Novel and Emerging Technologies (NET) Grant
Prof Ioakim Spyridopoulos, Newcastle University
Summary: The coronary arteries supply the heart muscle with oxygen-rich blood and a heart attack is usually caused by the blockage of a coronary artery. This starves the heart muscle of oxygen and the heart may be permanently damaged. The death rate from heart attacks has significantly fallen over the last decade and more people are surviving heart attacks than ever before. This is thought to be partly due to advances in treatment, including coronary angioplasty and stent implantation to re-open the blocked coronary artery. However, 20 per cent of patients who undergo this procedure need to be readmitted to hospital in the first year after a heart attack due to heart failure and 40 per cent have enlargement of the left side of the heart, showing that they are at risk of developing heart failure in the future. This may be because the treatment has failed and the blood flow to the heart muscle has not been restored.
Current blood tests used in the NHS do not identify patients at high risk of developing problems in the future. Professor Spyridopoulos and his team have discovered very small molecules, called microRNAs, in the blood stream that are increased soon after patients have undergone stent treatment to re-open the blocked artery. These microRNAs may be useful as ‘biomarkers’ to predict which patients are at future high risk. However, current technology to measure these small molecules is unfortunately not accurate enough to replace the conventional NHS-based blood tests.
A new technology is now available at Newcastle University, called ‘droplet digital PCR’. With this technique the blood sample is divided into 20,000 small droplets and microRNAs are measured in each droplet, so that every single molecule in the blood stream can be counted. A similar approach has been used to develop a precise and reliable blood test in cancer patients, but so far no studies have been carried out in patients with heart disease or who have had a heart attack.
If this project is successful, a new and affordable blood test could replace current blood tests for patients who have had stent treatment for heart attacks. The test may help doctors to identify which patients are at higher risk of developing heart failure so that they can be closely monitored prior to discharge or given further treatments. Those patients with a small increase in the biomarker and therefore low risk could potentially be discharged early, whereas those at high risk would undergo additional tests and follow-ups.