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1. Sex differences in coronary atherosclerotic plaque activity using 18F-sodium fluoride positron emission tomography

Author

Kwiecinski, Jacek, Wang, Kang-Ling, Tzolos, Evangelos, Moss, Alastair, Daghem, Marwa, Adamson, Philip D., Dey, Damini, Molek-Dziadosz, Patrycja, Dawson, Dana, Arumugam, Parthiban, Sabharwal, Nikant, Greenwood, John P., Townend, John N., Calvert, Patrick A., Rudd, James HF., Berman, Daniel, Verjans, Johan W., Williams, Michelle C., Slomka, Piotr, Dweck, Marc R., and Newby, David E.

Published
2024
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2. Rationale and Design of SCOT-HEART 2 Trial: CT Angiography for the Prevention of Myocardial Infarction

Author

McDermott, Michael, Meah, Mohammed N., Khaing, Phyo, Wang, Kang-Ling, Ramsay, Jennifer, Scott, Gillian, Rickman, Hannah, Burt, Tom, McGowan, Ian, Fairbairn, Timothy, Bucukoglu, Marise, Bull, Russell, Timmis, Adam, van Beek, Edwin J.R., Roditi, Giles, Adamson, Philip D., Lewis, Steff, Norrie, John, McKinstry, Brian, Guthrie, Bruce, Ritchie, Lewis, Mills, Nicholas L., Dweck, Marc R., Williams, Michelle C., and Newby, David E.

Published
2024
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3. Bypass Grafting and Native Coronary Artery Disease Activity

Author

Kwiecinski, Jacek, Tzolos, Evangelos, Fletcher, Alexander J, Nash, Jennifer, Meah, Mohammed N, Cadet, Sebastien, Adamson, Philip D, Grodecki, Kajetan, Joshi, Nikhil, Williams, Michelle C, van Beek, Edwin JR, Lai, Chi, Tavares, Adriana AS, MacAskill, Mark G, Dey, Damini, Baker, Andrew H, Leipsic, Jonathon, Berman, Daniel S, Sellers, Stephanie L, Newby, David E, Dweck, Marc R, and Slomka, Piotr J

Subjects
Biomedical and Clinical Sciences, Cardiovascular Medicine and Haematology, Heart Disease - Coronary Heart Disease, Atherosclerosis, Cardiovascular, Heart Disease, Clinical Research, Aged, Calcinosis, Calcium, Coronary Angiography, Coronary Artery Disease, Disease Progression, Female, Humans, Male, Middle Aged, Plaque, Atherosclerotic, Predictive Value of Tests, Sodium Fluoride, F-18-NaF, CABG, coronary artery bypass graft, coronary artery disease, PET/CT, (18)F-NaF, Cardiorespiratory Medicine and Haematology, Clinical Sciences, Cardiovascular System & Hematology, Cardiovascular medicine and haematology, Clinical sciences
Abstract

ObjectivesThe aim of this study was to describe the potential of 18F-sodium fluoride (18F-NaF) positron emission tomography (PET) to identify graft vasculopathy and to investigate the influence of coronary artery bypass graft (CABG) surgery on native coronary artery disease activity and progression.BackgroundAs well as developing graft vasculopathy, CABGs have been proposed to accelerate native coronary atherosclerosis.MethodsPatients with established coronary artery disease underwent baseline 18F-NaF PET, coronary artery calcium scoring, coronary computed tomographic angiography, and 1-year repeat coronary artery calcium scoring. Whole-vessel coronary microcalcification activity (CMA) on 18F-NaF PET and change in calcium scores were quantified in patients with and without CABG surgery.ResultsAmong 293 participants (mean age 65 ± 9 years, 84% men), 48 (16%) underwent CABG surgery 2.7 years [IQR: 1.4-10.4 years] previously. Although all arterial and the majority (120 of 128 [94%]) of vein grafts showed no 18F-NaF uptake, 8 saphenous vein grafts in 7 subjects had detectable CMA. Bypassed native coronary arteries had 3 times higher CMA values (2.1 [IQR: 0.4-7.5] vs 0.6 [IQR: 0-2.7]; P < 0.001) and greater progression of 1-year calcium scores (118 Agatston unit [IQR: 48-194 Agatston unit] vs 69 [IQR: 21-142 Agatston unit]; P = 0.01) compared with patients who had not undergone CABG, an effect confined largely to native coronary plaques proximal to the graft anastomosis. In sensitivity analysis, bypassed native coronary arteries had higher CMA (2.0 [IQR: 0.4-7.5] vs 0.8 [IQR: 0.3-3.2]; P < 0.001) and faster disease progression (24% [IQR: 16%-43%] vs 8% [IQR: 0%-24%]; P = 0.002) than matched patients (n = 48) with comparable burdens of coronary artery disease and cardiovascular comorbidities in the absence of bypass grafting.ConclusionsNative coronary arteries that have been bypassed demonstrate increased disease activity and more rapid disease progression than nonbypassed arteries, an observation that appears independent of baseline atherosclerotic plaque burden. Microcalcification activity is not a dominant feature of graft vasculopathy.

Published
2022

5. Prognostic performance of soluble urokinase plasminogen activator receptor for heart failure or mortality in Western and Asian patients with acute breathlessness

Author

Chew-Harris, Janice, Frampton, Chris, Greer, Charlotte, Appleby, Sarah, Pickering, John W., Kuan, Win Sen, Ibrahim, Irwani, Chan, Siew Pang, Li, Zisheng, Liew, Oi Wah, Adamson, Philip D., Troughton, Richard, Tan, Li Ling, Lin, Weiqin, Ooi, Shirley Beng Suat, Richards, A. Mark, and Pemberton, Christopher J.

Published
2024
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6. Coronary Atherosclerotic Plaque Activity and Risk of Myocardial Infarction

Author

Wang, Kang-Ling, Balmforth, Craig, Meah, Mohammed N., Daghem, Marwa, Moss, Alastair J., Tzolos, Evangelos, Kwiecinski, Jacek, Molek-Dziadosz, Patrycja, Craig, Neil, Bularga, Anda, Adamson, Philip D., Dawson, Dana K., Arumugam, Parthiban, Sabharwal, Nikant K., Greenwood, John P., Townend, Jonathan N., Calvert, Patrick A., Rudd, James H.F., Verjans, Johan W., Berman, Daniel S., Slomka, Piotr J., Dey, Damini, Mills, Nicholas L., van Beek, Edwin J.R., Williams, Michelle C., Dweck, Marc R., and Newby, David E.

