Institute of Cellular Medicine

Staff Profile

Dr Vijay Kunadian

Senior Lecturer and Honorary Consultant Interventional Cardiologist

Background

Roles and Responsibilities

Honorary Consultant Interventional Cardiologist, Freeman Hospital, Newcastle upon Tyne Hospital NHS Foundation Trust 

Other Responsibilities: Newcastle University

Academic lead for Cardiology: MSc Cardiac Science Module, Newcastle University

Academic lead for Cardiology: NIHR Academic Clinical Fellowship, Health Education North East (HENE)

Academic lead for Cardiology: NIHR Academic Foundation Programme, HENE 

Academic lead for Cardiology: Cardiology Training Programme, HENE

Associate Fellow: Graduate School, Newcastle University 

Lead Supervisor: MBBS Stage 4 SSC in Cardiology and Clinical Cardiology Research, Newcastle University 

Lead Supervisor: MRes Cardiovascular Science, Newcastle University

Other Responsibilities: National and International

British Cardiovascular Intervention Society (BCIS): Steering Committee Member, Research and Development Group

European Society of Cardiology/European Association of Percutaneous Cardiovascular Interventions (EAPCI): Steering Committee Member, Women's Committee, International Collaborations Lead

European Society of Cardiology/European Association of Percutaneous Cardiovascular Interventions (EAPCI): Steering Committee Member, Young Interventionalist Committee, Research Lead  

European Society of Cardiology/European Association of Percutaneous Cardiovascular Interventions (EAPCI): EUROPCR Programme Committee 

American College of Cardiology: Fellow, Abstract Reviewer, Scientific Sessions, USA

European Society of Cardiology: Fellow, Abstract Reviewer,  Faculty member, Scientific Sessions, Europe

Transcatheter Cardiovascular Therapeutics: Abstract Reviewer,  Faculty member, Scientific Sessions USA

Associate Editor: European Heart Journal- Case Reports, Advances in Interventional Cardiology

Qualifications

Women Transforming Leadership Programme, Said Business School, University of Oxford

Postgraduate Diploma in Clinical Trials, University of London (London School of Hygiene and Tropical Medicine), UK

FESC Fellow of the European Society of Cardiology, Europe

FACC Fellow of the American College of Cardiology, USA

FRCP Fellow of Royal College of Physicians Edinburgh, UK

MD Newcastle University, UK

MRCP Royal College of Physicians Edinburgh, UK

MBBS 

Postgraduate and Academic Training

General and Internal Medicine, Northern Deanery, UK

General and Interventional Cardiology, Northern Deanery, UK

Research Scholar: TIMI/PERFUSE Angiographic Core Lab, Brigham and Women's Hospital, Harvard Medical School, Boston MA, USA

Research Registrar: The James Cook University Hospital, Middlesbrough, UK 

Invited Peer Reviewer for journals and funding bodies

The American Journal of Cardiology, Heart, Herz, Catheterization and Cardiovascular Intervention, Journal of Interventional Cardiology, The Lancet , American Heart Journal, Open Heart, Circulation and many others

Expert grant reviewer: Medical Research Council (MRC), NIHR, BHF

Expert technology appraiser: NICE

Memberships

British Cardiovascular Society

British Cardiovascular Intervention Society

European Society of Cardiology

European Association of Percutaneous Cardiovascular Interventions

American College of Cardiology 

Invited Faculty/Speaker National and International Cardiology Societies

Chair: Royal College of Physicians Edinburgh Cardiology Symposium 2016 Organising Committee

European Society of Cardiology Congress 2015, 2016, 2017

EUROPCR 2016, 2017

Transcatheter Cardiovascular Therapeutics, USA 2010, 2012, 2013, 2014, 2015, 2016, 2017

British Cardiovascular Intervention Society, London, UK 2011, 2012, 2013, 2017, 2018

World Heart Federation Dubai 2012

Stent for Life Prague 2012

Awards, Honours, Fellowships ICON Study Group

The Frank Knox Memorial Harvard Fellowship 2016-2017 Award to Dr. Jonathan Batty (VK Lead Supervisor)

The Barbour Foundation Scholarship Award 2015-2016 to Mr. Benjamin Beska (VK Lead Supervisor) 

Best abstract award ICON1 study, American College of Cardiology Scientific Sessions- Geriatric Cardiology Group 2015, San Diego 

Winning Moderated Poster Award, European Society of Cardiology Congress 2014, Barcelona

American Heart Association International Mentorship Award 2014 to Dr Denton (VK Lead Supervisor)

Finalist, TCT 2010, Thomas J Linnemeier Young Investigator Award- Washington DC.

