Genetic tool to predict adult heart attack risk in childhood
People at high risk of a heart attack in adulthood could be identified much earlier in life with a one-off DNA test, according to new research published in the Journal of the American College of Cardiology.
Researchers from University of Leicester, University of Cambridge and the Baker Heart and Diabetes Institute in Australia used UK Biobank data to develop and test a powerful scoring system, called a Genomic Risk Score (GRS) which helps to identify people who are at risk of developing coronary heart disease prematurely because of their genetics.
Genetic factors are major contributors of someone’s risk of developing coronary heart disease – the leading cause of heart attacks. In today's health system, doctors identify those at risk by using scores based on lifestyle and clinical conditions associated with coronary heart disease such as cholesterol level, blood pressure, diabetes and smoking. But these scores are imprecise, age-dependent and miss a large number of people who appear ‘healthy’, but will still develop the disease.
The ‘big-data’ GRS technique factors in the 1.7 million genetic variants in a person’s DNA to calculate their underlying genetic risk for coronary heart disease.
The team analysed genomic data of nearly half a million people from the UK Biobank research project aged between 40-69 years. This included over 22,000 people who had coronary heart disease.
Professor Sir Nilesh Samani, Professor of Cardiology at the University of Leicester and senior study author said: At the moment we assess people for their risk of coronary heart disease in their 40’s through NHS health checks. But we know this is imprecise and also that coronary heart disease starts much earlier, several decades before symptoms develop. Therefore, if we are going to do true prevention, we need to identify those at increased risk much earlier.
“This study shows that the GRS can now identify such individuals. Applying it could provide a most cost-effective way of preventing the enormous burden of coronary heart disease, by helping doctors select patients who would most benefit from interventions and avoiding unnecessary screening and treatments for those unlikely to benefit.”
Study co-author Professor Panos Deloukas from the William Harvey Research Institute, Queen Mary University of London commented: "It was one of our objectives in the UK Biobank Cardiometabolic consortium - heart disease working group. The paper is a follow up of our Nature Genetics paper last year which focused on the discovery of risk variants. This is now looking at prediction and is using the totality of genetic information."
- Research paper: ‘Genomic Risk Prediction of Coronary Artery Disease in 480,000 Adults: Implications for Primary Prediction’ by Michael Inouye, Nilesh Samani et. JACC. doi: 10.1016/j.jacc.2018.07.079
- Find out about postgraduate courses at the William Harvey Research Institute, Queen Mary University of London, including in Genomic Medicine.