Published
2024
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7. Uniform or Sex-Specific Cardiac Troponin Thresholds to Rule Out Myocardial Infarction at Presentation

Author

Mills, Nicholas L., Strachan, Fiona E., Tuck, Christopher, Anand, Atul, Akinlade, Olawale Mathias, Barker, Stephanie, Blades, Jennifer, Boeddinghaus, Jasper, Bularga, Anda, de Bakker, Marie, Chapman, Andrew R., Doudesis, Dimitrios, Ferry, Amy V., Fujisawa, Takeshi, Georgiev, Konstantin, Kimenai, Dorien M., Lee, Kuan Ken, Lyell, Iona, Li, Ziwen, Lowry, Matthew TH., McKinlay, Lynn, McDermott, Michael, McPherson, Jean, Mendusic, Filip, Sorbie, Andrew, Souter, Grace, Schulberg, Stacey D., Taggart, Caelan, Thurston, Alexander JF., Tew, Yong Yong, Perez-Vicencio, Daniel, Wang, Yiqing, Wereski, Ryan, Williams, Kelly, Newby, David E., Fox, Keith AA., Berry, Colin, Walker, Simon, Weir, Christopher J., Ford, Ian, Gray, Alasdair, Collinson, Paul O., Apple, Fred S., Reid, Alan, Cruikshank, Anne, Findlay, Iain, Amoils, Shannon, McAllister, David A., Maguire, Donogh, Stevens, Jennifer, Norrie, John, Shah, Anoop SV., Andrews, Jack PM., Adamson, Philip D., Moss, Alastair, Anwar, Mohamed S., Hung, John, Malo, Jonathan, Fischbacher, Colin M., Croal, Bernard L., Leslie, Stephen J., Keerie, Catriona, Parker, Richard A., Walker, Allan, Harkess, Ronnie, Wackett, Tony, Weir, Christopher, Armstrong, Roma, Stirling, Laura, MacDonald, Claire, Sadat, Imran, Finlay, Frank, Harrison, Kathy, Linksted, Pamela, Lavenberg, Stephen, Lowry, Matthew T.H., Tuck, Chris, and Shah, Anoop S.V.

Published
2024
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8. Observer repeatability and interscan reproducibility of 18F-sodium fluoride coronary microcalcification activity

Author

Tzolos, Evangelos, Kwiecinski, Jacek, Lassen, Martin Lyngby, Cadet, Sebastien, Adamson, Philip D, Moss, Alastair J, Joshi, Nikhil, Williams, Michelle C, van Beek, Edwin JR, Dey, Damini, Berman, Daniel S, Dweck, Marc R, Newby, David E, and Slomka, Piotr J

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Heart Disease, Biomedical Imaging, Atherosclerosis, Cardiovascular, Clinical Research, Heart Disease - Coronary Heart Disease, Detection, screening and diagnosis, 4.2 Evaluation of markers and technologies, Calcinosis, Fluorine Radioisotopes, Humans, Observer Variation, Positron Emission Tomography Computed Tomography, Reproducibility of Results, Sodium, Sodium Fluoride, Motion correction, PET, CT, cardiac PET, F-18-NaF, vulnerable plaque, coronary microcalcification activity, 18F-NaF, PET/CT, Cardiorespiratory Medicine and Haematology, Cardiovascular System & Hematology, Cardiovascular medicine and haematology
Abstract

BackgroundWe aimed to establish the observer repeatability and interscan reproducibility of coronary 18F-sodium-fluoride positron emission tomography (PET) uptake using a novel semi-automated approach, coronary microcalcification activity (CMA).MethodsPatients with multivessel coronary artery disease underwent repeated hybrid PET and computed tomography angiography (CTA) imaging (PET/CTA). CMA was defined as the integrated standardized uptake values (SUV) in the entire coronary tree exceeding 2 standard deviations above the background SUV. Coefficients of repeatability between the same observer (intraobserver repeatability), between 2 observers (interobserver repeatability) and coefficient of reproducibility between 2 scans (interscan reproducibility), were determined at vessel and patient level.ResultsIn 19 patients, CMA was assessed twice in 43 coronary vessels on two PET/CT scans performed 12 ± 5 days apart. There was excellent intraclass correlation for intraobserver and interobserver repeatability as well as interscan reproducibility (all ≥ 0.991). There was 100% intraobserver, interobserver and interscan agreement for the presence (CMA > 0) or absence (CMA = 0) of coronary18F-NaF uptake. Mean CMA was 3.12 ± 0.62 with coefficients of repeatability of ≤ 10% for all measures: intraobserver 0.24 and 0.22, interobserver 0.30 and 0.29 and interscan 0.33 and 0.32 at a per-vessel and per-patient level, respectively.ConclusionsCMA is a repeatable and reproducible global measure of coronary atherosclerotic activity.

Published
2022

11. Machine Learning with 18F-Sodium Fluoride PET and Quantitative Plaque Analysis on CT Angiography for the Future Risk of Myocardial Infarction

Author

Kwiecinski, Jacek, Tzolos, Evangelos, Meah, Mohammed N, Cadet, Sebastien, Adamson, Philip D, Grodecki, Kajetan, Joshi, Nikhil V, Moss, Alastair J, Williams, Michelle C, van Beek, Edwin JR, Berman, Daniel S, Newby, David E, Dey, Damini, Dweck, Marc R, and Slomka, Piotr J

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Heart Disease, Heart Disease - Coronary Heart Disease, Biomedical Imaging, Atherosclerosis, Cardiovascular, Clinical Research, 4.2 Evaluation of markers and technologies, 4.1 Discovery and preclinical testing of markers and technologies, Detection, screening and diagnosis, Positron Emission Tomography Computed Tomography, myocardial infarction, CT, F-18-NaF PET, quantitative plaque analysis, machine-learning, 18F-NaF PET, Nuclear Medicine & Medical Imaging, Clinical sciences
Abstract

