Cutting through the silence of heart disease

A low-cost blood test could have potential to pick up silent heart disease and direct treatment or lifestyle changes before symptoms appear, potentially cutting damaging heart attacks and sudden death, and saving money for the payors and healthcare providers. The research, from the University of Dundee (Scotland, U.K.) and sponsored by the British Heart Foundation uses a £25 ($41) test already used to confirm heart disease in people with symptoms.

The research, published in the Journal of the American College of Cardiology, screened people with high blood pressure or raised cholesterol, looking at their levels of two biomarkers: high sensitivity troponin and B-type natriuretic peptide. These can be used to point out heart damage and stress. Of the 300 people screened, 102 had silent heart disease, confirmed by heart scans.

Allan Struthers of the University of Dundee, who led the study, said: "We've shown that a suite of already available blood tests could identify early but silent heart disease. This could one day propel screening for presymptomatic heart disease into the same league as screening for some cancers achieved long ago."

Up to 50% of people who have sudden cardiac death have not been diagnosed with heart disease, and there is currently no way of stratifying people at risk other than by blood pressure and blood fats. The next step for the researchers is to confirm how sensitive and reliable the test is, in longer and larger studies. They also need to work out who would benefit the most, as screening an entire population would be "economically and logistically challenging," according to Mark Richards, Christchurch School of Medicine and Health Sciences, New Zealand, in an accompanying editorial.

While Richards suspects that the world is not yet ready for "the combination of biomarkers and detailed cardiac phenotyping to aid better outcomes in primary prevention," because of a lack of suitable interventions, that when the therapeutic options are available, the approach could be beneficial.

- read the press release
- see the paper
- check out the editorial