Discovery
Discovering new causes of coronary artery disease enables detection, prevention, and treatment. We focus on understanding the causes of coronary artery disease by taking an approach that intersects human genetics with deep phenotyping through invasive and non-invasive coronary imaging and physiology. In addition to association analyses on genomic data from biobanks, we leverage catheterization-based imaging and physiology of the coronary circulation and coronary CT plaque imaging to better understand patterns and subtypes of atherosclerosis, as well as poorly studied non-atherosclerotic coronary artery diseases such as microvascular and endothelial dysfunction and spontaneous coronary artery dissection.
Prediction
Predicting who will have coronary artery disease earlier in the life course creates an opportunity for intervening before it is too late. We develop risk models for coronary artery disease that integrate genomic information present from time of birth, accumulated risk factors through the life course, and biomarkers and data collected in the context of healthcare. We leverage advanced statistical and machine learning methods to develop pragmatic models informed by the everyday practice of medicine. We then use existing datasets to validate the clinical utility of those models in diverse settings and populations.
treatment
All discoveries and predictive models need to be ultimately brought back to patients in the clinic through innovative implementation efforts and prospective studies such as clinical trials. We design and conduct genomic medicine implementation studies and genome-informed clinical trials for coronary artery disease. We believe that polygenic risk scores are powerful tools to enrich clinical trials and deliver precision medicine. Our landmark PROACT clinical trials are testing a polygenic risk-based detection strategy for subclinical coronary atherosclerosis to improve cardiovascular health and treat coronary plaque. We also participate in multisite clinical trials and registries for innovative catheter-based coronary interventions and drugs for atherosclerosis.
