Heart Attack Prevention
What is a heart attack?
A heart attack, medically known as a myocardial infarction (MI), occurs when blood flow to a part of the heart is blocked. This can happen when an artery supplying the heart with blood becomes narrowed or blocked, usually due to the build-up of cholesterol-rich plaque in the vessel. If one of the plaques ruptures, it can cause a blood clot at the site of the rupture which stops the flow of blood to the heart and triggers a heart attack. Without oxygen-rich blood, the affected part of the heart muscle can be damaged or die, leading to serious complications or even death.
Common risk factors for heart attack include hypertension, diabetes, high cholesterol, smoking, obesity, sedentary lifestyle, excessive alcohol consumption, age, family history of heart disease and gender. Patients at high risk of heart attack are often prescribed preventative medications to reduce the risk of cardiovascular events.
What medicines are typically prescribed to help prevent a heart attack?
Heart attack prevention often involves the use of medications to manage risk factors such as high blood pressure, high cholesterol, and blood clot formation. Common medications prescribed for heart attack prevention include:
Statins (such as simvastatin, atorvastatin and fluvastatin) to lower cholesterol.
Beta blockers (such as atenolol, bisoprolol, carvedilol and metoprolol) to reduce blood pressure and heart rate.
Antiplatelet medicines (such as aspirin, clopidogrel, prasugrel and ticagrelor) to prevent blood clots.
ACE inhibitors or ARBs (such as captopril and lisinopril) to lower blood pressure and reduce strain on the heart.
Many of these heart attack prevention medications are covered on the Mantara PGx test. You can see the full list of medicines included here.
What are the common side effects of heart attack prevention medicines?
While these medications are effective in preventing heart attacks, they may also come with potential side effects.
Statins:
Constipation
Diarrhoea
Headaches
Abdominal pain
Beta Blockers:
Fatigue
Dizziness
Cold hands and feet
A slow heartbeat
Diarrhoea
Feeling sick
Difficulty sleeping or nightmares
Erectile dysfunction or impotence
Antiplatelet Medicines:
Diarrhoea
Bruising or bleeding
Breathlessness
Abdominal pain
Indigestion
Heartburn
ACE inhibitors or ARBs:
Dizziness
Tiredness or weakness
Headaches
A persistent, dry cough
Elevated potassium levels.
How can pharmacogenomics (PGx) help?
Pharmacogenomics (PGx) offers a personalised approach to heart attack prevention by analysing an individual's genetic makeup to determine how they may respond to certain medications. Many antiplatelet drugs, statins, and beta-blockers, all vital for heart attack prevention, are covered on the Mantara PGx test (click here to see the full list of drugs included). PGx testing can identify genetic variations that affect how the body metabolises and responds to these medications.
Clopidogrel, for instance, one of the most commonly prescribed antiplatelet medications for heart attack prevention, has particularly high rates of ineffectiveness due to genetic variations. Studies suggest that around 30% of patients in the UK may not respond adequately to clopidogrel because they do not have the enzymes to metabolise the drug. Therefore, as is highlighted in draft guidelines for the NHS, testing for these variations with PGx can help identify patients who may benefit from alternative medications or adjusted dosages to optimise heart attack prevention strategies.
By providing insights into a patient's genetic profile, PGx testing enables healthcare providers to tailor treatment plans, select the most effective medications, and minimise the risk of adverse drug reactions.