Imperial College London

DrRashaAl-Lamee

Faculty of MedicineNational Heart & Lung Institute

Clinical Reader in Cardiovascular Science
 
 
 
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r.al-lamee13

 
 
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Block B Hammersmith HospitalHammersmith Campus

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Summary

 

Publications

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134 results found

Rajkumar C, Simader F, Al-Lamee R, 2023, Typical angina and coronary artery disease: is the common ground smaller than we think?, Heart, Vol: 109, Pages: 1422-1423, ISSN: 1355-6037

Journal article

Foley M, Rajkumar CA, Ahmed-Jushuf F, Nour D, Fung CH, Seligman H, Pathimagaraj RH, Petraco R, Sen S, Nijjer S, Howard JP, Ahmad Y, Allahwala U, Bhindi R, Chamie D, Doi S, Kuwata S, Kaihara T, Koga M, Ishibashi Y, Higuma T, Tanabe Y, Nakayama M, Kawase Y, Watanabe A, Funayama N, Horinaka R, Hijikata N, Takahashi T, Matsuo H, Hansen PS, Manica A, Weaver J, Alzuhairi K, Yong T-H, Warisawa T, Francis DP, Shun-Shin MJ, Al-Lamee RKet al., 2023, The ability of contemporary cardiologists to judge the ischemic impact of a coronary lesion visually., Cardiovasc Revasc Med

BACKGROUND: Landmark trials showed that invasive pressure measurement (Fractional Flow Reserve, FFR) was a better guide to coronary stenting than visual assessment. However, present-day interventionists have benefited from extensive research and personal experience of mapping anatomy to hemodynamics. AIMS: To determine if visual assessment of the angiogram performs as well as invasive measurement of coronary physiology. METHODS: 25 interventional cardiologists independently visually assessed the single vessel coronary disease of 200 randomized participants in The Objective Randomized Blinded Investigation with optimal medical Therapy of Angioplasty in stable angina trial (ORBITA). They gave a visual prediction of the FFR and Instantaneous Wave-free Ratio (iFR), denoted vFFR and viFR respectively. Each judged each lesion on 2 occasions, so that every lesion had 50 vFFR, and 50 viFR assessments. The group consensus visual estimates (vFFR-group and viFR-group) and individual cardiologists' visual estimates (vFFR-individual and viFR-individual) were tested alongside invasively measured FFR and iFR for their ability to predict the placebo-controlled reduction in stress echo ischemia with stenting. RESULTS: Placebo-controlled ischemia improvement with stenting was predicted by vFFR-group (p < 0.0001) and viFR-group (p < 0.0001), vFFR-individual (p < 0.0001) and viFR-individual (p < 0.0001). There were no significant differences between the predictive performance of the group visual estimates and their invasive counterparts: p = 0.53 for vFFR vs FFR and p = 0.56 for viFR vs iFR. CONCLUSION: Visual assessment of the angiogram by contemporary experts, provides significant additional information on the amount of ischaemia which can be relieved by placebo-controlled stenting in single vessel coronary artery disease.

Journal article

Kanagaratnam P, Francis DP, Chamie D, Coyle C, Marynina A, Katritsis G, Paiva P, Szigeti M, Cole G, de Andrade Nunes D, Howard J, Esper R, Khan M, More R, Barreto G, Meneguz-Moreno R, Arnold A, Nowbar A, Kaura A, Mariveles M, March K, Shah J, Nijjer S, Lip GY, Mills N, Camm AJ, Cooke GS, Corbett SJ, Llewelyn MJ, Ghanima W, Toshner M, Peters N, Petraco R, Al-Lamee R, Boshoff ASM, Durkina M, Malik I, Ruparelia N, Cornelius V, Shun-Shin Met al., 2023, A randomised controlled trial to investigate the use of acute coronary syndrome therapy in patients hospitalised with COVID-19: the C19-ACS trial, Journal of Thrombosis and Haemostasis, Vol: 21, Pages: 2213-2222, ISSN: 1538-7836

