A better way to predict heart attacks- BWH Bulletin - For and about the People of Brigham and Women's Hospital
A better way to predict heart attacks- BWH Bulletin - For and about the People of Brigham and Women's Hospital
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April 18, 2000
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In This Issue:
Transplant recipient gears up for Marathon
A better way to predict heart attacks
Ask Yourself:
Spring into a Healthy Heart
Pike Notes
Meet Julie Von Lambsdorff
Town Meeting
Walk for hunger
High cholesterol has long been a standard for predicting heart attack risk. Yet half of the 1.5 million Americans who suffer heart attacks each year have normal cholesterol levels. How can doctors better predict who will suffer heart attacks? BWH researchers recently made national news with their preliminary answers. In the process of atherosclerosis—commonly known as hardening of the arteries—plaques grow within blood vessels and cause injury. Immune-system cells rush in to repair injured blood vessels. But in doing so, they stick to the vessel walls and can loosen and rupture the plaque, leading to a heart attack. This process can occur even among people with normal cholesterol. How does a person find out if he or she has this type of problem, since current screening techniques do not look at the immune system? According to a report by Paul Ridker, MD, MPH, Cardiovascular Medicine, and colleagues published in the New England Journal of Medicine in March, one way is to measure the levels of inflammatory molecules in the blood. Ridker and his group showed that an inexpensive high-sensitivity test for one of these molecules, C-reactive protein, predicted risk much more faithfully than cholesterol testing. The test, known as hs-CRP, was approved by the FDA last fall. Noted Ridker, “The use of combined hs-CRP and cholesterol testing may provide a substantially better method to determine who is at high risk for cardiovascular disease.” This test might be used to help direct people to the right therapy to prevent heart attack. Clinical trials have shown that statin drugs are highly effective in reducing the risk of heart attack and stroke, even among individuals without known cardiovascular disease. However, because of the large number of patients who would require treatment, the use of these agents for preventing first heart attacks has been limited. The hs-CRP test may provide a new method to determine which patients are most likely to benefit from statin therapy. The hs-CRP test can predict heart attack and stroke up to 10 years in advance, so if testing becomes routine, "We'll not only have a markedly better method for identifying people at risk," Ridker says. "These individuals will have a powerful new incentive to take action to reduce their risk and stay healthy.”