Coronary 18F-sodium fluoride (18F-NaF) PET and CT angiography-based quantitative plaque analysis have shown promise in refining risk stratification in patients with coronary artery disease. We combined both of these novel imaging approaches to develop an optimal machine-learning model for the future risk of myocardial infarction in patients with stable coronary disease. Methods: Patients with known coronary artery disease underwent coronary 18F-NaF PET and CT angiography on a hybrid PET/CT scanner. Machine-learning by extreme gradient boosting was trained using clinical data, CT quantitative plaque analysis, measures and 18F-NaF PET, and it was tested using repeated 10-fold hold-out testing. Results: Among 293 study participants (65 ± 9 y; 84% male), 22 subjects experienced a myocardial infarction over the 53 (40-59) months of follow-up. On univariable receiver-operator-curve analysis, only 18F-NaF coronary uptake emerged as a predictor of myocardial infarction (c-statistic 0.76, 95% CI 0.68-0.83). When incorporated into machine-learning models, clinical characteristics showed limited predictive performance (c-statistic 0.64, 95% CI 0.53-0.76) and were outperformed by a quantitative plaque analysis-based machine-learning model (c-statistic 0.72, 95% CI 0.60-0.84). After inclusion of all available data (clinical, quantitative plaque and 18F-NaF PET), we achieved a substantial improvement (P = 0.008 versus 18F-NaF PET alone) in the model performance (c-statistic 0.85, 95% CI 0.79-0.91). Conclusion: Both 18F-NaF uptake and quantitative plaque analysis measures are additive and strong predictors of outcome in patients with established coronary artery disease. Optimal risk stratification can be achieved by combining clinical data with these approaches in a machine-learning model.

Published
2022

12. Matter-wave Atomic Gradiometer Interferometric Sensor (MAGIS-100)

Author

Abe, Mahiro, Adamson, Philip, Borcean, Marcel, Bortoletto, Daniela, Bridges, Kieran, Carman, Samuel P., Chattopadhyay, Swapan, Coleman, Jonathon, Curfman, Noah M., DeRose, Kenneth, Deshpande, Tejas, Dimopoulos, Savas, Foot, Christopher J., Frisch, Josef C., Garber, Benjamin E., Geer, Steve, Gibson, Valerie, Glick, Jonah, Graham, Peter W., Hahn, Steve R., Harnik, Roni, Hawkins, Leonie, Hindley, Sam, Hogan, Jason M., Jiang, Yijun, Kasevich, Mark A., Kellett, Ronald J., Kiburg, Mandy, Kovachy, Tim, Lykken, Joseph D., March-Russell, John, Mitchell, Jeremiah, Murphy, Martin, Nantel, Megan, Nobrega, Lucy E., Plunkett, Robert K., Rajendran, Surjeet, Rudolph, Jan, Sachdeva, Natasha, Safdari, Murtaza, Santucci, James K., Schwartzman, Ariel G., Shipsey, Ian, Swan, Hunter, Valerio, Linda R., Vasonis, Arvydas, Wang, Yiping, and Wilkason, Thomas

Subjects
Physics - Atomic Physics
Abstract

MAGIS-100 is a next-generation quantum sensor under construction at Fermilab that aims to explore fundamental physics with atom interferometry over a 100-meter baseline. This novel detector will search for ultralight dark matter, test quantum mechanics in new regimes, and serve as a technology pathfinder for future gravitational wave detectors in a previously unexplored frequency band. It combines techniques demonstrated in state-of-the-art 10-meter-scale atom interferometers with the latest technological advances of the world's best atomic clocks. MAGIS-100 will provide a development platform for a future kilometer-scale detector that would be sufficiently sensitive to detect gravitational waves from known sources. Here we present the science case for the MAGIS concept, review the operating principles of the detector, describe the instrument design, and study the detector systematics., Comment: 65 pages, 18 figures

Published
2021
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14. Remote haemodynamic-guided heart failure management in France: Results from the CardioMEMS HF System Post-Market Study (COAST) French cohort

Author

de Groote, Pascal, Thuny, Franck, Blanchart, Katrien, Gueffet, Jean-Pierre, Habib, Gilbert, Salvat, Muriel, Leclercq, Christophe, Mouquet, Frederic, Roncalli, Jérôme, Sebbag, Laurent, Cassagneau, Romain, Peyrol, Michael, Sabatier, Remi, Gazzola, Carlo, Henderson, John, Adamson, Philip B., and Roubille, François

Published
2024
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17. Coronary 18F-Sodium Fluoride Uptake Predicts Outcomes in Patients With Coronary Artery Disease

Author

Kwiecinski, Jacek, Tzolos, Evangelos, Adamson, Philip D, Cadet, Sebastien, Moss, Alastair J, Joshi, Nikhil, Williams, Michelle C, van Beek, Edwin JR, Dey, Damini, Berman, Daniel S, Newby, David E, Slomka, Piotr J, and Dweck, Marc R

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Heart Disease - Coronary Heart Disease, Cardiovascular, Heart Disease, Atherosclerosis, Prevention, 4.2 Evaluation of markers and technologies, Detection, screening and diagnosis, Aged, Computed Tomography Angiography, Coronary Artery Disease, Female, Fluorine Radioisotopes, Humans, Male, Middle Aged, Myocardial Infarction, Positron-Emission Tomography, Prognosis, coronary artery disease, coronary computed tomography, coronary event risk prediction, F-18-NaF PET, myocardial infarction, (18)F-NaF PET, Cardiorespiratory Medicine and Haematology, Public Health and Health Services, Cardiovascular System & Hematology, Cardiovascular medicine and haematology
Abstract

BackgroundReliable methods for predicting myocardial infarction in patients with established coronary artery disease are lacking. Coronary 18F-sodium fluoride (18F-NaF) positron emission tomography (PET) provides an assessment of atherosclerosis activity.ObjectivesThis study assessed whether 18F-NaF PET predicts myocardial infarction and provides additional prognostic information to current methods of risk stratification.MethodsPatients with known coronary artery disease underwent 18F-NaF PET computed tomography and were followed up for fatal or nonfatal myocardial infarction over 42 months (interquartile range: 31 to 49 months). Total coronary 18F-NaF uptake was determined by the coronary microcalcification activity (CMA).ResultsIn a post hoc analysis of data collected for prospective observational studies, the authors studied 293 study participants (age: 65 ± 9 years; 84% men), of whom 203 (69%) showed increased coronary 18F-NaF activity (CMA >0). Fatal or nonfatal myocardial infarction occurred only in patients with increased coronary 18F-NaF activity (20 of 203 with a CMA >0 vs. 0 of 90 with a CMA of 0; p 1.56 had a >7-fold increase in fatal or nonfatal myocardial infarction (hazard ratio: 7.1; 95% confidence interval: 2.2 to 25.1; p = 0.003) independent of age, sex, risk factors, segment involvement and coronary calcium scores, presence of coronary stents, coronary stenosis, REACH and SMART scores, the Duke coronary artery disease index, and recent myocardial infarction.ConclusionsIn patients with established coronary artery disease, 18F-NaF PET provides powerful independent prediction of fatal or nonfatal myocardial infarction.

