Workshop speakers in the spotlight: Kausik Ray and Gerd Assmann

Prof. Kausik Ray, UK

Kausik Ray is Professor of Cardiovascular Disease Prevention at St George’s University of London. His research interests focus on cardiometabolic risk and preventive cardiology, cardiovascular epidemiology and clinical trials. He has conducted some of the most definitive analyses to date on lipid lowering and glycaemic control for the prevention of cardiovascular outcomes, which have contributed towards national and international guidelines. His aim is to develop a biobank from the unique ethnic mix of south London for identifying novel markers of risk, targets for treatment and for clinical intervention trials based on biomarkers, genotype and ethnicity.

Prof. Gerd Assmann, Germany

Gerd Assmann is the President of the Board of the Assmann‐Foundation for Prevention. He is also Executive Director of the International Task Force for Prevention of Coronary Heart Disease. Professor Assmann is the lead investigator of the seminal Prospective Cardiovascular Münster (PROCAM) study. The PROCAM Study, which was initiated in 1978, is the largest prospective evaluation of cardiovascular risk markers in Europe. By July 2007, 50,000 people - 31,376 men and 18,624 women – had participated in the study. Research interests of Prof. Assmann include lipoproteins, lipid transport and metabolism, medical genetics, biotechnology, and the epidemiology of atherosclerosis.

Despite therapeutic advances, cardiovascular disease (CVD) remains the leading cause of morbidity and mortality, and is a major cause of disability affecting quality of life. The global epidemics of obesity, metabolic syndrome and type 2 diabetes have substantially impacted the landscape of CVD risk. Evidence that risk increases incrementally with each additional feature of the metabolic syndrome, highlights the need to consider other approaches beyond traditional risk factors. Increasingly, attention has focused on atherogenic dyslipidemia, the combination of elevated triglycerides and low plasma levels of high-density lipoprotein (HDL) cholesterol. Recent analyses of the PROCAM study have shown that atherogenic dyslipidemia, the combination of elevated triglycerides/ high-density lipoprotein (HDL) was an important contributor to residual coronary risk, especially in individuals who achieve low-density lipoprotein ( LDL) cholesterol goals

Additional biomarkers are implicated in this residual CV risk, given that up two-thirds of events occur in people at low to moderate risk based on conventional risk factors. Of those under investigation, high-sensitivity C-reactive protein, lipoprotein-associated phospholipase A2 and brain natriuretic peptide, which focus on inflammation and arterial wall stress, show most promise. However, while these have been independently associated with outcome, their addition to conventional risk factors only marginally improves risk factor prediction. Imaging variables may offer an alternative approach with the advantage of serial assessment of markers over time.

Identification of risk factors relevant to this emerging risk factor landscape, together with novel technologies and an earlier proactive approach, are key to reducing the burden of CVD

Key references

Ray KK, Seshasai SR, Erqou S, Sever P, Jukema JW, Ford I, Sattar N. Statins and all-cause mortality in high-risk primary prevention: a meta-analysis of 11 randomized controlled trials involving 65,229 participants. Arch Intern Med 2010;170:1024-31.

Emerging Risk Factors Collaboration, Di Angelantonio E, Sarwar N, Perry P, Kaptoge S, Ray KK, Thompson A, Wood AM, Lewington S, Sattar N, Packard CJ, Collins R, Thompson SG, Danesh J. Major lipids, apolipoproteins, and risk of vascular disease. JAMA 2009;302:1993-2000.

Assmann G, Cullen P, Schulte H. Non-LDL-related dyslipidaemia and coronary risk: a case-control study. Diab Vasc Dis Res 2010;7:204-12.

Assmann G, Schulte H, Cullen P, Seedorf U. Assessing risk of myocardial infarction and stroke: new data from the Prospective Cardiovascular Münster (PROCAM) study. Eur J Clin Invest 2007;37:925-32.

Forrás: The European Atherosclerosis Society website