Clinical trials in CVDM range from observational studies in large numbers (n = 5 million) to smaller “proof of concept” clinical trials (n = 50) to large multicentre safety/efficacy randomised trials (n = 6000+). The funding of these trials varies from the EU, the BHF, IHR-HTA and the MRC to the pharmaceutical industry e.g. £4 million for POPADAD study from the MRC, £4 million from IHR-HTA and £25 million for the FAST study from industry. The topics of these clinical trials are in Cardiovascular Medicine, Diabetes, Respiratory Medicine and Ageing and Health. All of these subspecialty research areas are underpinned by a strong Imaging centre involving MRI, CT and PET/CT including using therapeutic interventions. Examples of imaging techniques used are whole body atheroma imaging, left ventricular structure/function imaging and measuring energetics in both cardiac and skeletal muscle. Another very productive group focuses on Pharmacoepidemiology and drug safety and large streamlined, post licensing studies in the Medicine Monitoring Unit (MEMO). These clinical trials are all underpinned by a state of the art Clinical Research Centre and Tayside Clinical Trials Unit.
A strong theme is the repurposing of old (inexpensive) drugs e.g. Allopurinol, Metformin and Spironolactone which initially are studied in “proof of concept” studies and then taken forward to large multicentre clinical trials e.g. the ALLHEART study of allopurinol in ischaemic heart disease funded by NIHR HTA. The Ageing & Health section is heavily involved in the NIH funded Scottish Longitudinal Ageing Study and in Informatics where our ability to link Healthcare data and Social Care data, give us a unique natural laboratory to study the effects of medication on disability and dependency in older people. In CVDM, we practice true translational medicine where the potential value of a new therapy is explored in a Pharmacoepidemiology study followed by small “proof of concept” clinical trials using reliable surrogates like LV mass followed by a definitive large multicentre clinical trial.