New blood test predicts risk of heart attack and stroke with twice previous accuracy

Scientists have developed a blood test that can predict whether someone is at high risk of a heart attack, stroke, heart failure or dying from one of these conditions within the next four years.

The test, which relies of measurements of proteins in the blood, has roughly twice the accuracy of existing risk scores. It could enable doctors to determine whether patients’ existing medications are working or whether they need additional drugs to reduce their risk.

“I think this is the new frontier of personalised medicine, to be able to answer the question, does this person need enhanced treatment? And when you’ve treated someone, did it actually work?” said Dr Stephen Williams at SomaLogic in Boulder, Colorado, who led the research.

It could also be used to hasten the development of new cardiovascular drugs by providing a faster means of assessing whether drug candidates are working during clinical trials.

The test is already being used in four healthcare systems within the US and Williams hopes it could be introduced to the UK in the near future. “The NHS is definitely on our radar screen, and we are talking to people about how it might work,” he said.

Whereas genetic tests can provide an idea of someone’s risk of certain diseases, protein analysis can provide a more accurate snapshot of what someone’s organs, tissues and cells are doing at any given moment in time.

Williams and his colleagues used machine learning to analyse 5,000 proteins in blood plasma samples from 22,849 people and identify a signature of 27 proteins that could predict the four-year likelihood of heart attack, stroke, heart failure or death.

When validated in 11,609 individuals, they found their model was roughly twice as good as existing risk scores, which use a person’s age, sex, race, medical history, cholesterol and blood pressure to assess their likelihood of having a cardiovascular event. The results were published in Science Translational Medicine.

Importantly, the test can also accurately assess risk in people who have previously had a heart attack or stroke, or have additional illnesses, and are taking drugs to reduce their risk, which is where existing risk prediction scores tend to fall down.

“There wouldn’t be an issue if everyone was the same. But the problem is that you can follow the treatment guidelines and some people will go back to having the same risks as a 40- or 30-year-old, whereas others are going to have another event within the next year, and they look the same from the outside,” Williams said.