New Orleans, LA –Although at greater risk, a new study found that patients of African ancestry with dilated cardiomyopathy (DCM) were less likely to have clinically actionable variants in DCM genes than those of European ancestry. LSU Health New Orleans is one of the 25 clinical sites nationally that enrolled participants in the study. Professor and Chief of Cardiology Dr. Frank Smart leads the LSU Health New Orleans site. The research, which adds critical genetic information about this understudied population, is published in the Journal of the American Medical Association, available here .
“Black patients with cardiomyopathy have an increased familial risk, as well as an increased risk of adverse outcomes from cardiomyopathy compared to white patients,” notes Dr. Smart. “Despite knowing the increased risk in black patients, most patients who have been involved in clinical trials for heart failure have been white. Genetic trials associated with heart failure have had an even more significant racial imbalance.”
The multisite study enrolled 1,198 patients with dilated cardiomyopathy, 43.0% of whom were black, 56,8% white, and 8,5% Hispanic. The authors write, “The estimated prevalence of any variant classified as pathogenic, likely pathogenic, or of uncertain significance among African ancestry patients was 57.5%, lower than the estimated 65.1% among European ancestry patients. Among patients with variants classified as pathogenic, likely pathogenic, or of uncertain significance, the estimated odds of having at least 1 pathogenic/likely pathogenic variant were 75% lower for patients of African ancestry compared with patients of European ancestry.
“As our ability to track and impact treatment of genetic cardiomyopathy improves, it is essential that we have characterized all genetic variants associated with heart failure and cardiomyopathy and not just those variants seen in white patients,” Smart adds. “This study was specifically designed to assess the lack of in-depth genetic information associated with cardiomyopathy in blacks. Moving forward, it is essential that we eliminate this racial inconsistency in scientific knowledge and disease pathology in order to improve care in all patient populations.”
Co-authors are from The Ohio State University, MedStar Washington Hospital Center, Cedars-Sinai Medical Center, Washington University, St Louis, Emory University School of Medicine, Perelman School of Medicine, University of Pennsylvania, University of Nebraska Medical Center, Cleveland Clinic, University of Texas Southwestern Medical Center, Houston Methodist DeBakey Heart and Vascular Center, Inova Heart and Vascular Institute, University of Alabama, Birmingham, University of Washington, University of Arizona, Stanford University School of Medicine, Northwestern University Feinberg School of Medicine, New York University Langone Medical Center, Westchester Medical Center and New York Medical College, Miami Cardiac and Vascular Institute, University of Washington, University of California Los Angeles Medical Center, University of Maryland School of Medicine, Medical University of South Carolina, University of Mississippi Medical Center, Tufts Medical Center and Tufts University School of Medicine, Massachusetts General Hospital, and Indiana University School of Medicine.
The research was supported by The Ohio State University and the National Heart, Lung, and Blood Institute of the National Institutes of Health, which included a supplement from the National Human Genome Research Institute.
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LSU Health Sciences Center New Orleans educates Louisiana's health care professionals. The state's flagship health sciences university, LSU Health New Orleans includes a School of Medicine with campuses in Baton Rouge and Lafayette, the state's only School of Dentistry, Louisiana's only public School of Public Health, and Schools of Allied Health Professions, Nursing , and Graduate Studies. LSU Health New Orleans faculty take care of patients in public and private hospitals and clinics throughout the region. In the vanguard of biosciences research in a number of areas in a worldwide arena, the LSU Health New Orleans research enterprise generates jobs and enormous economic impact. LSU Health New Orleans faculty have made lifesaving discoveries and continue to work to prevent, advance treatment , or cure disease. To learn more, visit http://www.lsuhsc.edu , http://www.twitter.com/LSUHealthNO , or http://www.facebook.com/LSUHSC .
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JAMA
Observational study
People
Genetic Architecture of Dilated Cardiomyopathy in Individuals of African and European Ancestry
1-Aug-2023
Dr Kinnamon reported receipt of grants from the National Institutes of Health (NIH) outside the submitted work. Dr Morris reported receipt of receipt of personal fees from Acorai, Abbott, BI Lilly, Cytokinetics, Edwards Lifesciences, Novo Nordisk, and Regeneron and receipt of personal fees and grants from Ionis and Merck. Dr Stoller reported receipt of personal fees from BMS and CareDx and grants from Amgen. Dr Tang reported receipt of personal fees from Sequana Medical, Cardiol Therapeutics, Genomics, Zehna Therapeutics, Renovacor, Boston Scientific, Kiniksa Pharmaceuticals, WhiteSwell, CardiaTec Biosciences, the American Board of Internal Medicine, and Springer Nature. Dr Shah reported receipt of personal fees from Procyrion, Natera, and Merck; receipt of grants from Merck, Roche, and Abbott; and receipt of grants from the NIH outside the submitted work. Dr Wheeler reported consulting for Leal Therapeutics and provision of clinical trial support and in-kind services from BMS and clinical trial support from Pfizer. Dr Wilcox reported consultancy and/or advisory board membership for Cytokinetics, Abiomed, Abbott, and Boehringer Ingelheim. Dr Katz reported receipt of grants from Pfizer, Luitpold, AMAG Pharmaceuticals, Biocardia, and Anylam and personal fees from Salubris Biotherapeutics. Dr Pan reported receipt of personal fees from Pfizer. Dr Wang reported receipt of personal fees from BMS. Dr Judge reported receipt of personal fees from Alexion, Alleviant Medical, Cytokinetics, LEXEO, Novo Nordisk, and Pfizer. Dr Vatta reported receipt of salary/stocks from Invitae. Dr Burke reported receipt of grants from the NIH outside the submitted work. No other disclosures were reported.