BACKGROUND: Patients hospitalised with COVID-19 suffer thrombotic complications. Risk factors for poor outcomes are shared with coronary artery disease. OBJECTIVES: To investigate efficacy of an acute coronary syndrome regimen in patients hospitalised with COVID-19 and coronary disease risk factors. PATIENTS/METHODS: A randomised controlled open-label trial across acute hospitals (UK and Brazil) added aspirin, clopidogrel, low-dose rivaroxaban, atorvastatin, and omeprazole to standard care for 28-days. Primary efficacy and safety outcomes were 30-day mortality and bleeding. The key secondary outcome was a daily clinical status (at home, in hospital, on intensive therapy unit admission, death). RESULTS: 320 patients from 9 centres were randomised. The trial terminated early due to low recruitment. At 30 days there was no significant difference in mortality (intervention: 11.5% vs control: 15%, unadjusted OR 0.73, 95%CI 0.38 to 1.41, p=0.355). Significant bleeds were infrequent and not significantly different between the arms (intervention: 1.9% vs control 1.9%, p>0.999). Using a Bayesian Markov longitudinal ordinal model, it was 93% probable that intervention arm participants were more likely to transition to a better clinical state each day (OR 1.46, 95% CrI 0.88 to 2.37, Pr(Beta>0)=93%; adjusted OR 1.50, 95% CrI 0.91 to 2.45, Pr(Beta>0)=95%) and median time to discharge home was two days shorter (95% CrI -4 to 0, 2% probability that it was worse). CONCLUSIONS: Acute coronary syndrome treatment regimen was associated with a reduction in the length of hospital stay without an excess in major bleeding. A larger trial is needed to evaluate mortality.

Journal article

Warisawa T, Cook CM, Kawase Y, Howard JP, Ahmad Y, Seligman H, Rajkumar C, Toya T, Doi S, Nakajima A, Tanigaki T, Omori H, Nakayama M, Vera-Urquiza R, Yuasa S, Sato T, Kikuta Y, Nishina H, Al-Lamee R, Sen S, Lerman A, Akashi YJ, Escaned J, Matsuo H, Davies JEet al., 2023, Physiology-guided PCI versus CABG for left main coronary artery disease: insights from the DEFINE-LM registry, CARDIOVASCULAR INTERVENTION AND THERAPEUTICS, Vol: 38, Pages: 287-298, ISSN: 1868-4300

Journal article

Warisawa T, Cook CM, Ahmad Y, Howard JP, Seligman H, Rajkumar C, Toya T, Doi S, Nakajima A, Nakayama M, Vera-Urquiza R, Yuasa S, Sato T, Kikuta Y, Kawase Y, Nishina H, Al-Lamee R, Sen S, Lerman A, Matsuo H, Akashi YJ, Escaned J, Davies JEet al., 2023, Deferred Versus Performed Revascularization for Left Main Coronary Disease With Hemodynamic Significance, CIRCULATION-CARDIOVASCULAR INTERVENTIONS, Vol: 16, ISSN: 1941-7640

Journal article

Foley MJ, Rajkumar CA, Ahmed-Jushuf F, Nour D, Fung CH, Seligman H, Pathimagaraj RH, Petraco R, Sen S, Nijjer S, Howard JP, Ahmad Y, Chamie D, Warisawa T, Shun-Shin MJ, Francis DP, Al-Lamee RKet al., 2023, The Ability of Contemporary Interventional Cardiologists to Judge the Ischaemic Impact of a Coronary Lesion From Visual Inspection, Publisher: ELSEVIER SCIENCE INC, Pages: S30-S30, ISSN: 1936-8798

Conference paper

Foley MJ, Hall K, Howard JP, Ahmad Y, Gandhi M, Mahboobani S, Okafor J, Rahman H, Hadjiloizou N, Ruparelia N, Mikhail G, Malik I, Kanaganayagam G, Sutaria N, Rana B, Ariff B, Barden E, Anderson J, Afoke J, Petraco R, Al-Lamee RK, Sen Set al., 2023, Aortic Valve Calcium Score Is Associated With Acute Stroke in Transcatheter Aortic Valve Replacement Patients, Publisher: ELSEVIER SCIENCE INC, Pages: S91-S91, ISSN: 1936-8798

Conference paper

Price S, Kaski JC, Al-Lamee R, Boden WE, Huber K, Katz JN, Krychtiuk Ket al., 2023, The year in cardiovascular medicine 2022: the top 10 papers in acute cardiac care and ischaemic heart disease, EUROPEAN HEART JOURNAL, Vol: 44, Pages: 445-447, ISSN: 0195-668X

