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Downloadable Application and Is Available at Umassmed.Org/Grace This work is protected by copyright and other intellectual property rights and duplication or sale of all or part is not permitted, except that material may be duplicated by you for research, private study, criticism/review or educational purposes. Electronic or print copies are for your own personal, non- commercial use and shall not be passed to any other individual. No quotation may be published without proper acknowledgement. For any other use, or to quote extensively from the work, permission must be obtained from the copyright holder/s. Use of invasive strategies in the management of non- ST elevation acute myocardial infarction and clinical outcomes A thesis submitted to the Keele University for the degree of Doctor of Philosophy in the Research Institute for Primary Care and Health Sciences October 2019 Next Senate date: 16/10/2019 Dr Muhammad Rashid Keele University 1 Acknowledgements This PhD thesis would not have been possible without the help and support of colleagues, friends and family, whom I would like to acknowledge here. Firstly, to my lead supervisor Professor Mamas A. Mamas. From the day, I met Prof Mamas to outline my plans for dedicated research and to pursue my interest in academic cardiology, I could not have wished for more supportive, knowledgeable and approachable PhD supervisor. Your guidance has been extremely influential for both the completion of the PhD and in developing my skills as an academic cardiologist. My appreciation also extends to my co-supervisors Professor Evangelos Kontopantelis and Dr Joie Ensor. Thank you for your supervision, guidance, and time over the past three years and I look forward to many future collaborations with you all. Secondly, to my wife: Zamurrad Rashid, my three beautiful daughters, my brother and my sister in law Mr & Mrs Muhammad Shahid, who all mean the world to me. I can proudly say that your love and support is second to none as always. You unquestionably have been a rock stone of my success as being a doctor and helped me immensely in being able to complete this PhD. I am so grateful to you for being part of my life, for being there through good and bad times and for helping me get over the line throughout my career. Thirdly, I thank all the students/researchers/staff within the Primary Care Sciences, Keele University, who I have had the pleasure of working alongside. I must mention Dr Ahmad Shoaib, Nafiu Ismail and M. O. Mohamed who have supported and contributed immensely to my academic success. 2 Similarly, I’d like to acknowledge the National Institute for Cardiovascular Outcomes Research and The Agency for Healthcare Quality and Research and all the other parties participated in collecting the data analysed in this thesis. Finally, I would like to dedicate this thesis to my parents Mr and Mrs Ashraf, who continue to inspire and pray for me. Many thanks to you all, Muhammad Rashid 3 Publications Publications arising directly from this PhD thesis are as follow 1. Rashid M, Lawson C, Potts J, Kontopantelis E, Kwok CS, Bertrand OF, Shoaib A, Ludman P, Kinnaird T, de Belder M, Nolan J, Mamas MA. Incidence, Determinants, and Outcomes of Left and Right Radial Access Use in Patients Undergoing Percutaneous Coronary Intervention in the United Kingdom: A National Perspective Using the BCIS Dataset. JACC Cardiovasc Interv. 2018 Jun 11;11 2. Rashid M, Fischman DL, Gulati M, Tamman K, Potts J, Kwok CS, Ensor J, Shoaib A, Mansour H, Zaman A, Savage MP, Mamas MA. Temporal trends and inequalities in coronary angiography utilization in the management of non-ST- Elevation acute coronary syndromes in the U.S. Sci Rep. 2019 Jan 18;9(1):240 3. Rashid M, Fischman DL, Martinez SC, Capers Q 4th, Savage M, Zaman A, Curzen N, Ensor J, Potts J, Mohamed MO, Kwok CS, Kinnaird T, Bagur R, Mamas M. Temporal trends and predictors of time to coronary angiography following non-ST-elevation acute coronary syndrome in the USA. Coron Artery Dis. 2019 May;30(3):159-170 4. Rashid M, Kontopantelis E, Kinnaird T, Curzen N, Gale CP, Mohamed MO, Potts J, Myint PK, Kwok CS, Nolan J, Zaman MJ, Timmis AD, Mamas MA. association between Hospital Cardiac Catheter Laboratory Status, Utilization of an Invasive Coronary Strategy and In-hospital Outcomes for the Management of Non-ST Elevation Acute Myocardial Infarction in the United Kingdom (In submission) 4 5. Rashid M, Kontopantelis E, Kinnaird T, Curzen N, Gale CP, Mohamed MO, Potts J, Myint PK, Kwok CS, Shoaib A, Timmis AD, Mamas MA. Baseline Risk and Timing of Invasive Strategy for 137,265 Patients Presenting with Non-ST elevation Acute Myocardial Infarction: Level of Compliance with International Guidelines (in submission) Other publications In addition to above publications, there are several other publications which I have led or contributed during the course of my PhD as follows. 