Andrew D Blann

Andrew D Blann
University of Birmingham · Centre for Cardiovascular Sciences

PhD FRCPath

About

641
Publications
40,529
Reads
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26,079
Citations
Additional affiliations
March 1997 - present
University of Birmingham
Position
  • Professor (Associate)
March 1997 - present
Sandwell and West Birmingham Hospitals NHS Trust
Position
  • Consultant
January 1990 - March 1997
University Hospital Of South Manchester NHS Foundation Trust
Position
  • Research Associate

Publications

Publications (641)
Article
Abstract Purpose Retinal oxygen supply is a critical requirement in ocular function, and when inadequate can lead to retinopathy. Endothelial dysfunction is a leading pathophysiology in diabetes and cardiovascular disease and may be assessed by endothelial microparticles (EMPs). We hypothesised links between retinal vessel oxygenation and EMPs, exp...
Article
Full-text available
As heart failure, coronary artery disease and atrial fibrillation all bring a risk of thrombosis, anti-thrombotic therapy is recommended. Despite such treatment, major cardiovascular events such as myocardial infarction and stroke still occur, implying inadequate suppression of thrombus formation. Accordingly, identification of patients whose haemo...
Article
As non-valvular atrial fibrillation (AF) brings a risk of stroke, oral anticoagulants (OAC) are recommended. In ‘real world’ clinical practice, many patients (who may be, or perceived to be, intolerant of OACs) are either untreated or are treated with anti-platelet agents. We hypothesised that edoxaban has a better net clinical benefit (NCB, balanc...
Article
The non-vitamin K oral anticoagulants (NOACs) are set to replace vitamin K antagonists (principally warfarin), unfractionated heparin and low molecular weight heparin as the leading anti-thrombotic prophylaxis in several medical and surgical settings. As a group, NOACs have a better safety profile and at least and equivalent (and sometimes superior...
Article
Full-text available
Cardiopulmonary bypass (CPB) causes reperfusion injury that when most severe is clinically manifested as a systemic inflammatory response syndrome. The anaesthetic propofol may have anti-inflammatory properties that may reduce such a response. We hypothesised differing effects of propofol and isoflurane on inflammatory markers in patients having CB...
Article
Treatment of type 2 diabetes with glucagon-like peptide-1 (GLP-1) receptor agonists may be limited by gastrointestinal side effects (GISE) in some patients. Risk factors for developing GISE are not known. We analysed patient characteristics that were associated with GISE among patients treated with the GLP-1 receptor agonist liraglutide. Data was o...
Article
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Products of hemeoxygenase (HO)-1 have anti-inflammatory and antioxidant functions. The HO-1 promoter has a variable number of GT(n) repeats: A low number (n < 23) is associated with high transcriptional activity in response to oxidative stress. We hypothesized that the frequency of GT(n) repeats in pediatric heart failure (HF) reflects plasma bioma...
Article
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The endothelium and angiogenesis are therapeutic targets in cancer. Response to treatment may be assessed by laboratory plasma markers such as circulating endothelial cells (CECs), endothelial progenitor cells (EPCs), von Willebrand factor (vWf), soluble E selectin, vascular endothelial growth factor (VEGF) and angiogenin. We hypothesised that thes...
Article
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Background Catheter ablation (CA) of atrial fibrillation (AF) is associated with inflammatory response, endothelial damage and with increased risk of thrombosis. However, whether these processes differ in peripheral and cardiac circulation is unknown. Methods Plasma markers (von Willebrand factor (vWf), soluble P-selectin (sPsel) and interleukin-6...
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Background: There is growing evidence that chemokines are potentially important mediators of the pathogenesis of atherosclerotic disease. Major atherothrombotic complications, such as stroke and myocardial infarction, are common among atrial fibrillation (AF) patients. This increase in risk of adverse events may be predicted by a score based on th...
Article
In atrial fibrillation (AF), oral anticoagulant(OAC) is the mainstay treatment in prevention of stroke. However, the various OAC confers one with different level of protection against thrombosis and bleeding risk, possibly due to different effect on fibrin clot structure. Coagulation and clot lysis can be assessed by Thrombelastography(TEG).
Article
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Introduction: The importance of the endothelium in angiogenesis and cancer is undisputed, and its integrity may be assessed by laboratory markers such as circulating endothelial cells (CECs), endothelial progenitor cells (EPCs), plasma von Willebrand factor (vWf), soluble E selectin, vascular endothelial growth factor (VEGF) and angiogenin. Antian...
Poster
Purpose To explore the association of renal function and retinal vessel oxygen saturation in patients suffering from diabetes and cardiovascular disease.Methods We examined three groups of patients (1: Diabetics, 2: Diabetics with cardiovascular disease and 3: patients suffering from cardiovascular disease without diabetes). All patients Intraocula...
