Blood Marker may Identify Coronary Danger

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Japanese researchers seem to have discovered a noninvasive method to potentially spot soft coronary lesions that are easily prone to rupture and cause a severe heart attack.

Blood levels of the recently released inflammatory biomarker pentraxin 3 (PTX3), which is connected to C-reactive protein, were considerably higher in patients with thin fibrous capped coronary lesions than in those without, noted Seiji Koga, MD, of Nagasaki University Graduate School of Biomedical Sciences in Nagasaki, Japan, and peers.

According to the study published online in the JACC: Cardiovascular Interventions; the researchers utilized optical coherence tomography and intravascular ultrasound to assess lesions. From a pool of 75 patients, 47 had stable angina and 28 had acute coronary syndrome. The average age of those with and without thin caps was 66, and 69, respectively.

Prior researchers have stipulated that PTX3 might play a fundamental role in the progression of atherosclerotic lesions, but the current study cannot present such a relationship.

Baseline MRI scans excluding late gadolinium enhancement seemed to distinguish patients with idiopathic dilated cardiomyopathy who would not need an implanted device, a small study suggested.

All 56 patients had increased left ventricular volume and reduced ejection fraction, yet the 30 patients without late gadolinium enhancement (LGE) on MRI remained free of LGE after a follow-up of two years.

According to Pier Giorgio Masci, MD, of Fondazione Toscana Gabriele Monasterio in Pisa, Italy, and peers, the LGE interrelated with positive structural and functional results including reductions in left ventricular mass with a simultaneous increase in stroke-volume and ejection fraction.

In the study published online in Circulation: Cardiovascular Imaging, patients with LGE at baseline had LGE at follow-up, which corresponded with worse structural and functional results.The overall average age of patients was 55, two-thirds were women, and one-quarter had previously been hospitalized for heart failure.

Moreover, a new app called GRACE 2.0 will aid physicians in determining the long-term risk stratification (1 to 3 years after hospital admission) in patients with acute coronary syndrome (ACS).

GRACE 2.0, which set to be released, is an improvement over the original GRACE app, which determines the 6-month risk. The original app is available for the web and for the iPhone.

GRACE (Global Registry of Acute Coronary Events) is an international observational database of outcomes for patients with ACS. It includes 100 hospitals in 14 countries that register a total of 10,000 patients a year.

The GRACE risk score has been authenticated and is highly recommended by ESC Guidelines for acute management of ACS.

A pilot study suggested that determining a patient's vascular age from carotid intima-media thickness (CIMT) and adding that to the Framingham risk score (FRS) may be a promising formula for identifying those at risk of an acute heart attack.

Ash Kabra, MD, of the Lehigh Valley Health Network in Allentown, Pa., and peers reported that the average age of the 26 patients who presented with ST-segment elevation myocardial infarction (STEMI) was 52, but the CMIT-calculated vascular age added an average of 26 years to the chronological age.

Use of vascular age to categorize risk considerably raised the average FRS from 12.1% to 16.6% and the analogous average 10-year event rate from 10.2% to 17.2%, reported in the journal Echocardiography.