Jaydeep Sarma | The University of Manchester (original) (raw)

Papers by Jaydeep Sarma

Canadian Journal of Cardiology, 2013

Heart, 2016

Mortality of tobacco abuse patients was compared by logistic regression. P values of <0.05 were t... more Mortality of tobacco abuse patients was compared by logistic regression. P values of <0.05 were taken as statistically significant. Results 28379 patients had comorbid tobacco abuse during the study period. Mean age of tobacco abusers was 44.9 years, 51.2% were male and 1918 (6.8%) tobacco abuse patients died. The majority were Caucasian (84.8%) with lower proportions of South Asian (4.7%), Afro-Caribbean (1.9%), Oriental (0.2%), mixed (1.0%), other (2.5%) and unknown (4.8%) ethnicities. Crude mortality was highest amongst Caucasian patients (7.3%) compared to South Asian (2.2%), Afro-Caribbean (2.7%), Oriental (1.7%), mixed (0.3%), other (3.1%) and patients with unknown ethnicities (6.1%). Of all these ethnic groups, logistic regression accounting for age and sex showed that only South Asian ethnic origin affected mortality rates amongst patients with comorbid tobacco abuse. South Asian patients were 1.90 times more likely to die (95% CI 1.21-2.97). Conclusion Our results demonstrate that mortality of tobacco abusers varies according to ethnicity with higher mortality amongst South Asian patients in particular. This could represent differences in smoking rates or an increased susceptibility to smoking. This is particularly important given that smoking and South Asian ethnicity are both known risk factors for developing cardiovascular disease.

cumulative secondary outcomes were MI (10 vs 6,p=0.373), TVR (5 vs 1,p=0.117), HF hospitalization... more cumulative secondary outcomes were MI (10 vs 6,p=0.373), TVR (5 vs 1,p=0.117), HF hospitalization (0 vs 2,p=0.136). Conclusion Angio-guided PCI to the left main stem in our retrospective study with prospective follow-up was associated with equivalent outcomes to IVUS-directed left main PCI. A quarter of patients in both groups (27% v 25%; p=0.3) were dead at 3 years reflective of a relatively poor medium-term prognosis associated with the left main disease despite the high procedural success and low peri-procedural complications. Our data though limited by relatively small numbers suggests that routine use of IVUS is not necessary for left main stem PCI.

the identification of MACE with no loss of sensitivity and excellent negative predictive value. (... more the identification of MACE with no loss of sensitivity and excellent negative predictive value. (100% sens, 86% spec, 100% NPV). Conclusion The CENTAUR hs-TnI assay and HEART score with modifications would facilitate the early discharge of patients with chest pain from ED within 4 hours without missing any MACE at 30 days. Conflict of Interest This is part of the finding of my thesis for MSc which will need to be completed in September 2019.

Technical and experimental issues and study limitations 6.4.1 Use of in vitro models in atheroscl... more Technical and experimental issues and study limitations 6.4.1 Use of in vitro models in atherosclerosis research 6.4.2 Normal distribution of cell molecules across populations 6.4.3 Cell culture: suspension vs. adherent culture 6.4.4

infarction: a randomised controlled trial patients with a previous myocardial fibrinolysis and pl... more infarction: a randomised controlled trial patients with a previous myocardial fibrinolysis and platelet activation in endothelial function, endogenous-3 fatty acid supplementation on ω Effect of http://bmjopen.bmj.com/content/3/9/e003054.full.html Updated information and services can be found at:

Circulation, Nov 20, 2012

Case Reports, Jul 15, 2011

A man presented with an exacerbation of heart failure following coronary artery bypass grafting. ... more A man presented with an exacerbation of heart failure following coronary artery bypass grafting. He was found to be severely hypocalcaemic secondary to a combination of decreased parathyroid reserve and severe vitamin D defi ciency. On treatment of his hypocalcaemia, all symptoms resolved. This case highlights the importance of recognising that metabolic derangement can affect cardiac function. Become a Fellow of BMJ Case Reports today and you can: Submit as many cases as you like ▶ Enjoy fast sympathetic peer review and rapid publication of accepted articles ▶ Access all the published articles ▶ Re-use any of the published material for personal use and teaching without further permission ▶

$Research paper thumbnail of Coronary–Subclavian Steal Syndrome: An usual cause of refractory unstable angina$

International Journal of Cardiology, Jul 1, 2008

A 73 year old woman, with previous history of coronary artery bypass grafting, was admitted for r... more A 73 year old woman, with previous history of coronary artery bypass grafting, was admitted for refractory unstable angina. The angiography revealed a significant stenosis of the ostium of the left subclavian artery. The patient underwent successful stenting of the subclavian artery and remained symptom free until hospital discharge a few days later.

