Dr Hoole qualified in medicine with distinction from University of Oxford, and subsequently trained in cardiology in London and Cambridge. He was appointed as a consultant interventional cardiologist in September 2011 and currently holds a national clinical excellence Silver award. 

He has published over 150 peer reviewed manuscripts and is an affiliated Associate Professor at the University of Cambridge. He is a specialist adviser to MHRA interventional device program, NICE interventional procedures program and the NIHR HTA program. He is an Expert Adviser for the NICE Centre for Guidelines and has participated in guideline and position paper publications for the ESC, ACC, AHA and NICE and is currently appointed as a NICE clinical guideline chair. He is regularly asked to act as a medicolegal expert and has an efficient and busy private practice.

Dr Hoole is happy to see adult self funding or insured private patients with any cardiological problem but he has a specialist interest in relieving patients of angina and in particular, performing complex coronary intervention and stenting via the wrist artery. This includes the treatment of chronic total occlusions, left main, bifurcation and heavily calcified lesions with calcium modification techniques including laser. He is an expert on stent safety and improving stent outcomes by utilising coronary physiology and advanced coronary imaging.

He specialises in treating refractory angina and leads the regional coronary sinus reducer service. He is also the national interventional lead for the UK balloon pulmonary angioplasty service.

Specialist Clinical Interests

Coronary Intervention, chronic total occlusion PCI, Calcium modification with RA, OA and ELCA, Structural Intervention, Coronary Sinus Reducer, Interventional Research, CT coronary angiography, cardiac support devices and balloon pulmonary angioplasty for CTEPH

Research Interests

Coronary stent safety
Cardioprotection during PCI
Metabolic optimisation during PCI
Myocardial injury during revascularization
Coronary/left ventricular physiological assessment during PCI
Coronary microvascular and collateral function assessment during PCI
Vulnerable plaque imaging with VH-IVUS and OCT
Biomarker profiling during PCI
Coronary intervention risk prediction modeling
Coronary stent design & technology
Innovation of interventional devices
PFO closure in sleep apneoa
Right ventricular haemodynamics

Education and Training

1995   BA (Class: I), University of Oxford
1998   BM BCh, University of Oxford
2001   MRCP, London
2001   MA, University of Oxford
2009   DM, University of Oxford
2010   Board Certified CCT, USA
2015   FESC
2015   FACC    
2016   FRCP, London

Current membership(s) of professional, national and regional bodies and university posts

Fellow of the Royal College of Physicians, London
Fellow of the American College of Cardiology
Fellow of the European Society of Cardiology
British Cardiovascular Intervention Society
General Medical Council (Full registration: 4530426)
Specialist Advisor to National Institute for Health and Clinical Excellence
Specialist Advisor to NIHR HTA Programme
Specialist Adviser to MHRA Interventional Devices Programme
Member of NICE NCGC Acute Chest Pain Guideline Committee, RCP
Member of Regional Specialist Training Committee (Cardiology), Eastern Deanery
NICE Clinical Guideline Chair
Elected Member of Early Career Section Leadership Council, ACC

Clinical Outcomes

To view Dr Hoole's clinical outcomes, please click on this link. This will take you to the British Cardiovascular Intervention Society website which is not part of the Royal Papworth Hospital website.

