Genetic testing identifies coronary artery disease patients who are at highest risk for sudden cardiac death.
A new research article shows a precision medicine technique is promising for identifying patients at highest risk for developing sudden cardiac death—an electrical malfunction of the heart that causes the organ to stop beating.
Sudden and/or arrhythmic death (SAD) is a leading cause of death in the United States, causing about 300,000 deaths annually. Internationally, SAD is responsible for 15% to 20% of all deaths. SAD is often associated with coronary artery disease.
The new research article, which was published this week by the Journal of the American College of Cardiology, is based on data collected in the PRE-DETERMINE study of more than 5,500 patients with coronary artery disease. The researchers used a polygenic risk score to identify patients at highest risk for SAD. A precision medicine technique, polygenic risk scores combine the different versions of many genes that an individual has that are related to a specific disease.
The researchers used a polygenic risk score that has been successful in predicting coronary artery disease. They found that coronary artery disease patients who did not have severely impaired heart function had the highest polygenic risk score. These patients had a 77% increased risk for SAD.
The first author of the study says the research is a significant step forward in SAD research. "In order to better predict and prevent sudden cardiac death, we must first understand the genetic connection between it and coronary artery disease. We found incorporating information from this genetic risk score improved our ability to predict sudden death beyond the contributions of other known risk markers. Most exciting, the genetics were able to identify patients where sudden death was more likely to limit their life expectancy," Roopinder Sandhu, MD, MPH, an interventional cardiology and cardiac electrophysiology specialist at Cedars-Sinai, said in a prepared statement.
SAD is different than myocardial infarctions—commonly called heart attacks. In most heart attacks, clogged coronary arteries reduce blood flow to the heart. Typically in SAD, there is the sudden onset of erratic electrical activity in the heart that decreases the pumping function of the organ. There usually is little or no warning of SAD, and death occurs within minutes unless resuscitation is performed.
The senior author of the study says the polygenic risk score could be used in the future to identify patients who could benefit most from lifesaving therapies such as an implantable cardioverter-defibrillator.
"This study indicates there is opportunity to identify patients at highest risk for sudden cardiac death, and then offering meaningful, preventative treatment solutions like a defibrillator. Based on our pivotal research, we now have the foundation to achieve this," Christine Albert, MD, MPH, chair of the Department of Cardiology in the Smidt Heart Institute at Cedars-Sinai, said in a prepared statement.
Christopher Cheney is the CMO editor at HealthLeaders.
KEY TAKEAWAYS
Typically in sudden cardiac death, there is the sudden onset of erratic electrical activity in the heart that decreases the pumping function of the organ.
Researchers find that coronary artery disease patients who did not have severely impaired heart function had the highest polygenic risk score, with a 77% increased risk for sudden cardiac death.