New Technology May Find Heart Disease in Seemingly Healthy Patients

Researchers say they have come up with a noninvasive way to check for inflammation in blood vessels that could be a prelude to a heart attack.

Despite major medical advances in recent years, heart disease can still be a silent killer for some.

Even as doctors develop better tools to diagnose and treat patients before a cardiac event, some people still suffer a heart attack despite having no known risk factors for the disease.

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Researchers are hoping a new test that looks for signs of arterial inflammation could be a helpful tool in the fight against heart disease.

Dr. Alexios S. Antonopoulos, from the University of Oxford, along with his co-authors, have developed a new noninvasive way of looking for signs of heart disease.

They look for inflammation in arteries by examining the surrounding fat tissue. The test could someday help doctors detect and treat heart disease in patients, who may not show signs of cardiac trouble under current methods of detection.

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“Noninvasive detection of vascular inflammation has been hailed as the ‘Holy Grail’ in cardiovascular medicine, because it would allow identification of patients at high risk for future cardiovascular events,” the authors wrote.

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Researchers develop new metric

Heart disease remains a big problem in the United States with an estimated 750,000 Americans experiencing a heart attack annually, according to the Centers for Disease Control and Prevention (CDC).

About 4 in 10 people who have a heart attack do not survive.

In the study published today in the Science Translational Medicine Journal, researchers examined 453 patients about to undergo cardiac surgery.

They also examined the CT scans from a clinical cohort of 273 subjects.

Of these people, 156 had significant coronary plaques and 117 did not.

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The researchers were then able to develop a metric called the CT fat attenuation index (FAI) to help identify risk of inflammation.

To identify a patient’s FAI, researchers looked at the makeup and appearance of fat surrounding arteries.

They looked to see if the fat showed signs of certain biomarkers that indicate nearby arteries were inflamed.

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They found that 40 patients’ FAI scores corresponded with pronounced blood vessel inflammation, as verified by a positron emission tomography (PET) scan.

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Identifying risk early

Keith Channon, co-author of the study and professor of cardiovascular medicine at the University of Oxford, said that most tests today are only able to detect heart disease after arteries are already narrowing.

This results in less time for doctors to treat or reverse the effects of heart disease.

“It’s likely to be too late to intervene and reverse narrowing of arteries that occurred over many years,” he said during a press conference.

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Earlier detection means patients could take steps earlier through diet, exercise, or taking statins to diminish their risk of a heart attack.

Additionally, if these preliminary results hold up under expanded study, it could mean doctors are able to more easily identify people at risk for heart attack.

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Many people may be at high risk for heart attack because current scans do not detect early narrowing or early signs of inflammation identified by the FAI, Channon explained.

The results of a larger study are expected to be published early next year, according to the researchers.

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More research needed

Dr. Sanjay Rajagopalan, a cardiologist and division chief of cardiovascular medicine at UH Cleveland Medical Center, said he thought the study findings were interesting, but that much more research needs to be done.

“I am enthusiastic but it has a long way to go,” Rajagopalan, who was not involved in the study, told Healthline.

He pointed out that doctors currently use a test called the coronary calcium score to help determine heart attack risk.

“It does a pretty good job — they would have to show that their test is better,” Rajagopalan said.

The study authors pointed out in their article that coronary calcium scoring “describes nonreversible structural changes of the vascular wall,” so that the damage has already occurred and using drugs such as statins has limited impact on reversing the damage.

They hope the FAI could identify heart disease symptoms even earlier.