Every two minutes someone in the UK has a heart attack and Liverpool has one of the highest rates of heart disease in the country.  New research suggests drugs targeting a bad type of white blood cell, a macrophage, which causes plaque rupture, could prevent heart attacks without affecting the normal ability of white blood cells to fight infections.

The research will be part of a murder mystery-style lecture during the BA Festival of Science in Liverpool on Saturday 6 September and is published online in the journal, 'Arteriosclerosis, Thrombosis, and Vascular Biology'.

The lecture by Professor Andrew Newby at the University of Bristol and supported by the British Heart Foundation, will investigate the biological culprits behind heart attacks and delve into some of the latest cutting-edge research.

There are more than 200,000 cases of heart attack in the UK alone each year and almost half this number of patient's dies.  Heart attack results from a blood clot at the site of a fatty narrowing.  Painstaking work of cardiovascular pathologists established that one quarter to one third of heart attack are caused by detachment of a large patch of the lining (endothelial cells) from the surface of a badly narrowed coronary artery.

Most of the remaining heart attacks result from rupture of a thin fibrous 'cap' overlying a plaque with a large, floppy pool of fat inside.  Such plaques 'wobble' during every heart beat and the cap eventually suffers fatigue, a bit like metal fatigue in an aeroplane wing.  Ruptured plaques tend to have lots of white blood cells (especially macrophages) in them showing that they are inflamed. 

There are relatively few smooth muscle cells and less collagen, a rope-like molecule that gives strength-giving to the plaque cap. Collagen is thought to be destroyed by digestive enzymes called 'proteases' that are secreted by the white cells as part of the inflammatory reaction.

It is thought that intact plaques with thin caps, lots of fat and white blood cells that haven't yet ruptured are 'vulnerable' to subsequent rupture and that patients with such plaques are vulnerable to heart attack. 

Drugs that remove the fat and reduce the inflammation should prevent heart attack.  So far this view holds true for statin drugs, which prevent about a third of heart attack.  The researchers objective is to identify additional, maybe even more effective treatments to prevent heart attack. 

Andrew Newby, British Heart Foundation Professor of Vascular Cell Biology, said: "Around 40 per cent of men and women die of cardiovascular disease of which heart disease is the biggest component.

"Despite successes in bringing down heart disease rates over the last three decades, our fatter, more sedentary population could soon be suffering a renewed epidemic.  Life expectancy may even decline!  We need better treatments to prevent heart attacks."

BA Festival of Science event: 'Heart attacks - the UK's biggest serial killer' by Professor Andrew Newby at the University of Bristol and supported by the British Heart Foundation, Saturday 6 September 2008 at the Quaker House, 22 School Lane, Liverpool at 6 pm.