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Dr. Andrew Maree
Consultant Cardiologist, Clinical Medicine
Consultant Cardiologist, School Office - Medicine

Publications and Further Research Outputs

Peer-Reviewed Publications

A Bajrangee, S Mahabir, W Khalifa, A O Maree, B McAdam, QT Prolongation in Non-Telemetered Hospitalized Elderly Patients, Journal of Electrocardiology , 55, 2019, p91 - 96 Journal Article, 2019

Pericardiocentesis in, editor(s)Eric Eeckhout, Patrick W. Serruys, William Wijns, Alec Vahanian, Marc Van Sambeek, Rodney De Palma , The PCR - EAPCI Textbook Percutaneous Interventional Cardiovascular Medicine, PCR on line, PCR Publishing, 2019, [Richard Armstrong, John D. Groarke, Igor F. Palacios, Andrew O. Maree] Book Chapter, 2019

C T O'Connor, S O'Rourke, A Buckley, R Murphy, P Crean, B Foley, A Maree, R Ryan, M Tolan, V Young, B O'Connell, C Daly, Infective Endocarditis: A Retrospective Cohort Study, QJM An International Journal of Medicine, 112, (9), 2019, p663 - 667 Journal Article, 2019

Wheen P, Armstrong R, Maree A, O'Connor S, Late Ventricular Standstill Following an Elective TAVI, British Medical Journal Case Reports, 10, (1136), 2019, p1136- Journal Article, 2019

Bajrangee A, Coughlan JJ, Teehan S, O'Connor C, Murphy RT, Foley B, Daly C, Burke D, Maree AO, Crean PA., Early and mid-term outcomes after transcatheter aortic valve implantation (TAVI) in Ireland., International journal of cardiology. Heart & vasculature, 16, 2017, p1-3 Journal Article, 2017 DOI

Bajrangee A, Ryan N, Vangjeli C, Brennan M, Cox D, Shields DC, Fitzgerald D, Maree A., Impact of genetic variation in the 5-HT transporter and receptor on platelet function in patients with stable CAD taking aspirin., Thrombosis research, 146, 2016, p51-55 Journal Article, 2016 DOI

Maree AO, Margey RJ, Selzer F, Bajrangee A, Jneid H, Marroquin OC, Mulukutla SR, Laskey WK, Jacobs AK., Renal insufficiency, bleeding and prescription of discharge medication in patients undergoing percutaneous coronary intervention in the National Heart, Lung, and Blood Institute (NHLBI) Dynamic Registry., Cardiovascular revascularization medicine : including molecular interventions, 17, (5), 2016, p302-307 Journal Article, 2016 DOI

A Bajrangee, S Mahabir, L Arkins, A Lopez, M Brennan, D Cox, AO Maree, Galectin-3 as a Novel Biomarker of Unstable Coronary Plaque, Circulation, American Heart Association Annual Scientific Session, New Orleans, Louisiana, USA, Nov 12 -16 2016, 134, (1), 2016 Poster, 2016

Reed GW, Kumar A, Guo J, Aranki S, Shekar P, Agnihotri A, Maree AO, McLean DS, Rosenfield K, Cannon CP., Point-of-care platelet function testing predicts bleeding in patients exposed to clopidogrel undergoing coronary artery bypass grafting: Verify pre-op TIMI 45--a pilot study., Clinical cardiology, 38, (2), 2015, p92-98 Journal Article, 2015 DOI

Ryan N, Bajrangee A, Vangjeli C, Brennan M, Crean P, Kenny RA, Cox D, Shields DC, Fitzgerald DJ, Maree AO. , Impact of Genetic variation in the 5-HT transporter and receptor on platelet function in patients with stable CAD taking aspirin. , European Heart Journal, European Society of Cardiology Annual Scientific Session. Eur Heart J (2014), Barcelona, Spain, 30/08/14 - 03/09/14, (35 ), 2014, pp1167- Poster, 2014

Cruz-Gonzalez I, Perez-Rivera A, Lopez-Jimenez R, Rodriguez-Collado J, Martín-Moreiras J, Cascon M, Arribas A, Gomez JC, Maree AO, Martin-Luengo C., Significance of the learning curve in left atrial appendage occlusion with two different devices., Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions, 83, (4), 2014, p642-646 Journal Article, 2014 DOI

, An unexpected case of ventricular fibrillation cardiac arrest in a Caucasian female., BMJ case reports, 2014 Journal Article, 2014

Groarke J, O'Brien J, Go G, Susanto M, Owens P, Maree AO., Cost burden of non-specific chest pain admissions., Ir J Med Sci, 182, (1), 2013, p57-61 Journal Article, 2013 DOI

