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Dr RALPH AKYEA's Outputs (48)

Opportunities and challenges for identifying undiagnosed Rare Disease patients through analysis of primary care records: long QT syndrome as a test case (2024)
Journal Article
Evans, W., Akyea, R. K., Simms, A., Kai, J., & Qureshi, N. (2024). Opportunities and challenges for identifying undiagnosed Rare Disease patients through analysis of primary care records: long QT syndrome as a test case. Journal of Community Genetics, https://doi.org/10.1007/s12687-024-00742-7

Background: Patients with rare genetic diseases frequently experience significant diagnostic delays. Routinely collected data in the electronic health record (EHR) may be used to help identify patients at risk of undiagnosed conditions. Long QT syndr... Read More about Opportunities and challenges for identifying undiagnosed Rare Disease patients through analysis of primary care records: long QT syndrome as a test case.

A Scoping Review of Electronic Health Records Based Screening Algorithms for Familial Hypercholesterolemia (2024)
Journal Article
Osei, J., Razavi, A. C., Otchere, B., Bonful, G., Akoto, N., Akyea, R. K., Qureshi, N., Coronado, F., Moonesinghe, R., Kolor, K., Mensah, G. A., Sperling, L., & Khoury, M. J. (2024). A Scoping Review of Electronic Health Records Based Screening Algorithms for Familial Hypercholesterolemia. JACC: Advances, https://doi.org/10.1016/j.jacadv.2024.101297

Background
Familial hypercholesterolemia (FH) is a common genetic disorder that is strongly associated with premature cardiovascular disease. Effective diagnosis and appropriate treatment of FH can reduce cardiovascular disease risk; however, FH is... Read More about A Scoping Review of Electronic Health Records Based Screening Algorithms for Familial Hypercholesterolemia.

Risk factors for long-term cardiovascular post-acute sequelae of COVID-19 infection: A nested case-control study in Hong Kong (2024)
Journal Article
Yu, Q., Fan, M., Lin, C. J., Lui, D. T. W., Tan, K. C. B., Yiu, K. H., Akyea, R. K., Qureshi, N., Lai, F. T. T., Wan, E. Y. F., Li, X., Chan, E. W. Y., Wong, I. C. K., & Chui, C. S. L. (2024). Risk factors for long-term cardiovascular post-acute sequelae of COVID-19 infection: A nested case-control study in Hong Kong. npj Cardiovascular Health, 1(1), Article 10. https://doi.org/10.1038/s44325-024-00011-z

People with COVID-19 can experience post-acute sequelae of SARS-CoV-2 (PASC). Studies on risk factors of PASC outcomes are ongoing, especially for endocrine system-related diseases that may impact the cardiovascular system. Cardiac-related PASC is on... Read More about Risk factors for long-term cardiovascular post-acute sequelae of COVID-19 infection: A nested case-control study in Hong Kong.

Arrhythmic Mitral Valve Prolapse Phenotype: An Unsupervised Machine Learning Analysis Using a Multicenter Cardiac MRI Registry (2024)
Journal Article
Akyea, R. K., Figliozzi, S., Lopes, P. M., Bauer, K. B., Moura-Ferreira, S., Tondi, L., Mushtaq, S., Censi, S., Pavon, A. G., Bassi, I., Galian-Gay, L., Teske, A. J., Biondi, F., Filomena, D., Stylianidis, V., Torlasco, C., Muraru, D., Monney, P., Quattrocchi, G., Maestrini, V., …Masci, P.-G. (2024). Arrhythmic Mitral Valve Prolapse Phenotype: An Unsupervised Machine Learning Analysis Using a Multicenter Cardiac MRI Registry. Radiology, 6(3), Article e230247. https://doi.org/10.1148/ryct.230247

In patients with mitral valve prolapse, cardiac MRI parameters pinpointing degenerative changes of the mitral apparatus, left and right chamber remodeling, and myocardial fibrosis identified a phenotype at increased arrhythmic risk.

Purpose
To us... Read More about Arrhythmic Mitral Valve Prolapse Phenotype: An Unsupervised Machine Learning Analysis Using a Multicenter Cardiac MRI Registry.

Prevalence and distributions of severely elevated low-density lipoprotein cholesterol (LDL-c) according to age, gender and clinic location among patients in the Malaysian primary care (2024)
Journal Article
Kanchau, J. D., Akyea, R. K., Baharudin, N., Mohamed-Yassin, M., Kamal, A., Chua, Y., …Ramli, A. S. (2024). Prevalence and distributions of severely elevated low-density lipoprotein cholesterol (LDL-c) according to age, gender and clinic location among patients in the Malaysian primary care. Clinical Epidemiology and Global Health, 27, Article 101619. https://doi.org/10.1016/j.cegh.2024.101619

Background
Adults with severely elevated low-density lipoprotein cholesterol (LDL-c) may have familial hypercholesterolaemia (FH) and are at high risk of atherosclerotic cardiovascular disease (ASCVD). The prevalence of elevated LDL-c in primary car... Read More about Prevalence and distributions of severely elevated low-density lipoprotein cholesterol (LDL-c) according to age, gender and clinic location among patients in the Malaysian primary care.

