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Massive heart disease: Many do not know about their own coronary artery disease


Biomarker enables improved early detection of coronary artery disease
Relatively many people suffer from coronary artery disease (CAD) without knowing it. Because the symptoms often show up later in the course of the disease. Then, however, they can turn out to be correspondingly drastic and even lead to a fatal heart attack. An early diagnosis of the KHK can therefore save lives. With the help of a special biomarker, the early detection options are to be significantly improved in the future.

At the annual conference of the German Society for Cardiology (DGK) in Mannheim, the results of a new study were presented, which examines the biomarker troponin for the early detection of coronary artery disease. The researchers come to the conclusion that the biomarker is of great prognostic importance in CHD and could contribute to significantly improved early detection in the future. This could potentially dramatically reduce the number of deaths from undetected and untreated CAD.

Early diagnosis significantly improves disease prognosis
According to the experts, KHK is one of the most common heart diseases worldwide and the sooner such a narrowing of the coronary arteries is recognized, the better the prognosis. The accurate diagnosis and elective assessment of the patient "demonstrably leads to a reduction in morbidity and mortality," emphasizes Dr. Jan Sebastian Wolter from the Kerckhoff Clinic Bad Nauheim in the press release of the German Society for Cardiology. So far, complex and invasive cardiac examinations have been required for the reliable detection of CHD. But the new study shows that a significant improvement in early diagnosis is possible with the biomarker troponin.

Invasive procedures not applicable to all concerned
So far, there are considerable difficulties in the early diagnosis of CAD in everyday clinical practice. The coronary artery narrowing can be reliably detected using coronary angiography, however, this complex and invasive procedure cannot be used in every suspected case, reports the German Society for Cardiology. According to Dr. In the current guidelines, Wolter "therefore in most cases an individual analysis of all risk factors (recommended), which should preferably be carried out with non-invasive diagnostics."

Troponin examined as a biomarker
In the current study, the research team led by PD Dr. Christoph Liebetrau from the Kerckhoff Clinic Bad Nauheim is investigating whether the detection of troponins in the blood has a prognostic meaning for the diagnosis of CHD. The German Society for Cardiology reports that troponin measurements have long been used in the diagnosis of acute coronary syndrome. Because these protein building blocks, which are important for muscle contraction, pass into the blood when the heart muscle is damaged, angina pectoris or various forms of heart attack can be reliably diagnosed using the troponin values.

More than 4,000 patients examined
So far, according to the researchers, it has remained unclear to what extent the troponin values ​​change even with stable CHD. However, there were indications that "that the highly sensitive measured troponins T and I could have a higher prognostic value than previously assumed", describes Dr. Wolter the starting point of the current study. Between 2009 and 2014, a total of 4,252 patients with suspected CHD or the deterioration of a known CHD were examined for this study.

All subjects with high cardiovascular risk
All study participants were between 58 and 78 years old and had a typical cardiovascular risk profile, reports German Society for Cardiology. 84.7 percent had increased blood pressure, 26.6 percent had diabetes and 69.1 percent had a lipid metabolism disorder. 19.7 percent of the subjects were also active smokers. 182 patients (4.2 percent of the men and 4.5 percent of the women) died within 23 months after the examination.

Foundation stone for improved early detection options?
According to Dr. Wolter states that "Troponin I is an independent risk factor and has a prognostic significance for all-cause mortality." This phenomenon is probably even more pronounced in women than in men, even if the gender-specific differences found were not statistically significant. If the results are confirmed in further examinations, this would significantly expand the early detection options for one of the most common heart diseases, according to the conclusion of the German Society for Cardiology. "We hope that with our work we have laid the foundation for a practicable, comparatively cheap and reliable method for early detection and risk assessment of the CHD," emphasizes Dr. Wolter. (fp)

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Video: Pathophysiology of Coronary Artery Disease CAD (October 2020).