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Hypercoagulability in mitral valve disease (MVD), a cause of atrial fibrillation (AF) and stroke, is potentially due to endothelial damage/dysfunction (marked by circulating endothelial cells [CECs]), platelet activation (soluble P-selectin [sPsel], platelet microparticles [PMPs], and soluble CD40 [sCD40]), and oxidized low-density lipoprotein (oxL...
Article
Red and white blood cells have two main functions: the carriage of oxygen; and defence against microbial attack. The full blood count is one of the most frequently requested routine blood tests; it provides key indices such as haemoglobin and the number of white cell subsets, and provides information to aid diagnosis of a range of conditions, inclu...
Article
Many age-related changes in health can be detected in blood tests. In particular, renal function deteriorates with age, and this is factored in when estimating the glomerular filtration rate. However, some symptoms may be wrongly attributed to old age, while some medication can mask, exacerbate or cause problems in older people. This article looks...
Article
The liver is the body's largest single discrete organ. It has four major functions: metabolism and synthesis; excretion; storage; and the detoxification of potential poisons. These diverse functions mean that a single test does not give enough information to assess fully how the liver is functioning; at least five different liver function tests are...
Article
Urea and electrolytes are the most commonly requested biochemistry tests. They provide essential information on renal function, principally in excretion and homoeostasis. Creatinine levels are a major factor in determining the estimated glomerular filtration rate, which is the gold standard marker of kidney health. The tests' clinical value is in t...
Article
Full-text available
Disadvantages with traditional anticoagulants (vitamin K antagonists and heparinoids) have led to the development on non-vitamin K antagonist oral anticoagulants (NOACs). These agents are set to replace the traditional anticoagulants in situations such as following orthopaedic surgery, in atrial fibrillation, and in the prevention and treatment of...
Article
Full-text available
Introduction There is concern that glucagon-like peptide-1 (GLP1) receptor agonists may be associated with acute pancreatitis. The data from the ABCD nationwide liraglutide audit (November 2009–June 2013; 6010 patients) provide an opportunity to assess the extent of the problem in routine clinical practice in the UK. Methods At every patient visit...
Article
The response to glucagon-like peptide 1 receptor agonist treatment may be influenced by endogenous β-cell function. We investigated whether urinary C-peptide creatinine ratio assessed before or during liraglutide treatment was associated with treatment response. A single, outpatient urine sample for urinary C-peptide creatinine ratio was collected...
Article
• A recent 'joint investigation by the BMJ and Channel 4's Dispatches current affairs programme' has brought widespread attention to the possibility that GLP-1 based therapies may cause pancreatic damage • A plausible mechanism has been proposed by which GLP-1 based therapies might lead to pancreatitis and even pancreatic cancer. The animal data be...
Article
Three functionally distinct monocyte subsets have been identified. Statins are of undoubted effect in atherosclerosis and have numerous pleiotropic effects that contribute to their clinical success, but the effect of these drugs on monocyte subsets is unclear. We hypothesised a beneficial effect of statins on key receptor expression by monocyte sub...
Article
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Melatonin may be involved in gastrointestinal tract physiology and could affect inflammation-related gastrointestinal disorders. Rat models of ulcerative colitis imply melatonin is beneficial. To determine potential pathophysiological mechanisms, we assessed colonic nuclear factor-kappa beta expression and measured serum levels of pentraxin-3, lipi...
Poster
Purpose To to evaluate the benefit of bilinear and linear fitting to characterize the retinal vessel dilation to flicker light stimulation for the purpose of risk stratification in cardiovascular disease. Methods Methods Forty-five patients (15 with coronary artery disease (CAD), 15 with Diabetes Mellitus (DM) and 15 with CAD and DM) all underwent...
Article
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Introduction Acute upper gastrointestinal bleeding (AUGIB) is a common reason for hospital admission and is associated with significant cardiovascular (CVS) morbidity and mortality. Patients who have aspirin withheld for 8 weeks following AUGIB have significantly higher rates of CVS events.1 We previously demonstrated that patients with AUGIB have...
Article
Background: Circulating endothelial cells (CECs), endothelial progenitor cells (EPCs), Willebrand factor (vWf), soluble E-selectin, vascular endothelial growth factor (VEGF) and angiogenin are of interest in cancer vascular biology. However, few studies have looked at more than one in combination. We set out to determine which would be best in pre...
Article
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Vascular function is an important pathophysiological factor in cardiovascular disease, and is influenced by many factors, one of the principles being hypertension. Developing evidence suggests that inflammation may be another risk factor. Vascular function and blood pressure haemodynamics can be assessed by arterial stiffness, pulse pressure and pl...
