There are a number of well-known factors that increase a person’s risk of heart attack: high cholesterol, high blood pressure, smoking, an inactive lifestyle, diabetes, obesity – and that list goes on.

But what about the seemingly healthy people who don’t have any of the obvious risk factors and end up having a heart attack unexpectedly? In an effort to identify such individuals at least two to three years before their heart attack, diagnostic company BG Medicine (Waltham, Massachusetts) has agreed to collaborate with researchers in Denmark and use data from various Copenhagen cohort studies in its High Risk Plaque (HRP) Initiative.

The HRP initiative is a joint research effort to advance the understanding and management of high-risk plaque, which is believed to be the primary underlying cause of heart attacks and strokes. BG, Merck (Whitehouse Station, New Jersey), Astra Zeneca (London) and Philips (Amsterdam, the Netherlands) started the initiative.

“If we succeed than this will really open up the opportunity to truly prevent heart attacks,” Pieter Muntendam, MD, president/CEO of BG, told Medical Device Daily. “Heart attacks kill more [people] in the western world, and increasingly throughout the world, than any other condition ... we can’t make a real dent because we can’t find the people at risk.”

The new research collaboration aims to discover new cardiovascular biomarkers, including those predictive of rupture of atherosclerotic plaque and myocardial infarction. The research, expected to begin next month, will apply BG’s proteomic and metabolomic discovery platform capabilities, the company said. It will include samples obtained from the Copenhagen City Heart Study and the ongoing Copenhagen General Population Study and will be conducted in multiple phases, BG said.

“This collaboration with the Copenhagen General Population Study is a core component of our cardiovascular program, which seeks to discover and develop novel cardiovascular diagnostics that address a significant unmet medical need,” Muntendam said. “This study is a complement to the other atherosclerosis-related research projects that we are conducting as part of the broader, collaborative HRP initiative.”

The HRP initiative expects to dedicate $30 million in funding toward this research over four years and to leverage recent advances in biology and technology to design and optimize a patient care-cycle for high-risk (vulnerable) plaque.

Muntendam said the current thinking is that over time there is a buildup of an individual’s artherosclerosis and plaque on their arteries. At some point that plaque gets thinner, or softer, he said, and ruptures. Those are the otherwise healthy individuals — the 68-year-old who played a game of tennis yesterday and all of a sudden drops dead of a heart attack, for example — that the researchers are trying to identify before it’s too late.

“Novel laboratory technologies allow for accurate measurements of up to one thousand different biological molecules in less than 1mL of plasma sample,” said Borge Nordestgaard, chairman of the Copenhagen General Population Study and principal investigator of the research collaboration with BG. “This research is an excellent example of how plasma samples from large-scale epidemiological studies can be used for the discovery and development of novel in-vitro diagnostics to address a significant unmet medical need.”

BG discovers biomarkers and develops diagnostic products using its technology platform designed to integrate and automate the precise measurement, analysis, characterization and interpretation of proteins, and metabolites collected from bodily fluids.

“The size of the Copenhagen City Heart Study and the Copenhagen General Population Study cohorts, combined with the exceptional, long-term follow-up of nearly 100% of the study participants, facilitates important discoveries that require high-quality samples from before the onset of disease symptoms,” said Erling Falk, MD, PhD, co-chair of the HRP study and professor of cardiovascular pathology in the Department of Cardiology at the University of Aarhus (Denmark). “These cohort studies leverage the advanced data systems that exist in Denmark to track medical events over the participants’ lifetimes.”

Valentin Fuster, MD, PhD, co-chair of the HRP study, director of Mount Sinai Heart Center (New York) and scientific president of the National Center for Cardiovascular Investigations (Madrid, Spain), called the HRP initiative and the Copenhagen City Heart Study an “outstanding cooperation” between the U.S. and Europe in “an important area of bioscience.”

Muntendam characterized the research collaboration as a “tremendous opportunity,” and said he is not sure if everyone fully appreciates the significance of it.