Research

Group Name: ICON Study Group

Despite significant developments in pharmacotherapy and interventional strategies, cardiovascular diseases remain the leading cause of death in the UK. Moreover, there is a growing ageing and co-morbid population in whom the cardiovascular disease burden is very high. My group’s research interests thus far primarily focussed on addressing the unmet needs of improving cardiovascular outcomes under the acronym ICON (Improve Cardiovascular Outcomes in High Risk PatieNts) in this neglected cohort of patients.

Chief Investigator: ICON 1 Study

Funder: Newcastle NIHR BRC (3 Years)

A Study to Improve Cardiovascular Outcomes in High Risk PatieNts with Acute Coronary Syndrome : UKCRN ID 12742.

Ischaemic heart disease (IHD) is the leading cause of death worldwide. There has been rapid progress in the management of acute coronary syndromes over the last decade with the use of adjunctive pharmacotherapy, specifically novel antiplatelets and anticoagulants, and advanced percutaneous coronary intervention (PCI) techniques. These medical and technical advancements have led to improved survival and gains in life expectancy, especially in younger individuals (<65 years of age) and in men. There is a steep increase in mortality due to ischaemic heart disease among those aged >70 years of age. Despite the increasing burden of ischemic heart disease among the ageing population, there are few studies evaluating novel therapies and interventions among older patients to improve their cardiovascular outcomes in this growing ageing population. My current research focuses to determine the predictors of poor quality of life and adverse outcomes following PCI for acute coronary syndrome in older patients by evaluating frailty scores, biomarker profile, non-invasive cardiovascular parameters (CIMT, vascular stiffness, endothelial function, diastolic function) and invasive imaging (coronary angiography, virtual histology intravascular ultrasound, optical coherence tomography) to develop an integrated risk score to predict outcomes and inform clinical decision making.

Chief Investigator: APPLE-COPD: ICON 2 Study

Funder: Astra Zeneca (2 Years) 

Antiplatelet therapy in the primary prevention of cardiovascular disease in patients with COPD 

Patients with COPD (chronic bronchitis and/or emphysema) are known to be at an increased risk of heart disease and death due to heart attacks. There are several possible reasons for this, one of which is an increased tendency of the blood to clot, that can give rise to blood clot formation in the coronary arteries, and lead to heart attack. Medications such as Aspirin and another new blood thinning tablet called Ticagrelor are already used for patients with heart attacks. Given that patients with COPD are at higher risk of heart attack, we wish to see if these tablets that can prevent blood clot formation in heart arteries might also prevent heart attacks happening in COPD patients. We hope to understand the effects by measuring clotting and inflammation in the blood. All patients will be followed up for 6-months. We also wish to study COPD patients who do not have high risk of developing future heart problems using the QRISK score to study their well being over a 1 year period to see if these patients might also benefit from blood thinning medications.

UK Chief Investigator: The British Heart Foundation SENIOR-RITA Trial

Funder: The British Heart Foundation Clinical Study Grant CS/15/7/31679 (5 Years)

The British Heart Foundation older patients with non-ST SEgmeNt elevatIOn myocaRdial infarction Randomized Interventional TreAtment Trial 

Our population is ageing. Age is a powerful predictor of adverse events following acute myocardial infarction and percutaneous coronary intervention (PCI): adjusted odds for in-hospital death increase by 70% for each 10-year increase in age. Older patients are often frail with up to a half of older patients (≥75 years) admitted with non-ST elevation myocardial infarction (NSTEMI) being severely frail. These frail older patients have a 4-fold increased risk of death at 1-year and yet are often denied coronary revascularisation because of fear of complications and causing harm. The goals of this study are to determine the benefit and risk of coronary revascularisation versus conservative management in high-risk older patients presenting with non-ST elevation myocardial infarction (NSTEMI) and receiving optimal medical therapy. We will explore the predictors and mechanisms of benefit and risk in relation to clinical outcomes, quality of life, and frailty scores.

Chief Investigator: ASPIRE Study 

Funder: Research Capability Fund (2 Years)

Aspirin Resistance Among Pregnant Women at Risk of Preeclampsia: UKCRN ID 14468. 