Recent and Important Publications
  • Prognostic Value of The Index of Microcirculatory Resistance After Primary Percutaneous Coronary Intervention: a Pooled Analysis of Individual Patient Data from 6 cohorts.
    El Farissi M, Zimmermann FM, De Maria GL, van Royen N,  van Leeuwen MAH, Carrick D, Carberry J,  Wijnbergen IF, Konijnenberg L,  Hoole SP, Fineschi M, Pijls NHJ, Oldroyd KG, Banning AP, Berry C, Fearon WF. JACC Intv 2023 in press
  • Balloon pulmonary angioplasty outcomes in patients previously treated by pulmonary endarterectomy surgery are inferior to those of inoperable patients. 
    Kirkby LC, Rodgers MS, Amaral-Almeida L, Sheares K, Toshner M, Taboada D, Ng C, Cannon JE, Tsui S, Taghavi FJ, Jenkins DP, Coghlan JG, Pepke-Zaba J, Hoole SPPulmonary Circulation 2023 in press
  • Long-Term Durability of Self-Expanding and Balloon-Expandable Transcatheter Aortic Valve Prostheses: UK TAVI Registry
    Ali N, Hildick-Smith D, Parker J, Malkin CJ, Cunnington MS, Gurung S, Mailey J, MacCarthy PA, Bharucha A, Brecker SJ, Hoole SP, Dorman S, Doshi SN, Wiper A, Buch MH, Banning AP, Spence MS, Blackman DJ. Catheterization and Cardiovascular Interventions 2023; 101(5):932-942.
  • Acute lung injury after balloon pulmonary angioplasty results in a similar haemodynamic response and possible clinical advantage at follow-up. 
    Rodgers MS, Kirkby LC, Amaral-Almeida L, Sheares K, Toshner M, Taboada D, Ng C, Cannon JE, D’Errico L, Ruggiero A, Screaton N, Jenkins DP, Coghlan JG, Pepke-Zaba J, Hoole SP Pulmonary Circulation 2022 12(4):e12166
  • Ticagrelor Monotherapy or Dual Antiplatelet Therapy After Drug-Eluting Stent Implantation: Per-Protocol Analysis of the GLOBAL LEADERS Trial. 
    Gragnano F, Zwahlen M, Vranckx P, Heg D, Schmidlin K, Hamm C, Steg PG, Gargiulo G, McFadden EP, Onuma Y, Chichareon P, Benit E, Möllmann H, Janssens L, Leonardi S, Zurakowski A, Arrivi A, Van Geuns RJ, Huber K, Slagboom T, Calabrò P, Serruys PW, Jüni P, Valgimigli M, Windecker S and GLOBAL LEADERS Investigators. J Am Heart Assoc. 2022 May 17;11(10):e024291. doi: 10.1161/JAHA.121.024291.
  • Interobserver variability between expert, experienced and novice operators affects interpretation of Optical Coherence Tomography & 20Mhz Intravascular Ultrasound imaging.
    Martin W, McNaughton E, Bambrough P, West NEJW, Hoole SPCRM 2023 47 (2023): 33-39.
  • Somatostatin receptor 2 PET/MR imaging of inflammatory disease activity in large vessel vasculitis and atherosclerosis
    Corovic A, Wall C, Chimeno MN, Huang Y, Gopalan D, Imaz M, Zulcinski M, Peverelli M, Lambert J, Bressan D, Maughan RT, Pericleous C, Jordan N, Hoole SP, Calvert PA, Dean A, Rassl D, Iles M, Hannon G, Frontini M, Manavaki R, Fryer T, Aloji G, Graves MJ, Gilbert F, Dweck M, Newby D, Fayad ZA, Reynolds G, Morgan A, Davenport AP, Jorgensen HF, Mallat Z, Bennett MR, Rudd JHF, Anury GA, Aboagye E, Barwick T, Dubash S, Jayne D, Peters J, Tarkin J Journal of the American College of Cardiology 2023, 81(4), 336-354
  • Trans-myocardial Extraction of Endothelin-1 Correlates with Increased Microcirculatory Resistance following Percutaneous Coronary Intervention
    Abraham GR, Nyimanu D, Kuc RE, Maguire J, Davenport AP, Hoole SPJ Interv Cardiol. 2022:9154048.
  • Low-dose interleukin-2 for the reduction of vascular inflammation in acute coronary syndromes (IVORY): protocol and study rationale for a randomised, double-blind, placebo-controlled, phase II clinical trial.
    Sriranjan R, Zhao T, Kostapanos M, Tarkin J. Hoole SP, Rudd JHF, Cheriyan J, Mallat Z BMJ Open 2022;12(10):e062602
  • A novel approach for assessing post-infarct myocardial injury and inflammation using hybrid somatostatin receptor PET/MRI
