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Coronary artery disease (CAD), also known as coronary heart disease, causes more deaths and disability worldwide than any other illness. However, predicting a person’s level of risk of heart attack or stroke and directing them towards preventative treatment is still very difficult.
The EU-funded RISKYCAD project set out to address this problem by identifying predictive biomarkers used in the study of lipids, genomes and microRNA molecules. This made it possible to examine for the first time the mechanisms of lipid activity at the molecular level. Researchers analysed specific species of lipids linked to inflammation and heart disease and identified novel lipid and small RNA circulating biomarkers.
‘Our research allowed us to build new risk models for identifying patients at high risk and develop more accurate diagnostic tests than existed previously,’ says project coordinator Evangelos Andreakos. ‘It also shed light on possible new targets for treatment by investigating to what extent these ceramides [lipid family] we were looking at were not just risk markers but may actually be driving the disease process.’
Better diagnosis for better treatment
In addition to identifying new biomarkers and revealing new mechanisms driving the disease process, the RISKYCAD project also developed a novel proprietary multi-marker algorithm, called Coropredict, for predicting cardiovascular risk in asymptomatic persons and in those with pre-existing cardiovascular disease. This valuable predictive tool consists of eight biomarkers that can be automated and cost-effectively measured within a standardised laboratory system.
The project moved the research forward to clinical application by selecting four molecules belonging to the lipid family of ceramides that are strongly linked to a person’s risk of developing cardiovascular disease and incorporating them into a simple test that can be used in routine laboratory testing. This test has now been advanced to clinical use in the USA and Finland. Further licence agreements in Europe and the USA are under negotiation.
A better understanding of the mechanisms of cardiovascular disease in relation to the new biomarkers is also helping to identify new treatment targets and drugs with repositioning potential for the treatment of CAD. Eventually, this could provide significant benefits for patients in the longer term.
Finally, by generating new human and mouse models of CAD and plaque vulnerability, the project supported basic and clinical research in the broader area of cardiovascular diseases and plaque vulnerability, enabling new target identification and evaluation as well as drug screening.
Reducing risks and costs
RISKYCAD has the potential to significantly improve patient care, contributing to personalised medicine solutions and improving disease management. The long-term effects will be better health with reduced morbidity, mortality and healthcare costs.
‘By helping to more accurately identify high-risk patients, the research carried out within RISKYCAD is likely to affect the way CAD patients are managed – both by reducing unnecessary treatment and by making sure that necessary treatment is given to the individuals most in need,’ says Andreakos.