Age and sex differences in LDL cholesterol distribution in adults in Malaysia: A cross-sectional study (2010 -2021) (2023)
Journal Article
Chalitsios, C. V., Akyea, R. K., Abdul-Hamid, H., Leonardi-Bee, J., Kanchau, J. D., Kamal, A., …Qureshi, N. (2023). Age and sex differences in LDL cholesterol distribution in adults in Malaysia: A cross-sectional study (2010 -2021). International Journal of General Medicine, 2023(16), 5885—5888. https://doi.org/10.2147/IJGM.S423091

Cardiovascular disease (CVD) is the leading cause of death worldwide. Hypercholesterolaemia, especially higher low-density lipoprotein cholesterol (LDL-c), has been recognised as one of the major key risk factors for CVD. Lipid lowering treatments, s... Read More about Age and sex differences in LDL cholesterol distribution in adults in Malaysia: A cross-sectional study (2010 -2021).

Alternative cascade-testing protocols for identifying and managing patients with familial hypercholesterolaemia: systematic reviews, qualitative study and cost-effectiveness analysis (2023)
Journal Article
Qureshi, N., Woods, B., Neves de Faria, R., Saramago Goncalves, P., Cox, E., Leonardi Bee, J., …Kai, J. (2023). Alternative cascade-testing protocols for identifying and managing patients with familial hypercholesterolaemia: systematic reviews, qualitative study and cost-effectiveness analysis. Health Technology Assessment, 27(16), https://doi.org/10.3310/CTMD0148

Background
Cascade testing the relatives of people with familial hypercholesterolaemia is an efficient approach to identifying familial hypercholesterolaemia. The cascade-testing protocol starts with identifying an index patient with familial hyperc... Read More about Alternative cascade-testing protocols for identifying and managing patients with familial hypercholesterolaemia: systematic reviews, qualitative study and cost-effectiveness analysis.

Obesity, metabolic health and clinical outcomes after incident cardiovascular disease: A nationwide population-based cohort study (2023)
Journal Article
Akyea, R. K., Ntaios, G., & Doehner, W. (2023). Obesity, metabolic health and clinical outcomes after incident cardiovascular disease: A nationwide population-based cohort study. Journal of Cachexia, Sarcopenia and Muscle, 14(6), 2653-2662. https://doi.org/10.1002/jcsm.13340

Background
The association between metabolic syndrome and increased cardiovascular disease (CVD) risk is well-established. However, in patients with incident CVD, the relationship between obesity, metabolic health, and subsequent CVD and mortality o... Read More about Obesity, metabolic health and clinical outcomes after incident cardiovascular disease: A nationwide population-based cohort study.

A population-based study exploring phenotypic clusters and clinical outcomes in stroke using unsupervised machine learning approach (2023)
Journal Article
Akyea, R. K., Ntaios, G., Kontopantelis, E., Georgiopoulos, G., Soria, D., Asselbergs, F. W., …Qureshi, N. (2023). A population-based study exploring phenotypic clusters and clinical outcomes in stroke using unsupervised machine learning approach. PLOS Digital Health, 2(9), Article e0000334. https://doi.org/10.1371/journal.pdig.0000334

Individuals developing stroke have varying clinical characteristics, demographic, and biochemical profiles. This heterogeneity in phenotypic characteristics can impact on cardiovascular disease (CVD) morbidity and mortality outcomes. This study uses... Read More about A population-based study exploring phenotypic clusters and clinical outcomes in stroke using unsupervised machine learning approach.

Association between pain intensity and depressive symptoms in community-dwelling adults: longitudinal findings from the Survey of Health, Ageing and Retirement in Europe (SHARE) (2023)
Journal Article
Ogliari, G., Ryg, J., Andersen-Ranberg, K., Scheel-Hincke, L. L., Collins, J. T., Cowley, A., …Masud, T. (2023). Association between pain intensity and depressive symptoms in community-dwelling adults: longitudinal findings from the Survey of Health, Ageing and Retirement in Europe (SHARE). European Geriatric Medicine, 14(5), 1111-1124. https://doi.org/10.1007/s41999-023-00835-5

Purpose
To investigate the longitudinal associations between pain and depressive symptoms in adults.

