10th January 2013 – Researchers say they have discovered a new way of diagnosing heart attacks based on a specific type of cell circulating in the blood.
Most heart attacks are caused when coronary arteries narrow due to a gradual build-up of fatty material, called atheroma, within their walls. If this atheroma becomes unstable, it may rupture and cause a blood clot, preventing blood from flowing properly and ultimately leading to a heart attack.
When atheroma builds up, ruptures or ulcerates, it causes inflammation in the arteries and, according to the US researchers, releases endothelial cells, which line the walls of the arteries. It is these endothelial cells which, the study suggests, could be detected by a 'fluid biopsy', identifying patients at a very high risk of a heart attack.
UK experts say it would be some time before the technique, outlined in the journal Physical Biology, could be used to assess heart attack risk.
Co-author of the study Professor Peter Kuhn says in a statement: "The goal of this paper was to establish evidence that these circulating endothelial cells can be detected reliably in patients following a heart attack and do not exist in healthy controls, which we have achieved."
The team developed a test, called the High-Definition Circulating Endothelial Cell assay, to detect endothelial cells.
The researchers, based at The Scripps Research Institute in California, tested 79 patients following a heart attack and compared them with 25 healthy people and 6 who were having vascular surgery. They found that the number of circulating endothelial cells were significantly higher in heart attack patients than in the other groups.
According to Professor Kuhn: "Our results were so significant relative to the healthy controls that the obvious next step is to assess the usefulness of the test in identifying patients during the early stages of a heart attack."
Commenting on the study in a statement, Dr Mike Knapton, associate medical director at the British Heart Foundation, says: "These scientists have found that you can detect circulating endothelial cells or CECs in the blood of patients following a heart attack, which are not found in healthy people. This is an interesting finding and suggests looking for CECs could be another way of identifying a heart attack.
"In the short to medium term, it is unlikely to change how people in the UK are treated as we already have good ways to treat and diagnose heart attacks, and targets to ensure rapid pain to treatment times.
"This study appears to be laying the groundwork for future research to see if this test could be used to identify patients in the early stages of a heart attack."
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