DNA Blood Test Identifies Serious Heart Problems

DNA fragments in the blood may help physicians quickly learn if chest pain means that the patient has narrowed heart arteries, which lead to coronary heart disease.

The DNA particles are shed by neutrophils, which are important immune cells that play a vital role in many diseases, and which become inappropriately active during the advanced stages of severe atherosclerosis.

Scientists at the Boston Children’s Hospital (MA; USA) studied 282 patients, ages 34 to 83, who reported chest pain and were suspected of having coronary artery disease. After computed tomography imaging to look for hardened, or calcified, buildup in the blood vessels that supply the heart, blood samples also were tested for genetic material. This included double-stranded DNA, nucleosomes, citrullinated histone H4, and myeloperoxidase–DNA complexes, considered in vivo markers of cell death. They also measured various plasma markers of coagulation activation and inflammation.

Plasma double-stranded DNA, nucleosomes, and myeloperoxidase–DNA complexes were positively associated with thrombin generation and significantly elevated in patients with severe coronary atherosclerosis or extremely calcified coronary arteries. These particles are potentially markers of disease, and may eventually help identify patients with severely narrowed coronary arteries, predict how many coronary vessels were affected, and even whether a patient is likely to suffer a serious heart problem or heart-related death. About half the patients in their study were followed for 18 months or more.

The investigators suggested that it was plausible to think that the DNA particles themselves might contribute to the progression of atherosclerosis and the risk of dangerous blood vessel blockages. Julian I. Borissoff, MD, PhD, the lead author of the study, said, “The more the ongoing cell death, which is normal with inflammation, the more DNA enters the circulation and more plaque builds up. Cells get damaged, and the products released from the damaged cells can cause even more damage and inflammatory responses.” If the markers do pan out, they have the potential to help doctors efficiently pinpoint which patients with chest pain are likely to have coronary artery disease rather than some other problem causing the discomfort. The study was published on July 1, 2013, in the journal Arteriosclerosis, Thrombosis, and Vascular Biology.

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