Tests identify possible indicators of heart attacks

BOSTON, Massachusetts (Reuters) -- Indicators of inflammation may give doctors a way to predict if a person is destined for a heart attack and should receive aggressive treatment, two studies in Thursday's New England Journal of Medicine found.

The studies looked at different markers of inflammation in the bloodstream but reached a similar conclusion: when inflammation is present, the risk of heart disease and a heart attack goes up.

Researchers remain far from understanding the link, said Dr. Daniel J. Rader of the University of Pennsylvania in an accompanying editorial, but "progress in this field enhances our ability to predict the risk of such events, allows clinicians to administer preventive therapies to those mostly like to benefit, (and) provides potential new targets" for treatment.

In one study, Swedish researchers led by Dr. Bertil Lindahl of the University of Uppsala looked at the death rate among people with heart disease who had high levels of troponin T, which reflects damage to the heart, and C-reactive protein, which appears during inflammation.

They followed 917 patients for an average of three years and found that the death rate was nearly 13 times higher among those with the highest levels of troponin T compared to those with the lowest levels.

Patients with the highest levels of C-reactive protein had a death rate nearly three times higher than those who had lesser amounts of the protein.

The second study, led by Chris J. Packard of the Glasgow Royal Infirmary in Scotland, was based on blood samples of 580 men with high cholesterol. Their samples were collected as part of a study on the cholesterol-lowering drug pravastatin.

When the samples were tested for an enzyme known as lipoprotein-associated phospholipase A2 (PLA2), Packard and his colleagues found that the men with the highest levels of the enzyme were nearly twice as likely to have a heart attack as people with the lowest levels.

High PLA2 levels "showed as strong a risk as inflammation did. It's independent of other risk factors and it didn't matter whether you were older or younger," Packard told Reuters in a telephone interview. The same chemicals that regulate inflammation also control PLA2 levels.

The study may give doctors a new test to identify which patients face the highest heart attack risk, Packard said. Two of his fellow researchers are working on just such a test that is being developed by California-based diaDexus, a joint venture of SmithKline Beecham Pharmaceuticals and Incyte Genomics, Inc.

The study was also financed in part by Bristol-Myers Squibb, which makes pravastatin.

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