Center for Genomics and Human Health, Saint Joseph's Translational Research Institute, Atlanta, Georgia, USA.
Clin Cardiol. 2010 Dec;33(12):E1-6. doi: 10.1002/clc.20684.
A family history of coronary heart disease (CHD) is an accepted risk factor for cardiovascular events and is independent of common CHD risk factors. Advances in the understanding of genetic influences on CHD risk provide the opportunity to apply this knowledge and improve patient care. Utility of inherited cardiovascular risk testing exists by utilizing both phenotypes and genotypes and includes improved CHD risk prediction, selection of the most appropriate treatment, prediction of outcome, and family counseling. The major impediment to widespread clinical adoption of this concept involves un-reimbursed staff time, educational needs, access to a standardized and efficient assessment mechanism, and privacy issues. The link between CHD and inheritance is indisputable and the evidence strong and consistent. For clinicians, the question is how to utilize this information, in an efficient manner, in order to improve patient care and detection of high-risk family members.
家族性冠心病史是心血管事件公认的风险因素,且独立于常见冠心病风险因素之外。人们对冠心病遗传影响的认识不断提高,为应用这些知识和改善患者护理提供了机会。通过利用表型和基因型,遗传性心血管风险检测的应用具有一定价值,包括改善冠心病风险预测、选择最合适的治疗方法、预测结果和家族咨询。该概念广泛应用于临床的主要障碍涉及未报销的员工时间、教育需求、获得标准化和有效的评估机制以及隐私问题。冠心病与遗传之间的联系是不容置疑的,且证据确凿一致。对于临床医生而言,问题是如何有效地利用这些信息来改善患者护理和发现高危家庭成员。