Defining the “actionable genome” toward risk assessment for recurrent cardiovascular events

Objectives and study: Cardiovascular disease remains a leading cause of death and at the same time, a global public health issue of major socio-economic impact. Optimal patient stratification and decision-making in the clinic demand the in-depth understanding of the (patho)physiology of the cardiovascular system, not only for a cardiovascular event to be successfully dealt with, but also to assess the risk of its recurrence. Herein, we aim to perform a state-of-the-art strategy towards risk assessment and better-informed patient stratification via multiomics data integration. Methods: Following the recruitment of patients with a cardiovascular event (first or a recurrent one) of Hellenic origin, we performed text- and data- mining and used a series of databases and chemoinformatics to explore a panel of genomic variants and their association to cardiovascular events and their recurrence. Such datasets are integrated to miRNAs and proteomics/metabolomics datasets to reveal the so-called “actionable genome” and map interindividual variability Results: Our preliminary datasets indicate that selected NOS3, NOA1, PHACTR1, PCSK9, APOB, MRAS, GUCY1A3, CDKN2B-AS1, BCAS3, VEGF and SMARCA4 variants may account for the cardiovascular events in question and their recurrence. Conclusion: Such a multi-omics strategy may serve as the building block of a nomogram to optimize cardiovascular disease management and patient stratification with an emphasis on risk assessment.