As many as 450,000 Americans die every year from a sudden, fatal heart condition, and in slightly more than one in ten cases the cause remains unexplained even after an autopsy. Researchers from the University of Maryland School of Medicine (UMSOM) and their colleagues found that nearly 20 percent of patients with unexplained sudden cardiac death - most of whom were under age 50 - carried rare genetic variants. These variants likely raised their risk of sudden cardiac death. In some cases, their deaths may have been prevented if their doctors had known about their genetic predisposition to heart disease. The study findings were published last week in JAMA Cardiology.
"Genetic screening isn't routinely used in cardiology, and far too many patients still die suddenly from a heart condition without having any previously established risk factors. We need to do more for them," said study corresponding author Aloke Finn, MD, Clinical Associate Professor of Medicine at UMSOM.
To conduct the study, Dr. Finn and his colleagues performed genetic sequencing in 413 patients, who died at age 41 on average of sudden unexplained heart failure. Nearly two-thirds of the group were men, and about half were African American. The study found that 18 percent of patients who experienced sudden death had previously undetected genes associated with life-threatening arrhythmia or heart failure conditions. None of those who carried these genetic variants had been previously diagnosed with these abnormalities. Their hearts looked normal on autopsies without any signs of heart failure or significant blockages in their coronary arteries.
"What we found opens the door and asks some important questions," said Dr. Finn. "Should we be doing routine genetic screening in those who have a family history of unexplained sudden cardiac death?"
Such screening could have the potential to save lives. It may also leave patients and doctors in a quandary over what to do with such information. There are currently no clear guidelines on how to monitor or treat patients with these variants in the absence of clinically detectable disease.
Study faculty co-authors from UMSOM include Kristen Maloney, MS, Instructor of Medicine, Libin Wang, BM PhD, Assistant Professor of Medicine, Susie Hong, MD, Assistant Professor of Medicine, Anuj Gupta, MD, Associate Professor of Medicine, Linda Jeng, MD, PhD, Clinical Associate Professor of Medicine, Braxton Mitchell, PhD, Professor of Medicine, and Charles Hong, MD, PhD, the Melvin Sharoky, MD, Professor of Medicine.
"This is a fascinating study that provides important new insights into devastating deaths due to unexplained cardiac abnormalities," said E. Albert Reece, MD, PhD, MBA, Executive Vice President for Medical Affairs, UM Baltimore, and the John Z. and Akiko K. Bowers Distinguished Professor and Dean, University of Maryland School of Medicine. "It certainly makes the case for more research to address this urgent health need and save lives in the future."
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About the University of Maryland School of Medicine
Now in its third century, the University of Maryland School of Medicine was chartered in 1807 as the first public medical school in the United States. It continues today as one of the fastest growing, top-tier biomedical research enterprises in the world -- with 45 academic departments, centers, institutes, and programs; and a faculty of more than 3,000 physicians, scientists, and allied health professionals, including members of the National Academy of Medicine and the National Academy of Sciences, and a distinguished two-time winner of the Albert E. Lasker Award in Medical Research. With an operating budget of more than $1.2 billion, the School of Medicine works closely in partnership with the University of Maryland Medical Center and Medical System to provide research-intensive, academic and clinically based care for nearly 2 million patients each year. The School of Medicine has more than $563 million in extramural funding, with most of its academic departments highly ranked among all medical schools in the nation in research funding. As one of the seven professional schools that make up the University of Maryland, Baltimore campus, the School of Medicine has a total population of nearly 9,000 faculty and staff, including 2,500 student trainees, residents, and fellows. The combined School of Medicine and Medical System ("University of Maryland Medicine") has an annual budget of nearly $6 billion and an economic impact more than $15 billion on the state and local community. The School of Medicine, which ranks as the 8th highest among public medical schools in research productivity, is an innovator in translational medicine, with 600 active patents and 24 start-up companies. The School of Medicine works locally, nationally, and globally, with research and treatment facilities in 36 countries around the world. Visit medschool.umaryland.edu
Journal
JAMA Cardiology