Prof. Kausik Ray
One of the most pre-eminent preventative cardiologists in the world, with over 100,000 citations for my research and over 280 publications in top-quality peer-reviewed journals, I am the Professor of Public Health and Honorary Cardiologist at Imperial College London.
1st October 2021
Hyperlipidemias: 'World Expert'
I have recently been named by ExpertScape as one of the top 0.014% of 70,949 global scholars writing on hyperlipidemias, based upon PubMed-based algorithms on 58 of my research papers published since 2011:
16th September 2021
A Momentous Day for the UK
Today the first ever patient in the UK (outside of a clinical trial) received the first dose of Inclisiran (LEQVIO) in my clinic, heralding a new and exciting medicine in our fight against cholesterol and heart disease.
8th September 2021
Global FH registry: detecting the most common genetic condition in the world
Familial Hypercholesterolaemia (FH) is a genetically inherited condition which means 1 in 311 people worldwide have severely raised bad cholesterol levels from the day they are born. Unfortunately not many people are aware of it, it is not routinely tested for and is not treated aggressively enough, with women being diagnosed with the condition far later than men. This leads to thousands of early heart attacks each year which could easily be prevented, but implementation of WHO guidelines (from 1998!) is frustratingly slow.
Since 2015 I have worked tirelessly with the EAS to set up the first global registry (FH studies collaboration: 'FHSC') to collect hard data on 42,000 people from 56 countries who suffer from FH. This data shows that there are age and sex differences in detection and treatment: most people were 40+ years of age when they were diagnosed, which means they have missed out on 40+ years of life-saving cholesterol-lowering treatment. For people with such high cholesterol, this should mean a combination of at least statins + ezetimibe (+ preferably more medication) to really reduce their bad (LDL) cholesterol as much as possible, for as many years as possible.
Today these findings have been published in The Lancet. Thank you to all the global investigators who have worked so hard over the last 6 years; we will continue to work to impact upon global policy to ensure this disease does not claim so many lives prematurely.
Please do read about it here:
1st September 2021
Inclisiran: the game-changer for bad cholesterol
After many years of research and having been the lead investigator on extensive global clinical trials, I have the huge pleasure in announcing that, from today, Inclisiran will be available on the NHS to patients who have already suffered a cardiac event and who have persistent LDL (bad) cholesterol of 2.6 mmol/L or above, despite taking statins and/or other medications. This first-of-its-kind agreement between the manufacturer (Novartis) and the NHS means this medication will be available to around 300,000 patients, potentially saving countless future events and lives. It is extremely safe and, even though it is conveniently given as an injection just twice a year, reduces LDL cholesterol by an average of 50%. Do read the press coverage here:
26th August 2021
European Society of Cardiology 2021
I have the pleasure of presenting my latest research at this year's ESC, as follows:
Evolocumab use in Europe: clinical guidelines vs. reimbursement thresholds - Results from the HEYMANS study. This shows how reimbursement thresholds impact availability of effective therapies: Twitter LinkedIn
Potential cardiovascular risk reduction with evolocumab in the real world: a simulation in patients with a history of myocardial infarction from the HEYMANS register. This shows that when effective treatments are used, cholesterol control predicts lower risk: Twitter LinkedIn
Treatment of high- and very high-risk patients for the prevention of cardiovascular events in Europe: baseline demographics from the multinational observational SANTORINI study. This shows that combinations of cholesterol-lowering therapies under-utilised in Europe and as such guideline implementation is still low: Twitter LinkedIn
Efficacy and safety of inclisiran in patients with established cerebrovascular disease: pooled, post hoc analysis of the ORION-9, ORION-10 and ORION-11, phase 3 randomised clinical trials. This shows that twice yearly injections of Inclisiran reduces cholesterol by about 50% in those with cerebrovascular disease: Twitter LinkedIn
Atherothrombotic residual risk in coronary and peripheral artery disease patients on guideline-recommended antiplatelet monotherapy: baseline preliminary results from the RESRISK study. This shows the burden of cardiovascular risk among those with peripheral arterial or coronary disease: Twitter LinkedIn
3rd August 2021
The 100,000 Club
I am immensely proud to announce that I have just passed 100,000 citations for my work. The number of citations an academic paper receives is used as a measure of its influence and is often used as a proxy for impact or quality, as papers published in higher quality academic journals generally tend to be cited more. To have been involved, over a lifetime, in various trials, which have lead to collaborations on myriad papers, which have ultimately lead to this achievement, is something I will be celebrating this weekend!
