Test to determine heart disease risk

Seven's On Call with Dr. Jay Adlersberg
June 19, 2008 5:46:15 AM PDT
Hundreds of thousands of Americans die from heart disease every year. But now, there is a test that can help show if you are at risk.Half of all men who die of heart disease have no symptoms. So how does a doctor know which patients may go on to have that deadly heart attack? There's a simple blood test that may help. No, it's not a cholesterol test. It's a test called CRP.

Sixty-five-year-old Bill Hawthorne had bypass heart surgery about 20 years ago. It started with a simple visit to his doctor for what sounded like a chest cold, but there was something else.

"And I said, you know, there are these episodes of chest pain, like something sitting on my chest," he said. "And that's when he said, 'What? You need a stress test.'"

A heart stress test looks for heart muscles that are not getting enough blood and are at risk for a heart attack. Bill was fortunate in a way. He had symptoms of heart disease, which prompted his doctor to act. The blood test, called CRP, may help the doctor to act when patients have heart attack risk factors but have no symptoms.

"If you have significant risk factors, an elevated level does correlate to the risk of things happening," said Dr. William Cole, of NYU Medical Center.

So in patients who are overweight, have high blood pressure or a high blood cholesterol, but no symptoms of chest pain or shortness of breath, a high CRP may push the doctor to use drugs or do heart tests, such as an angiogram, to look at the heart's blood vessels.

CRP simply measures inflammation in the joints (arthritis), inflammation in the sinuses (a sinus infection) or inflammation in the heart's arteries.

How a blood test that measures inflammation relates to a higher risk of a heart attack is not known.

Inflamed blood vessels may form clots more easily. Those clots can block blood flow and kill heart muscles.

CRP may be just the first of these tests.

"There's a lot of different other measurements of inflammation that they're now studying," Dr. Cole said. "And I think that in the next year or two, we'll be coming out with more testing."

And Dr. Cole makes the point that any change in symptoms, new onset of chest pain or a worsening of shortness of breath, should trigger a call to the doctor. He says a heart patient ignoring a change in symptoms is a set up for a heart attack.


STORY BY: Dr. Jay Adlersberg