, Pericardial Tamponade, Critical Care Medicine: Diagnosis and Management in the Adult, 2013 Journal Article, 2013

Cruz-Gonzalez I, Semigram MJ, Inglessis-Azuaje I, Sanchez-Ledesma M, Martin-Moreiras J, Jneid H, Rengifo-Moreno P, Cubeddu RJ, Maree AO, Sanchez PL, Sanchez PL, Palacios IF., Effect of elevated pulmonary vascular resistance on outcomes after percutaneous mitral valvuloplasty., The American journal of cardiology, 112, (4), 2013, p580-584 Journal Article, 2013 DOI

, Pericardiocentesis, Percutaneous Interventional Cardiovascular Medicine: The PCR-EAPCI Textbook , 2012 Journal Article, 2012

Cruz-Gonzalez I, Jneid H, Sanchez-Ledesma M, Cubeddu RJ, Martin-Moreiras J, Rengifo-Moreno P, Diaz TA, Kiernan TJ, Inglessis-Azuaje I, Maree AO, Sanchez PL, Sanchez PL, Palacios IF., Difference in outcome among women and men after percutaneous mitral valvuloplasty., Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions, 77, (1), 2011, p115-120 Journal Article, 2011 DOI

, Percutaneous Balloon Pericardiotomy for Patients with Pericardial Effusion and Tamponade, 1001 Questions: An Interventional Cardiology Board Review, 2011 Journal Article, 2011

Joglar F, Kabutey NK, Maree A, Farber A., The role of stent grafts in the management of traumatic tibial artery pseudoaneurysms: case report and review of the literature., Vascular and endovascular surgery, 44, (5), 2010, p407-409 Journal Article, 2010 DOI

Maree AO, Vangjeli C, Jneid H, Ryan J, Cox D, Cannon CP, Shields DC, Fitzgerald DJ., G-protein beta3 subunit polymorphism and bleeding in the orbofiban in patients with unstable coronary syndromes-thrombolysis in myocardial infarction 16 trial., Journal of thrombosis and haemostasis : JTH, 8, (5), 2010, p934-941 Journal Article, 2010 DOI

Cruz-Gonzalez I, Cubeddu RJ, Sanchez-Ledesma M, Cury RC, Coggins M, Maree AO, Palacios IF., Left atrial appendage exclusion using an Amplatzer device., International journal of cardiology, 134, (1), 2009, pe1-3 Journal Article, 2009 DOI

Patel, P.M., Eisenberg, J., Islam, M.A., Maree, A.O., Rosenfield, K.A., Percutaneous revascularization of persistent renal artery in-stent restenosis, Vascular Medicine, 14, (3), 2009, p259-264 Journal Article, 2009

Rodriguez, A.E., Maree, A., Tarragona, S., Fernandez-Pereira, C., Santaera, O., Rodriguez Granillo, A.M., Rodriguez-Granillo, G.A., Russo-Felssen, M., Kukreja, N., Antoniucci, D., Palacios, I.F., Serruys, P.W., Percutaneous coronary intervention with oral sirolimus and bare metal stents has comparable safety and efficacy totreatment with drug eluting stents, but with significant cost saving: Long-term follow-up results from the randomised, controlled ORAR III (Oral Rapamycin in ARgentina) study, EuroIntervention, 5, (2), 2009, p255-264 Journal Article, 2009

Maree, A.O., Fitzgerald, G.A., A roadmap for the twilight zone: Navigating United States cardiovascular career development for international trainees, Circulation, 120, (15), 2009, p1542-1549 Journal Article, 2009

O'Halloran AM, Patterson CC, Horan P, Maree A, Curtin R, Stanton A, McKeown PP, Shields DC., Genetic polymorphisms in platelet-related proteins and coronary artery disease: investigation of candidate genes, including N-acetylgalactosaminyltransferase 4 (GALNT4) and sulphotransferase 1A1/2 (SULT1A1/2)., Journal of Thrombosis and Thrombolysis, 27, (2), 2009, p175 - 184 Journal Article, 2009 URL DOI

Islam, M.A., Rosenfield, K., Maree, A.O., Patel, P.M., Jaff, M.R., Percutaneous revascularization of occluded renal arteries in the setting of acute renal failure, Vascular Medicine, 14, (4), 2009, p365-369 Journal Article, 2009

, Non-coronary sinus of Valsalva aneurysm rupture., BMJ case reports, 2009 Journal Article, 2009