Cardiovascular diseases (CVD) remain the leading cause of death particularly among younger women. Diseases such as preeclampsia and gestational diabetes are unique among women that lead to poor outcomes including the occurrence of myocardial infarction and death in the future. Strategies to prevent such pregnancy related diseases are required to improve clinical outcomes among women. The current study is designed to determine the benefit of the use of low dose aspirin (ASA) among women at risk of preeclampsia. Given not all patients respond to aspirin therapy adequately in terms of platelet inhibition, the present study will determine response to aspirin therapy among pregnant women at risk of preeclampsia using specialised platelet function assays (Verify Now, Multiplate, serum thromboxane B2 and urine 11-Dehydrothromboxane B2). Data collected in this pilot study will be used to develop a proposal for a randomised controlled study of the effectiveness of aspirin dosage adjustment according to bedside platelet function testing for the prevention of preeclampsia.

UK National Coordinating Investigator: TWILIGHT Study

Sponsor: Mount Sinai School of Medicine New York, USA

Funder: Astra Zeneca

The purpose of this study is to compare the use of ticagrelor alone versus ticagrelor and aspirin together. Both ticagrelor and aspirin stop platelets from sticking together and forming a blood clot that could block blood flow to the heart. This study will look to determine the effectiveness and safety of ticagrelor alone, compared to ticagrelor plus aspirin in reducing clinically relevant bleeding and in reducing ischemic adverse events among high-risk patients who have had a percutaneous intervention with at least one drug-eluting stent. A patient is considered high-risk if they meet certain clinical and/or anatomic criteria. Up to 9000 subjects will be enrolled at the time of their index PCI. Subjects meeting randomization eligibility criteria at 3 months post enrollment will be randomized to either ticagrelor plus aspirin or ticagrelor plus placebo for an additional 12 months. Follow-up clinic visits will be performed at 3 months, 9 months and 15 months post enrollment.

https://clinicaltrials.gov/ct2/show/NCT02270242

Local Principal Investigator: 

MVO/REFLOW MI Trial: Randomized Controlled Trial Comparing Intracoronary Administration of Adenosine or Sodium Nitroprusside to Control for Attenuation of Microvascular Obstruction During Primary Percutaneous Coronary Intervention - UKCRN ID 12168

COMPLETE Trial: A randomised, comparative effectiveness study of complete versus culprit-only revascularization strategies to treat multi-vessel disease after primary percutaneous coronary interventions for ST-segment elevation myocardial infarction - UKCRN ID 15425

Lead Supervisor-Postgraduates, Newcastle University:

Doctor of Philosophy (PhD)

Dr. Hannah Sinclair MB ChB MRCP (Newcastle NIHR BRC Fellow) 

Doctor of Medicine (MD)

Dr. Murugapthy Veerasamy MBBS MRCP

Dr. Hani Ali MBBS MRCP

NIHR Academic Foundation Programme in Cardiology

Dr. Jonathan Batty BSc MB ChB (2014-2016)

Dr. Benjamin Beska MBBS MRes (2017-2019)

NIHR Academic Clinical Fellowship in Cardiology

Dr. Sophie Gu MBBS MRCP (2016-)

Dr. Danny Chan MBBS PhD MRCP (2017-)

Lead Supervisor-Newcastle University BSc/MRes/MSc Students:

1. Ms. Lucy Lawson MBBS/MRes (Newcastle University), 2018

2. Ms. Amina Khan MBBS/MRes (Newcastle University), 2018

3. Ms. Shobana Anpalakhan MBBS/MRes (Newcastle University) 2017, Pass with Merit

4. Mr. Adam Miller MBBS/MRes (Newcastle University) 2017, Pass with Merit

5. Ms. Amy Burrell BSc (Newcastle University) 2017

6. Mr. Benjamin Beska MBBS (Newcastle University) 2016 (MRes Pass with Distinction)- Thesis Title: The Role of Vitamin D and Parathyroid Hormone as Biomarkers in Older Patients with Non-ST Elevation Acute Coronary Syndrome: The ICON1 Biomarker Sub-study

7. Ms. Rebecca Jordan MSc (Newcastle University) 2016 (MSc Pass with Distinction)- Thesis Title: Evaluation of pattern of coronary artery disease in older patients with non ST elevation acute coronary syndrome

8. Ms. Shristy Subba BSc MRes Cardiovascular Science, Newcastle University-2015 (Pass)- Thesis Title: Characterisation of coronary artery plaque composition using virtual histology intravascular ultrasound imaging in older patients with non-ST elevation myocardial infarction

9. Dr. Meedya Sharifpour MBBS MRes (Keele University)- 2014 (Merit)- Thesis Title: Association of Circulating Inflammatory Biomarkers, Cardiovascular Function and Frailty Among Older Patients with Acute Coronary Syndrome

