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  1. Article ; Online: Editorial: More than one way to skin a clot? Differing techniques for solving the problem of clinically significant pulmonary embolism.

    Sharp, Andrew S P / Piazza, Gregory

    Cardiovascular revascularization medicine : including molecular interventions

    2023  Volume 60, Page(s) 53–54

    MeSH term(s) Humans ; Pulmonary Embolism/diagnostic imaging ; Pulmonary Embolism/therapy ; Thrombosis
    Language English
    Publishing date 2023-12-05
    Publishing country United States
    Document type Editorial
    ZDB-ID 2212113-4
    ISSN 1878-0938 ; 1553-8389
    ISSN (online) 1878-0938
    ISSN 1553-8389
    DOI 10.1016/j.carrev.2023.11.023
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 5562: Show issues Location:
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  2. Article ; Online: Learning the lessons (again) of the challenges of conducting sham-controlled device trials in hypertension.

    Sharp, Andrew S P / Kirtane, Ajay J

    EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology

    2023  Volume 19, Issue 7, Page(s) 541–543

    MeSH term(s) Humans ; Hypertension ; Learning ; Controlled Clinical Trials as Topic
    Language English
    Publishing date 2023-09-18
    Publishing country France
    Document type Journal Article
    ZDB-ID 2457174-X
    ISSN 1969-6213 ; 1774-024X
    ISSN (online) 1969-6213
    ISSN 1774-024X
    DOI 10.4244/EIJ-E-23-00036
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 6680: Show issues Location:
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    Zs.MO 571: Show issues

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  3. Article ; Online: Microbubble Enhanced Ultrasound-Assisted Catheter-Directed Thrombolysis for VTE-A Sound Idea?

    Sharp, Andrew S P

    Thrombosis and haemostasis

    2019  Volume 119, Issue 7, Page(s) 1036

    MeSH term(s) Catheterization ; Catheters ; Fibrin Fibrinogen Degradation Products/analysis ; Humans ; Microbubbles ; Risk ; Thrombolytic Therapy/methods ; Ultrasonography/methods ; Venous Thrombosis/therapy
    Chemical Substances Fibrin Fibrinogen Degradation Products ; fibrin fragment D
    Language English
    Publishing date 2019-06-24
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 518294-3
    ISSN 2567-689X ; 0340-6245
    ISSN (online) 2567-689X
    ISSN 0340-6245
    DOI 10.1055/s-0039-1692644
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Uh III Zs.192: Show issues Location:
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    Zs.MO 433: Show issues

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  4. Article ; Online: The Bigger the Highway, the Less Likely the Traffic Jam.

    Ali, Ziad A / Sharp, Andrew S P

    Circulation. Cardiovascular interventions

    2022  Volume 15, Issue 9, Page(s) e012368

    Language English
    Publishing date 2022-09-20
    Publishing country United States
    Document type Editorial ; Comment
    ZDB-ID 2450797-0
    ISSN 1941-7632 ; 1941-7640
    ISSN (online) 1941-7632
    ISSN 1941-7640
    DOI 10.1161/CIRCINTERVENTIONS.122.012368
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 6746: Show issues Location:
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  5. Article ; Online: Renal sympathetic denervation for treatment of hypertension: where are we now in 2019?

    Dasgupta, Indranil / Sharp, Andrew S P

    Current opinion in nephrology and hypertension

    2019  Volume 28, Issue 5, Page(s) 498–506

    Abstract: Purpose of review: Although sound physiological principles and surgical precedent underpin renal denervation as a therapy for treatment resistant hypertension, and early clinical studies had produced encouraging results, the first sham-controlled study ( ...

    Abstract Purpose of review: Although sound physiological principles and surgical precedent underpin renal denervation as a therapy for treatment resistant hypertension, and early clinical studies had produced encouraging results, the first sham-controlled study (SYMPLICITY HTN-3) failed to achieve its primary efficacy endpoint. Lessons learnt from this trial, and the knowledge derived from further animal and autopsy work, have been applied in three recently published sham-controlled trials.
    Recent findings: These trials - SPYRAL OFF-MED, RADIANCE SOLO and SPYRAL ON-MED - using newer technologies, demonstrate a 5-10 mmHg incremental reduction in ambulatory SBP from RDN against sham-control, in patients with mild-to-moderate hypertension taking 0-3 drugs.
    Summary: These results provide proof of principle of the blood pressure-lowering effect of renal denervation. We now require data on long-term safety and durability of the procedure. Research is needed to identify predictive markers of response as about one-third of individuals do not respond to renal denervation. Hard-outcome data would be welcome but might be difficult to acquire. Individuals with treatment resistance are obvious treatment candidates, but RDN may also potentially benefit those with medication nonadherence and/or intolerance and those unwilling to take pills.
    MeSH term(s) Clinical Trials as Topic ; Humans ; Hypertension/physiopathology ; Hypertension/surgery ; Kidney/innervation ; Sympathectomy/methods
    Language English
    Publishing date 2019-07-03
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 1151092-4
    ISSN 1473-6543 ; 1535-3842 ; 1062-4813 ; 1062-4821
    ISSN (online) 1473-6543 ; 1535-3842
    ISSN 1062-4813 ; 1062-4821
    DOI 10.1097/MNH.0000000000000532
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 3686: Show issues Location:
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  6. Article ; Online: Cost-effectiveness of catheter-based radiofrequency renal denervation for the treatment of uncontrolled hypertension: an analysis for the UK based on recent clinical evidence.

