 | ATHEROSCLEROSIS V THE FIFTH SARATOGA INTERNATIONAL CONFERENCE
Copyright © 2000 by the New York Academy of Sciences
description
Annals of the New York Academy of Sciences 902:17-26 (2000)
© 2000 New York Academy of Sciences
Tailored Therapy to Fit Individual Profiles: Genetics and Coronary Artery Disease
J. WOUTER JUKEMAa,b AND
JOHN J.P. KASTELEINc
bDepartment of Cardiology, C5-P, Leiden University Medical Center, Leiden, The Netherlands
cDepartment of Vascular Medicine, Academic Medical Center, Amsterdam, The Netherlands
aAddress for correspondence: J.W. Jukema, M.D., Ph.D., Department of Cardiology, C5-P, Leiden University Medical Center, P.O. Box 9600, 2300 RC Leiden, the Netherlands. Voice: 31-71-5262020; fax: 31-71-5266885.
j.w.jukema{at}lumc.nl
In the twentieth century, coronary artery disease (CAD) was the major cause of morbidity and mortality in western societies. Genetics and environmental influences clearly contribute to CAD. Our genetic makeup contributes to not only coronary risk factors, but also determines an individual's response to environmental challenges such as diet, drugs, and tobacco. Genetic testing is likely to be more predictive of our predisposition to CAD than current conventional testing of known risk factors. Therapy aimed at altering the regulation of genes or their transcribed proteins may prove appropriate in individual patients, depending on their genetic background. The understanding of our genetic predisposition to CAD may enable targeted environmental modification strategies aimed at individuals at greatest risk. Both in terms of the huge costs of drugs to society and in terms of needless medicalization, genotyping in order to tailor therapy might become a routine part of risk management earlier than we think.
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