Christopher Rajkumar @rajkumar_chris Twitter profile

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@bokeplokalmalam

Christopher Rajkumar

@rajkumar_chris

1 year

Just 8 days until we present the results of the placebo-controlled #ORBITA2 trial as late breaking science at #AHA23 in Philadelphia. Join us at 10:35 ET on Saturday 11/11/23. @rallamee @mshunshin @ProfDFrancis @American_Heart

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Christopher Rajkumar

@rajkumar_chris

2 years

Our #JACC letter shows troponin release is common following exercise in patients with a severe coronary stenosis. ⬆️exercise intensity, ⬆️troponin increment PCI markedly⬇️ischaemia, but no effect on troponin release compared with placebo. Suggests ischaemia not the mechanism

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Christopher Rajkumar

@rajkumar_chris

11 months

To find out more about the #ORBITA2 trial, come to our deep dive session at 0800 in room 103C @American_Heart @rallamee @Drroxmehran

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Christopher Rajkumar

@rajkumar_chris

5 years

#ISCHEMIA and #ORBITA are not trials of Revasc vs. OMT (common misconception). Both arms get "OMT", so the trials examine the *additive* benefit of Revasc on a background of medical therapy. Here's why assessing quality of medical therapy is critical:

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Christopher Rajkumar

@rajkumar_chris

1 year

Thank you @RoySocMed , @SukhNijjer and @doctor_paz . Only possible with amazing supervisors and colleagues @rallamee @mshunshin @ProfDFrancis @MikeFoley89 @fiyyazAJ

Sukh Nijjer

@SukhNijjer

1 year

A real pleasure to join some of the brightest minds in UK Cardiology as they competed for the RSM @RoySocMed Cardiology President’s Prize. Great work from all the speakers including @arunsau_ @DoctorMitShah @drgeorgejoy @DrKiranPatel1 @DrAdamHartley . Congrats to @rajkumar_chris

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Christopher Rajkumar

@rajkumar_chris

11 months

This is the principal question of the ORBITA-STAR trial, coming in the next year @rallamee @ImperialNHLI

Robert W. Yeh

@rwyeh

11 months

PCI is effective at reducing angina when the target coronary lesion is responsible for angina. Sounds obvious, but bears repeating because of the implications: This is a DIAGNOSTIC problem, not a therapeutic one. We don't have a perfect test linking symptoms to disease.

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Christopher Rajkumar

@rajkumar_chris

1 year

Teams like this don’t come around very often: an enormous privilege to work alongside @rallamee @MikeFoley89 and @fiyyazAJ to deliver #ORBITA2 Huge thanks to the patients and our amazing centres across the UK. As for the result, watch this space 🍿

Rasha Al-Lamee

@rallamee

1 year

This is a really exciting day for the ORBITA family! The last of 301 patients randomised in the ORBITA-2 trial. Smiles all round!! Well done to @rajkumar_chris for driving this trial and thanks to all our incredible collaborators all over the UK who really made this happen

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Christopher Rajkumar

@rajkumar_chris

11 months

Having spent an unhealthy amount of time together making #ORBITA2 happen, I can confirm that these are the TWO smartest people on the planet @mshunshin @rallamee

Rasha Al-Lamee

@rallamee

11 months

There is an unsung hero in the ORBITA family and we don’t do forgotten heroes. @mshunshin is the cleverest man I know and responsible for all the statistics and beautiful figures in ORBITA-2 (with a little help from my RAL chart). Give this man a round of applause!

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Christopher Rajkumar

@rajkumar_chris

6 years

Got an MRC Training Fellowship! Huge thanks to all these awesome people @rallamee @ProfDFrancis @DrShaiSen @SukhNijjer @DrJHoward @mshunshin @RicardoPetraco @ya43266242 @CCook_MD @henselig

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Christopher Rajkumar

@rajkumar_chris

2 years

Pleased to present our work with #EAPCI examining differences in consenting practice in interventional cardiology across Europe #ESCCongress @rallamee @EAPCIPresident @ImperialNHLI @DonnaFitzQUB

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Christopher Rajkumar

@rajkumar_chris

6 years

Our take on the complex question of upcoding. Not a malicious process, but a fascinating experiment of nature. @ProfDFrancis @willsuh76 with commentary from @bnallamo @SVRaoMD

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Christopher Rajkumar

@rajkumar_chris

2 years

Incredible 3 days at #CVCT2022 . A masterclass in clinical trial design, conduct and interpretation. @Drroxmehran @djc795 @rallamee

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Christopher Rajkumar

@rajkumar_chris

4 years

@IamSpurs

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Christopher Rajkumar

@rajkumar_chris

3 years

So grateful to @DrKeeble @rallamee @DrPeterOKane @pajhaworth @manasinha @neilruparelia @HelenRoutledge2 @dr_tkot @timkinnaird2 @NickCurzen @RicardoPetraco James Spratt, Rupert Williams and of course @MikeFoley89 for driving this forwards!

