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The Future of Heart Disease Research in Singapore

Professor Stuart Cook is optimistic about the future of research into heart disease. The Deputy Director of the Cardiovascular and Metabolic Disorders (CVMD) Signature Research Program (SRP) at Duke-NUS, who also helms the new National Heart Research Institute Singapore (NHRIS), sees huge potential in the strengthened partnerships that will arise from the NHRIS.

Professor Cook, who was recently named the Tanoto Foundation Professor of Cardiovascular Medicine, said the NHRIS will focus on key research focus areas such as heart function and genetics, regenerative medicine and metabolic heart disease and cardiac imaging. “The NHRIS will be the umbrella under which Duke-NUS and the National Heart Centre Singapore (NHCS) can collaborate. It will be both a real and virtual environment for the basic science of Duke-NUS to come together with the patient-facing translational work done at NHCS.” The vision, he said, is for NHRIS is to be a premier regional center for cardiovascular research to drive excellence in patient care and to better understand cardiovascular disease manifestation in the Asian population so that treatment and prevention can be improved. The recently awarded Tanoto Foundation gift of S$3 million (see box story) will allow his research team to take what has been done so far in genetics and translate the findings into patient care.

A Focus on Diagnosis and Prevention

Cardiovascular disease – such as stroke and heart disease – is the leading cause of death worldwide. Alarmingly, the incidence of the disease is on the rise due to an increase of individuals with metabolic syndromes and also because of rapidly aging populations in a number of countries. While science and research has gone a long way to treat the condition, much of the focus has been on the ‘end result’ – and those therapies tend to be increasingly expensive. “Instead, we (as researchers) should look at cheaper approaches, such as moving towards prevention. Genetics is one way to do this,” said Prof. Cook. “We need to focus on diagnosis and prevention so people can live longer healthier lives rather than longer but sicker ones.”

Genetic studies – a key focus area for the NHRIS – can identify markers that can play an important role in stemming future complications, he added. One example is a simple diagnostic array that has been developed to identify the people with an inherited condition called familial hypercholesterolemia. This disease causes people to develop high cholesterol levels from a young age, thereby dramatically increasing their risk of stroke or heart attack. “It affects one in 500 people – so it’s not that rare and this means some 15,000 people in Singapore suffer from this; we just don’t know who they are,” explained Prof. Cook.

Prof. Cook is currently developing a test that will be able to diagnose the illness early so that treatment can be administered before it manifests into a serious condition. “If we know the condition is there, we can give a tablet to the affected person and this will stop them from getting a heart attack or stroke when they are 20 or 30.”

This is just one example of the vast potential in the area of genetics that can lead to a better understanding of the variations for improved diagnostics and more targeted treatments. Having an Asian-based research population also helps to build a better understanding of how treatments vary based on ethnic differences. “It helps doctors make more informed decisions, understand disease processes in a local context and improves healthcare,” Prof. Cook said.

About Professor Stuart Cook, Tanoto Foundation Professor in Cardiovascular Medicine

Professor Stuart Cook, a leading cardiovascular research expert with extensive work in human genetics, heart muscle disease and cardiac imaging, has explored both the clinical and academic facets of the field in prestigious institutions such as St Bartholomew’s Hospital, the National Heart and Lung Institute, Harvard and the Imperial College London. In 2012, he was conferred a Singapore Translational Research (STaR) Investigator Award by Singapore Ministry of Health’s National Medical Research Council (NMRC), and appointed as Professor of Clinical and Molecular Cardiology at Duke-NUS and senior consultant at the NHCS.

Prof. Cook became the Deputy Director of the CVMD SRP at Duke-NUS in 2013 and was appointed as founding Director of the NHRIS in 2014 where he heads a cross-disciplinary research team that delves into genetics to identify new genes and pathways for heart disease for better therapeutic targets. These discoveries that impact diagnosing, stratifying and testing patients with cardiovascular diseases have been published in high-impact journals and been presented at international cardiovascular meetings. His work in Singapore is particularly relevant as the differences in the genetic makeup of Asians from other ethnic groups are important to understand as they impact the prevalence and course of several cardiovascular disorders. Working with his network of international collaborators, the multi-disciplinary team at NHRIS aims to identify new targets for diagnostic and therapeutic applications for patients who are genetically pre-disposed to cardiovascular disease.

The Tanoto Foundation Professorship in Cardiovascular Medicine

The gift of S$3 million is awarded to an outstanding clinician researcher who demonstrates the ability to advance cardiovascular medicine through academic leadership, medical education and innovation. S$2.5 million of the grant will be used to set up the Professorship in Cardiovascular Medicine and the remaining S$500,000 will go to the Tanoto Foundation Initiative for Genetics and Stem Cell Research at NHRIS to identify new ways of diagnosing, stratifying and testing patients with cardiovascular diseases, so as to drive early prevention for those who are genetically predisposed.

Tanoto Foundation’s gift check was presented by Mr. Sukanto Tanoto, Founder and Chairman of the Tanoto Foundation Board of Trustees, to Singapore President Tony Tan Keng Yam, who received it in his capacity as Patron for the Duke-NUS Development Committee at the SingHealth Duke-NUS Scientific Congress held on September 5, 2014.

Bey Soo Khiang, Chairman of the Tanoto Foundation Board of Governance, highlighted the Foundation’s goals in improving the quality of people’s lives. He said, “Tanoto Foundation has, over the years, been a strong supporter of medical research that has the potential to bring about transformative impact to society. We are particularly delighted today to contribute to the advancement of research in cardiovascular medicine for the Asian community, as we believe the breakthrough results will enable healthcare practitioners to address the region’s medical needs more effectively, in relation to heart diseases. To this end, Tanoto Foundation hopes to continue to play a positive role in helping to improve the quality of people’s lives.” Professor Ranga Krishnan, Dean of Duke-NUS stressed that the gift would be instrumental in catalyzing a stronger collaboration, “We are deeply grateful to the Tanoto Foundation for establishing the Professorship in Cardiovascular Medicine and the Initiative in Genetics and Stem Cell Research. The gift will strengthen Duke-NUS’ and SingHealth’s joint push in improving clinical care and translational research for better patient outcomes.”

This article appeared in the December edition of Vital Science. Read the issue here.