21 Jun Panel of Nine Proteins Improves Risk Assessment in Patients With Stable Coronary Artery Disease
MedicalResearch.com Interview with:
Peter Ganz, MD
Chief, Division of Cardiology
Director, Center of Excellence in Vascular Research
Zuckerberg San Francisco General Hospital
Maurice Eliaser Distinguished Professor of Medicine
University of California, San Francisco
MedicalResearch.com: What is the background for this study? What are the main findings?
Dr. Ganz: The research described in the JAMA paper involved measuring 1,130 different proteins in nearly 2000 individuals with apparently stable coronary heart disease, who were followed up to 11 years. Initially, two hundred different proteins were identified whose blood levels could be related to the risk of heart attacks, strokes, heart failure and death, and ultimately a combination of nine proteins was selected for a risk prediction model, based on their combined accuracy and sensitivity.
Application of these findings to samples of patients with stable coronary heart disease demonstrated that some of those who were deemed clinically stable instead had a high risk of adverse cardiovascular outcomes, while other patients with the same clinical diagnosis had a very low risk. Thus, individuals who all carried the same clinical diagnosis of stable coronary heart disease had a risk of an adverse cardiovascular event that varied by as much as 10-fold, as revealed by analysis of the levels of the nine proteins in their blood. Given such large differences in risk and outcomes, patients could reasonably opt to be treated differently, depending on their level of risk. We hope that in the future, management of patients with stable angina will at least in part rely on risk assessment based on levels of blood proteins.
MedicalResearch.com: What should readers take away from your report?
Dr. Ganz: This study marks a significant advance for “personalized” or “precision” medicine. The study’s findings suggest that – at least for some diseases (like stable coronary heart disease) – an “agnostic” protein-based discovery program that makes no assumptions about pre-existing knowledge of disease pathophysiology can lead to a more personalized risk assessment than any other evaluations available, including those based on traditional disease risk factors and genomics.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Dr. Ganz: In addition to further evaluation of the results described in the JAMA paper, there is an ongoing discovery program to identify proteins that can predict the risk of cardiovascular disease in additional patient populations, including lower-risk individuals who appear healthy but may actually be at high risk of coronary heart disease due to high cholesterol, high blood pressure, diabetes or smoking, or higher-risk individuals with kidney disease or HIV infection.
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