Dr Lee Nedkoff

Cardiovascular disease surveillance for the 21st century

Dr Lee Nedkoff, University of Western Australia

2020 Future Leader Fellowship

Years funded: 2021-2024

This project aims to develop and integrate evidence-based methods and data platforms across coronary disease, stroke, rheumatic heart disease and CVD more broadly. Best-practice surveillance across the whole population and targeting of high-risk population sub-groups is essential so that we know where to focus policy and prevention efforts to the best advantage. We therefore require an accurate understanding of the burden and distribution of this disease yet changes in diagnostic practices, disease rates, and data availability mean that current approaches need to be improved. My research program will address these gaps by specifically targeting the following aims:

• Aim 1 will investigate the impact of changes in the sensitivity of cardiac biomarker assays (troponin) on rates and trends in myocardial infarction (MI, ‘heart attack’) to determine how the current adverse trends are affected by these changes.
• Aim 2 will extend into investigating chronic forms of coronary diseases by developing a unique data platform utilising new national linked data infrastructure. I will develop a computable phenotype for identification and investigation of this patient group (the size of which is unknown).
• Aim 3 will measure the contribution of cardiac diseases and predictors of the onset of stroke and thus determine targets for stroke prevention.
• Aim 4 will address the current gap in indicators for measuring short-term case fatality for both heart attacks and stroke.

Finally, the findings from across this research program, combined with additional algorithms and indicators, including for rheumatic heart disease mortality in Australia, will be integrated into a broad range of recommendations for implementation in CVD surveillance in Australia. The whole-population approach will be supplemented by important targeted analyses for rural/remote patients, Indigenous people, and younger adults, to enable specific targeting of policy and prevention measures.