CGA/16/39 Understanding the implications of multimorbidity analysis of UK Biobank data. Barbara Nicholl, Frances Mair, Bhautesh Jani and Duncan Lee

Transcription

1 CGA/16/39 Understanding the implications of multimorbidity analysis of UK Biobank data Barbara Nicholl, Frances Mair, Bhautesh Jani and Duncan Lee

2 Methods Participants recruited from England, Wales and Scotland UK Biobank participants N= Self report data on- Demographics Health related behaviour 43 Long term conditions (LTCs) Medication Follow-up using data linkage with mortality, cancer and hospital registers

3 Results Project 1: Multimorbidity, Socio-economic Deprivation and Mortality

4 Results Project 2: AF, Comorbidity and Mortality Project 3: Stroke, Multimorbidity and Mortality

5 Project 4: COPD and Polypharmacy Results

6 Key Outputs Publications 2 papers accepted for publication 2 under review Conference abstracts 15 oral presentations 6 poster presentations Future Funding Cancer Research UK MRC Arthritis Research UK

7 Thank you! Funder: CSO catalyst grant UKB GPPC team: Ross McQueenie, Katie Gallacher, Peter Hanlon, Derek Connelly

8 Increasing physical activity among teenage girls: Establishing the theoretical bases for an intervention CSO Funding: CGA/16/10-25K Sept 2016 Feb 2017 Calum Arthur

9 The Team: Nina Verma Prof Eklund Dr Gibson Dr Howle Dr Arthur

10 The Theoretical Model Transformational Teaching A-A A-C P-A EIS Eng MVPA P-C

11 273 Girls S1-S3 33 wore accelerometers (WGT3X-BT) 1 Week Results A-A Transformational Teaching A-C EIS Eng P-A MVPA P-C

12 Results: Accelerometer Data TTQ.37 A-C P-A Accl. Data

13 Discussion Evidence for theoretical model Transformational teaching is important in predicting Female PA Key Mechanism: Self-Presentation Motives Exercise Identity Future: Intervention Development Feasibility testing Controlled Pilot Trial

14 Increasing physical activity among teenage girls: Establishing the theoretical bases for an intervention Calum Arthur

15 Establishing the Incidence of Takotsubo Cardiomyopathy in Scotland Scottish Takotsubo Retrospective Registry (the STARR study) Dana K. Dawson Reader in Cardiovascular Medicine and Honorary Consultant Cardiologist Universities of Aberdeen CSO pilot grant CGA-16-4,

16 Tako-tsubo Cardiomyopathy Acute form of left ventricular systolic dysfunction mimicking myocardial infarction Normal coronaries Triggered by intense emotional or physical stress Modestly elevated Tn I contrasting with highly elevated BNP, Long QT in days 1-3 Rapid and spontaneous recovery of left ventricular EF Patients often continue to experience symptoms, 15% recurrence

17 Background Rates of neurologic or psychiatric disorders were higher (55.8% vs. 25.7%) and the mean LV EF was markedly lower (40.7±11.2% vs. 51.5±12.3%) compared to ACS Templin, Inter-Tak, N Engl J Med 2015;373: Three most common declared co-morbidities in patients presenting acutely with takotsubo are: systemic hypertension (28%), mental health disorder (32%) and thyroid disease (26%) Scally, Am J Cardiol 2016;117: Schwarz, J Am Soc Echocardiogr Aug 25;

18 Background Numerous reports of takotsubo occurring in first degree relatives as well as a known recurrence rate Strongly supports a familial predisposition and calls for a systematic genetic-epidemiology analysis of probands and their first and second degree relatives which has never been undertaken in takotsubo cohorts

19 Background 2015: Outline to BHF it seems that the numbers are pragmatically determined by case numbers, though whether your ability to recruit will be sufficient to reach your conservative estimate needs some evidence

20 Time-line Feb 2016: NRS meeting, May 2016 CSO pilot grant Number of cases CSO would expect that the data on Scotland-wide prevalence of takotsubo cardiomyopathy obtained through this funding be submitted for publication Ethics, PBPP approvals, work started in September 2016

21 Methods Cath lab databases: Individual search of all acutely admitted cases with normal coronaries

22 Results ANNUAL TAKO-TSUBO CASES TOTAL NUMBER OF TAKO-TSUBO CASES TOTAL CASES TAYSIDE INVERNESS LOTHIAN LANARKSHIRE GRAMPIAN GLASGOW (GJH AND GGC) INVERNESS TAYSIDE GLASGOW (GJH AND GGC) LANARKSHIRE LOTHIAN GRAMPIAN GRAMPIAN LOTHIAN LANARKSHIRE GLASGOW (GJH AND GGC) TAYSIDE INVERNESS INVERNESS TAYSIDE GLASGOW (GJH AND GGC) LANARKSHIRE LOTHIAN GRAMPIAN

23 Further action Scottish-wide Genetic-Epidemiology and Psychology Interviews study with ultimate aim of gene sequencing Glasgow 2010 ERI Lanarkshire Dundee Raigmore ARI GJ+GGC st and 2 nd degree relatives for genetic testing and thorough family history for mental health disorders ICD-10: I takotsubo in 2017 ICD-11: BB43.8 Stress-induced cardiomyopathy

24 Conclusion Special Project Grant outline submitted to the BHF 2 nd February 2017 THANK YOU!

25 The itinerant team