New Test Could Help Identify Patients That Would Benefit From Blood Thinners
Currently, blood-thinning medications are only prescribed to patients who have already had a heart attack or stroke, as the drugs can cause serious bleeding.
A new blood test called TRIPLE Score could help identify patients who would most likely benefit from preventive medication, according to the results of a study published in Circulation Research. Currently, blood-thinning medications are only prescribed to patients who have already had a heart attack or stroke, as the drugs can cause serious bleeding for people who have not at either event.1,2
There are 2 main types of blood-thinning medication: antiplatelets and anticoagulants. | Image Credit: joyfotoliakid | stock.adobe.com
"Around 100,000 heart attacks occur each year in the UK, despite significant progress in preventing them. We must think of smarter ways to use drugs like aspirin if we are going to bring this number down. Our new test will help [physicians] make sure that patients receive the best treatment and keep their quality of life. Next, we aim to make the test even easier to use by developing a finger prick test, so that it [is] as simple as measuring blood glucose,” Alexander Bye, researcher at the University of Reading, said in a release.2
There are 2 main types of blood-thinning medication: antiplatelets and anticoagulants. Antiplatelet therapy is typically the first blood thinner that is used after a heart attack or stroke, which could include aspirin, clopidogrel, and sometimes dipyridamole. Anticoagulants are used for people with heart conditions such as atrial fibrillation or metal heart valve replacement, which could include apixaban, dabigatran, edoxaban, and rivaroxaban.3
Investigators developed the thrombotic reactivity indicator using platelet GPVI CD36 (cluster of differentiation 36) expression and age score, which can predict platelet hyperreactivity associated with increased in vitro thrombus formation. Investigators stated the test “presents a novel method for stratifying patients based on a platelet function phenotype that could enable the identification of high-risk patient populations for personalization of antiplatelet therapy.”1
Investigators identified the platelet function by using an in vitro model of arterial thrombosis in a healthy cohort. They found that the thrombus formation was correlated significantly with platelet sensitivity to the GPVI agonist CRP-XL, leading investigators to believe CRP-XL sensitivity could be a biomarker. Because of these findings, the investigators developed the TRIPLE Score that incorporated age, HPVI, expression, and CD36 expression each score 1, and a total score of 2 or greater to predict high CRP-XL sensitivity.
Blood samples were collected from 252 patients who had suspected coronary artery disease. The score predicted that approximately 36% of patients would have high CRP-XL sensitivity. Investigators found these patients had greater measured sensitivity to CRP-XL compared to those with normal sensitivity. Furthermore, those who had higher CRP-XL sensitivity also had larger thrombi in vitro.1
“This test could transform heart attack prevention in the NHS. Right now, we're caught in a difficult position—we have medications that can prevent heart attacks, but we can't safely give them to everyone who might benefit because of bleeding risks. With this new test, we can finally identify which patients would benefit most from preventive treatment. For cardiology departments across the country, this means we could protect thousands of at-risk patients while potentially saving the NHS millions in emergency care costs,” Neil Ruparelia, DPhil, FRCP, FESC, cardiologist at Royal Berkshire Hospital, said in the news release.2
