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Published on: January 18, 2021
Personalizing treatments for patients based on cardiovascular phenotyping
1Division of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School.
Insights
Precision cardiovascular phenotyping uses omics data to understand diverse patient responses to treatment. This approach moves beyond reductionism, aiming for personalized therapies and improved outcomes in cardiovascular disease management.
Area of Science:
- Cardiovascular medicine
- Genomics
- Proteomics
- Metabolomics
Background:
- Cardiovascular disease is a leading global cause of death, with current treatments often based on a reductionist view of patient phenotypes.
- Existing therapeutic approaches assume uniform patient responses, which is challenged by the complex and heterogeneous nature of cardiovascular diseases.
Purpose of the Study:
- To explore the role of advanced phenotyping in personalizing cardiovascular disease treatment.
- To highlight the potential of integrating molecular data for more precise patient stratification and outcome prediction.
Main Methods:
- Utilizing high-throughput omics platforms (genomics, proteomics, metabolomics) to gather large-scale molecular data.
- Combining molecular data with traditional clinical information (history, physical examination, lab results) for comprehensive phenotyping.
- Analyzing multiscale data to identify diverse patient phenotypes within cardiovascular disease cohorts.
Main Results:
- Omics profiling has enabled the definition of more precise cardiovascular phenotypes.
- Molecular data aids in predicting adverse outcomes and informing drug efficacy based on individual patient profiles.
- Multiscale phenotyping reveals patient diversity crucial for personalized pharmacotherapies.
Conclusions:
- Precision phenotyping in cardiovascular disease, though nascent, offers significant potential for improving patient care.
- Personalized pharmacotherapies and outcome prediction are key benefits of advanced phenotyping.
- Demonstrating improved treatment responses and reduced adverse events is essential for clinical adoption of precision cardiovascular medicine.
Introduction:
Cardiovascular disease persists as the leading cause of death worldwide despite continued advances in diagnostics and therapeutics. Our current approach to patients with cardiovascular disease is rooted in reductionism, which presupposes that all patients share a similar phenotype and will respond the same to therapy; however, this is unlikely as cardiovascular diseases exhibit complex heterogeneous phenotypes.
Areas Covered:
With the advent of high-throughput platforms for omics testing, phenotyping cardiovascular diseases has advanced to incorporate large-scale molecular data with classical history, physical examination, and laboratory results. Findings from genomics, proteomics, and metabolomics profiling have been used to define more precise cardiovascular phenotypes and predict adverse outcomes in population-based and disease-specific patient cohorts. These molecular data have also been utilized to inform drug efficacy based on a patient's unique phenotype.
Expert Opinion:
Multiscale phenotyping of cardiovascular disease has revealed diversity among patients that can be used to personalize pharmacotherapies and predict outcomes. Nonetheless, precision phenotyping for cardiovascular disease remains a nascent field that has not yet translated into widespread clinical practice despite its many potential advantages for patient care. Future endeavors that demonstrate improved pharmacotherapeutic responses and associated reduction in adverse events will facilitate mainstream adoption of precision cardiovascular phenotyping.
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