Dr Tina Khan is a cardiology specialist registrar whose PhD with Imperial College London is supervised by Dr Mahmoud Barbir and Professor Dudley Pennell and funded by the NIHR Royal Brompton Cardiovascular Biomedical Research Unit. We had a chat with her to discuss her research.
This is a very challenging group of patients to manage and therapeutic options are few and far between - there’s a massive need to develop effective treatments for them. Amongst such patients, I'm particularly interested in those that have raised levels of lipoprotein(a) (Lp(a)) which is a cholesterol that we are only recently learning more about.
We know that Lp(a) is a risk factor for heart disease and unfortunately conventional lipid lowering therapies do very little to reduce lipoprotein(a), therefore it is challenging to manage. In fact, the only treatment currently available for use is a dialysis type of treatment called apheresis which physically removes lipoproteins such as Lp(a) and low density lipoprotein from the blood. What remains to be determined is if we should be aggressively treating elevated Lp(a), and whether by treating it we can improve cardiovascular outcomes and clinical parameters affecting the heart.
So in a nutshell, my research is looking at that challenging population of patients with refractory angina and raised Lp(a) by doing a randomised, controlled, cross over pilot study. I am looking at numerous clinical parameters and most importantly for patients, looking at angina symptoms, quality of life and exercise capacity and how these things might be improved by treatment.
How might your research benefit patients in the future?
If our hypotheses are verified in my research, we will identify a potential therapeutic option for patients with refractory angina. However, this is a pilot study and to fully answer this important question a larger scale study will be needed. A pilot such as mine provides the foundation and rationale for a larger scale study. I believe it stands to answer an extremely important question that could benefit a large number of patients currently living with chronic symptoms of untreatable angina.
It is important to communication research to a wide variety of audiences. What has been your experience of this so far?
I agree it’s extremely important to convey research to wide variety of audiences. I’ve discussed my research with patient, public, academic and scientific audiences. At the beginning of my research and throughout my research I’ve involved our patient advisory group to get their opinions on how I should conduct the research and also feedback on how the research is going. Additionally, I’ve listened to the personal experiences of research patients taking part in the study so I can continue to make improvements and use this feedback in any further research I conduct.
I recently took part in the Three Minute Thesis Competition at the National Heart & Lung Institute where I was selected by the judging panel, largely comprising of lay members, to represent the institute in the next stage of the competition. I think this was an excellent experience and I found it very educational. It has helped to improve how I summarise my research so it’s clear, concise and easy to understand. In fact, it has helped me in communicating my research to patients when recruiting and to patients participating in the study. I have presented my research at the Institute of Cardiovascular Medicine Symposium last year and at the Royal Society of Medicine to cardiology trainees across London. At an international level, I was one of the guest speakers at the 3rd Dresden Apheresis Conference.
And finally, how do you think your PhD will help your future career in medicine and do you think this will include research?
I think my PhD is an excellent opportunity for me to develop some very sound research skills including running a clinical research trial. I think research is extremely important as without research we cannot come up with innovative means of treating patients and improving patient care and without research we would not be guided by evidence based medicine. For me, although research has its ups and downs, it’s extremely challenging and rewarding and compliments clinical cardiology. I wish to continue with a strong academic role in my future career.
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