1. Rashid M, Sperrin M, Ludman PF, O'Neill D, Nicholas O, de Belder MA, Mamas MA, Impact of operator volume for percutaneous coronary intervention on clinical outcomes: what do the numbers say? Eur Heart J Qual Care Clin Outcomes. 2016 Jan 1;2(1):16-22. 2. Rashid M, Kwok CS, Pancholy S, Chugh S, Kedev SA, Bernat I, Ratib K, Large A, Fraser D, Nolan J, Mamas MA, Radial Artery Occlusion After Transradial Interventions: A Systematic Review and Meta-Analysis. J Am Heart Assoc. 2016 Jan 25;5(1) 3. Rashid M, Kwok CS, Gale CP, Doherty P, Olier I, Sperrin M, Kontopantelis E, Peat G, Mamas MA, Impact of co-morbid burden on mortality in patients with coronary heart disease, heart failure, and cerebrovascular accident: a systematic review and meta-analysis. Eur Heart J Qual Care Clin Outcomes. 2017 Jan 1;3(1):20-36 4. Rashid M, Rushton CA, Kwok CS, Kinnaird T, Kontopantelis E, Olier I, Ludman P, De Belder MA, Nolan J, Mamas MA, Impact of Access Site Practice on Clinical Outcomes in Patients Undergoing Percutaneous Coronary Intervention Following Thrombolysis for ST-Segment Elevation Myocardial Infarction in the United Kingdom: An Insight From the British Cardiovascular 5 Intervention Society Dataset, JACC Cardiovasc Interv. 2017 Nov 27;10(22):2258-2265. 5. Rashid M, Ludman PF, Mamas MA. British Cardiovascular Intervention Society registry framework: a quality improvement initiative on behalf of the National Institute of Cardiovascular Outcomes Research (NICOR). Eur Heart J Qual Care Clin Outcomes. 2019 May 3. pii: qcz02 6. Noman A, Balasubramaniam K, Alhous MHA, Lee K, JesudasoP, Rashid M, Mamas MA, Zaman AG, Mortality after percutaneous coronary revascularization: Prior cardiovascular risk factor control and improved outcomes in patients with diabetes mellitus. Catheter Cardiovasc Interv. 2017 Jun 1;89(7):1195-1204. 7. Kwok CS, Bagur R, Rashid M, Lavi R, Cibelli M, de Belder MA, Moat N, Hildick-Smith D, Ludman P, Mamas MA, Aortic stenosis and non-cardiac surgery: A systematic review and meta-analysis, Int J Cardiol. 2017 Aug 1;240:145-153. 8. Ul Haq MA, Rashid M, Kwok CS, Wong CW, Nolan J, Mamas MA. Hand dysfunction after transradial artery catheterization for coronary procedures. World J Cardiol. 2017 Jul 26;9(7):609-619 9. Olier I, Sirker A, Hildick-Smith DJR, Kinnaird T, Ludman P, de Belder MA, Baumbach A, Byrne J, Rashid M, Curzen N, Mamas MA; Association of different antiplatelet therapies with mortality after primary percutaneous coronary intervention, Heart. 2018 Feb 2. pii: heartjnl-2017-312366 10. Kwok CS, Kontopantelis E, Kinnaird T, Potts J, Rashid M, Shoaib A, Nolan J, Bagur R, de Belder MA, Ludman P, Mamas MA, Retroperitoneal Hemorrhage After Percutaneous Coronary Intervention: Incidence, Determinants, and Outcomes as Recorded by the British Cardiovascular Intervention Society, Circ Cardiovasc Interv. 2018 Feb;11(2). 11. Kwok CS, Potts J, Gulati M, Alasnag M, Rashid M, Shoaib A, Ul Haq MA, Bagur R, Mamas MA, Effect of Gender on Unplanned Readmissions After Percutaneous Coronary Intervention (from the Nationwide Readmissions Database), Am J Cardiol. 2018 Apr 1;121(7):810-817. 12. Kwok CS, Rao SV, Potts JE, Kontopantelis E, Rashid M, Kinnaird T, Curzen N, Nolan J, Bagur R, Mamas MA, Burden of 30-Day Readmissions After Percutaneous Coronary Intervention in 833,344 Patients in the United States: 6 Predictors, Causes, and Cost: Insights From the Nationwide Readmission Database, JACC Cardiovasc Interv. 2018 Apr 9;11(7):665-674 13. Jackson M, Austin D, Kwok CS, Rashid M, Kontopantelis E, Ludman P, de Belder M, Mamas MA, Zaman A. The impact of diabetes on the prognostic value of left ventricular function following percutaneous coronary intervention: Insights from the British Cardiovascular Intervention Society. Catheter Cardiovasc Interv. 2018 Nov 15;92(6) 14. Kwok CS, Rao SV, Gilchrist I, Martinez SC, Al Ayoubi F, Potts J, Rashid M, Kontopantelis E, Myint PK, Mamas MA. Relation Between Age and Unplanned Readmissions After Percutaneous Coronary Intervention (Findings from the Nationwide Readmission Database). Am J Cardiol. 2018 Jul 15;122(2):220-228 15. Muhammad Ayyaz Ul Haq, Sheraz A. Nazir, Muhammad Rashid, Chun Shing Kwok, Syed Mubashiruddin, Zaheer Alisiddiq, Ahmed Shoaib, Karim Ratib, Mamas A. Mamas, James Nolan, Accelerated Patent Haemostasis Using a Procoagulant Disk; A Protocol Designed to Minimise the Risk of Radial Artery Occlusion Following Cardiac Catheterisation,CRM (Inpress) 16. Kwok CS, Bell M, Anderson HV, Al Shaibi K, Gulati R, Potts J, Rashid M, Kontopantelis E, Bagur R, Mamas MA, Discharge Against Medical Advice After Percutaneous Coronary Intervention in the United States. JACC Cardiovasc Interv. 2018 Jul 23;11(14) 17. Potts J, Kwok CS, Ensor J, Rashid M, Kadam U, Kinnaird T, Curzen N, Pancholy SB, Van der Windt D, Riley RD, Bagur R, Mamas MA.
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