Methods
Prospective cohort study on data from 28,515 community-dwelling adults ≥ 50 years, free from depression at baseline (Wave 5), with follo... Read More about Association between pain intensity and depressive symptoms in community-dwelling adults: longitudinal findings from the Survey of Health, Ageing and Retirement in Europe (SHARE).

Frequency and impact of medication reviews for people aged 65 years or above in UK primary care: an observational study using electronic health records (2023)
Journal Article
Joseph, R. M., Knaggs, R. D., Coupland, C. A., Taylor, A., Vinogradova, Y., Butler, D., …Jack, R. H. (2023). Frequency and impact of medication reviews for people aged 65 years or above in UK primary care: an observational study using electronic health records. BMC Geriatrics, 23(1), Article 435. https://doi.org/10.1186/s12877-023-04143-2

Background Medication reviews in primary care provide an opportunity to review and discuss the safety and appropriateness of a person’s medicines. However, there is limited evidence about access to and the impact of routine medication reviews for old... Read More about Frequency and impact of medication reviews for people aged 65 years or above in UK primary care: an observational study using electronic health records.

Reducing Premature Coronary Artery Disease in Malaysia by Early Identification of Familial Hypercholesterolemia Using the Familial Hypercholesterolemia Case Ascertainment Tool (FAMCAT): Protocol for a Mixed Methods Evaluation Study (2023)
Journal Article
Ramli, A. S., Qureshi, N., Abdul-Hamid, H., Kamal, A., Kanchau, J. D., Shahuri, N. S., …Nawawi, H. (2023). Reducing Premature Coronary Artery Disease in Malaysia by Early Identification of Familial Hypercholesterolemia Using the Familial Hypercholesterolemia Case Ascertainment Tool (FAMCAT): Protocol for a Mixed Methods Evaluation Study. JMIR Research Protocols, 12, Article e47911. https://doi.org/10.2196/47911

Background: Familial hypercholesterolemia (FH) is predominantly caused by mutations in the 4 FH candidate genes (FHCGs), namely, low-density lipoprotein receptor (LDLR), apolipoprotein B-100 (APOB-100), proprotein convertase subtilisin/kexin type 9 (... Read More about Reducing Premature Coronary Artery Disease in Malaysia by Early Identification of Familial Hypercholesterolemia Using the Familial Hypercholesterolemia Case Ascertainment Tool (FAMCAT): Protocol for a Mixed Methods Evaluation Study.

How does cholesterol burden change the case for investing in familial hypercholesterolaemia? A cost-effectiveness analysis (2022)
Journal Article
Faria, R., Saramago, P., Cox, E., Weng, S., Iyen, B., Akyea, R. K., …Woods, B. (2023). How does cholesterol burden change the case for investing in familial hypercholesterolaemia? A cost-effectiveness analysis. Atherosclerosis, 367, 40-47. https://doi.org/10.1016/j.atherosclerosis.2022.12.001

Background and aims
This study aimed to ascertain how the long-term benefits and costs of diagnosis and treatment of familial hypercholesterolaemia (FH) vary by prognostic factors and ‘cholesterol burden’, which is the effect of long-term exposure t... Read More about How does cholesterol burden change the case for investing in familial hypercholesterolaemia? A cost-effectiveness analysis.

Cardiovascular outcomes and mortality after incident ischaemic stroke in patients with a recent cancer history (2022)
Journal Article
Akyea, R. K., Iyen, B., Georgiopoulos, G., Kai, J., Qureshi, N., & Ntaios, G. (2023). Cardiovascular outcomes and mortality after incident ischaemic stroke in patients with a recent cancer history. European Journal of Internal Medicine, 109, 50-57. https://doi.org/10.1016/j.ejim.2022.12.006

Background: Up to 10% of patients with ischaemic stroke have comorbid cancer and stroke in these patients is thought to have a poor short-term prognosis. There is little known about the long-term cardiovascular morbidity and mortality outcomes after... Read More about Cardiovascular outcomes and mortality after incident ischaemic stroke in patients with a recent cancer history.

Electronic health record-based facilitation of familial hypercholesterolaemia detection sensitivity of different algorithms in genetically confirmed patients (2022)
Journal Article
Mohammadnia, N., Akyea, R. K., Qureshi, N., Bax, W. A., & Cornel, J. H. (2022). Electronic health record-based facilitation of familial hypercholesterolaemia detection sensitivity of different algorithms in genetically confirmed patients. European Heart Journal – Digital Health, 3(4), 578-586. https://doi.org/10.1093/ehjdh/ztac059

Aims: Familial hypercholesterolaemia (FH) is a disorder of LDL cholesterol clearance, resulting in increased risk of cardiovascular disease. Recently, we developed a Dutch Lipid Clinic Network (DLCN) criteria-based algorithm to facilitate FH detectio... Read More about Electronic health record-based facilitation of familial hypercholesterolaemia detection sensitivity of different algorithms in genetically confirmed patients.

