Measuring C-reactive protein using blood tests could better identify whether heart attack patients are at risk of dying within the next three years.
In the largest study of its kind, researchers at the National Heart and Lung Institute, Imperial College London, in collaboration with the National Institute for Health Research (NIHR) Health Informatics Collaborative (HIC), found that measuring levels of high sensitivity C-reactive protein (CRP) – a sign of inflammation – could allow doctors to identify patients at risk of dying following a heart attack.
Measuring C-reactive protein
The blood test, which is already used in hospitals to diagnose other conditions, could be utilised to streamline how patients are treated following a heart attack. This could lead to monitoring high-risk patients closely and more aggressive treatment, whilst those identified as low risk could be given reassurance and sent home.
Current practises when doctors believe someone has had a heart attack include performing a blood test for troponin, a protein that is released into the bloodstream when the heart is damaged. Now, scientists have found that measuring C-reactive protein levels at the same time provides a more detailed picture to show which patients are at high or low risk.
The team used data gathered by the NIHR HIC from over 250,000 patients who were admitted to the hospital with a suspected heart attack. Normally, the level of C-reactive protein in the blood is 2 mg/L or under, but they found a mildly raised measurement of 10-15 mg/L C-reactive protein in those with a positive troponin test predicted a greater than 25% chance of death three years later.
Targeted treatment
This discovery could lead to more targeted treatment for heart attack patients who have life-threatening C-reactive protein inflammation. Doctors could also give these people more intensive therapies.
A selection of anti-inflammatory drugs such as colchicine has already been found to be effective against atherosclerosis – the build-up of fatty deposits in the arteries that increases your chance of a heart attack. Dr Ramzi Khamis now hopes to test colchicine specifically in patients with increased CRP levels to determine whether it could be an effective treatment to increase survival after a heart attack.
Dr Ramzi Khamis, BHF Intermediate Clinical Research Fellow and consultant cardiologist at the National Heart and Lung Institute, Imperial College London, said: “Testing for this biological ‘red flag’ at the same time as other hospital tests identifies those more vulnerable patients who should be receiving closer medical attention. Importantly, we hope with more research, we can be successful in developing new therapies that specifically combat inflammation to improve outcomes in heart disease.
Dr Amit Kaura, BHF Clinical Research Fellow and lead researcher for the NIHR HIC at Imperial College London, said: “This study shows that analysing large sets of real-world clinical data can cast light on patterns of disease and identify those at high risk of dying. We hope to use this knowledge to guide our clinical decision making in treating patients with suspected heart attacks.
