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SIMPLE TESTS CAN



Published: Fri, February 14, 2003 @ 12:00 a.m.


SIMPLE TESTS CAN
PROVIDE ANSWERS
Many tests are used to predict heart-disease risk, including two relatively new blood tests measuring C-reactive protein, which at high levels indicates inflammation, and homocystine, an amino acid thought to double the risk of heart disease when elevated.
C-REACTIVE PROTEIN
Pro: Inflammation could be a chief cause of heart attacks, especially those that happen with no warning, studies suggest. Doctors measure levels of C-reactive protein in the blood to determine a patient's amount of inflammation. Many doctors think it offers great promise in reducing heart-disease deaths with a simple, inexpensive blood test. Aspirin and cholesterol-lowering drugs reduce inflammation.
Con: Any infection, from a cold to a urinary-tract infection, could boost C-reactive protein levels, causing undue worry.
HOMOCYSTINE
Pro: Studies continue to suggest a direct link between high homocystine levels, also detected with an inexpensive blood test, and heart disease. Levels can be lowered easily and inexpensively with folic acid and B-complex.
Con: A negative test does not rule out heart disease, as homocystine level is only one factor.
CHOLESTEROL
Pro: Still considered reliable markers for heart disease, blood-fat levels can be monitored easily. For those at high risk, a more expensive but more specific test can be ordered. Acceptable LDL (bad fat) levels for people at high risk were lowered from 130 to 100. HDL (good fat) should be at least 40, and triglyceride levels should be below 150. Total cholesterol for the general population should be below 200.
Con: The average total cholesterol level among emergency-room heart-attack patients is 208, considered borderline.
STRESS TESTS, EKGS, ANGIOGRAMS
Pro: The older tests can help doctors decide who is in immediate danger (EKG) or has serious artery blockages requiring aggressive treatment (stress test, angiogram).
Con: These tests identify only those with progressed heart disease.


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