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ESC Gold Medal Award winner: Professor Renu Virmani

27 Aug 2021
ESC Gold Medalist

The work of one of this year’s ESC Gold Medal Award winners, the cardiovascular pathologist Professor Renu Virmani (Georgetown University; University of Maryland-Baltimore; George Washington University; and Vanderbilt University, USA), revolutionised the understanding of coronary atherosclerotic plaques and their role in sudden coronary death.

Prof. Virmani was astonished and overwhelmed to be awarded an ESC Gold Medal. “I think I am the first pathologist to be given one of these awards and I feel honoured that someone in my profession should receive this level of recognition from cardiologists. I never dreamed that I would achieve something like this in my career,” she said.

It is a career that began in 1974, when she arrived in the US and developed a love of cardiovascular pathology while working in the laboratory of Doctor William Roberts at the National Institutes of Health in Maryland. She was also driven by loss to cardiovascular disease in her own family.

Prof. Virmani has made important contributions in a number of different areas of coronary disease. According to Prof. Virmani, one of the highlights of her career so far is the identification of plaque erosion and calcified nodules as additional causes of thrombosis. Another is somewhat controversial work she conducted on the first generation of drug-eluting stents, in which she described a high incidence of thrombosis. Her suggestions for solutions to the problem led to the improved safety of this widely used intervention.

She considers her greatest professional achievement, and the one for which she is most well-known, to be the description of the vulnerable plaque. “We now understand that this is a precursor lesion to the rupture of plaques, the main cause of myocardial infarction and sudden death,” she said. “However,” she continued, “while it is quite amazing to see how much progress has been made in treating acute myocardial infarction and reducing mortality, we now need to find ways to prevent sudden coronary deaths in young people who have never shown any manifestations of their disease.” This area is a primary interest of Prof. Virmani, and she hopes she can persuade more investigators to prioritise it as a focus of research. “We should be able to use non-invasive techniques to identify precursor lesions to plaque rupture and this might help us to reduce the number of young people dying in this way,” she said.

It is possible that it will be the young cardiologists coming through her laboratory who will help to find solutions. “I have had the privilege of working with a lot of young cardiologists and my advice to them is always the same,” she said. “Choose an area of research that you are passionate about and study it exhaustively. Be creative and think outside the box. Do not be afraid to say something controversial and do not be intimidated by criticism. Above all, be persistent!”