Scientists develop early warning system to predict fatal heart attacks years in advance

Doctors could treat most at-risk patients with more aggressive therapies

Samuel Osborne
Wednesday 29 August 2018 01:02 BST
Heart disease and stroke remain largest overall causes of death worldwide
Heart disease and stroke remain largest overall causes of death worldwide (iStock)

Scientists have developed a method to predict fatal heart attacks years in advance by identifying “ticking time bomb” arteries.

The number one cause of heart attacks is arteries rupturing and blocking blood flow as a result of inflamed plaques – fatty deposits on artery walls.

By understanding which plaques are most likely to trigger a heart attack, doctors could treat the most at-risk patients with more aggressive therapies.

The predictive technique looks for fat-modifying chemical signals which are released by the most dangerous arterial plaques.

By analysing computerised tomography (CT) scan images of the fat surrounding arteries, scientists were also able to flag up patients at risk of deadly heart attacks years before they occurred.

What to do if someone is having a heart attack

The new heart attack warning system, called the Fat Attenuation Index (FAI), was tested in a large study published by The Lancet medical journal. Its findings were also presented at the European Society of Cardiology congress taking place in Munich, Germany.

The study monitored the progress of 3,900 heart patients from Germany and the US for 10 years after they had undergone a coronary CT scan, or angiogram.

FAI predicted fatal heart attacks many years before they happened.

Patients with an abnormal FAI reading were up to nine times more at risk of having a fatal heart attack in the next five years than those with normal readings, the research showed.

Study leader Professor Charalambos Antoniades, from Oxford University, said: “This new technology may prove transformative for primary and secondary prevention.

“For the first time we have a set of biomarkers, derived from a routine test that is already used in everyday clinical practice, that measures what we call the ‘residual cardiovascular risk’ currently missed by all risk scores and non-invasive tests.

“Knowing who is at increased risk for a heart attack could allow us to intervene early enough to prevent it. I expect these biomarkers to become an essential part of standard CT coronary angiography reporting in the coming years.”

Each year, more than 100,000 people die from a heart attack or related stroke in the UK alone. Heart disease and stroke remain the two biggest overall causes of death worldwide.

Yet currently there is no way of detecting the potentially fatal build-up of plaque that can trigger a heart attack at an early stage.

Professor Metin Avkiran, associate medical director at the British Heart Foundation – which funded the research, said: “Most heart scans are good at spotting blockages caused by large plaques, but not the smaller, high-risk plaques that are likely to rupture and cause a heart attack.

“This new technique could be a game changer – allowing doctors to spot those ‘ticking time bomb’ patients who are most at risk of a heart attack, and getting them on to intensive treatment. This would undoubtedly save lives.”

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