1. What does MaGiCAD stand for?
2. Who is responsible for PUMA?
3. What will MaGiCAD tell us that we don't already know?
4. How will this help other heart disease sufferers?
5. When will the results be available?
6. Can I be kept informed of the outcome?

1. What does PUMA stand for?

PUMA stands for “Pioneering the Use of Multiplex assays in Atherosclerosis” - so it is easy to see why we call it PUMA for short. Multiplex assays are new laboratory techniques which allow hundreds or thousands of different molecules to be measured simultaneously. Recent research has suggested that obtaining a profile using certain multiplex assays on a simple blood sample can be used to identify people who might be suffering from atherosclerosis (heart disease). PUMA is the first large scale trial of such a profiling test.

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The PUMA study is a multi-centre trial, which means that patients are being recruited from different hospitals throughout the UK. Dr David Mosedale of Total Scientific Ltd. is the Chief Investigator. He is assisted in the design and running of the study by Dr Peter Schofield (Papworth Hospital NHS Trust) and Dr David Grainger (University of Cambridge, Department of Medicine). The Principle Investigators of the study at each of the sites are Dr Leisa Freeman at Norfolk & Norwich Hospital, Dr Jo Porter at Peterborough Hospital and Prof. Juan Carlos Kaski at St. George’s Hospital, London. As you can see, a study as large and complex as PUMA depends on the collaboration of a number of researchers across the country.

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At present, your risk of developing heart disease is assessed by your doctor using a relatively small number of tests, such as measuring your blood cholesterol. The only way to be certain whether you have heart disease is to perform an invasive test called an angiogram, where X-ray dye is injected into the arteries that supply the heart. Recently, we discovered that measuring the levels of thousands of different chemicals in the blood can give us a diagnosis of heart disease which is almost as accurate as performing the angiogram, but which is both cheaper and less traumatic for the patient. This new profiling test was studied extensively in a large clinical trial, called MaGiCAD, based at Papworth Hospital, beginning in 2001. It also featured on the BBC News and in national newspapers. Before this test can be made available to everyone, it is necessary for us to check how well it functions in normal clinical practice. PUMA is designed to directly compare the performance of the new profiling test with the established angiography test. If PUMA shows that the two tests give the same results, the profiling test can be added to the battery of tests available to your doctor to help decide on the best treatment for you.

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Currently, the first indication that someone has heart disease is often when they suffer a heart attack. If PUMA is successful, we should be able to identify sufferers much earlier, allowing lifestyle changes (such as altering your diet) or medical treatments to start much sooner. For many people, these changes may be sufficient to prevent them from ever having a heart attack.

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The PUMA study is a very large undertaking. We hope to have more than 1,000 patients enrolled, and that will take time. However, the first results from the study should be available by the end of 2008. Further results from PUMA will probably be released over a five year period. At present, we hope to be able to make profiling tests more widely available, on the basis of the data obtained from PUMA, in 2008.

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Absolutely. Studies such as PUMA would never be possible without the willingness of patients to take part. All of the results we obtain will be published in the scientific literature, much of which is available on the Web (the keywords puma and coronary heart disease should help you find them). However, we will also provide a summary of our findings suitable for non-scientists. This summary will posted on this web-site and will be regularly updated as new information is generated.

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