A new genetic test called polygenic risk score could help some patients reduce their risk of heart attack at a young age, The New York Times reported May 30.
Polygenic risk score looks at thousands of genetic variations that could point to who is likely to have a heart attack. The test, which costs about $150 and is not typically covered by insurance, could identify people likely to have heart attacks decades before they are at high risk.
"There's a real unmet need to identify high-risk people very early in life," Nicholas Marston, MD, a cardiologist at Brigham and Women's Hospital in Boston, told the Times. "We know the solution to preventing heart disease is getting your bad cholesterol as low as possible for as long as possible."
Those at high risk could begin treatment early, while others who might have high cholesterol but low risk of heart attack may be spared unnecessary treatment. However, some critics said the tests may cause further problems down the line.
Patients treated at younger ages may not want to take statin or other drugs for the rest of their lives because the risk is too far in the future. One study found about 40 percent of people 65 and older who had a heart attack and needed lipid-lowering medications stopped taking statins within two years.
Polygenic risk scores could also cause some patients to label themselves with a disease. That label may "inexorably [lead] to tests and a search for treatments," Rita Redberg, MD, a cardiologist at the University of California San Francisco and the editor at JAMA Internal Medicine, told the Times. "Now, whenever they experience the common aches, pains and twinges of life, they wonder if it is because they have this 'disease,'" which could possibly lead to an overutilization of healthcare, she said.
And some critics emphasize that more research is needed to show that treatment at a young age can prevent heart attacks years down the line. One study used data from hundreds of thousands of people in Britain and Japan. It found the polygenic risk score can help make treatment decisions for patients under 50 when it's not clear whether or how aggressively to lower their LDL levels, but for those over age 50, lifestyle factors had more of an influence on risk.