Date of Award
Master of Physician Assistant Studies (MPAS)
Physician Assistant Studies
Coronary artery disease; Genetics; Epigenomics; Diabetes; Hypertension; Obesity; Dyslipidemia; Primary prevention; Standard of care
This systematic literature review intended to ascertain if epigenetic testing for the primary prevention of Coronary Artery Disease (CAD) decreases mortality compared to the current standard of care. This systemic review used PubMed and Cochrane medical databases to assess epigenetic variances and their association with CAD. The Medical Subject Headings (MeSH) terms used were as follows: CAD, genetics, epigenomics, diabetes, hypertension, obesity, dyslipidemia, primary prevention, and standard of care. Further limiting the search results to Randomized Control Trials (RCT’s), meta-analysis, peer-reviewed, and published within the last 10 years. Exclusion criteria included publications before 2011, articles that did not compare genetic variances to the development of CAD, and poor study design. The final review included twelve articles. The research demonstrates multiple epigenetic variances in patients with a prior diagnosis of CAD. The research also demonstrates statistically significant evidence that epigenetic variance in modifiable co-morbid states such as hypertension, obesity, hyperlipidemia, and diabetes exacerbates a patient’s evolution of CAD. Although the research demonstrates multiple epigenetic variances in patients with CAD, questions ascend as to the external validity of the research. The systemic review produced two research articles designed at primary prevention and epigenetic risk stratification of CAD. To further assess epigenetic variances in CAD, more research is needed in the form of a longitudinal, multi-country, multigenerational cohort, multi-ethnic with environmental factors included, along with the comparison of epigenetic risk stratification and gene deletion therapy. Keywords:
Majewski, David, "Epigenetics as Primary Prevention of Coronary Artery Disease" (2022). Physician Assistant Scholarly Project Papers. 127.