Published
2020

18. Triple-gated motion and blood pool clearance corrections improve reproducibility of coronary 18F-NaF PET

Author

Lassen, Martin Lyngby, Kwiecinski, Jacek, Dey, Damini, Cadet, Sebastien, Germano, Guido, Berman, Daniel S, Adamson, Philip D, Moss, Alastair J, Dweck, Marc R, Newby, David E, and Slomka, Piotr J

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Biomedical Imaging, Cardiovascular, Clinical Research, Heart Disease, Heart Disease - Coronary Heart Disease, Bioengineering, 4.2 Evaluation of markers and technologies, 4.1 Discovery and preclinical testing of markers and technologies, Detection, screening and diagnosis, Aged, Angiography, Coronary Artery Disease, Female, Fluorine Radioisotopes, Gated Blood-Pool Imaging, Humans, Image Processing, Computer-Assisted, Male, Movement, Positron Emission Tomography Computed Tomography, Reproducibility of Results, Sodium Fluoride, Data-driven motion detection, Motion correction, PET, CT, Cardiac PET, F-18-sodium fluoride, Vulnerable plaque, 18F-sodium fluoride, PET/CT, Other Physical Sciences, Nuclear Medicine & Medical Imaging, Clinical sciences
Abstract

PurposeTo improve the test-retest reproducibility of coronary plaque 18F-sodium fluoride (18F-NaF) positron emission tomography (PET) uptake measurements.MethodsWe recruited 20 patients with coronary artery disease who underwent repeated hybrid PET/CT angiography (CTA) imaging within 3 weeks. All patients had 30-min PET acquisition and CTA during a single imaging session. Five PET image-sets with progressive motion correction were reconstructed: (i) a static dataset (no-MC), (ii) end-diastolic PET (standard), (iii) cardiac motion corrected (MC), (iv) combined cardiac and gross patient motion corrected (2 × MC) and, (v) cardiorespiratory and gross patient motion corrected (3 × MC). In addition to motion correction, all datasets were corrected for variations in the background activities which are introduced by variations in the injection-to-scan delays (background blood pool clearance correction, BC). Test-retest reproducibility of PET target-to-background ratio (TBR) was assessed by Bland-Altman analysis and coefficient of reproducibility.ResultsA total of 47 unique coronary lesions were identified on CTA. Motion correction in combination with BC improved the PET TBR test-retest reproducibility for all lesions (coefficient of reproducibility: standard = 0.437, no-MC = 0.345 (27% improvement), standard + BC = 0.365 (20% improvement), no-MC + BC = 0.341 (27% improvement), MC + BC = 0.288 (52% improvement), 2 × MC + BC = 0.278 (57% improvement) and 3 × C + BC = 0.254 (72% improvement), all p  10 mm following corrections, reproducibility was improved by 133% (coefficient of reproducibility: standard = 0.745, 3 × MC = 0.320).ConclusionJoint corrections for cardiac, respiratory, and gross patient motion in combination with background blood pool corrections markedly improve test-retest reproducibility of coronary 18F-NaF PET.

Published
2019

21. Uniform or Sex-Specific Cardiac Troponin Thresholds to Rule Out Myocardial Infarction at Presentation

Author

Li, Ziwen, primary, Wereski, Ryan, additional, Anand, Atul, additional, Lowry, Matthew T.H., additional, Doudesis, Dimitrios, additional, McDermott, Michael, additional, Ferry, Amy V., additional, Tuck, Chris, additional, Chapman, Andrew R., additional, Lee, Kuan Ken, additional, Shah, Anoop S.V., additional, Mills, Nicholas L., additional, Kimenai, Dorien M., additional, Strachan, Fiona E., additional, Tuck, Christopher, additional, Akinlade, Olawale Mathias, additional, Barker, Stephanie, additional, Blades, Jennifer, additional, Boeddinghaus, Jasper, additional, Bularga, Anda, additional, de Bakker, Marie, additional, Fujisawa, Takeshi, additional, Georgiev, Konstantin, additional, Lyell, Iona, additional, Li, Ziwen, additional, Lowry, Matthew TH., additional, McKinlay, Lynn, additional, McPherson, Jean, additional, Mendusic, Filip, additional, Sorbie, Andrew, additional, Souter, Grace, additional, Schulberg, Stacey D., additional, Taggart, Caelan, additional, Thurston, Alexander JF., additional, Tew, Yong Yong, additional, Perez-Vicencio, Daniel, additional, Wang, Yiqing, additional, Williams, Kelly, additional, Newby, David E., additional, Fox, Keith AA., additional, Berry, Colin, additional, Walker, Simon, additional, Weir, Christopher J., additional, Ford, Ian, additional, Gray, Alasdair, additional, Collinson, Paul O., additional, Apple, Fred S., additional, Reid, Alan, additional, Cruikshank, Anne, additional, Findlay, Iain, additional, Amoils, Shannon, additional, McAllister, David A., additional, Maguire, Donogh, additional, Stevens, Jennifer, additional, Norrie, John, additional, Shah, Anoop SV., additional, Andrews, Jack PM., additional, Adamson, Philip D., additional, Moss, Alastair, additional, Anwar, Mohamed S., additional, Hung, John, additional, Malo, Jonathan, additional, Fischbacher, Colin M., additional, Croal, Bernard L., additional, Leslie, Stephen J., additional, Keerie, Catriona, additional, Parker, Richard A., additional, Walker, Allan, additional, Harkess, Ronnie, additional, Wackett, Tony, additional, Weir, Christopher, additional, Armstrong, Roma, additional, Stirling, Laura, additional, MacDonald, Claire, additional, Sadat, Imran, additional, Finlay, Frank, additional, Harrison, Kathy, additional, Linksted, Pamela, additional, and Lavenberg, Stephen, additional

Published
2024
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22. Quantifying microcalcification activity in the thoracic aorta

Author

Fletcher, Alexander J., Lembo, Maria, Kwiecinski, Jacek, Syed, Maaz B. J., Nash, Jennifer, Tzolos, Evangelos, Bing, Rong, Cadet, Sebastien, MacNaught, Gillian, van Beek, Edwin J. R., Moss, Alistair J., Doris, Mhairi K., Walker, Niki L., Dey, Damini, Adamson, Philip D., Newby, David E., Slomka, Piotr J., and Dweck, Marc R.