Jneid H, Cruz-Gonzalez I, Sanchez-Ledesma M, Maree AO, Cubeddu RJ, Leon ML, Rengifo-Moreno P, Otero JP, Inglessis I, Sanchez PL, Sanchez PL, Palacios IF., Impact of pre- and postprocedural mitral regurgitation on outcomes after percutaneous mitral valvuloplasty for mitral stenosis., The American journal of cardiology, 104, (8), 2009, p1122-1127 Journal Article, 2009 DOI

Cruz-Gonzalez I, Sanchez-Ledesma M, Sanchez PL, Sanchez PL, Martin-Moreiras J, Jneid H, Rengifo-Moreno P, Inglessis-Azuaje I, Maree AO, Palacios IF., Predicting success and long-term outcomes of percutaneous mitral valvuloplasty: a multifactorial score., The American journal of medicine, 122, (6), 2009, p581.e11-9 Journal Article, 2009 DOI

, Moyamoya disease with peripheral pulmonary artery stenoses and coronary artery fistulae., Case reports in medicine, 2009 Journal Article, 2009

Cubeddu RJ, Jneid H, Don CW, Witzke CF, Cruz-Gonzalez I, Gupta R, Rengifo-Moreno P, Maree AO, Inglessis I, Palacios IF., Retrograde versus antegrade percutaneous aortic balloon valvuloplasty: immediate, short- and long-term outcome at 2 years., Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions, 74, (2), 2009, p225-231 Journal Article, 2009 DOI

Jneid, H., Fonarow, G.C., Cannon, C.P., Hernandez, A.F., Palacios, I.F., Maree, A.O., Wells, Q., Bozkurt, B., LaBresh, K.A., Liang, L., Hong, Y., Newby, L.K., Fletcher, G., Peterson, E., Wexler, L., Sex differences in medical care and early death after acute myocardial infarction, Circulation, 118, (25), 2008, p2803-2810 Journal Article, 2008

Rodriguez, A.E., Maree, A.O., Palacios, I.F., Quality of life with PCI versus medical therapy in stable coronary disease [6], New England Journal of Medicine, 359, (21), 2008, p2290 Journal Article, 2008

Meliga E, Garcia-Garcia HM, Valgimigli M, Chieffo A, Biondi-Zoccai G, Maree AO, Cook S, Reardon L, Moretti C, De Servi S, Palacios IF, Windecker S, Colombo A, van Domburg R, Sheiban I, Serruys PW, DELFT (Drug Eluting stent for LeFT main) Registry., Longest available clinical outcomes after drug-eluting stent implantation for unprotected left main coronary artery disease: the DELFT (Drug Eluting stent for LeFT main) Registry., Journal of the American College of Cardiology, 51, (23), 2008, p2212-2219 Journal Article, 2008 DOI

Jneid, H., Maree, A.O., Palacios, I.F., Acute pericardial disease: Pericardiocentesis and percutaneous pericardiotomy, Acute Heart Failure, 2008, p255-265 Journal Article, 2008

Meliga, E., Garcia-Garcia, H.M., Valgimigli, M., Chieffo, A., Biondi-Zoccai, G., Maree, A.O., Gonzalo, N., Cook, S., Cruz-Gonzalez, I., Marra, S., De Servi, S., Palacios, I.F., Windecker, S., Van Domburg, R., Colombo, A., Sheiban, I., Serruys, P.W., Diabetic patients treated for unprotected left main coronary artery disease with drug eluting stents: A 3-year clinical outcome study. The Diabetes and Drug Eluting stent for LeFT main registry (D-Delft), EuroIntervention, 4, (1), 2008, p77-83 Journal Article, 2008

, Complications in Percutaneous Intervention , Congenital and Structural heart Disease," , 2008 Journal Article, 2008

Jneid, H., Fonarow, G.C., Cannon, C.P., Palacios, I.F., Kilic, T., Moukarbel, G.V., Maree, A.O., LaBresh, K.A., Liang, L., Newby, L.K., Fletcher, G., Wexler, L., Peterson, E., Impact of time of presentation on the care and outcomes of acute myocardial infarction, Circulation, 117, (19), 2008, p2502-2509 Journal Article, 2008

Jneid, H., Maree, A.O., Palacios, I.F., Pericardial Tamponade: Clinical Presentation, Diagnosis, and Catheter-Based Therapies, Critical Care Medicine: Principles of Diagnosis and Management in the Adult, 2008, p85-92 Journal Article, 2008

Sanchez-Ledesma M, Cruz-Gonzalez I, Sanchez PL, Sanchez PL, Martin-Moreiras J, Jneid H, Rengifo-Moreno P, Cubeddu RJ, Inglessis I, Maree AO, Palacios IF., Impact of concomitant aortic regurgitation on percutaneous mitral valvuloplasty: Immediate results, short-term, and long-term outcome., American heart journal, 156, (2), 2008, p361-366 Journal Article, 2008 DOI

