Diabetic heart complications is focus of $14 million grant

A five-year, $14 million grant from the National Heart, Lung, and Blood Institute will establish a University center that will develop better ways to prevent and treat heart disease in diabetic patients.

Diabetics who have heart attacks confront a poor prognosis, according to Daniel P. Kelly, M.D., professor of medicine, of pediatrics and of molecular biology and pharmacology.

Daniel Kelly
Daniel P. Kelly

“Heart disease is the leading killer of diabetics,” Kelly said. “When we treat diabetic patients following a heart attack with standard cardiac therapies, they do not respond as well as the non-diabetic patients.”

The grant establishes a Specialized Center for Clinically Oriented Research (SCCOR) in Cardiac Function and Disease at the University. Kelly will direct the center, one of the first of a new generation of National Institutes of Health-sponsored research centers designed to emphasize clinical research.

“One of the main goals of the new SCCOR grants is to aggressively link research discoveries to improving patient treatments,” Kelly said.

Kelly also is the director of the University’s Center for Cardiovascular Research and co-director of the Cardiovascular Division. In addition to his clinical work, he oversees an extensive research program to develop and study mouse models of diabetes and heart disease.

A major research initiative of the new center will be to study heart attacks in animal models and use findings of new diagnostics and treatments for human diabetics.

“One of our hypotheses is that too much fat is entering the diabetic heart, where it doesn’t belong,” Kelly said.

“If you don’t treat the fat accumulating in the heart, all the cardiologic therapies in the world may not remedy the heart failure caused by the fat.”

Through research in mouse models, Kelly aims to identify new drugs to eliminate fat in cardiac tissues. Kelly and his colleagues will also use the animal research to identify biochemical markers and genetic factors associated with increased risk.

Another research program will be run by John Spertus, M.D., professor of medicine and health outcomes research at Mid-America Heart Institute and the University of Missouri-Kansas City.

To begin the process of applying animal-model results to patient populations, Spertus will enroll 4,500 heart-attack patients across the nation. Approximately 1,500 of those patients will be diabetic.

“We will compare what we learn from the mice with human diabetic and non-diabetic populations,” Kelly said. “This will allow us to confirm whether the biomarkers we identify are useful in humans.”

Spertus also plans to study differences in outcomes based on patient race and ethnicity.

A third facet of the SCCOR grant, led by Howard L. McLeod, Pharm.D., associate professor of genetics, will examine how genetic differences in diabetic patients affect their response to drug therapies.

“The final goal is to develop something called ‘a diabetic cardiovascular panel,'” Kelly said.

“It will help us stratify diabetic patients based, in part, on the severity of the metabolic disease, a key step toward choosing treatment strategies.”