A straightforward £5 blood test could accurately allow doctors to predict someone’s risk of heart attacks and strokes in the next decade, according to groundbreaking research. It is hoped these tests could be conducted alongside routine cholesterol tests at GP surgeries, saving lives.
This test would look for a protein called troponin, which is found in heart muscle cells and is released into the bloodstream when the heart is damaged.
High-sensitivity troponin blood tests, currently used in hospitals to diagnose heart attacks, can also detect silent ongoing damage to the heart, indicating a future risk of cardiovascular disease.
Now, a study, published in the Journal of the American College of Cardiology, has discovered that individuals with higher levels of troponin in their blood are at a greater risk of experiencing a heart attack or stroke within the next 10 years.
Researchers’ modelling suggests that the tests could prevent one heart attack or stroke for approximately every 500 people tested.
As part of the study, a team analysed anonymised health data from over 62,000 individuals across 15 studies in Europe and North America. Each person had their troponin levels measured, along with conventional risk factors such as age, blood pressure, history of diabetes, smoking status and cholesterol levels.
Participants were then monitored for around 10 years to see if they suffered a heart attack or stroke. Current assessments for cardiovascular health use an algorithm to predict the risk of heart attack or stroke within the next decade, based on risk factors such as cholesterol levels measured through a blood test.
However, by incorporating troponin results into these conventional risk factors, researchers found that the algorithm’s predictions became up to four times more accurate than relying solely on cholesterol results.
Notably, the researchers’ modelling revealed that the troponin test was particularly effective in identifying danger in the 35% of individuals currently assessed as being at intermediate risk of cardiovascular issues.
This group, which includes people with a 2.5% to 15% chance of experiencing a heart attack or stroke within 10 years, depending on their age, poses a challenge for medical professionals as they are not at low risk, but the risk is not high enough to warrant preventative treatment.
The modelling demonstrated that including troponin tests led to the reclassification of up to 8% of individuals initially categorised as intermediate risk to high risk.
As reported by the British Heart Foundation (BHF), which funded the research, providing preventative treatments like statins to these reclassified individuals would prevent numerous severe cardiovascular events, including heart attacks or strokes.
Professor Anoop Shah, professor of cardiovascular medicine at the London School of Hygiene and Tropical Medicine and the study’s lead author, said: « Troponin, even in the normal range, is a powerful indicator of silent heart muscle damage.
“As such, the test provides an extra layer of information that we can use to boost our accuracy when predicting people’s risk. We want to identify as many high-risk people as possible, so that no one misses out on the opportunity to get preventative treatment. »
He further noted that: « Incorporation of troponin into current cardiovascular risk estimation guidelines can be useful for identifying high-risk individuals who will benefit from preventative treatment, reducing the risk of future circulatory problems. »
Commenting on the development, Professor Bryan Williams, chief scientific and medical officer at the BHF, added: « Developments in risk prediction have helped doctors to build effective algorithms that can spot those most at risk of heart attacks and strokes.
« But, with around 100,000 hospital admissions for heart attacks alone in the UK each year, it’s clear that there is still plenty of room for improvement.
« This new data suggests adding this blood test to current risk prediction models could help medical professionals identify more people who are at higher risk and deliver advice and treatment to reduce their risk of future heart attack and strokes. »
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