New test could optimise preventive treatment for heart attacks

A simple scoring system could revolutionise how doctors prevent heart attacks and strokes by identifying patients most likely to benefit from preventive medications, according to new UK research that has been published in the journal Circulation Research.

The breakthrough test, called the TRIPLE Score, measures specific proteins on blood platelets along with the patient’s age to help doctors make more informed decisions about prescribing blood-thinning medications such as aspirin and clopidogrel. Currently, blood-thinning drugs are only given to patients who have already had a heart attack or stroke, as they can cause serious bleeding in some people — meaning doctors have been unable to prescribe these potentially life-saving drugs preventively to at-risk patients.

“Around 100,000 heart attacks occur each year in the UK, despite significant progress in preventing them,” said lead author Dr Alexander Bye, from the University of Reading. “We must think of smarter ways to use drugs like aspirin if we are going to bring this number down.”

The study team found that their new scoring system successfully identified patients whose blood was more likely to form clots in laboratory tests. The results also aligned with existing risk scores that doctors use to predict a patient’s likelihood of having a heart attack in the next 10 years.

The test requires only a small blood sample and could be developed into a straightforward tool that any healthcare provider could use, not just specialists. It could eventually be used at the point of care, with Bye noting that “we aim to make the test even easier to use by developing a finger prick test, so that it as simple as measuring blood glucose”.

Professor Neil Ruparelia, a cardiologist at Royal Berkshire Hospital who was involved in the study, said the test could transform heart attack prevention in the UK.

“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,” he said. “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.”

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