    Sharp, Andrew S P / Cao, Khoa N / Esler, Murray D / Kandzari, David E / Lobo, Melvin D / Schmieder, Roland E / Pietzsch, Jan B

    European heart journal. Quality of care & clinical outcomes

    2024  

    Abstract: Aims: Catheter-based radiofrequency renal denervation (RF RDN) has recently been approved for clinical use in the European Society of Hypertension guidelines and by the US FDA. This study evaluated the lifetime cost-effectiveness of RF RDN using ... ...

    Abstract Aims: Catheter-based radiofrequency renal denervation (RF RDN) has recently been approved for clinical use in the European Society of Hypertension guidelines and by the US FDA. This study evaluated the lifetime cost-effectiveness of RF RDN using contemporary evidence.
    Methods and results: A decision-analytic model based on multivariate risk equations projected clinical events, quality-adjusted life years (QALYs) and costs. The model consisted of seven health states: hypertension alone, myocardial infarction (MI), other symptomatic coronary artery disease, stroke, heart failure (HF), end-stage renal disease, and death. Risk reduction associated with changes in office systolic blood pressure (oSBP) was estimated based on a published meta-regression of hypertension trials. The base case effect size of -4.9 mmHg oSBP (observed vs. sham control) was taken from the SPYRAL HTN-ON MED trial of 337 patients. Costs were based on NHS England data. The incremental cost-effectiveness ratio (ICER) was evaluated against the NICE cost-effectiveness threshold of £20 000-30 000 per QALY gained. Extensive scenario and sensitivity analyses were conducted, including the ON-MED subgroup on three medications and pooled effect sizes. RF RDN resulted in a relative risk reduction in clinical events over 10 years (0.80 for stroke, 0.88 for MI, 0.72 for HF), with an increase in health benefit over a patient's lifetime, adding 0.35 QALYs at a cost of £4 763, giving an ICER of £13 482 per QALY gained. Findings were robust across tested scenarios.
    Conclusion: Catheter-based radiofrequency RDN can be a cost-effective strategy for uncontrolled hypertension in the UK, with an ICER substantially below the NICE cost-effectiveness threshold. Funding: Medtronic Inc.
    Language English
    Publishing date 2024-01-09
    Publishing country England
    Document type Journal Article
    ZDB-ID 2823451-0
    ISSN 2058-1742 ; 2058-5225
    ISSN (online) 2058-1742
    ISSN 2058-5225
    DOI 10.1093/ehjqcco/qcae001
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article: Future perspectives in catheter-based treatment of pulmonary embolism.

    Sharp, Andrew S P / Attallah, Antonious

    European heart journal supplements : journal of the European Society of Cardiology

    2019  Volume 21, Issue Suppl I, Page(s) I31–I37

    Abstract: Pulmonary embolism is the third commonest cause of cardiovascular death globally. The majority of such patients present with low-risk features and can be managed with simple anticoagulation; however, a large group of patients exhibit evidence of right ... ...

    Abstract Pulmonary embolism is the third commonest cause of cardiovascular death globally. The majority of such patients present with low-risk features and can be managed with simple anticoagulation; however, a large group of patients exhibit evidence of right ventricular dysfunction on echocardiography or CT at the time of presentation and these patients are at risk of early haemodynamic compromise, particularly in those with abnormal cardiac biomarkers. Catheter-directed thrombolysis has been proposed as a treatment-strategy for patients with pulmonary embolism with evidence of acute right ventricular dysfunction. We review the current technologies in mainstream use, the evidence base in support of their use and discuss future research requirements in this area.
    Language English
    Publishing date 2019-11-21
    Publishing country England
    Document type Journal Article
    ZDB-ID 1463769-8
    ISSN 1554-2815 ; 1520-765X
    ISSN (online) 1554-2815
    ISSN 1520-765X
    DOI 10.1093/eurheartj/suz226
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    Zs.A 1563 -Suppl.-: Show issues Location:
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    Jg. 1995 - 2021: Lesesall (1.OG)
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  8. Article ; Online: Renal denervation for uncontrolled hypertension: a systematic review and meta-analysis examining multiple subgroups.

    Sharp, Andrew S P / Sanderson, Alice / Hansell, Neil / Reddish, Katie / Miller, Paul / Moss, Joe / Schmieder, Roland E / McCool, Rachael

    Journal of hypertension

    2024  

    Abstract: This systematic review and meta-analysis was conducted to assess the randomized controlled trial (RCT) evidence available for renal denervation (RDN) in uncontrolled arterial hypertension. Twenty-five RCTs met the eligibility criteria for the systematic ... ...

