Dr Lee NedkoffJoins the Institute

Meet our new laboratory head Dr Lee Nedkoff

30 March 2022

Dr Lee Nedkoff brings an entirely new set of skills to the Victor Chang Cardiac Research Institute that will prove instrumental in our fight against heart disease.

Dr Nedkoff is an epidemiologist – a scientist that mines data to discover what is driving heart disease in different communities. Dr Nedkoff is our newest laboratory head and joins our growing heart research centre based at the University of Western Australia, working alongside the Institute's Professor Livia Hool.

The importance of epidemiology in Dr Lee Nedkoff's work cannot be overstated – it offers us a true picture of the burden of heart disease and who’s most affected. By knowing the cause, and who’s most at risk, we can work to drive new strategies to beat heart disease through public health campaigns and through research programs in our laboratories that will deliver new treatments and diagnoses for all populations in Western Australia and beyond.

Dr Nedkoff sees her work as a vital new addition to the work taking place across the Institute’s laboratories in Western Australia and NSW.

“At first glance my research may appear to be the opposite of what many of the Institute’s scientists are doing. It’s not lab based or clinical based. It’s about studying populations, but my work really complements what is taking place at an Institute and it’s essential.

“In order to tackle heart disease, you need to demonstrate the true scale of the problem. You would think with heart disease we would already have this data out there, but not all of it is accurate or robust, and there are many gaps.

“It’s not only important to have a true picture of the rates of heart attack and stroke, we also need to discover if there are any disparities. For instance, we need to breakdown what’s happening across different age groups, different locations, by gender and by cultural background.”

A focus on coronary heart disease that stretches back almost two decades

Dr Nedkoff first trained as a physiotherapist and mostly worked in hospitals. It wasn’t until after the birth of her first child that she decided to do a Masters of Public Health.

“I loved epidemiology from the start. It just clicked and once I finished my masters, I did a dissertation on acute coronary syndrome and was able to start working with my supervisor on a project related to heart disease and stroke. And I’ve stayed with this area ever since. There is still so much to discover.”

One area Dr Nedkoff is focusing on currently is the burden of coronary heart disease and how rates appear to be increasing.

Data already unearthed in WA and in NSW is showing that rates of heart attack, particularly in women under the age of 55 are starting to rise. Dr Nedkoff is determined to find out why it’s on the up.

“Many people might assume rates are increasing because of the prevalence of chronic diseases – like obesity and diabetes which raise your risk of heart disease. But it could also be because the way we diagnose heart attacks has changed over the last 10-15 years or there is growing awareness about women and heart disease. It’s important that we don’t jump to conclusions but find out the real cause of this perceived increase.

“If it turns out it is lifestyle-related then we could be looking at new public health campaigns to ensure women are fully aware of the increased risks, or investigate new ways of treating people at heightened risk to prevent the onset of heart disease in the first place.

“For now, I have to keep on digging to find out what’s happening so we determine the next steps.”

The link between heart disease and stroke

As head of the Institute's Cardiology Population Health Laboratory, Dr Nedkoff is also working on stroke prevention alongside a number of investigators in Australia.

“We’re exploring how having heart disease contributes to your risk of stroke. Demonstrating the magnitude of increased risk of having a stroke if you have heart disease, and in which population groups, could potentially change the way stroke sufferers are treated and the medications they are given.

“The implications are enormous due to the sheer number of people in Australia and around the world who have heart disease and may be oblivious to the fact they may be at far greater risk of having a stroke. That’s why our work is so pivotal in disease prevention.”

Ending the epidemic of RHD in First Nations communities

Another key focus area is Aboriginal and Torres Strait Islander health. Dr Nedkoff is part of a team of investigators, led by Associate Professor Judith Katzenellenbogen, who are studying rheumatic heart disease (RHD), which can cause atrial fibrillation, heart failure, stroke, death, and disability.

Aboriginal and Torres Strait Islander peoples aged under 45 years old are 64 times more likely to suffer from RHD than non-Aboriginal people in Australia.

These stark statistics are the result of three years of work by the team led by A/Professor Katzenellenbogen, and was part of the End RHD in Australia: Study of Epidemiology (ERASE) project, published in the Journal of the American Heart Association.

This disproportionate burden of disease means that RHD is the greatest cause of disparity in cardiovascular health between Aboriginal and Torres Strait Islander and non-Indigenous people in Australia.

Dr Nedkoff says it was essential to document the true extent of RHD in Australia to provide the Federal Government with accurate data on the RHD burden.

“Our work involved bringing together data from all over the country. Health data in Australia is often fragmented so it took two years to gather all the data from health authorities from different states,” says Dr Nedkoff.

Rheumatic heart disease and its prevalence in Aboriginal communities will be an area of research she will continue to drive whilst at the Institute.

The challenges of being an epidemiologist

My work is extremely methodological, and you must be very patient. To get a national picture you have to get data from both the state and federal level and that can be very challenging, and time consuming to obtain. Also, because we are dealing with health data there are all sorts of governance and approvals needed before you can access and use this data. It can also be very costly – just getting an update of an existing data set can cost $10,000 and can range up to $50,000 for more complex requests. It’s why some of our projects can take years to come to fruition.