, Coronary Artery Perforation and Pericardial Intervention, CathSAP III Chapter, 2008 Journal Article, 2008

, Identification of serum endoglin as a novel prognostic marker after acute myocardial infarction., Journal of cellular and molecular medicine, 2008 Journal Article, 2008

Cruz-Gonzalez I, Martin-Herrero F, Gonzalez-Santos JM, Gutierrez-Diez JA, Sanchez-Ledesma M, Maree AO., Images in cardiovascular medicine. Anaphylaxis and recurrent hydatid disease., Circulation, 115, (25), 2007, pe643-5 Journal Article, 2007 DOI

, Non-coronary sinus of Valsalva aneurysm rupture., Heart (British Cardiac Society), 2007 Journal Article, 2007

Rodriguez AE, Maree AO, Mieres J, Berrocal D, Grinfeld L, Fernandez-Pereira C, Curotto V, Rodriguez-Granillo A, O'Neill W, Palacios IF., Late loss of early benefit from drug-eluting stents when compared with bare-metal stents and coronary artery bypass surgery: 3 years follow-up of the ERACI III registry., European heart journal, 28, (17), 2007, p2118-2125 Journal Article, 2007 DOI

, Acute pericardial disease, The Textbook Acute Heart Failure Syndromes., 2007 Journal Article, 2007

Dodd, J.D., Maree, A., Palacios, I., De Moor, M.M., Mooyaart, E.A.Q., Shapiro, M.D., Ferencik, M., Brady, T., Abbara, S., Cury, R.C., Hoffmann, U., Left main coronary artery compression syndrome: Evaluation with 64-slice cardiac multidetector computed tomography, Circulation, 115, (1), 2007 Journal Article, 2007

Maree AO, Cox D, Fitzgerald DJ., Drug insight: aspirin resistance-fact or fashion?, Nature clinical practice. Cardiovascular medicine, 4, (3), 2007, pE1; author reply E2 Journal Article, 2007 DOI

Fitzgerald DJ, Maree A., Aspirin and clopidogrel resistance., Hematology. American Society of Hematology. Education Program, 2007, p114-120 Journal Article, 2007 DOI

Maree, A.O., Rosenfield, K.A., Endarterectomy versus stenting for carotid stenosis [3], New England Journal of Medicine, 356, (3), 2007, p306 Journal Article, 2007

Maree AO, Jneid H, Palacios IF, Rosenfield K, MacRae CA, Fitzgerald DJ., Growth arrest specific gene (GAS) 6 modulates platelet thrombus formation and vascular wall homeostasis and represents an attractive drug target., Current pharmaceutical design, 13, (26), 2007, p2656-2661 Journal Article, 2007 DOI

Maree, A.O., Fitzgerald, D.J., Variable platelet response to aspirin and clopidogrel in atherothrombotic disease, Circulation, 115, (16), 2007, p2196-2207 Journal Article, 2007

Maree, A.O., Islam, M.A., Snuderl, M., Lamuraglia, G.M., Stone, J.R., Olmsted, K., Rosenfield, K.A., Jaff, M.R., External iliac artery endofibrosis in an amateur runner: Hemodynamic, angiographic, histopathological evaluation and percutaneous revascularization, Vascular Medicine, 12, (3), 2007, p203-206 Journal Article, 2007

Cruz-Gonzalez, I., Martin-Herrero, F., Gonzalez-Santos, J.M., Gutierrez-Diez, J.A., Sanchez-Ledesma, M., Maree, A.O., Anaphylaxis and recurrent hydatid disease, Circulation, 115, (25), 2007 Journal Article, 2007

Levine GN, Berger PB, Cohen DJ, Maree AO, Rosenfield K, Wiggins BS, Spinler SA., Newer pharmacotherapy in patients undergoing percutaneous coronary interventions: a guide for pharmacists and other health care professionals., Pharmacotherapy, 26, (11), 2006, p1537-1556 Journal Article, 2006 DOI

, Pericardial Tamponade, Clinical Presentation, Diagnosis and Catheter-based Therapies" in " Critical Care Medicine: Principles of Diagnosis & Management in the Adult, 2006 Journal Article, 2006

Cox D, Maree AO, Dooley M, Conroy R, Byrne MF, Fitzgerald DJ., Effect of enteric coating on antiplatelet activity of low-dose aspirin in healthy volunteers., Stroke, 37, (8), 2006, p2153-2158 Journal Article, 2006 DOI

