探花直播 of Cambridge - heart attack

Anti-inflammatory drug could reduce future heart attack risk

Anonymous — Mon, 02 Sep 2024 10:52:31 +0000

A cancer drug that unlocks the anti-inflammatory power of the immune system could help to reduce the risk of future heart attacks, according to research part-funded by the British Heart Foundation. By repurposing an existing drug, researchers hope it could soon become part of routine treatment for patients after a heart attack.

探花直播findings will be presented at the European Society of Cardiology Congress in London by Dr Rouchelle Sriranjan, NIHR Clinical Lecturer in Cardiology at the 探花直播 of Cambridge.

High levels of inflammation in blood vessels are linked to an increased risk of heart disease and heart attacks. After a heart attack, the body鈥檚 immune response can aggravate existing inflammation, causing more harm and increasing risk even further. However, NICE guidelines don鈥檛 currently recommend the use of any anti-inflammatory drugs to reduce future risk.

Now, a team of researchers, led by Dr Joseph Cheriyan from Cambridge 探花直播 Hospitals NHS Foundation Trust, have found that low doses of an anti-inflammatory drug called aldesleukin, injected under the skin of patients after a heart attack, significantly reduces inflammation in arteries.

探花直播researchers are currently following up patients to investigate the longer-term impact of this fall in inflammation. To date, in the two and a half years after their treatment, there have been no major adverse cardiac events in the group that received aldesleukin, compared to seven in the group that received the placebo.

Professor Ziad Mallat, BHF Professor of Cardiovascular Medicine at the 探花直播 of Cambridge who developed the trial, said: 鈥淲e associate inflammation with healing 鈥� an inbuilt response that protects us from infection and injury. But it鈥檚 now clear that inflammation is a culprit in many cardiovascular conditions.

鈥淓arly signs from our ongoing trial suggest that people treated with aldesleukin may have better long-term outcomes, including fewer heart attacks. If these findings are repeated in a larger trial, we鈥檙e hopeful that aldesleukin could become part of routine care after a heart attack within five to 10 years.鈥�

Aldesleukin is already used to treat kidney cancer, as high doses stimulate the immune system to attack cancer cells. 探花直播Cambridge team previously found that doses one thousand times lower than those used in cancer treatment increased the number of regulatory T cells 鈥� a type of anti-inflammatory white blood cell 鈥� in patients鈥� blood compared to a placebo.

In the current trial at Addenbrooke's and Royal Papworth hospitals in Cambridge, 60 patients admitted to hospital with a heart attack or unstable angina received either low dose aldesleukin or placebo. Patients received an injection once a day for the first five days, then once per week over the next seven weeks. Neither the participants nor their doctors knew whether they had received the drug or placebo.

At the end of treatment, Positron Emission Tomography (PET) scans showed that inflammation in the artery involved in patients鈥� heart attack or angina was significantly lower in the group treated with aldesleukin, compared to those who received the placebo.

探花直播anti-inflammatory effect of aldesleukin appeared even more striking in the most inflamed arteries, leading to a larger reduction in inflammation levels in these vessels and a bigger difference between the two groups by the end of the study.

Dr Sonya Babu-Narayan, Associate Medical Director at the British Heart Foundation and consultant cardiologist said: 鈥淭hanks to research, we have an array of effective treatments to help people avoid heart attacks and strokes and save lives. But, even after successful heart attack treatment, unwanted inflammation in the coronary arteries can remain, which can lead to life-threatening complications.

鈥淎 treatment to reduce inflammation after a heart attack could be a game-changer. It would help doctors to interrupt the dangerous feedback loop that exacerbates inflammation and drives up risk. This research is an important step towards that treatment becoming a reality.鈥�

探花直播study was predominantly funded by the Medical Research Council, with significant support from the BHF and National Institute for Health and Care Research Cambridge Biomedical Research Centre (NIHR-BRC).

Originally published by the British Heart Foundation.聽

Repurposed cancer drug helps to calm inflammation in arteries.

Sebastian Kaulitzki/Science Photo Library via Getty Images

Illustration of human heart

探花直播text in this work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. Images, including our videos, are Copyright 漏探花直播 of Cambridge and licensors/contributors as identified. All rights reserved. We make our image and video content available in a number of ways 鈥� on our main website under its Terms and conditions, and on a range of channels including social media that permit your use and sharing of our content under their respective Terms.

Yes

New risk calculator to help save many more lives from heart attack and stroke

Anonymous — Sun, 13 Jun 2021 23:12:13 +0000

探花直播risk calculator, SCORE2, will be adopted by the upcoming European Guidelines on Cardiovascular Disease Prevention in Clinical Practice, and enables doctors across Europe to predict who鈥檚 at risk of having a heart attack or stroke in the next 10 years with greater accuracy.

