Five simple medical tests together provide a broader and more accurate assessment of heart–disease risk than currently used methods, cardiologists at UT Southwestern Medical Center found.

Combined, results from the five tests: an EKG, a limited CT scan, and three blood tests better predict who will develop heart disease compared with standard strategies that focus on blood pressure, cholesterol, diabetes, and smoking history, researchers reported.

This set of tests is really powerful in identifying unexpected risk among individuals with few traditional risk factors. These are people who would not be aware that they are at risk for heart disease and might not be targeted for preventive therapies, said Dr. James de Lemos, Professor of Internal Medicine.

The five tests, and the information they provide:

• 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. Troponin testing is regularly used by hospitals to diagnose heart attacks, but high–sensitivity troponin fine–tunes that measure, pointing to small amounts of damage that can be detected in individuals without any symptoms or warning signs.

Four of the five tests are currently readily available and the fifth high–sensitivity troponin T will be available soon.

Researchers used data from two large population studies, including the Dallas Heart Study, that each followed a large group of healthy individuals for more than a decade. Their study, which appears in the journal Circulation, was partly funded by NASA to develop strategies for predicting heart disease in astronauts.

The new study focused on a broader spectrum of cardiovascular disease events rather than only those related to cholesterol plaque buildup, as traditional risk assessment does.

“A major focus of this study is to expand the scope of risk prediction beyond just heart attack and stroke. We believe that people are interested in the whole portfolio of heart problems that can develop including heart failure and atrial fibrillation, said Dr. Amit Khera, Professor of Internal Medicine and Director of UT Southwestern Preventive Cardiology Program.

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.