Understanding social care need through primary care big data: a rapid scoping review (2022)
Journal Article
Simpson, G., Kaluvu, L. M., Stokes, J., Roderick, P., Chapman, A., Akyea, R. K., …Dambha-Miller, H. (2022). Understanding social care need through primary care big data: a rapid scoping review. BJGP Open, 6(4), Article BJGPO.2022.0016. https://doi.org/10.3399/BJGPO.2022.0016

Background: A more comprehensive understanding and measurement of adult social care need could contribute to efforts to develop more effective, holistic personalised care, particularly for those with multiple long-term conditions (MLTC). Progress in... Read More about Understanding social care need through primary care big data: a rapid scoping review.

Identifying Patients with Bicuspid Aortic Valve Disease in UK Primary Care: A Case–Control Study and Prediction Model (2022)
Journal Article
Evans, W., Akyea, R. K., Weng, S., Kai, J., & Qureshi, N. (2022). Identifying Patients with Bicuspid Aortic Valve Disease in UK Primary Care: A Case–Control Study and Prediction Model. Journal of Personalized Medicine, 12(8), Article 1290. https://doi.org/10.3390/jpm12081290

Bicuspid aortic valve disease (BAV) is the most common congenital heart condition, and early detection can improve outcomes for patients. In this case–control study, patients with a diagnosis of BAV were identified from their electronic primary-care... Read More about Identifying Patients with Bicuspid Aortic Valve Disease in UK Primary Care: A Case–Control Study and Prediction Model.

Comparison of Risk of Serious Cardiovascular Events after Hemorrhagic versus Ischemic Stroke: A Population-Based Study (2022)
Journal Article
Akyea, R. K., Georgiopoulos, G., Iyen, B., Kai, J., Qureshi, N., & Ntaios, G. (2022). Comparison of Risk of Serious Cardiovascular Events after Hemorrhagic versus Ischemic Stroke: A Population-Based Study. Thrombosis and Haemostasis, 122(11), 1921-1931. https://doi.org/10.1055/a-1873-9092

Background Patients with ischemic stroke are considered a very high risk population for subsequent cardiovascular events and guidelines recommend intensive preventive strategies. However, there is no clear recommendation that patients with hemorrhagi... Read More about Comparison of Risk of Serious Cardiovascular Events after Hemorrhagic versus Ischemic Stroke: A Population-Based Study.

Development and Validation of Population Clusters for Integrating Health and Social Care: Protocol for a Mixed Methods Study in Multiple Long-Term Conditions (Cluster-Artificial Intelligence for Multiple Long-Term Conditions) (2022)
Journal Article
Dambha-Miller, H., Simpson, G., Akyea, R. K., Hounkpatin, H., Morrison, L., Gibson, J., …Farmer, A. (2022). Development and Validation of Population Clusters for Integrating Health and Social Care: Protocol for a Mixed Methods Study in Multiple Long-Term Conditions (Cluster-Artificial Intelligence for Multiple Long-Term Conditions). JMIR Research Protocols, 11(6), Article e34405. https://doi.org/10.2196/34405

Background: Multiple long-term health conditions (multimorbidity) (MLTC-M) are increasingly prevalent and associated with high rates of morbidity, mortality, and health care expenditure. Strategies to address this have primarily focused on the biolog... Read More about Development and Validation of Population Clusters for Integrating Health and Social Care: Protocol for a Mixed Methods Study in Multiple Long-Term Conditions (Cluster-Artificial Intelligence for Multiple Long-Term Conditions).

Cost-Effectiveness of Screening Algorithms for Familial Hypercholesterolaemia in Primary Care (2022)
Journal Article
Jones, M., Akyea, R. K., Payne, K., Humphries, S. E., Abdul-Hamid, H., Weng, S., & Qureshi, N. (2022). Cost-Effectiveness of Screening Algorithms for Familial Hypercholesterolaemia in Primary Care. Journal of Personalized Medicine, 12(3), Article 330. https://doi.org/10.3390/jpm12030330

Although familial hypercholesterolemia (FH) screening within primary care is considered cost-effective, which screening approach is cost-effective has not been established. This study determines the cost-effectiveness of six case-finding strategies f... Read More about Cost-Effectiveness of Screening Algorithms for Familial Hypercholesterolaemia in Primary Care.

Behaviours of Patients Who Take Their Strong Opioids as Unmeasured ‘Sips’ (2022)
Journal Article
Perkins, P., Parkinson, A., Hebdon, R., & Akyea, R. K. (2022). Behaviours of Patients Who Take Their Strong Opioids as Unmeasured ‘Sips’. Journal of Pain and Symptom Management, 63(6), e691-697. https://doi.org/10.1016/j.jpainsymman.2022.01.018

Context: Some patients take their strong opioid painkillers as unmeasured sips. Objectives: To investigate how and why patients take their medication in this way. Methods: Patient receiving specialist palliative care who take their strong opioid pain... Read More about Behaviours of Patients Who Take Their Strong Opioids as Unmeasured ‘Sips’.

