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Early identification of cardiovascular risk using genomics and proteomics

Nature Reviews Cardiology volume 7, pages 309–317 (2010)Cite this article

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Abstract

Coronary heart disease (CHD) will soon become the leading cause of death and morbidity in the world. Early detection and treatment of CHD is thus imperative to improve global health. Atherosclerosis of the coronary arteries is a complex multifactorial disease process involving multiple pathways that can be influenced by both genetic and environmental factors. With the recent advances in genomics and proteomics, many new risk factors with small-to-moderate effects are likely to be identified. Additionally, individualized risk stratification and targeted therapy may become feasible; each individual could potentially be assessed with a panel of tests for genomic and proteomic markers and, on the basis of the individual's composite risk profile, preventive and therapeutic steps could then be undertaken. With a multimarker approach, it may also be possible to identify alterations in pathways involved in atherogenesis, rather than focus on individual risk factors. In this article, we use the specific example of atherosclerosis to discuss the role of genomics and proteomics in cardiovascular risk assessment.

Key Points

  • Conventional risk factors for atherosclerosis are prevalent in much of the general population and, therefore, available risk-prediction algorithms based on such risk factors have less than desired accuracy

  • New genomic and proteomic markers are likely to have an important role in refining cardiovascular risk assessment, thereby permitting individualized risk stratification and targeted therapy

  • Genome-wide association studies have identified variants that have modest effects on disease propensity; sequencing of entire genomes, or parts thereof, might allow identification of rare variants with stronger effects

  • Proteomic discovery technology is improving and holds promise for identifying new biomarkers that will refine cardiovascular risk stratification

  • In the future, individuals could potentially be assessed with a panel of tests for the many new genomic and proteomic markers that each have small-to-moderate effects

  • A multimarker approach might also enable us to identify alterations in specific pathways of atherogenesis as a means to assess cardiovascular risk, rather than assessing risk by focusing on individual risk factors

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Figure 1: Flow diagram illustrating the use of GWAS to identify new genetic markers.
Figure 2: Flow diagram illustrating the use of MS to identify new protein biomarkers.

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Acknowledgements

This work was supported in part by grants HL81331 and HG04599 from the NIH, USA, and a generous gift from the Marriot family.

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  1. Division of Cardiovascular Diseases, Mayo Clinic, 200 First Street SW, Rochester, 55905, MN, USA

    Iftikhar J. Kullo & Leslie T. Cooper

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Kullo, I., Cooper, L. Early identification of cardiovascular risk using genomics and proteomics. Nat Rev Cardiol 7, 309–317 (2010). https://doi.org/10.1038/nrcardio.2010.53

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