    Abstract This systematic review and meta-analysis was conducted to assess the randomized controlled trial (RCT) evidence available for renal denervation (RDN) in uncontrolled arterial hypertension. Twenty-five RCTs met the eligibility criteria for the systematic review, and 16 RCTs were included in the meta-analysis. The results of the random effects meta-analysis estimated a mean difference of -8.5 mmHg [95% confidence interval (CI) -13.5 to -3.6] for office SBP, -3.6 mmHg (95% CI -5.2 to -2.0) for 24 h SBP and -3.9 mmHg (95% CI -5.6 to -2.2) for ambulatory daytime SBP in favour of RDN compared with control (medication and/or sham-only) at primary follow-up. Similarly favourable results were observed across a range of prespecified subgroup analyses, including treatment-resistant hypertension. This meta-analysis suggests that the use of RDN in uncontrolled hypertension leads to consistent reductions in blood pressure. Reductions appear to be statistically consistent in the presence or absence of medications and in populations resistant to the use of three medications.
    Language English
    Publishing date 2024-04-15
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 605532-1
    ISSN 1473-5598 ; 0263-6352 ; 0952-1178
    ISSN (online) 1473-5598
    ISSN 0263-6352 ; 0952-1178
    DOI 10.1097/HJH.0000000000003727
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.MO 614: Show issues

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  9. Article: Microbubble Enhanced Ultrasound-Assisted Catheter-Directed Thrombolysis for VTE—A Sound Idea?

    Sharp, Andrew S. P.

    Thrombosis and Haemostasis

    2019  Volume 119, Issue 07, Page(s) 1036–1036

    Language English
    Publishing date 2019-06-24
    Publisher Georg Thieme Verlag KG
    Publishing place Stuttgart ; New York
    Document type Article
    ZDB-ID 518294-3
    ISSN 2567-689X ; 0340-6245
    ISSN (online) 2567-689X
    ISSN 0340-6245
    DOI 10.1055/s-0039-1692644
    Database Thieme publisher's database

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  10. Article ; Online: Cost-effectiveness of intravascular ultrasound-guided percutaneous intervention in patients with acute coronary syndromes: A UK perspective.

    Sharp, Andrew S P / Kinnaird, Tim / Curzen, Nick / Ayyub, Ruba / Alfonso, Jorge Emilio / Mamas, Mamas A / Bavière, Henri Vanden

    European heart journal. Quality of care & clinical outcomes

    2023  

    Abstract: Background: Use of intravascular ultrasound (IVUS) during percutaneous coronary intervention (PCI) is associated with improved clinical outcomes over angiography alone. Despite this, the adoption of IVUS in clinical practice remains low.: Aims: To ... ...

    Abstract Background: Use of intravascular ultrasound (IVUS) during percutaneous coronary intervention (PCI) is associated with improved clinical outcomes over angiography alone. Despite this, the adoption of IVUS in clinical practice remains low.
    Aims: To examine the cost-effectiveness of IVUS-guided PCI compared to angiography alone in patients with acute coronary syndromes (ACS).
    Methods: A one-year decision tree and lifetime Markov model were constructed to compare the cost-effectiveness of IVUS-guided PCI to angiography alone for two hypothetical adult populations consisting of 1,000 individuals: ST-elevation myocardial infarction (STEMI) and unstable angina/ non-ST-elevation myocardial infarction (UA/NSTEMI) patients undergoing drug-eluting stent (DES) implantation. The UK healthcare system perspective was applied using 2019/20 costs. All-cause death, myocardial infarction (MI), repeat PCI, lifetime costs, life expectancy and quality-adjusted life-years (QALYs) were assessed.
    Results: Over a lifetime horizon, IVUS-guided PCI was cost-effective compared to angiography alone in both populations, yielding an incremental cost-effectiveness ratio of £3,649 and £5,706 per-patient in STEMI and UA/NSTEMI patients, respectively. In the one-year time horizon, the model suggested that IVUS was associated with reductions in mortality, MI and repeat PCI by 51%, 33% and 52% in STEMI and by 50%, 29% and 57% in UA/NSTEMI patients, respectively. Sensitivity analyses demonstrated the robustness of the model with IVUS being 100% cost-effective at a willingness-to-pay (WTP) threshold of £20,000 per QALY-gained.
    Conclusions: From a UK healthcare perspective, an IVUS-guided PCI strategy was highly cost-effective over angiography alone amongst ACS patients undergoing DES implantation due to the medium- and long-term reduction in repeat PCI, death, and MI.
    Language English
    Publishing date 2023-12-18
    Publishing country England
    Document type Journal Article
    ZDB-ID 2823451-0
    ISSN 2058-1742 ; 2058-5225
    ISSN (online) 2058-1742
    ISSN 2058-5225
    DOI 10.1093/ehjqcco/qcad073
    Database MEDical Literature Analysis and Retrieval System OnLINE

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