New blood test may be best predictor of heart attack

From Medical Correspondent Rhonda Rowland

March 22, 2000
Web posted at: 5:09 p.m. EST (2209 GMT)

(CNN) -- Scientists have identified a new simple blood test that may be even better at predicting heart attack risk than a cholesterol test, according to a study in this week's New England Journal of Medicine.

The test measures c-reactive protein, an indicator of inflammation of the arteries.

"We were able to find that the c-reactive protein is a stronger predictor of risk than were the regular cholesterol levels, and that's very important because almost half of all heart attacks occur among people who have normal cholesterol levels," said lead researcher Dr. Paul Ridker of Brigham and Women's Hospital in Boston.

Researchers believe inflammation of the arteries may explain heart disease in people without other known risk factors -- people with normal cholesterol, low blood pressure and in good physical shape. These patients make up a third of all heart attack cases.

"We've known for years there must be some other cause for coronary artery disease," said cardiologist Basil Margolis of St. Joseph's Hospital in Atlanta. But arterial inflammation has only recently been identified as a possible trigger.

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The new blood test, combined with a screening for high cholesterol, could help doctors make more accurate diagnoses.

The study evaluated blood samples from more than 28,000 healthy nurses. Those with the highest levels of c-reactive protein had more than four times the risk of having future heart trouble.

High levels of both c-reactive protein and cholesterol could be "one of the most sensitive risk indicators of coronary artery disease," Margolis said.

The Food and Drug Administration approved the c-reactive protein test last November. It is an inexpensive procedure that costs about the same as a cholesterol test.

For people who do have high levels of c-reactive protein, a class of cholesterol drugs called statins may reduce inflammation in the arteries, study authors found.

Scientists are still trying to understand how inflammation plays a role in heart disease. In the meantime, researchers believe this new test can help identify thousands of healthy people who may be at risk of heart attack.

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New England Journal of Medicine
American Heart Association
Food and Drug Administration
Brigham and Women's Hospital
Saint Joseph's Hospital of Atlanta

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