June 27, 1996
Media Contact: John Cramer
Phone: (410) 955-1534

A newly discovered inherited risk factor for blood clots may have played an important role in fatally damaging the heart of Sergei Grinkov, the Olympic gold medalist figure skater from Russia who died last year at age 28, according to Johns Hopkins scientists.

The finding dramatically underscores the importance of the new risk factor in silent heart disease, particularly in younger people who appear healthy but who have relatives with premature coronary artery disease, say researchers.

The Hopkins team recently tested the skater's DNA from a blood sample taken when he was admitted to the hospital after collapsing on the ice on Nov. 29. The tests revealed that Grinkov had the genetic risk factor, called PlA2, which may promote clots that block those blood vessels in the heart that are narrowed by fatty deposits, say Pascal J. Goldschmidt, M.D., and Paul F. Bray, M.D., associate professors of cardiology. The finding is reported in the June 29 issue of The Lancet.

A recent Hopkins study discovered that PlA2, the first platelet risk factor to be identified, may be a faulty form of an adhesive protein on the surface of platelets, the cells required for normal blood clotting. The protein may cause the platelets to stick together too easily, creating a plug in a narrowed passage that cuts off blood supply to the heart, especially in people under age 60.

Grinkov, whose father at age 52 also died without warning of an apparent heart attack, appeared healthy and was training actively, but an autopsy revealed he had severe coronary artery disease, an enlarged heart and suffered a mild heart attack about five hours before collapsing. The heart attack triggered ventricular fibrillation, or the chaotic heart rhythm that caused his death.

"In spite of the autopsy findings, he never sought medical attention for a cardiac problem," says Goldschmidt. "His risk for premature coronary artery disease was very low; he was not a smoker, did not use drugs or medications, did not have high blood pressure or diabetes, had normal cholesterol and lipid levels and he trained several hours a day."

Further research into PlA2 and other biological and environmental factors that interact to cause coronary artery disease should help detect people who are the highest risk for heart attacks and perhaps prevent thousands of deaths each year, says Goldschmidt. PlA2 occurs in about 20 percent of the population but can be detected in a simple blood test and may eventually be added to the list of major risk factors for heart disease, the nation's leading killer, he says.

"People testing positive for PlA2 could take anti-clotting medication that specifically targets the problem, although aspirin may be sufficient to the do the job," Goldschmidt says. "Moreover, traditional approaches such as exercise, lowering cholesterol and not smoking remain the best ways to prevent heart disease."

Hopkins has created a thrombosis center to continue research into PlA2's role in heart attacks and has proposed naming PlA2 the "Grinkov risk factor" in honor of the skater.

-- JHMI --
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