Too much clot  pg. 2

Canary in the Coal Mine
Colorized image of a retinal scan reveals a tiny clot (white spot at the intersection of two blood vessels).  This occasionally is the first sign of heart disease in patients being screened for something else—in this case, diabetic retinopathy.  "The canary in the coal mine" analogy is particularly apt," says Lawrence M. Merin, who directs the Vanderbilt Ophthalmic Imaging Center, "as the vast majority of these patients have no visual symptoms.  The clinical significance of these lesions is most important; if left untreated, there is a 50 percent mortality rate within five years of identification of these lesions."
Courtesy of Lawrence M. Merin

Certainly diet and exercise can help people avoid the serious health consequences of obesity and diabetes. But lifestyle changes are easier said than done. And it is becoming increasingly clear that genetic predispositions influence risk—and the effectiveness of risk-lowering interventions.

“If you have a set of inherited risk factors…, even modest hypertension (and) modest elevations in lipids… may have a more deleterious effect on you than they do on another individual with the same numbers but a lower set of genetic risk factors,” says Samuel Santoro, M.D., Ph.D., chair of Pathology at Vanderbilt and a SCCOR participant.

Better understanding of the molecular and genetic contributions to clotting disorders could lead to new therapies that are more effective and have fewer side effects. It also could help doctors identify and manage patients at risk of serious complications during and after heart procedures such as angioplasty.

Another goal of the SCCOR is to help open the door to individualized, preventive medicine. If genetic variations or polymorphisms that increase the risk for thrombosis can be identified, it may be possible to screen patients in advance, and make adjustments in the drugs they are given, the procedures they undergo and the lifestyle changes they make so that they never experience that first heart attack or stroke.

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