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Genetic Test for Heart Disease Risk in the Works
Date:2/8/2009

a heart attack, compared to the 20 percent with the best genetic profile."

Work needs to be done before this information can be put to medical use, he said. "We must test this panel in other studies," he said. "If the results hold up, it will be worth doing tests in clinical situations."

Such a genetic test would not be a big deal compared to tests now done routinely, Kathiresan noted. "It would be no more expensive than the standard tests that are done to measure blood cholesterol levels," he said.

Such a test "could be useful in guiding treatments, such as who should get statins at an early age to lessen LDL cholesterol levels," Kathiresan said. Meanwhile, research is being done to learn how these genetic variants increase heart attack risk.

"Of the nine, three seem to be acting through LDL cholesterol," Kathiresan said. "One gene region seems to directly increase the risk of build-up of atherosclerotic plaque in heart arteries."

The four other studies in the journal indicated that a heart attack risk test would not be limited to those nine genes. A report from France described an association with clusters of variants of three genes on chromosome 6. A Japanese study found an association with a gene, designated BRAP, that may be involved in inflammation. Researchers in Iceland identified five genetic variations governing the blood cells called eosinophils, which also play a role in inflammation. A German study described a gene that is highly expressed in the cardiovascular system and might be involved in the adhesion of cells to one another.

"We know that this is not the end," said Jeanette Erdmann, a professor of genetics at the University of Lubeck, and lead author of the German report. "It is hard to predict how many loci you might find."

Such tests probably wouldn't be used in childhood, Erdmann said. "But I can imagine a 30-year-old man with a family history of heart disease having one," sh
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