28th May 2021
Congress of the European Atherosclerosis Society 2021
I'd like to invite everyone to register and join the 89th EAS annual congress - my first as President - held this year virtually from Helsinki. We are looking forward to sharing a wealth of world-class science, world-leading experts and an array of opportunities for interaction and collaboration. Join us for an exciting four days from this Sunday:
27th May 2021
World Heart Federation Cholesterol Roadmap
Today I co-chaired the first meeting of the core writing group for the World Heart Federation cholesterol roadmap to feed into global initiatives. Prevention starts with early screening, meaning everyone should have a cholesterol measurement before the age of 20 to better predict lifetime risk and change life course early.
11th March 2021
And then the world changed forever, welcome to the future...
Dr Theo van Berkel, of Leiden University (Amsterdam) recently wrote an article on the background story of the development of Inclisiran. Here is an excerpt celebrating the first dose being given recently:
"And then the world changed forever, welcome to the future’’. These are the words that Kausik Ray (President of the European Atherosclerosis Society) spoke when the worldwide first dose of inclisiran, a novel SiRNA based cholesterol lowering agent, was administered at the Cardiology lipid clinic at the University of Vienna. The SiRNA , provided with a GalNAc anchor for targeting to the liver, lowers PCSK9, a protein that normally degrades the LDL-receptor. This leads to upregulation of the LDL-receptor in the liver and consequently to a 50% lowering of LDL cholesterol in the blood. Due to the novel mechanism of action two injections/year are sufficient. Such an administration frequency mimics the protocol for vaccination, only 2 shots a year for control of cholesterol!"
8th February 2021
Familial Hypercholesterolaemia (FH) has a prevalence of 1:311 but globally unfortunately less than 1% of cases have been identified.
To improve FH detection, diagnosis and referrals to specialist clinics and to direct patients to support groups, locally, nationally and internationally, I have developed the following service for patients and clinicians. It is now live, so please do feel free to use it:
1st January 2021
President, European Atherosclerosis Society
I am honoured and delighted to take on the role of President of the European Atherosclerosis Society - a global organisation which is committed to the following activities and initiatives:
"For more than 50 years the Society’s expertise has been used to teach clinicians how to manage lipid disorders and how to prevent atherosclerosis. Through our publications, EAS creates a framework for discussion of new developments in the field. With live and online educational activities, EAS supports exchange of knowledge between scientists and clinicians. By reaching out to involve young scientists and researchers also from related disciplines we strengthen and expand development of the field now and in the future. The EAS-Familial Hypercholesterolaemia Studies Collaboration (EAS-FHSC) is a global registry established to accurately and reliably investigate the burden of FH, how FH is detected and managed, and the clinical consequences of current practices on delivery of care and outcomes. These activities will ultimately lead to improved healthcare for persons with cardiovascular disease and lipid disorders."
Together with a new Executive Committee and dedicated staff at the EAS central office, we hope to make significant progress in research and education about the leading cause of death and disability globally, and improve implementation of preventive strategies at a global level.
30th December 2020
NEJM Most Notable Articles 2020
I have received the incredible distinction of one of my papers being included in this year's exclusive list of the New England Journal of Medicine's Most Notable Articles.
Each one of the 13 peer-reviewed articles on the list, as voted for by the editors of the Journal, is considered Practice-Changing, i.e. that they will impact upon the practice of medicine globally.
