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Test May Spot Heart Attacks Before They Happen

Blood Test Looks for Type of Cell That Breaks Away From Artery Walls

Test Finds Circulating Cells continued...

Study researcher Mark C. Connelly, PhD, director of cellular research at Veridex, the company that makes the test, declined to speculate on how much the experimental blood test might cost if it’s used for heart attacks.

Researchers gave the test to 50 patients who were having major heart attacks that could be confirmed by changes to their heart’s electrical rhythms and to key levels of enzymes that are indicators of heart damage.

They also gave the test to 44 blood donors who reported being free of any chronic disease.

Heart attack patients had levels of CECs that were more than four times higher than the levels seen in healthy blood donors.

There were other important differences, too. Under a microscope, the CECs seen in heart attack patients were larger and appeared to be stuck together in clusters, whereas the CECs in healthy people were smaller and appeared more often as single cells.

The study is published in the journal Science Translational Medicine.

Many Questions Remain

Experts who were not involved in the study say the results are intriguing, but note that much more work is needed before such a test could be used to predict heart attacks.

“This is an interesting observation, but it fails to demonstrate that finding these cellular patterns in blood during stable, asymptomatic phases of [heart] disease actually will predict the future risk of a heart attack,” says Prediman K. Shah, MD, director of the division of cardiology at Cedars-Sinai Medical Center in Los Angeles. Shah also directs atherosclerosis research at Cedars-Sinai.

“That’s a fundamental flaw of the study. Maybe that will be their next study, but that’s going to be a hard study to do,” says Shah, noting that such a study would require following thousands of patients at risk for heart attack, rather than testing people who’ve already had one.

Other experts agree that the test has potential but needs more research.

“I think the key word is potential,” says Suzanne Steinbaum, MD, a preventive cardiologist who directs the division of women and heart disease at Lenox Hill Hospital in New York City. “We’re really looking at people who’ve already had heart attacks. Their theory is that if we can see these cells in people before they have a heart attack, can we really diagnose those that are at risk?”

If the test checks out in future studies, Steinbaum says it could have a major impact. “I think it would change the face of how we manage heart disease, in general. It’s exciting to think about.”

Advice to Patients

Until researchers get more answers, Kaplan says there are important things patients can do to reduce their risk of a plaque rupture.

“Number one is not smoking. The second is to keep cholesterol levels very low, particularly in patients who we know have coronary disease,” he says.

“We know from studies that keeping cholesterol very low with diet and with statins decreases the risk of plaque rupture,” Kaplan says.

The study was co-authored by doctors and scientists from Scripps Health; STSI; TSRI; Veridex, LLC (a Johnson & Johnson company), the manufacturer of the test used in the study; Palomar Health; and Sharp HealthCare. Funding came from a $2 million grant from the National Institutes of Health.

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