Could a vaccine prevent heart attack and stroke?
A major national collaboration is now testing whether a safe, one-off vaccination can help to reduce the risk of heart attacks and strokes.
The Australian Study for the Prevention through Immunisation of Cardiovascular Events (AUSPICE) is recruiting 6000 men and women aged 55 to 60 years across six centres – based in Newcastle, Gosford, Canberra, Melbourne, Adelaide and Perth.
Medical Doctor and Chief Investigator Professor John Attia, from the University of Newcastle and John Hunter Hospital, says that the study will formally test whether the existing pneumococcal vaccine can not only reduce invasive pneumococcal disease but also help to prevent heart attack and stroke.
“The evidence from laboratory studies and observational studies in humans suggests there may be a component of the adult pneumococcal vaccine that looks like oxidized LDL, the bad cholesterol, that builds up in arteries of people with heart disease,” Professor Attia said.
“The antibodies that are generated in response to the vaccine appear to bind to and reduce the build-up of cholesterol, thereby reducing vascular disease.”
“The only way to definitely explore this is through a randomised controlled trial and to our knowledge this is the first and only trial registered in the world exploring this possibility.”
Professor Attia says that cardiovascular disease is still the number one killer in Australia, despite ongoing efforts in prevention and treatment.
“If shown to be effective, it would be relatively easy to incorporate changes into clinical practice because the pneumococcal vaccine is safe and has already been used in Australia for over 20 years in a different target group,” he said.
Each trial centre is aiming to recruit 1000 participants, who are asked to attend a single clinic visit for less than one hour. Tens of thousands of letters of invitation and eligibility screening are being sent out by the Department of Human Services (Medicare) throughout 2016.
Health record linkage will be used to determine the rates of heart attack and stroke in the treatment and control groups, four to five years after vaccination.
“People with at least two risk factors for heart disease – high blood pressure, high cholesterol, or overweight/obesity – will be randomised to receive either the active vaccine or a saline placebo,” Professor Attia said.
“We are asking anyone who receives an invitation for AUSPICE in their letterbox to please take the time to consider participating and to complete the eligibility screening, either in hard copy or online.”
AUSPICE is funded by the National Health and Medical Research Council and the investigators have no conflicts of interest to declare.
Professor Attia is Professor of Medicine and Clinical Epidemiology at the University of Newcastle; Director HMRI Epidemiology and Statistical Support Unit; and Academic Director of General Medicine at Hunter New England Local Health District.
* HMRI is a partnership between the University of Newcastle, Hunter New England Health and the community.