Published
2022
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24. Thoracic Aortic 18F-Sodium Fluoride Activity and Ischemic Stroke in Patients With Established Cardiovascular Disease

Author

Fletcher, Alexander J., Tew, Yong Y., Tzolos, Evangelos, Joshi, Shruti S., Kaczynski, Jakub, Nash, Jennifer, Debono, Samuel, Lembo, Maria, Kwiecinski, Jacek, Bing, Rong, Syed, Maaz B.J., Doris, Mhairi K., van Beek, Edwin J.R., Moss, Alistair J., Jenkins, William S., Walker, Niki L., Joshi, Nikhil V., Pawade, Tania A., Adamson, Philip D., Whiteley, William N., Wardlaw, Joanna M., Slomka, Piotr J., Williams, Michelle C., Newby, David E., and Dweck, Marc R.

Published
2022
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25. High-sensitivity cardiac troponin and the diagnosis of myocardial infarction in patients with kidney impairment

Author

Mills, Nicholas L., Strachan, Fiona E., Tuck, Christopher, Shah, Anoop S.V., Anand, Atul, Bularga, Anda, Wereski, Ryan, Lowry, Matthew T.H., Taggart, Caelan, Ferry, Amy V., Lee, Kuan Ken, Chapman, Andrew R., Sandeman, Dennis, Adamson, Philip D., Stables, Catherine L., Vallejos, Catalina A., Tsanas, Athanasios, Marshall, Lucy, Stewart, Stacey D., Fujisawa, Takeshi, McPherson, Jean, McKinlay, Lynn, Newby, David E., Fox, Keith A.A., Berry, Colin, Walker, Simon, Weir, Christopher J., Ford, Ian, Gray, Alasdair, Collinson, Paul O., Apple, Fred S., Reid, Alan, Cruikshank, Anne, Findlay, Iain, Amoils, Shannon, McAllister, David A., Maguire, Donogh, Stevens, Jennifer, Norrie, John, Andrews, Jack P.M., Moss, Alastair, Anwar, Mohamed S., Hung, John, Malo, Jonathan, Fischbacher, Colin M., Croal, Bernard L., Leslie, Stephen J., Keerie, Catriona, Parker, Richard A., Walker, Allan, Harkess, Ronnie, Wackett, Tony, Weir, Christopher, Armstrong, Roma, Stirling, Laura, MacDonald, Claire, Sadat, Imran, Finlay, Frank, Charles, Heather, Linksted, Pamela, Young, Stephen, Alexander, Bill, Duncan, Chris, Gallacher, Peter J., Miller-Hodges, Eve, Farrah, Tariq E., Halbesma, Nynke, Blackmur, James P., Cruickshank, Anne, and Dhaun, Neeraj

Published
2022
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26. Pericoronary Adipose Tissue Attenuation, Low-Attenuation Plaque Burden, and 5-Year Risk of Myocardial Infarction

Author

Tzolos, Evangelos, Williams, Michelle C., McElhinney, Priscilla, Lin, Andrew, Grodecki, Kajetan, Flores Tomasino, Guadalupe, Cadet, Sebastien, Kwiecinski, Jacek, Doris, Mhairi, Adamson, Philip D., Moss, Alastair J., Alam, Shirjel, Hunter, Amanda, Shah, Anoop S.V., Mills, Nicholas L., Pawade, Tania, Wang, Chengjia, Weir-McCall, Jonathan R., Roditi, Giles, van Beek, Edwin J.R., Shaw, Leslee J., Nicol, Edward D., Berman, Daniel S., Slomka, Piotr J., Dweck, Marc R., Newby, David E., and Dey, Damini

Published
2022
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27. Validation of the myocardial-ischaemic-injury-index machine learning algorithm to guide the diagnosis of myocardial infarction in a heterogenous population: a prespecified exploratory analysis

Author

Mills, Nicholas L, Strachan, Fiona E, Tuck, Christopher, Shah, Anoop SV, Anand, Atul, Chapman, Andrew R, Ferry, Amy V, Lee, Kuan Ken, Doudesis, Dimitrios, Bularga, Anda, Wereski, Ryan, Taggart, Caelan, Lowry, Matthew TH, Mendusic, Filip, Kimenai, Dorien M, Sandeman, Dennis, Adamson, Philip D, Stables, Catherine L, Vallejos, Catalina A, Tsanas, Athanasios, Marshall, Lucy, Stewart, Stacey D, Fujisawa, Takeshi, Hautvast, Mischa, McPherson, Jean, McKinlay, Lynn, Ford, Ian, Newby, David E, Fox, Keith AA, Berry, Colin, Walker, Simon, Weir, Christopher J, Gray, Alasdair, Collinson, Paul O, Apple, Fred S, Reid, Alan, Cruikshank, Anne, Findlay, Iain, Amoils, Shannon, McAllister, David A, Maguire, Donogh, Stevens, Jennifer, Norrie, John, Andrews, Jack PM, Moss, Alastair, Anwar, Mohamed S, Hung, John, Malo, Jonathan, Fischbacher, Colin, Croal, Bernard L, Leslie, Stephen J, Keerie, Catriona, Parker, Richard A, Walker, Allan, Harkess, Ronnie, Wackett, Tony, Armstrong, Roma, Stirling, Laura, MacDonald, Claire, Sadat, Imran, Finlay, Frank, Charles, Heather, Linksted, Pamela, Young, Stephen, Alexander, Bill, Duncan, Chris, Yang, Jason, Shah, Anoop S V, Pickering, John W, and Than, Martin P

