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One-off DNA test could predict heart attack risk in childhood
People at high risk of a heart attack in adulthood could be
spotted much earlier in life with a reasonably inexpensive,
one-off DNA test, according to research funded, among
others, by the British and Australian heart foundations.
An international team led by researchers from the
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 can identify
people who are at risk of developing coronary heart disease
prematurely because of their genetic make-up.
Genetic factors have long been known to be major
contributors of someone’s risk of developing coronary heart
disease – the leading cause of heart attacks. Currently, to
identify those at risk, doctors use 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 proportion of people who appear ‘healthy’,
but will still develop the disease.
The ‘big-data’ GRS technique takes into account 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, aged
between 40 and 69 years, from the UK Biobank research
project. This included over 22 000 people who had coronary
heart 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 ability of the GRS to
predict coronary heart disease was also largely independent
of these known risk factors. This showed that the genes that
increase the risk of coronary heart disease don’t simply work
by elevating blood pressure or cholesterol, for example.
People with a genomic risk score in the top 20% of the
population were over four times more likely to develop
coronary heart disease than someone with a genomic risk
score in the bottom 20%. In fact, men who appeared healthy
by current NHS health check standards but had a high
GRS were just as likely to develop coronary heart disease
as someone with a low GRS and two conventional risk
factors such as high cholesterol or high blood pressure. These
findings help to explain why people with healthy lifestyles
and no conventional risk factors can still be struck by a
devastating heart attack.
continued on page 74…