Many are surprised to hear that their hearts are the organ most likely to fail them. The reality is, despite all the amazing advances of medicine, the fragility of the human heart remains a key deterrent to human health. Until the last decade, there had been little in the way of preventative screening for the internal processes of the cardiovascular system. However, a recent paradigm shift in preventive cardiology, by way of novel biomarker screening and genetic testing, has altered the nature of preventative treatment through simple blood tests in the setting of your primary care doctor’s office.
One such test is an ultra-sensitive immunoassay technology that measures the release of Troponin I (cTnI), a biomarker released when the heart muscle is stressed. An elevated cTnI may mean you are at higher risk for having a heart attack or developing heart failure. Troponin I enables your doctor to identify chronic injury in asymptomatic individuals with unrecognized heart disease who are at high risk for adverse cardiovascular outcomes. This test can be tracked over time to fine-tune your heart health. I find this marker especially important for female patients, as it is well-known that females often do not express symptoms before experiencing a heart attack. Testing high-sensitivity troponins better equips us to prevent such unfortunate outcomes.
Another available test analyzes inflammation, the body’s natural response to injury. The inflammatory markers measured are Interlukins 6 & 17A and TNF-α (tumor necrosis factor- alpha), CRP-hs, and LpPla2. Increased inflammatory markers over time may be a sign that your blood vessels are under attack, resulting in the passage of cholesterol into the walls of your arteries, plaque build-up, and clogged arteries, while increasing your risk of heart disease.
A simple blood test, Corus CAD, now offers a non-invasive way to assess whether you are suffering from obstructive coronary artery disease (CAD). Before the availability of this test just 5 years ago, the initial screening process for a patient suspected to have artery disease consisted of invasive and time consuming lab studies conducted outside of the doctor’s office. The initial test consisted of more invasive procedures that use radiation, dyes, and even surgical procedures. Corus CAD, conversely, measures the activity of specific genes in the blood that change when there is a significant blockage in the heart arteries. Corus CAD is unique in that it is the first sex-specific test for coronary artery disease which takes into account the key biological differences between men and women.
Heart disease often does not act alone, and for that reason, many preventative doctors standardly run cardiometabolic tests to assess the future risk for diabetes. Besides the traditional blood sugar testing methods, new hormones such as adiponectin and leptin are included. These hormones regulate appetite, calorie burning power, inflammation, and cell efficiency. Abnormal results in these cardiometabolic tests also provide new insights when individuals have difficulty losing weight, which can also increase their risk for heart disease.
Despite their effectiveness, not every doctor has elected to utilize these new tests for their patients. Although not yet a standard of care, they are being readily used by integrative and preventative medical professionals.
“Just as our government has a system of checks and balances between the Senate and the House of Representatives, so should our practice of medicine,” says board-certified integrative medicine doctor Hessam Mahdavi, MD of Eisenhower Medical Center. “There is a danger in relying on just one main test, such as an exercise stress test, to assess the true risk of heart disease. It’s always good to get a comprehensive viewpoint, including advanced biomarker testing, to assess the true status of heart disease.”
As a proactive patient, you can begin the conversation with your primary care doctor about what tests they offer to assess your true cardiac risk profile. Ask about tests such as Singulex, HDL labs, Corus CAD, Genova, or Atherotech advanced cardiometabolic testing, which are only some of the many preventative tests now available. The testing can be run through your insurance and is often completely covered or available for a reasonable co-pay.
The latest developments in preventative cardiac screening allow us as primary care providers to make more accurate assessments of our patients’ true health risks, and to better develop a treatment plan unique to each person’s specific imbalances. The tests covered in this article, when applied to a preventative treatment philosophy, can be invaluable tools for early detection of problems, as well as, maintenance of cardiovascular health.
Dr. Nicole Ortiz is the co-owner of Live Well Clinic and a Naturopathic Doctor with a focus in preventative cardiology. For more information call (760) 771.5970 or visit www.livewellclinic.org.
Sources: 1) Increased cardiac troponin I as measured by a high-sensitivity assay is associated with high odds of cardiovascular death: the Minnesota Heart Survey. Apple FS, Steffen LM, Pearce LA, Murakami MM, Luepker RV Clin Chem. 2012 May;58(5):930-5; 2) PREDICT Study. Clinical trial summary found at: www.clinicaltrials.gov, NCT00500617; 3) Clinical trial summary found at: www.clinicaltrials.gov, -NCT01117506.http://www.singulex.com/understand-health-risks-and-test-results