Completed Heart, Stroke & Blood Infection & Immunity

Exploiting the potential offered by the increasing computerisation of health records for population based research.

In plain English

AI plain-English summary

Doctors already know that inflammation plays a role in heart attacks and strokes, but they lack practical ways to turn that knowledge into routine prevention. This research programme will use the UK’s electronic health records to run clinical trials and observational studies that are embedded directly into everyday patient care. The problem is that most evidence on inflammation and cardiovascular disease comes from laboratory experiments or expensive, separate clinical trials. That gap means patients with chronic inflammatory conditions—such as rheumatoid arthritis or psoriasis—do not have reliable tools to predict their personal risk of a heart attack or stroke. The same is true for people who experience acute flare-ups of lung disease, which may temporarily spike their vascular risk. If this research succeeds, it could change how the NHS delivers preventive medicine. One trial will test whether a short course of statins given during periods of heightened risk—for example, after a hospital admission for a lung infection—can prevent large numbers of heart attacks and strokes. Another study will assess whether the shingles vaccine also reduces vascular events after a shingles infection. The work will also produce validated risk calculators for people with chronic inflammatory disorders, allowing GPs to target prevention more precisely. Beyond these specific results, the programme aims to establish electronic health records as a standard platform for rigorous medical research, making future trials cheaper, faster, and more representative of real-world patients.

View original technical description
Laboratory research has demonstrated the importance of inflammation in cardiovascular disease. Translating this knowledge into benefits for human health presents a huge challenge. We propose an innovative programme of translational research exploiting the extraordinary opportunities for offered by electronic health records. The first key goal is to integrate randomised controlled trials into clinical care utilising electronic health records. We will then test the hypothesis that preventive in terventions targeted at periods of high vascular risk could have large absolute benefits by undertaking a randomised trial of a short course of statin treatment at a time of heightened risk. We will also undertake a programme of rigorous observational studies. The key goals are: (i) Quantifying the risk of vascular disease and developing valid risk prediction tools for people with a range of chronic inflammatory disorders. (ii) Assessing the risk of vascular events following acute ex acerbations of chronic obstructive pulmonary disease and how such risk could be mitigated. (iii) Establishing whether herpes zoster vaccine reduces the risk of acute vascular events following herpes zoster. The proposed work will lead to step changes in translating knowledge of inflammation in vascular disease and establish optimal approaches for scientific enquiry using electronic health records.

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Researchers

Liam Smeeth (EPMC Awardee)

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Original classification

Senior Research Fellowship Clinical Renewal

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