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What is Coronary Artery Disease?

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Coronary artery disease (CAD) is characterised by the accumulation of fatty deposits, cholesterol, calcium, and cellular waste substances in the coronary artery walls, impeding the flow of oxygen to the heart. Gradually, this build-up transforms into hardened plaque, which can rupture unexpectedly, triggering a blood clot that obstructs the artery. As a consequence, the heart muscle is deprived of oxygen-rich blood, leading to a heart attack. Remarkably, many patients experience no warning symptoms before an actual heart attack, despite the gradual development of plaque over years.

 

In Australia, heart attacks remain the primary cause of mortality, resulting in a patient being admitted to the hospital every 9 minutes. Globally, CAD claims the lives of 7.2 million individuals annually.

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Beyond traditional cardiovascular risk factors

The four key Standard Modifiable cardiovascular Risk Factors (SMuRFs) for CAD are high blood pressure, high cholesterol, diabetes and smoking. For the last 50 years, CAD has been treated through identification and management of SMuRFs, which significantly reduces the risk of a life-threatening heart attack. However, an increasing number of first-time heart attack patients have no risk factor ‘alarms’ and silently develop CAD over time. It is not uncommon for patients to present with extensive atherosclerosis and a life-threatening heart attack without any evident risk factors or prior symptoms, leaving them questioning, ‘Why me?’.

SMuRFless CAD

In 2015, a significant 27% of patients experiencing heart attacks displayed none of the commonly known SMuRFs. This percentage has consistently increased from 14% over the past decade.

Recent data indicates that individuals without SMuRFs have poorer outcomes following initial hospital treatment. Within 30 days of the initial heart attack, a higher number of these patients experience higher mortality rates compared to those with traditional risk factors, particularly impacting women.

For individuals predisposed to heart attacks due to smoking, diabetes, high blood pressure, or high cholesterol levels, addressing these modifiable factors significantly reduces the likelihood of first-time or recurrent heart attacks. However, the question remains: How can we prevent heart attacks in individuals who do not exhibit any of these modifiable factors?

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Addressing the Unmet Need

A critical gap exists in the management of heart attack patients without traditional risk factors. Current clinical guidelines and research fail to provide specific guidance for this group, resulting in an estimated 1.34 million deaths worldwide each year. To address this unmet need, the CRE for CAD, is dedicated to pioneering new approaches.

We aim to revolutionise heart attack prevention through novel diagnostics, improved clinical guidelines, and new therapeutic strategies, specifically:

  • Early detection for early CAD: The BioHEART Study

  • Improved clinical guidelines for all CAD patients: The SMuRFless CAD Clinics

  • Improved therapeutics 

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