Journal article

Ganesananthan S, Rajkumar CA, Foley M, Francis D, Al-Lamee Ret al., 2022, Remote digital smart device follow-up in prospective clinical trials: early insights from ORBITA-2, ORBITA-COSMIC, and ORBITA-STAR, EUROPEAN HEART JOURNAL SUPPLEMENTS, Vol: 24, Pages: H32-H42, ISSN: 1520-765X

Journal article

Akbari T, Al-Lamee R, 2022, Percutaneous Coronary Intervention in Multi-Vessel Disease, CARDIOVASCULAR REVASCULARIZATION MEDICINE, Vol: 44, Pages: 80-91, ISSN: 1553-8389

Journal article

Morris PD, Al-Lamee RK, Berry C, 2022, Coronary physiological assessment in the catheter laboratory: haemodynamics, clinical assessment and future perspectives, HEART, Vol: 108, Pages: 1737-1746, ISSN: 1355-6037

Journal article

Nowbar AN, Francis DP, Al-Lamee RK, 2022, Quality of Life Assessment in Trials of Revascularization for Chronic Stable Angina: Insights from ORBITA and the Implications of Blinding, CARDIOVASCULAR DRUGS AND THERAPY, Vol: 36, Pages: 1011-1018, ISSN: 0920-3206

Journal article

Pathimagaraj R, Foley M, Nowbar A, Rajkumar C, Shun-Shin M, Howard J, Al-Lamee Ret al., 2022, A Symptom-Stratified Analysis of the Objective Randomised Blinded Investigation With Optimal Medical Therapy of Angioplasty in Stable Angina Trial, 34th Annual Symposium on Transcatheter Cardiovascular Therapeutics (TCT), Publisher: ELSEVIER SCIENCE INC, Pages: B80-B80, ISSN: 0735-1097

Conference paper

Rajkumar C, Foley M, Syam S, Pathimagaraj R, Ahmed-Jushuf F, Towbar A, Seligman H, Nijjer S, Sen S, Petraco R, Davies J, Ruparelia N, Kotecha T, Keeble T, Clesham G, Shun-Shin M, Al-Lamee Ret al., 2022, The Role of the Collateral Circulation in Stable Coronary Artery Disease: A Placebo-Controlled Study in Patients With Stable Angina, 34th Annual Symposium on Transcatheter Cardiovascular Therapeutics (TCT), Publisher: ELSEVIER SCIENCE INC, Pages: B120-B121, ISSN: 0735-1097

Conference paper

Ganesananthan S, Rajkumar C, Foley M, Thompson D, Nowbar A, Seligman H, Petraco R, Sen S, Nijjer S, Thom S, Wensel R, Davies J, Francis D, Shun-Shin M, Howard J, Al-Lamee Ret al., 2022, Cardiopulmonary exercise testing and efficacy of percutaneous coronary intervention: A substudy of the ORBITA trial, European Heart Journal, Vol: 43, Pages: 3132-3145, ISSN: 0195-668X

AimsOxygen-pulse morphology and gas exchange analysis measured during cardiopulmonary exercise testing (CPET) has been associated with myocardial ischaemia. We examine the relationship between CPET parameters, myocardial ischaemia and anginal symptoms in patients with chronic coronary syndrome. We also determine the ability of these parameters to predict the placebo-controlled response to percutaneous coronary intervention (PCI).Methods and resultsPatients with severe single vessel coronary artery disease were randomised 1:1 to PCI or placebo in the ORBITA trial. Subjects underwent pre-randomisation treadmill CPET, dobutamine stress-echocardiography (DSE) and symptom assessment. These assessments were repeated at the end of a 6-week blinded follow-up period. 195 patients with CPET data were randomised (102 PCI, 93 placebo). Patients in whom an oxygen-pulse plateau was observed during CPET had higher (more ischaemic) DSE score (+0.82 segments; 95%CI, 0.40 to 1.25, P=0.0068) and lower FFR (-0.07; -0.12 to -0.02, P=0.011) compared to those without. At lower (more abnormal) oxygen-pulse slopes, there was a larger improvement of the placebo-controlled effect of PCI on DSE score (oxygen-pulse plateau presence [Pinteraction=0.026] and oxygen-pulse gradient [Pinteraction=0.023]) and Seattle angina physical-limitation score (oxygen-pulse plateau presence [Pinteraction=0.037]). Impaired peak VO2, VE/VCO2 slope, peak oxygen-pulse and oxygen-uptake efficacy slope was significantly associated with higher symptom burden but did not relate to severity of ischaemia or predict response to PCI.ConclusionAlthough selected CPET parameters relate to severity of angina symptoms and quality of life, only an oxygen-pulse plateau detects the severity of myocardial ischaemia and predicts the placebo-controlled efficacy of PCI in patients with single-vessel coronary artery disease.