    Corovitch A, Gopalan D, Wall C, Peverelli M, Hoole SP, Calvert PA, Maughan RT, Fryer TD, Aloj L, Graves MJ, Bennett MR, Rudd JHF, Tarkin J. Circ Cardiovasc Imaging 2023 Jan;16(1):e014538.
  • Endothelin-1 is Increased in the Plasma of Patients Hospitalized with Covid-19. 
    Abraham G, Kuc R, Althage M, Greasley P, Ambery P, Maguire J, Wilkinson I, Hoole SP, Cheriyan J, Davenport A JMCC 2022; 167: 92-96
  • Mechanistic Study of the Effect of Endothelin SNPs in Microvascular Angina – protocol of the PRIZE Endothelin Sub-Study
    Abraham GR, Morrow AJ, Dempster J, Oliveira J, Weir-McCall J, Duckworth M, Berry C, Davenport AP, Hoole SP IJC Heart & Vasculature 2022; 39: 100980
  • Coronary flow variations following PCI affects diastolic non-hyperemic pressure-ratios more than the whole cycle ratios.
    Aetesam-ur-Rahman M, Zhao TX, Paques K, Oliveira J, Khialani B, Kyranis S, Braganza DM, Clarke SC, Bennett MR, West NEJ, Hoole SPJ Am Heart Assoc. 2022; 11 (9): e023554
  • Coronary imaging of cardiac allograft vasculopathy predicts current and future deterioration of left ventricular function in patients with orthotopic heart transplantation.
    Reddy SA, Khialani BV, Lambert B, Floré V, Brown AJ, Pettit SV, West NEJ, Lewis C, Parameshwar J, Bhagra S, Kydd A, Hoole SP Clinical Transplantation 2022; 36 (2): e14523
  • Trans-myocardial blood Interleukin-6 levels relate to intracoronary imaging defined features of plaque vulnerability and predict procedure-induced myocardial infarction.
    Bambrough P, Peverelli M, Brown AJ, Giblett JP, Bennett MR, West NEJ, Hoole SP CRM 2021; 39: 6-11
  • Coronary Flow Reserve and Cardiovascular Outcomes: A Systematic Review and Meta-Analysis
    Kelshiker MA*, Seligman H*, Howard JP, Rahman H, Foley M, Nowbar AN, Rajkumar CA, Shun-Shin M, Ahmad Y, Sen S, Al-Lamee R, Petraco R, Cole G, Hoole SP, Morris PD, Rigo F, Mayet J, Francis D; Eur Heart J 2022;43(16):1582-1593.
  • Regulatory T cell response to low-dose interleukin-2 in patients with ischemic heart disease
    Zhao TX, Sriranjan RS, Tuong ZK, Lu Y, Sage AP, Nus M, Hubsch A, Kaloyirou F, Vamvaka E, Helmy J, Kostapanos M, Klatzmann D, Tedgui A, Rudd JHF, Horton SJ, Huntly BJP, Hoole SP, Bond SP, Clatworthy MR, Cheriyan J, Mallat Z NEJM Evidence 2022; 1 (1): EVIDoa2100009
  • Five-year outcomes after state-of-the-art percutaneous coronary revascularization in patients with de novo three-vessel disease: final results of the SYNTAX II study
    Banning AP, Serruys P, De Maria GL, Ryan N, Walsh S, Gonzalo N, van Geuns RJ, Onuma Y, Sabate M, Davies J, Lesiak M, Moreno R, Cruz-Gonzalez I, Hoole SP, Piek JJ, Appleby C, Fath-Ordoubadi F, Zaman A, Van Mieghem NM, Uren N, Zueco J, Buszman P, Iniguez A, Goicolea J, Hildick-Smith D, Ochala A, Dudek D, de Vries T, Taggart D, Farooq V, Spitzer E, Tijssen J, Escaned J EHJ 2022;43 (13): 1307-1316
  • Pericoronary and periaortic adipose tissue density are associated with inflammatory disease activity in Takayasu arteritis and atherosclerosis
    Wall C, Huang Y, Le E, Ćorović A, Uy C, Gopalan D, Ma C, Manavaki R, Fryer TD, Aloj L, Graves MJ, Tombetti E, Ariff B, Bambrough P, Hoole SP, Rusk R, Jayne DR, Dweck MR, Newby D, Fayad ZA, Bennett MR, Peters JE, Slomka P, Dey D, Mason JC, Rudd JHF, Tarkin JM. European Heart J Open 2021; 1 (2): oeab019
  • Serial right heart catheter assessment between Balloon Pulmonary Angioplasty sessions identify procedural factors that influence response to treatment
    Hug KP, Coghlan JG, Cannon J, Taboada D, Toshner M, Sheares K, Ruggiero A, Screaton N, Jenkins D, Pepke-Zaba JP, Hoole SP J Heart Lung Transplant. 2021;40(10):1223-1234.
  • Current Strategies for Managing CTEPH: Results of the Worldwide Prospective CTEPH Registry