The paper in question is attached herewith, please do feel free to read it:
23rd November 2020
Clarivate Most Cited 2020
I have the huge pleasure in announcing that I have been included in Clarivate Analytics' list of the most cited academic authors in the whole of medicine, globally, for the third year in a row. This prestigious accolade is explained by Clarivate as follows:
"Out of nearly 8M researchers in the world over the last decade, less than 1% have published multiple papers frequently cited by their peers that rank in the top 1% of citations for field and year"
I am truly honoured to have been included in the 2018, 2019 and now the 2020 lists:
There is a new class of cholesterol-lowering medicine which will soon be available and could help people who need their cholesterol lowering further, those who cannot tolerate statins, or those who can't afford expensive injections. I and my colleagues recently published two papers in the New England Journal of Medicine showing the largest evidence of safety and effectiveness of this new treatment, called Bempedoic Acid. Read the media coverage here:
A study was badly reported in the media recently, with deliberately shocking headlines claiming "half of those on statins won't have 'healthy' cholesterol after two years' of taking the pills". Fortunately I had the opportunity to correct journalists' interpretation of the (purely observational) study and respond to headlines which must have worried a vast number of statin users. In short, you have to be on the correct dose and take the medication every day for it to be effective. If you are on a dose which is too low and you don't take the pills every day, then you obviously will not achieve the desired outcome. Coverage:
The Lancet recently published a study about the 'Polypill', a cost-effective single pill combining four drugs which helps to reduce blood pressure and cholesterol and shows some cardiovascular benefits, such as reducing the risk of heart attacks, strokes and sudden death. Although the trial and implications are more relevant for low- and middle-income countries, in the UK as many as a third of people with high blood pressure are undiagnosed and, amongst those who are diagnosed, many don't manage their condition properly. Coverage:
In the News
I presented the 18 month safety and efficacy data of the ORION-11 trial, which is testing the cholesterol-lowering drug, inclisiran, for safety. The drug shows remarkable results - with an initial injection, one at 3 months and thereafter one jab every 6 months - patients had an average reduction of cholesterol of 54% with, most importantly, no adverse safety signals. This is a novel and very exciting treatment which should make a huge difference in the lives of everyone with high cholesterol, particularly those who cannot tolerate statins and those who struggle to remember to take their medications on a daily basis. Full media coverage:
I had the honour of being invited to the BBC World News and the BBC World Service to discuss a ground-breaking collaboration between Novartis and the NHS: once approved, tens of thousands of NHS patients will be supplied with Inclisiran, the twice-yearly cholesterol-lowering injection I have led the development of. Up to 30,000 lives could be saved over a decade thanks to this pioneering initiative to tackle UK heart disease. Press release with full details, plus recording of the TV interview:
The Daily Mail has recently investigated three prominent UK Statin Deniers and their devastating effect upon the health of members of the public, thousands of whom continue to have a far higher risk of a heart attack or stroke because these unqualified persons have cast so much doubt upon statins' efficacy in their ongoing anti-statin propaganda. These three have been condemned by the Health Secretary (who called their claims 'pernicious lies') and 30 Editors-In-Chief of major heart-health journals. Read the articles here:
On 18th March the three pivotal phase 3 trials of Inclisiran, the first in class siRNA-based therapeutic for cholesterol-lowering (ORION-9, 10, 11) were published in the New England Journal of Medicine. The largest of these, ORION-11, led by myself, studied populations with established cardiovascular disease and high-risk primary prevention patients in 7 countries across Europe and South Africa. This trial showed that 6-monthly injections of Inclisiran safely reduce LDL (ie bad) cholesterol by over half. The same findings were observed in the ORION-10 trial, conducted in the US, and in the ORION-9 trial, conducted in people with Familial Hypercholesterolaemia. This new approach could revolutionise cholesterol management for millions around the world and is now being considered for approval in the US and Europe. As follows links to the publications in the New England Journal of Medicine and related press coverage:
