Marker predicts patients who are seven times more likely to die after suffering a heart attack

Researchers at Brigham and Women’s Hospital (BWH) have found a protein in the blood that may one day produce a simple and inexpensive test to help determine who is at high risk for problems following a heart attack. The study indicates that heart attack victims with elevated levels of the protein were seven times more likely to die in the month following the heart attack compared to patients with the lowest levels of the marker. The findings are published in the April 19, 2004 issue of Circulation: Journal of the American Heart Association.

“While preliminary, this study suggests we may have the potential to incorporate a new blood tests into our diagnostic routine and treatment planning for heart attack patients, many of who go on to develop severe heart failure or die,” said Richard Lee, MD, lead author and BWH cardiologist. “We are constantly searching for better methods to guide therapy for heart attack patients because early intervention is key to preserving heart function.”

Researchers estimate that between five and 10 percent of patients suffer from heart failure or die in the first month of a heart attack. Currently, physicians do not use blood biomarkers to direct therapy. Clinical factors such as symptoms and imaging tests help physicians determine additional risk.

The protein - called ST2 - is an inflammatory marker produced when stress is put on heart cells. Dr. Lee and his team measured ST2 levels in 810 heart attacks patients. When death and heart failure were combined as end points, patients with the highest levels of ST2 had a four-fold increased risk of death or congestive heart failure compared to those with lower levels. 

“If our data are confirmed in other patient groups, ST2 may become a new blood test to help identify who is in greatest need of aggressive treatment intervention,” said Lee, associate professor of medicine at Harvard Medical School. “Further studies need to be conducted to determine if this protein can be a therapeutic tool and a potential target for drug development as well.”

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