030522 - Are you programmed for a Heart Attack? ( VEGF treatment, cancer drug Avastin)
You eat right, exercise and take vitamins, but can you really prevent heart disease if it’s in your genes?
By Dahlia Reich (Canadian Living)
Risk factors
Researchers say that all the well-known risk factors for heart disease – a diet high in saturated fat, physical inactivity, smoking, diabetes, high blood pressure, increasing age, elevated cholesterol and stress – are only about 50% of the problem; the other half is genetic. Genes set the stage, while your environment, or lifestyle, determines how early, or quickly, the arteries harden and become clogged.
Genetic treatment of Coronary Heart Disease (CHD)
A gene therapy now being studied in Canada appears to induce the heart to grow new blood vessels – little bypasses of its own – to provide blood flow to areas that are lacking it.
The Procedure doesn’t actually alter defective genes that cause heart disease. Instead, it uses genes as therapy: the gene for Vascular Endothelial Growth Factor (VEGF) is injected into the heart to encourage blood vessel growth, says Dr. Duncan Stewart, head of cardiology at St. Michael’s hospital in Toronto, which is spearheading six-center Canadian trial with 120 patients. If it’s successful, the procedure could be boon to the 15 to 20 per cent of heart patients who are not candidates for standard procedures, such as bypasses or angioplasty.
Preventing heart disease, however, is another story. The genetic factors are complicated. The problem is, heart disease is not a single gene condition like cystic fibrosis or other gene disease that people hear about. While some types of heart disease are linked to single gene, hundreds of genes may play a role.
For every risk factor associated with heart disease, there are different groups of gene responsible: one cluster of genes is linked to high blood pressure, another group to diabetes, another to obesity, another to cholesterol and so on. “There are many different genes, and each contributes in a little way,” says Dr. Robert Hegele, a scientist at the John Robarts Research Institute in London Ont., and a Canada Research Chair in human genetic. Individual gene doesn’t tell you very much. The hunt for genes is intense, but right now, of the many genes they’ve analyzed, researchers have discovered only 2 that can help determine susceptibility to heart disease.
There are a variety of biochemical markers that may very well predict heart disease but not sure how to apply them yet. These markers are where cholesterol information was 20 years ago, when there wasn’t strong evidence of the importance of cholesterol, says Hegele. Among the new markers under study are C-reactive protein, homocysteine, lipoprotein (a), and fibrinogons – all proteins in the blood that can be measured and may contribute to plague buildup or blood clotting in various ways. As with cholesterol, abnormal levels of these proteins may be a sign of greater risk of heart disease.
Diagnosis/Tests
Generally, a stress test and an Electrocardiogram (ECG) are only ordered if there are symptoms of heart disease. There aren’t enough machines and technicians to test everyone with potential risks, and the test can have false positive and false negative results, says Hegele. 
“Most physicians will make decisions based on 10 or 12 bits of information,” says Genest, coauthor of the latest Health Canada screening guidelines to help doctors evaluate heart disease risk. “It’s not perfect. They will underestimate or overestimate risk with some people, but it’s the best we have at this time.”
Quick facts
Every year in Canada, more than 75,000 people have a heart attack, and about one-third of those die.
Of all cardiovascular deaths, 56% are due to coronary artery disease; 20% are due to stroke; 15 % are caused by other forms of heart disease, such as problems with the electrical system of the heart, viral heart infections and heart muscle disease; and he remaining 9% of deaths are due to vascular problem, such as hypertension and congenital heart defects.
The average age of a heart attack patient in Canada is 65. 

030522 – VEGF (CHD gene bypass), inhibited by Avastin drug for cancer curing 
Genentech (DNA), a South San Francisco, Calif.-based biotech heavyweight that issued some positive results for its experimental cancer treatment, Avastin. A late-stage trial showed the drug, when used in combination with chemotherapy, improved the survival rate of colon-cancer patients. 
Avastin is designed to work by inhibiting a protein, called vascular endothelial growth factor, which is crucial in the formation of a tumor's new blood vessels as well as the maintenance of existing ones. This interruption of blood flow to weaken a tumor, a process known as antiangiogenesis, has been an industry focus point in recent years. Analysts regarded Genentech's news as a potential breakthrough for the treatment of colon cancer, which kills about 57,000 Americans each year.

BACK