Discovery of Novel Markers of Inflammation for Earlier Diagnosis of Heart Disease

2018 Vanguard Grant

Years funded: 2019-2020

Atherosclerosis (cholesterol build-up in arteries) is a process that is started by fatty ‘plaques’ sticking to vessel walls. If left unchecked, these plaques can lead to partial or complete blockage of a vessel, resulting in a heart attack (where blood flow downstream of the blockage is prevented or reduced, causing lack of oxygen to the heart tissue and therefore stopping of that part of the heart). This project will apply a highly detailed assessment of patient-specific immune function that we have developed, and examine its ability to predict atherosclerosis and clinical outcomes, with particular interest in patients with coronary disease in the absence of known risk factors.

The known modifiable risk factors of atherosclerosis- diabetes, high cholesterol, high blood pressure, and smoking- are central to the risk scores used to identify those at highest risk of plaque build-up and heart attack. However, there is a growing group of patients presenting with plaque without any of these risk factors. Given that atherosclerosis remains the leading cause of death worldwide, there is an urgent need to develop tools to detect these patients, to allow for earlier treatment.

Inflammation plays a key role in plaque development. Inflammatory signals in the vessel can increase the chance of a plaque becoming unstable and “bursting”, to cause heart attack. Our ‘BioHEART-CT’ biobank study has recruited ~1000 patients with comprehensive CT coronary angiogram assessment of plaque burden, complemented by 350 heart attack patients. In addition to baseline and follow-up clinical data, patient bloods are collected at time of presentation. Given recent technology advances in the assessment of inflammatory function, paired with our expanding biobanks, we are exceptionally well placed to study the links between immune function and heart attack and improve the precision of risk prediction, and targeting of aggressive preventative treatments.