Grant: Project Grant

A family history of cardiovascular disease increases the risk for heart attack suggesting that genetics plays a role. Recent studies have even identified specific genetic variants that are associated with heart attack, confirming the role of genetics. While each of these variants has only a small effect, their combination can have a much stronger effect. Multiple genetic variants can be combined into a "Genetic Risk Score" or GRS and this approach is a step towards quantifying an individual's genetic risk. We recently demonstrated that among individuals who had a heart attack, a high GRS was associated with an earlier age of onset. Furthermore, the risk for individuals with a high GRS may be even greater if they have other risk factors such as smoking, high cholesterol, high blood pressure, or obesity. In addition, individuals at high risk of developing a heart attack due to high GRS may derive greater benefit from statin therapy than those with a low GRS. Thus, the goals of this study are: 1) to investigate whether specific risk factors do indeed modify genetic risks and 2) to investigate the influence of genetic risk on the effectiveness of commonly prescribed heart disease medications. Our study will be conducted on over 2400 heart attack patients who were recruited from two Canadian studies, RISCA and PRAXY. Both studies have collected data on many relevant risk factors including cholesterol, blood pressure, obesity, etc. and have already contributed to our knowledge of the causes of heart attack. In our study, we will test over 80,000 genetic variants including rare ones that have only recently been discovered. Knowledge of the role of these specific genetic variants as well as the interactions between genetic and non-genetic risk factors will help to clarify the ability of all these risk factors to provide information on possible preventive approaches (including drugs such as statins) that should be tailored to specific patients.