Risk of Coronary Heart Disease and Ischemic Stroke Risk Predicted

progression_of_ruptureprone_plaque-smRisk of Coronary Heart Disease and Ischemic Stroke Risk Predicted
FDA-Approved Blood Test Helps Physicians Determine Hidden risk and Manage Moderate to High-Risk Patients

Author: Mark J. Alberts, MD

Coronary Heart Disease and Ischemic Stroke

Heart disease is the leading cause of death in the United States, with over 600,000 coronary heart disease (CHD) deaths occurring annually. Stroke, another form of cardiovascular disease, is the third leading cause of death in the United States. The risk of stroke is of particular interest to our senior citizens, since the National Institute of Aging reports that nearly 75% of all strokes occur in people over the age of 65 and the risk of having a stroke more than doubles each decade after the age of 55.

Patients lucky enough to survive a heart attack or stroke are then at increased risk for another cardiac event and a subsequent stroke. In fact, according to the American Heart Association of the estimated 770,000 coronary events forecasted this year nearly 60% of these patients will suffer a recurrent event. With obesity at an all time high in the United States it’s imperative that people educate themselves on their risks for life threatening incidents.

Knowing your risk

Often times the first sign of cardiac event or a stroke is the event itself; that’s why finding out one’s hidden risk is so important. There are several factors that raise a person’s risk of a heart attack and stroke, including high cholesterol, high blood pressure, obesity, diabetes, smoking and physical inactivity. The more risk factors a patient has the greater the risk of having a heart attack or stroke. Some risk factors are inherent and can not be changed, such as increasing age, family history, and gender. Several risk factors, however, can be addressed with lifestyle changes such as exercise and diet, as well as medications.

Many mistakenly believe that heart attacks occur as a result of clogged arteries or plaque buildup (stenosis). In fact, approximately 68 percent of coronary events are caused by plaque rupture and thrombosis. Thrombosis occurs when unstable plaque enters the blood stream and causes blood clots that block the coronary or carotid arteries resulting in a heart attack or stroke.

Fortunately, there is a simple new blood test that goes beyond traditional risk factors to help identify patients at increased risk of heart disease and stroke. The PLAC® Test is the only FDA-approved blood test that aids in assessing risk for both CHD and ischemic stroke associated with atherosclerosis. The PLAC Test measures levels of the risk marker lipoprotein-associated phospholipase A2 (Lp-PLA2), a cardiovascular-specific inflammatory enzyme implicated in the formation of vulnerable, rupture-prone plaque. Used in conjunction with the clinical evaluation of traditional risk factors, the PLAC Test helps identify people who may not be identified by traditional risk factors but who may benefit from more aggressive treatment programs.

While risk factor identification remains one of the most important approaches to preventing cardiovascular disease, traditional risk factors fail to identify many people at risk. In fact, approximately 50 percent of all coronary events strike people with low-to-moderate cholesterol levels, and about 20 percent occur in individuals with none of the four major risk factors (high cholesterol, high blood pressure, smoking, or diabetes). Therefore, hidden or additional cardiovascular risk factors are likely to be common and there is a critical need to identify all patients at-risk. The PLAC test appears to be sensitive and specific for identifying patients with vascular disease who are at increased risk for having a heart attack or ischemic stroke. It can be done using a simple blood test.

It’s important to talk to you physician to determine your risks. Patients interested in more information about the PLAC Test can visit www.plactest.com.

Mark J. Alberts, MD, Â is a professor of neurology at Northwestern University Medical School and the Director of the Stroke Program at Northwestern Memorial Hospital in Chicago.

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