New Marker for Heart Trouble Found

Study ties it to inflammation in people with chest pain

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HealthDay Reporter

TUESDAY, Jan. 27, 2004 (HealthDayNews) -- A newly described molecular marker of inflammation is the best indicator yet of trouble for people who suffer chest pain serious enough to bring them to emergency rooms, German cardiologists report.

The molecule is placental growth factor (PIGF), named for the organ in which it was first detected. It is a major actor in the inflammatory process that has emerged in the last year or two as a major risk factor for heart attack, stroke and other cardiovascular conditions.

A study of 547 patients who came to the emergency room with acute chest pains found elevated levels of PIGF predicted a high risk of heart attack or death in the hospital and continuing problems for those who were discharged, says a report in the Jan. 28 issue of the Journal of the American Medical Association by doctors at Johann Wolfgang Goethe University in Frankfurt.

Studies of inflammation in cardiovascular disease have centered on a different molecular marker, C-reactive protein (CRP). And it is a useful indicator of risk for people with stable heart disease, says study author Dr. Christopher Heeschen, an associate professor for experimental medicine at Goethe University.

But because CRP is released by any inflammatory response, "it is sometimes very difficult to determine whether the CRP elevation is really related to inflammatory processes in the arterial walls," Heeschen says.

By contrast, PIGF is released only when the delicate endothelial cells that line artery walls become inflamed, a reaction that can cause severe chest pain, he says.

"In this setting, which is the real-world setting in the emergency room, PIGF was an extremely powerful predictor for early cardiovascular events, and that is what we want to know," Heeschen says.

The risk of heart attack or death in the next 30 days was more than triple for patients with severe chest pain who had high PIGF levels -- 21.2 percent, compared to 5.3 percent for those with normal levels, the researchers report.

But the role of PIGF in heart disease is still being defined, Heeschen says. "Currently, no data for patients with stable coronary heart disease are available," he says.

In addition, "no routine test for PIGF is available to date," he says. "It should take about a year from now before an assay is available."

PIGF also has gained the attention of cancer researchers working on ways to curb tumors by interfering with angiogenesis, the creation of new blood vessels that a cancer needs to grow, says Irwin Libeskind, president of Cell Sciences Inc., a Massachusetts biotechnology company that sells a recombinant form of the molecule.

"It stimulates the growth of endothelial cells, which line the blood vessels of a tumor," Libeskind explains.

The Cell Sciences product is not approved for human use, and "not too many people buy it, because it is a very new product," he says.

More information

You can learn what is known about the role of inflammation in cardiovascular disease from the American Heart Association and MedlinePlus.

SOURCES: Christopher Heeschen, M.D., associate professor, experimental medicine, Johann Wolfgang Goethe University, Frankfurt, Germany; Irving Libeskind, president, Cell Sciences Inc., Canton, Mass.; Jan 28, 2004, Journal of the American Medical Association

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