deCODE MI™
Analyzes five SNPs in the CYP2C19 gene that affect response to the anti-platelet drug clopidogrel. This test identifies those who may need adjustment of their clopidogrel dose or who should be put on an alternative medicaiton to prevent recurrent adverse cardiovascular events.
Screening and prevention
How deCODE MI™ can help.
More Comprehensive Risk Assessment
Understanding a patient’s risk of cardiovascular disease is the prerequisite for effective prevention, including decisions and follow-through on life style modification and medication. deCODE MI™ detects genetic risk factors for heart attack that are independent of traditional risk factors, helping to provide a more complete picture of individual susceptibility as well as important information on risk of early-onset disease.
Integration with established risk modelling tools
The results of deCODE MI™ are presented as a numerical score of individual risk of heart attack compared to the population average. Because this risk is complementary to that conferred by traditional risk factors, deCODE MI™ results can be used directly to modify scores from the Framingham, Reynolds, or ARIC tools. This can impact the recommended prevention strategies and medication for a substantial proportion of patients.
Empowering physicians and patients
Preventive measures for MI are to a great extent dependent on successful changes in lifestyle. deCODE MI™ results can give physicians’ advice extra emphasis and impact, and provide their patients with additional incentive to follow through on that advice.
Risk modification
deCODE MI™ provides a novel means of detecting the substantial genetic component to risk of heart attack, risk that appears moreover to be independent of well known risk factors such as elevated cholesterol and hypertension. The results can therefore be used to directly modify the risk scores derived from conventional risk assessment tools such as Framingham, ARIC or Reynolds, simply by multiplying the two results together. Large clinical cohort studies have demonstrated that testing even for only the 9p21 markers included in deCODE MI™ shifts a significant proportion of patients either up or down in risk category, impacting guideline LDL targets and statin dosing(1-4). Patients found through deCODE MI™ to be at higher risk of heart attack may also benefit from more aggressive management of other risk factors such as weight, smoking, elevated blood pressure, and diabetes. The test results are also independent of family history of MI and therefore have value both for patients with and without family history of the disease.
More, personalized risk information empowers physicians and patients.
When it comes to MI and coronary heart disease, understanding risk is the first step in empowering prevention. And as preventive measures for MI are to a great extent dependent on successful changes in lifestyle, deCODE MI™ results can give physicians’ advice to their patients extra emphasis and provide valuable additional incentive to follow through on lifestyle modification.
Irrespective of whether deCODE MI™ results move a given patient into another risk category, physicians are likely to have numerous patients with well known risk factors for coronary heart disease. Many patients need to do more to stop smoking, lose weight, get more exercise, improve their diet, or remember to take their blood lipid and/or blood pressure medication – and efforts to get them to do so are not always as successful as they should be. Additional, personalized information indicating which patients may also be at increased genetic risk of heart disease can add weight to this medical advice and its relevance. For patients, it can increase their incentive to implement and stick to lifestyle modification regimens and prescribed medications that can reduce their chances of getting MI. There is also a strong case to be made that it is the patient’s right to know about all of his/her relevant risk factors. This may be especially relevant for those having difficulties adhering to diet and weight recommendations, and to the physician’s role in reminding them of the importance of compliance with his/her recommendations. An understanding of genetic risk can therefore be both important and useful to doctor and patient alike.
deCODE MI™ is not a determinative genetic test like those done for Mendelian conditions but a risk test, analogous in many ways to testing for risk with LDL cholesterol.
This content was last reviewed on March 16, 2011.