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Doctors may have new tool for gauging heart attack risk

Doctors might be able to gauge heart patients' risk of death or heart attack by measuring levels of a growth factor protein in their blood, a German study suggests.

The report adds the protein to a growing list of biomarkers for inflammation that could help predict a person's risk of heart disease and that can be detected through a simple blood test.

The newly recognized marker, called placental growth factor protein, or PlGF, has been shown to contribute to inflammation in the arteries. Animal research has shown that blocking its effects suppresses growth of fatty plaques in the arteries.

The latest findings, which appear in today's Journal of the American Medical Association, suggest that testing for PlGF might be more effective at predicting patients' risks than measuring some other inflammation markers, including C-reactive protein, or CRP.

That is because PlGF appears to be released primarily from cells inside blood vessel walls, whereas CRP levels might rise in response to inflammation or infection elsewhere in the body.

Still, the lead researcher, Dr. Christopher Heeschen of Johann Wolfgang Goethe University in Frankfurt, said more studies confirming the results are needed before doctors can rely on P1GF as an early warning sign.

The discovery of the protein's link to heart disease could also lead to new treatments that would protect against heart damage by blocking the protein's effects, Heeschen said.

The study involved 1,173 patients, mostly men, with either severe chest pain or mild heart attacks.

Blood tests showed high PlGF levels in more than 300 patients. Those patients were about three times more likely than those with low levels to die or have heart attacks within 30 days of their first symptoms.

Study: Communication on research needs improving

CHICAGO _ Sick children who participate in medical research often do so without their parents adequately understanding that the youngsters are randomly assigned to get the standard treatment or the experimental one being tested, a study found.

Such research generally is undertaken in hopes that experimental treatment will be more effective than standard therapy.

Parents' failure to understand the process probably reflects a lack of effective communication between doctors and parents rather than any ethical lapses, the study authors said.

The study involved 137 parents of children with leukemia treated at six children's hospitals nationwide.

Most youngsters with leukemia become participants in so-called randomized studies, in which children are randomly assigned to receive differing types of treatment or standard care, the study authors said.

Randomization was explained to most parents studied, but half of them did not understand the concept, and those who did not understand were more likely to allow their children to participate.

The study appears in today'sJournal of the American Medical Association.

New tremor disorder

discovered by researchers

CHICAGO _ Researchers say they have discovered a tremor disorder in adults that is often mistaken for Parkinson's or Alzheimer's and is linked to a common cause of mental retardation in children.

The disorder, which can cause memory loss, might affect more than 1 in 3,000 adults, mostly men, according to scientists at the University of California at Davis.

There is no known cure for the disorder, but its symptoms can sometimes be treated with some of the same medications used against Parkinson's and Alzheimer's.

The researchers have named the disorder Fragile X-associated Tremor/Ataxia Syndrome, or FXTAS.

"FXTAS may be one of the most common causes of tremor and balance problems in the adult population, yet it is being misdiagnosed because neurologists who see adults with movement disorders are not aware that they need to look for a family history of fragile X in grandchildren or to check for carriers of the gene mutation," said study co-author Randi Hagerman, medical director of UC-Davis' MIND Institute.

The findings appear in today'sJournal of the American Medical Association.

Warning signs

It is well-established that high levels of cholesterol in the blood raise the risks of heart attacks and stroke. Other substances in the blood researchers think might also be warning signs when present at elevated levels:

+ C-REACTIVE PROTEIN: Appears in the blood as a result of inflammation or infection anywhere in the body.

+ PLACENTAL GROWTH FACTOR, OR PLGF. Protein involved in inflammation.

+ CD40 LIGAND. Protein that forms in blood platelets in response to inflammation.

+ MYELOPERIXODASE, MPO. An inflammation-related protein in white blood cells.

+ SERUM AMYLOID A. Inflammation-related protein.

+ INTERLEUKIN 6. Inflammatory protein.

+ HOMOCYSTEINE: Amino acid formed when the body breaks down a substance found in protein-rich food. Elevated levels are thought to irritate the blood vessels.

+ FIBRINOGEN: Protein involved in the formation of blood clots.

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