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A blood test with 90 parameters to find out who is at risk of a heart attack

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A blood test with 90 parameters to find out who is at risk of a heart attack

The risk of a heart attack doubles in the month following a divorce. And it even grows five times in the week following the cancer diagnosis. These are just examples taken from the scientific literature of how much and how tailored prevention, case by case, is fundamental. But how do you find out who, regardless of these specific conditions, is at greatest risk of suffering cardiac ischemia in the short term? And what happens, on the biological front and the body’s reactions to stress, before ischemia occurs, to anticipate by focusing attention on the various risk factors?

A simple blood test

The answer to this question may come from the results of an original study, conducted by experts at Uppsala University led by Johan Sundströmappeared on Nature Cardiovascular Research. The scholars have identified 90 potential markers, many recordable with a simple blood test, capable of defining who runs the greatest risk of suffering a heart attack in the six months following the test. And it emerged that a particular parameter, called brain natriuretic peptide, could reveal who is more exposed to cardiac ischemia in the months following the test.

Not only that: scholars are developing a test, available online, for the population. The goal is to ensure that people at higher risk can focus their efforts on prevention, avoiding “forgetting” to keep under control factors that amplify the dangers such as high LDL cholesterol, hypertension, overweight, diabetes and more.

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Towards tailor-made prevention

The research, let’s be clear, does not highlight a clear cause-effect relationship. But it represents an important step forward for prevention plans aimed at the person. The scholars analyzed 817 proteins and 1,025 metabolites in the blood of six biological databases from as many countries, as well as 16 clinical variables. Which parameters are highlighted as potential “signals” of the risk of a first heart attack? From the skimming of the information, 48 proteins, 43 metabolites emerged as well as general parameters such as age, gender and systolic blood pressure.

A forecasting model

These indicators, combined with each other, were associated with the risk of a first myocardial infarction in the period immediately following registration. In short: simply by using easily obtainable data, one can have a prediction model for an imminent first myocardial infarction for clinical use in the general population.

The objective, let it be clear, is not self-diagnosis but rather the strengthening of primary prevention in subjects at particularly high risk. To reach this conclusion, blood samples from 169,053 individuals without previous cardiovascular disease in six European cohorts were analyzed. Within six months, 420 of these people suffered their first heart attack. Their blood was then compared with that of 1,598 healthy members of the populations under study.

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An algorithm for designing risk

The objective of the study, as mentioned, is not to anticipate the diagnosis. But encouraging adherence to healthy lifestyles and therapies possibly indicated to control risk factors. In fact, those who know they are exposed to potential short-term ischemia might naturally feel more attentive to prevention. “We hope that this will increase people’s motivation to take preventive medicine or to stop smoking, for example – comments Sundström, in a note from the university”. Thanks to the online risk calculator, we hope to achieve precisely this result in the future.

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Every year in Italy 100 thousand heart attacks

“The study is very important because heart attack represents the leading cause of death in the Western world and in Italy it affects around 100,000 people every year – he explains Giuseppe Musumeci, director of Cardiology at the Mauriziano Hospital in Turin. It is essential to do prevention by reducing risk factors such as smoking, high blood pressure, diabetes and above all LDL cholesterol. Have a algorithm which tells us who runs a higher risk can lead us to stimulate an even healthier lifestyle or is an even more incisive correction of these risk factors in these people. For example, if we know that the basic risk is higher, instead of keeping LDL cholesterol in primary prevention below the traditional 100 milligrams per deciliter, we can think about keeping it even lower as in those who have already had a heart attack (55 milligrams per deciliter ). The same thing, with stringent objectives, must be done for blood pressure or glycemic values”.

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