Dr Thomas Keeble

@DrKeeble

3 years

Special day at Essex CTC today. ORBITA2 randomisation in lab 1 and simultaneously ORBITA CTO randomisation in cath lab 2. We are getting good at placebo controlled pci ! Can’t wait for both trial results. @rallamee @CCook_MD @rajkumar_chris @dr_skhan1 @essexheartfund

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Christopher Rajkumar

@rajkumar_chris

5 years

@londontaxi_pr @rallamee @alibendertv @SCatlingAuthor @SukhNijjer Hi, thanks. Can you ask your drivers to fill this out if they are able to help?

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Christopher Rajkumar

@rajkumar_chris

6 years

Very honoured to be included in this! @ProfDFrancis @rallamee @SukhNijjer @drgrahamcole

John Mandrola, MD

@drjohnm

6 years

My Top-10 Cardiology/Medical Stories of 2018 is up @theheartorg Gosh. I was often wrong last year. > Let me know if I missed any of your favorites. #FOAMed #cardiotwitter #CardioEd #Meded

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Christopher Rajkumar

@rajkumar_chris

5 years

@rallamee So far @HpTaxi @mirna0405 @teegee217 @whalley1207 @biffbaffboffboo @g_lizard @AllaCarenko @CabbyMan63 @frosty267 @TheLudlows @dopepeddlar @Catdaman @samthecabby @AitchNewby @cabbienorrie @lp12lft @EmreOzCabbie @Rcurtis24 @ladycabdriver73 @FreeLondonTaxi

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Christopher Rajkumar

@rajkumar_chris

5 years

Thanks @madedotcom for kitting out our Cardiology staff rest rooms at Hammersmith with a very generous donation! @ImperialNHS @rallamee @SukhNijjer @LCC_DrMalik @rkhamis

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Christopher Rajkumar

@rajkumar_chris

1 year

@MedCrisis @rallamee Thanks Rohin. Couldn’t have done it without The Essex CTC. Missed you today @DrKeeble

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Christopher Rajkumar

@rajkumar_chris

1 year

@DrPeterOKane @DrKeeble @pajhaworth @dr_tkot @manasinha @SukhNijjer @neilruparelia @HelenRoutledge2 @NickCurzen @RicardoPetraco @Dr_Stig @DrShaiSen @ProfDFrancis and many many more.

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Christopher Rajkumar

@rajkumar_chris

4 years

Side effect from statins or nocebo? Find out in an hour! #SAMSON #AHA20 @DrJHoward @ProfDFrancis @mshunshin @AlexNowbar

Rasha Al-Lamee

@rallamee

4 years

If you only want to watch one presentation today - make it this one! #SAMSON #AHA20 @DrJHoward @ProfDFrancis @mshunshin

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Christopher Rajkumar

@rajkumar_chris

4 years

BHF Imperial CRE COVID-19 Experience Symposium starting now @ImperialNHLI @BHFCoREImperial

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Christopher Rajkumar

@rajkumar_chris

6 years

The Christmas BMJ's guide to spinning a negative clinical trial

Alex Nowbar

@AlexNowbar

6 years

Key opinion leaders’ guide to spinning a disappointing clinical trial result

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Christopher Rajkumar

@rajkumar_chris

7 years

@bnallamo @CircOutcomes @JJRyanMD @ProfDFrancis @SukhNijjer @rallamee @venkmurthy @rwyeh @drjohnm @RogueRad ISCHEMIA was designed to be definitive. By randomising patients with more ischemia than COURAGE and being powered for hard endpoints (CV death and MI) (unlike FAME2) it promised to finally define the role of contemporary revasc in SIHD

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Christopher Rajkumar

@rajkumar_chris

5 years

@seanpaulday @HayleyFreedman @rallamee @HpTaxi @mirna0405 @teegee217 @whalley1207 @biffbaffboffboo @g_lizard @AllaCarenko @CabbyMan63 @frosty267 @TheLudlows @dopepeddlar @Catdaman @samthecabby @AitchNewby @cabbienorrie @lp12lft @EmreOzCabbie @Rcurtis24 @ladycabdriver73 @FreeLondonTaxi If you could direct all cab drivers to this form, that would be great

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Christopher Rajkumar

@rajkumar_chris

2 years

Article here: @rallamee @HighSTEACS @mshunshin @louiseacullen @rkhamis @RyanWereski @f2harrell @MikeFoley89 @JACCJournals @ImperialNHLI

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Christopher Rajkumar

@rajkumar_chris

7 years

@barttels2 @ProfDFrancis @bnallamo @venkmurthy @cardiobrief @ajaykirtane @SripalBangalore @GreggWStone @hmkyale @rwyeh @SVRaoMD Think of subtraction anxiety as medical FOMO (Fear Of Missing Out) - (not my analogy). It affects both patients and physicians in the control arm, and influences soft endpoints in unblinded trials.

