Personalizing Cardiovascular Care
To date, the bulk of personalized medicine research centers on the field of oncology. Whether it’s using genomics to better classify pancreatic cysts or developing statistical models to determine the optimal treatment course in prostate cancer, it’s clear that individualization is the future of cancer care. Translating personalized medicine principles to cardiology has proven more difficult. This may be due, in part, to the classification of many cardiovascular conditions on the basis of clinical presentation rather than an understanding of the underlying disease mechanisms. However, the authors of a review published in Circulation demonstrate how studying individual variation in disease-related processes has the potential to improve cardiovascular care.
Pharmacokinetics, the study of how a body interacts with drugs, represents one such area with potential. Certain individual characteristics are known to impact how a person’s body metabolizes a drug. The medication prasugrel, indicated for people who have suffered a heart attack, can be used as an example. Given the same dose, individuals with more body weight will not only be exposed to a higher drug concentration, they are also more likely to experience adverse events like bleeding, pointing to a need to tailor dosing to body size. Discovering more characteristics associated with variation in drug metabolism can help clinicians pinpoint the ideal drug class and dose for each patient.
Better understanding of the mechanistic underpinnings of cardiovascular disease can also improve treatment by producing higher quality clinical trials. Preliminary research can be used to predict which patients are most likely to respond well to a drug, based on their genomic profile or a specific type of cardiovascular event they experienced in the past. Clinical trials could then enrich for these types of patients when selecting participants, ensuring that drugs are tested in those with the highest probability of benefitting and eventually leading to more tailored treatment regimens.
These efforts to improve the personalization of cardiovascular care are important given the high prevalence of cardiovascular disease globally and in the US. Learn more about inHealth efforts to individualize cardiovascular care here.