Heart and Stroke Backgrounder

Preventing Thrombosis – A common complication of surgery can be hospital-acquired deep vein thrombosis (DVT), where a blood clot forms in the deep vein (usually in the leg) that partially or totally blocks the flow of blood. According to a recent report from the U.S. Surgeon general, 350,000 to 600,000 Americans each year suffer from DVT and pulmonary embolism. A new potential first-in-class medicine in development is designed to prevent DVT from occurring. It is an oral, direct Factor Xa inhibitor (an anticoagulant that limits blood clotting) that acts at the central point in the coagulation cascade, to regulate thrombin generation, which leads to clot formation.

Inhibiting Platelets – Acute coronary syndrome, which includes heart attack and unstable angina (chest pain, usually caused by a low supply of oxygen to the heart muscle), affects more than 1.4 million Americans, according to the American Heart Association. Acute coronary syndrome may develop slowly over time by the building up of plaques in the arteries in your heart, causing the arteries to narrow and make it more difficult for blood to flow through them. If the plaque in the coronary arteries ruptures it can cause a heart attack. A blood clot will form on the site of the rupture, blocking the flow of blood through the artery. Many patients suffering from acute coronary syndromes are managed using percutaneous coronary intervention (PCI) and a stent to relieve clogged arteries. A new medicine in development is an anti-platelet that inhibits platelet activation and prevents them from clumping and sticking together, causing clogged arteries that can lead to heart attack or stroke.

Treating Heart Failure – More than 5 million adults in the United States suffer from heart failure. Heart failure is a complex syndrome where a certain protein can cause the formation of collagen cross-links with result in myocardial stiffness where the heart fails to relax between beats and allow blood to flow into the chamber. As a result, blood backs up into the lungs and causes shortness of breath and can lead to death. A potential first-in-class medicine in testing is believed to break the cross-link that results in the heart stiffness.

Reducing Complications from Atrial Fibrillation – Atrial fibrillation is a common heart arrhythmia in which the upper chambers of the heart beat in an uncoordinated and disorganized fashion, which can cause palpitations, shortness of breath and fatigue. It can also lead to serious complications such as stroke and congestive heart failure. One investigational medicine inhibits multiple channels – calcium, potassium and sodium – without any causing thyroid or pulmonary toxicity. In clinical trials it has shown to significantly reduce cardiovascular hospitalization or death in patients with atrial fibrillation or atrial flutter.

Long-term Treatment for Chronic Heart Disease – Coronary heart disease is the single largest killer of Americans, according to the American Heart Association. Atherosclerosis, an inflammatory disease characterized by the building-up of plaque within the arteries, is the underlying cause of most heart attacks and strokes. One novel medicine in development is a selective inhibitor of an enzyme found in blood and atherosclerotic plaque. Elevated levels of the enzyme are involved in the development and progression of atherosclerosis.

Improving Heart Function – More than 5 million Americans are living with congestive heart failure, according to the American Heart Association. Patients with congestive heart failure due to myocardial infarction often have scar tissue in the heart, limiting the heart’s ability to pump blood. A new treatment in development delivers human stem cells (myoblasts) to form new heart muscle to restore cardiac function to the damaged heart.

Preventing Heart Attacks – Each year, nearly 1 million Americans suffer a new or recurrent heart attack (myocardial infarction), according to the American Heart Association. Clinical evidence has shown that a high number of circulating platelets are associated with an increased incidence of heart attack and thrombotic stroke. A potential first-in-class medicine in development simply reduces the circulating platelets without interfering with platelet function. This approach is thought to prevent thromboembolic events without increasing the risk of bleeding.

Stem Cell Therapy – A potential treatment for ischemic heart disease (and being tested in heart failure patients) uses cells from the patient’s own bone marrow to target damaged tissue in the heart. It is believed that patient’s immune system will not attack the newly transplanted cells because they are native to the patient.

Lowering Blood Lipids – More than 106 million American adults have a total blood cholesterol level over 200, according to the American Heart Association. High cholesterol levels are a major risk factor of heart disease. A potential medicine in development is a selective inhibitor of a protein that plays a major role in transferring high-density cholesterol lipoprotein (HDL, or good cholesterol) to low-density lipoprotein cholesterol (LDL, or bad cholesterol). High HDL levels can help decrease the risk of cardiovascular disease.

February 2009