Global spotlight on Cambridge heart trial

Results of an NIHR Cambridge BRC and NIHR Cambridge CRF supported trial which may help prevent patients from having repeat heart attacks, will be presented at the 30^th European Society of Cardiology (ESC) Congress, the largest cardiology conference globally.

The IVORY and IVORY FINALE trial looked at whether a low dose of the cancer drug, known as aldesleukin, could increase the activation of immune cells shown to protect the heart and help patients who have had a heart attack.

Current treatment for heart attacks centres on the re-establishment and maintenance of blood flow in the coronary arteries using blood thinners, with or without stents, as well as cholesterol lowering medication. Despite current optimal therapy, heart attacks can re-occur.  

The team believes the immune system is an important process in the development of atherosclerosis (plaque disease in arteries) which has not been directly harnessed in these patients and attempted to target it using a novel approach.

The researchers found in a previous trial that low doses of aldesleukin, a drug normally used to treat kidney cancer (at much higher doses), stimulates the production of protective immune cells, called Tregs safely in patients with heart attacks.

In the current trial, they tested to see if the drug reduced inflammation in the arteries of patients after an initial heart attack, as inflammation in the arteries has previously been associated with an increase in the risk of recurrent heart attacks and death.

The study was led by researchers at Cambridge University Hospitals (CUH) and the University of Cambridge (UofC) as well as Royal Papworth Hospital, and was supported by the Medical Research Council, the British Heart Foundation, the NIHR Cambridge Biomedical Research Centre and the NIHR Cambridge Clinical Research Facility.

The results will be unveiled at the ‘late-breaking’ sessions of the 30^th European Society of Cardiology (ESC) Congress 2024 in London on 30 August and will be presented by Dr Rouchelle Sriranjan, an interventional cardiology registrar and NIHR clinical lecturer in cardiology, pictured right.

CUH consultant clinical pharmacologist, affiliated associate professor and trial chief investigator, Dr Joseph Cheriyan, said: “We are delighted to be presenting these novel data at the ESC and particularly in the late breaking session, which is a highlight of the conference.

“This study was the product of very intense work by many different teams on the campus in very sick patients and demonstrates the importance of collaborative teamwork. We are very grateful to the patients for their time and dedication to our trial.”

Dr Stephen Hoole was the trial lead for Royal Papworth Hospital, whilst Professor Rudd led the imaging component for the trial.

Professor Ziad Mallat, BHF professor of cardiovascular medicine, UofC, who conceived the trial said: “If positive, this is potentially a new treatment approach that boosts our immune defence mechanisms to tame heart attacks. It could also be an important step forward in the treatment of patients with heart attacks which needs continued exploration.

“Our results should be of interest to the wider cardiovascular community. In addition to our supporters and funders, we would like to thank everyone who has worked so hard on the trial, especially the patients who have taken part.”