Familial hypercholesterolemia (FH) is an inherited disease that affects how the body breaks down LDL-cholesterol. But it’s unclear how many people live with the condition without knowing. A team led by myself carried out the largest meta-analysis to date to estimate the global prevalence of FH. Our findings, published this week, reveal the condition is more prevalent than previously thought. As follows the paper and related press coverage:
My recent paper looking at statins dose and adherence, and cardiovascular deaths, as published in JAMA Network Open, was universally acclaimed within the scientific community and widely reported in the British press; even garnering a front page on both the iPaper and Express. Full coverage:
I recently had the pleasure of recording a podcast with my colleague and good friend, Professor Stephen Nicholls, Director of MonashHeart in Melbourne, in which we discussed issues of high interest in atherosclerotic cardiovascular disease (ASCVD) prevention. These topics included CVD risk worldwide, first-line therapy approaches with LDL-C reduction, key lipid management challenges, statin adherence, and new LDL-lowering options, all with useful guidance to consider. Please feel free to watch here:
All our hard work (including revising a New England Journal of Medicine paper whilst on holiday in Alaska!) now means we have another option for patients who can’t tolerate statins. Please do read the NICE guidance, mainstream media and pharmaceutical trade media coverage here:
Over the past few years I have helped lead the development of a revolutionary new tablet to lower bad cholesterol, which has just been given approval by NICE. Bempedoic Acid will be able to be used by adults with primary hypercholesterolaemia or mixed dyslipidemia who are unable to tolerate statins. It is the first new such treatment in over 10 years and should make a difference to the cardiovascular risk of up to 70,000 patients. Please do read coverage here:
I recently had the pleasure of being interviewed by BBC Inside Health for an in-depth program they are making about gene 'silcencing'. Inside Health is a program which discussed topical health issues which sometimes may be difficult to understand. It was aired on Tuesday 19th October at 21:00 on BBC's Inside Health, Radio 4; please do listen here:
I was recently asked to provide an expert opinion on the statins debate by Virgin Media television; in this article I set out the minor side effects which occur, how common they are (evidence backed up by large randomised controlled trials), and how effective statins are at preventing future cardiovascular events, particularly in those who have already had a heart attack or stroke. Hopefully this will help people make the best decision for their own health:
My Latest Research
Among people with a prior history or heart or vascular disease despite medications a significant residual risk of recurrent events and dying remains high. As with anything individual risk varies. To allow more reliable quantification yet, the SMART tool was validated in the largest study yet using GP data in the UK in 380 000 people. It shows that in men and women using routinely captured data the observed risk corresponds closely to that predicted by the tool meaning it could be used easily in routine clinical practice. Moreover, by knowing the risk, newer often more expensive treatments which are sometimes restricted could be better targeted to those that derive the greatest benefit. Insurers, healthcare providers as well as patients and doctors could therefore for a given cost of a therapy reliably identify risk thresholds, therefore how many people would be offered treatment and hence how many adverse vents avoided.
I recently discussed challenges and barriers in achieving LDL-c goals with my esteemed colleague, Prof Lale Tokgozoglu. Do watch it here:
I helped put together an educational presentation around achieving lipid modification goals with combination medications. Do read it here:
Please watch my recent chat with Prof Kastelein re: the proven case for LDL-c lowering here:
I was quoted in a Novartis press release which confirmed a sustained 17 month LDL-C reduction from inclisiran, regardless of age and gender:
I recently discussed using RNA interference to block synthesis of PCSK9 in the liver (commonly referred to as gene silencing), which in turn lowers LDL (bad) cholesterol. Do watch it here:
The first safe and effective gene silencing therapy for cholesterol-lowering, Inclisiran, is starting to become approved globally. Our most recent paper, published in the Journal of the American College of Cardiology, pools data from 3 trials (ORION 9, 10 and 11) and 3,600 patients. It shows that a 6-monthly injection maintains annualised reductions in bad cholesterol of around 52% and has a good safety profile comparable to placebo.
