AstraZeneca, the American Heart Association (AHA) and Verily (formerly Google Life Sciences) announced Wednesday that Dr. Calum MacRae is the recipient of a $75 million research award to study coronary heart disease (CHD) and its consequences. Applications for the project, known as “One Brave Idea,” were accepted earlier this year and sought to identify an entirely new approach to eradicate the number one killer of Americans.
Below are highlights from an extended interview with Dr. MacRae, Chief of Cardiovascular Medicine at Brigham and Women’s Hospital in Boston, one of the core training hospitals for Harvard Medical School, where he is also an associate professor.
How is your plan different from typical scientific research?
Dr. MacRae: What we're trying to do is say, `Let’s collect information from every system in your body and every system around you, and use it to understand coronary disease.’ All this information has never all been brought under the same tent…we want to be sure we capture everything that is relevant in traditional medicine, along with everything else – the patient, the family, all of modern technology – and bring it to the very root of the problem so we can start to understand it in a different way.
The traditional journey involves things like blood pressure and cholesterol. Why does your journey plan to go down new roads?
Dr. Calum MacRae, Chief of Cardiovascular Medicine at Brigham and Women’s Hospital in Boston
Dr. MacRae: For example, the abnormal pathways in your heart that lead to coronary blockages also have been shown to affect bone mass. So it may be that if we looked in the right way at how bones are forming early on in life that we’d be able to say, `Oh, now we know what some of the earliest problems are in these people’ and we could use that as a test when they are teenagers to identify who is at risk and begin to think anew about ways to treat the underlying problem.
So an 18-year-old's thigh bone could be a predictor?
Dr. MacRae: Right. Or it might be their skin. Maybe the shape of their face. Maybe the way in which your jaw forms – the rate in which your face changes could be a marker of underlying diseases. … People with familial hypercholesterolemia, their cholesterol ends up in large collections in the skin on their knuckles or in other areas when they're in their 40s and 50s. So maybe if we just look for that using much more sensitive techniques when they're 5 years old then we'd be able to understand better who is at risk and find forms of it that we had previously not recognized.
Part of what made your bid successful was the team you’ve assembled, which includes experts from prestigious institutions and organizations across the U.S. and into Canada. What excites you about leading this group?
Dr. MacRae: In medicine, there's a tendency for investigation to be driven by one person from one field. And I think what we've learned in the last four or five years, and what we've seen in other industries, is that if you build the right teams, you can do things in ways that are totally transformative because you're not dependent on one particular world view to solve a problem.
Part of the team approach includes engaging patients, as well as their family. What is the role of the relatives?
Dr. MacRae: Almost every family I've ever worked with that has an inherited disease, they know who in their family has the disease well before the doctors know. They recognize there's something different about the affected family members, sometimes even as kids. They’ll say `He always gets palpitations when he exercises’ or `He doesn't like to play sports and he's been like that since he was 10.’ And you’re seeing them when they’re 50. So we're trying to catch them at 15 or 25 and capture that intuition, that patient insight.
What is your favorite aspect of One Brave Idea?
Dr. MacRae: From the start, the funders were saying, `Do things differently.’ This was taking an idea around which you arranged the people whereas in science it’s often the other way around. Even the application process was different. And then also the way it was being judged, the way the questions were being asked was different.
Aside from curing coronary heart disease, what will success look like?
Dr. MacRae: The current timeline for a new drug is 15 years and $1.2 billion. So we will have to think very differently to use $75 million to find a new cure for coronary disease in 5 years-but that is what the new research model we will use is designed to do. I am certain that we’ll find new way to go about the problem and move the whole field forward and I believe we will be able to make a direct impact on actual outcomes in CHD.
Are you ready for the challenge/burden of being the $75 million researcher?
Dr. MacRae: I think there's going to be intense scrutiny and there are going to be high expectations, more than I’ve ever faced. It’s a good problem to have.
Learn more at OneBraveIdea.com and stay tuned for updates from AstraZeneca, AHA and Verily as this initiative progresses.