5 tests to better predict heart disease risk:

A 12-lead EKG provides information about hypertrophy, or thickening of the heart muscle.
A coronary calcium scan, a low-radiation imaging test, identifies calcified plaque buildup in the arteries of the heart.

A blood test for C-reactive protein indicates inflammation.
A blood test for the hormone NT-proBNP indicates stress on the heart.
A blood test for high-sensitivity troponin T indicates damage to heart muscle.
The set of five tests not only expanded risk prediction to include the likelihood of heart failure and atrial fibrillation, but also proved to be a better predictor of heart attack and stroke than currently recommended approaches. Heart failure is a chronic condition in which the heart progressively weakens and atrial fibrillation is a heart rhythm problem. Both conditions have been increasing as the population ages.

"There has been a real need to bring modern science to the problem of heart disease risk prediction, which has relied on traditional risk factors for decades" said Dr. de Lemos, who holds the Sweetheart Ball?Kern Wildenthal, M.D., Ph.D. Distinguished Chair in Cardiology. "We wanted to determine whether advances in imaging and blood-based biomarkers could help us to better identify who was at risk for heart disease."

The added value of the test panel results from the careful selection of tests that were complementary but not redundant, Dr. Khera said.

"These five tests have all stood on their own already. And they each tell us something different about potential heart problems - they're additive. As a result, we are getting a good look at global cardiovascular disease risk," said Dr. Khera, who holds the Dallas Heart Ball Chair in Hypertension and Heart Disease.

The tests were combined in a simple scoring system with one point for each abnormal result. Compared with those with no abnormal tests, those with five abnormal results had more than a 20-fold increased risk of developing heart complications over the next 10 years.

The study was funded in part by a research grant from the National Space Biomedical Research Institute, a NASA-related consortium studying the health effects of long-term space flight.

"NASA is considering long-term missions, for example to Mars. Astronauts are highly trained people and there's a heightened investment in long-term missions. If someone has a cardiovascular event, that would be catastrophic," said Dr. Khera.

And what's useful for predicting astronauts' heart health is useful for the public.

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