Dr Yuk-ki Wong

Winner of 2004 DTI Smart award.

Winner of DTI SMART award 2004

Dr Yuk-ki Wong's undergraduate training was at Manchester University and he graduated with MB ChB in 1990 having gained an intercalated BSc(Hons) in Physiology in 1987. After junior posts in the North West and obtaining his MRCP, he started his cardiology training including research in the Wessex Region during 1993 and was awarded his certificate of completion of specialist training (CSST) in cardiology and general medicine in 2002. He was elected FRCP in 2008.

Since 2003, he has been a Consultant Cardiologist working for the Western Sussex Hospitals NHS Foundation Trust. He is based at St. Richard’s Hospital, Chichester. He is the clinical lead for Heart Failure and is also a General Cardiologist caring for patients with a wide range of conditions including coronary disease, arrhythmias such as atrial fibrillation, valvular heart disease and hypertension. His routine work includes cardiac catheterisation, implantation of permanent pacemakers and both transoesophageal and transthoracic echocardiography. He helped to develop CT coronary angiography at WSHFT. He is also the lead for cardiology research with interests in heart failure, coronary disease, hyperlipidaemia and atrial fibrillation.

Research

Doctor of Medicine Degree (1999)

In the 1990s, there was great excitement because coronary disease was thought to be caused by a bacterium known as Chlamydia pneumoniae which meant it could potentially be eradicated by antibiotics. Under the supervision of Professor Mike Ward at the Department of Molecular Microbiology, Southampton University, Dr Wong worked on projects funded by the British Heart Foundation and Wessex Heartbeat Charity. There was also collaborative work with groups from Oxford, the MRC Environmental Epidemiology Unit and the Biobanque De Picardie. This work resulted in a number of important papers but the results were mixed and it does not look as if Chlamydia is an important cause of coronary disease.

The ALARM study. Predicting when heart attacks will occur

It is often thought that heart attacks occur without warning and unfortunately, death can occur shortly afterwards. Therefore, a tremendous amount of research and re-organisation of services has been carried out in order to treat patients within the first “Golden Hour”.

If patients could be treated in the period before a heart attack, even more lives could be saved. In fact, approximately 50% of patients have unstable angina in the 2 week period leading up to a heart attack with symptoms occurring at lower levels of exertion. Since heart rate is a measure of exertion, then symptoms occurring at low heart rate could be warning for an impending heart attack. Dr Wong was awarded an NIHR grant to test his hypothesis and the results of a clinical trial were promising and published in 2015. Ongoing work involves the development of a reliable, portable heart rate monitor.

Large Databases

Dr Wong is a self taught computer programmer and has developed a number of clinical databases including a Rapid Access Chest Pain Clinic database used in 3 South Coast Hospitals including the Wessex Cardiothoracic Unit at Southampton General Hospital. He also developed Jersey General Hospital's first CCU electronic database. Some of his research pertains to analysis of data from such databases as well as other sources of data including the UK National Census.

Phase III Clinical Trials

Many drugs have been introduced into clinical practice that have improved the lives of patients with cardiac diseases. These drugs were tested in large clinical trials which in total have involved hundreds of thousands of patients and numerous research staff, Principal Investigators and research centres. Dr Wong has been the Principal Investigator for many trials including ILLUMINATE, RIVER, REVEAL, THRIVE, FIDELIO, FIGARO, ODYSSEY, ODYSSEY LONG TERM, CRESCENDO, AVERROES, ARISTOTLE, ATMOSPHERE, CLEAR-HARMONY, COMMANDER, IMPROVE-IT, SIGNIFY, SOLID, STABILITY, EXAMINE, TRANSITION and TRILOGY.

The drugs investigated in these trials include ranolazine, ivabradine, rivaroxaban, ezetimibe, alirocumab, finerenone, anacetrapib, laropiprant, Rimonabant, alogliptin, aliskiren, bempedoic acid, darapladib, torcetrapib and apixaban.

Two new trials that will be commenced in 2018 are IRONMAN which is investigating the role of intravenous iron in heart failure and SELECT which will be investigating the role of semaglutide in reducing cardiovascular risk and weight.

Teaching of Medical Undergraduates

Dr Wong is a Honorary Senior Lecturer for Kings College Medical School and was previously a Firm Head and Sub Dean. He also teaches medical students from Brighton and Southampton Medical Schools and is a clinical and educational supervisor for junior doctors.