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Christopher Rajkumar

@rajkumar_chris

5 years

Here’s our tips and tricks paper for right sided trans-axillary #TAVR with the Edwards Sapien 3 and Ultra valves @LCC_DrMalik @CCook_MD @MikhailGhada @DrShaiSen

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Christopher Rajkumar

@rajkumar_chris

1 year

@DrPeterOKane @rallamee @imperialcollege @BCIS_uk @PCRonline @crfheart Thanks @DrPeterOKane London-Bournemouth return >50 times is a lot of miles but always happy to do it because the quality is so so high and the team totally superb @UHD_NHS @BCIS_uk Thank you all

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Christopher Rajkumar

@rajkumar_chris

5 years

@rallamee @HpTaxi @mirna0405 @teegee217 @whalley1207 @biffbaffboffboo @g_lizard @AllaCarenko @CabbyMan63 @frosty267 @TheLudlows @dopepeddlar @Catdaman @samthecabby @AitchNewby @cabbienorrie @lp12lft @EmreOzCabbie @Rcurtis24 @ladycabdriver73 @FreeLondonTaxi And many many more not on twitter. Who else's out there?

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Christopher Rajkumar

@rajkumar_chris

1 year

@pajhaworth @rallamee Thanks Peter, likewise. HUGE contribution from you to ORBITA2! @PHU_NHS feels like a home from home!

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Christopher Rajkumar

@rajkumar_chris

4 years

@DrPeterOKane @Mariathas83 @BHIBristol @UHD_NHS @WessexSpRs @UHSFT @twj1974 @jstrange1 @ncurzen @BCIS_uk @AbbottCardio @divaka_perera Congratulations Mark! How about delivering some placebo for us in Bristol?

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Christopher Rajkumar

@rajkumar_chris

11 months

@rajivxgulati Absolutely - we need to start applying tests of symptom verification (just identifying ischaemia is not enough).

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Christopher Rajkumar

@rajkumar_chris

11 months

@djc795 @rajivxgulati 👍 Watch this space… hopefully we can explain some of the 59% residual symptoms in ORBITA-2.

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Christopher Rajkumar

@rajkumar_chris

7 years

@CircOutcomes @bnallamo @JJRyanMD @ProfDFrancis @SukhNijjer @rallamee @venkmurthy @rwyeh @drjohnm @RogueRad Here we explore the dangers of soft endpoints in unblinded trials using DEFER and FAME2 as examples. And explore the implications for ISCHEMIA

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Christopher Rajkumar

@rajkumar_chris

3 years

@fiona73938473 @manasinha @SDHResearch @CardiacSuite @rallamee Thanks Fiona, easy job when you’ve got a great team 👍

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Christopher Rajkumar

@rajkumar_chris

2 years

@HighSTEACS @Anping18 @rallamee @mshunshin @RyanWereski @f2harrell @louiseacullen @MikeFoley89 We need a third arm of age matched controls with no CAD at all.

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Christopher Rajkumar

@rajkumar_chris

4 years

The side effects of statins are overwhelmingly caused by the act of taking the tablet, but not by the drug itself...

James Howard

@DrJHoward

4 years

Thank you everyone who made SAMSON happen, but by far most of all Frances Wood. It's truly her trial. We are so grateful from the @TheBHF and @ImperialNHLI 's support. You can read our simultaneously published research correspondence in NEJM here

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Christopher Rajkumar

@rajkumar_chris

7 years

@barttels2 @ProfDFrancis @bnallamo @venkmurthy @cardiobrief @ajaykirtane @SripalBangalore @GreggWStone @hmkyale @rwyeh @SVRaoMD You are quite right, however I can confirm we will not be changing the article again 😂

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Christopher Rajkumar

@rajkumar_chris

7 years

@ProfDFrancis @bnallamo @RogueRad Subtraction anxiety is a powerful force affecting any unblinded trial of an intervention already considered beneficial. ISCHEMIA will suffer from this bias now that hospitalisation for heart failure / unstable angina is counted

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Christopher Rajkumar

@rajkumar_chris

7 years

@DavidLBrownMD @GreggWStone @bnallamo @ProfDFrancis @venkmurthy @cardiobrief @ajaykirtane @SripalBangalore @hmkyale @rwyeh @SVRaoMD And pre-specified definitions can only be applied to patients who turn up to be assessed

