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influence.Morethan500researchersfrom SpainandItalyparticipatedvoluntarily, withthestudyfundedentirelybypublic institutionsincludingCNIC,theSpanish SocietyofCardiology,andCIBERCV.
"Thetrialwasdesignedtooptimiseheart attackcarebasedonsolidscientificevidenceandwithoutcommercialbias,"emphasisedDrIbanez."Theseresultswillhelp
simplifyandstreamlinetreatment,reduce adverseeffects,andimprovethequalityof lifeforthousandsofpatientseveryyear."
Theresearchaffectsmillionsofpatientsannually.Morethantwomillion Europeanssufferheartattackseachyear, includingaround70,000inSpainalone. Untilnow,themajorityweredischarged withbeta-blockerprescriptions-aprac-
ticenowfundamentallyquestioned. DrValentfnFuster,CNICGeneralDirectorandseniorREBOOTinvestigator, placedthefindingsinbroadercontext: "Thistrialwillreshapeallinternational clinicalguidelines.ItjoinsotherlandmarktrialsledbyCNICthathavealready transformedtheglobalapproachtocardiovasculardisease."mm
Reference:
REBOOTTrialInvestigators.(2025).TreatmentwithBeta-BlockersafterMyocardialInfarctionwithoutReduced EjectionFraction.The NewEnglandJournalofMedicine.doi: https://doi.org/10.1056/NE]Moa2504735
Pioneering study findsmyocardial infarctionmay resultfrom bacterial infections
FinnishandUKresearchershave demonstratedthatheartattacksmay resultfrombacterialinfectionshidingwithincholesterol-ladenarterial plaques.Thegroundbreakingstudy challengesconventionalunderstandingofcardiacpathologyandopens possibilitiesforvaccinedevelopment andnoveltherapeuticapproachestargetingdormantbacterialcommunities incoronaryarteries.
Myocardialinfarctionmayfundamentallyrepresentaninfectiousdiseaseratherthanpurelyacholesteroldrivenpathologicalprocess,according topioneeringresearchpublishedin theJournaloftheAmericanHeartAssociationon6August2025.
Theinternationalstudy,ledbyProfessorPekkaKarhunenfromTampere University,providesthefirstcompellingevidencethatbacterialbiofilms residingwithinatheroscleroticplaques couldtriggerfatalheartattacks.This discoveryfundamentallychallenges currentmedicalunderstandingand suggestsentirelynewavenuesforpreventionandtreatment.
Hidden bacterial communities discovered
Usingadvancedmoleculartechniquesand immunohistochemistry,researchersanalysed coronaryplaquesfrom121suddendeath victimsand96surgicalpatientsundergoing arterialprocedures.Theirfindingsrevealed thatviridansgroupstreptococcalDNAwas foundin42.1%ofcoronaryplaquesand 42.9%ofendarterectomysamples.
Thestudy'smoststrikingdiscoverycentres onbacterialimmuneevasion.Viridansstreptococcicolonisedthecoreofatherosclerotic plaquesasbiofilmsunrecognisedbyimmune systemmacrophages,whilstsimultaneously dispersedbacteriainfiltratedrupturedfibrous caps,readilydetectedbyimmunecells.
"Bacterialinvolvementincoronaryarterydiseasehaslongbeensuspected,but directandconvincingevidencehasbeen lacking.Ourstudydemonstratedthepresenceofgeneticmaterialfromseveraloral bacteriainsideatheroscleroticplaques," Karhunenexplains.
Clinicalsignificanceand therapeutic potential
Bacterialimmunopositivitydemonstrated
strongassociationswithdiseaseseverityandclinicaloutcomes,correlating significantlywithsevereatherosclerosisanddeathfromcoronaryheartdisease.Genome-wideexpressionanalysis revealedsubstantialupregulationof bacterialrecognitionpathways,supportingactivebacterial-hostinteractionswithindiseasedarterialtissue.
Thefindingssuggestthatviralinfectionsorotherexternaltriggersmayactivatedormantbiofilms,leadingtobacterialproliferationandinflammatory responsesthatultimatelycauseplaque ruptureandthrombosisformation.
"Theobservationspavethewayfor thedevelopmentofnoveldiagnostic andtherapeuticstrategiesformyocardialinfarction.Furthermore,they advancethepossibilityofpreventing coronaryarterydiseaseandmyocardialinfarctionbyvaccination,"the researchersnote.
Thisresearchrepresentsaparadigm shiftinunderstandingmyocardialinfarctionpathogenesisandmayherald aneweraofinfection-focusedcardiac therapeutics.mm
Reference:
Karhunen,P.J.,Pessi,T.,Hi:irkki:i,S.,et.al.(2025).ViridansStreptococcalBiofilmEvadesImmuneDetectionandContributes toInflammationandRuptureofAtheroscleroticPlaques.JournaloftheAmericanHeartAssociation,14,e041521. https://doi.org/10.1161/]AHA.125.041521
By Sunil Kumar CEO, DataFlow Group
Wes Streeting, UK Health Secretary