Publications

  1. Angina at Low heart rate And Risk of imminent Myocardial infarction (the ALARM study): a prospective, observational proof-of-concept study. Wong YK, Stearn S, Moore S, Hale B. BMC Cardiovasc Disord. 2015 Nov 14;15:148. doi: 10.1186/s12872-015-0140-z.
  2. The prevalence of Chlamydia pneumoniae in atherosclerotic and nonatherosclerotic blood vessels of patients attending for redo and first time coronary artery bypass graft surgery. Wong Y, Thomas M, Tsang V, Gallagher PJ, Ward ME. J Am Coll Cardiol. 1999 Jan;33(1):152-6.
  3. Chlamydia pneumoniae and atherosclerosis. Wong YK, Gallagher PJ, Ward ME. Heart. 1999 Mar;81(3):232-8.
  4. Chronic infection with Helicobacter pylori, Chlamydia pneumoniae, or cytomegalovirus: population based study of coronary heart disease. Danesh J, Wong Y, Ward M, Muir J. Heart. 1999 Mar;81(3):245-7.
  5. Relation between direct detection of Chlamydia pneumoniae DNA in human coronary arteries at postmortem examination and histological severity (Stary grading) of associated atherosclerotic plaque. Thomas M, Wong Y, Thomas D, Ajaz M, Tsang V, Gallagher PJ, Ward ME. Circulation. 1999 Jun 1;99(21):2733-6.
  6. The species specificity of the microimmunofluorescence antibody test and comparisons with a time resolved fluoroscopic immunoassay for measuring IgG antibodies against Chlamydia pneumoniae. Wong YK, Sueur JM, Fall CH, Orfila J, Ward ME. J Clin Pathol. 1999 Feb;52(2):99-102.
  7. Strong correlation between Helicobacter pylori seropositivity and Chlamydia pneumoniae IgG concentrations. Danesh J, Wong YK, Ward M, Hawtin P, Murphy M, Muir J. J Epidemiol Community Health. 1998 Dec;52(12):821-2.
  8. Circulating Chlamydia pneumoniae DNA as a predictor of coronary artery disease. Wong YK, Dawkins KD, Ward ME. J Am Coll Cardiol. 1999 Nov 1;34(5):1435-9.
  9. Risk factors for coronary heart disease and persistent infection with Chlamydia pneumoniae or cytomegalovirus: a population-based study. Danesh J, Wong Y, Ward M, Muir J. J Cardiovasc Risk. 1999 Dec;6(6):387-90.
  10. Chlamydia pneumoniae infection and mortality from ischaemic heart disease: large prospective study. Wald NJ, Law MR, Morris JK, Zhou X, Wong Y, Ward ME. BMJ. 2000 Jul 22;321(7255):204-7.
  11. Chlamydia pneumoniae IgG titres and coronary heart disease: prospective study and meta-analysis. Danesh J, Whincup P, Walker M, Lennon L, Thomson A, Appleby P, Wong Y, Bernardes-Silva M, Ward M. BMJ. 2000 Jul 22;321(7255):208-13.
  12. The association between deaths from myocardial infarction and household size in England and Wales. Wong YK, Dawkins KD, Ward ME. J Cardiovasc Risk. 2001 Jun;8(3):159-63.
  13. Chlamydia pneumoniae IgA titres and coronary heart disease; prospective study and meta-analysis. Danesh J, Whincup P, Lewington S, Walker M, Lennon L, Thomson A, Wong YK, Zhou X, Ward M. Eur Heart J. 2002 Mar;23(5):371-5.
  14. Sex differences in investigation results and treatment in subjects referred for investigation of chest pain. Wong Y, Rodwell A, Dawkins S, Livesey SA, Simpson IA. Heart. 2001 Feb;85(2):149-52.
  15. Improving the positive predictive value of exercise testing in women. Wong YK, Dawkins S, Grimes R, Smith F, Dawkins KD, Simpson IA. Heart. 2003 Dec;89(12):1416-21.
  16. Influences of matrix metalloproteinase-3 gene variation on extent of coronary atherosclerosis and risk of myocardial infarction. Beyzade S, Zhang S, Wong YK, Day IN, Eriksson P, Ye S. J Am Coll Cardiol. 2003;41(12):2130-7.
  17. Genotypic effect of the -565C T polymorphism in the ABCA1 gene promoter on ABCA1 expression and severity of atherosclerosis. Kyriakou T, Hodgkinson C, Pontefract DE, Iyengar S, Howell WM, Wong YK, Eriksson P, Ye S. Arterioscler Thromb Vasc Biol. 2005 Feb;25(2):418-23. Epub 2004 Nov 4.