Publications

AHRE was an independent factor associated with increased risk of clinical outcomes. The addition of AHRE to the clinical risk scores significantly improved discrimination for thromboembolism or death.

Atrial fibrillation (AF) and diabetes mellitus (DM) are common worldwide and their incidence is increasing, representing a significant public health and economic burden as well as an increase in individual increased morbidity and mortality risk profiles. Both conditions are closely related, as patients with DM are at increased risk of incident AF, and AF patients with DM are at higher risk of cardiovascular events compared to non-AF patients. Areas covered: This review article aims to provide an overview of the current evidence linking DM and AF, as well as the impact of obesity, weight loss and stroke on these coexisting conditions. Second, the effects of new oral anti hyperglycaemic medications on cardiovascular risk will be considered. Expert opinion: In conclusion, coexisting AF and DM represent a high risk population of patients requiring aggressive risk factor identification and treatment optimisation. The multifactorial interplay between these conditions requires individual assessment of patient risk profiles with the aim of minimising the impact of each modifiable risk factor.

Atrial fibrillation (AF) is known to be characterised by increased RR interval variability.However, the characteristics of RR intervals in AF detected through screening have not been extensively studied.The aim of this study was to characterise RR intervals in AF detected in screening of older, community dwelling adults.RR interval characteristics were extracted from 2,709 ECGs from the SAFER AF Screening Programme, consisting of 671 ECGs exhibiting AF, and 2,038 non-AF ECGs.The characteristics included measures of the mean RR interval, the variability in RR intervals, and the proportion of successive RR intervals differing by at least 50ms (pNN50).All characteristics differed significantly between AF and non-AF ECGs.pNN50 provided the highest performance for discriminating between AF and non-AF, with an AUROC of 96%.In AF the majority of successive RR intervals differed by more than 50ms, although there was large variation in the level of RR interval variability between AF ECGs.This study contributes to furthering our understanding of RR interval characteristics in AF.In the future this could form the basis of an algorithm to automatically identify ECGs exhibiting AF with potential applications in AF screening.

Relative wall thickness was independently associated with ischaemic stroke/SE among Japanese patients with non-valvular AF, suggesting the importance of left ventricular morphology in contributing to adverse outcomes, particularly thromboembolism.

In a large contemporary cohort of Asian patients with AF, adherence to ABC pathway was associated with a reduction of the risk for adverse outcomes. (Clinical Survey on the Stroke Prevention in Atrial Fibrillation in Asia (AF-Registry; NCT04807049).

guidelines-FINAL.pdf.

This feasibility study will inform a larger future definitive trial.

<b>Introduction:</b> Long-term azithromycin (AZM) reduces inflammation and acute exacerbations of COPD (AECOPD), key predictors of cardiovascular events. We were therefore interested to understand whether AZM modulates cardiovascular risk in AECOPD. Aims and Objective: Investigate cardiovascular outcomes following AECOPD in AZM users and non-users. <b>Methods:</b> We conducted a retrospective cohort study within the global TriNetX Platform. Major adverse cardiovascular events (MACE: acute coronary, stroke, arrythmia or heart failure) were recorded up to 30 days post-AECOPD and compared between AZM users (at least 3 months use and using at index) and non-users. Cardiac risk factor propensity-matched logistic regression analyses compared MACE between groups. <b>Results:</b> We identified 13,564 AZM users and 341,448 non-users. MACE was reduced in AZM users at day 30 (Hazard Ratio [95% CI] 0.90 [0.86 to 0.94], p&lt;0.001). Reduced all-cause mortality (HR 0.71 [0.59 to 0.85], p&lt;0.001), myocardial infarction (HR 0.85 [0.76 to 0.96], p=0.006), and heart failure (HR 0.91 [0.87 to 0.97], p=0.002) were the major drivers of improved outcomes. No increased risk of arrythmia and no difference in ischaemic stroke were observed. Sub-group analyses generally showed greatest effects in the first week compared to weeks 2-4. <b>Conclusion:</b> We found long-term macrolide use was associated with reduced cardiovascular risk up to 30 days after an AECOPD and effects were most pronounced in the first week, previously shown to the period of highest cardiovascular risk. More work is needed to understand the role of AZM in cardiovascular disease risk modulation in people with chronic lung disease.