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Heart attack: The ‘red flag’ warning of an increased risk of death in the next three years

What's the difference between a heart attack and cardiac arrest?

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A recent study, one of the largest of its kind, has identified a way to better identify if somebody is at higher risk of dying in the next three years following a heart attack. Higher levels of the sensitivity C-reactive protein (CRP) – a marker for inflammation – was a good indication as to whether a person was going to die within three years of having a heart attack. Such a simple blood test, which is already used in hospitals to diagnose other conditions, could be a life-saver.

The tool could be used to streamline how patients are treated in hospital following a suspected heart attack.

For example, those identified as higher risk (of death) could be given more aggressive treatment and monitored more closely.

Meanwhile those identified as lower risk could be given reassurance and sent home.

Right now, when patients are admitted to hospital following a suspected heart attack, a blood test is carried out to check for the protein troponin.

Troponin is released into the bloodstream when the heart is damaged, hence why it’s a good indication of a heart attack.

Yet, the blood test would be an optimal opportunity to also measure CPR levels.

Measuring CPR levels, alongside troponin, could differentiate which patients are at higher or lower risk of death.

Doctor Ramzi Khamis, the British Heart Foundation (BHF) Intermediate Clinical Research Fellow and consultant cardiologist at the National Heart and Lung Institute, Imperial College London, commented on the research.

“Testing for this biological ‘red flag’ at the same time as other hospital tests identifies those more vulnerable patients who should be receiving closer medical attention.”

Doctor Khamis added: “Importantly, we hope with more research, we can be successful in developing new therapies that specifically combat inflammation to improve outcomes…”

The research project, published in PLOS Medicine – and funded by the BHF – was based on over 250,000 patients who were admitted to hospital with a suspected heart attack.

The data – gathered by the NIHR Health Informatics Collaborative (HIC) – revealed the following.

Those at higher risk of death had CPR levels of 10-15mg/L compared to “normal” levels of 2mg/L or under.

This “red flag” also predicted a greater than 35 percent chance of death within the next three years of a confirmed heart attack.

Looking into the usefulness of this information, Doctor Khamis wants to test whether anti-inflammatory medication could prolong life.

One anti-inflammatory medicine, in particular, comes to mind for Doctor Khamis – colchicine.

Colchicine has already been proven effective against atherosclerosis – a build-up of fatty deposits in the artery that can increase the risk of a heart attack.

Doctor Khamis now wants to test whether patients with elevated CRP levels, who are given colchicine, would live longer.

This research collaboration was between the National Heart and Lung Institute, Imperial College London, and the National Institute for Health Research (NIHR) Health Informatics Collaborative (HIC).

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