Team Develops Simple Test to Predict Heart Attacks

New findings from a landmark research study led by Scripps Translational Science Institute (STSI)—a collaborative program between Scripps Health and The Scripps Research Institute—shows a promising new blood test may be useful in helping doctors predict who is at risk for an imminent heart attack.

The study, published March 21, 2012, in Science Translational Medicine, concludes that circulating endothelial cells (CEC) from heart attack patients were abnormally large and misshapen and often appeared with multiple nuclei, which indicates that CECs are promising biomarkers for the prediction of acute ongoing arterial plaque rupture. 

“The ability to diagnose an imminent heart attack has long been considered the holy grail of cardiovascular medicine,” said Eric Topol, the study’s principal investigator and director of STSI, who also holds positions at Scripps Health, Scripps Clinic, and Scripps Research. “This has been a tremendous collaboration of two institutions on the research side, three health care systems in San Diego, and a life science industry leader, which has resulted in an important discovery that may help to change the future of cardiovascular medicine.”

The study involved 50 patients who presented to emergency rooms with heart attacks at four acute care hospitals in San Diego. Using different cell isolation platforms, including the Veridex CellSearch System®, the researchers found that CEC counts and the cell structural features were dramatically altered in the heart attack population when compared to the healthy control group.

“Our image analysis showed that the myocardial infarction CECs have a unique morphological signature (larger cells, greater cellular/nuclear areas, multicellular and multimuclear clusters), compared to CECs from control individuals,” said Professor Velia Fowler, one of the Scripps Research investigators contributing to the study.

The findings are significant, as more than 2.5 million U.S. individuals experience a heart attack or ischemic stroke, most commonly the result of obstructive coronary artery disease, according to STSI. If the arteries get abruptly and completely occluded by the buildup of fatty cholesterol, it will cause a massive heart attack that will likely lead to a sudden death, as was the case involving former NBC News Washington Bureau Chief Tim Russert.

“With some additional validation, the hope is to have this test developed for commercial use in next year or two,” said Raghava Gollapudi, a co-author from Sharp HealthCare. “This would be an ideal test to perform in an emergency room to determine if a patient is on the cusp of a heart attack or about to experience one in the next couple of weeks. Right now we can only test to detect if a patient is currently experiencing or has recently experienced a heart attack.”

The first author of the study, “Characterization of Circulating Endothelial Cells in Acute Myocardial Infarction” was Samir Damani of STSI. In addition to Topol, Fowler, Gollapudi, and Samani, additional authors were Andrea Bacconi, Kelly Bethel, Peter Kuhn, Malcolm Wood, and Bridget Carragher of Scripps Research; Ondrej Libiger and Nicholas J. Schork of STSI and Scripps Research; Aparajita H. Chourasia, John Jiang, Chandra Rao, and Mark Connelly of Veridex (a Johnson & Johnson company); Rod Serry of Palomar Pomerado Health; Ron Goldberg and Kevin Rapeport of Sharp Memorial and Grossmont Hospitals; and Sharon Haaser, Sarah Topol, and Sharen Knowlton of STSI. For more information, see http://stm.sciencemag.org/content/4/126/126ra33

Funding for the study came from a $2 million grant from the National Institutes of Health.

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