Current state and future directions of genomic medicine in aortic dissection: A path to prevention and personalized care
Alana C. Cecchi, Madeline Drake, Chrisanne S. Campos, Jake Howitt, Jonathan Medina, Scott M. Damrauer, Sherene Shalhub, Dianna M. Milewicz, Melanie Case, Novelett E. Cotter, Carmen C. David, Mark Fasano, Richard Goldenberg, Jake Howitt, Timo T. Söderlund, Debra Trotter, Asaf Rabin, Mattie Boehler-Tatman, Melissa L. Russo, Laura M. Drudi, Laura L. Marks, Maisoon D. Yousif, Tabea Hoffstaetter, Ella Taubenfeld, Sreekanth Vemulapalli, Chrisanne S. Campos, Lindsey Rusche, Robert C.F. Pena, Firas F. Mussa, Gretchen MacCarrick, Earl Goldsborough, Christeen Samuel, Lillian Xu, Nicolas J. Mouawad, Eanas S. Yassa, Xiaoyi Teng, Amani D. Politano, Jesse Teindl, Lara Bloom, Rebecca Gluck, Meredith Ford O'Neal, Josephine Grima, Eileen Masciale, Takeyoshi Ota, Katelyn Wright, Alan J. Hakim, Gareth Owens, George J. Arnaoutakis, Dejah R. Judelson, Mario D’Oria, Lurdes del Rio-Sola, Mark Ajalat, Marvin Chau, Stephanie D. Talutis, Karen Woo, Max V. Wohlauer, JeniannA. Yi, Kim A. Eagle, Marion A. Hofmann Bowman, Eva Kline‐Rogers, Hyein Kim, Claudine Henoud, Scott M. Damrauer, Emilia Król, Rana O. Afifi, Alana C. Cecchi, Madeline Drake, Anthony L. Estrera, Avery M Hebert, Dianna M. Milewicz, Siddharth K. Prakash, Aaron W. Roberts, Harleen K. Sandhu, Akili Smith-Washington, Akiko Tanaka, Jacob Watson, Myra Ahmad, Catherine M. Albright, Christopher R. Burke, Peter H. Byers, L’Oreal Kennedy, Sarah Lawrence, Jenney R. Lee, Jonathan Medina, Thamanna Nishath, Julie Pham, Courtney Segal, Sherene Shalhub, Michael Soto, Linell Catalan, Megan Patterson, Nicole Ilonzo
Abstract
Aortic dissection confers high mortality and morbidity rates despite advances in treatment, impacts quality of life, and contributes immense burden to the healthcare system globally. Efforts to prevent aortic dissection through screening and management of modifiable risk factors and early detection of aneurysms should incorporate genomic information, as it is integral to stratifying risk. However, effective integration of genomic-guided risk assessment into clinical practice will require addressing implementation barriers that currently permeate our healthcare systems. The Aortic Dissection Collaborative was established to define aortic dissection research priorities through patient engagement. Using a collaborative patient-centered feedback model, our Genomic Medicine Working Group identified related research priorities that could be investigated by pragmatic interventional studies aimed at aortic dissection prevention, utilization of genomic information to improve patient outcomes, and access to genomic medicine services. Further research is also needed to identify the genomic, lifestyle, and environmental risk factors that contribute to aortic dissection so these data can be incorporated into future comparative effectiveness studies to prevent aortic dissection.