Jneid H, Maree AO, Palacios IF., Drug-eluting stents in primary PCI., The New England journal of medicine, 355, (23), 2006, p2483-4; author reply 2484-6 Journal Article, 2006 DOI

Maree AO, Jneid H, Fitzgerald DJ., Aspirin resistance and atherothrombotic disease., Journal of the American College of Cardiology, 48, (4), 2006, p846-7; author reply 847 Journal Article, 2006 DOI

, Percutaneous Balloon Pericardiotomy for Patients with Pericardial Effusion and Tamponade, 900 Questions: An Interventional Cardiology Board Review, 2006 Journal Article, 2006

Maree AO, Jneid H, Palacios IF., Percutaneous closure of a post-infarction ventricular septal defect that recurred after surgical repair., European heart journal, 27, (13), 2006, p1626 Journal Article, 2006 DOI

Maree, A., Walsh, K., Coronary stent insertion into a 20-year-old Blalock-Taussig Shunt, Irish Medical Journal, 99, (7), 2006 Journal Article, 2006

Maree A, Palacios IF, Lago RM., Transcatheter closure of atrial septal defects in adults using two devices: an angiographic overview., Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions, 68, (6), 2006, p946-947 Journal Article, 2006 DOI

Maree AO, Curtin RJ, Dooley M, Conroy RM, Crean P, Cox D, Fitzgerald DJ., Platelet response to low-dose enteric-coated aspirin in patients with stable cardiovascular disease., Journal of the American College of Cardiology, 46, (7), 2005, p1258-1263 Journal Article, 2005 DOI

Maree AO, Curtin RJ, Chubb A, Dolan C, Cox D, O'Brien J, Crean P, Shields DC, Fitzgerald DJ., Cyclooxygenase-1 haplotype modulates platelet response to aspirin., Journal of thrombosis and haemostasis : JTH, 3, (10), 2005, p2340-2345 Journal Article, 2005 DOI

Maree AO, Fitzgerald DJ., Aspirin and coronary artery disease., Thrombosis and haemostasis, 92, (6), 2004, p1175-1181 Journal Article, 2004 DOI

Maree AO, Cox D., Thrombosis and nitric oxide donor drugs., Thrombosis and haemostasis, 91, (5), 2004, p848-850 Journal Article, 2004 DOI

Maree A, Fitzgerald DJ., Glycoprotein IIb/IIIa antagonists in acute coronary syndromes: where are we now?, Seminars in vascular medicine, 3, (4), 2003, p385-390 Journal Article, 2003 DOI

Maree A, Fitzgerald D., PAR2 is partout and now in the heart., Circulation research, 90, (4), 2002, p366-368 Journal Article, 2002 DOI

Maree A, Fitzgerald D., Glycoprotein IIb/IIIa antagonists in acute coronary syndromes., Haematologica, 86, (11 suppl 2), 2001, p45-48 Journal Article, 2001 DOI

Mahon NG, Maree A, McKenna P, McCann HA, Sugrue DD., Emergency coronary angioplasty and stenting following acute myocardial infarction during pregnancy., The Journal of invasive cardiology, 11, (4), 1999, p233-236 Journal Article, 1999 DOI

Non-Peer-Reviewed Publications

L McGovern, N McEniff, S Walsh, J Cosgrave, A Maree, LIMA Jeopardy CABG and Aorto-Iliac Disease, EuroIntervention, EuroPCR 2020, Paris, France, 25-27 june, 2020 Oral Presentation, 2020

Maree A, Cardiac Rehabilitation and Secondary prevention, 8th World Congress of Cardiology; Published in Heartwise 7/'04, 2004 Report, 2004

Maree A, Sugrue D, C.R.P and Statins for All, Irish Medical News., 2002 Report, 2002

Maree A, Hillmann A, McRedmond J, Fitzgerald DJ., Homo sapiens growth arrest-specific 6 (GAS6) gene, exons 1 and 2 and partial, National Centre for Biotechnology Information. GenBank Submission (Accession No. AY170372) - 2002 Report, 2002

Maree A, Sugrue D, The evolving relationship of C-Reactive protein and coronary heart disease, Hospital Doctor and Modern Medicine., 2001 Report, 2001

