Researchers that we fund at the University of Oxford have developed a new technology that can flag patients at risk of deadly heart attacks years before they occur.
Heart attacks are usually caused by inflamed plaques in the coronary artery causing an abrupt blockage of blood getting to the heart. The challenge for doctors is knowing which plaques are most likely to cause blockages, and therefore which patients should be treated with more aggressive therapies.
The team at the University of Oxford has shown that the most dangerous plaques release chemical messengers which modify the surrounding fat. They have developed a technology that detects the inflamed plaques that are prone to cause heart attacks by analysing CT images of the fat surrounding the arteries.
Their new biomarker, called the Fat Attenuation Index (FAI), has been tested for the first time in a large study published today in The Lancet, and was presented at the European Society of Cardiology congress in Munich – the world’s largest cardiology meeting.
The study involved 3,900 patients from Europe and the United States, who were followed up for ten years after they had a CT coronary angiogram. The FAI technology was found to predict fatal heart attacks many years before they happen, with a significantly superior predictive accuracy compared with other methods.
People with abnormal FAI had up to nine times higher risk of having a fatal heart attack in the next five years. Importantly, these patients would be the ideal candidates for aggressive medical therapy to prevent this from happening.
Every year, over 100,000 people die from a heart attack or related stroke in the UK alone, and heart disease and stroke remain the two biggest overall causes of death worldwide. Yet there is no method that allows for early detection of a potentially fatal build-up of plaque that could trigger a heart attack.
With this new technology, clinicians would be able to identify those at risk of having a fatal heart attack in the next few years and take preventative steps before it strikes.
Professor Metin Avkiran, our Associate Medical Director, said:
"Most heart scans are good at spotting blockages caused by large plaques, but not the smaller, high-risk plaques that are likely to rupture and cause a heart attack. This new technique could be a game changer – allowing doctors to spot those “ticking time bomb” patients who are most at risk of a heart attack, and getting them on to intensive treatment. This would undoubtedly save lives.
"By using this non-invasive scan, we could prevent a lurking heart attack that might occur down the road. But it also potentially gives us a real-time window into tracking the effect of drugs on inflamed arteries, helping us to identify new life-saving therapies."