American Heart Association issues statement supporting precision medicine for heart failure
Precision medicine could one day personalize heart failure care by identifying groups of patients more likely to develop heart failure and tailoring which medications and other therapies could be most effective for them, according to a new scientific statement from the American Heart Association (AHA) and published in the journal Circulation: Genomic and Precision Medicine.
The AHA statement offers provides a state-of-the-science overview of heart failure as it relates to the different aspects of precision medicine, including how variations in genes, biomarkers in the blood, or bacteria in the gut can predict the risk of heart failure and how a person may respond to various treatments. The prognosis for people with heart failure has improved in recent decades as research studies have demonstrated the effectiveness of various medications. However, within those clinical trial populations are groups of people who are less likely to benefit from the drug and some who may have serious side effects.
Precision medicine uses information about a person's genetic make-up, metabolism and other biological and environmental factors to determine what strategies can better prevent or treat a health condition. The goal is to provide personalized treatment that is more likely to be successful for each individual patient, rather than a one-size-fits-all approach.
"We aim to improve care for everyone with heart failure by more clearly defining the best treatment options for specific groups of people," said Sharon Cresci, MD, chair of the statement writing group and associate professor of medicine and genetics at Washington University in St. Louis, Missouri. "This statement details the potential of precision medicine to improve patient outcomes."
Some aspects of precision medicine are already routinely used by healthcare providers treating heart failure. For example, the blood level of a biomarker called B-type natriuretic peptide is a sensitive indicator of whether heart failure is worsening or if treatments are helping. It can also help determine whether symptoms such as shortness of breath are due to heart failure rather than another medical problem.
As health professionals may be unfamiliar with one or more precision medicine approaches, the statement aims to be an educational resource by combining information on how each applies to heart failure.
Recognizing the value of this multi-faceted and personalized approach to heart disease, the AHA established the Institute for Precision Cardiovascular Medicine in 2015. It provides training in new skills that medical researchers will need, such as data science and artificial intelligence, a cloud-based platform for scientists to collaborate and share data internationally, an initiative to involve women across the United States in health research, and a drug discovery center to use the power of supercomputing to rapidly predict the outcomes of possible new treatments.
"The field of precision medicine is still in its infancy, with infrastructure and programs to be built,” said Cresci. “We'll need specialized training for clinicians, processes for sharing information across large databases and guarantees for patient privacy. It's exciting to realize the potential life-saving innovations on the horizon through precision medicine."