Brussels, 12 December 2007
A Health European research project offers new insight into the cardiovascular diseases process.
Two European researchers, Giovanni Davi and Carlo Patrono, have been able to demonstrate persistent platelet activation in association with major cardiovascular risk factors, including diabetes mellitus and visceral obesity. Platelets play a key role in atherothrombosis. Antiplatelet therapy can reduce vascular mortality and prevent stroke recurrence by about a quarter. Giovanni Davi and Carlo Patrono are members of the EICOSANOX project, a large Integrated Project funded by the European Commission and coordinated by Professor Jesper Haeggstrom. Their demonstration offers new insight into the mechanisms of accelerated artherosclerosis in these metabolic disorders and provides a rationale for exploring the efficacy and safety of early antiplatelet interventions in slowing down its progression. This investigation will be published in the December 13th issue of the New England Journal of Medicine.
At the beginning of the 20th century, cardiovascular disease (CVD) was responsible for approx 10% of all deaths worldwide. Today, that figure has risen to approx 30%, and CVD is the no. 1 cause of death worldwide. Substantial progress was made, particularly during the past 25 years, in fighting coronary heart disease (CHD) and the age-adjusted death rate for CHD was cut in half in many industrialized countries. Two factors appear to have contributed equally to this decline: reductions in major risk factors (eg, elevated cholesterol, blood pressure and cigarette smoking), and evidence-based medical interventions (eg, treatments for acute coronary syndromes and secondary prevention).
However, this favourable trend has been reversed, at least in part, by recent increases in the prevalence of obesity and diabetes, both contributing to a substantial increase in CHD deaths.
Atherothrombosis is the leading cause of fatal and non-fatal ischemic events occurring in the coronary (myocardial infarction) and cerebral (stroke) vasculature. Platelets play a key role in atherothrombosis. Basic as well as clinical research carried out in Europe during the past 30 years has contributed importantly to discovering lipid mediators of platelet activation, defining the optimal pharmacologic strategies (eg, low-dose aspirin) to interfere with platelet activation, and demonstrating that antiplatelet therapy can reduce vascular mortality in the setting of acute myocardial infarction and acute ischemic stroke and prevent their recurrence by about a quarter.
In the December 13 th issue of the New England Journal of Medicine, two FP6-funded Investigators, Giovanni Davì and Carlo Patrono, have co-authored a Mechanisms of Disease review article on “Platelet Activation and Atherothrombosis”. Professor Davì, at the “G. d’Annunzio” University Foundation in Chieti, and Professor Patrono, at the Catholic University School of Medicine in Rome, are members of the EICOSANOX Consortium, a large Integrated Project funded by the European Commission to investigate the role of eicosanoids and nitric oxide in cardiovascular disease, cancer and neurodegeneration, and coordinated by Professor Jesper Haeggstrom at the Karolinska Institutet in Stockholm. By measuring the in vivo biosynthesis of thromboxane (an important platelet eicosanoid discovered by Nobel Laureate Bengt Samuelsson), the Italian investigators have been able to demonstrate persistent platelet activation in association with major cardiovascular risk factors, including diabetes mellitus and visceral obesity, and to characterize both aspirin-sensitive and aspirin-insensitive mechanisms of platelet activation in patients with vascular disease.
Their demonstration of abnormal platelet activation in the early stage of diabetes mellitus as well as in young, otherwise healthy, obese women, when integrated with a substantial wealth of basic research on the role of platelets in the development of atherosclerotic lesions, offers new insight into the mechanisms of accelerated atherosclerosis in these metabolic disorders and provides a rationale for exploring the efficacy and safety of early antiplatelet interventions in slowing down its progression.
NOTE TO EDITORS
Catherine Audouze-Ouannes, Press officer
Communication Unit, Research DG, European Commission
Tel: +32.2.296 66 72, Fax: +32.2.295 82 20, E-Mail: Catherine.Audouze-Ouannes@ec.europa.eu