Majd Protty

Majd Protty
Cardiff University | CU · School of Medicine

MBChB (Hons) | PgDip (Distinction) | MSc (Distinction) | MRCP (UK) | MAcadMEd | PhD

About

62
Publications
4,133
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355
Citations

Publications

Publications (62)
Article
Full-text available
Objectives Determine the real-world difference between 2 groups of patients with severe aortic stenosis and similar baseline comorbidities: surgical turn down (STD) patients, who were managed medically prior to the availability of transcatheter aortic valve implantation (TAVI) following formal surgical outpatient assessment, and patients managed wi...
Article
Full-text available
Abdominal aortic aneurysm (AAA) is an inflammatory vascular disease with high mortality and limited treatment options. How blood lipids regulate AAA development is unknown. Here lipidomics and genetic models demonstrate a central role for procoagulant enzymatically oxidized phospholipids (eoxPL) in regulating AAA. Specifically, through activating c...
Article
Introduction: Excimer laser coronary atherectomy (ELCA) is a recognized adjunctive therapy utilized in the percutaneous management of complex coronary lesions. Studies examining its safety and utility have been limited by small sample sizes. Our study examines the determinants and outcomes of ELCA. Methods: Using the British Cardiac Intervention...
Article
Objectives The authors used the BCIS (British Cardiovascular Intervention Society) database to define the factors associated with percutaneous coronary intervention (PCI) procedural complexity. Background Complex high-risk indicated percutaneous coronary intervention (CHIP-PCI) is an emerging concept that is poorly defined. Methods The BCIS (Brit...
Article
Full-text available
Phospholipids (PLs) are found in all cell types and are required for structural support and cell activation signalling pathways. In resting cells, PLs are asymmetrically distributed throughout the plasma membrane with native procoagulant aminophospholipids (aPLs) being actively maintained in the inner leaflet of the membrane. Upon platelet activati...
Article
Full-text available
The lipid envelope of SARS-CoV-2 is an essential component of the virus; however, its molecular composition is undetermined. Addressing this knowledge gap could support the design of anti-viral agents, as well as further our understanding of viral-host protein interactions, infectivity, pathogenicity, and innate immune system clearance. Using lipid...
Article
Purpose of the study In 2010, the National Institute for Health and Care Excellence (NICE) recommended the use of anticoagulants rather than aspirin as pharmacological thromboprophylaxis after hip fracture. We examine the impact of implementing this change in guidance on the clinical incidence of deep vein thrombosis (DVT). Study design Demographi...
Article
Full-text available
Introduction: There is increasing evidence supporting the use of intracoronary imaging to optimize the outcomes of percutaneous coronary intervention (PCI). However, there are no studies examining the impact of imaging on PCI outcomes in cases utilising rotational atherectomy (RA-PCI). Our study examines the determinants and outcomes of using intr...
Preprint
Full-text available
The lipid envelope of SARS-CoV2 is an essential component of the virus, however its molecular composition is unknown. Addressing this knowledge gap could support the design of anti-viral agents, and further understanding of viral interaction with extracellular host proteins, infectivity, pathogenicity, and innate immune system clearance. Lipidomics...
Article
Full-text available
Background: Despite the accumulation of research papers on aspirin and cancer, there is doubt as to whether or not aspirin is an acceptable and effective adjunct treatment of cancer. The results of several randomised trials are awaited, and these should give clear evidence on three common cancers: colon, breast and prostate. The biological effects...
Article
Objectives The aims of this study were to use a national percutaneous coronary intervention (PCI) registry to study temporal changes in procedure volumes of PCI using rotational atherectomy (ROTA-PCI), the patient and procedural factors associated with differing quartiles of operator ROTA-PCI volume, and the relationship between operator ROTA-PCI v...
Article
Background: The use of potent P2Y12 inhibitors (ticagrelor & prasugrel) in acute coronary syndrome (ACS) patients undergoing percutaneous coronary interventions (PCI) is a class I recommendation. We performed a sex-specific analysis comparing the difference in efficacy and safety outcomes between ticagrelor and prasugrel in a real-world ACS popula...
Article
Full-text available
Background Coronary stent avulsion is a rare, infrequently reported complication of percutaneous coronary intervention (PCI) with no consensus on management options. Case summary This case series presents three descriptions of iatrogenic coronary stent avulsions, and three different bailout management strategies. All patients presented with acute...
Article
Purpose of study This study examines the associations between dual antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI) and gastrointestinal bleeding (GIB), to explore possible predictors of outcomes. Study design Retrospective analysis of 3342 patients who underwent PCI between 1 August 2011 and 31 December 2018 in a single...
Article
The prothrombotic state in atrial fibrillation (AF) occurs as a result of multifaceted interactions, known as Virchow’s triad of hypercoagulability, structural abnormalities and blood stasis. More recently, there is emerging evidence that lipoproteins are implicated in this process, beyond their traditional role in atherosclerosis. In this review,...
Article
