Henry Krum

Abstract

Cardiovascular researcher and specialist in heart failure management and therapies. Born on March 6, 1958, in Melbourne, Australia, he died there on Nov 28, 2015, from pancreatic neuroendocrine cancer aged 57 years. Henry Krum, a professor in the Department of Epidemiology and Preventive Medicine at Monash University in Australia for nearly 20 years, dedicated his career to undertaking and honing clinical trials to improve the way drug and non-drug therapies are used to manage cardiovascular disease. He was Director of Monash University's Centre of Cardiovascular Research and Education in Therapeutics and during his career his work spanned basic science, clinical research, and medical practice. “He had a broader vision of medicine than most of us and worked outside the narrow confines of the super-specialties”, says colleague John McMurray, Professor of Medical Cardiology at the University of Glasgow. “Henry did the science that explained how drugs worked, did the trials that showed drugs helped patients, wrote the guidelines that summarised the trial evidence and made recommendations for how patients should be treated, and actually cared for individual patients of his own. He was both a personal physician for his local patients but contributed to the treatment of patients globally through his trials, guideline work, teaching, and lecturing.” In 2003, Krum and his colleagues showed that administering the β blocker carvedilol to patients in the first 8 weeks after severe heart failure could improve clinical outcomes with fewer deaths and hospital admissions, especially among those at high risk for adverse events. The finding challenged conventional wisdom about the efficacy and safety of giving β blockers to patients soon after heart failure; today they are mandated in many cases. “He was a major contributor to this turnaround and found that not only could they be used, they actually benefit patients' quality of life”, says collaborator and friend Richard Gilbert, Head of the Division of Endocrinology at St Michael's Hospital in Toronto and Professor of Medicine at Canada's University of Toronto. “He was purely merit-driven. He didn't have preconceived notions. He let the science speak for itself.” That trial was one of some 150 different clinical studies Krum did during his career. He recently chaired the executive committee of a 7000-patient global study on the efficacy of renin inhibitors in patients with systolic heart failure. Jennifer Martin, Chair of Clinical Pharmacology in the School of Medicine and Public Health at Australia's University of Newcastle, says Krum will be remembered for “his ability to ruthlessly pull apart a clinical trial design, conduct an interpretation in under 5 seconds, and then distill a possible message, whilst still disagreeing that much was positive. He could always offer a list of how the trial could have been done better (unless he had been part of the trial committee). That served his team well and we all learned the critical appraisal skill and the importance of translation into practice early.” Krum's interests extended beyond cardiovascular disease and included chronic kidney disease and diabetes. He sought interventions to address the fact that people with chronic kidney disease are more likely to die from cardiovascular disease than from renal failure. In 2009, he published a proof-of-principle study in The Lancet on renal sympathetic denervation for refractory hypertension. Krum received a medical degree from the University of Melbourne in 1981, trained as a clinical pharmacologist and completed his doctorate in that field at the Austin Clinical School in 1991. After 2 years as a postdoctoral fellow at Columbia University in New York, he returned to Melbourne. Krum joined Monash University in 1996 and was appointed Head of the Clinical Pharmacology Department at the Alfred Hospital. He was the Co-Editor-in-Chief and Founding Editor of Cardiovascular Therapeutics. He, Gilbert, and their colleagues co-founded the biotechnology company Fibrotech Therapeutics, which was acquired by Shire in 2014. Laid back, fun, and enthusiastic, Krum was an extraordinary achiever. “Henry was self-deprecating and I'm not sure he ever really realised as much as his team around him did of the enormous contribution he was making”, says Martin, who Krum supervised at Monash University. “He had boundless energy and intellectual spirit”, says Gilbert. “He was someone who was always busy and striving ahead but never lost sight of his relationships with patients, colleagues, and especially his family.” Krum is survived by his wife, Lauren Berkowitz; two children, Joshua and Emily; and a sister, Sharon. This online publication has been corrected. The corrected version first appeared at thelancet.com on Jan 15, 2016 This online publication has been corrected. The corrected version first appeared at thelancet.com on Jan 15, 2016 Department of ErrorSnyder A. Henry Krum. Lancet 2016; 387: 120—In this Obituary, the date of birth should be March 6, 1958. This correction has been made to the online version as of Jan 15, 2016. Full-Text PDF