Revolutionizing Cardiovascular Risk Assessment
A groundbreaking study led by researchers at NYU Grossman School of Medicine has developed a new method to detect previously unmeasured risks of heart attack and stroke. Published in Nature Communications on August 20, 2024, the research introduces the Platelet Reactivity ExpresSion Score (PRESS), a genetic-based scoring system that could transform how we assess and manage cardiovascular risk.
The study, spearheaded by Dr. Jeffrey Berger, director of the Center for the Prevention of Cardiovascular Disease at NYU Grossman School of Medicine, addresses a long-standing challenge in cardiology: the reliable measurement of platelet hyperreactivity, a key factor in abnormal blood clotting that can lead to heart attacks and strokes.
“Our results demonstrate that our new platelet-centric scoring system can, for the first time and across populations, circumvent aggregometry to reliably predict platelet hyperreactivity and the related risk of cardiovascular events,” Dr. Berger explains.
Beyond Traditional Risk Factors
Current cardiovascular risk assessments rely on factors like high cholesterol or high blood pressure, which are not directly related to platelet function. The PRESS system offers a more targeted approach by focusing on the genetic markers associated with platelet hyperreactivity.
To develop PRESS, the research team first identified 451 genes whose activity differed significantly in patients with hyperreactive platelets. They then used bioinformatics to assign weights to these genetic differences, creating a score that reliably predicts platelet hyperreactivity.
The study found that PRESS can detect platelet hyperreactivity both in patients at imminent risk of heart attack and in seemingly healthy individuals whose future risk might otherwise remain unknown. This breakthrough could lead to more personalized and effective prevention strategies.
Dr. Tessa Barrett, assistant professor in the departments of Medicine and Pathology at NYU Langone and study author, highlights the potential impact: “Our score has the potential to further personalize cardiovascular disease risk prevention.”
Why it matters: The development of PRESS represents a significant leap forward in cardiovascular medicine. By providing a more accurate and individualized assessment of platelet-related risk, this new tool could help physicians make more informed decisions about prescribing anti-platelet therapies like aspirin.
Currently, aspirin is often prescribed based on general risk factors, which can lead to unnecessary treatment and increased bleeding risk in some patients. PRESS could help target anti-platelet treatment to those most likely to benefit, potentially reducing adverse effects while improving cardiovascular outcomes.
The study validated PRESS across several patient groups, including women undergoing coronary angiography and patients with lower extremity atherosclerosis. In the latter group, patients with above-average PRESS scores were 90% more likely to experience a major cardiovascular event over an 18-month follow-up period.
As we continue to seek ways to prevent and manage cardiovascular disease, which remains a leading cause of death worldwide, tools like PRESS offer hope for more precise, personalized care. By uncovering hidden risks and enabling targeted interventions, this research paves the way for a new era in cardiovascular medicine, where prevention strategies can be tailored to each individual’s unique genetic profile.
The development of PRESS not only advances our understanding of platelet biology but also demonstrates the power of integrating genetic information into clinical practice. As further research validates and refines this approach, we may see a significant shift in how cardiovascular risk is assessed and managed, potentially saving countless lives in the process.
