Natalie A. Bello, MD, MPH; Eliza C. Miller, MD; Kirsten Lawrence Cleary, MD, MSc; Ronald Wapner, MD
Disclaimer: The content of this article is solely the responsibility of the authors and does not represent the official views of the National Institutes of Health.
Grant Support: The authors acknowledge support from the Columbia Precision Medicine Initiative, Columbia University, New York, New York, as well as the National Institutes of Health (NIH), Columbia Clinical and Translational Science Award grant UL1TR001873 from the National Center for Advancing Translational Sciences (NCATS). Dr. Bello reports support from the NIH/National Heart, Lung, and Blood Institute grant K23 HL136853 and the Katz Foundation. Dr. Miller reports support from the NIH/NCATS grant 5KL2TR001874, the NIH/National Institute of Neurological Disorders and Stroke grant K23NS107645, and the Louis V. Gerstner, Jr. Foundation.
Disclosures: Dr. Bello reports nonfinancial support from the American Heart Association outside the submitted work. Dr. Miller reports personal compensation for medicolegal consulting related to maternal stroke. Authors not named here have disclosed no conflicts of interest. Disclosures can also be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M19-1601.
Editors' Disclosures: Christine Laine, MD, MPH, Editor in Chief, reports that her spouse has stock options/holdings with Targeted Diagnostics and Therapeutics. Darren B. Taichman, MD, PhD, Executive Editor, reports that he has no financial relationships or interests to disclose. Cynthia D. Mulrow, MD, MSc, Senior Deputy Editor, reports that she has no relationships or interests to disclose. Jaya K. Rao, MD, MHS, Deputy Editor, reports that she has stock holdings/options in Eli Lilly and Pfizer. Catharine B. Stack, PhD, MS, Deputy Editor, Statistics, reports that she has stock holdings in Pfizer, Johnson & Johnson, and Colgate-Palmolive. Christina C. Wee, MD, MPH, Deputy Editor, reports employment with Beth Israel Deaconess Medical Center. Sankey V. Williams, MD, Deputy Editor, reports that he has no financial relationships or interests to disclose. Yu-Xiao Yang, MD, MSCE, Deputy Editor, reports that he has no financial relationships or interest to disclose.
Corresponding Author: Natalie A. Bello, MD, MPH, Division of Cardiology, Columbia University Medical Center, 622 West 168th Street, PH 3-342, New York, NY 10032; e-mail, firstname.lastname@example.org.
Current Author Addresses: Dr. Bello: Division of Cardiology, Columbia University Medical Center, 622 West 168th Street, PH 3-342, New York, NY 10032.
Dr. Miller: Neurological Institute of New York, 710 West 168th Street, 6th Floor, New York, NY 10032.
Dr. Cleary: Columbia University Irving Medical Center, 622 West 168th Street, 16-66, New York, NY 10032.
Dr. Wapner: Columbia University Irving Medical Center, 622 West 168th Street, PH-16-66D, New York, NY 10032.
Author Contributions: Conception and design: N.A. Bello, E.C. Miller, K.L. Cleary.
Analysis and interpretation of the data: K.L. Cleary, R. Wapner.
Drafting of the article: N.A. Bello, E.C. Miller, K.L. Cleary, R. Wapner.
Critical revision of the article for important intellectual content: N.A. Bello, E.C. Miller, K.L. Cleary, R. Wapner.
Final approval of the article: N.A. Bello, E.C. Miller, K.L. Cleary, R. Wapner.
Administrative, technical, or logistic support: K.L. Cleary, R. Wapner.
Collection and assembly of data: N.A. Bello.
Cardiovascular disease is the leading cause of death among women in the United States, and stroke is third. This article uses a case scenario to examine female sex–specific cardiovascular risk factors across the lifespan and describes a precision medicine–based approach to risk factor modification and primary prevention. It also presents recent updates to the role of genetic testing and polygenic risk scores for the prediction of stroke and cardiovascular disease.
Bello NA, Miller EC, Cleary KL, et al. Cases in Precision Medicine: A Personalized Approach to Stroke and Cardiovascular Risk Assessment in Women. Ann Intern Med. 2019;:. [Epub ahead of print 15 October 2019]. doi: https://doi.org/10.7326/M19-1601
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Published: Ann Intern Med. 2019.
Cardiology, Coronary Risk Factors, Neurology, Prevention/Screening, Stroke.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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