Some 43 years ago in 1976, Dr. Michael Davies made a major discovery that would ultimately save many lives.
He discovered that heart attacks were caused by blood clots in the arteries that supply blood to the heart. Our knowledge has grown since then, and we’re much better at preventing and treating heart attacks, but more than a million people in the U.S. have heart attacks each year. New advances may reduce that number dramatically.
Doctors and scientists have been trying to predict who may suffer a heart attack and learn how to prevent the attack. Genetic analyses have identified 67 different variants in human DNA that are linked to increased heart attack risk.
Last year, scientists in England published a new Genomic Risk Score that’s more accurate than current risk calculations for heart attacks. This new score was based on data from half a million people, and it could lead to an inexpensive genetic screening test.
Many people develop atherosclerotic plaques in their heart arteries, and scientists want to find a way to identify the plaques that might cause a clot.
Current methods cannot determine which plaques are the most dangerous. Inflammation appears to be a good indicator that a plaque might break off, because it changes the fat surrounding the arteries.
Scientists can measure these fat changes, and a 10-year study has shown that the test is highly predictive of death from a heart attack.
Probes that detect the presence and amount of certain molecules in arteries and plaques could also predict heart attack risk. For example, the presence of oxidized low-density lipoprotein (LDL, the bad cholesterol) is a good predictor of dangerous plaques.
Scientists have made a molecule that glows when it binds to LDL for a simple lab test, and they’re testing it to determine if it can predict heart attack risk.
New drugs can reduce heart attack risk, including a new type of cholesterol-reducing drug. This drug is an artificial antibody that inactivates a liver protein to lower LDL levels.
Another new class of antibodies can reduce heart attack risk by reducing artery inflammation. A large study of one of these drugs, canakinumab, determined that it reduced the risk by 24 percent in people with heart disease.
Your body also makes its own antibodies that target oxidized LDL and remove it to the liver to be eliminated.
In a large study, people with high blood pressure, heart attacks and unstable plaques had the lowest levels of these antibodies. People with high levels of these antibodies had a 70 percent lower chance of having a heart attack within five years.
The levels of these antioxidized LDL antibodies could be another predictive marker, and we could find ways to boost their production to reduce oxidized LDL and heart attacks.
What’s exciting is there are multiple new approaches in the pipeline to prevent and improve the outcomes of a heart attack. Let’s hope no one we know needs them.