International Journal of Cardiology, Jun 1, 2016

European Heart Journal, Aug 1, 2018

Background: Ventricular fibrillation (VF) during reperfusion in ST-elevation myocardial infarctio... more Background: Ventricular fibrillation (VF) during reperfusion in ST-elevation myocardial infarction (STEMI) is an infrequent event, however it contributes to increased in-hospital mortality. Dispersion of ventricular repolarization is known to contribute to ventricular vulnerability during acute ischemia. Prolongation of Tpeak-Tend interval was proposed as a ventricular repolarization dispersion marker, however its value for prediction of reperfusion VF has not been studied. We aimed to assess whether Tpeak-Tend early in the course of STEMI is associated with reperfusion VF. Methods: Consecutive STEMI patients admitted to a tertiary care hospital for primary PCI during 2007-2012 (n=3274) were retrospectively assessed for the presence of VF during reperfusion. Pre-PCI ECGs recorded in 40 patients who developed reperfusion VF (rVF group; age 67±12 years, 67% male) were compared with pre-PCI ECGs from 402 consecutive patients admitted for primary PCI during 2007 and not suffered from reperfusion arrhythmias (No-rVF; age 66±13 years; 80% male) group. ECGs were exported from digital archive and automatically processed in order to calculate Tpeak-Tend interval on a per-lead basis. The global Tpeak-Tend was calculated between the earliest Tpeak and the latest Tend in any lead. Tpeak-Tend interval was tested for association with reperfusion VF using logistic regression analysis adjusted for significant clinical covariates. Results: The leftward shift of Tpeak towards QRS onset in ischemic leads resulted in Tpeak-Tend prolongation. Global Tpeak-Tend in rVF group was higher than in No-rVF group (142±24 vs 129±28 ms; p=0.005). The optimal cutoff for global Tpeak-Tend for VF prediction was 131 ms (Sp=73%; Se= 58%). Global Tpeak-Tend >130 ms predicted reperfusion VF (OR=3.60; 95% CI 1.76-7.40; p=0.001) and remained a significant predictor of reperfusion VF after adjustment for age, gender, smoking, myocardial infarction localization and QRS duration (OR=4.23; 95% CI 1.89-9.43; p<0.001). Conclusion: Tpeak-Tend interval before PCI in STEMI was an independent predictor of reperfusion VF in a single-center study. Our findings warrants further research aimed at prospective validation of Tpeak-Tend as a marker of periprocedural arrhythmic risk.

Blackwell Publishing Ltd eBooks, May 5, 2009

Heart, Jun 1, 2016

adverse events during the follow up period. Average patient travel time and distance for follow u... more adverse events during the follow up period. Average patient travel time and distance for follow up was reduced. Hospital transport was not required for any patient. The feedback from patients was positive and based around ease of travel, length of travel and stay, and flexibility to attend. Conclusions and Implications This pilot study demonstrates the feasibility and benefits of remote pacemaker monitoring from a community location. This model could be replicated in the future by other Trusts.

Catheterization and Cardiovascular Interventions, 2001

The aim of this study was to assess the quality of angiograms obtained using 4 Fr catheters compa... more The aim of this study was to assess the quality of angiograms obtained using 4 Fr catheters compared with 6 Fr catheters, the ease of use of the 4 Fr catheters, and the safety of patient mobilization 1 hr following 4 Fr angiography. Details of catheter performance and procedural details were recorded at the time of the angiogram. The angiographic images were scored on the quality and completeness of vessel opacification throughout systole and diastole. A total of 410 patients were recruited. There was no difference between 4 and 6 Fr for procedural variables. All angiograms were considered to be of diagnostic quality. The angiographic scores for the right coronary artery and left ventricular injections were no different between 4 and 6 Fr. However, the angiographic scores for the left anterior descending and circumflex arteries were lower with 4 than with 6 Fr (both P < 0.05). Patients who had 4 Fr angiography mobilized safely at 1 hr and reported significantly less discomfort and bruising than 6 Fr patients. Good-quality diagnostic coronary angiograms can be achieved using 4 Fr catheters with the advantage of earlier postprocedural mobilization and reduced discomfort and bruising for the patient.

Circulation-cardiovascular Imaging, Sep 1, 2011

C ardiac allograft vasculopathy (CAV) is common, with a prevalence of 52% at 10 years after trans... more C ardiac allograft vasculopathy (CAV) is common, with a prevalence of 52% at 10 years after transplantation, and represents a leading cause of death beyond the first year, responsible for approximately 15% of deaths annually. 1 It is characterized by diffuse and concentric intimal proliferation, typically involving the intramural as well as epicardial coronary arteries. Its diagnosis is difficult to establish clinically because of denervation of the transplanted heart. Consequently, it presents late with silent myocardial infarction, progressive heart failure, or arrhythmic sudden death. 2 Screening is therefore required for its early detection. Although coronary intravascular ultrasound (IVUS) is considered the gold-standard technique for detecting the anatomic features of CAV (Table 1), its broad clinical use in this context is limited by cost and lack of widespread expertise, and its evaluation is limited to epicardial vessels. 3 Coronary angiography, performed annually or biannually, remains the most common clinical screening method. 4 However, because of the diffuse nature of CAV with a lack of normal reference segments and the relatively late occurring luminal narrowing, the sensitivity of angiography is as low as 30% when compared with IVUS (Figure 1). 5 As a result, complications frequently occur before disease is evident angiographically. 6 Furthermore, angiography is associated with significant albeit uncommon complications (overall complication rate, 7.4/1000 procedures, including rates of 0.65/1000, 1.6/1000, and 0.72/1000 for cerebrovascular accidents, vascular complications, and death, respectively), is disliked by transplant recipients, is costly, and repeated studies are associated with an important cumulative radiation dose. 7 Noninvasive screening would conceivably be safer, more tolerable and cheaper and as such is highly desirable. Echocardiography and single-photon emission computed tomography (SPECT) are the most extensively investigated, but neither has become widely accepted as an alternative to invasive screening. Preliminary data regarding positron emission tomography (PET), cardiovascular magnetic resonance (CMR), and coronary computed tomographic angiography

This case highlights the use of the MitraClip to treat a patient with severe functional mitral re... more This case highlights the use of the MitraClip to treat a patient with severe functional mitral regurgitation. Of note, TEE imaging, especially 3-D imaging, showed that the maximal mitral regurgitation jet was from a restricted P2 scallop with a slight medial bias. This allowed targeted placement of the MitraClip with dramatic results.