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The Role of Genetics in Preventive Cardiology: Utility of Clinically Available Genetic Tests

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ASPC Manual of Preventive Cardiology

Part of the book series: Contemporary Cardiology ((CONCARD))

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Abstract

Genetic testing can help fill an unmet clinical need in the specialty of preventive cardiology. While significant advances have been made over the past two decades in identification and treatment of individuals at increased risk for coronary artery disease events, a huge reservoir of residual cardiovascular risk remains. Genetic tests can help avoid the one diet, or one drug, fits all conundrum prevalent in modern cardiovascular disease prevention. Relevant genetic tests are commercially available and may be utilized to provide improved individualized cardiovascular disease (CVD) management. Genetic tests can improve CVD risk prediction, identify which primary prevention patients receive the greatest CVD event reduction benefit from daily aspirin treatment, create the foundation of a family heart disease clinic with cascade testing, assist in atrial fibrillation and dysrhythmia detection and management, assist in the diagnosis of cardiomyopathy, identify the genetic cause of severe hypercholesterolemia, and can help in the etiologic diagnosis of polygenic dyslipidemias. This allows more efficient clinical care by identification of patient groups who receive the greatest, or least, benefit from preventive intervention. This chapter will briefly address genetic history, what unmet clinical need genetic testing addresses, genetic tests that improve CVD risk prediction, the concept of a family heart disease clinic, tests that are associated with atrial fibrillation, tests available for cardiomyopathy and dysrhythmias, and tests useful in dyslipidemias. Such tools were not clinically available a decade ago, but now with increased commercial availability, and markedly reduced costs, they are accessible, affordable, and clinically applicable. Genetic testing can provide the preventive cardiologist with a powerful and sophisticated tool that can greatly enhance their ability to identify high coronary artery disease risk patients and family members, while enhancing clinical personalized management.

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  1. Cholesterol, Genetics, and Heart Disease Institute, Carmel, CA, USA

    H. Robert Superko

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  1. Heart Disease Prevention Program, Division of Cardiology, University of California, Irvine, Irvine, CA, USA

    Nathan D. Wong

  2. Division of Cardiovascular Medicine, University of California, Davis, Sacramento, CA, USA

    Ezra A. Amsterdam

  3. Cicarrone Center for the Prevention of Cardiovascular Disease, John Hopkins University School of Medicine, Baltimore, MD, USA

    Peter P. Toth

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Superko, H.R. (2021). The Role of Genetics in Preventive Cardiology: Utility of Clinically Available Genetic Tests. In: Wong, N.D., Amsterdam, E.A., Toth, P.P. (eds) ASPC Manual of Preventive Cardiology. Contemporary Cardiology. Springer, Cham. https://doi.org/10.1007/978-3-030-56279-3_15

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