The finding, published Wednesday in the journal Science Translational Medicine, could potentially address "the greatest unmet need" facing cardiologists, said lead author Dr. Eric Topol, a cardiologist at the Scripps Translational Science Institute in San Diego. Though physicians can easily detect a heart attack that's already underway, every year tens of thousands of patients walk away from the doctor's office after having passed a stress test, only to suffer a devastating heart attack within a few weeks.
A heart attack occurs when an area of plaque ruptures in an artery, forming a blood clot that blocks blood flow to the heart, resulting in heart tissue damage.
Ruptures resulting from mild cholesterol buildups can lead to particularly deadly heart attacks, said Dr. Douglas Zipes, a cardiologist at the Indiana University School of Medicine in Indianapolis, because patients with such blockages are often asymptomatic, and — unlike people with larger blockages — are unlikely to have developed new blood vessels that can help bypass the obstruction.
Knowing that the endothelial lining has been damaged before a blood clot grows might allow physicians to predict onset of a heart attack or stroke, said Zipes, who was not involved in the study.
One key detail yet unknown is how long before a heart attack the circulating endothelial cells appear.
"Is it a day before? A week before? That would be good to understand," Harrington said.
It could become possible to develop a wearable device for constantly monitoring the blood for endoteliel cells that indicate earlier damage of blood vessels.
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