The findings suggest that this blood marker effectively detect a severe form of peripheral artery disease that narrows the arteries in the legs and increases the risk of heart attack and stroke.
Doctors monitor cardiovascular health by measuring blood pressure, cholesterol levels, and blood sugar, among other risk factors for cardiovascular disease. These indicators can assist in determining whether a person is at risk of having a heart attack or stroke. However, no blood test can correctly determine the degree to which an individual’s arteries are narrowing or at danger of occlusion.
Now, a team of researchers from Washington University School of Medicine in St. Louis have demonstrated that elevated blood levels of a specific protein effectively detect a severe form of peripheral artery disease that narrows the arteries in the legs and increases the risk of heart attack and stroke.
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The protein, circulatory fatty acid synthase (cFAS), is a saturated fatty acid synthesis enzyme. Until recently, it was believed that fatty acid synthase was located solely inside cells. According to the new study, fatty acid synthase circulates in the bloodstream and may have a significant role in the production of plaques associated with cardiovascular disease.
The results of the study were published in the journal Scientific Reports.
Around 12 million people in the United States have some kind of peripheral artery disease, which is characterized by a narrowing of the arteries in the legs, and around 1 million of these patients acquire a severe form called chronic limb-threatening ischemia. These patients frequently require vascular surgery to widen their peripheral arteries in order to increase blood flow to their legs. In severe circumstances, patients may require amputation of the afflicted leg.
These patients face the possibility of losing their legs, which would have a terrible effect on their quality of life, as well as their ability to walk, and around half of them die within the following two years, according to study authors.
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The authors of the study gathered blood samples from 87 patients prior to vascular surgery for persistent limb-threatening ischemia. The researchers discovered that cFAS levels in the blood were connected with the disease in an independent manner.
Type 2 diabetes diagnosis and smoking status were also significantly and independently associated with persistent limb-threatening ischemia. When all three of these indicators were combined, they were able to predict the presence of the disease with an accuracy of 83 percent.
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Additionally, the researchers discovered a correlation between cFAS levels in the blood and the fatty acid synthase concentration of plaque samples taken from the femoral artery, the main channel providing blood to the legs. Additionally, the researchers discovered that cFAS circulates in the bloodstream coupled to LDL, the so-called “bad” LDL cholesterol, raising an intriguing question.
Because LDL is more plentiful in the blood than cFAS, the crucial metric may not be LDL itself, but how much LDL carries cFAS.
The study authors previously demonstrated that blood cFAS levels are also increased in patients who have plaque accumulation in the carotid arteries, which carry blood to the brain. Additionally, this research established that the cFAS circulating in the blood originates in the liver. The research implies that LDL acts as a carrier for cFAS, which then contributes to plaque formation in critical arteries throughout the body.
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Additionally, the team is looking at cFAS as a potential target for future pharmacological therapy aimed at slowing plaque buildup and treating or preventing cardiovascular disease.
“There are drugs that inhibit fatty acid synthase, and we’re working on evaluating new ones that are more targeted,” said the authors.
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“None of them are ready for clinical trials in people for this purpose yet, but we’re using those drugs to test animal models of the disease to see if they actually decrease the buildup of plaque in the arteries. It would be wonderful to be able to practice precision vascular medicine — to tailor therapy to high-risk patients to reduce their risk of developing severe complications of cardiovascular disease.”
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The study authors are also collaborating with Washington University’s Office of Technology Management to develop a test kit for detecting cFAS in the blood, which will allow for earlier identification of high-risk individuals.
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Source: Scientific Reports, 2021; 11 (1) DOI: 10.1038/s41598-021-98479-7
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