Research led by the National Institute for Health and Care Research (NIHR) Leicester Biomedical Research Center (BRC) and Universite Paris Cite, and supported by global partners in Canada, the United States, and Australia, has identified new genes linked to an increased risk of a type of heart attack that primarily affects young to middle-aged women. The findings were published in Nature Genetics.
SCAD, or Spontaneous Coronary Artery Dissection, happens when a bruise or bleed forms in the wall of a coronary artery, cutting off blood flow to a portion of the heart. This causes a heart attack. SCAD, unlike other forms of heart attacks, is most common in women under the age of 60 and is a primary cause of heart attacks during pregnancy. Furthermore, those who have had SCAD are generally healthy, and SCAD can occur more than once.
To date, nothing is known about why a SCAD occurs, which generally occurs unexpectedly, making prevention now unattainable.
The researchers provide a genome-wide association meta-analysis encompassing 1,917 cases of SCAD and 9,292 controls of European origin. They discovered 16 genes that enhanced the risk of SCAD. The found genes are involved in mechanisms that control how cells and connective tissue hold together, as well as how blood clots when tissue bleeding occurs.
Interestingly, the researchers discovered that, while many genes linked to an increased risk of SCAD are shared with risk genes for traditional coronary artery disease (CAD), they have the opposite impact. This suggests that patients with SCAD have some genetic protection against the risk of CAD, demonstrating that these diseases are substantially distinct. The only shared risk factor seems to be genetically raised blood pressure.
Dr. David Adlam, Associate Professor of Acute and Interventional Cardiology at the University of Leicester, and lead author of the study, said, “This research confirms that there are multiple genes involved in determining the risk of a person having a SCAD. These genes give us the first key insight into the underlying causes of this disease and provide new lines of enquiry, which we hope will guide future new treatment approaches.”
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