Thursday 22 March 2012

Doctors find clue in quest to predict heart attack

 Doctors are one step closer to a simple test that could predict whether a patient is about to have a heart attack — by using a blood sample to detect cells that have sloughed off of damaged blood vessel walls.


The finding, published Wednesday in the journal Science Translational Medicine, could potentially address "the greatest unmet need" facing cardiologists, said lead author Dr. Eric Topol, a cardiologist at the Scripps Translational Science Institute in San Diego. Though physicians can easily detect a heart attack that's already underway, every year tens of thousands of patients walk away from the doctor's office after having passed a stress test, only to suffer a devastating heart attack within a few weeks.


Topol called the phenomenon the "Tim Russert syndrome," referring to the newsman who died of a heart attack in 2008, weeks after undergoing a stress test with apparently normal results.


"When someone is having the real deal, we know that," Topol said. "The real question is, is something percolating in their artery? We'd like to prevent the heart attack from happening," or mitigate its effects with drugs.


Next, Topol said his team soon will begin needed studies to learn how early those cells might appear before a heart attack, and if spotting them could allow use of clot-preventing drugs to ward off damage. Some San Diego emergency rooms will study an experimental blood test with chest-pain sufferers whose standard exams found no evidence of a heart attack, he said.


Don't expect a test to predict heart attacks any time soon , a lot more research is needed, caution heart specialists not involved with the study. But they're intrigued.


"This study is pretty exciting," said Dr. Douglas Zipes of Indiana University and past president of the American College of Cardiology. It suggests those cells are harmed "not just in the minutes prior" to a heart attack, he said, "but probably hours, maybe even days" earlier.


"It's a neat, provocative first step," added Dr. William C. Little, cardiology chief at Wake Forest Baptist Medical Center. "But it is not a biomarker ready for prime time."


About 935,000 people in the U.S. have a heart attack every year, according to government figures. Doctors can tell who's at risk: People with high blood pressure and cholesterol, who smoke, have diabetes, are overweight or sedentary.


But there's no way to tell when a heart attack is imminent. Tests can spot that an artery is narrowing, or if a heart attack is under way or already has damaged the heart muscle. They can't tell if the plaque inside arteries is poised to rupture.

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