Ethnic disparities in mortality among overweight or obese adults with newly diagnosed type 2 diabetes: a population-based cohort study (2022)
Journal Article
Iyen, B., Vinogradova, Y., Akyea, R. K., Weng, S., Qureshi, N., & Kai, J. (2022). Ethnic disparities in mortality among overweight or obese adults with newly diagnosed type 2 diabetes: a population-based cohort study. Journal of Endocrinological Investigation, 45(5), 1011-1020. https://doi.org/10.1007/s40618-021-01736-9

Purpose: Ethnic variation in risk of type 2 diabetes is well established, but its impact on mortality is less well understood. This study investigated the risk of all-cause and cardiovascular mortality associated with newly diagnosed type 2 diabetes... Read More about Ethnic disparities in mortality among overweight or obese adults with newly diagnosed type 2 diabetes: a population-based cohort study.

Understanding the barriers and enablers of pharmacogenomic testing in primary care: a qualitative systematic review with meta-aggregation synthesis (2021)
Journal Article
Qureshi, S., Latif, A., Condon, L., Akyea, R. K., Kai, J., & Qureshi, N. (2022). Understanding the barriers and enablers of pharmacogenomic testing in primary care: a qualitative systematic review with meta-aggregation synthesis. Pharmacogenomics, 23(2), 135-154. https://doi.org/10.2217/pgs-2021-0131

Introduction: Pharmacogenomic testing can indicate which drugs may have limited therapeutic action or lead to adverse effects, hence guiding rational and safe prescribing. However, in the UK and other countries, there are still significant barriers t... Read More about Understanding the barriers and enablers of pharmacogenomic testing in primary care: a qualitative systematic review with meta-aggregation synthesis.

Determining propensity for sub-optimal low-density lipoprotein cholesterol response to statins and future risk of cardiovascular disease (2021)
Journal Article
Weng, S. F., Akyea, R. K., Man, K. K., Lau, W. C. Y., Iyen, B., Blais, J. E., …Kai, J. (2021). Determining propensity for sub-optimal low-density lipoprotein cholesterol response to statins and future risk of cardiovascular disease. PLoS ONE, 16(12), Article e0260839. https://doi.org/10.1371/journal.pone.0260839

Background: Variability in low-density lipoprotein cholesterol (LDL-C) response to statins is underappreciated. We characterised patients by their statin response (SR), baseline risk of cardiovascular disease (CVD) and 10-year CVD outcomes.

Method... Read More about Determining propensity for sub-optimal low-density lipoprotein cholesterol response to statins and future risk of cardiovascular disease.

Statin treatment and LDL-cholesterol treatment goal attainment among individuals with familial hypercholesterolaemia in primary care (2021)
Journal Article
Iyen, B., Akyea, R. K., Weng, S., Kai, J., & Qureshi, N. (2021). Statin treatment and LDL-cholesterol treatment goal attainment among individuals with familial hypercholesterolaemia in primary care. Open Heart, 8(2), Article e001817. https://doi.org/10.1136/openhrt-2021-001817

Objectives: Guidance recommends statin treatment in Familial Hypercholesterolaemia (FH) achieve at least a 50% reduction in low-density lipoprotein cholesterol (LDL-C). We assessed statin prescribing rates and LDL-cholesterol treatment goal attainmen... Read More about Statin treatment and LDL-cholesterol treatment goal attainment among individuals with familial hypercholesterolaemia in primary care.

Comparing the performance of the novel FAMCAT algorithms and established case-finding criteria for familial hypercholesterolaemia in primary care (2021)
Journal Article
Qureshi, N., Akyea, R. K., Dutton, B., Leonardi-Bee, J., Humphries, S. E., Weng, S., & Kai, J. (2021). Comparing the performance of the novel FAMCAT algorithms and established case-finding criteria for familial hypercholesterolaemia in primary care. Open Heart, 8(2), Article e001752. https://doi.org/10.1136/openhrt-2021-001752

Objective Familial hypercholesterolaemia (FH) is a common inherited disorder causing premature coronary heart disease (CHD) and death. We have developed the novel Familial Hypercholesterolaemia Case Ascertainment Tool (FAMCAT 1) case-finding algorith... Read More about Comparing the performance of the novel FAMCAT algorithms and established case-finding criteria for familial hypercholesterolaemia in primary care.

