Curbing atherosclerosis and precision medicine should be main strategies to transform the landscape of treatments to prevent heart attacks and strokes

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According to research presented at the Canadian Cardiovascular Congress (CCC) by Jean-Claude Tardif, director of the Famille Desmarais Research Center at the Montreal Heart Institute, professor of Medicine at the University of Montreal and holder of the Canada Research Chair in personalised medicine, personalised therapy should become a main strategy in the treatment and prevention of heart disease and stroke.

“Curbing atherosclerosis will require a multi-faceted approach targeting LDL-cholesterol, high-density lipoproteins (HDL) and probably inflammation”, he explains. “Precision medicine will transform our approach to patients by moving away from the one size fits all practice as we better understand the genetic and molecular basis of cardiovascular diseases. Patients’ different genetic profiles will lead the same drug to be very useful in some but ineffective or even harmful in others”, explains Tardif, who was presented with the Canadian Institutes for Health Research’s ICRH Distinguished Lecture in Cardiovascular Sciences award at the conference.

One example discussed was dalcetrapib, which was shown by his Montreal Heart Institute group to potentially reduce hard cardiovascular events by 39% and induce atherosclerosis regression in patients with a specific genetic profile (AA genotype at marker rs1967309 in the adenylate cyclase ADCY9 gene). These benefits appear to be explained by a major increase in cholesterol efflux from white blood cells and a significant decrease in C-reactive protein (a marker of inflammation) in the “AA” patients only when treated with dalcetrapib.

This research is part of the Dal-Gene study, which requires recruitment of 5000 “AA” patients with a recent acute coronary syndrome aims to result in the first cardiovascular personalised therapy for atherosclerotic cardiovascular disease with pharmacogenomics-guided dalcetrapib treatment.

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