Heart health: 16 genes linked to increased risk of heart attack in women

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Younger and middle-aged women may be at greater risk for certain health conditions. Stanislaw Pytel/Getty Images
  • Researchers have examined the genetics behind spontaneous coronary artery dissection (SCAD), a condition that can be life-threatening.
  • Spontaneous coronary artery dissection can lead to heart attacks, particularly in women younger than 60.
  • The condition can occur without warning and often affects otherwise healthy people, making early diagnosis difficult.
  • Scientists conducted a genome-wide association meta-analysis and found 16 gene variants associated with an increased risk of developing the condition.

Researchers from the UK, France, Australia, Canada and the US collaborated to study whether there are genetic factors that contribute to the development of a spontaneous coronary artery dissection (SCAD). Because SCAD can be life-threatening and difficult to predict, scientists want to learn more about the causes.

The study, published in Genetics of natureidentified 16 genes, including genes involved in artery integrity and blood clotting, that are associated with increased risk.

This research into the genetic factors of SCAD has the potential to lead to preventative strategies.

The researchers performed a meta-analysis of eight independent studies investigating genetic factors associated with SCAD.

They compared a group of 1,917 people with SCAD with a control group of 9,292 people. The investigators included patients with SCAD who had similar clinical characteristics and met the diagnostic criteria.

To look for genes associated with SCAD, the researchers performed a special type of analysis called a genome-wide association study. The researchers looked at genes likely involved in some of the problems that may contribute to SCAD. They analyzed genes likely regulated in vascular smooth muscle cells, as well as genes involved in blood clotting.

This is significant because blood clotting, or blood clotting, prevents an injured vessel from bleeding profusely. An injured blood vessel can lead to a heart attack in EXP.

The research team also investigated the causal relationships between cardiovascular disease risk factors (predicted on the basis of genetics) and SCAD and coronary heart disease (CAD).

In their combined genetic analysis of the eight studies, comparing the control group to the SCAD group, the team found 16 genes that contribute to SCAD.

They found that the lower expression of the tissue factor gene F3involved in blood clotting, is associated with a higher risk of SCAD.

The scientists found a new signal associating SCAD with the gene THSD4 which is associated with fibrillin, which regulates the functioning of the heart.

The team also found causal genes involved in maintaining arterial wall integrity and function, including genes HTRA1, TIMP3, ADAMTSL4, LRP1, COL4A1AND COL4A2.

This research confirms that there are multiple genes involved in determining a person’s risk of having SCAD, says study’s lead author Dr. David Adlamassociate professor of acute and interventional cardiology at the University of Leicester in England.

These genes give us the first key insight into the underlying causes of this disease and provide new lines of investigation, which we hope will guide future new therapeutic approaches.
Dr. David Adlam

The team also found that some of the genetic variants in SCAD and coronary artery disease (CAD) are linked but have the opposite impact.

Several associated variants have diametrically opposed associations with CAD, suggesting that shared biological processes contribute to both diseases but through different mechanisms, the authors write.

SCAD occurs when a tear occurs spontaneously within the artery wall and causes blood to become trapped. According to American Heart AssociationThis narrows or blocks the artery and can cause a heart attack because blood flow cannot reach the heart muscle.

While typical coronary heart disease often affects people with certain risk factors (such as a family history of it or people with high cholesterol levels), SCAD can occur without warning and in healthy people.

SCAD mainly affects young women and it’s the cause of 25% of cases of acute coronary syndrome in women under 50 years. Also, SCAD can cause heart attacks in pregnant women.

While the symptoms of SCAD can vary, they can resemble symptoms of a heart attack and can include chest pain, shortness of breath, profuse sweating, and dizziness.

He spoke with Dr. Shahid Rahman, an interventional cardiologist at Memorial Hermann in Houston Medical News Today after reviewing the study.

This study was able to provide insight into this understudied disease process (SCAD). A genetic basis for SCAD appears to be suggested, and therefore, any woman with a family history of SCAD, or who has had SCAD previously, should have regular follow-ups, said Dr. Rahman.

Dr. Rahman also highlighted the importance of women talking to their doctors about their risks for SCAD before becoming pregnant.

SCAD is a rare cause of myocardial infarction but a leading cause of myocardial infarction in young women, especially during the time of childbirth. Women should be aware of this risk and not delay seeking treatment if they have symptoms of a heart attack (such as chest pain).
Dr. Shahid Rahman

Dr. Meesha Dogan, co-founder, CEO and board member of Cardio Diagnostics also spoke MNT extension.

While SCAD is a less common cause of heart attacks than coronary artery disease, its unexpected occurrence in younger women with no prior suspicion can be alarming, Dr. Dogan said.

Dr. Dogan believes the study findings could help with preventative strategies in the future.

Findings from this study on the genetic basis of SCAD could potentially help women and their providers gain early risk information, lead to new prevention and treatment strategies, and promote greater advocacy of research funding, clinical attention, and public health initiatives focused on women’s heart health, said Dr. Dogan.

Sometimes people are genetically at higher risk for heart disease. For example, they may have a family history of heart disease or conditions such as a heart arrhythmia.

In these situations, it’s important for people to be proactive with their health to prevent heart disease, which can often be life-threatening.

One thing people with this concern can do is lead a healthy lifestyle. This includes eating a heart-healthy diet, avoiding smoking, and participating in regular physical activity (particularly aerobic exercise).

Getting yearly checkups with a doctor is also important, so people can get their cholesterol and blood pressure checked. If these are high, the doctor can offer suggestions or medications and monitor their condition regularly.

It’s also important for people with a higher risk of heart disease manage your stress levels, as chronic stress can lead to high blood pressure, which can lead to heart attacks and strokes. Focusing on meditation, talk therapy, or yoga are some ways to help with this.

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