Heart failure is a serious condition that affects millions of people around the world. It develops when the heart becomes too weak or too stiff to pump enough blood to meet the body’s needs.
As the disease progresses, people may experience tiredness, shortness of breath, swollen legs, and difficulty carrying out everyday activities.
Heart failure is one of the leading causes of hospital admissions among older adults and can greatly reduce quality of life. Scientists are now looking for ways to identify people at high risk before symptoms begin so that treatment can start earlier.
A new study from researchers at the Mass General Brigham Heart and Vascular Institute and the Broad Institute of MIT and Harvard offers encouraging news.
The research, published in Nature Medicine, found that a medicine called dapagliflozin may provide especially strong protection against heart failure in people who carry rare genetic changes that increase the risk of developing an inherited heart disease called cardiomyopathy.
Cardiomyopathy is a disease in which the heart muscle becomes weak, enlarged, or stiff. In many cases it is caused by inherited genetic variants passed from parents to their children.
People carrying these variants may feel completely healthy for many years before heart problems develop. Until recently, doctors could identify these genetic changes but had very few treatments to offer before symptoms appeared.
The medicine studied, dapagliflozin, was first developed to treat type 2 diabetes. It lowers blood sugar by helping the kidneys remove extra glucose and sodium through the urine.
Over the past several years, researchers have also discovered that the drug protects the heart and kidneys, even beyond its effects on blood sugar. It is already used to treat many patients with heart failure, but scientists wanted to know whether people with inherited cardiomyopathy genes might benefit even more.
To answer this question, the researchers analyzed genetic information from the DECLARE-TIMI 58 clinical trial, which included 12,685 people with type 2 diabetes.
Among them, 121 participants carried rare cardiomyopathy-related genetic variants. The team compared people who received dapagliflozin with those who received a placebo and followed them for a median of 4.2 years.
The results were striking. Among participants carrying cardiomyopathy variants, about 16% of those receiving placebo were hospitalized for heart failure. In contrast, only 3% of those taking dapagliflozin required hospitalization.
This represented an approximately 82% reduction in relative risk. The medicine also benefited participants who did not carry these genetic variants, reducing heart failure hospitalizations by about 32%, but the protective effect was much greater among genetic carriers.
The researchers also found that dapagliflozin worked in participants regardless of whether they already had heart failure. This suggests that the medicine may help prevent disease as well as treat existing heart problems.
The findings highlight the growing role of genetic testing in medicine. Instead of treating everyone the same way, doctors may eventually use genetic information to identify people who would benefit most from certain medications. For families affected by inherited cardiomyopathy, this could allow treatment to begin years before symptoms appear.
Although the results are highly encouraging, the researchers caution that all participants in this study had type 2 diabetes. More research is needed to determine whether dapagliflozin provides the same level of protection for people who carry cardiomyopathy genes but do not have diabetes.
Overall, this study represents an important step toward personalized medicine. It suggests that combining genetic screening with targeted treatment could dramatically reduce the risk of heart failure in some high-risk individuals.
While larger studies are still needed, the findings provide strong evidence that identifying inherited heart disease early may allow doctors to prevent serious complications before they begin.
If you care about heart health, please read studies about how eating eggs can help reduce heart disease risk, and Vitamin K2 could help reduce heart disease risk.
For more information about health, please see recent studies that olive oil may help you live longer, and Vitamin C linked to lower risk of heart failure.
Source: Mass General Brigham.
