DNA clues reveal new opportunity for personalised heart care

Monash University researchers have been awarded $1.4 million for a clinical trial looking at how a person’s DNA may determine their risk of heart disease.

The first-of-its-kind, this trial will look at the DNA of people who have already been diagnosed with heart disease to test new ways to better control their disease with statins, a common and very effective heart disease medication.

Led by Professor Stephen Nicholls, this is the first of many new clinical trials that will run out of the Victorian Heart Hospital, Australia’s first dedicated heart hospital, due to open in 2022.

As Director of the Victorian Heart Hospital, Professor Nicholls is bringing together researchers from across Monash University, and the country, to create the cardiovascular solutions of the future.

“Nearly one in four Australians are estimated to have cardiovascular disease.  The work of the Victorian Heart Hospital team will create meaningful change to prevention, treatment and management of cardiovascular disease,” said Professor Nicholls.

“While we understand the risks of poor diet, a lack of exercise and smoking on heart disease, there’s still far more to uncover within a patient’s DNA.  Understanding the hidden clues within the DNA, and how we can use those to tackle heart disease head on is what makes this study such a monumental step forward in our understanding of genetic risk and heart disease,” said Professor Nicholls.

Called the DA VINCI trial (Do stAtins faVourably modify atherosclerotIc plaque in patients with differeNt levels of polygenic Cardiovascular rIsk) it will enroll 600 patients with established coronary atherosclerosis (heart disease) from 15 sites across Australia.

“This trial is about understanding an individual’s genetic risk,using that knowledge to find ways to better treat their disease.  After all, a more personalised approach to health , where everyone receives a more targeted treatment, at the right time in their disease is what we want the future of cardiovascular disease care to look like for all Australians.”

The grant was announced by the Federal Minister for Health, the Honorable Greg Hunt MP, as part of a package of $29 million from the Medical Research Future Fund (MRFF).

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Further information on the DA VINCI trial

The aim of the Monash trial is to show if a polygenic risk score, those genetic risk scores that take into account variations in a person's entire DNA, are able to predict coronary artery disease in those who have not yet had heart attacks. It will look at how to:

·    Reliably predict heart disease in people who are at risk of heart attack and may not even be showing symptoms of heart disease.

·    Determine if statin use is more or less effective depending on a person’s polygenic score, with a view to the score being used as a predictor for those best suited for statin therapy and those who need alternative treatments.

There have been a number of studies recently published using genome wide polygenic risk (GPR) scores as biomarkers to predict the risk to develop coronary artery disease and heart attack in Europe and Canada. Several published studies have used GPR scores with high accuracy in people of European ancestry.

More than million cholesterol-reducing statins are prescribed in Australia every year.