Introduction To compare the impact of an e-learning package with theoretical teaching on the ability of both graduate and undergraduate medical students to learn the management of supraventricular tachycardia. Methods We conducted a randomised, controlled, study at two Welsh medical schools. Participants were graduate-entry and undergraduate medic...
Article
Introduction Combining rotational (RA) and excimer laser coronary atherectomy (ELCA)—RASER atherectomy—is technique utilized in the percutaneous management of calcific coronary disease. The evidence base examining its safety and utility is sparse and limited to small case‐series. This study examines the patterns and outcomes of RASER atherectomy us...
Article
Background Rotational atherectomy (RA) during PCI is linked to a higher likelihood coronary perforations (CP). However, the evidence base on incidence, predictors and outcomes of this complication in RA-PCI remains limited. Methods Using the British Cardiac Intervention Society database, data were analysed on all RA-PCI procedures in UK 2007–2014....
Article
Full-text available
Behaviors which are associated with the preservation of health include nonsmoking, regular exercise, a low body weight, a healthy diet, and a low alcohol intake. Together, as a healthy lifestyle, these have been shown to be associated with marked protection against a wide range of diseases: diabetes, vascular disease, cancer, and dementia. On the o...
Article
Full-text available
Background Percutaneous coronary intervention (PCI) is increasingly utilized for treatment of coronary disease involving the unprotected left main stem (ULMS). However, no studies to date have examined the outcomes of such interventions when complicated by coronary perforation (CP). Methods Using the British Cardiovascular Intervention society (BC...
Article
Full-text available
Objectives We sought to evaluate whether socioeconomic status influences outcome after first-time transcatheter aortic valve implantation (TAVI). Method This is a single-centre study carried out in Swansea, South West Wales, UK between 5 November 2009 and 10 June 2018. Data included age, gender, domiciliary postal code, comorbidities, complication...
Article
Full-text available
WW domain binding protein 1‐like (WBP1L), also known as outcome predictor of acute leukaemia 1 (OPAL1), is a transmembrane adaptor protein, expression of which correlates with ETV6‐RUNX1 (t(12;21)(p13;q22)) translocation and favourable prognosis in childhood leukaemia. It has a broad expression pattern in haematopoietic and in non‐haematopoietic ce...
Article
Full-text available
Solitary cardiac metastasis remains an uncommon diagnosis. Herein, the authors report describes a rare case of a 53-year-old woman with cardiac metastasis of a peripheral de-differentiated myxofibrosarcoma. This case demonstrates the complexity of pairing multimodality imaging and invasive techniques to achieve tissue characterization and diagnosis...
Conference Paper
Background Phospholipids on the surface of platelets play a key role in supporting coagulation in both health and disease. Alterations to phospholipid composition in platelets can contribute to thrombotic and bleeding disorders. We recently identified pro-coagulant enzymatically oxidized phospholipids (eoxPL) generated by platelets in response to t...
Conference Paper
Full-text available
Introduction To compare the impact of e-learning package and theoretical teaching on the ability of both graduate and undergraduate medical students to learn the management of supraventricular tachycardia (SVT). Methods We conducted a randomized controlled blinded study at two medical schools in Wales, UK. Participants included graduate-entry medi...
Article
Full-text available
The prescribing patterns of antiplatelet medicines in primary care in Wales have significantly changed in the last decade. In the 10 years to the end of Q1 2018, the use of aspirin (as measured by the defined daily dose per 1000 prescribing units [DDD per 1000PUs]) has declined in absolute terms by 45% and the use of clopidogrel has more than doubl...
Article
Full-text available
Aim: Antiplatelets have been used for decades to prevent atherothrombotic disease, but there is limited 'real-life' prescribing data. We hereby report the prescribing patterns for oral antiplatelets in Wales, UK. Methods/results: Retrospective analysis of anonymized data in Wales from 2005 to 2016 revealed differences in prescribing patterns of...
Article
Background Application to cardiology specialty training is competitive with uncertainty among candidates as to what the secret recipe for a successful appointment is. We aimed to investigate objective variables, which were demonstrated by successful appointees to cardiology training schemes in the UK. Methods Data from successful cardiology applic...
Conference Paper
Introduction Diabetes mellitus (DM) is a recognised risk factor for the development of non-alcoholic fatty liver disease (NAFLD). Both entities are increasingly recognised to be different manifestations of a wide spectrum of metabolic syndrome phenotypes. Our study aims to determine whether incidental abnormal liver function tests (LFT) precede the...
Article
Background and aim Cardiovascular disease is the biggest killer in Wales, with non-ST-elevation acute coronary syndrome (NSTEACS) forming the commonest diagnosis. NSTEACS patients are at risk of death, reinfarction and ischaemia, a risk that increases as cardiovascular risk (GRACE) increases. Standard initial medical therapy followed by the conside...
Article
Full-text available
Objectives Following non-ST-elevation acute coronary syndrome (NSTEACS), patients are treated with medication and considered for invasive therapy and revascularization. Mortality for this whole population is high in the first year with multiple studies suggesting anything from 4% to 10%. However, the risk of death after the first year has a wide di...