Obesity and long-term outcomes after incident stroke: a prospective population-based cohort study (2021)
Journal Article
Akyea, R. K., Doehner, W., Iyen, B., Weng, S. F., Qureshi, N., & Ntaios, G. (2021). Obesity and long-term outcomes after incident stroke: a prospective population-based cohort study. Journal of Cachexia, Sarcopenia and Muscle, 12(6), 2111-2121. https://doi.org/10.1002/jcsm.12818

Background: The association between obesity, major adverse cardiovascular events (MACE), and mortality in patients with incident stroke is not well established. We assessed the relationship between body mass index (BMI) and MACE in patients with inci... Read More about Obesity and long-term outcomes after incident stroke: a prospective population-based cohort study.

Case-finding and genetic testing for familial hypercholesterolaemia in primary care (2021)
Journal Article
Qureshi, N., Akyea, R. K., Dutton, B., Leonardi-Bee, J., Humphries, S. E., Weng, S., & Kai, J. (2021). Case-finding and genetic testing for familial hypercholesterolaemia in primary care. Heart, 107(24), 1956-1961. https://doi.org/10.1136/heartjnl-2021-319742

Objective: Familial Hypercholesterolaemia (FH) is a common inherited disorder causing premature heart disease and death. We have developed novel case-finding algorithms (FAMCAT version 1 & 2) for application in primary care, to improve detection of... Read More about Case-finding and genetic testing for familial hypercholesterolaemia in primary care.

Sex disparity in subsequent outcomes in survivors of coronary heart disease (2021)
Journal Article
Akyea, R. K., Kontopantelis, E., Kai, J., Weng, S. F., Patel, R. S., Asselbergs, F. W., & Qureshi, N. (2022). Sex disparity in subsequent outcomes in survivors of coronary heart disease. Heart, 108(1), 37-45. https://doi.org/10.1136/heartjnl-2021-319566

Objective: Evidence on sex differences in outcomes after developing coronary heart disease (CHD) has focused on recurrent CHD, all-cause mortality or revascularisation. We assessed sex disparities in subsequent major adverse cardiovascular events (M... Read More about Sex disparity in subsequent outcomes in survivors of coronary heart disease.

Long-term body mass index changes in overweight and obese adults and the risk of heart failure, cardiovascular disease and mortality: a cohort study of over 260,000 adults in the UK (2021)
Journal Article
Iyen, B., Weng, S., Vinogradova, Y., Akyea, R. K., Qureshi, N., & Kai, J. (2021). Long-term body mass index changes in overweight and obese adults and the risk of heart failure, cardiovascular disease and mortality: a cohort study of over 260,000 adults in the UK. BMC Public Health, 21, Article 576. https://doi.org/10.1186/s12889-021-10606-1

Background: Although obesity is a well-recognised risk factor for cardiovascular disease (CVD), the impact of long-term body mass index (BMI) changes in overweight or obese adults, on the risk of heart failure, CVD and mortality has not been quantifi... Read More about Long-term body mass index changes in overweight and obese adults and the risk of heart failure, cardiovascular disease and mortality: a cohort study of over 260,000 adults in the UK.

Sex, Age, and Socioeconomic Differences in Nonfatal Stroke Incidence and Subsequent Major Adverse Outcomes (2021)
Journal Article
Akyea, R. K., Vinogradova, Y., Qureshi, N., Patel, R. S., Kontopantelis, E., Ntaios, G., …Weng, S. F. (2021). Sex, Age, and Socioeconomic Differences in Nonfatal Stroke Incidence and Subsequent Major Adverse Outcomes. Stroke, 52(2), 396-405. https://doi.org/10.1161/strokeaha.120.031659

Background and Purpose:
Data about variations in stroke incidence and subsequent major adverse outcomes are essential to inform secondary prevention and prioritizing resources to those at the greatest risk of major adverse end points. We aimed to de... Read More about Sex, Age, and Socioeconomic Differences in Nonfatal Stroke Incidence and Subsequent Major Adverse Outcomes.

Lipid levels and major adverse cardiovascular events in patients initiated on statins for primary prevention: an international population-based cohort study protocol (2020)
Journal Article
Blais, J. E., Akyea, R. K., Coetzee, A., Chan, A. H., Lau, W. C., Man, K. K., …Weng, S. (2021). Lipid levels and major adverse cardiovascular events in patients initiated on statins for primary prevention: an international population-based cohort study protocol. BJGP Open, 5(1), 1-9. https://doi.org/10.3399/bjgpopen20X101127

Background: Clinical guidelines recommend specific targets for low-density lipoprotein cholesterol (LDL-C) and non-high-density lipoprotein cholesterol (non-HDL-C) for primary prevention of cardiovascular disease (CVD). Furthermore, individual variab... Read More about Lipid levels and major adverse cardiovascular events in patients initiated on statins for primary prevention: an international population-based cohort study protocol.

