It is with great pleasure that we share the Canadian VIGOUR Centre (CVC) 2020 annual report, which showcases our work around Bridging the Gap. We focus on building connections between clinical trials and population health, and traditional and artificial intelligence/machine learning methodologies, while always maintaining our focus on the patient experience. Although COVID-19 kept us apart physically, we saw the best from both people and science when collaboration occurred, bridging the need for quality research and timely delivery of science.
As we reflect upon this turbulent year, as well as the projects, colleagues, and patients who participated in the work undertaken together, there is no doubt this was a challenge for everyone involved. That said, we learned valuable lessons that will alter how we go forward.
The Canadian VIGOUR Centre (CVC) was established in 1997 as an academic research organization (ARO) at the University of Alberta, and has since been committed to the enhancement of cardiovascular health.
The CVC is recognized for its pioneering research in cardiovascular medicine, which embraces the translation of research through thought leadership and management of innovative clinical trials. Furthermore, the CVC is focused on the generation of new knowledge from patient registries and population outcome studies, which inform the direction of future pathways.
As an ARO, the CVC is committed to the scholarly value of scientific inquiry and truth, and believes knowledge should be shared openly in an ethical research environment. The CVC’s dedications to lifelong learning has also inspired one of our central tenets –engaging the next generation of health professionals in a research culture that embraces curiosity, welcomes new ideas, and seeks to address key unanswered questions in health care.
Aspire to the highest standard of work while respecting a balanced life perspective. Attract, mentor, and retain high quality colleagues and collaborators with similar core values.
Promote and support an outstanding team that integrates a diversity of knowledge, experience, ideas, and skills supportive of our mission/vision.
Perform our roles in an ethical framework, which enhances our reputation as honest, trustworthy, and responsible.
Create an innovative, engaging, and inclusive work environment, appreciative of individual differences and contributions. Our workplace will be conducive to personal growth and development that is aligned with our overall mission.
This section highlights the innovative and expansive research projects undertaken by the CVC in 2020, and some of the key contributions from our faculty, staff, and trainees. These highlights are categorized into six research areas: acute coronary syndromes, atrial fibrillation, critical care and cardiac surgery, heart failure, syncope, and women’s health. This work exemplifies our organization’s dedication to collaboration, innovation, and bridging the gap between clinical research and real-world evidence.
The CVC was established on the backbone of clinical trials exploring therapies for acute coronary syndromes (ACS). Over the past two decades, this has evolved to a broader context involving therapies beyond those in the first minutes or day of an ACS, to those applied later in-hospital, or for patients with underlying coronary artery disease (CAD). The CVC has continued to push to understand timely diagnosis and treatment of ACS while pursuing primary and secondary prevention of CAD.
Atrial fibrillation (AF) is the most common cardiac rhythm disorder encountered in clinical practice. The consequences associated with AF are significant with a five-fold increase risk for ischemic stroke, a three-fold increase risk in developing heart failure, and a near doubling in mortality. The prevalence of AF is rapidly rising and is projected to double over the next 30 years due to an aging population, increasingly adverse lifestyles, and cardiovascular risk factors. The CVC is partnering with colleagues from British Columbia and other provinces, national agencies, such as the Canadian Cardiovascular Society, and industry to investigate the burden of AF in Canada.
Since their inception in the 1960s as acute care wards for patients with myocardial infarction due to the development of common arrhythmias, coronary care units have evolved into cardiac intensive care units (CICU) for critically ill patients with cardiovascular disease complicated by multisystem organ failure. Early in CVC history, the focus was on new treatment options for patients with ST-elevation myocardial infarction, however, this has evolved to look at a broader population (such as those with heart failure and arrhythmias), how CICUs are utilized, and strategy-based studies of how to manage this population.
Heart failure continues to exert a toll on patients and impact quality and length of life. Additionally, frequent emergency department visits and hospitalizations affect patients and health systems alike, despite best therapy. The CVC continues its long history in exploring the epidemiology of heart failure, and acute and chronic treatments that will alter the trajectory for these patients.
Syncope, defined as transient loss of consciousness associated with an inability to maintain postural tone followed by rapid and spontaneous recovery, is a common symptom, and reason for health care encounters. Since syncope may be the final common presentation for various conditions, determining the underlying diagnosis and estimating prognosis can be challenging. This often results in an unstructured approach to evaluation, which is ineffective and costly. The CVC is using Alberta’s unique integrated population-level data, which can track a patient from the emergency department to the hospital and beyond, to further examine the impact of syncope on both short-term and long-term outcomes.
Heart disease is a leading cause of death in both men and women in Canada, however, it is more likely to be missed in women than men. This may be due, in part, to the fact that women are known to present with different types of symptoms than men. Women also tend to delay seeking emergency medical services, which leads to longer times between symptom onset and receiving treatment. Additionally, the CVC is exploring early markers, such as adverse events during pregnancy, to identify women at high-risk of developing heart disease.
As the global COVID-19 pandemic has taken its toll on people, workplaces, and overall health and happiness, there are important questions that have seen science at its best. Relatively simple things, such as the number of patients tested for, or with, COVID-19 has shed a spotlight on high-quality, real-time data that will have a lasting impact. Furthermore, rapid development and deployment of diagnostic tests has shown how communities, when focused, can adapt and excel in scientific discoveries. Finally, as the specific cardiovascular relationship to SARS-CoV-2 is explored, it is apparent that testing old and new therapies has brought renewed focus to the continued value of randomized controlled trials.
As a learning organization, one of the CVC’s central tenets is to engage the next generation of health professionals in a research culture that embraces curiosity, welcomes new ideas, and seeks to address key unanswered questions that are likely to alter the minds and actions of all those involved in health care delivery.
The CVC is anchored by a dedicated group of internationally recognized thought leaders in cardiovascular medicine and clinical investigation, and is supported by accomplished administrative and clinical operations teams, as well as experienced biostatisticians, data and machine analysts, and ECG Core Laboratory personnel.
Research is a team sport, and our diverse and multidimensional CVC personnel are committed to continuous innovation that has an impact on informing health policy.
The CVC has forged strong partnerships with a number of institutions and centres around the world in the pursuit of novel research directions and the advancement of cardiovascular research. The CVC takes great pride in our relationships with these collaborators, who are internationally recognized leaders in the advancement of cardiovascular research.
The patients, for their willing participation in our trials and registries. They are the true heroes of clinical research and we honour their volunteer spirit.
The CVC faculty, external advisors, and collaborators for their enriching contributions and for providing ongoing research opportunities. We look forward to providing continued support and to future collaborations in advance of our mission.
The CVC staff and management for their outstanding dedication, professionalism, excellent contributions, and ingenuity, which enhances the quality of our research work.
Our trainees for their commitment, ideas, and enthusiasm. You are the next generation of researchers and health care providers.
The excellent work of our communications group for their time and the dedication required to produce this report.
The sponsors and granting agencies; without their generous financial support our research and educational activities would not be possible.
The team at AM/FM for the concept and design.
Photographer, Richard Siemens, for the group photos of our staff and faculty featured withinthis report.