探花直播researchers say this new prediction tool will help save many more people across Europe from having a potentially deadly heart attack or stroke, ultimately saving lives. People who are flagged as having an increased risk can be put on personalised preventative treatment, such a statins, or will receive lifestyle advice to lower their risk.

Researchers from the 探花直播 of Cambridge played a leading role in a major collaborative effort involving around 200 investigators聽to develop SCORE2. Researchers across Europe analysed data from nearly 700,000 participants - mostly middle-aged - from 45 different studies. 探花直播tool has also been tailored for use in different European countries.

Participants had no prior history of heart and circulatory disease when they were recruited to the studies, and in the 10 years they were followed up, 30,000 had a 鈥榗ardiovascular event鈥� 鈥� including fatal or non-fatal heart attack or stroke.

探花直播risk tool was then statistically 鈥榬ecalibrated鈥�, by using regional-specific cardiovascular and risk factor data from 10.8 million people, to more accurately estimate cardiovascular risk for populations split into four European risk regions. 探花直播tool uses known risk factors for heart and circulatory diseases such as age, sex, cholesterol levels, blood pressure and smoking.

This is a much-needed upgrade from the previous prediction tool that was developed using data before 1986 and underestimated the cardiovascular risk in some countries. 探花直播new SCORE2 risk calculator now accounts for current trends in heart and circulatory diseases, can predict both fatal and non-fatal conditions and is adaptable to countries with different levels of risk.

探花直播researchers say that this upgrade will better estimate the cardiovascular risk amongst younger people, and will improve how treatment is tailored for older people and those in high-risk regions across Europe.

Professor Emanuele Di Angelantonio at the 探花直播 of Cambridge British Heart Foundation (BHF) Centre of Research Excellence, said: 鈥淭his risk tool is much more powerful and superior than what doctors have used for decades. It will fit seamlessly into current prevention programmes with substantial real-world impact by improving the prevention of cardiovascular diseases across Europe before they strike.鈥�

Dr Lisa Pennells, also at Cambridge鈥檚 BHF Centre of Research Excellence, said: 鈥淭his project was a highly collaborative effort that has brought together key experts and extensive data sources to develop improved risk prediction tools for cardiovascular disease for use across the UK and Europe.

鈥淎 key feature is that our calculators are relevant to current day rates of cardiovascular disease in different regions of Europe. Importantly, our methods allow them to be easily updated using routinely collected data in the future to ensure they stay relevant as trends in heart and circulatory diseases change.鈥�

This study was carried out by the SCORE2 Working Group and the European Society of Cardiology Cardiovascular Risk Collaboration. It was supported by organisations including the British Heart Foundation, the Medical Research Council, National Institute for Health Research Cambridge Biomedical Research Centre and Health Data Research UK.

Professor Sir Nilesh Samani, Medical Director at the BHF and cardiologist, said: 鈥淗eart and circulatory diseases are the world鈥檚 biggest killers, impacting the lives of 7.6 million people across the UK alone.

鈥淭his new risk tool is a major advance and will save many more people from developing heart attacks, stroke and heart disease, all of which develop silently over many years and strike without warning. It will be the new gold standard for doctors to determine which patients are at the highest risk of these conditions, and enable tailored treatment and lifestyle advice to be given much earlier.鈥�

Reference
SCORE2 risk prediction algorithms: revised models to estimate 10-year risk of cardiovascular disease in Europe. European Heart Journal; 14 June 2021; DOI: 10.1093/eurheartj/ehab309

Adapted from a press release from the British Heart Foundation

A new risk calculator will better predict people at high risk of heart and circulatory diseases years before they strike, and is ready for use across the UK and Europe, according to research published in the journal European Heart Journal.

This risk tool... will fit seamlessly into current prevention programmes with substantial real-world impact by improving the prevention of cardiovascular diseases across Europe before they strike

Emanuele Di Angelantonio

Pexels

Man clutching his heart

探花直播text in this work is licensed under a Creative Commons Attribution 4.0 International License. Images, including our videos, are Copyright 漏探花直播 of Cambridge and licensors/contributors as identified.聽 All rights reserved. We make our image and video content available in a number of ways 鈥� as here, on our main website under its Terms and conditions, and on a range of channels including social media that permit your use and sharing of our content under their respective Terms.

Yes

Licence type:

Public Domain

Could a vaccine protect us against heart attacks?

cjb250 — Thu, 20 May 2021 07:15:46 +0000

Professor Ziad Mallat and his team have been shortlisted for a 拢30 million grant from the British Heart Foundation. If successful, atherosclerosis 鈥� hardening of the arteries 鈥� could become a thing of the past.