Article
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The platelet adenosine diphosphate (ADP)-receptor blocker clopidogrel is effective in reducing the rate of thrombosis in cardiovascular disease, but may also have nonplatelet activity. However, there is variability in the suppression of platelet function in individuals, leading to the concept of clopidogrel resistance, that is, reduced platelet-sup...
Article
Background: Risk stratification schemes assessing stroke and thromboembolism (stroke/TE) and bleeding relating to atrial fibrillation (AF) have largely been derived and validated in Western populations. We assessed risk factors that constitute scores for assessing stroke/TE (CHADS2, CHA2DS2-VASc) and bleeding (HAS-BLED), and the predictive value o...
Article
Background: Variability in the response to aspirin (sometimes known as aspirin resistance) in modulating platelet activity is a potentially important clinical issue in coronary artery disease (CAD), but may be also be important in other areas of pathophysiology. Materials and methods: Testing the hypothesis of a relationship between aspirin resi...
Article
Background: The risk of stroke associated with atrial fibrillation (AF) is higher in Far Eastern population than in Western population, and warfarin use suboptimal. There is uncertainty whether the novel oral anticoagulants (NOACs) would have a major impact on stroke prevention in Far Eastern populations with AF. Objectives: We investigated curr...
Article
Childhood iron deficiency has a high incidence in Pakistan. Some but not all studies have shown that dietary iron deficiency may cause increased absorption of lead as both compete for the same transporters in the small intestine. Therefore, children in Pakistan, residing in heavily polluted cities like Karachi may be prone to lead poisoning. This h...
Article
Aspirin resistance and chronic renal failure are both potentially important clinical issues in coronary artery disease. To test the hypothesis of a relationship between the two, we recruited 169 stable outpatients with proven coronary artery disease (myocardial infarction, coronary artery bypass grafting, intra-coronary stents) taking 75 mg aspirin...
Article
The assessment of different aspects of endothelial dysfunction in cardiovascular medicine in general and in heart failure (HF) has been the focus of intense research, and includes vasomotor, haemostatic, antioxidant, and inflammatory activities. Differences also exist in the pattern of endothelial dysfunction depending on aetiology, severity, and s...
Article
Introduction Acute upper gastrointestinal bleeding (AUGIB) is a common reason for medical admissions and is associated with significant morbidity and mortality. Studies have previously noted an excess of cardiovascular events in patients who have suffered from AUGIB. Patients who have aspirin withheld for 8 weeks following admission with AUGIB have...
Article
Introduction Acute upper gastrointestinal bleeding is a medical emergency associated with a significant health burden and risk of mortality. A significant proportion of patients are admitted to hospital unnecessarily for endoscopy following presentation with acute upper gastrointestinal bleeding. The Blatchford score can be used to identify patient...
Article
Introduction Acute upper gastrointestinal bleeding is a medical emergency associated with a significant health burden and risk of mortality. Previous studies have looked for diurnal and seasonal variations in presentation. No studies have addressed these issues in the UK population. Methods All patients admitted with acute upper gastrointestinal bl...
Article
Background Cumulative ventricular pacing (VP) is associated with development of atrial fibrillation and cardiac remodelling. Contemporary pacemaker devices are able to quantify atrial high-rate episodes (AHREs) and atrial fibrillation burden (AFB). No previous study has investigated the relationship of reverse LA remodelling and AHRE. We tested the...
Article
Background: South Asians presenting with chest pain in the UK experience disproportionately greater delays with respect to diagnosis and treatment for acute myocardial infarction (AMI). The duration of time between symptom onset and hospital intervention is a critical delay for AMI but there are limited data amongst South Asians. The objectives of...
Article
Objective: To determine (a) whether ethnic/racial differences exist in circulating markers of angiogenesis (Angiopoietin-1 (Ang-1), Angiopoietin-2 (Ang-2), soluble Tie-2 receptor (sTie-2) and Angiogenin) between South Asian (SA; from India, Pakistan and Bangladesh); Black African-Caribbean and White (W) ethnic groups, and (b) associations between...
Article
The importance of the endothelium is cancer is not disputed. However, equally without doubt is the fact that cancer is a hypercoagulable state. Furthermore, there is evidence that two are linked, and that this link may also be causative in that changes to vascular biology in cancer lead to an increased risk of thrombosis. The objective of this comm...
Article
Matrix metalloproteinases (MMPs) are a family of endopeptidases that degrade the components of the extracellular matrix (ECM) such as collagen, and thus contribute to the remodelling and the physiological homeostasis of the ECM and its blood supply. The activities of these enzymes are regulated by endogenous tissue inhibitors of metalloproteinases...