Evaluating a clinical tool (FAMCAT) for identifying familial hypercholesterolaemia in primary care: a retrospective cohort study (2020)
Journal Article
Akyea, R. K., Qureshi, N., Kai, J., de Lusignan, S., Sherlock, J., McGee, C., & Weng, S. (2020). Evaluating a clinical tool (FAMCAT) for identifying familial hypercholesterolaemia in primary care: a retrospective cohort study. BJGP Open, 4(5), 1-10. https://doi.org/10.3399/bjgpopen20X101114

Background: Familial hypercholesterolaemia (FH) is an inherited lipid disorder causing premature heart disease, which is severely underdiagnosed. Improving the identification of people with FH in primary care settings would help to reduce avoidable h... Read More about Evaluating a clinical tool (FAMCAT) for identifying familial hypercholesterolaemia in primary care: a retrospective cohort study.

Performance and clinical utility of supervised machine-learning approaches in detecting familial hypercholesterolaemia in primary care (2020)
Journal Article
Akyea, R. K., Qureshi, N., Kai, J., & Weng, S. F. (2020). Performance and clinical utility of supervised machine-learning approaches in detecting familial hypercholesterolaemia in primary care. npj Digital Medicine, 3(1), Article 142. https://doi.org/10.1038/s41746-020-00349-5

Familial hypercholesterolaemia (FH) is a common inherited disorder, causing lifelong elevated low-density lipoprotein cholesterol (LDL-C). Most individuals with FH remain undiagnosed, precluding opportunities to prevent premature heart disease and de... Read More about Performance and clinical utility of supervised machine-learning approaches in detecting familial hypercholesterolaemia in primary care.

Does acupressure help reduce nausea and vomiting in palliative care patients? A double blind randomised controlled trial (2020)
Journal Article
Perkins, P., Parkinson, A., Parker, R., Blaken, A., & Akyea, R. K. (2020). Does acupressure help reduce nausea and vomiting in palliative care patients? A double blind randomised controlled trial. BMJ Supportive and Palliative Care, 12, 58-63. https://doi.org/10.1136/bmjspcare-2020-002434

Introduction: Nausea and vomiting are common symptoms for patients with advanced cancer. While there is evidence for acupuncture point stimulation for treatment of these symptoms for patients having anticancer treatment, there is little for when they... Read More about Does acupressure help reduce nausea and vomiting in palliative care patients? A double blind randomised controlled trial.

Data‐driven machine‐learning analysis of potential embolic sources in embolic stroke of undetermined source (2020)
Journal Article
Ntaios, G., Weng, S. F., Perlepe, K., Akyea, R., Condon, L., Lambrou, D., …Michel, P. (2021). Data‐driven machine‐learning analysis of potential embolic sources in embolic stroke of undetermined source. European Journal of Neurology, 28(1), 192-201. https://doi.org/10.1111/ene.14524

Background: Hierarchical clustering, a common “unsupervised” machine‐learning algorithm, is advantageous for exploring potential underlying aetiology in particularly heterogeneous diseases. We investigated potential embolic sources in ESUS using a da... Read More about Data‐driven machine‐learning analysis of potential embolic sources in embolic stroke of undetermined source.

Predicting major adverse cardiovascular events for secondary prevention: protocol for a systematic review and meta-analysis of risk prediction models (2020)
Journal Article
Akyea, R. K., Leonardi-Bee, J., Asselbergs, F. W., Patel, R. S., Durrington, P., Wierzbicki, A. S., …Weng, S. F. (2020). Predicting major adverse cardiovascular events for secondary prevention: protocol for a systematic review and meta-analysis of risk prediction models. BMJ Open, 10(7), Article e034564. https://doi.org/10.1136/bmjopen-2019-034564

Introduction: Cardiovascular disease (CVD) is the leading cause of morbidity and mortality globally. With advances in early diagnosis and treatment of CVD and increasing life expectancy, more people are surviving initial CVD events. However, models t... Read More about Predicting major adverse cardiovascular events for secondary prevention: protocol for a systematic review and meta-analysis of risk prediction models.

Nasal fentanyl alone plus buccal midazolam: an open-label, randomised, controlled feasibility study in the dying (2020)
Journal Article
Perkins, P., Parkinson, A., Akyea, R. K., & Husbands, E. (2020). Nasal fentanyl alone plus buccal midazolam: an open-label, randomised, controlled feasibility study in the dying. BMJ Supportive and Palliative Care, 10(3), 300-303. https://doi.org/10.1136/bmjspcare-2019-002029

Introduction: Many patients want to stay at home to die. They invariably become unable to take oral medication during their terminal phase. Symptoms are usually controlled by subcutaneous medications. There have been no studies on nasal fentanyl (NF)... Read More about Nasal fentanyl alone plus buccal midazolam: an open-label, randomised, controlled feasibility study in the dying.

