Q&A with Dr Umar Ali

Dr Umar Ali received a Heart Foundation 2021 Charles Campbell Coghlan OAM PhD Scholarship.

What are you currently researching?

My research aims to identify people at risk of a heart attack earlier, by examining the stability of fatty material (plaque) inside arteries.

When plaque builds up inside arteries, this is called atherosclerosis. The arteries can become hardened and narrowed, reducing the flow of blood and oxygen to the heart and other parts of the body. When atherosclerosis occurs in the coronary arteries, this is called coronary heart disease.

Coronary heart disease is the main cause of heart attack, which can happen when a plaque in a coronary artery ruptures. A blood clot forms, which blocks the artery. This means blood and oxygen can’t reach the heart muscle, so it becomes damaged.

Although there have been advances in diagnostic tools and treatments for atherosclerosis, coronary heart disease remains the leading cause of death worldwide. Atherosclerosis has a progressive nature and can be silent, meaning a person might not have any symptoms for a long period of time. It has been estimated that approximately 50% of apparently healthy people have atherosclerosis despite being considered ‘low risk’ based on their cardiovascular risk factors. If we can intervene before a plaque ruptures, even before a person has symptoms, we can help prevent heart attacks.

My research includes taking plaque samples from coronary arteries in the hearts of people undergoing heart transplantation. We will also take plaque samples from people undergoing cardiac surgery with symptoms of coronary heart disease. This will allow us to compare plaque samples in people with symptoms and those without, and also to compare levels of specific markers in urine and blood samples.

The overarching goal is to improve our understanding of how plaques can change and rupture. This will allow us to develop non-invasive, cost-effective tools like blood and urine tests, to identify people most at risk. We can act earlier to prevent a heart attack and help save lives.

What difference will your research make to people’s cardiovascular health in Australia?

We believe that our research has the potential to improve clinical and prevention medicine in the future. We hope to discover new metabolic risk factors to add to the already-established cardiovascular risk factors, such as high blood pressure, high cholesterol and smoking. Identifying these new risk factors may lead to the discovery of new treatments, including medicines. In addition, we hope that we can use simple blood and urine tests as a way of screening people for coronary heart disease. This may replace invasive investigations such as CT coronary angiograms and coronary angiography for coronary heart disease. Our goal is to translate our research into clinical practice and health policies, to detect coronary heart disease early and ultimately prevent angina and heart attacks.

What motivated you to do your research?

I have focussed my efforts on research related to cardiovascular surgery since beginning my research career as a junior doctor in 2018. I have a specific interest in coronary heart disease, and in using novel approaches to prevent damage to the heart muscle during cardiac surgery. Coronary heart disease is a leading cause of death worldwide with a significant health burden. This research has the potential to detect disease before people develop symptoms and allow for early prevention measures. The potential to significantly reduce the burden of disease provides substantial motivation for me to do this research.

What role has Heart Foundation funding had in your career journey?

The Heart Foundation PhD Scholarship will allow me to dedicate more time to my research. This funding provides further motivation for me to complete this research and validates my research aims, hypotheses and research plan. It encourages me to improve my track record for future research projects and collaborations.

Do you have a message for Heart Foundation supporters?

Thank you to the Charles Coghlan family for your donation towards this research. As an early career researcher, this means a lot to me and provides me with a great deal of motivation to continue doing high quality research.