Journal article

Patel P, Thomas R, Hamady M, Hague J, Raja J, Tan T, Bloom S, Richards T, Weiss C, Prechtl C, Smith C, Thiagarajah S, Fiorentino F, Markakis H, Hesketh R, Foley M, Rajkumar C, Al-Lamee R, Syed S, Nimer A, Walkden M, Viloria E, Garrick F, Guerrero M, Ahmed Aet al., 2022, Simulation training to create the gold standard framework to run the EMBIO trial (left gastric artery embolisation vs placebo), a double blinded, multi-centre, randomised controlled trial., 13th Annual Scientific Meeting of the British-Obesity-and-Metabolic-Surgery-Society (BOMSS), Publisher: SPRINGER, Pages: 27-27, ISSN: 0960-8923

Conference paper

Al-Lamee RK, Foley M, Rajkumar CA, Francis DPet al., 2022, Revascularization in stable coronary artery disease, BMJ-BRITISH MEDICAL JOURNAL, Vol: 377, ISSN: 0959-535X

Journal article

Rajkumar CA, Wereski R, Parsonage W, Cullen L, Khamis R, Foley M, Harrell FE, Shun-Shin MJ, Mills NL, Al-Lamee RKet al., 2022, Association Between High-Sensitivity Cardiac Troponin, Myocardial Ischemia, and Revascularization in Stable Coronary Artery Disease, JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, Vol: 79, Pages: 2185-2187, ISSN: 0735-1097

Journal article

Kelshiker M, Seligman H, Howard JAMES, Rahman H, Foley M, Nowbar A, Rajkumar C, Shun-Shin M, Ahmad Y, Sen S, Al-Lamee R, Cole G, Hoole S, Morris P, Rigo F, Mayet J, Francis D, Petraco Ret 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

Journal article

Rajkumar CA, Ganesananthan S, Ahmad Y, Seligman H, Thornton GD, Foley M, Nowbar AN, Howard JP, Francis DP, Keeble TR, Grunwald IQ, Al-Lamee RK, Malik I, Shun-Shin MJet al., 2022, Mechanical thrombectomy with retrievable stents and aspiration catheters for acute ischaemic stroke: a meta-analysis of randomised controlled trials, EUROINTERVENTION, Vol: 17, Pages: E1425-+, ISSN: 1774-024X

Journal article

Nowbar AN, Rajkumar C, Foley M, Ahmed-Jushuf F, Howard JP, Seligman H, Petraco R, Sen S, Nijjer SS, Shun-Shin MJ, Keeble TR, Sohaib A, Collier D, McVeigh P, Harrell FE, Francis DP, Al-Lamee RKet al., 2022, A double-blind randomised placebo-controlled trial of percutaneous coronary intervention for the relief of stable angina without antianginal medications: design and rationale of the ORBITA-2 trial, EUROINTERVENTION, Vol: 17, Pages: 1490-+, ISSN: 1774-024X

Journal article

Millenaar D, Dillmann M, Fehlmann T, Flohr A, Mehran R, Al-Lamee R, Lauder L, Ukena C, Boehm M, Keller A, Mahfoud Fet al., 2022, Sex Differences in Cardiovascular Research: A Scientometric Analysis, JOURNAL OF THE AMERICAN HEART ASSOCIATION, Vol: 11

Journal article

Kelshiker M, Seligman H, Howard JP, Rahman H, Foley M, Nowbar AN, Rajkumar CA, Shun-Shin M, Ahmad Y, Sen S, Al-Lamee R, Hoole SP, Rigo F, Mayet J, Francis DP, Cole G, Morris PD, Petraco Ret 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