Research Expertise

Projects

  • Title
    • Novel Markers of Plaque Rupture in Patients with Chest Pain
  • Summary
    • Despite extensive research cardiovascular disease remains the leading cause of death in developed countries. Thus, its primary and secondary prevention remain a public health priority. Non-traumatic chest pain presentation to the accident and emergency department accounts for between 6-10% of patients' seen and management of these patients is challenging. An assay that detects patients with chest pain who are at risk of plaque rupture and in whom coronary thrombosis and myocardial injury have not yet occurred would provide for pre-emptive treatment and thereby also diminish the risk of progression to chronic cardiovascular disease would be extremely useful. This is the basis of our novel serum biomarker study. We will evaluate patients who present with chest pain and screen them for novel serum biomarkers of coronary plaque instability. We will also develop assays for measuring these proteins and ultimately develop a blood test that will identify patients at high risk of MI. The aim is that when a patient presents to A&E with chest pain a series of point of care serum marker assay will facilitate rapid stratification as cardiac or non-cardiac chest pain. This will allow for early treatment or discharge. We have been working with collaborators in Bristol who have developed a mouse model of atherosclerosis (Research Frontiers Programme funded by SFI). Using this ApoE mouse model of atherosclerosis and a protein array we have already identified a number of serum proteins (biomarkers) where changes in their levels predict plaque rupture. We collected serum from mice both before and after plaque rupture and analysed the levels of different proteins in the serum of these mice. Plaque rupture was determined by histological analysis of the brachiocephalic artery. We identified a number of novel proteins that were present at significantly high levels in the serum prior to plaque rupture and may be predictive of higher risk of rupture. A number of these proteins have never been shown to be associated with plaque rupture previously. Although we provided evidence that these serum proteins have the potential to act as biomarkers of plaque rupture we did so in an artificial animal model of plaque rupture and therefore needed to confirm that the same protein pattern occurred in humans. We therefore conducted a preliminary pilot study of 40 patients who presented with chest pain. We identified similar markers of plaque rupture in patients presenting with unstable angina. While these biomarker proteins were clearly expressed in mice we needed to confirm that the same proteins were expressed in humans. To achieve this we enrolled a small number of patients at Waterford Regional Hospital in 2013 and repeated the same protein biomarker assays confirming that these markers were present in human serum and detectable by ELISA.
  • Funding Agency
    • Royal City of Dublin Hospital Trust
  • Date From
    • 7/2014
  • Date To
    • 6/2017
  • Title
    • Assessment of Speed of Heart Rate Recovery as a Modifiable Risk Factor Post Coronary Intervention and Cardiac Surgery
  • Summary
    • Ongoing research and unpublished therefore methodology withheld.
  • Funding Agency
    • Royal City of Dublin Hospital Trust
  • Date From
    • 7/2019
  • Date To
    • 6/2021
  • Title
    • Platelet Proteome and Thromboxane Synthesis in Coronary Artery Disease
  • Summary
    • B) Proteomic Analysis Many types of CVD have a platelet component in their pathogenesis. These include atherosclerosis leading to coronary artery disease (platelet secretion contributes to atherosclerosis, thrombotic events leading to myocardial infarction (platelets are central to thrombosis); and potentially atrial fibrillation leading to stroke (there is evidence of platelet activation in atrial fibrillation that may contribute to thrombosis leading to embolism and stroke. For this arm of our study we hypothesize that biomarkers may be identified in platelet samples that are associated with risk of developing various forms of CVD, or with suboptimal responses to antithrombotic therapy (bleeding, or continued risk of thrombosis). Furthermore, it is hypothesised that these markers are present chronically, not just at the time of acute events, and could be used to diagnose disease or predict treatment response. Proteomics offers a way to transform how platelets are analysed by determining the composition of platelet proteins and their changes upon stimulation and in disease. Proteomics can be used to explore the differences in protein profiles between different cardiovascular disease (CVD) populations, using information from multiple proteins to identify shared features of patient groups. Such a 'signature' of disease may have several future applications. Firstly, it may ultimately be used in the prediction of outcomes in CVD. Secondly, it may be used to monitor treatments of CVD, to determine if treatment normalises the signature. Thirdly, variations in the signature may identify subcategories and stratifications in CVD populations, and may be used to determine the type and extent of treatment suitable for individual patients. As part of a research and development programme in platelet biomarkers, Java Clinical Research in University College Dublin (UCD) has developed a method to analyse platelet samples for protein markers that may predict risk of thrombosis and response to antiplatelet drugs. Platelets are an excellent source of biomarkers for this, since they play a role in many types of CVD, including atherogenesis, thrombosis and bleeding. Furthermore, platelets are readily sampled from peripheral blood, and Java has developed streamlined methods to process and analyse them for biomarkers that reflect the donor's status and the impact of genetic variation, disease and drug treatment. The study was withdrawn due to closure of the Java Clinical Research in University College Dublin (UCD) and inability to perform proteomic analysis shortly after funding awarded.