Published
2022
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28. Novel approaches to the diagnostic and prognostic assessment of coronary heart disease

Author

Adamson, Philip Douglas, Newby, David, and Mills, Nick

Subjects
coronary heart disease, troponin, positron emission tomography, computed tomography coronary angiography, atherosclerosis
Abstract

BACKGROUND: Cardiovascular disease, principally manifest as myocardial infarction or stroke, is the dominant cause of death worldwide and despite therapeutic advances, the global burden of these conditions continues to increase. In order to address this ongoing disease burden, there is a clear need to more effectively target the use of existing and novel diagnostic investigations and medical therapies. Emerging cardiovascular biomarkers include the biochemical, such as high-sensitivity cardiac troponin, and the radiological, such as computed tomography coronary angiography (CTCA) and 18Ffluoride positron emission tomography (PET). Cardiac troponins can now be reliably quantified in clinically stable or asymptomatic populations and provide information about myocardial pathophysiology, whilst CTCA can non-invasively quantify atherosclerotic burden and 18F-fluoride PET imaging offers insight into plaque vulnerability. Improved targeting of diagnostic investigations requires more reliable estimation of pre-test probability of coronary disease whilst optimizing the use of pharmacological or interventional treatments requires more accurate prognostic stratification. Achieving both objectives in an equitable manner across all population groups will depend upon updated clinical guidelines containing improved risk models and enhanced management pathways. The objective of this thesis was to investigate the potential clinical benefit of novel approaches to the diagnostic and prognostic assessment of coronary heart disease. EVALUATION OF THE 2016 NATIONAL INSTITUTE FOR HEALTH AND CARE EXCELLENCE (NICE) GUIDANCE ON THE ASSESSMENT OF SUSPECTED STABLE ANGINA. A post-hoc analysis was undertaken of the Scottish COmputed Tomography of the HEART (SCOT-HEART) trial of 4,146 participants with suspected angina randomised to assessment with computed tomography coronary angiography or standard care. Patients were dichotomised according to guideline definitions into groups representing possible angina and non-anginal presentations. The primary (diagnostic) endpoint was diagnostic certainty of angina at 6 weeks and the prognostic endpoint comprised fatal and non-fatal myocardial infarction. In 3,770 eligible participants, CTCA increased diagnostic certainty more in those with possible angina (relative risk [RR] 2.22 (95% CI 1.91-2.60), p < 0.001) than those with non-anginal symptoms (RR 1.30 (1.11-1.53), p=0.002; pinteraction < 0.001). In the possible angina cohort, CTCA did not change rates of invasive angiography (p=0.481) but markedly reduced rates of normal coronary angiography (hazard ratio [HR] 0.32 (0.19-0.52), p < 0.001). In the non-anginal cohort, rates of invasive angiography increased (HR 1.82 (1.13-2.92), p=0.014) without reducing rates of normal coronary angiography (HR 0.78 (0.30-2.05), p=0.622). At 3.2 years of follow-up, fatal or nonfatal MI was reduced in patients with possible angina (3.2% to 1.9%; HR 0.58 (0.34- 0.99), p=0.045) but not in those with non-anginal symptoms (HR 0.65 (0.25-1.69), p=0.379). Overall the updated NICE guidance on patient assessment maximises the benefits of CTCA with respect to diagnostic certainty, the use of invasive coronary angiography, and reductions in fatal and non-fatal myocardial infarction. Patients with non-anginal chest pain derive minimal benefit from CTCA, which instead increases rates of invasive investigation. EXTERNAL VALIDATION OF THE PROSPECTIVE MULTICENTER IMAGING STUDY FOR EVALUATION OF CHEST PAIN (PROMISE) TOOL FOR DETERMINING MINIMAL-RISK OF CORONARY ARTERY DISEASE. The PROspective Multicenter Imaging Study for Evaluation of chest pain (PROMISE) minimal-risk tool was recently developed to identify patients with suspected stable angina at very low risk of coronary artery disease and clinical events. The external validity of this tool was investigated within the context of the Scottish Computed Tomography of the HEART multicenter randomised controlled trial of patients with suspected stable angina due to coronary artery disease. Model discrimination and calibration was determined amongst 1,764 patients in whom complete CCTA data were available and compared with the European Society of Cardiology guideline-endorsed Coronary Artery Disease Consortium (CADC) risk score. The PROMISE minimal-risk tool improved discrimination compared with the CADC model (c-statistic 0.785 vs 0.730, p < 0.001) and was improved further following re-estimation of covariate coefficients (c-statistic 0.805, p < 0.001). Model calibration was initially poor (c2 197.6, Hosmer-Lemeshow [HL] p < 0.001), with significant overestimation of probability of minimal risk, but improved significantly following revision of the PROMISE minimal-risk intercept and covariate coefficients (c2 5.6, HL p=0.692). HIGH-SENSITIVITY CARDIAC TROPONIN I IN THE DIAGNOSIS OF STABLE CORONARY ARTERY DISEASE In a pre-specified sub-study of the Scottish COmputed Tomography of the Heart trial, plasma cardiac troponin was measured using a high-sensitivity single molecule counting assay in 943 adults with suspected stable angina who had undergone coronary computed tomography angiography. Rates of obstructive coronary artery disease were compared with the pre-test probability determined by the European Society of Cardiology Coronary Artery Disease Consortium risk model with and without cardiac troponin concentrations. External validation was undertaken in an independent study population from Denmark comprising 487 patients with suspected stable angina. Higher cardiac troponin concentrations were associated with obstructive coronary artery disease with a 5-fold increase across quintiles (9 to 48%, p < 0.001) independent of known cardiovascular risk factors (odds ratio [OR] 1.35 [95% confidence interval (CI) 1.25-1.46] per doubling of troponin). Cardiac troponin concentrations improved the discrimination of the ESC model for identifying obstructive coronary artery disease (c-statistic 0.785 to 0.800, p=0.003) and improved classification into ESCrecommended categories of clinical risk (net reclassification improvement 0.143 [95% CI, 0.093-0.193]). The revised model achieved similar improvements in discrimination and net reclassification when applied in the external validation cohort. HIGH-SENSITIVITY CARDIAC TROPONIN I IN CARDIOVASCULAR RISK STRATIFICATION OF PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE AND HEIGHTENED CARDIOVASCULAR RISK. The association between plasma high-sensitivity cardiac troponin I concentration and cardiovascular events in patients with chronic obstructive pulmonary disease and heightened cardiovascular risk was examined within the context of a double-blind randomised controlled trial of inhaled corticosteroids and bronchodilators (1 placebo arm and 3 different treatment arms). Plasma cardiac troponin I concentrations were measured with a high-sensitivity assay in a subgroup of 1,599 patients. The cardiovascular endpoint was a composite of cardiovascular death, myocardial infarction, stroke, unstable angina and transient ischaemic attack during follow-up of 1.5 years. Baseline plasma cardiac troponin I concentrations were above the lower limit of detection (1.0 ng/L) in 1,559 (97.5%) patients and were unaffected by inhaled therapies at 3 months (p > 0.05 for all). Compared with the lowest tertile (cardiac troponin I ≤3.0 ng/L), patients in the highest tertile (≥ 5.5 ng/L) were at greater risk of cardiovascular events (hazard ratio 3.0, 95% confidence interval 1.5 to 6.2, p=0.002) and cardiovascular death (hazard ratio 9.6, 95% confidence interval 2.6 to 35.6, p < 0.001) after adjustment for cardiovascular risk factors. There were no differences in COPD exacerbations between tertiles even after adjustment (p > 0.05)., REPRODUCIBILITY OF CORONARY 18F-FLUORIDE PET-CT IMAGING The inter-observer and scan-rescan reproducibility of coronary 18F-fluoride PET-CT imaging was investigated in 20 patients with clinically stable but high risk multi-vessel coronary artery disease who underwent repeated 18F-fluoride PET-CT scans 11.5±4.5 days apart. Scan analysis using the currently accepted approach of normalisation to a referent coronary segment (TBRREFERENT) identified 10 (50%) patients with evidence of focal coronary 18F-fluoride uptake and demonstrated moderate agreement across observers on a per-patient level (k = 0.56). This was similar to the level of agreement achieved with visual assessment alone (k = 0.64). Reproducibility was improved by semi-quantitative reporting combining visual assessment with a threshold uptake value for determining the presence of tracer uptake (k = 0.84). Using the optimised approach achieved excellent agreement on overall segmental uptake counts (intra-class correlation = 0.97). CONCLUSION: Cardiovascular diagnostic and prognostic assessments represent a complex endeavour and established tools for risk prediction can demonstrate suboptimal predictive accuracy when evaluated in patient cohorts that are independent of the population used for model derivation.