Conference paper

Seligman H, Nijjer SS, van de Hoef TP, de Waard GA, Mejia-Renteria H, Echavarria-Pinto M, Shun-Shin MJ, Howard JP, Cook CM, Warisawa T, Ahmad Y, Androshchuk V, Rajkumar C, Nowbar A, Kelshiker MA, van Lavieren MA, Meuwissen M, Danad I, Knaapen P, Sen S, Al-Lamee R, Mayet J, Escaned J, Piek JJ, van Royen N, Davies JE, Francis DP, Petraco Ret 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

Journal article

Ahmad Y, Kane C, Arnold AD, Cook C, Keene D, Shun-Shin M, Cole G, Al-Lamee R, Francis D, Howard Jet al., 2022, Randomized blinded placebo-controlled trials of renal sympathetic denervation for hypertension: a meta-analysis, Cardiovascular Revascularization Medicine, Vol: 34, Pages: 112-118, ISSN: 1553-8389

BackgroundThe efficacy of renal denervation has been controversial, but the procedure has now undergone several placebo-controlled trials. New placebo-controlled trial data has recently emerged, with longer follow-up of one trial and the full report of another trial (which constitutes 27% of the total placebo-controlled trial data). We therefore sought to evaluate the effect of renal denervation on ambulatory and office blood pressures in patients with hypertension.MethodsWe systematically identified all blinded placebo-controlled randomized trials of catheter-based renal denervation for hypertension. The primary efficacy outcome was ambulatory systolic blood pressure change relative to placebo. A random-effects meta-analysis was performed.Results6 studies randomizing 1232 patients were eligible. 713 patients were randomized to renal denervation and 519 to placebo. Renal denervation significantly reduced ambulatory systolic blood pressure (−3.52 mmHg; 95% CI −4.94 to −2.09; p < 0.0001), ambulatory diastolic blood pressure (−1.93 mmHg; 95% CI −3.04 to −0.83, p = 0.0006), office systolic blood pressure size (−5.10 mmHg; 95% CI −7.31 to −2.90, p < 0.0001) and office diastolic pressure (effect size −3.11 mmHg; 95% CI −4.43 to −1.78, p < 0.0001). Adverse events were rare and not more common with denervation.ConclusionsThe totality of blinded, randomized placebo-controlled data shows that renal denervation is safe and provides genuine reduction in blood pressure for at least 6 months post-procedure. If this effect continues in the long term, renal denervation might provide a life-long 10% relative risk reduction in major adverse cardiac events and 7.5% relative risk reduction in all-cause mortality.

Journal article

Gallone G, Baldetti L, Angelini F, Saglietto A, Bellettini M, Beneduce A, Ranotti V, Chiarito M, Leone PP, Pagnesi M, De Filippo O, Landra F, Bruno F, Marengo G, Collino M, Ferrante G, Stefanini GG, Colombo A, Al-Lamee R, Francis DP, Jolicoeur ME, Henry TD, Giannini F, D'Ascenzo F, De Ferrari GMet al., 2022, The Placebo Effect on Symptoms, Quality of Life, and Functional Outcomes in Patients With Angina Pectoris: A Meta-analysis of Randomized Placebo-Controlled Trials, CANADIAN JOURNAL OF CARDIOLOGY, Vol: 38, Pages: 113-122, ISSN: 0828-282X

Journal article

Al-Lamee R, Mintz GS, 2021, What are the PROSPECTs and clinical implications of vulnerable plaque?, Eur Heart J, Vol: 42, Pages: 4680-4682

Journal article

Al-Lamee R, Mintz GS, 2021, What are the PROSPECTs and clinical implications of vulnerable plaque?, EUROPEAN HEART JOURNAL, Vol: 42, Pages: 4680-4682, ISSN: 0195-668X

Journal article

Al-Lamee RK, Foley M, Rajkumar C, Nowbar ANet al., 2021, Recruitment for placebo-controlled trials of interventional procedures: a patient-centred approach, EUROINTERVENTION, Vol: 17, Pages: E963-E965, ISSN: 1774-024X

Journal article

Mohan P, Hartley A, Khaldi H, Sethi A, Petraco R, Al-Lamee R, Baker C, Khamis Ret al., 2021, Use of Intravascular Lithotripsy in a Population With a High Prevalence of Renal Disease and Diabetes: Insights From Real-World Data, Publisher: ELSEVIER SCIENCE INC, Pages: B169-B169, ISSN: 0735-1097

Conference paper

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