Researchers that we've funded have developed a high-sensitivity blood test could be used to predict which patients are at risk of a heart attack.
In a study, published today in the Journal of the American College of Cardiology, they show that the troponin test – currently used to help diagnose a heart attack – could also be a an effective way of assessing a person's future heart disease risk.
The UK's single biggest killer
Coronary heart disease – the cause of heart attacks – is the UK’s single biggest killer, accounting for nearly 70,000 deaths in the UK each year. When heart muscle is damaged it leaks a protein called troponin into the blood stream.
Patients suspected of suffering a heart attack will often be given a troponin test to aid diagnosis, but until now the test has not been used to assess future heart attack risk.
Troponin levels predict risk
In this study of over 3,000 men with high cholesterol but no history of heart disease, the team found that changes in blood levels of a high-sensitivity troponin test accurately predicted the risk of a person suffering a heart attack or dying of coronary heart disease up to 15 years later.
Troponin testing improved the prediction of coronary heart disease risk adding to traditional ways of measuring risk, such as cholesterol levels and blood pressure.
If borne out in larger, more diverse, studies doctors may be able to use the troponin test to determine which patients are most likely to develop coronary heart disease.
Professor Nicholas Mills, BHF Senior Clinical Research Fellow at the University of Edinburgh, who led the research, said: "These results are tremendously exciting, and could revolutionise the way we manage patients at risk of coronary heart disease."
Targeting treatment to those who need it most
The researchers from the University of Edinburgh and University of Glasgow also found that by measuring levels of troponin in the blood they could tell which patients were responding to the statins used to treat them.
A decrease in troponin could indicate treatment is effective, whereas any increases in blood troponin could prompt a change in treatment strategy.
Statins are currently recommended for patients considered at high risk of cardiovascular disease based on traditional clinical indicators. Higher levels of troponin may reflect ‘silent’ coronary heart disease, and identify those at greatest risk who could benefit from targeted therapy.
Professor Mills added: "Whilst blood cholesterol levels and blood pressure are important and associated with the risk of developing heart disease, troponin is a direct measure of injury to the heart. Troponin testing will help doctors to identify apparently healthy individuals who have silent heart disease so we can target preventative treatments to those who are likely to benefit most."
More life-saving research is needed
While encouraging, these results were obtained in a population of middle-aged men with high blood cholesterol. Further work to see whether the same effects are seen in women and men with lower cholesterol levels will need to take place.
Our Medical Director, Professor Sir Nilesh Samani, said: "Before the findings from this research can be clinically applied, the usefulness of measuring troponin findings need to be demonstrated in a wider group of patients. If this confirms its value, the test could easily be administered by GPs during standard check-ups, and could ultimately save lives."
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