- Research work has delivered crucial impacts in changing national and international clinical practice guidelines and improvements in patient care within three principal areas: (i) treatment decisions related to stroke and bleeding risk in atrial fibrillation (AF), which is the commonest cardiac arrhythmia in the general population, (ii) screening practice in primary care, and (iii) stroke and bleeding risk assessment. These ultimately lead to reduced morbidity and mortality for a significant proportion of the population, particularly among the elderly.
- Research impact on improvements in healthcare is summarised in a University of Birmingham 2014 Research Excellence Framework (REF) Impact Case Study.
- Selected to the Thomson Reuters Science Watch list of ‘World’s Most Influential Scientific Minds 2014’, a ranking of today’s top global 17 scholars who have published the greatest number of hot papers, ranked in the top 0.1% by citations, issued June 2014. In 2013, Professor Lip was also selected to the Thomson Reuters Science Watch list of “Who and What was Hot in Scientific Research in 2012” (issued June 2013) which lists the most influential scientific researchers and research papers of the year.
- Listed as Highly Cited Researcher [2014, 2015, 2016, 2017], representing the top 1% most cited for their subject field, representing the list of the world’s most influential scientists whose work has been consistently judged by their peers to be of particular significance, ie. being the top 1% most cited for their subject field and year of publication.
- October 2016: SWBH ‘Trust Beacon Service award’ for Cardiology, as ‘an internationally-recognised centre for atrial fibrillation’, and SWBH ‘Excellence in Research’ award for my Atrial Fibrillation research team, which topped the SWBH league table in 2015-16 in terms of numbers of patients recruited to research studies on the NIHR portfolio, as well as major contributions to the delivery of the Trust’s R&D plan including enhanced integration with primary care and the translation of research into better and safer clinical care.
- Recently awarded National Institute for Health Research (NIHR) Senior Investigator status (2017-2020) in open competition.
- January 2014, ranked by Expertscape as the world's leading expert in the understanding and treatment of AF, and correspondingly, the University of Birmingham listed as the world's top institution for AF research. Professor Lip's global top ranking is still maintained in September 2017.
- In June 2014, ranked by Expertscape as amongst the world's leading expert in the understanding and treatment of Hypertension.
- Work into improving AF clinical management won the Heart Rhythm UK ‘Arrhythmia Alliance Team of the Year Award 2012' and the BMJ Group ‘Cardiovascular Team of the Year 2013’ award
- 2016 National Institute for Health Research (NIHR) CRN West Midlands Clinical Research Impact award; for atrial fibrillation research, September 2016
- July 2017, West Midlands Academic Health Sciences Network Celebration of Innovation ‘Excellence in Wellness and Prevention Award’ Winner for “Birmingham 3 step approach” Professor GYH Lip/Dr S Sarwar: University of Birmingham and Sandwell and West Birmingham Hospitals NHS Trust.
1. With regard to clinical management, clinical risk scores developed and validated by Professor Lip's work to assess stroke & bleeding risk in atrial fibrillation (AF) (ie. CHA2DS2-VASc & HAS-BLED) are used in national/international management guidelines, eg. UK National Institute for Health & Care Excellence (NICE, 2006 & 2014), European Society of Cardiology (ESC 2012, 2016), Canadian Cardiovascular Society (2012), Asia Pacific Heart Rhythm Society (APHRS 2013, 2017), American Heart Association/American College of Cardiology/Heart Rhythm Society guidelines (2014) etc.
The CHA2DS2-VASc score helps clinicians formally assess stroke risk and identify `truly low risk' patients who do not need antithrombotic therapy, and effectively captures those patients who should be considered for stroke prevention. Risk assessment with CHA2DS2-VASc is part of the NICE Quality Outcomes Framework (QOF) and is easily available for use by GPs as part of the Guidance on Risk Assessment and Stroke Prevention for Atrial Fibrillation (GRASP-AF) risk stratification tool, which is freely available and compatible for use with all GP clinical systems in England.
The simple, user-friendly HAS-BLED score, comprising risk factors either readily available from the clinical medical history or routinely tested in (new) patients, allows clinicians to formally assess bleeding risk, focusing on modifiable risk factors (optimising blood pressure control, removing concomitant anti-platelets, reducing alcohol intake, and optimising time in therapeutic range for those taking warfarin), and those who require regular review (patients at higher bleeding risk). The impact on implementing these risk scores into AF populations Europe-wide could potentially prevent >60000 major cardiovascular events & deaths each year amongst AF patients with a CHA2DS2-VASc ≥2 (Thromb Haemost 2013;109:328).
