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Emerging Role of Precision Medicine in Cardiovascular Disease

Circulation research, 2018-04, Vol.122 (9), p.1302-1315 [Peer Reviewed Journal]

2018 American Heart Association, Inc. ;Copyright Lippincott Williams & Wilkins Ovid Technologies Apr 27, 2018 ;ISSN: 0009-7330 ;EISSN: 1524-4571 ;DOI: 10.1161/CIRCRESAHA.117.310782 ;PMID: 29700074

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Title:
Emerging Role of Precision Medicine in Cardiovascular Disease
Author: Leopold, Jane A ; Loscalzo, Joseph
Subjects: Cardiovascular Agents - therapeutic use ; Cardiovascular disease ; Cardiovascular diseases ; Cardiovascular Diseases - epidemiology ; Cardiovascular Diseases - genetics ; Cardiovascular Diseases - prevention & control ; Cardiovascular Diseases - therapy ; Computational Biology ; Data processing ; Demography ; Disease prevention ; Drug Discovery ; Forecasting ; Gene-Environment Interaction ; Genetic Association Studies ; Genetic Diseases, Inborn - genetics ; Genetic Variation ; Humans ; Metabolomics ; Mutation ; Pharmacogenetics ; Phenotype ; Phenotypes ; Phenotyping ; Precision medicine ; Precision Medicine - trends ; Proteomics ; Therapeutic applications
Is Part Of: Circulation research, 2018-04, Vol.122 (9), p.1302-1315
Description: Precision medicine is an integrative approach to cardiovascular disease prevention and treatment that considers an individual’s genetics, lifestyle, and exposures as determinants of their cardiovascular health and disease phenotypes. This focus overcomes the limitations of reductionism in medicine, which presumes that all patients with the same signs of disease share a common pathophenotype and, therefore, should be treated similarly. Precision medicine incorporates standard clinical and health record data with advanced panomics (ie, transcriptomics, epigenomics, proteomics, metabolomics, and microbiomics) for deep phenotyping. These phenotypic data can then be analyzed within the framework of molecular interaction (interactome) networks to uncover previously unrecognized disease phenotypes and relationships between diseases, and to select pharmacotherapeutics or identify potential protein–drug or drug–drug interactions. In this review, we discuss the current spectrum of cardiovascular health and disease, population averages and the response of extreme phenotypes to interventions, and population-based versus high-risk treatment strategies as a pretext to understanding a precision medicine approach to cardiovascular disease prevention and therapeutic interventions. We also consider the search for resilience and Mendelian disease genes and argue against the theory of a single causal gene/gene product as a mediator of the cardiovascular disease phenotype, as well as an Erlichian magic bullet to solve cardiovascular disease. Finally, we detail the importance of deep phenotyping and interactome networks and the use of this information for rational polypharmacy. These topics highlight the urgent need for precise phenotyping to advance precision medicine as a strategy to improve cardiovascular health and prevent disease.
Publisher: United States: American Heart Association, Inc
Language: English
Identifier: ISSN: 0009-7330
EISSN: 1524-4571
DOI: 10.1161/CIRCRESAHA.117.310782
PMID: 29700074
Source: Geneva Foundation Free Medical Journals at publisher websites
MEDLINE

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Emerging Role of Precision Medicine in Cardiovascular Disease

2018 American Heart Association, Inc. ;Copyright Lippincott Williams & Wilkins Ovid Technologies Apr 27, 2018 ;ISSN: 0009-7330 ;EISSN: 1524-4571 ;DOI: 10.1161/CIRCRESAHA.117.310782 ;PMID: 29700074

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