Published
2018

29. Association of Lipoprotein(a) With Atherosclerotic Plaque Progression

Author

Kaiser, Yannick, Daghem, Marwa, Tzolos, Evangelos, Meah, Mohammed N., Doris, Mhairi K., Moss, Alistair J., Kwiecinski, Jacek, Kroon, Jeffrey, Nurmohamed, Nick S., van der Harst, Pim, Adamson, Philip D., Williams, Michelle C., Dey, Damini, Newby, David E., Stroes, Erik S.G., Zheng, Kang H., and Dweck, Marc R.

Published
2022
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30. Implantable Hemodynamic Monitors Improve Survival in Patients With Heart Failure and Reduced Ejection Fraction

Author

Lindenfeld, JoAnn, primary, Costanzo, Maria Rosa, additional, Zile, Michael R., additional, Ducharme, Anique, additional, Troughton, Richard, additional, Maisel, Alan, additional, Mehra, Mandeep R., additional, Paul, Sara, additional, Sears, Samuel F., additional, Smart, Frank, additional, Johnson, Nessa, additional, Henderson, John, additional, Adamson, Philip B., additional, Desai, Akshay S., additional, and Abraham, William T., additional

Published
2024
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33. Haemodynamic-guided management of heart failure (GUIDE-HF): a randomised controlled trial

Author

Lindenfeld, JoAnn, Zile, Michael R, Desai, Akshay S, Bhatt, Kunjan, Ducharme, Anique, Horstmanshof, Douglas, Krim, Selim R, Maisel, Alan, Mehra, Mandeep R, Paul, Sara, Sears, Samuel F, Sauer, Andrew J, Smart, Frank, Zughaib, Marcel, Castaneda, Paige, Kelly, Jean, Johnson, Nessa, Sood, Poornima, Ginn, Greg, Henderson, John, Adamson, Philip B, and Costanzo, Maria Rosa

Published
2021
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34. Pulmonary Artery Proportional Pulse Pressure (PAPP) Index Identifies Patients With Improved Survival From the CardioMEMS Implantable Pulmonary Artery Pressure Monitor

Author

Mazimba, Sula, Ginn, Greg, Mwansa, Hunter, Laja, Olusola, Jeukeng, Christiana, Elumogo, Comfort, Patterson, Brandy, Kennedy, Jamie L.W., Mehta, Nishaki, Hossack, John A., Parker, Alex M., Mihalek, Andrew, Tallaj, Jose, Sodhi, Nishtha, Kwon, Younghoon, Pamboukian, Salpy V., Adamson, Philip B., and Bilchick, Kenneth C.

Published
2021
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37. Convalescent Growth Differentiation Factor-15 and Long-Term Outcomes after an Acute Coronary Syndrome.

