News in brief: Monash role for dual cardiologist-geneticist; Colchicine benefit in heart disease translates to the long-term; Hypertension in pregnancy stable over time;


Monash role for dual cardiologist-geneticist

Australia’s first dual-trained clinical geneticist and cardiologist, Dr Kunal Verma, has been appointed to lead cardiac genetics at Monash Health. 

Dr Verma will help develop cardiac genetics services in the lead up to the opening of the Victorian Heart Hospital, said Associate Professor Matthew Hunter, Director of General Genetics. 

“As genetics becomes increasingly complex, dual-trained specialists like Kunal are best placed to bridge the gap with non-genetic teams so that access to genomics is maximised,” he said.

“It is rare to have a geneticist who has also specialised in another field. The few dual-trained genetics specialists in Australia play key roles in ensuring patients receive efficient and expert genetics care and follow-up.  

Dr Verma completed most of his cardiology training at Monash Heart, following which he trained in genetics at the Royal Melbourne Hospital and Monash Genetics. 


Colchicine benefit in heart disease translates to the long-term 

The benefits of low-dose colchicine in chronic cardiovascular disease extends to the long-term, an exploratory analysis of the LoDoCo2 trial shows.

Latest results from the Australian-Dutch led study reveal that the effects of gout drug on the risk of the composite of cardiovascular death, spontaneous myocardial infarction, ischaemic stroke, or ischaemia driven coronary revascularisation were consistent across each year of the trial compared to placebo.

Events per 100 person-years in year 1 was 2.4 versus 3.6 events; year 2:  2.1 versus 3.1 events; year 3: 3  versus 5 events and year 4 until the end of follow-up, 2.2 versus 4.1 events.

“These findings are in line with the hypothesis that subclinical vascular inflammation is an ongoing process and the notion that modulation of the innate immune system cannot be achieved by short term treatment,” the authors wrote in their paper published in Circulation.

As previously reported by the limbic,  the LoDoCo2 trial randomised over 5,500 clinically stable patients with evidence of coronary artery disease from angiography or coronary calcium scores to either 0.5 mg colchicine per day or placebo.


Hypertension in pregnancy stable over time despite medical advances

Hypertensive diseases in pregnancy have not declined over time and are significantly associated with adverse outcomes, latest figures from Victoria show.

The retrospective population based study of 624,193 births in Victoria found the incidence of hypertensive disorders was 5.7% in 2010 and by 2017 remained stable at 5.9% despite medical advancements.

Hypertensive disorders were associated with medically-initiated birth (aOR 4.70, caesarean section (aOR 1.46), placental abruption (aOR 1.94), maternal intensive care or high-dependency unit admission (aOR 6.80) compared to pregnant women with no hypertensive disorders.

The worst maternal and perinatal outcomes were among women with superimposed preterm preeclampsia (PE) who had the highest rate of caesarean section (66.3%), placental abruption (1.3%), renal failure (0.2%), admission to ICU/HDU (28.9%) and composite adverse maternal outcome (30.5%).

Women with superimposed PE were also delivered at the lowest mean gestational age (35.3 ± 3.6 weeks’), with 21.6% of all neonates being admitted to NICU and 23.0% having a composite adverse major perinatal outcome.

According to the authors their findings alert clinicians to the need to screen all women for potential risk factors for PE.

“Internationally, there is already a shift towards the implementation of first trimester screening tests for PE, and such an approach to better prediction and more targeted prevention is feasible in clinical practice and has the potential to reduce the rates and the burden of preterm forms of PE,” they wrote in their paper published in Pregnancy Hypertension.

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