACC), Publisher: ELSEVIER SCIENCE INC, Pages: 209-209, ISSN: 0735-1097

Conference paper

Christopoulos C, Farag M, Sullivan K, Wellsted D, Gorog DAet al., 2017, Impaired thrombolytic status predicts adverse cardiac events in patients undergoing primary percutaneous coronary intervention, THROMBOSIS AND HAEMOSTASIS, Vol: 117, Pages: 457-470, ISSN: 0340-6245

Journal article

Huisman MV, Rothman KJ, Paquette M, Teutsch C, Diener H-C, Dubner SJ, Halperin JL, Ma CS, Zint K, Elsaesser A, Bartels DB, Lip GYH, Abban D, Abdul N, Abelson M, Ackermann A, Adams F, Adams L, Adragao P, Ageno W, Aggarwal R, Agosti S, Marin JA, Aguilar F, Linares JAA, Aguinaga L, Ahmad Z, Ainsworth P, Al Ghalayini K, Al Ismail S, Alasfar A, Alawwa A, Al-Dallow R, Alderson L, Alexopoulos D, Ali A, Ali M, Aliyar P, Al-Joundi T, Al Mahameed S, Almassi H, Almuti K, Al-Obaidi M, Alshehri M, Altmann U, Alves AR, Al-Zoebi A, Amara W, Amelot M, Amjadi N, Ammirati F, Andrawis N, Angoulvant D, Annoni G, Ansalone G, Antonescu SA, Ariani M, Arias JC, Armero S, Arora R, Arora C, Ashcraft W, Aslam MS, Astesiano A, Audouin P, Augenbraun C, Aydin S, Azar R, Azim A, Aziz S, Backes LM, Baig M, Bains S, Bakbak A, Baker S, Bakhtiar K, Bala R, Banayan J, Bandh S, Bando S, Banerjee S, Bank A, Barbarash O, Baron G, Barr C, Barrera C, Barton J, Kes VB, Baula G, Bayeh H, Bazargani N, Behrens S, Bell A, Benezet-Mazuecos J, Benhalima B, Berdague P, van den Berg BJ, van Bergen PFMM, Berngard E, Bernstein R, Berrospi P, Berti S, Bertomeu V, Berz A, Bettencourt P, Betzu R, Beyer-Westendorf J, Bhagwat R, Black T, Ibaceta JHB, Bloom S, Blumberg E, Bo M, Bockisch V, Bohmer E, Bongiorni MG, Boriani G, Bosch R, Boswijk DJ, Bott J, Bottacchi E, Kalan MB, Brandes A, Bratland B, Brautigam D, Breton N, Brouwers PJAM, Browne K, Bruguera J, Brunehaut M, Brunschwig C, Buathier H, Buhl A, Bullinga J, Butcher K, Honorio JWC, Caccavo A, Cadinot D, Cai S, Calvi V, Camm J, Candeias R, Capo J, Capucci A, Cardoso JN, Vera YCD, Carlson B, Carvalho P, Cary S, Casanova R, Casu G, Cattan S, Cavallini C, Cayla G, Cha TJ, Cha KS, Chaaban S, Chae JK, Challappa K, Chand S, Chandrashekar H, Chang M, Charbel P, Chartier L, Chatterjee K, Cheema A, Chen S-A, Chevallereau P, Chiang F-T, Chiarella F, Lin C-C, Cho YK, Choi DJ, Chouinard G, Danny HFC, Chrysos D, Chumakova G, Roberto EJJ, Valenzuela C, Cieza-Lara T, Nica VC, Ciobotet al., 2017, The Changing Landscape for Stroke Prevention in AF Findings From the GLORIA-AF Registry Phase 2, JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, Vol: 69, Pages: 777-785, ISSN: 0735-1097

Journal article

Davis E, Gorog DA, Rihal C, Prasad A, Srinivasan Met al., 2017, "Mind the gap" acute coronary syndrome in women: A contemporary review of current clinical evidence, INTERNATIONAL JOURNAL OF CARDIOLOGY, Vol: 227, Pages: 840-849, ISSN: 0167-5273

Journal article

Farag M, Shoaib A, Gorog DA, 2017, Nitrates for the Management of Acute Heart Failure Syndromes, A Systematic Review, JOURNAL OF CARDIOVASCULAR PHARMACOLOGY AND THERAPEUTICS, Vol: 22, Pages: 20-27, ISSN: 1074-2484

