Project summary
Identification of vascular inflammation and treatment of high risk unstable atherosclerotic plaque.
What is the issue for NSW?
Cardiovascular disease (CVD) affects 22% (4.2 million) of Australians. It is expected that in 2019, some 80,000 Australians will be admitted to hospital with acute coronary syndrome (ACS), with more than 55,500 suffering a heart attack. The major cause of heart attacks is atherosclerosis, a progressive disease of large arteries that culminates in the rupture of unstable (or ‘soft’) atherosclerotic plaque, which can lead to a blood clot, the abrupt blocking of the artery and acute, life-threatening heart attack (or stroke).
While death from CVD in Australia has declined over the last decades, the rate of heart attacks has paradoxically increased, and in NSW, the population-adjusted number of heart attacks has remained above the nation’s average. The annual cost of ACS to the Australian Government is around two billion dollars, of which ~75% is due to hospitalisation. To reduce these costs and save lives, it is important to prevent avoidable hospital admission and improve patient outcomes by targeting those most at risk and by improving the diagnosis and treatment of high-risk people.
What does the research aim to do and how?
Currently, the assessment of coronary plaque relies on information obtained from the physical contour of the arterial lumen (coronary angiography) and plaque burden (computed tomography coronary angiography). While these methods have significantly improved the treatment and management of heart disease, they cannot detect ‘soft’ plaques, the rupture of which is thought to cause up to half of all fatal heart attacks. Therefore, identifying and treating ‘soft’ plaque and subjects at high risk of developing an acute event remain major unresolved problems in clinical cardiology and could save the lives of 30-50% of those experiencing a heart attack.
This proposal addresses these important contemporary issues in clinical cardiology, by using novel non-invasive imaging methods to selectively detect ‘soft’ plaque, based on measuring inflammatory activity in arteries; and specific drug-induced inhibition of this arterial activity to prevent plaque rupture and associated thrombosis.
To facilitate translation of the research findings from bench-to-bedside, the investigating team includes clinicians and scientists to provide relevant expertise and practical advice in pre-clinical models (development of novel methods and tools); clinical cardiology (current clinical needs, alignment and improvement of methods to be developed with current practice in ACS diagnosis and patient treatment stratification); cardiovascular imaging (development of probes and specialised imaging sequences for coronary arteries, e.g., for motion correction); thrombosis (assessment of clinically relevant parameters); and industry (economical and intellectual property considerations).