One of the investigators, Dr Sekar Kathiresan from the Consortium, said: "Since we already have effective ways to reduce heart-attack risk, individuals at higher genetic risk may benefit from earlier intervention, something that needs to be tested in future studies."
Other studies reported in the journal included one from the Universite Pierre et Marie Curie in Paris which newly identified a new gene cluster (of three genes) as a possible susceptibility site for coronary artery disease. This study, unlike the first, compared individual and reference groups of SNPs (known as haplotypes).
Adding the studies together, the results suggest the identification of several new gene sites (loci) which appear to affect the risk of coronary heart disease and early heart attack. So far, the added risk from any abnormality in these gene sequences seems small, but the genomic association seems clear. Furthermore, there seems no specific theme to the SNPs involved, suggesting that, while the expression (phenotype) of heart disease and infarction may be consistent, the pathways of risk may be multiple at the genetic level.
Speaking on behalf of the European Society of Cardiology, Professor Thomas Lüscher from the University of Zurich in Switzerland agreed that risk stratification via genetic pathways in coronary heart disease is an important future approach, but warned that these latest results reported in Nature Genetics were from case-control and not prospective studies. He said: "The next stage is to confirm the results in a prospective cohort to find out if they really do provide the same sort of prognostic information we already have from the classical risk factors."
Professor Lüscher added that there is also a need to discover what the SNPs and gene clusters are doing biologically. "We have to find out what's going on at the cellular level as well," he said. "Several of the SNPs have been linked to cholesterol metabolism in the liver, but there are some new ones here associated with coronary artery disease and atherosclerosis.
"This is important work but we need further evidence with statistical power and biological plausibility."
The European Society of Cardiology (ESC):
The ESC represents nearly 53,000 cardiology professionals across Europe and the Mediterranean. Its mission is to reduce the burden of cardiovascular disease in Europe.
The ESC achieves this through a variety of scientific and educational activities including the coordination of: clinical practice guidelines, education courses and initiatives, pan-European surveys on specific disease areas and the ESC Annual Congress, the largest medical meeting in Europe. The ESC also works closely with the European Commission and WHO to improve health policy in the EU.
The ESC comprises 3 Councils, 5 Associations, 19 Working Groups, 50 National Cardiac Societies and an ESC Fellowship Community (Fellow, FESC; Nurse Fellow, NFESC). For more information on ESC Initiatives, Congresses and Constituent Bodies see www.escardio.org.
European Society of Cardiology, The European Heart House 2035 Route des Colles, B.P. 179 - Les Templiers, Sophia Antipolis F-06903 France
1. See Myocardial Infarction Genetics Consortium. Genome-wide association of early-onset myocardial infarction with single nucleotide polymorphisms and copy number variants. Nat Genet 2009; DOI: 10.1038/ng.327.
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