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February 9, 1999
Penn Researchers Hone in on
Heart Disease Prevention by Taking a Closer Look at
Genetic Markers and Other Risk Factors
To what extent does a family
history of heart disease pose a risk for a future
heart attack? Can risk for a heart attack be
predicted by evaluating a person's genes? To help
answer these questions, researchers at the
University of Pennsylvania Medical Center are
taking a unique approach to studying the role of
genes in heart disease. In this innovative study,
an advanced, noninvasive imaging technique known as
Ultrafast CT scanning is being used to measure
coronary plaque in the arteries of healthy people
in order to investigate its relation to a variety
of different genes.
Although many risk factors for heart disease,
such as hypertension and high cholesterol, are well
known, they contribute to less than one-half of
coronary heart disease (CHD) cases. In fact, more
than half of all serious cardiac events - including
heart attack - occur in healthy people with no
previous symptoms. "The purpose of this study is to
evaluate a broader range of factors related to
premature CHD in people with a family history of
the disease," says Daniel J. Rader, M.D., the
study's principal investigator and director of
Preventive Cardiology and the Lipid Research Center
at Penn. "A search continues for better markers,
including specific genetic factors that cause CHD,
that will improve the prediction of individuals at
risk for heart disease, and allow for early
intervention."
The study will involve individuals who have a
family history of premature CHD, as well as their
siblings. The Ultrafast CT scan will be used to
detect and quantify coronary artery calcification,
a known specific marker for coronary plaque
build-up or atherosclerosis. The Ultrafast CT
obtains images in as little as 50 milliseconds -
literally, an image of the heart with each
heartbeat. Its advanced sensitivity for detecting
coronary plaque can indicate the presence of CHD
even before any symptoms have appeared, making it a
valuable research and clinical tool. In addition,
blood tests for laboratory analysis will be
performed, including DNA-based genetic analysis of
genes possibly causing early heart disease.
The identification of genes which contribute to
the development of heart disease will provide a
major tool for the understanding and prevention of
the disease, especially among susceptible
individuals with a positive family history of CHD.
This fundamentally new approach to studying risk
factors for heart disease could eventually lead to
the development of new genetically based tests to
predict premature CHD and give insight into new
genes which may be associated with the disease.
"There has not yet been a study directly
investigating the relationship between genetic
markers and coronary artery calcification,"
explains Rader. "A better understanding of this
association may allow for more accurate and earlier
identification of individuals at risk, thereby
facilitating earlier preventive intervention."
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