    Guth S, D'Armini A, Delcroix M, Nakayama K, Fadel E, Hoole SP, Jenkins D, Kiely D, Kim N, Lang I, Madani M, Matsubara H; Ogawa A, Ota-Arakaki J, Quarck R, Sadushi-Kolici R, Simonneau G, Wiedenroth C, Yildizeli B, Mayer E, Pepke-Zaba J, ERJ Open Research 2021 doi.org/10.1183/23120541.00850-2020
  • GLP-1 vasodilatation in humans with coronary artery disease is not adenosine mediated.
    Aetesam-ur-Rahman M, Giblett JP, Khialani B, Kyranis S, Clarke SJ, Zhao TX, Braganza DM, Clarke SC, West NEJ, Bennett MR, Hoole SP. BMC Cardiovasc Disord. 2021 May 1;21(1):223. doi: 10.1186/s12872-021-02030-5.
  • Percutaneous Coronary Intervention in Spontaneous Coronary Artery Dissection: a balance of risk and benefit
    Kotecha D, Garcia-Guimaraes M, Premawardhana D, Pellegrini D, Oliver-Williams C, Boutziouka V, Wood A, Natarajan N, Jackson R, Chan N, Rakhit R, Hoole SP, Johnson TW, Kadziela J, Ludman P, Samani NJ, Maas AHEM, Van Geuns RJ, Alfonso F and Adlam D Heart. 2021;107(17):1398-1406.
  • International Prospective Registry of Acute Coronary Syndromes in Patients With COVID-19
    Kite TA, Ludman P, Gale CP, Wu J, Caixeta A, Mansourati J, Sabate M, Quevedo M, Candilio L, Sadeghipour P, Manjavacas A, Hoole SP, Palmer N, Arize-Sole A, Namitokov A, Escutia-Cuevas H, Vincent F, Cristea O, Ngunga M, Meray I, Morrow AJ, Arefin M, Lindsay S, Kazamel G, Sharma V, Saad A, Sinagra G, Eriksson A, Sanchez FA, Roik M, Savonitto S, Vavlukis M, Sangaraju S, Jabbour R, Kean S, Curzen N, Berry C, Stone GW, Gersh BJ, Gershlick AH On behalf of the COVID-ACS Global Registry Investigators J Am Coll Cardiol. 2021 May 25;77(20):2466-2476
  • Outcomes following PCI in CABG candidates during the COVID-19 Pandemic: The Prospective Multi-Centre UK-ReVasc Registry
    Kite TA, Ladwiniec A, Owens CG, Chase A, Shaukat A, Mozid AM, O’Kane P, Routledge H, Perera D, Jain AK, Palmer N, Hoole SP, Egred M, Sinha MK, Cahill TJ, Candilio L, Anantharam B, Byrne J, Walsh SJ, McEntegart M, Kean S, Siddique L, Curzen N, Budgeon C, Berry C, Ludman P, Gershlick AH Catheter Cardiovasc Interv. 2022; 99 (2): 305-313.
  • Rituximab in Patients with Acute ST-elevation Myocardial Infarction (RITA-MI): an Experimental Medicine Safety Study
    Zhao T, Hoole SP, Mallat Z Cardiovasc Res. 2022; 118 (3): 872-882
  • Adenosine induced Coronary Steal is observed in patients presenting with ST-elevation myocardial infarction.
    Aetesam-ur-Rahman M, Brown AJ, Jaworski C, Giblett JP, Zhao T, Braganza DM, Clarke SC, Agrawal SK, Bennett MR, West NEJ, Hoole SP J Am Heart Assoc. 2021;10(13):e019899. doi: 10.1161/JAHA.120.019899.
  • Rationale and design of the Medical Research Council's Precision Medicine with Zibotentan in Microvascular Angina (PRIZE) trial
    Morrow AJ, Ford, TJ, Mangion K, Kotecha T, Rakhit, R, Galasko G, Hoole SP, Davenport A, Kharbanda K, Ferreira VM, Shanmuganathan M, Chiribiri, A, Perera D, Rahman H, Arnold JR, Greenwood JP, Fisher IM, Husmeier D, Hill NA, Luo X, Williams N, Miller L, Dempster J, Macfarlane PW, Welsh P, Sattar P, Whittaker A, McConnachie A, Padmanabhan S, Berry C Am Heart J 2020 229:70-80.
  • Balloon pulmonary angioplasty for inoperable chronic thromboembolic pulmonary hypertension in the UK
    Hoole SP, Coghlan JG, Cannon J, Taboada D, Toshner M, Sheares K, Fletcher A, Martinez G, Ruggiero A, Screaton N, Jenkins D and Pepke-Zaba J. Open Heart 2020 27;7(1):e001144
  • Chronic infarct size after spontaneous coronary artery dissection: implications for pathophysiology and clinical management
    ​​​​​​​Al-Hussaini A, Abdelaty AMSEK, Gulsin SK, Arnold J, Garcia-Guimaraes M, Premawardhana D, Budgeon C, Wood A, Natarajan N, Mangion K, Rakhit R, Hoole SP, Johnson TW, Berry C, Hudson I, Gershlick AH, Ladwiniec A, Kovac J, Squire I, Samani NJ, Plein S, McCann GP, Adlam D European Heart Journal 2020 41(23):2197-2205