Predict and avoid heart attack. New research from the Monzino Cardiology Center

by time news

The Monzino Cardiology Center opens the second phase of the recruitment of the INTESTRAT-CAD study, which will allow predicting whether a person with atherosclerosis will develop an acute myocardial infarction, based on the results of a coronary CT scan and a blood sample. In fact, many studies show that statistically one in five patients in which the CT scan shows the presence of atherosclerotic plaques at an early stage of development, in the medium term it undergoes a severe cardiological event. Thanks to this study and the new tools identified, we will know who will be the one who will get sick, who will be protected with ad hoc preventive programs, and who will be the four who will remain healthy and who will be able to avoid unnecessary treatments.

The project

The goal of INTESTRAT-CAD it is in fact to identify molecular markers combined with radiological markers that can predict in advance, in the absence of symptoms, what will be the first clinical manifestation in the course of the life of a subject with coronary atherosclerosis (i.e. whether he will present an acute event or a chronic stable form of heart disease ). To this end, cardiovascular imaging data (high definition coronary CT) are associated with a series of parameters that come from the so-called “omics” sciences: genomics, epigenomics, transcriptomics. The study will search in the blood of people with no previous heart attacks or coronary revascularizations – but for whom the CT scan showed an initial coronary atherosclerotic disease – one or more biomarkers to be associated with the picture highlighted by the CT scan. Thanks to the identified markers it will be possible to identify patients at greater risk with a simple blood test.

INTERSTRAT-CAD is funded by Regional Foundation for Biomedical Research (FRRB) and unites in partnership the Humanitas Clinical Institute, IFOM (FIRC Institute of Molecular Oncology), the University of Pavia and the Policlinico San Matteo of Pavia, with Monzino as coordinator and recruiter center.

“The original idea of ​​the research starts from the assumption of the EPIPHANY study (from the Greek verb επιφαίνω, epifaino,” I make myself manifest “), started at Monzino 4 years ago: not all coronary plaques are the same and above all not all lead to an event cardiovascular – he declares Gualtiero Colombo, Head of the Monzino Functional Genomics and Immunology Unit -. We therefore set ourselves the goal of classifying the different risk of coronary events of patients with initial plaques, on the basis of personalized molecular prognostic indicators. The partnership with some of the best excellences of Lombardy allows important evolutions compared to EPIPHANY. We will use artificial intelligence to generate risk prediction models, we will study new molecular aspects of the disease, such as the structure of the immune / inflammatory response at the cellular level. Preliminary data from EPIPHANY confirmed to us that we can classify different types of plaque. The forms of atherosclerosis can therefore be different from a molecular point of view: consequently, specific parameters may exist for different subtypes of coronary heart disease. Now we can broaden our horizons and our ambitions and find a greater number of these parameters, to define the predisposition to heart attack at the level of the individual subject. Phase two of the project is now starting: to call back the patients for whom there is an indication to perform a second coronary CT scan, in order to assess the progression of the disease. “

“We have recently shown – concludes Daniele Andreini, Head of the Monzino Radiology and Cardiovascular CT – that with coronary CT we are already able not only to highlight and quantify a coronary stenosis, but also to study it in more detail . In fact, we are able to obtain indications on the possible composition of the plaque and to evaluate both its volume and certain more refined characteristics, from which it is possible to obtain a perspective of the long-term risk of developing an acute coronary event. By integrating this information with the new molecular markers, we will have the concrete possibility of applying Precision Medicine: specific interventions only for those who need it with certainty. “

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