Years of analysis have proven that beside danger components like weight problems, diabetes or smoking, there’s a hereditary part to atherosclerotic illnesses that speed up the build-up of plaques and ldl cholesterol, resulting in coronary heart assaults. Researchers assume {that a} check like PRS that takes into consideration this genetic historical past is more likely to higher predict the longer term. Doctors presently decide the chance of coronary heart assaults by analysing an individual’s danger components.

Practising cardiologists, nevertheless, are nonetheless not satisfied of its use, particularly as a broad screening mechanism. “Genetic history is important but if you have a good lifestyle — if you have been eating healthy, exercising regularly, not smoking — then you will overcome this genetic predisposition,” says Dr RR Kasliwal, Chairman of Clinical and Preventive Cardiology at Medanta Hospital, Gurugram. “If we talk about India, we see heart attacks at a very young age — nearly 25 per cent of all heart attacks happen in people below the age of 45 years. This means the plaque formation started in them at a very early age. So, we have to ensure that even as children, parents ensure a healthy diet and exercise. Parents shouldn’t aspire to chubby cheeks in children,” he provides.

For now, he feels the check could have a restricted use and assist predict interventions in individuals who have already got a number of danger components. “The only meaningful intervention, other than lifestyle changes, is to prescribe statins. And, when we talk about early prescription of statins, we are already doing it in India because of the young heart attacks. We prescribe statins even at the age of say 35 years if a person has several risk factors and a high calcium scoring. Lifestyle changes in such people may not help in preventing heart attacks in the immediate future,” he says.

Dr Kasliwal says that his research have proven CT calcium scoring to be an excellent predictor of coronary heart assaults. “If you do a treadmill test, for example, it will detect a blockage only when it is over 70 per cent but a CT calcium scoring can show the true picture of plaque formation in the heart. And, when done in the high risk individuals it can help us determine the course of action.”

Dr VK Bahl, Principal Director of Cardiac Sciences at Max Hospitals, and former Head of Cardiology at AIIMS-Delhi, agreed that the check has a restricted position at current. “You have to show that an intervention actually helps us detect cases where we can make meaningful changes and reduce morbidity and mortality from the disease. Now, let’s say we have a way to detect early plaque formation —what will you do with this information? Several studies have shown that in people with asymptomatic plaques or even stable angina — chest pain on exertion — even a procedure like stenting doesn’t help in reducing mortality. That is because someone might have a big plaque that blocks 70 per cent of a vessel and not get a heart attack while someone with 10 per cent blockage might. This is because heart attacks happen when a plaque becomes unstable and breaks up. So, a pre-emptive stenting doesn’t help. Only prescribing statins helps — it not only reduces the cholesterol levels it also stabilises the plaques, preventing them from breaking off.”

He provides the disclaimer that stenting when an individual is having a coronary heart assault is completely life-saving, it isn’t of any use earlier than that time. According to him, statins could also be prescribed even at a younger age if an individual fulfils any of the 4 standards — they’ve Type 2 diabetes, levels of cholesterol are greater than 190, have a number of danger components like weight problems, household historical past, and smoking, or they’ve had a coronary heart assault. There are borderline sufferers the place extra markers like CT calcium scoring is perhaps carried out to begin intervention.