Publications

Aims: Whether a single cardiac troponin measurement can safely rule out myocardial infarction in patients presenting within a few hours of symptom onset is uncertain. The study aim was to assess the performance of troponin in early presenters.

No abstract available

Introduction: Problematic polypharmacy, where patients are prescribed multiple medications that are not therapeutically beneficial and can cause unnecessary and potentially harmful adverse drug reactions, can be mitigated using medication reviews. Polypharmacy can occur in patients with asthma taking multiple types of inhalers and medications for their asthma.

Although guidelines recommend fixed cardiac troponin thresholds for the diagnosis of myocardial infarction, troponin concentrations are influenced by age, sex, comorbidities and time from symptom onset. To improve diagnosis, we developed machine learning models to compute the Collaboration for the Diagnosis and Evaluation of Acute Coronary Syndrome (CoDE-ACS) score (0–100) that corresponds to an individual’s probability of myocardial infarction.

Background: The development of new biomarkers allows for the accurate prediction of breast cancer therapy response in the neoadjuvant setting. The implementation of these tools in routine NHS operations could have the potential for better clinical outcomes and a more cost-effective use of resources.

Background: Important disparities in the treatment and outcomes of women and men with atrial fibrillation (AF) are well recognized. Whether introduction of direct oral anticoagulants has reduced disparities in treatment is uncertain.

Background: Despite poor cardiovascular outcomes, there are no dedicated, validated risk stratification tools to guide investigation or treatment in type 2 myocardial infarction.

Background: Cognitive impairment is common following a stroke. Structural neuroimaging and blood tests are a routine part of acute stroke management, and may identify those at risk of post-stroke cognitive problems. This thesis focuses on identifying clinically relevant risk factors, present at the time of stroke, that are associated with post-stroke cognitive impairment, including dementia.