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Christopher Rajkumar

@rajkumar_chris

5 years

@docmasoodkhan @ProfDFrancis

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Christopher Rajkumar

@rajkumar_chris

7 years

@ProfDFrancis Me: “But Sukh has some valid reservations over the term ‘Faith Healing....” Darrel:

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Christopher Rajkumar

@rajkumar_chris

2 years

@DrJHoward @hollymorgs Same! Was a regular in the 90’s

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Christopher Rajkumar

@rajkumar_chris

2 years

@AMaznyczka @PHU_NHS @pajhaworth @nanoinspiration @HBulluck @abdulmozid We will miss you for the #ORBITA2 procedures at Portsmouth @AMaznyczka . See you soon!

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Christopher Rajkumar

@rajkumar_chris

6 years

@bnallamo @venkmurthy @DLBHATTMD @DavidLBrownMD @denniskomd @HeartRPh @SripalBangalore @ProfDFrancis @rwyeh @RanLeeMD @JAMA_current @outcomesjc @gabrielsteg Subtraction anxiety will exist although I suspect more from the physician’s than the patient’s perspective. Few patients will be too concerned that they take 4 rather than 5 tablets post MI.

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Christopher Rajkumar

@rajkumar_chris

2 years

@ajaykirtane @crfheart @mbmcentegart @atunuguntla1 Brilliant course! Thanks for having us over, learned a huge amount! @MikeFoley89

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Christopher Rajkumar

@rajkumar_chris

2 years

@Dr_Stig @DrR_Jabbour @UHSFT Congratulations @DrR_Jabbour I’ll see you down there for some ORBITA2 cases

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Christopher Rajkumar

@rajkumar_chris

1 year

@DrPeterOKane @JonathanWHinton @UHD_NHS @BCIS_uk @Siggers1000 @ncurzen @johnpaisey @JehangirDin @Mariathas83 @kristelly79 @kliokon Congratulations @JonathanWHinton 👏👏👏

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Christopher Rajkumar

@rajkumar_chris

6 years

@MarcDweck @venkmurthy @DrJHoward @Guusdewaard @SukhNijjer @CCook_MD @rallamee @ProfDFrancis Yes - relationship looks to be poor (from limited studies). Surely if we want to treat symptoms, the symptomatic response a patient experiences during induced ischaemia testing may be the best predictor of response to revasc?

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Christopher Rajkumar

@rajkumar_chris

1 year

@HelenRoutledge2 @rallamee Worcester was always my favourite 🤫

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Christopher Rajkumar

@rajkumar_chris

5 years

@billythered33 @rallamee @HpTaxi Hi Billy, we are just collecting a list of names and numbers of cabbies able to help NHS workers get in and out of hospitals. If you follow back I'll get some details from you by DM

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Christopher Rajkumar

@rajkumar_chris

7 years

@DrAfzalSohaib @ImperialNHLI @TheBJCA Haha Thanks @DrAfzalSohaib , learned from the best!

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Christopher Rajkumar

@rajkumar_chris

6 years

@bnallamo @venkmurthy @DLBHATTMD @DavidLBrownMD @denniskomd @HeartRPh @SripalBangalore @ProfDFrancis @rwyeh @RanLeeMD @JAMA_current @outcomesjc @gabrielsteg A placebo control would be optimal although perhaps impractical given the long duration of follow up likely needed for a trial in normal EF post MI patients

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Christopher Rajkumar

@rajkumar_chris

2 years

@DrKeeble @rallamee @MikeFoley89 @fiyyazAJ No scabs here. Had a talk at BCS meeting. I promise!

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Christopher Rajkumar

@rajkumar_chris

5 years

@petergross11 @rallamee @Catdaman @alibendertv @SCatlingAuthor @SukhNijjer Hi Peter, thanks! If you could follow back I will get your details via DM

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Christopher Rajkumar

@rajkumar_chris

7 years

@ProfDFrancis @DavidLBrownMD @bnallamo @SripalBangalore @CircOutcomes @JJRyanMD @SukhNijjer @rallamee @venkmurthy @rwyeh @drjohnm @RogueRad @ajaykirtane @GreggWStone @CMichaelGibson I’ll be avoiding Potter’s bar then!

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Christopher Rajkumar

@rajkumar_chris

7 years

@bnallamo @CircOutcomes @JJRyanMD @ProfDFrancis @SukhNijjer @rallamee @venkmurthy @rwyeh @drjohnm @RogueRad A lower than expected event rate may reflect a rarefied patient population as a result of hefty exclusion criteria. However, ultimately we must acknowledge that a negative trial can be as informative as a positive one and we should learn from and respect the result.

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