Evolving Paradigm of Precision Medicine in Cardiovascular Disease.
Dr. Manish Narang, Dr. Ramanpreet Walia, Dr. Upendra Kaul and Dr. Krishnakutty Sudhir
In the year 1892, Sir William Osler, the legendary Canadian physician and one of the four founding professors of Johns Hopkins Hospital, said “If it were not for the great variability among individuals, medicine might as well be a science and not an art”. It is this heterogeneity among patients with seemingly homogenous medical conditions, that form the basis of what we today refer to as precision medicine. The fundamental of precision medicine is based on the tenets of ‘The right drug for the right patient at the right time’. Personalized or precision medicine found immense popularity in oncology. With the completion of Human Genome Project and the advent of genomics, big data and artificial intelligence, 21st century saw rapid progress of precision medicine in predicting, diagnosing and treating cancer. However, the same has not happened to cardiovascular diseases, the biggest killer of humanity. In this review article, we aim to address the concepts, components, outcomes and applications of precision medicine in general, and to review the evolving paradigm of how precision medicine is shaping the management of cardiovascular diseases. We delve deep into the aspects of risk prediction, preventative measures, and targeted therapeutic approaches for cardiovascular diseases. We also look at the recent trends and current applications of precision medicine in this area, the problems they solve and the challenges they possess, and what is in store for the future. Finally, we review the application of artificial intelligence specific to cardiovascular diseases, and the role of precision medicine in interventional cardiology.View pdf