Please do read the paper here:
I recently discussed the current gaps between international cholesterol guidelines and their implementation into clinical practice in Europe. Please do watch it online here:
I have just published a paper exploring the implementation gap between Europe-wide lipid targets and the reality; as many as 80% of high-risk patients will fail to reach goals without additional medication on top of statins. Please read it here:
I recently recorded a short discussion in which I discuss what the latest research tells us about LDL-C ('bad' cholesterol) targets. Watch it here:
At this year's American Heart Association Congress, Philadelphia, I presented the most recent data from the BETonMACE trial which I am leading. Read the results here:
At the recent ESC in Paris, I discuss the results of the Phase 3 ORION-11 trial: the impact of Inclisiran on LDL-C over 18 months in patients with ASCVD or equivalent. Watch it here:
Please do watch my key takeaways from the recent EASD conference: cardiac risk reduction should be a priority for diabetic patients and the importance of cardiometabolic disease management:
I am pleased to announce my latest paper, "Pharmacological Lipid Modification Therapies for the Prevention of Ischaemic Heart Disease-Current and Future Options"published in the Lancet is available to read now:
Please do read a recent paper authored by myself and my visiting international fellow, published in the Journal Frontiers of Medicine, explaining new therapies and methods to lower bad cholesterol:
At ESC 2020 I discussed cholesterol management in patients with high LDL-C. Please watch it here:
I also recorded a program at the ESC on the results of the ORION data for Medscape, discussing siRNA (emerging gene silencing therapies) and PCSK9s:
At the recent European Society of Cardiology Congress in Paris I recorded the following educational presentation, explaining how we select statin doses to address intolerance:
I gave a lecture at the recent EAS on risk prediction, particularly on the interaction between relative and absolute risk - what they are and what factors influence them. View it here:
I recently presented results for THEMIS at the ESC, a trial which has helped define the role of anti-platelet therapy in those with CAD and Type 2 Diabetes. Watch here (password: AZesc2019):
Here I discuss the key issues and challenges impacting clinical management with novel cholesterol-lowering therapeutics:
New insights on lipid management have emerged since 2016; here I discuss with Francois Mach ways in which guidelines should be changed:
I am delighted to announce that my paper on global insulin use has just been published in the Journal of Diabetes, Obesity and Metabolism. Read it here:
Read about my global FH initiative in this EAS publication. 1 in 250 people globally have genetically determined elevations in cholesterol - get screened now.
I am proud to announce my paper explaining the common mechanism through which triglycerides and cholesterol increase heart disease has just been published in JAMA. Read it here:
I spoke about Bempedoic Acid at this year's ESC; watch my interview with Radcliffe Cardiology here:
At this year's ESC I talked about Statins, Diabetes and Glucose Metabolism: Challenging Cases and Considerations and also about Statins and the Elderly. Watch both videos here:
At the recent American Diabetes Association Congress I discussed Statins, Diabetes and Glucose Metabolism - watch it here:
I was delighted to be included in the ESC's "Best of 2017" research roundup, for our research on prediction of CV events in FH patients
I discuss micro- and macrovascular disease in type 2 diabetes, the implications and risk modification with new glucose-lowering agents
I was interviewed at the 2017 American Heart Association Congress on High vs Moderate dosing for the secondary prevention of coronary artery disease:
Listen to a recent CIRCULATION Podcast outlining analyses from the WOSCOPS trial and the importance of LDL-C lowering for the primary prevention of CV disease amongst men.
I was interviewed about the efficacy and safety of Alirocumab in patients with diabetes at the recent EASD Congress; watch it here:
During the recent ESC I spoke with Congress Report about the CLEAR Harmony, a trial testing a new therapeutic compound for patients with high CV risk. Watch my summary here:
I recently had the honour of saying a few words at my good friend Prof Kees Hovingh's inaugural speech; watch me speak about Today's Trials and Tomorrow's Treatments:
Watch my discussion on Familial Hypercholesterolaemia for Congress Report at the 2018 EAS Congress, Lisbon.
Watch my presentation at the recent American College of Cardiology congress in which I evaluated the evidence for lower LDL-C goals
Read my research from the WOSCOPS study showing that a small daily dose of statins in primary prevention patients reduces deaths from heart disease in participants by over 25%.
Watch me discuss the analysis of the WOSCOPS study with Lead Author, Dr Antonio Vallejo-Vaz
Watch me talk about the primary results of the Exenatide Study of Cardiovascular Event Lowering at the recent European Association for the Study of Diabetes (EASD) Congress
Here I discuss the key take home message of the WOSCOPS study for clinicians: