Plasma ceramides and cardiac risk

Mark Nicholls reports on a new blood test that may predict cardiovascular events in patients with or without coronary artery disease A new type of blood test could be used to help physicians identify which patients with and without evidence of coronary blockages are at risk of a cardiovascular event. Developed by researchers at Mayo Clinic in the USA, the test measures blood concentrations of plasma ceramides, a class of lipids that are highly linked to cardiovascular disease processes. It is believed to be sensitive enough that even individuals with normal levels of low-density lipoprotein (LDL) but still at risk may be identified. Ceramides are lipids and, like cholesterol, are carried by LDL and become embedded in the arterial wall of atherosclerotic plaques. But as Dr Jeff Meeusen, co-director of Cardiovascular Laboratory Medicine at Mayo Clinic, explained: ‘Unlike cholesterol, which is mostly inert (both in the LDL and in the artery wall), ceramides are biologically active signal molecules that contribute to the pathophysiology of heart disease.’ Ceramides in the LDL increase the rate of lipoprotein infiltration across vascular endothelium, while ceramides in the vascular intima stimulate cytokines that draw inflammatory immune cells to the plaque site.