Professor Lip's development of SAMe-TT2R2 score (2013) aids decision-making between warfarin and new anticoagulants. This score is incorporated into ESC/NICE consensus recommendations, Clinical Commissioning Group (CCG) for AF (2014) and the PRIMIS Warfarin Patient Safety audit tool (2014). The CHA2DS2-VASc, HAS-BLED and the SAMe-TT2R2 scores are now part of the CCG AF patient pathway streamlining decision making and improving the primary-secondary care interface (the ‘Birmingham 3-step’ AF pathway, 2016). The latter forms the basis of the West Midland Academic Health Science Network (AHSN) ‘Preventing AF related Strokes’ initiative (2017).
Overall clinical research work into AF has also had a major impact on recommendations in AF guidelines issued by NICE (2006 and 2014), as well as the ESC (2010, 2012 and 2016), CCS (2011) and ACCP (2012). Professor Lip's research has informed European consensus guidelines on the optimal management of anticoagulated AF patients who present with an acute coronary syndrome ± undergo coronary intervention/stenting (ESC, 2010 and 2014), as well as the assessment/management of bleeding in AF patients (European Heart Rhythm Association (EHRA), 2011).
2. The concept of ‘atrial fibrillation is a prothrombotic or hypercoagulable state’ was first proposed by Professor Lip in a Lancet article in 1996. His ongoing work has validated biomarkers of thromboembolism and vascular biology in cardiovascular disease (esp AF) as prognostic indices, and such biomarkers have been used in the assessment and investigation of AF, and the study of new antithrombotic drugs by industry (various ongoing studies, 2009-), as surrogate biomarkers of clot formation in AF.
3. Since 2009, Professor Lip's research group has ongoing research collaborations nationally (Aston University, Birmingham; London; Leeds) and internationally (Copenhagen and Aalborg Universities, Denmark; University of Murcia, Spain; University of Iowa, USA; Fushimi Community AF registry, Japan; University of Belgrade, Serbia; University of Tours, France; University of Hong Kong; Beijing, Nanjing and Guangzhou, China; National Yang-Ming University, Taipei, Taiwan; University of Lodz, Poland).
His international network of collaborators has allowed him to pursue the strategy of research globalisation & the study of culture/ethnic/country-specific issues, particularly cardiovascular conditions esp. in AF. This has led to numerous key publications, addressing global aspect of AF epidemiology & implications for healthcare systems in emerging economies.
Professor Lip currently has joint programme grants with the University of London (BHF/Stroke Association – CROMIS-2 study, c£1m; 2010-ongoing; European Union H2020 programme, PRESTIGE-AF, Euro 9m, 20117-ongoing); Leeds (Wellcome Trust, £3m; 2015- ongoing) and Aalborg University, Denmark (Danish National Research Council – epidemiology and pathophysiology of AF, c£2.5m; 2010-ongoing). He is part of the Lipid, Blood Pressure Meta-analysis Collaboration (LBPMC) Group and Health Ageing Research Center (HARC) funded by European Union FP7 Funding (FP7-REGPOT-2012-2013-1), based at University of Lodz, Poland. The latter collaboration is recently extended with EU funding for the LIPIDOGRAM2015 & LIPIDOGEN2015 studies.
Overall, Professor Lip has successfully attracted major grant funding (total £20+ million cumulative) from the British Heart Foundation, Heart Research UK, Medical Research Council, NHS HTA Programme, Arthritis Research Council, Action Medical Research, Peel Medical Research Trust, etc). He has acted as principal investigator for various projects in his department and successfully supervised/co-supervised approximately 45 postgraduate theses, leading to MD, PhD, Masters, etc higher degrees.
4. Professor Lip has regular invitations to deliver Keynote/plenary lectures at International/Major National Meetings, often delivering the Opening Ceremony inaugural lecture, or Named Lecture at major congresses. Some recent examples (selected) as follows:
- Bradshaw Lecturer for the Royal College of Physicians of London, in November 2013
- March 2014, appointed Visiting Professor and delivered the annual Razavi Lecture at the Cleveland Clinic Medical School, Cleveland, USA.
- March 2014, appointed Wu Chung Visiting Professor and lecturer at the University of Hong Kong
- May 2014, Special Grand Rounds Visiting Lecturer at Columbia University, New York, USA.
- September 2014, awarded the Polish Cardiac Society medal and gave the Inaugural Opening Lecture at the XVIII Congress of the Polish Cardiac Society, in Poznan, Poland.
- January 2015, delivered the Sun Chieh Yeh Heart Foundation Lecture at the Opening Ceremony of the Cardiorhythm 2015 meeting in Hong Kong.
