This new therapy may prevent heart disease in older people

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In a new study, researchers found that therapies that soothe inflammation could be an effective way to prevent heart disease in people with a common age-related blood condition.

They identified how the blood condition, called clonal hematopoiesis, worsens atherosclerosis.

The findings suggest that an anti-inflammatory drug previously tested in people with heart disease may have potential if used only in those with clonal hematopoiesis.

The research was conducted by a team at Columbia University.

Although great strides have been made in reducing atherosclerotic heart disease with therapies such as statins that reduce cholesterol, many people still have increased disease despite these current treatments.

In the study, the researchers took a close look at a common blood condition, called clonal hematopoiesis, that is linked to aging.

Clonal hematopoiesis is thought to occur in roughly 10% of people over age 70, and most people have no symptoms.

But researchers recently realized that the condition—for unknown reasons—raises the risk of heart disease by 40%.

Clonal hematopoiesis occurs when hematopoietic (blood) stem cells acquire mutations.

As people age, each hematopoietic stem cell acquires genetic mutations, though most of these mutations have no impact.

But in clonal hematopoiesis, some mutations supercharge the stem cell so that it produces a greater number of blood cells compared with other stem cells.

Clonal hematopoiesis usually arises when one of four specific genes is mutated. The team looked specifically at JAK2, which imparts the strongest risk of premature coronary artery disease.

They found that the JAK2 mutations can lead to a number of changes that increased inflammation in the atherosclerotic plaques, and enhanced the plaque’s necrotic core. This can cause heart attacks or strokes.

The researchers also found that inhibiting various components of the inflammasome improved the stability of the plaques, as did inhibition of IL-1ß, a product of the inflammasome.

Though an IL-1ß inhibitor called canakinumab reduced heart disease, the drug was linked to a small risk of infection.

The team says if doctors take a precision medicine approach and only use canakinumab to treat patients with JAK-driven clonal hematopoiesis, they may increase the heart benefit.

The study is published in Nature. One author of the study is Alan Tall, M.D.

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