Researchers have found that CT scans are more accurate than genetics in predicting a middle-aged person’s risk of heart disease, such as a heart attack. The study was published in the journal “JAMA”.
“Finding the best way to identify who is at risk for developing heart disease can help determine what needs to be done to reduce the risk,” said lead study author Dr. Sadiya Khan, assistant professor of medicine and preventive medicine at Northwestern University Feinberg School.of Medicine and Cardiologist of Northwestern Medicine.
“This finding may help doctors and patients manage the risk of heart disease, which is the leading cause of death in the US.”
Conventional measurements of risk factor levels, such as blood pressure and cholesterol, are used by doctors to determine the likelihood of developing coronary heart disease, or blockage of the arteries in the heart. However, some people can experience a heart attack or a related heart problem without any of these conventional factors causing it.
Because heart disease risk can be inherited, researchers were optimistic that a person’s genetics could inform who is most at risk, Khan said. It was thought that the polygenic risk score a compilation of more than 6 million commonly occurring genetic variants associated with heart disease could be used as a potential breakthrough for personalized medicine.
But a new Northwestern study directly compares genetics and CT scans for coronary artery calcium and shows that the CT scan does a better job than genetics at predicting heart disease risk in middle age.
“These findings support the recommendation to consider CT screening to calculate heart disease risk in middle-aged patients if their risk score is uncertain or in the intermediate range,” Khan said.
The study used data from 3,208 adults from two cohort studies, one in the US and one in Rotterdam, the Netherlands. The investigators used data on heart disease risk factors (smoking status, cholesterol levels, blood pressure), genetics, and CT scan data to estimate the risk of developing heart disease. Study monitoring up to 17 years.
The investigators looked at how the use of CT scans or polygenic risk scores affected the risk predicted in individuals based on conventional risk factors blood pressure and cholesterol and whether the addition of either of these markers (CT or genetics) put them at a different risk category. Low risk means someone has less than a 7.5% risk of developing heart disease in the next 10 years. If it is above 7.5 percent, statins are recommended.
The use of genetic data did not affect a person’s risk category based on their conventional risk factors (blood pressure and cholesterol). But only when considering a CT scan did half of the study participants move into the high-risk group.
“Data from CT scans can help identify individuals who may benefit from drugs such as statins to reduce the risk of heart disease,” Khan said.
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