Patching up a broken heart

lw355 — Fri, 16 Jun 2017 15:00:54 +0000

When the body鈥檚 repair system kicks in, in an attempt to remove the dead heart cells, a thick layer of scar tissue begins to form. While this damage limitation process is vital to keep the heart pumping and the blood moving, the patient鈥檚 problems have really only just begun.

Cardiac scar tissue is different to the rest of the heart. It doesn鈥檛 contract or pump because it doesn鈥檛 contain any new heart muscle cells. Those that are lost at the time of the heart attack never come back. This loss of function weakens the heart and, depending on the size of the damaged area, affects both the patient鈥檚 quality of life and lifespan.

鈥淚n many patients, not only is their heart left much weaker than normal but they are unable to increase the amount of blood pumped around the body when needed during exercise,鈥� explains Dr Sanjay Sinha. 鈥淚鈥檝e just walked up a flight of stairs鈥� it鈥檚 something I take for granted but many patients who鈥檝e survived heart attacks struggle to do even basic things, like getting dressed. While there are treatments that improve the symptoms of heart failure, and some even improve survival to a limited extent, none of them tackles the underlying cause 鈥� the loss of up to a billion heart cells.鈥�

探花直播numbers are stark. 鈥淗alf a million people have heart failure in the UK. Almost half of them will not be alive in five years because of the damage to their heart. At present, the only way to really improve their heart function is to give them a heart transplant. There are only 200 heart transplants a year in the UK 鈥� it鈥檚 a drop in the ocean when many thousands need them.鈥�

Sinha wants to mend these hearts so that they work again. 鈥淣ot just by a few percent improvement but by a hundred percent.鈥�

He leads a team of stem cell biologists in the Cambridge Stem Cell Institute. Over the past five years, with funding from the British Heart Foundation, they have been working with materials scientists Professors Ruth Cameron and Serena Best and biochemist Professor Richard Farndale on an innovative technique for growing heart patches in the laboratory 鈥� with the aim of using these to repair weakened cardiac tissue.

鈥淚n the past, people have tried injecting cardiomyocytes into damaged hearts in animal models and shown that they can restore some of the muscle that鈥檚 been lost,鈥� says Sinha. 鈥淏ut even in the best possible hands, ninety percent of the cells you inject are lost because of the hostile environment.鈥�

Instead, the Cambridge researchers are building tiny beating pieces of heart tissue in Petri dishes. 探花直播innovation that makes this possible is a scaffold. 鈥� 探花直播idea is to make a home for heart cells that really suits them to the ground. So they can survive and thrive and function.鈥�

探花直播scaffold is made of collagen 鈥� a highly abundant protein in the animal kingdom. Best and Cameron are experts at creating complex collagen-based structures for a variety of cell types 鈥� bone marrow, breast cancer, musculoskeletal 鈥� both as implants and as model systems to test new therapeutics.

鈥� 探花直播technology we鈥檝e developed for culturing cells is exciting because it is adaptable to a huge range of applications 鈥� almost any situation where you鈥檙e trying to regenerate new tissue,鈥� explains Best.

Best and Cameron use 鈥榠ce-templating鈥� to build the scaffold. They freeze a solution of collagen, water and certain biological molecules. When the water crystals form, they push the other molecules聽to their boundaries. So, when the crystals are vapourised (by dropping the pressure to low levels), what鈥檚 left is a complex three-dimensional warren.

鈥淲e have immense control over this structure,鈥� adds Cameron. 鈥淲e can vary the pore structure to make cells align in certain orientations and control the ratios of cell types. We are building communities of millions of cells in an environment that resembles the heart.鈥�

Cardiomyocytes fare better when they are surrounded by other cell types and have something to hold on to. They use proteins on their surface called integrins to touch, stick to and communicate with their environment. Farndale has perfected a 鈥榯oolkit鈥� that pinpoints exactly which parts of collagen the integrins bind best; he then makes matching peptide fragments to 鈥榙ecorate鈥� the collagen scaffold. This gives cells a foothold in the scaffold and encourages different cell types to move in and populate the structure.

鈥淲e don鈥檛 just want a cardiac scaffold 鈥� we want it to have blood vessels and the same mechanical properties as the heart,鈥� explains Sinha. 鈥淚f it鈥檚 going to contract and function efficiently, it needs a really good blood supply. And the whole three-dimensional structure must be strong enough to survive the hostile environment of a damaged heart.鈥�

Meanwhile, Sinha鈥檚 team pioneered the production of the different cell types needed for the patch. Their starting material is human embryonic stem cells, but they have also taken adult human cells and 鈥榬eset鈥� their developmental clock. 鈥淚n theory this means we can take a patient鈥檚 own cells and make patches that are identical to their own tissue. That said, millions of people are going to need this sort of therapy and so our focus at the moment is on coming up with a system where a small number of patches might be available 鈥榦ff the shelf鈥�, with patients receiving the nearest match.聽

探花直播team is completing tests on the ideal combination of scaffold structure, peptide decoration and mix of cells to create a beating vascularised tissue. Next, the researchers will work with Dr Thomas Krieg in the Department of Medicine to graft the tissue into a rat heart. Their aim is to show that the patch makes vascular connections, integrates mechanically and electrically with heart muscle, and contracts in synchrony with the rest of the heart. Once they鈥檝e accomplished this, they will scale up the size of the patches for future use in people.

