Mar 21, 2012
Excerpt from the Union Tribune, San Diego
By Gary Robbins; Mar 21, 2012
An experimental blood test suggests that it’s possible to give a person up to two weeks’ notice that they are at serious risk for suffering a heart attack, says a new study led by renowned Scripps Health cardiologist Eric Topol.
If the test turns out to be reliable, it could enable doctors to intervene with at-risk patients and possibly prevent many heart attacks and the damage they cause.
The findings are based on a study of 50 people who reported to four San Diego County hospitals while they were having a heart attack. A blood test revealed that circulating endothelial cells, or CECs, that normally coat the inside of heart arteries were sloughing off, allowing a blood clot to develop in patients. That’s a classic cause of a heart attack.
“The CECs are supposed to be like insulation for the artery,” said Topol, chief academic officer at Scripps Health. “When they start to slough off, become numerous, misshapen and have multiple nuclei, it is sign that a heart attack is imminent. They’re a biomarker.”The findings were reported today in the journal Science Translational Medicine (the report can be downloaded here).
Physicians are eager to develop better ways to determine if a person is suffering heart-related problems before any damage to the heart occurs. Heart disease is the leading cause of death in the U.S., killing almost 600,000 people a year. Currently, it’s not unusual for a patient to report to an emergency room with chest pains. If blood tests show that they haven’t suffered damage, they’re often sent home. Some suffer heart attacks within a matter of days. Topol and his colleagues say that a heart attack takes shape days and weeks before it actually happens. The chain reaction can begin with CECs flaking off the interior wall of an artery and gradually creating a crack that attracts a blood clot.
“It is the clot that cuts off the blood supply and serves as the proximate cause of a heart attack,” Topol said. “Eventually, a plaque ruptures and a blood clot develops.”