Thousands of heart attacks and strokes could be prevented with the aid of a simple £5 blood test, research suggests.
Checking levels of troponin in patients could enable doctors to predict their risk of cardiovascular events with much greater accuracy, according to a study funded by the British Heart Foundation (BHF) and published in the Journal of the American College of Cardiology.
The protein is found in heart muscle cells and seeps into the blood when hearts are damaged. Troponin blood tests are already used in hospitals to diagnose heart attacks after they have occurred.
Research suggests the inexpensive tests could also be used to detect “silent” harm to the heart, helping to predict a patient’s future risk of cardiovascular events.
The tests, which can be done alongside routine cholesterol tests at GP surgeries, could enable preventive treatment, such as statins, with the potential to avoid thousands of heart attacks and strokes.
The study’s lead author, Anoop Shah, a professor of cardiovascular medicine at the London School of Hygiene & Tropical Medicine, said: “Troponin, even in the normal range, is a powerful indicator of silent heart muscle damage.
“As such, the test provides an extra layer of information that we can use to boost our accuracy when predicting people’s risk. We want to identify as many high-risk people as possible, so that no one misses out on the opportunity to get preventative treatment.”
Adding troponin tests into existing heart-risk estimation guidelines could help spot high-risk patients who would benefit from preventive treatment, said Shah, which would reduce their risk of future circulatory issues.
The study found people with higher levels of troponin in their blood were at greater risk of having a heart attack or stroke within 10 years. Modelling suggests that, for people currently found to be at intermediate risk on existing cardiovascular health assessments, the tests would prevent one heart attack or stroke for roughly every 500 people tested.
Researchers analysed the health data of more than 62,000 people across Europe and the US.
Each person had their troponin levels measured, as well as conventional risk factors such as age, blood pressure, history of diabetes, smoking status and cholesterol levels. Participants were then tracked for a decade to see if they had a heart attack or stroke.
Current cardiovascular health assessments use an algorithm to predict a patient’s risk of having a heart attack or stroke in the next 10 years based on their risk factors, including cholesterol levels measured using a blood test.
By adding troponin results to these existing risk factors, the algorithm’s predictions were up to four times more accurate than adding cholesterol results alone, the researchers said.
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Crucially, modelling suggested troponin tests were especially effective at spotting danger in people currently assessed and found to be at “intermediate risk” of cardiovascular issues.
This intermediate risk group can pose problems for doctors, the BHF said, because they are not deemed low-risk, but their risk is not high enough to justify preventive treatment.
The study found adding troponin tests meant that up to 8% of people classified as intermediate risk were changed to high-risk. Offering preventive treatments, such as statins, to reclassified patients could prevent thousands of cardiovascular events, such as heart attacks or strokes.
Prof Bryan Williams, the chief scientific and medical officer at the BHF, said: “Developments in risk prediction have helped doctors to build effective algorithms that can spot those most at risk of heart attacks and strokes. But, with around 100,000 hospital admissions for heart attacks alone in the UK each year, it’s clear that there is still plenty of room for improvement.
“This new data suggests adding this blood test to current risk-prediction models could help medical professionals identify more people who are at higher risk and deliver advice and treatment to reduce their risk of future heart attack and strokes.”