Presentation
Full-text available
BACKGROUND Malignant mixed tumour is an exceedingly rare cutaneous adnexal carcinoma with a propensity for aggressive growth, recurrence and metastasis. More common in men (x2), it can affect all age groups (range 15 months to 50 years. ) Malignant mixed tumour usually presents as a firm, circumscribed, asymmetrical cutaneous or subcutaneous large...
Article
Full-text available
Aim: Statins have a proven role for the secondary prevention of cardiovascular disease. Despite this, typical patient use in real life is variable. Our aim was to investigate the typical clinical use, including adherence, for statins in a sample population in South Wales (UK). Methods: We identified 2248 patients admitted to hospitals in South W...
Article
Full-text available
What is known and objective: Oral anticoagulants (OACs) have been used for decades for the long-term prevention of arterial and venous thromboembolic disease. These include warfarin and the newer direct-acting OACs (DOACs). Data on 'real-life' prescribing patterns for DOACs are limited. In this commentary, we report the prescribing patterns for OA...
Article
Full-text available
Background: Friday the 13th is described as an "unlucky" day that brings misfortune. There are few studies on the question, and none on its effect in cardiovascular patients. The recently misreported "weekend effect" has led to changes in the junior doctor contract in England, providing greater staffing levels on weekends. Should we make similar p...
Article
Objectives: Determine the real-world difference between 2 groups of patients with severe aortic stenosis and similar baseline comorbidities: surgical turn down (STD) patients, who were managed medically prior to the availability of transcatheter aortic valve implantation (TAVI) following formal surgical outpatient assessment, and patients managed w...
Article
Full-text available
Background Coronary artery disease (CAD) is a major public and economic health problem. Coronary angiography is a gold standard for diagnosing CAD and is indicated in patients with 61–90% pre-test probability of the disease when the diagnosis cannot be made on clinical grounds alone and when revascularisation is being considered. The natural histor...
Article
Severe Symptomatic Aortic Stenosis: Historical medical treatment vs Transcatheter Aortic Valve Implantation. A Real World Analysis of Admission profiles, Cost, and Mortality using the Secure Anonymised Information Linkage (SAIL) databank. Majd B Protty †, Phillip M Freeman †*, Omar Aldalati §, Arron Lacey §, William King *, Richard A Anderson †, Da...
Article
Full-text available
Objectives To determine the association between the side of the hip fracture and the subsequent occurrence of symptomatic lower limb DVT. Setting Single tertiary trauma centre, Wales. Participants All 3657 patients presenting with hip fracture between 2007 and 2013 were identified from our unit's National Hip Fracture Database. We excluded 404 pati...
Article
Full-text available
Background. Near-peer teaching is becoming increasingly popular as a learning methodology. We report the development of a novel near-peer biological sciences revision course and its acceptability and impact on student confidence and exam performance. Methods. A cross-sectional analysis of tutee-completed evaluation forms before and after each sessi...
Article
Full-text available
The GMC has emphasized the importance of teaching skills for doctors and recommended that training for these skills is introduced early on in the medical education curriculum. One way to achieve this is in the form of near-peer assisted learning, where junior medical students are taught by senior ones. We here report the development of an extensive...
Conference Paper
Full-text available
The risk of increased IOP was significantly raised with higher serum PAI-1, with adjusted odds ratios (95% confidence intervals) for second and third tertiles of 1.31 (0.81-2.12) and 1.81 (1.15-2.83), respectively. Haematocrit, glycosylated haemoglobin (HbA1c), heart rate, and high-density lipoprotein (HDL-C) were the only vascular risk factors pos...
Article
Full-text available
We investigated the cause of mild mucocutaneous bleeding in a 14-year-old male patient (P1). Platelet aggregation and ATP secretion induced by arachidonic acid and the thromboxane A(2) receptor (TxA(2)R) agonist U46619 were reduced in P1 compared with controls, whereas the responses to other platelet agonists were retained. P1 was heterozygous for...
Article
Full-text available
Background Increasing evidence suggests that individual isoforms of protein kinase C (PKC) play distinct roles in regulating platelet activation.Methodology/Principal FindingsIn this study, we focus on the role of two novel PKC isoforms, PKCδ and PKCε, in both mouse and human platelets. PKCδ is robustly expressed in human platelets and undergoes tr...
Article
Full-text available
Platelets are essential for wound healing and inflammatory processes, but can also play a deleterious role by causing heart attack and stroke. Normal platelet activation is dependent on tetraspanins, a superfamily of glycoproteins that function as 'organisers' of cell membranes by recruiting other receptors and signalling proteins into tetraspanin-...
Article
Full-text available
During thrombopoiesis, maturing megakaryocytes (MKs) migrate within the complex bone marrow stromal microenvironment from the proliferative osteoblastic niche to the capillary-rich vascular niche where proplatelet formation and platelet release occurs. This physiologic process involves proliferation, differentiation, migration, and maturation of MK...

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