Roger Sabbadini, PhD

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Sphingolipids for ischemia detection

• Roger Sabbadini, PhD
• Professor of Biology
• San Diego State University
• San Diego, CA

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Sphingolipids
What are they?

• Naturally occurring signaling molecules in cells.
• Released by heart cells lacking sufficient oxygen
  supply.

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Sphingolipids
MIRF trial

• Myocardial Ischemia Rating Function trial
• 318 consecutive patients undergoing cardiac
  catheterization for all causes.
• Sphingosine-1-phosphate (S1P) levels correlated
  to angiographically demonstrable stenosis.
  (plt.001)

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Sphingolipids
MIRF trial effectiveness

• Accuracy maintained across age, gender, and
  clinical presentation.
• Particularly effective in the active ischemia
  group (Patients hospitalized for their symptoms
  and eventually displayed multi-vessel disease)
• Both the incidence and severity of disease
  tracked to sphingolipids.

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Sphingolipids
Comparisons to other tests

• Other tests measure risk factors, not the
  presence of active disease.
• Sphingolipids detect the presence of ischemic
  tissue.

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Sphingolipids
Potential uses

• General yearly screening
• Triage in emergency department
• Evaluation of therapeutic efficacy

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Sphingolipids
Potential uses triage

• Able to distinguish cardiac-related chest pain
  from other causes
• Sphingolipids may appear earlier than other
  markers of ischemia (troponin, CKMB)

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Sphingolipids
Potential uses efficacy evaluation

• Evaluate procedures and medications that reduce
  ischemia associated with coronary artery disease.
• MIRF-2 will measure sphingolipids before and
  after balloon angioplasty.

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Sphingolipids
Other ischemia

• It may be possible to detect microvascular
  ischemia in the heart as well as forms of
  ischemia not related to obstructive disease
  (heart failure, cardiomyopathy).

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Sphingolipids
FDA approval

• Plan to submit for FDA approval in late 2001.
• Two other trials underway.
• Dont expect FDA approval before 2002.

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Sphingolipids
Cost