  • Funding Agency
    • Royal City of Dublin Hospital Trust
  • Date From
    • 2016
  • Date To
    • 2016
  • Title
    • (K123 HL083781). P I: Joseph A Vita: Boston University Medical Center Leadership Program in Vascular
  • Funding Agency
    • NIH
  • Date From
    • 2008
  • Title
    • Peripheral Arterial Vascular closure with Starclose Device.
  • Summary
    • Clinical trail of StarClose Device use in PAD patients
  • Funding Agency
    • Abbott Laboratories
  • Date From
    • 2006
  • Date To
    • 2007
  • Title
    • Aspirin responsiveness testing predicts bleeding during coronary artery bypass grafting: The Verify Pre-Op TIMI 45 Study
  • Summary
    • Introduction: Many patients receive aspirin prior to coronary artery bypass grafting (CABG), despite its association with perioperative bleeding and variable effectiveness among individuals. Hypothesis: We assessed the hypothesis that point-of-care aspirin responsiveness testing predicts bleeding and ischemic events during CABG. Methods: Verify Pre-Op [[Unable to Display Character: -]] TIMI 45 was a prospective study of 38 patients on aspirin who underwent CABG. VerifyNow Aspirin Reaction Units (ARU) (Accumetrics, San Diego, CA) were measured < 24 hours before CABG, with higher ARU indicating more reactive platelets. Endpoints were decrease in hemoglobin (Hgb) and hematocrit (HCT), platelet transfusion, major bleeding (≥ 5 red blood cell units transfused or > 2 L chest tube output), and myocardial infarction < 24 hours after surgery. Endpoints were analyzed by ARU tertiles, and the cut-point for the lowest tertile (ARU 412), reported as mean ± SD. Results: Mean ARU was 472 ± 85. There was less bleeding across tertiles of higher ARU (p=0.039 for Hgb; p=0.028 for HCT) (Figure). Decrease in Hgb was greater in patients with ARU < 412 (5.4 ± 2.3 g/dL v. 3.4 ± 2.0 g/dL, p=0.011). Decrease in HCT was also greater in those with ARU < 412 (16.3 ± 6.9% v. 10.2 ± 6.2%, p=0.008). As a continuous variable, higher platelet reactivity (ARU) correlated with less of a decrease in Hgb and HCT (Spearman r=0.422, p=0.008 for Hgb; r=0.426, p=0.008 for HCT). Patients with ARU < 412 were more likely to have at least one platelet transfusion (53.9% v. 8.7%, p=0.005), and more units transfused (2.3 ± 3.8 units v. 0.2 ± 0.6 units, p=0.003). Major bleeding was more frequent in those with ARU < 412 (25% v. 0%, p=0.026). There was no difference in myocardial infarction, though there were few events (n=3). Conclusion: Aspirin responsiveness testing predicts bleeding in patients exposed to aspirin undergoing CABG. An ARU ≥ 412 was predictive of less bleeding, less need for platelet transfusion, and was not associated with increased ischemic risk.
  • Funding Agency
    • Accumetrics Inc
  • Date From
    • 2006
  • Date To
    • 2007
  • Title
    • Genetics of GAS6: A Novel Target in Coronary Thrombosis and Atherosclerosis.
  • Summary
    • Since 2001 I have been investigating the impact of platelet genetic variation on signal transduction and drug response. GAS6 is implicated in vascular remodelling, inflammation and atherothrombosis and is a novel antiplatelet drug target (Maree et al., 2007 Curr Pharm Des.) (Maree et al., 2002 GAS6 Nucleotide Sequence (AY170372) EMBL/GenBank/DDBJ databases). This work was performed in collaboration with Prof Desmond Fitzgerald and Prof Denis Shields and was supported by grants from the Irish Heart Foundation and the Higher Education Authority, Ireland.
  • Funding Agency
    • Irish Heart Foundation
  • Date From
    • 2001
  • Date To
    • 2004
  • Title
    • "The effect of Genetic Variation and Platelet Receptor expression on the Antiplatelet response to Aspirin."
  • Funding Agency
    • Irish Heart Foundation Research Grant
  • Date From
    • 2002
  • Date To
    • 2004
  • Title
    • "The effect of Genetic Variation and Platelet Receptor expression on the Antiplatelet response to Aspirin."
  • Summary
    • Abstract Background: Serotonin (5-HT) induces platelet aggregation by activating its 5-HT2A receptor. Platelet uptake is mediated by the 5-HT transporter (5-HTT). A common 5-HTT promoter (5-HTTLPR) splice variant results in long (L) and short (S) alleles. 5-HTTLPR genotype has been associated with increased platelet activation and risk of MI. Variation within HTR2A gene (C1354T) that encodes the 5-HT2A receptor has also been associated with enhanced platelet aggregation. We hypothesised that 5-HTT and/or HTR2A variation may influence platelet response to aspirin in patients with stable CAD. Methods: Patients (n=144) with stable cardiovascular disease taking aspirin were genotyped for the 5-HTTLPR and HTR2A variants. Platelet inhibition was assessed by serum thromboxane and arachidonic acid-induced platelet aggregation assay. Results: 5-HTT genotype (LL vs *S) was a significant determinant of serum TX level (8.9±2.6ng/ml vs 6.0±1.6ng/ml respectively; p<0.02) and 5-HTT LL genotype predicted an incomplete aspirin response (serum TXB2>2.2ng/ml) (p=0.04; OR=2.22, CI=1.03-4.79). Odds ratio of the effect of LL genotype on TX elevation was 3.8 (95% CI 1.2-11.6) in younger patients (under 64) compared to 1.0 (95% CI=0.3-3.8) in older subjects. LL genotype did not influence AA aggregation (p=0.83, OR=1.2, CI=0.3-4.1). The HTR2A variant had no effect on TX generation (p=0.70; OR=1.22, CI=0.45-3.26) nor AA aggregation (p=0.99; OR=1.0, CI=0.2-4.9). Conclusions: In younger patients with stable CAD 5HTT LL genotype carried by almost one third of our cohort is associated with a diminished response to aspirin that may increase cardiovascular risk. Genotypic variation in platelet activation may be a contributing mechanism. Keywords: Aspirin; Coronary disease; Genetic; Serotonin.
  • Funding Agency
    • Irish Heart Foundation Research Grant
  • Date From
    • 2002
  • Date To
    • 2004

