Kardigan’s pulse-quickening fundraises stand in stark contrast to CEO Tassos Gianakakos’ earlier venture MyoKardia, which initially struggled to attract investors.\n Since launching one year ago with a hearty $300 million series A, Kardigan has been on a biotech speedrun. The company padded its coffers with another $254 million just 10 months later and announced its three licensed late-stage cardio assets, which Kardigan hopes to bring to market over the next four years.A common saying is that haste makes waste. But for Kardigan CEO Tassos Gianakakos, proving that heart medicines can be developed quickly is the whole point.“Hopefully, if we can execute here and get three medicines out in the next four years, we\'ll see more and more [biotechs] approaching cardiovascular disease,” Gianakakos told Fierce during a Jan. 26 interview. “And then we won\'t be talking about it anymore as the No. 1 killer of people in the world.” Cardiovascular disease’s killer status isn’t matched by concomitant interest from the biotech sector, the CEO noted, with just 8% of all biotechs focused on the area.“Five percent of drugs in development, full stop, are focused on cardiovascular disease,” he added. “There\'s 10 times as many for oncology, [but] CV disease kills more people than all cancers combined.”With Kardigan, Gianakakos is weaving together his past leadership experience with a mature pipeline, extensive data collection and clinical trial innovations he hopes will produce a biotech tapestry that is built to last—and inspire the rest of the industry to follow suit. Pumped-up investors Kardigan’s pulse-quickening fundraises stand in stark contrast to Gianakakos’ earlier venture MyoKardia. That company, he said, struggled to attract interest from investors.“Every financing was a bit of a struggle,” Gianakakos recalled. “When I joined as the first CEO, we were shaking some test tubes and thinking about some stuff preclinically. It was not a hot place to be, cardiology.”All that tube shaking ultimately led to mavacamten, a myosin inhibitor that MyoKardia put through phase 3 trials for obstructive hypertrophic cardiomyopathy. The data impressed Bristol Myers Squibb, which came knocking in 2020 with a $13.1 billion acquisition offer the biotech simply couldn’t refuse.Mavacamten was eventually approved in 2022 as Camzyos and is on track to become a reliable moneymaker for BMS, netting $714 million in revenue through the first nine months of 2025. With his first CEO gig spinning into such success, Gianakakos has secured support from investors who believe mavacamten’s victory can be replicated. His team has brought in a clutch of late-stage candidates that “address the root cause of disease” in areas where there are currently no approved drugs, he said.They include tonlamarsen from Ionis Pharmaceuticals for acute severe hypertension, ataciguat from Sanofi and the Mayo Clinic for calcific aortic valve stenosis and, funny enough, danicamtiv, which was originally discovered by MyoKardia and has now come home to Gianakakos’ crew via BMS.“We wanted to start at scale,” Gianakakos explained. “I set off and essentially was business development guy, and we evaluated about 25 or so late-stage products.”Kardigan is now recruiting for a phase 2b/3 trial of danicamtiv in genetic and familial dilated cardiomyopathy, while tonlamarsen is in a phase 2b study and ataciguat in phase 3. The company has previously shared that it expects multiple data readouts this year and has already revealed a slice of phase 2b data for danicamtiv at the Heart Failure Society of America’s annual conference in September 2025.The Bay Area biotech also has a phase 2 program that is currently under wraps, Gianakakos said, along with several internal discovery programs that are still a few years away from the clinic. The company intends to market and commercialize its potential products itself, he added.But even the impressive $554 million raised by Kardigan so far isn’t enough to power this pipeline, Gianakakos said, at least not if you’re running a traditional cardiology trial. For Kardigan, innovative trial operations are just as important as innovative science, if not more so. Typical late-stage cardio studies can run up a price tag in the billions, an imposing cost that may serve to scare away would-be financiers.“I would have a lot of conversations with investors, even after we started generating data, where you can just tell they have been burned in the past by these kinds of big, expensive studies,” Gianakakos said. So Kardigan got creative. Whole-hearted health Gianakakos is doing CEO double-duty these days, also running a digital health company called Prolaio that Kardigan acquired in March 2025. Gianakakos and fellow former MyoKardia exec Jay Edelberg, M.D., Ph.D., co-founded both Kardigan and Prolaio, with the latter outfit now providing a massive bedrock of data for the burgeoning cardio company.It’s Prolaio’s software platform and wearable heart monitoring devices, in addition to traditional tools like genetics and biomarker analysis, that enable Kardigan to streamline its trials while also building a base of knowledge to inform future decision-making.“Our studies are 300 to 500 patients in the entire registration program, generally speaking,” Gianakakos said. “Usually those are in the thousands, if not tens of thousands, for the traditional approach.”Kardigan’s first step to smaller trials is targeting specific patients using genetic data, similar to how specific populations are enrolled in cancer trials.“We have a sense going in [of] who is going to receive optimal benefit, and we select for those patients,” Gianakakos said. Once patients are confirmed responders to treatment, “then we will move people and study them appropriately in different arms.”The second step is the mounds of data provided by Prolaio, with Gianakakos using Kardigan’s hypertension study as an example. The biotech is harnessing its tech outfit’s monitoring tools to track daily blood pressure at home rather than taking a baseline measurement that is then compared to data from the end of the treatment period.“That gives you 10 to 100x more data, and just improves your statistical power significantly,” the CEO said. “So you can run with smaller studies without sacrificing your statistics.” It also means the data come from everyday life rather than during a clinic visit, he noted. This kind of extensive data collection is often overlooked by other companies, according to Gianakakos, which instead focus on just the data needed to support a given drug’s approval. If a trial is focused on heart function, he said, why not also give the patient a smartwatch to see whether the drug affects the heart’s rhythm, too?“The cost in doing that research is basically trivial,” he said. “You just have to have the intention.”Kardigan also keeps an eye on patients who don’t respond to treatment, gathering reams of data to try to understand why the drug isn’t working and how a new approach could potentially benefit them.“This is something that I think generally our industry doesn\'t do,” Gianakakos said. “Go all the way with the nonresponders, because you are going to learn something.”As Gianakakos, Chief Medical Officer Edelberg and the rest of the Kardigan team continue developing their pipeline through internal research and acquisitions, the CEO hopes to emulate in cardiovascular disease what Gilead Sciences and Vertex Pharmaceuticals have achieved in HIV and cystic fibrosis, respectively.“[Vertex] focused on the disease and not on a drug. And when you\'re wired to say, ‘We\'re going to cure cystic fibrosis,’ you keep going. Today, they are covering almost all of the forms of cystic fibrosis,” Gianakakos said. “You can say the same about Gilead and HIV.”For Kardigan, the goal isn’t to get drugs approved—it’s to end cardiovascular disease’s reign of terror.“We\'re defining ourselves as a heart health company, not as a ‘this particular drug’ company,” Gianakakos said. “We have an expansive view.”