Apollo Hospitals Conducts a Pilot Study on Identification of Genetic Risk Factors for Myocardial Infarction in Young Indians

NEW DELHI, April 19, 2013 /PRNewswire/ --

According to a pilot study conducted by Apollo Hospitals Educational and Research Foundation (AHERF), a non-profit organization that promotes basic and translational research within the Apollo Hospitals, the genetic factors contributing to the high incidence of myocardial infarction (MI) at a younger age in Indians can be possibly screened out if a larger full-scale prospective study is undertaken.

A 2005 report titled "The Burden of Disease in India" published by the National Commission in Macroeconomics and Health, had estimated that the prevalence of cardiovascular disease (CVD) would be 11% (males) and 16% (females) in the 5th decade, 14% (males) and 15.3% (females) in the 6th decade and 23% in both genders in the 7th decade. It is widely accepted that Myocardial Infarction (MI) occurs a decade earlier in Indians as compared to other ethnicities. Any possible diagnostic tests for predicting susceptibility to CVD would be very useful in introducing life style changes and enhance abilities to manage this forthcoming epidemic.

AHERF used a state-of-art technology platform, to perform genomic data analysis for detecting genome specific signatures and associations for MI in a small exploratory study. AHERF recruited 109 MI patients from Chennai, Delhi, Hyderabad and Ahmedabad who were under the age of 50 years at the time of a definite MI event. In order to provide a high contrast and enhance the possibility of finding genes underlying MI susceptibility, a control population was chosen from among those who were a decade older, without any history of MI, diabetes or hypertension. The mean age of the patients was 42.3 for males and 42.6 for females while it was 63 years and 52 years respectively for the controls.

All the blood samples from the four centers were sent to Institute for Genomics and Integrative Biology (IGIB), New Delhi, for performing the genomic analysis. Unbiased and agnostic choice of 1.14 million genomic markers was made and DNA sample of each individual was genotyped for these markers in National Institute for Biomedical Genomics (NIBMG) using the Human Omni 1 Quad v1.0 DNA Bead Chip by the team led by Prof. Partha Majumdar.

Statistical Quality control analysis performed at NIBMG revealed exceptionally high quality data. Data on 941882 genetic markers on each of 189 individuals (patients and controls) were included for analysis. None of the markers showed statistically significant differences between patients and controls, which is not totally unexpected. AHERF looked closely at the 10 genetic markers, which showed the highest significant association with MI in the present study. These were located on chromosomes 10 (4), 4 (4), 2 and 20 (1 each) and some of these markers were located close to known markers that are responsible for various CVD risk factors such as obesity. However, many of these were being identified for the first time which needs to be established and validated in consecutive replication studies. 

The encouraging results of this pilot study indicate that the genetic factors contributing to the high incidence of MI at a younger age in Indians linked with other risk factors can be possibly screened out if a larger full-scale prospective study is undertaken. 

The biggest drawback of the findings was the small sample size, a constraint dictated by the high cost of these studies.

"Such a study can provide robust genomic markers for risk prediction and disease progression which can then lead to development of new management algorithms. We are confident about carrying out such a study and that we in India will have to do it for ourselves if we are to help our patients. The community will however have to repose faith in this research partnership and provide the financial support to make the study happen and usher a new era of predictive medicine for our people," said Dr. Ranjit Roy Chaudhury, Chairman - Task Force for Research, AHERF.

"In today's day and age, CVD is looming large as the new epidemic afflicting Indians at a relatively younger age. The prevalence of CVD has progressively increased in India during the last half of the century, particularly among the urban population. The conventional risk factors namely hypertension, diabetes mellitus, hypercholesterolemia and tobacco smoking do not fully explain the vulnerability of Indian community to CVD. Conducting such a study at a large scale would help demystify this and fill all the blanks in information," said Dr. Sita Naik, Advisor to the Chairman - Task Force for Research, AHERF.

About Apollo Hospitals:

It was in 1983, that Dr. Prathap C Reddy made a pioneering endeavour by launching India's first corporate hospital - Apollo Hospitals in Chennai. Now, as Asia largest and most trusted healthcare group, its presence includes over 8,500 beds across 50 Hospitals, 1,350 Pharmacies, 100 primary care and diagnostic Clinics, 100 Telemedicine units across 9 countries, medical business process outsourcing services, Health Insurance services, Global Projects Consultancy, 15 colleges of Nursing and Hospital Management and a Research Foundation with a focus on global Clinical Trials, epidemiological studies, stem cell and genetic research.

In a rare honour, the Government of India issued a commemorative stamp in recognition of Apollo's contribution, the first for a healthcare organization. Apollo Hospitals Chairman, Dr. Prathap C Reddy, was conferred with the prestigious Padma Vibhushan in 2010. For more than 29 years, the Apollo Hospitals Group has continuously excelled and maintained leadership in medical innovation, world-class clinical services and cutting-edge technology. Our hospitals are consistently ranked amongst the best hospitals globally for advanced medical services and research.

Primary Media Contact: Parul Chabbra, [email protected], 91-9810588410

Secondary Media Contact: Kusum Sahijpal, [email protected], 91-9999973090