10. Dr. Kimberly Batanghari MBBS MRes (Indonesia)- 2014 (Merit)- Thesis Title: ICON1: Association Between Ageing and The Pattern of Coronary Artery Disease in Older Patients With Acute Coronary Syndrome

11. Ms. Dhiluni Kandage BSc (Newcastle University) 2014 (Completed with Distinction)- Thesis Title: A comparison of coronary angiographic variables among frail versus non-frail older patients undergoing percutaneous coronary intervention 

12. Ms. Jennie Parker BSc (Newcastle University) 2014 (Completed with Distinction)- Thesis Title: The association between carotid intima-media thickness and angiographic SYNTAX score 

Teaching

Undergraduate Teaching and Supervision

Supervisor: Student Selected Components (SSC) Stage 4 MBBS Students- Newcastle University

Personal Tutor: Stage 1 and Stage 3 Medical Students- Newcastle University

Postgraduate Teaching

Academic Lead Cardiology/Instructor: Department of Health Modernising Scientific Careers MSc in Cardiovascular Science, Newcastle University

Lead Supervisor: Masters by Research (MRes), Newcastle University 

Manuscripts Published by Stage 4 MBBS SSC students so far:

  1. Kuldeepa Ghoorah, Peter Campbell, Alexandra Kent, Annette Maznyczka, Vijay KunadianObesity and cardiovascular outcomes: a review. European Heart Journal: Acute Cardiovascular Care 2016 Feb;5(1):77-85
  2. Raheel Ahmed, Joseph Dunford, Roxana Mehran, Stephen Robson, Vijay Kunadian. Preeclampsia and Future Cardiovascular Risk among Women: A Review. Journal of the American College of Cardiology 2014;63(18):1815-22.
  3. Vijay Kunadian, Hannah Sinclair, Aaron Sutton, George Dangas. Aspirin, Platelet P2Y12 Receptor Inhibitors and other Oral Antiplatelets: Comparative Pharmacology and Role in Elective PCI.  Interventional Cardiology Clinics 2013; Vol. 2, Issue 4, Pages 527-535.
  4.  Vijay Kunadian, Joseph Dunford, Daniel Swarbrick, C Michael Gibson. Triple antiplatelet therapy and combinations with oral anticoagulants after stent implantation. Interventional Cardiology Clinics 2013; Vol. 2, Issue 4, Pages 595-606.
  5.  Vijay Kunadian, Andrew Harper, Bilal Bawamia, Azfar Zaman. Drug eluting stents versus bare metal stents in primary PCI. Future Medicine Dec 2012; Vol. 4, No. 6, Pages 689-700.
  6. Kuldeepa Ghoorah, Anthony De Soyza, Vijay Kunadian. Increased Cardiovascular Risk in Patients with Chronic Obstructive Pulmonary Disease and the Potential Mechanisms Linking the Two Conditions: A Review. Cardiology in Review. 2013 Jul-Aug;21(4):196-202.
  7. Andrew Pugh, John Bourke, Vijay Kunadian. Sudden Cardiac Death in Athletes and the Potential Role of Screening in its Prevention. Post Graduate Medical Journal. 2012; Jul;88(1041):382-90
  8. Vijay Kunadian, Andrew Pugh, Azfar Zaman, Weiliang Qiu. Percutaneous Coronary Intervention among Patients with Severe Left Ventricular Dysfunction: A Review and Meta-analysis of 19 Clinical Studies. Coronary Artery Disease 2012; 23(7):469-79.
  9. Backshall J, Ford GA, Bawamia B, Quinn L, Trenell M, Kunadian V. Physical Activity in the Management of Patients with Coronary Artery Disease: A Review. Cardiology in Review. 2014
  10. Raheel Ahmed, Kuldeepa Ghoorah, Vijay Kunadian. Abdominal Aortic Aneurysms and Risk Factors for Adverse Events: A Review. Cardiology in Review.2016 Mar-Apr;24(2):88-93
  11. Carpenter M, Sinclair H, Kunadian V. Carotid Intima Media Thickness and Its Utility as a Predictor of Cardiovascular Disease. A Review of Evidence. Cardio Rev. 2016; 24(2):70-5
  12. Tan YC, Sinclair H, Ghoorah K, Teoh X, Mehran R, Kunadian V. Gender differences in outcomes in patients with acute coronary syndrome in the currentera: A review. Eur Heart J Acute Cardiovasc Care 2015 

Publications