鈥淚t鈥檚 exciting,鈥� says Sinha. 鈥淲e are recreating a tissue that has all the components we see in an organ, where the cells start talking together in mysterious and wonderful ways, and they start to work together as they do in the body. Our vision is that this technology will bring hope to the millions of patients worldwide who are suffering from heart failure, and allow them to lead a normal life again.鈥�

It is almost impossible for an injured heart to fully mend itself. Within minutes of being deprived of oxygen 鈥� as happens during a heart attack when arteries to the heart are blocked 鈥� the heart鈥檚 muscle cells start to die. Sanjay聽Sinha聽wants to mend these hearts so that they work again.聽

We are recreating a tissue that has all the components we see in an organ, where the cells start talking together in mysterious and wonderful ways, and they start to work together as they do in the body.

Sanjay Sinha

探花直播District and Jonathan Settle

探花直播text in this work is licensed under a Creative Commons Attribution 4.0 International License. For image use please see separate credits above.

Yes

Apple shaped obesity as bad for heart as other obesity

ns480 — Mon, 21 Mar 2011 11:32:27 +0000

These are the conclusions of an Article published Online First and in an upcoming Lancet, from the Emerging Risk Factors Collaboration, a consortium of 200 scientists from 17 countries led from the 探花直播 of Cambridge, UK.

Some earlier studies had claimed that people with "central obesity" (as assessed by the ratio of the waist to hip circumference, or "waist-to-hip" ratio) have 3 times greater risk of heart attack than people with general obesity (as assessed by the body-mass index (BMI), or the weight divided by the height squared). However, these earlier studies had major design limitations.

探花直播current study involved over 220,000 adults, each monitored for almost a decade, of whom over 14,000 developed a heart attack or stroke during monitoring. 探花直播researchers confirmed that obesity is a major determinant of cardiovascular disease, but that body mass index (BMI), waist circumference, and waist-to-hip ratio each had a similar impact on the risk of subsequent heart attack and strokes.

A further finding of this study is that BMI, waist circumference, and waist-to-hip ratio, whether assessed singly or in combination, do not improve cardiovascular disease risk prediction in people in developed countries when additional information is available for systolic blood pressure, history of diabetes, and lipids.

This result highlights the value of GPs continuing to measure blood cholesterol and blood pressure levels. 探花直播findings should also help guide medical practice worldwide because national and international guidelines have provided differing recommendations about the value of clinical measures of obesity for prediction of cardiovascular disease risk in primary prevention.

探花直播authors conclude: "Whether assessed singly or in combination, body-mass index, waist circumference, and waist-to-hip ratio do not improve prediction of first-onset cardiovascular disease when additional information exists on blood pressure, history of diabetes, and cholesterol measures鈥� This finding applies to a wide range of circumstances and clinically relevant subgroups."

But they add: " 探花直播main finding of this study does not, of course, diminish the importance of adiposity as a major modifiable determinant of cardiovascular disease."

In a linked Comment, Dr Rachel R Huxley and Dr David R Jacobs Jr, School of Public Health, 探花直播 of Minnesota, conclude: "BMI used with good clinical judgment is highly appropriate in adults because it is so strongly associated with chronic disease risk, although we caution that it is correlated with height in children. Many overweight or obese adolescent, young adult, and middle-aged individuals with few risk factors for cardiovascular disease will develop that risk relatively soon, so BMI should serve as an early warning, both to them and their general practitioners. But discriminating which overweight individuals without current risk factors for cardiovascular disease will go on to develop those risk factors, and ultimately clinical cardiovascular disease, remains a challenge-here, blood tests continue to be helpful."

聽

An international study of 220,000 people has challenged the idea that obese people who have an 鈥渁pple shape鈥� (fat deposits on the middle section of the body) are at higher risk of heart attacks and strokes than obese people with other types of fat distribution.

Whether assessed singly or in combination, body-mass index, waist circumference, and waist-to-hip ratio do not improve prediction of first-onset cardiovascular disease when additional information exists on blood pressure, history of diabetes, and cholesterol measures.

FightObesity from Flickr

obesity

This work is licensed under a Creative Commons Licence. If you use this content on your site please link back to this page.

Yes