Author

Greer, Charlotte E., Chew-Harris, Janice, Adamson, Philip D., Pemberton, Chris J., Pickering, John W., Pilbrow, Anna P., Frampton, Chris M., Troughton, Richard W., Doughty, Robert N., and Richardsa, A. Mark

Subjects
ACUTE coronary syndrome, MYOCARDIAL infarction, CORONARY disease, MYOCARDIAL injury, HEART failure
Abstract

Background: Growth differentiation factor-15 (GDF-15) has been shown to be associated with adverse clinical outcomes in patients after an acute coronary syndrome when measured soon after an event. Although dynamic in the acute phase after myocardial injury, GDF-15 has been shown to remain stable during convalescence. In this study, we aimed to assess the value of GDF-15 as a long-term prognostic marker for clinical outcomes when measured in the convalescent phase following an acute coronary syndrome. Methods: GDF-15 concentrations were measured in 1945 patients who were recruited between 2002 and 2009 to the Coronary Disease Cohort Study. For this analysis, follow-up was curtailed at 10 years and association of GDF-15 with all-cause death, cardiovascular death, recurrent myocardial infarction, and heart failure hospitalizations were assessed with multivariate Cox proportional hazard regression analysis. Results: After 10 years of follow-up, there were 648 deaths (348 from cardiovascular causes), 500 admissions for myocardial infarction, and 436 for heart failure. Four-month convalescent GDF-15 demonstrated a robust independent association with all endpoints, which remained after adjustment for Global Registry of Acute Coronary Events score and other convalescent biomarkers. When compared to the lowest quartile of GDF-15 concentrations, those in the highest quartile had a 3-fold increased risk of all-cause death. Conclusions: Convalescent plasma GDF-15 is a strong and independent predictor of 10-year all-cause death, cardiovascular death, recurrent myocardial infarction, and heart failure admission following an acute coronary syndrome. [ABSTRACT FROM AUTHOR]

Published
2024
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41. The Fermilab Main Injector: high intensity operation and beam loss control

Author

Brown, Bruce C., Adamson, Philip, Capista, David, Chou, Weiren, Kourbanis, Ioanis, Morris, Denton K, Seiya, Kiyomi, Wu, Guan Hong, and Yang, Ming-Jen

Subjects
Physics - Accelerator Physics
Abstract

From 2005 through 2012, the Fermilab Main Injector provided intense beams of 120 GeV protons to produce neutrino beams and antiprotons. Hardware improvements in conjunction with improved diagnostics allowed the system to reach sustained operation at ~400 kW beam power. Transmission was very high except for beam lost at or near the 8 GeV injection energy where 95% beam transmission results in about 1.5 kW of beam loss. By minimizing and localizing loss, residual radiation levels fell while beam power was doubled. Lost beam was directed to either the collimation system or to the beam abort. Critical apertures were increased while improved instrumentation allowed optimal use of available apertures. We will summarize the improvements required to achieve high intensity, the impact of various loss control tools and the status and trends in residual radiation in the Main Injector.

Published
2013
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42. Sex-Specific Thresholds of High-Sensitivity Troponin in Patients With Suspected Acute Coronary Syndrome

Author

Mills, Nicholas L., Strachan, Fiona E., Tuck, Christopher, Shah, Anoop S.V., Anand, Atul, Ferry, Amy V., Lee, Kuan Ken, Chapman, Andrew R., Sandeman, Dennis, Adamson, Philip D., Stables, Catherine L., Vallejo, Catalina A., Tsanasis, Athanasios, Marshall, Lucy, Stewart, Stacey D., Fujisawa, Takeshi, Hautvast, Mischa, McPherson, Jean, McKinlay, Lynn, Newby, David E., Fox, Keith A.A., Berry, Colin, Walker, Simon, Weir, Christopher J., Ford, Ian, Gray, Alasdair, Collinson, Paul O., Apple, Fred S., Reid, Alan, Cruikshank, Anne, Findlay, Iain, Amoils, Shannon, McAllister, David A., Maguire, Donogh, Stevens, Jennifer, Norrie, John, Weir, Christopher, Andrews, Jack P.M., Moss, Alastair, Anwar, Mohamed S., Hung, John, Malo, Jonathan, Fischbacher, Colin M., Croal, Bernard L., Leslie, Stephen J., Keerie, Catriona, Parker, Richard A., Walker, Allan, Harkess, Ronnie, Wackett, Tony, Armstrong, Roma, Flood, Marion, Stirling, Laura, MacDonald, Claire, Sadat, Imran, Finlay, Frank, Charles, Heather, Linksted, Pamela, Young, Stephen, Alexander, Bill, Duncan, Chris, Kimenai, Dorien M., Meex, Steven J.R., Cruickshank, Anne, and Tuck, Chris

Published
2019
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43. Guiding Therapy by Coronary CT Angiography Improves Outcomes in Patients With Stable Chest Pain

Author

Adamson, Philip D., Williams, Michelle C., Dweck, Marc R., Mills, Nicholas L., Boon, Nicholas A., Daghem, Marwa, Bing, Rong, Moss, Alastair J., Mangion, Kenneth, Flather, Marcus, Forbes, John, Hunter, Amanda, Norrie, John, Shah, Anoop S.V., Timmis, Adam D., van Beek, Edwin J.R., Ahmadi, Amir A., Leipsic, Jonathon, Narula, Jagat, Newby, David E., Roditi, Giles, McAllister, David A., and Berry, Colin

Published
2019
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47. Operational use of ionization profile monitors in the Fermilab Main Injector

Author

Morris, Denton K., Adamson, Philip, Capista, David, Kourbanis, Ioanis, Meyer, Thomas, Seiya, Kiyomi, Slimmer, David, Yang, Ming-Jen, and Zagel, James

Subjects
Physics - Accelerator Physics
Abstract

Ionization profile monitors (IPMs) are used in the Fermilab Main Injector (MI) to monitor injection lattice matching by measuring turn-by-turn sigmas at injection and to measure transverse emittance of the beam during the acceleration cycle. The IPMs provide a periodic, non-destructive means of performing turn-by-turn emittance measurements where other techniques are not applicable. As Fermilab is refocusing its attention on the intensity frontier, non-intercepting diagnostics such as IPMs are expected to become even more important. This paper gives an overview of the operational use of IPMs for emittance measurements and injection lattice matching measurements at Fermilab, and summarizes the future plans., Comment: 3 pp. Particle Accelerator, 24th Conference (PAC'11) 2011. 28 Mar - 1 Apr 2011. New York, USA

Published
2012

50. Temporal Changes in Coronary18F-Fluoride Plaque Uptake in Patients with Coronary Atherosclerosis

Author

Daghem, Marwa, primary, Adamson, Philip D., additional, Wang, Kang-Ling, additional, Doris, Mhairi, additional, Bing, Rong, additional, van Beek, Edwin J.R., additional, Forsyth, Laura, additional, Williams, Michelle C., additional, Tzolos, Evangelos, additional, Dey, Damini, additional, Slomka, Piotr J., additional, Dweck, Marc R., additional, Newby, David E., additional, and Moss, Alastair J., additional

Published
2023
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