Coronary Artery Disease

Our research spans the whole spectrum of atherosclerosis from bench to bedside. We aim at understand the pathogenesis of ischemic heart disease and identify effective therapies and develop preventative measures.

Our basic science work focuses mainly on inflammation and immune mechanisms of atherogenesis and rapid atheromatous plaque growth, as well as protective mechanisms such as high-density lipoprotein cholesterol. Biomarker discovery is an integral part of this research programme.

The role of the coronary microcirculation in angina pectoris and hypertension and the study of the lymphatic system represent major research themes in this area. The study of the pathogenesis and treatment of coronary artery disease in patients with chronic kidney disease and chronic inflammatory conditions also feature prominently in our translational research programme.

Our research also focuses on the assessment of novel circulating biomarkers of risk and genetic biomarkers. The programme includes the creation of a large biobank to underpin our research on cardiovascular disease prevention, patient risk stratification, drug discovery and pharmacogenomics.

Principal Investigators
Prof Juan Carlos KaskiHead, Cardiovascular Sciences Research Centre
Prof Marek MalikProfessor of Cardiac Electrophysiology
Prof Peter MortimerProfessor of Dermatological Medicine
Prof Kausik RayProfessor of Cardiovascular Disease Prevention, Honorary Consultant Cardiologist St George’s Hospital NHS Trust
Dr Debasish BanerjeeConsultant Nephrologist/Physician
Dr Tarek Francis AntoniosSenior Lecturer & Consultant Physician in Cardiovascular & General Medicine, Head of Blood Pressure Unit
Dr Ingrid DumitriuSenior Lecturer in Immunology
Dr Evelyn TorsneyLecturer of Vascular Biology
Dr Gillian CockerillReader of Vascular Biology, Associate Dean of Biological Research Facility

Research Groups

The Coronary Artery Disease research area comprises eight research groups. Click on the tabs below for further information.

The Biomarker research group in the Cardiovascular Sciences Research Centre at St Georges’ University of London has a leading international role in studies assessing neopterin (Kaski, Ray, Avanzas), hs-cardiac troponins (Collinson and Gaze), and PAPP-A (Kaski, Holt and Consuegra) and QT segment changes in myocardial ischaemia (Kaski).

Group Administrator: Julie Norwood  jnorwood@sgul.ac.uk

 

Click here to view the Biomarkers research group

The CVD in Renal Disease research group focuses on cardiovascular complications of chronic kidney disease (CKD), including the risk factors, mechanisms and interventions.

In this research group we investigate the potential markers of sudden cardiac death in dialysis patients, and conduct association studies on Pulse Pressure as a predictor of adverse outcome in patients with CKD.

Click here to view the CVD in Renal Disease research group

The scope of our work at the Epidemiology research group is broad and includes the study of modifiable factors such as lifestyle and their impact on cardiometabolic traits in different populations, and the study of the barriers for the effective delivery of cardiovascular prevention strategies in different ethnic groups.

A second and important part of our work is in the area of clinical trials. We actively participate in large international trials of therapeutic interventions in cardiovascular disease.

Future work will undertake focused pharmacogenomic research into cohorts specifically established to study prospectively the genetic determinants of variability in pharmacological response to different agents.

We conduct systematic reviews and meta-analyses of randomised trials to generate more reliable evidence of the benefits/ harm of interventions which have the potential to impact clinical practice.

Click here to view the Epidemiology research group

The Hypertension Group focuses on the role of the microcirculation in the pathogenesis of hypertension and cardiovascular disease;  the management of severe and refractory hypertension; and the role of salt reduction in the management of hypertension.

Hypertension is the most common chronic medical disease and is the most important risk factor for cardiovascular disease, including strokes and heart attacks.

The main objective of our research is the ‘prevention of hypertension’ through the reversal of microcirculatory abnormalities that precede the onset of the rise in blood pressure in hypertension. Prevention of hypertension will result in a significant reduction in cardiovascular disease morbidity and mortality.

 

Click here to view the Hypertension research group

The Immunology Research Group is led by Dr Ingrid E. Dumitriu whose research interests focus on the characterisation of T-cell-mediated immune response in disorders associated with chronic inflammation.

The research interests of this group are as follows: atherosclerosis, chronic inflammation, T cells, dendritic cells and immuno-modulation with the objective of understanding immune dysregulation in atherosclerosis and other chronic inflammatory conditions that are associated with an increased risk of cardiovascular complications.

Click here to view the Immunology research group

The Lymphatic research group is led by Professor Peter Mortimer.

Lymphovascular Medicine is an emerging clinical speciality which addresses the contribution of lymphatic system dysfunction to disease pathology.  Currently the obvious clinical consequences of lymphatic failure are disturbed tissue fluid balance, particularly lymphoedema, but also infection given the important immune surveillance function of the lymphatic.  Recent developments in lymphatic biology indicate how the lymphatic system contributes to immune and inflammatory responses in various pathologies as well as its role in disseminating cancer cells.  These pathologies include wound healing, inflammatory skin disease such as psoriasis, granulomatous diseases, obesity, artherosclerosis and cardiovascular disease.

The St George’s Lymphoedema service is tertiary referral from throughout the UK.  Its strong research focus has resulted in the identification of six new causal genes for inherited lymphoedema.  Accurate clinical phenotyping using available lymphatic investigation methods such as lymphoscintigraphy has been the key to success.  By re-investigating patients with known causal mutations the mechanisms for lymphoedema development are better understood.  The upsurge in knowledge borne out of the discovery of the genes and proteins controlling lymphangiogenesis is likely to lead to new treatments targeted on molecular signalling known to affect lymphatic function.

Click here to view the Lymphatic Research research group

The Microvascular Disease research group is led by Professor JC Kaski, and is focused on the following areas:

* Coronary microvascular dysfunction in angina pectoris and hypertension;

* Inflammation and immunological mechanisms in the pathogenesis of microvascular dysfunction and endothelial activation; and

* Cardiac syndrome X – Pathogenesis and management.

Click here to view the Microvascular Disease research group