Risk of cardiovascular disease outcomes in primary care subjects with familial hypercholesterolaemia: A cohort study (2019)
Journal Article
Iyen, B., Qureshi, N., Leonardi-Bee, J., Kai, J., Akyea, R. K., Roderick, P., …Weng, S. (2019). Risk of cardiovascular disease outcomes in primary care subjects with familial hypercholesterolaemia: A cohort study. Atherosclerosis, 287, 8-15. https://doi.org/10.1016/j.atherosclerosis.2019.05.017

Background and aims: Familial hypercholesterolaemia (FH) is a known major cause of premature heart disease. However, the risks of atherosclerotic disease in other vascular regions are less known. We determined the risk of major cardiovascular disease... Read More about Risk of cardiovascular disease outcomes in primary care subjects with familial hypercholesterolaemia: A cohort study.

Detection of familial hypercholesterolaemia: external validation of the FAMCAT clinical case-finding algorithm to identify patients in primary care (2019)
Journal Article
Weng, S., Kai, J., Akyea, R., & Qureshi, N. (2019). Detection of familial hypercholesterolaemia: external validation of the FAMCAT clinical case-finding algorithm to identify patients in primary care. Lancet Public Health, 4(5), e256-e264. https://doi.org/10.1016/S2468-2667%2819%2930061-1

Background: The vast majority of individuals with familial hypercholesterolaemia (FH) in the general population remain unidentified worldwide. Recognising patients most at risk of having the condition, to enable targeted specialist assessment and tre... Read More about Detection of familial hypercholesterolaemia: external validation of the FAMCAT clinical case-finding algorithm to identify patients in primary care.

Sub-optimal cholesterol response to initiation of statins and future risk of cardiovascular disease (2019)
Journal Article
Akyea, R., Kai, J., Qureshi, N., Iyen, B., & Weng, S. (2019). Sub-optimal cholesterol response to initiation of statins and future risk of cardiovascular disease. Heart, 105(13), 975-981. https://doi.org/10.1136/heartjnl-2018-314253

Objective:
To assess low-density lipoprotein cholesterol (LDL-C) response in patients after initiation of statins, and future risk of CVD.

Method:
Prospective cohort study of 165,411 primary care patients, from the UK Clinical Practice Research... Read More about Sub-optimal cholesterol response to initiation of statins and future risk of cardiovascular disease.

A systematic review showing the lack of diagnostic criteria and tools developed for lower limb cellulitis (2019)
Journal Article
Patel, M., Lee, S. I., Akyea, R. K., Grindlay, D., Francis, N., Levell, N. J., …Thomas, K. (2019). A systematic review showing the lack of diagnostic criteria and tools developed for lower limb cellulitis. British Journal of Dermatology, 181(6), 1156-1165. https://doi.org/10.1111/bjd.17857

Background: Cellulitis can be a difficult diagnosis to make. 31% of patients admitted from the emergency department with suspected lower limb cellulitis are misdiagnoses, with incorrect treatment potentially resulting in avoidable hospital admission... Read More about A systematic review showing the lack of diagnostic criteria and tools developed for lower limb cellulitis.

Hip fracture outcomes in patients with COPD (2018)
Journal Article
Buss, L., McKeever, T. M., Nightingale, J., Akyea, R., Ollivere, B., Moppett, I., & Bolton, C. E. (2018). Hip fracture outcomes in patients with COPD. British Journal of Anaesthesia, 121(6), 1377-1379. https://doi.org/10.1016/j.bja.2018.09.008+hideArticle+Info

Hip fractures are common in patients with COPD and contemporary outcome data is needed. Patients admitted with a hip fracture to one acute trust (2010-2015) were assessed prospectively (UK National Hip Fracture Database audit) and mortality data col... Read More about Hip fracture outcomes in patients with COPD.

The changing clinical pattern of endemic Burkitt lymphoma in Western Africa: Experience from a tertiary center in Ghana (2018)
Journal Article
Offor, U. T., Akyea, R. K., Neequaye, J. E., Renner, L. A., & Segbefia, C. I. (2018). The changing clinical pattern of endemic Burkitt lymphoma in Western Africa: Experience from a tertiary center in Ghana. Pediatric Blood and Cancer, 65(10), Article e27275. https://doi.org/10.1002/pbc.27275

Abstract Background Burkitt lymphoma (BL) is the most common childhood cancer in Ghana, where the endemic variant is the predominant subtype and historically presents as a highly chemo-sensitive jaw tumor. This study aimed to update the current epide... Read More about The changing clinical pattern of endemic Burkitt lymphoma in Western Africa: Experience from a tertiary center in Ghana.