New blood test predicts risk of heart attack and stroke with twice the accuracy | Heart attack

Scientists have developed a blood test that can predict whether a person is at high risk of heart attack, stroke, heart failure, or death from any of these conditions within the next four years.

The test, which relies on blood protein measurements, has about twice the accuracy of existing risk scores. This could allow doctors to determine if patients’ existing medications are working or if they need additional drugs to reduce their risk.

“I think that’s the new frontier of personalized medicine, to be able to answer the question, does that person need enhanced treatment? And when you’ve treated someone, does that really worked?” said Dr. Stephen Williams of SomaLogic in Boulder, Colorado, who led the research.

It could also be used to speed up the development of new cardiovascular drugs by providing a faster way to assess whether drug candidates work during clinical trials.

The test is already in use in four health systems in the US and Williams hopes it could be introduced in the UK in the near future. “The NHS is definitely on our radar screen, and we’re talking to people about how that might work,” he said.

While genetic testing can give an idea of ​​the risk of certain diseases, protein analysis can provide a more accurate snapshot of what a person’s organs, tissues and cells are doing at any given time.

Williams and his colleagues used machine learning to analyze 5,000 proteins in blood plasma samples from 22,849 people and identify a signature of 27 proteins that could predict four-year odds of heart attack, stroke, heart failure or death.

When validated on 11,609 people, they found their model was about twice as good as existing risk scores, which use age, gender, race, medical history, cholesterol and blood pressure. a person’s blood pressure to assess their likelihood of having a cardiovascular event. The results were published in Science Translational Medicine.

Importantly, the test can also accurately assess risk in people who have had a heart attack or stroke in the past, or have other illnesses, and are taking medication to reduce their risk, c This is where existing risk prediction scores tend to drop.

“There would be no problem if everyone was the same. But the problem is, you can follow the treatment guidelines and some people will go back to the same risks as someone in their 40s or 30s, while others will have another event within the next year, and they have l looks even from the outside,” Williams said.

“Being able to distinguish between these two people, so that we can deliver improved cardioprotective drugs to people at risk is an unmet medical need.”

SomaLogic’s test uses protein measurements to classify people from high to low risk, as well as providing a percentage chance that they will suffer a cardiovascular event within the next four years. “If it turned out that your score was high, you would have about a one in two chance of an event, but the average time frame for that event would be just over 18 months, and the most likely would be death,” Williams said. “This person will need immediate enhanced cardio protection [in the form of drugs or other interventions]because these are catastrophic short-term risks.

“And the good thing is that treatments already exist. The problem is to associate them with the people who need them the most and to measure whether they have worked well enough.

He said the test could eventually be used as a surrogate endpoint in clinical trials to assess the effectiveness of experimental therapies, rather than waiting months or years for patients’ health to improve or deteriorate. which slows the pace of drug development.

Professor Manuel Mayr, British Heart Foundation Professor of Cardiovascular Proteomics at King’s College London, said: “Proteins are the building blocks of our bodies. This study provides measurements for a quarter of all the proteins encoded by our genes, which has become possible thanks to new emerging technologies that allow the measurement of thousands of proteins and offer new opportunities to assess risk in patients.

“While this study reveals new associations between blood proteins and death from all causes, further research is needed to assess the potential clinical impact of using these 27 proteins, compared to current predictive tools. risk of cardiovascular disease.”

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