Posted on 01/10/2007 7:43:54 AM PST by COUNTrecount
Predicting whether someone will have a heart attack or stroke within the next four years could be as simple as taking a blood test.
A study of nearly 1,000 people with stable coronary heart disease found those with the highest levels of a protein linked to stretched or stressed heart muscle were nearly eight times more likely to die or to have a heart attack, stroke or heart failure than those with the lowest levels.
The findings held after all other risks factors, such as high blood pressure, were taken into account.
As well, the blood test identified people at high risk even when other routine tests assessing heart function came back normal.
"That was what was so amazing," said principal author Dr. Mary Whooley, an associate professor of medicine at the University of California, San Francisco. Her team's research is published in this week's Journal of the American Medical Association.
"Even in patients who had totally normal echocardiograms [an ultrasound of the heart], this marker was predicting greater risks. Obviously, it's picking up something we can't see by echo and haven't been able to detect with other routine tests."
Dr. Whooley, a staff physician at the San Francisco VA Medical Centre, is not suggesting that "tomorrow everybody should go out and have this test. "But there may be a select group of patients who already have heart disease in which this test might help us know they aren't doing as well and may need more aggressive treatment."
Almost 74,000 Canadians die each year from cardiovascular disease, the leading cause of death in Canada.
Heart researchers are searching for biomarkers -- molecules that can indicate whether disease is present, and, if so, how severe it is.
The California team looked at a protein that's a marker for a hormone called BNP. BNP rises when the heart wall expands because of a blood volume or pressure overload, or is damaged by lack of blood flow to the heart.
The more cardiac "stretch or stress," the higher the BNP, and the more protein.
The study involved 987 men and women who were followed for an average of 3.7 years each. They were put into four groups, depending how much of the protein was circulating in their blood.
Overall, 26%, or 256 patients, died or had a cardiovascular event during the study.
Each incremental increase by a certain level of the protein was associated with a 2.3-fold increased risk of death or being hospitalized with a heart attack, stroke or heart failure.
People in the highest "quartile" had a nearly eight-fold increased risk (19.6% event rate versus 2.6% for those in the lowest group).
Eighty per cent of the study sample was men, so it's not clear how much the findings apply to women.
And while the test identified people at greater risk, "we don't have any magical treatment to prevent that risk at the moment," Dr. Whooley said. "We don't have any new way to treat the people who are going to die.
"But these people should already be on all of the medicines that we would use to try to prevent heart disease," she said. Dr. Whooley says the test isn't ready to be used as a screening tool for heart disease. A study published last month in the New England Journal of Medicine involving researchers with the Framingham Heart Study found that while people with high levels of BNP had twice the risk of heart attack and stroke, it was only slightly better at forecasting future trouble than blood pressure, cholesterol and whether the person smoked.
But, for people who already have heart disease, "it tells you who is going to do worse."
About 300,000 Canadians are hospitalized each year with cardiovascular disease.
Dr. Beth Abramson, a cardiologist at St. Michael's Hospital in Toronto and spokeswoman for the Heart and Stroke Foundation, called the study "exciting," but cautioned that "we're not ready yet to recommend mass screening with newer tests until we know how accurately they can predict future events."
Uncontrolled diabetes, high cholesterol and high blood pressure all increase the risk of death in heart patients. People who may have coronary heart disease should talk to their doctors to make sure they are on the right medications, Dr. Abramson says.
This test could scare a lot of people.
Interesting. Thanks for posting.
Brain Natrietic (sp?) Peptide or BNP is an example of the usefulness of In Vitro Diagnostics. Much more moola goes to research for the cure than for detecting the diseases. Of course, there is more profit in being cured than finding out you are sick. But, a good investment is in joint ventures between the pharma companies and the diagnostic companies who are marrying the two areas.
ping
Another Pre-Existing condition rejection coming from Insurance companies.....
I've been on the operating table ten times for blocked arteries. Maybe someday they can reverse this problem.
If the insurance companies could use the fact that since you are alive, you are a risk for death, they would.
Fortunately for me, Uncle Sam, takes care of that for me. Those long cold nights in the field and the time in the rice paddies paid off.
Good....Fear is a terrific motivator for change. Worked with me. I was 6'3" 250...Ate like a maniac, drank like a fish, smoked like a chimney and thought exercising my ass off would counter the effects. At age 56 I came down with coronary artery disease, peripheral artery disease and Type II diabetes. I got the message.. Now I'm 191, HBA1c of 5.2, quit smoking and drinking.
10 angioplasties?...is it a restenosis problem or new plague formations?
Actually, I was reacting to the operations and scaring inside the arteries. About two year ago they did (sounds like) braci (sp?) surgery where they use radiated beads inside the arteries. That seems to have worked so far.
I was thinking about having a zipper put on my leg where they went in.
ping
Yep.....began getting chest pains and thought it was indigestion and ignored it. Frequency began to increase and I went to my doctor. He told me to go to the emergency room.
I said "I'll drive over immediately."
He said "not a problem...I've already called the ambulance"
" That bad?"I said..
" Yup...that bad" he said, " here put on this oxygen"
36 hours later I had five stents and more pills than I could shake a stick at...
Today I walk ten miles a day...and watch my weight and eat like a novice nun.
Going for the plague regression effort. I figure I might as well put the same energy into getting well that I did getting sick.
Getting in shape is easy if you begin with small increments. Get down to 2,000 calories a day in a couple of months. When I began I couldn't walk 500 yards without getting winded and my legs hurt. I began pathetically small ( 400 yards twice a day) Added 20 yards a day. Now ? 10 miles a day ( five in the morning after breakfast and 5 in the evening after dinner) Once a month I do a 20 miler ( the Roman march) just to impress the hell out of myself.
It is the best thing I have ever done....We do control our own lives and we are responsible for them.
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