Duke Cardiomics Network to Unravel Genetic Links to Heart Disease
DURHAM, N.C. -- In the largest project of its kind, Duke University Medical Center researchers have organized a nationwide collaborative effort to collect clinical and genetic data on 500,000 patients undergoing cardiac catheterization.
The researchers said such large populations of patients are needed statistically to uncover genetic relationships that are sometimes extremely subtle. They expect new insights into heart disease to be revealed as the genetic information gained from the patients' blood samples is correlated with specific clinical information, such as medications, procedures and outcomes.
Ultimately, the researchers would like to tailor specific treatments for individual patients. For example, the researchers might find that patients with a specific gene or variant would benefit the most from one specific lipid-lowering medication; or that another gene or variant predisposes patients to premature re-occlusion of coronary arteries after angioplasty.
The new venture, known as the Duke Cardiomics Network (DCN), was organized by the Duke Clinical Research Institute (DCRI), the Duke Institute for Genome Sciences and Policy (IGSP), the Duke University School of Medicine and Duke's department of medicine.
"Duke is already a world leader in clinical research and database science in cardiovascular disease," said Robert Califf, M.D., director of the DCRI. "With the DCN, this expertise will now be married to basic science in an unprecedented manner. The network should provide the data needed to achieve new insights into cardiovascular disease, one of the leading causes of death and disability in the world."
The Duke team anticipates that cardiac catheterization centers or hospitals will begin joining the network within the next few months. The researchers hope to have enrolled the 500,000 patients within five years.
"The DCN has the potential to be a cornerstone of the IGSP's growing emphasis in genomic medicine," said Huntington Willard, Ph.D., IGSP director. "It will provide a very powerful resource for translational and clinical research for Duke and its partners. This is also the first significant collaboration involving the DCRI, the department of medicine and the IGSP. The confluence of strengths in those three units represents Duke's most powerful opportunity for having a measurable impact on the future of medicine."
The DCN will be led by Duke's Kristin Newby, M.D., and Kevin Schulman, M.D., who played a key role in organizing the effort. Schulman worked with a group of Duke medical students, many of whom are also pursuing second degrees in business and public health, in organizing the DCN.
"The ultimate goal of this endeavor will be to identify tools that can be incorporated reliably and safely into the daily practice of medicine," said cardiologist Pascal Goldschmidt, M.D., who chairs the department of medicine. "The potential of the data generated by this study to guide us in targeting therapies for the individual patient will be profound."
Duke already has a long history of organizing and maintaining large databanks. Over the past 30 years, it has collected clinical data on more than 150,000 patients who have received cardiac catheterizations at Duke. Recently, Duke cardiologists have also begun collecting genetic data obtained through blood samples.
However, the researchers explained, no single institution can enroll enough patients to make statistically significant distinctions in outcomes based on such patient-specific characteristics as ethnicity, age, gender and socio-economic status.
"The DCN is a bold and forward-looking effort to capture genomic data about patients with cardiovascular disease on an enormous and unprecedented scale," said R. Sanders Williams, M.D., dean of the Duke University School of Medicine and vice chancellor of academic affairs at Duke University Medical Center. "It is likely that numbers of the scale proposed will be necessary to extract the information of greatest clinical value in predicting clinical outcomes and guiding therapy in the best possible way."
The DCN will be a wholly owned, non-profit subsidiary of Duke University. It is being funded by the DCRI, IGSP, the school of medicine and the department of medicine, as well as by future collaborations.