Hundreds of thousands of Danes suffer from cardiovascular diseases, and many of them are receiving preventive treatment. However, despite extensive knowledge about the many different risk factors impacting the development of heart disease, physicians are struggling to target treatment to the individual patient. As a result, some patients receive unnecessary preventive treatment, whereas others do not receive the optimal preventive measures.

An extensive new collaboration in the Nordic countries is now developing a model to provide cardiologists with better opportunities to target patient treatment. Henning Bundgaard, project manager, a consultant at Rigshospitalet and professor at the University of Copenhagen, said:

"The new collaboration will combine in-depth knowledge from clinical data at hospitals and biobanks, register data, data on medicine consumption, and data from genetic studies. In many cases this data has been collected over several years. This provides a unique basis for developing models that can tell us the exact profile of cardiovascular disease in the individual patient, and thereby prevent both overtreatment and undertreatment in the future," said Professor Bundgaard. 

Photo: Professor Henning Bundgaard

In addition to cardiologists and the biobank at Rigshospitalet, the University of Copenhagen, the Danish National Genome Center, Oslo University Hospital, Norwegian University of Science and Technology - NTNU, and deCODE genetics from Iceland are participating in the ‘Precision Diagnostics and Prediction in Ischemic Heart Disease including Identification of Over-Treated Patients’ project. 

The funding of DKK 22.5 million comes from the national innovation funds and research councils in Denmark, Norway and Iceland, and from NordForsk, a programme under the Nordic Council of Ministers. 

Genes are viewed as networks

Professor in Bioinformatics at the University of Copenhagen, Søren Brunak, will be working with new analysis models in the project. 

"Genetic predisposition to heart disease involves far more genes than we thought only a few years ago. Therefore, it's relevant to use systems biology approaches to analyse genes as large networks. Our genetic material also contains many factors that reduce our risk of heart disease. It's just as important to identify these protecting factors in precision medicine," said Professor Brunak. 

Focus on ethics, law and finances

The project also focuses on ethical, legal and socio-economic aspects in using data from patients. 

"The use of genetic analyses raises a number of ethical and legal issues, for example concerning access to sensitive data and protection of patient privacy. Relationships and responsibilities regarding the patient's relatives should also be considered. There’s also a need for more knowledge about the socio-economic aspects of using precision medicine. We now have an opportunity to examine this in relation to a disease that affects a very large part of the population," said Professor Mette Hartlev, director of the Centre for Legal Studies in Welfare and Market at University of Copenhagen. 

PM Heart funding:

• 'Precision Diagnostics and Prediction in Ischemic Heart Disease including Identification of Over-Treated Patients' has a total budget of DKK 29.4 million (EUR 4 million). 
• Denmark will finance DKK 16.8 million (EUR 2.25 million) with DKK 10.7 million (EUR 1.5 million) from Innovation Fund Denmark, DKK 3.2 million (EUR 430,000) from NordForsk and DKK 2.9 million (EUR 390,000) from the partners involved. 
• Norway and Iceland will finance DKK 12.6 million (EUR 1.7 million) through the Research Council of Norway, the Icelandic Centre for Research (Rannis), Nordforsk and the individual partners.