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Circulating cells signal upcoming heart attack

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Heart attacks can be devastating for the family and the patient, and around half of heart attacks or strokes can occur in people who don't seem to have any obvious risk factors. A blood test that detects abnormal cells in the blood could pinpoint people at risk of a heart attack, and has been described as the holy grail of cardiovascular medicine.

Most people's arteries have levels of thickening or hardening, where the walls fur up with cholesterol (atheromatous plaques). If these swellings rupture, this can cause a heart attack, also called an acute myocardial infarction (MI). According to research headed up by Scripps Translational Science Institute (STSI), odd-shaped or overly large circulating endothelial cells (CEC) could signpost an arterial plaque rupture. This could lead to a simple blood test warning of a high risk of a heart attack in the near future.

In a group of 50 heart attack patients seen in emergency rooms and 44 healthy people, the numbers of CECs, which normally line the arteries of the heart, were significantly higher in the blood of heart patients than in the healthy individuals, and many of the cells were misshapen, enlarged or had three or more nuclei.

"The CECs are supposed to be like insulation for the artery," Eric Topol, the study's principal investigator and director of STSI, told the San Diego Union-Tribune. "When they start to slough off, become numerous, misshapen and have multiple nuclei, it is sign that a heart attack is imminent. They're a biomarker." Topol suggests that the cells could start to break off the artery lining days or weeks before the heart attack happens, making this a potential early warning signal.

Collaborator Sharp HealthCare believes that a test could be available within a year or two. Current tests just indicate whether a patient has actually had a heart attack--if this test comes through it could allow doctors to prevent a heart attack from happening, rather than dealing with the problems after it has actually happened. This could not only reduce the risk of death or disability for the patient but also significantly cut healthcare costs and reduce the social burden of lost days working.

- read the press release
- see the abstract from Science Translational Medicine
- check out the article in the San Diego Union-Tribune

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