Monday, 10 August 2015

Introducing ISTM's Recently Appointed Professor of Cardiology, Mamas Mamas

My name is Professor Mamas Mamas and I was recently appointed as a Professor in Cardiology at Keele University’s Institute for Science and Technology in Medicine (ISTM). I am also based at the Royal Stoke University Hospital working as an honorary consultant cardiologist. 

ISTM's recently appointed Professor of Cardiology, Mamas Mamas
Coronary heart disease is the common most cause of cardiovascular disease in the world and accounts for 74,000 deaths in the UK each year. Inflammatory processes within the coronary artery wall lead to the development of atherosclerosis, resulting in narrowing of the coronary artery resulting in an insufficient blood supply to the heart. Occasionally, a blood clot may also develop within the inflamed wall of the coronary artery obstructing the vessel and resulting in a “heart attack” in which the heart muscle is irreversibly damaged.

I am an interventional cardiologist whose role is to treat such patients with coronary artery disease both in the elective outpatient and the emergency heart attack setting through the deployment of metal tubes called stents into the narrowed / blocked coronary arteries thereby restoring blood flow in the diseased vessel. This procedure is called percutaneous coronary intervention or PCI.

My research interest focuses around the complications that occur during such PCI procedures, in particular major bleeding complications. Major bleeding can occur in upto 10% of all PCI procedures and our work has shown that major bleeding is independently associated with a 3-fold increase in mortality and major adverse cardiovascular events. My research group has shown that it might not only be the bleeding event itself that is associated with poor outcomes, but also how we treat the bleed, such as the use of judicious blood transfusions.

Using the British Cardiovascular Interventional Society dataset, that records data from every PCI procedure undertaken in the UK from 2006 onwards with over ½ million patient records, my research group’s work focuses on identifying the types of patients that are at high risk from sustaining such bleeding complications, how the prognostic impact of such bleeding events vary according to the site of the bleeding and the characteristics of the patient that it occurs in, as well as how we can undertake PCI procedures more safely to minimise such bleeding events. Using this dataset, my group has shown that changing the site through which we do these PCI procedures can reduce major bleeding by 60% and that this is associated with a 30% reduction in mortality, that we estimate has contributed to 400 lives saved in the UK in the past 6 years. Over the next couple of years, my research group aims to develop risk stratification tools that can accurately predict the risk of developing major bleeding complications in patients undergoing PCI, so that interventional cardiologists such as myself can tailor our interventional and pharmacological approaches to the individual patient depending on their calculated bleeding risk.

Whilst we have studied bleeding events that occur in the hospital setting post PCI, less is known about what happens to patients post discharge into primary care, how common bleeding events are in this setting, their prognostic impact and how such bleeding events are managed by general practitioners. My research group aims to use routinely collected GP data to provide further insight into major bleeding in the primary care setting, to identify patients at risk from such bleeding events and develop evidence based guidance to GPs that will enable patients who sustain such bleeding events to be treated safely, without exposing them to excess risks of developing blood clots.

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