Cardiovascular disease (CVD) affects 4.2 million Australians. It’s expected by 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 deaths from heart disease in Australia have declined over the last decades, the rate of heart attacks has paradoxically increased, and, in NSW, the number of heart attacks has remained above the nation’s average. The annual cost 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 of heart attack and by improving the diagnosis and treatment of high-risk people.

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 remains a major unresolved problems in clinical cardiology and could save the lives of 30-50% of those experiencing a heart attack.

This project will use 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.

*This project was supported by the NSW Government's Cardiovascular Research Capacity Building Program.

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