Jagan Sivakumaran

University Health Network/University of Toronto
Project: Assessment of the QRISK3, SLE Cardiovascular Risk Equation, Modified Framingham and Framingham Risk Calculators as Predictors for Development of Atherosclerotic Cardiovascular Disease in Patients with Systemic Lupus Erythematosus
Mentor: Zahi Touma, MD, PhD

About the Researcher

Sivakumaran is currently studying for his Doctorate in Medicine at the University of Toronto. Prior to commencing medical school at the University of Toronto in August 2016, Jagan attended Western University from 2012 – 2016 where he completed an Honours Specialization in Pharmacology. While at Western, he was involved in several research ventures, including a pharmacology thesis project examining the effects of exercise on CYP3A enzymes in mice and an investigation of calcium oxalate monohydrate, the principle component of kidney stones, using atomic force microscopy within the Physics Department.   Jagan was awarded several research awards including two Natural Sciences and Engineering Research Council (NSERC) Undergraduate Student Research Awards (USRA) in 2014 and 2015, and the Centre for Advanced Materials and Biomaterials Research’s (CAMBR) Advanced Materials and Biomaterials Interdisciplinary (AMBI) Undergraduate Research Award in 2013.  

Summary from Sivakumaran’s Research Proposal

Systemic lupus erythematosus (SLE) is an autoimmune disease where the immune system attacks the body's organs because it fails to differentiate self from foreign and potentially dangerous matter. This can cause inflammation in any organ, including the heart and arteries. Thus, patients with SLE are at a higher risk for developing cardiovascular disease (CVD), resulting in more frequent and younger occurrence of heart attack, angina, stroke, and other CVD. This increased risk is likely related to SLE itself, inflammation of the vessels, and complications of SLE treatment.
Tools are available to assess CVD risk in the general population. These tools focus on risk factors such as hypertension, smoking, dyslipidemia, obesity, and others without accounting for SLE.Research shows these tools inadequately identify SLE patients who develop CVD. 

This study aims to assess the QRISK3 in comparison to other risk tools to determine which best identifies SLE patients who develop CVD. These tools will be applied to data available on over 300 patients followed for at least 10 years. The scores according to these tools will be calculated and compared to whether they developed CVD. Analysis will identify which tool best identifies patients at higher risk. Having a tool that identifies patients who could develop CVD earlier will allow physicians to better manage their risk factors and prevent disease development, adverse outcomes, and death.

Research

Assessment of cardiovascular disease risk prediction tools in patients with systemic lupus erythematosus
Supervisor: Dr. Zahi Touma, Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital

Medical education in Anesthesia: Differences in self-motivation and access of e-Modules between LInC and traditional clerkship students
Supervisor: Dr. Ahtsham Niazi, Department of Anesthesia, University of Toronto

Expression and activity of CYP3A enzymes following exercise in mice
Supervisor: Dr. Rommel Tirona, Department of Pharmacology, Western University

Differential effects of segmented amino acid sequences of phosphoprotein osteopontin on calcium oxalate monohydrate nucleation and growth observed using atomic force and optical microscopy
Supervisor: Dr. Jeffrey Hutter, Department of Physics, Western University

Publications and Presentations

1. Sivakumaran J, Harvey P, Omar A, Urowitz MB, Gladman DD, Anderson N, Su J, Touma Z. Assessment of the QRISK2, QRISK3, SLE Cardiovascular Risk Equation, Modified Framingham and Framingham risk calculators as predictors for the development of cardiovascular disease in patients with systemic lupus erythematosus. 
2. Jagan Sivakumaran, Paula Harvey, Ahmed Omar, Murray Urowitz, Dafna Gladman, Nicole Anderson, Jiandong Su and Zahi Touma. Assessment of the QRISK2, QRISK3, SLE Cardiovascular Risk Equation, Framingham and Modified Framingham Risk Calculators as Predictors of Cardiovascular Disease Events in Systemic Lupus Erythematosus

Awards and Honors

Mack Foundation University Health Network Medical Student Bursary, University of Toronto
Competitively awarded for outstanding original research presented at a conference.

Lupus Scientific Merit Award, International Congress on SLE
Outstanding abstract submitted to the International Congress on SLE.
 

Learn more about research funded by the Lupus Foundation of America

For more information on Lupus Foundation on America’s granted research, please contact Ashley Marion at marion@lupus.org.