Article by Sharon Rosen
Heart disease can sometimes be a silent killer. Many of us know seemingly healthy people who’ve suddenly or unexpectedly had a heart attack. It can be shocking when people who are at a a healthy weight and exercise regularly die from heart disease that they never knew they had. Many forms of heart disease can be prevented or treated with healthy lifestyle changes. Physicians are turning to genetic testing to help identify whether a patient is at risk for developing the disease or to detect and treat it early.
Mayo Clinic researchers have developed practical approaches that physicians can use to bring precision medicine care to their patients with heart disease, a leading killer in America. John Giudicessi, M.D., Ph.D., Iftikhar Kullo, M.D., and Michael Ackerman, M.D., Ph.D. outline these clinical guidelines in their paper Precision Cardiovascular Medicine: State of Genetic Testing in the April 2017 issue of Mayo Clinic Proceedings.
The authors highlight the importance of creating the guidelines to help guide patient care.
“As genomic testing has become more affordable, faster and more accessible, both physicians and patients have many questions. Which genetic tests should be used? What do the genetic test results mean for patients and their family members? The clinical guidelines we have assembled will help physicians understand how to use current genomic knowledge to provide the best care for their patients. This can help physicians diagnose heart disease earlier, before the patient, and in some cases other family members, experience a life threatening event like a heart attack, ” explain the researchers.
Genomics – improving care for cardiovascular disease
Genomics has already played a key role in providing individualized care for many patients with cardiovascular diseases.
The Mayo researchers highlight these areas where precision medicine has led to improved prevention, screening, earlier diagnosis and treatment for patients, and in many cases, their family members:
Team approach – ensures the maximum benefit
The Mayo researchers emphasize the importance of using a multidisciplinary team to select the appropriate genetic tests and interpret test results for each patient. The team should include coordinated care from cardiologists, genetic counselors and medical geneticists.
Why is this team approach so important? Because as the authors explain, when it comes to genetic testing, one size does not fit all.
“A ‘one size fits all’ mentality to genetic testing is not advised. Genetic testing should be used only if the medical team suspects that a patient has an underlying genetic cardiovascular disease after performing a thorough clinical evaluation, which should include a detailed family history and comprehensive cardiovascular testing,” explain the authors.
Once testing is complete, the team plays a critical role in interpreting test results for each patient. Many genetic tests generate large amounts of data that often contain ambiguous or uncertain findings. Medical geneticists and genetic counselors can help identify which test results can be used to guide patient care and when a patient’s family members need screening for heart disease. Team members work with the patients and their families through every step of the genetic testing process.
Mayo Clinic Proceedings Symposium on Precision Medicine
This paper is the third in Mayo Clinic Proceedings Symposium on Precision Medicine, a series of articles that cover a wide range of topics in personalized medicine. Watch for upcoming articles in the symposium, which will focus on how personalized medicine and genomics are impacting patient care. Learn more about the series.
John Giudicessi, M.D., Ph.D, is a resident in the Department of General Internal Medicine at Mayo Clinic’s campus in Rochester, Minnesota.
Michael Ackerman, M.D., Ph.D. professor of Pharmacology, Medicine and Pediatrics and consultant in the Department of Cardiovascular Diseases and Department of Pediatrics and Adolescent Medicine at Mayo Clinic’s campus in Rochester, Minnesota.
This post originally appeared on the Center for Individualized Medicine blog on April 14, 2017.