Keywords

ANTIPLATELETS; Cardiac physiology; CONGENITAL HEART DISEASE; Heart rate recovery; Heart rate variability; INTERVENTIONAL CARDIOLOGY; ISCHAEMIC HEART DISEASE; PHARMACOGENETICS; PLATELET AGGREGATION INHIBITORS; PLATELET-FUNCTION

Recognition

Representations

National Office of Clinical Audit: Members of the ACS Audit Governance Committee 2020

Board Member Irish Heart Foundation 2015

The CoMPPAS Career Development Advisory Forum: The Royal College of Surgeons in Ireland 2020

2009- National Acute Coronary Syndrome Program committee 14-4-2009

2012 - Treasurer Irish Cardiac Society 2012

2013- Member RCPI Policy Group on Obesity 2012

Dublin Midlands Hospital Network Clinical lead, National ACS programme 2019

Awards and Honours

European Society of Cardiology Annual Scientific Meeting, Young Investigator Award in Thrombosis (Non-presenting co-primary investigator) 2003

American College of Cardiology Annual Scientific Meeting, Young Investigator Award (Physiology, Pathology, Pharmacology) 2004

European Society of Cardiology Annual Scientific Meeting, Young Investigator Award in Thrombosis 2004

American Heart Association, second author on winning Laennec Clinical Case Competition 2007

Irish Association of Internal Medicine "Brian Lemass" Gold Medal for research 2003

Irish Board for Training in Cardiovascular Medicine Specialist Registrar in Cardiology Research Prize 2003

Irish Cardiac Society Young Investigator Medal 2003

Royal College of Physicians of Ireland "William Stokes Award" for Research 2003

Irish Association of Internal Medicine "Brian Lemass" Gold Medal for research 2004

Irish Board for Training in Cardiovascular Medicine / Bristol-Myers Squibb College Inaugural Travelling Fellowship 2004

Irish Cardiac Society, 1st Placed Moderated Poster 2004

Beaumont Hospital Sheppard Prize - 1st placed research poster presentation 2004

Distinctions in Final examinations - Medicine/Surgery/Paediatrics/Obstetrics/Gynaecology/ Ophthalmology honours. 1994

Memberships

Collegiate Member Royal College of Physicians in Ireland 2002

Member of the American Heart Association, Council on Atherosclerosis, Thrombosis and Vascular Biology 2003

Member AHA Interdisciplinary working group in Functional Genomics and Translational Biology. 2003

2004 - Member of the European Society of Cardiology 2004

Member of the Irish Cardiac Society 2004

Member of the American College of Cardiology 2005

Fellow of the American Heart Association 2008

Fellow of the Royal College of Physicians in Ireland 2011

Treasurer Irish Cardiac Society 2012

Board Member Irish Heart Foundation 2015