The research, published online in The Lancet, suggests the interleukin 6 (IL6) receptor – a protein involved in the inflammatory process – plays a key role in the development of the condition. By using drugs that block this inflammatory pathway, scientists may be able in the future to develop effective new treatments to prevent CHD.
Lead author of the study Daniel Swerdlow, an MRC-funded researcher at UCL (University of London) said:
“Previous studies have shown an association between inflammation and the risk of heart attacks, but until now there has been no direct evidence of a cause-and-effect relationship. Here we show that the IL6 receptor plays a pivotal role in the development of coronary heart disease. This is very exciting, as it suggests that the IL6 receptor could be an important target for future treatments.”
CHD is the UK’s biggest killer. It is caused by a build up of fat in the walls of arteries causing them to narrow. This can lead to chest pains known as angina or, if a coronary artery becomes completely blocked, a heart attack.
The researchers conducted a genetic analysis of 40 studies involving more than 130,000 people to see whether drugs similar to one commonly used to treat rheumatoid arthritis, which block the IL6 receptor, could reduce the risk of CHD in the general population.
This method, known as mendelian randomisation, allows scientists to evaluate the likely effectiveness of a new treatment in humans without the potential risks of exposing them to a novel drug.
Dr David Crosby, programme manager for cardiorespiratory and inflammation research at the Medical Research Council, said:
“Despite the many advances in medical science in recent years, coronary heart disease remains the nation’s biggest killer, causing around 94,000 deaths each year. This research is a significant step forward in the field and emphasises the power of large-scale genetic studies to explain the science behind many of the common conditions observed in the population at large.”
The study was a collaboration between 43 research institutions around the world and was led by Aroon Hingorani from UCL and Juan Pablo Casas from UCL and the London School of Hygiene and Tropical Medicine. It was funded by the MRC and the British Heart Foundation, among others.