Article
Full-text available
The BJC is owned by Cancer Research UK, a charity dedicated to understanding the causes, prevention and treatment of cancer and to making sure that the best new treatments reach patients in the clinic as quickly as possible. The journal reflects these aims. It was founded more than fifty years ago and, from the start, its far-sighted mission was to...
Article
Aspirin is an irreversible inhibitor of platelet prostaglandin synthase activity, and is the most widely prescribed drug for the secondary prevention of cardiovascular disease. In recent years, clinical and laboratory evidence has shown significant individual variability in the response to aspirin and its link to clinical outcome. The term 'aspirin...
Article
Objective: To determine whether ethnic differences exist in circulating markers of angiogenesis between South Asians, Blacks and Whites. To determine associations between these markers, cardiovascular risk factors and Peripheral arterial disease (PAD). Patients and Methods: We recruited 255 subjects (86 South Asians, 81 Blacks and 79 Whites) betwee...
Article
Atrial fibrillation (AF) is a common complication of coronary artery bypass grafting (CABG), and may have an inflammatory and/or thrombotic etiology. We sought to determine the expression of inflammatory (interleukin [IL]-6), thrombotic (tissue factor and von Willebrand factor [VWF]) and remodeling (matrix metalloproteinase [MMP]-9 and tissue inhib...
Article
Full-text available
Thrombin is the central protease in the coagulation cascade and one of the most extensively studied of all enzymes. In addition to its recognised role in the coagulation cascade and haemostasis, thrombin is known to have multiple pleiotropic effects, which mostly have been shown only in in vitro studies: it plays a role in inflammation and cellular...
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Erythropoietin (EPO) enhances formation of red blood cells and also affects thrombopoiesis and platelet function. We hypothesized that the effect of EPO may be reflected by changes in thromboxane B2 (TXB2) and endothelial cell function. Six male and six female subjects received recombinant human epoetin alpha (Erypo®) intravenously (300 U/kg). Biom...
Article
Full-text available
The BJC is owned by Cancer Research UK, a charity dedicated to understanding the causes, prevention and treatment of cancer and to making sure that the best new treatments reach patients in the clinic as quickly as possible. The journal reflects these aims. It was founded more than fifty years ago and, from the start, its far-sighted mission was to...
Article
Endothelial dysfunction is present in established rheumatoid arthritis, but it is not clear at what stage of the disease this abnormality develops. We set out to determine whether endothelial damage/dysfunction is present in a group of patients with early arthritis (EA) (new onset inflammatory arthritis, EA). Eighteen patients with EA, 48 healthy c...
Article
Full-text available
Endothelial dysfunction is implicated in the pathophysiological features of heart failure (HF), and ethnic differences in the presentation of cardiovascular disease are evident, with an excess seen among South Asians (SAs). However, data on ethnic differences in endothelial function in HF are limited. In a cross-sectional study, we recruited 128 su...
Article
Hypertension is a common medical condition that complicates pregnancy, and has significant adverse effects on pregnancy outcomes, including maternal and perinatal morbidity and mortality. In seeking the aetiology of pregnancy-related hypertension there has been a shift in focus from the foeto-placental axis to the maternal vasculature, and two poss...
Article
Angiogenesis is a key process in cancer biology, and justifies focus on the endothelium. Separate studies have looked at different aspects of angiogenesis and vascular biology, primarily focusing on certain laboratory and imaging techniques that generally reflect one particular aspect of the assessment of the endothelium. These techniques include t...
Article
Separate studies indicate that endothelial perturbation, as demonstrated by abnormal endothelial progenitor cells (EPCs), circulating endothelial cells (CECs), and plasma markers such as von Willebrand factor (vWf) and soluble E selectin (sEsel) are present in cancer. However, there are no reports where these indices are compared. Accordingly, we h...
Article
Full-text available
Circulating microparticles released from various cell types are present in healthy individuals and the number and composition of their membrane vary in different disorders. Long considered to be cellular debris, microparticles have been recently identified as regulatory vectors of intercellular cross-talk. Indeed, circulating microparticles represe...
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Combined therapy of metronomic cyclophosphamide, methotrexate and high-dose celecoxib targeting angiogenesis was used in a phase II trial. Patients with advanced cancer received oral cyclophosphamide 50 mg o.d., celecoxib 400 mg b.d. and methotrexate 2.5 mg b.d. for two consecutive days each week. Response was determined every 8 weeks; toxicity was...
Article
Full-text available
We determined the diagnostic accuracy of the Edinburgh Claudication Questionnaire (ECQ) in 1st generation Black African-Caribbean UK migrants as previous diagnostic questionnaires have been found to be less accurate in this population. We also determined the diagnostic accuracy of translated versions of the ECQ in 1st generation South Asian UK migr...