Date: 09 October 2018
People at high risk of a heart attack in adulthood could be spotted much earlier in life with a one-off DNA test, according to new research supported by the NIHR.
Researchers at the NIHR Biomedical Research Centres in Leicester and Cambridge analysed genomic data of nearly half a million people aged between 40-69 years from the UK Biobank. This included over 22,000 people who had coronary heart disease.
This data was used to develop and test a powerful scoring system that can identify people who are at risk of developing coronary heart disease prematurely because of their genetics.
The Genomic Risk Score (GRS) takes into account 1.7 million genetic variants in a person’s DNA to calculate their underlying genetic risk for coronary heart disease.
Genetic factors are major contributors of someone’s risk of developing coronary heart disease – the leading cause of heart attacks. To identify those at risk, doctors currently use scores based on lifestyle and clinical conditions associated with coronary heart disease, but these scores are imprecise and miss a large proportion of people who appear ‘healthy’ but will still develop the disease.
The GRS was better at predicting someone’s risk of developing heart disease than each of the classic risk factors for coronary heart disease alone.
The research, published in Journal of the American College of Cardiology, showed that people with a GRS in the top 20 percent of the population were over four-times more likely to develop coronary heart disease than someone with a score in the bottom 20 percent.
Crucially, the GRS can be measured at any age, including childhood, because your DNA does not change with age. This means that those at high risk can be identified much earlier than is currently possible and can be targeted for prevention with lifestyle changes and, where necessary, medicines.
Senior author Professor Sir Nilesh Samani, Cardiovascular Theme Lead at the NIHR Leicester Biomedical Research Centre and Medical Director at the British Heart Foundation, 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.”
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