ESC Congress highlights Part One

Highlights from the European Society of Cardiology Congress in Barcelona, including research into cancer and heart disease risk, the dangers of air pollution and a drug to stop repeat heart attacks.

Measuring the effects of air pollution

BHF Professor David Newby spoke about a collaboration with Umea University in Sweden and the National Institute for Public Health and the Environment (RIVM) in the Netherlands, which had unique exposure facilities to investigate the effects of dilute diesel exhaust on the heart and blood vessels of volunteers.

Concentrations of diesel exhaust could be very precisely controlled in order to match that which a person might be exposed to while commuting through a heavily polluted city.

A volunteer in the chamber being exposed to dilute diesel fumes.

The BHF-funded programme of research showed that diesel exhaust can damage the heart and blood vessels in many different ways. Understanding the biology behind these effects is a crucial part of this research and one area that is still not well understood is how particles go on to affect the heart after they have entered the lung. Several theories have been put forward to explain this link, yet no single theory can fully account for the many different effects inhaled particles have on the cardiovascular system.

One recent theory is that ultrafine particles, known as nanoparticles, are so small that they may be able to cross from the lung into the blood vessels of the lung. They can then be carried around the body in the blood where they can directly damage different areas of the cardiovascular system. Currently though, there is no satisfactory way to detect environmental particles in the blood. For this reason, the researchers at the University of Edinburgh tried a novel approach –instead using gold nanoparticles. Gold nanoparticles can be detected by specialist laboratory techniques. Also, they can be made in the same size of diesel exhaust particles and are safe for human exposure.

The researchers exposed healthy volunteers to inhaled gold nanoparticles for two hours while exercising. Gold could be detected in the blood and urine of the volunteers within 24 hours after the exposure and remarkable gold was still detected three months after the exposure.

A volunteer breathing in gold nanoparticles.

The results clearly showed that inhaled nanoparticles could pass into the bloodstream of people and that their removal from the blood appeared to be very slow. Importantly, the gold nanoparticles not only reached areas of disease, but they appeared to accumulate in the diseased arteries, compared to arteries without disease. So, while it appears that only a very small In the trial population, lung cancer deaths were reduced by 75 per cent, although the researchers do not yet understand why.

Cancer and heart disease — linking two deadly diseases

Dr Husam Abdel-Qadir, one of this year’s Young Investigator Award nominees, presented a study that followed 125,000 early-stage breast cancer patients in Ontario and looked at the effect on their risk of cardiovascular disease. While we have known for some time that breast cancer patients are more likely to go on to have heart problems, the research questioned the simplistic view that the increased risk was down to the cancer alone.

Cancer and heart disease share a number of risk factors. This means someone diagnosed with early-stage breast cancer may already be at a higher risk of CVD. It can often be the result of leading an unhealthy lifestyle, such as smoking, being overweight and not doing enough physical activity. But it is also true that some cancer treatments can have a detrimental effect on heart health.

The researchers argue that the risk of CVD in cancer patients is down to all the usual suspects before diagnosis, the effects of treatment and then risk factors after treatment finishes. Building up a more detailed picture of risk should help doctors to advise patients and give them the best chance of a healthy life after their cancer.

Winning the fight against inflammation.

The results of the clinical trial involving 10,000 heart attack patients showed that an anti-inflammatory drug, called canakinumab, reduces the risk of a subsequent cardiovascular event — including fatal or non-fatal heart attacks and strokes.

The drug lowered inflammation but had no effects on cholesterol, showing that inflammation plays a key role in the onset of a heart attack or stroke.

Patients who received it were 15 per cent less likely to suffer another heart attack or a stroke and needed fewer expensive interventional procedures, such as bypass surgery.

However, due to it’s effects on the immune system the drug did increase a patient’s chance of dying from a severe infection.

Surprisingly, in the trial population, lung cancer deaths were reduced by 75 per cent, although the researchers do not yet understand why.

The team are now planning further trials to investigate canakinumab’s potentially protective effect against cancer.

Enjoyed reading? You’ll find more coverage from the world’s largest cardiology conference below:

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