Assessing factors that boost the risk of major coronary artery disease can help to improve risk assessments for those with Type 2 diabetes, but new findings show adding genetic factors into the equation can help to further hone these risk assessments.
Traditional risk indicators for predicting coronary artery disease heart include weight, fasting levels of blood glucose and family history of the disease. Doctors typically also consider more general measures of health such as cholesterol levels, blood pressure, and smoking history.
What was the Study Design?
The study, led by Dr. Alessandro Doria, an investigator at Joslin Diabetes Center and an associate professor of medicine at Harvard Medical School, leveraged information gathered in recent years about genes implicated in coronary artery disease among the general population.
Scientists at Joslin used a genetic risk score derived from 160 gene locations now associated with coronary artery disease in the population at large.
They then examined how well this score applied to people in two groups of Type 2 diabetes: The Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial and the Outcome-Reduction with an Initial Glargine Intervention (ORIGIN) trial.
Scores were calculated for 5,360 ACCORD participants and 1,931 ORIGIN participants.
What did the results show?
The results showed that the genetic score provides a significant improvement in the ability to correctly predict future major coronary events, according to Doria.
The advantage of a score based on genetic markers is that it can be used early in life, when clinical predictors of cardiovascular risk, such as increased body weight or increased cholesterol may not yet be apparent.
However, the researchers note the score isn’t useful for predicting which treatments, such as intensive control of blood glucose levels, may help to guard against major coronary events.
Doria and his colleagues’ findings show that large clinical trials such as ACCORD and ORIGIN can continue to provide useful data long after their main conclusions have been gathered.
Lead funding for the research was provided by The National Institutes of Health.
The study is published in the journal, Diabetes Care.
- “Genetic analyses hone risk prediction for coronary disease,” Joslin Diabetes Center. 2018, Sept. 28. Retrieved: https://joslin.org/news/genetic-analysis-risk-prediction-coronary-disease.html