Journal article

Farag M, Shoaib A, Gorog DA, 2017, Nitrates for the Management of Acute Heart Failure Syndromes, A Systematic Review., J Cardiovasc Pharmacol Ther, Vol: 22, Pages: 20-27

Intravenous nitrates are widely used in the management of acute heart failure syndrome (AHFS) yet with lack of robust evidence to support their use. We therefore sought to analyze all randomized studies that evaluated the effects of nitrates on clinical outcomes in patients with AHFS. In total, 15 relevant trials comparing nitrates and alternative interventions in 1824 patients were identified. All but 3 were conducted before 1998. No trials demonstrated a beneficial effect on mortality, apart from 1 trial reporting a reduction in mortality, which was related to the time of treatment. Retrospective review suggests that there is a lack of data to draw any firm conclusions concerning the use of nitrates in patients with AHFS. More studies are needed to evaluate the safety and efficacy of these agents in the modern era of guideline-directed use of heart failure therapy.

Journal article

Farag M, Gorog DA, 2017, Platelet Function Testing: A Role for Personalised Therapy in Coronary Disease, CURRENT PHARMACEUTICAL DESIGN, Vol: 23, Pages: 1315-1327, ISSN: 1381-6128

Journal article

Spinthakis N, Abdulkareem N, Farag M, Gorog DAet al., 2016, Spontaneous Coronary Artery Dissection: The Phantom Menace, Cardiology Research, Vol: 7, Pages: 214-217, ISSN: 1923-2829

We present a case of a 66-year-old lady with chest pain, without dynamic12-lead electrocardiographic (ECG) changes and normal serialtroponin. Coronary angiography revealed a linear filing defect inthe first obtuse marginal branch of the circumflex artery indicatingcoronary artery dissection, with superadded thrombus. She was managedmedically with dual antiplatelet therapy and has responded well.Spontaneous coronary artery dissection (SCAD) is a rare cause of cardiacchest pain, which can be missed without coronary angiography.Unlike most other lesions in patients with unstable symptoms, wherecoronary intervention with stenting is recommended, patients withSCAD generally fare better with conservative measures than with intervention,unless there is hemodynamic instability.

Journal article

Farag M, Spinthakis N, Gorog DA, Prasad A, Sullivan K, Akhtar Z, Kukreja N, Srinivasan Met al., 2016, Use of bioresorbable vascular scaffold: a meta-analysis of patients with coronary artery disease., Open Heart, Vol: 3, Pages: e000462-e000462, ISSN: 2053-3624

BACKGROUND: Differences in outcomes between bioresorbable vascular scaffold (BVS) systems and drug-eluting metal stents (DES) have not been fully evaluated. We aimed to compare clinical and angiographic outcomes in randomised studies of patients with coronary artery disease (CAD), with a secondary analysis performed among registry studies. METHODS: A meta-analysis comparing outcomes between BVS and DES in patients with CAD. Overall estimates of treatment effect were calculated with random-effects model and fixed-effects model. RESULTS: In 6 randomised trials (3818 patients), BVS increased the risk of subacute stent thrombosis (ST) over and above DES (OR 2.14; CI 1.01 to 4.53; p=0.05), with a trend towards an increase in the risk of myocardial infarction (MI) (125 events in those assigned to BVS and 50 to DES; OR 1.36; CI 0.97 to 1.91; p=0.07). The risk of in-device late lumen loss (LLL) was higher with BVS than DES (mean difference 0.08 mm; CI 0.03 to 0.13; p=0.004). There was no difference in the risk of death or target vessel revascularisation (TVR) between the two devices. In 6 registry studies (1845 patients), there was no difference in the risk of death, MI, TVR or subacute ST between the two stents. Final BVS dilation pressures were higher in registry than in randomised studies (18.7±4.6 vs 15.2±3.3 atm; p<0.001). CONCLUSIONS: Patients treated with BVS had an increased risk of subacute ST and slightly higher LLL compared with those with DES, but this might be related to inadequate implantation techniques, in particular device underexpansion.

Journal article

Farag M, Srinivasan M, Wellsted D, Sullivan K, Gorog DAet al., 2016, ASSESSMENT OF ENDOGENOUS THROMBOLYSIS PREDICTS CARDIOVASCULAR RISK IN PATIENT WITH ST-ELEVATION MYOCARDIAL INFARCTION, Annual Conference of the British-Cardiovascular-Society (BCS) on Prediction and Prevention, Publisher: BMJ PUBLISHING GROUP, Pages: A69-A70, ISSN: 1355-6037

Conference paper

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