- April 2015, delivered the Michaelides lecture, at the 30th International Meeting on Clinical Cardiology, organized by the Hellenic Heart Foundation; Athens, Greece
- May 2015, delivered the Founders Lecture at the Heart Rhythm Society meeting (the world’s largest arrhythmia meeting) in Boston, USA
- June 2015, delivered the Opening Ceremony Plenary Lecture at the Norwegian Cardiac Society meeting, Tromso, Norway
- September 2015, delivered the Opening Ceremony Inaugural Lecture at the Romanian Congress of Cardiology meeting, Sinaia, Romania (September 2015) and conferred honorary membership of the Romanian Society of Cardiology.
- October 2015, Opening Ceremony lecture 26th Great Wall International Congress of Cardiology (GW-ICC) & Asia Pacific Heart Congress 2015 & International Congress Cardiovascular Prevention and Rehabilitation 2015
- November 2016, Key Note Speaker at National Institute for Preventive Cardiology of Ireland - National Prevention Meeting in Galway, Ireland.
- December 2016, Opening Ceremony Lecture at the Icelandic Society of Internal Medicine Congress, Reykjavik.
- February 2017: Closing Ceremony Plenary Lecture, at 61st Annual Meeting of the Society of Thrombosis and Hemostasis Research (GTH), Basel, Switzerland, February 15th – 18th2017.
- September 2017, Polish Cardiac Society medal and awarded honorary membership of the society. XXI International Congress of the Polish Cardiac Society - Katowice, Poland.
- March 2016, Opening Plenary guest lecturer: Dutch Cardiology Society Conference, Noordwijkerhout, The Netherlands
- April 2016, Opening Plenary ‘State of the Art’ Lecture, National Heart Association of Malaysia
- May 2016, Hungarian Society of Cardiology medal, Opening ceremony and Honorary Membership lecture, Annual Scientific Congress of the Hungarian Society of Cardiology, Balatonfüred
- June 2016, Cardiostim-EHRA Europace 2016 Opening Ceremony ‘State of the (he)Art’ lecture ‘Stroke and bleeding risk in atrial fibrillation: evidence, guidelines and clinical practice.’
- June 2016: Martin Green Lecture, Ottawa Heart Research Conference 2016: Translational Research in Atrial Fibrillation
- October 2016: Prof. Chudomir Nachev Lecture, at the 15th Bulgarian National Congress of Cardiology, Sofia, Bulgaria
6. Engagement with industry and translational research:
- Professor Lip has significant engagement with industry, especially in areas related to AF and thrombosis, acting as steering committee or Chairman of multicentre, international studies. In addition, he has worked with translational scientists in new drug developments, leading to partnerships between academia (eg. Universities of Aston, Birmingham, Leeds etc). Some recent examples (selected) as follows:
- Steering Committee Chair on various multicentre clinical trials that bring research from industry to the UK. These include various Phase II trials with new anticoagulants (eg. AZD0837, see PubMed PMID: 19690349) and Phase III international trials (eg. ENSURE-AF, PMID: 25965706), and registries (eg. GLORIA-AF, PMID: 26239094; PMID: 24576516). Professor Lip has also acted as UK lead investigator for international trials, with representation on trial steering committees (eg. PIONEER-AF, see PMID: 25819853)
- Translational work on AF as a prothrombotic or hypercoagulable state as validated biomarkers of thromboembolism in AF (Lancet. 2009;373:155-66). These biomarkers are used in industry trials as surrogate biomarkers of clot formation in AF, eg. for characterisation of the direct thrombin inhibitor AZD0837 (see PMID: 26174611). Recent focus on AF and renal impairment, assessing clot structure and function (PMID: 27356648), with a view to new therapeutic interventions for such patients.
- Professor Lip has worked with translational scientists in new drug development, leading to a recent Wellcome Trust Seeding Drug Discovery Award in 2015 (‘Lead identification of a novel anticoagulant agent targeting activated factor XII for the prevention of thrombosis with minimal risk of bleeding; £3m). These include funding for basic scientists and addressing the unmet clinical needs of new anticoagulants, bridging bench to bedside.
- Current translational research partnerships ongoing with Aston University in collaboration with life sciences for early and exploratory development of new drugs to modulate cardiac fibrosis (grant applications in process)
- Other engagement includes contract research with the life sciences industry, including testing novel diagnostic biomarkers, eg. free light chains quantification in cardiovascular disease with the Binding Site PLC (see PMID: 25260814; PMID: 25828674)
- Professor Lip has led various 'real world' registries, as well as health economic analyses and outcomes research independently or industry-sponsored (see PMID: 26316345; PMID: 26477648). Some have been used to inform NICE cost-effectiveness models and appraisals, allowing the NHS and public sector to make informed decisions with efficient use of resources.