Genetics seems to largely explain a form of infarction that mainly affects women under the age of 60, in good health, according to the results of a large study which could allow better management of these patients. “I had no cholesterol, I was athletic, I did not have the usual profile”, is still surprised Gaëlle Martin, 59, victim of a heart attack five years ago.
For a long time, women were considered relatively protected against cardiovascular diseases. However, unlike myocardial infarction, which mainly affects elderly or overweight men, spontaneous dissection of the coronary artery, better known by the acronym SCAD, is a cause of infarction of which nine out of ten victims are women between the ages of 40 and 60 in apparent good health.
Gaëlle Martin must now take lifelong treatment to thin her blood and regulate her blood pressure. When she felt chest pains, the first signs of her heart attack, she first said to herself: “I’m still not going to call the Samu! It was finally SOS Médecins who redirected her to number 15. Taken to the hospital, an examination of the arteries revealed her SCAD. “The victims often seem to have the same profile: women, active, rather stressed”, describes to AFP this teacher in Rennes, who learned to “listen to herself” and found support on a Facebook group created in 2019 .
In SCAD, the inner wall of an artery tears and separates from the outer wall. The circulating blood enters the tear, spreads in the space between the two walls and forms a clot which, in fine, narrows the passage in the artery and blocks the blood circulation. Still poorly understood, this disease often remains underdiagnosed, which complicates its management, while it could represent up to a third of cases of infarction in women under 60 years old.
The team of geneticist Nabila Bouatia-Naji, from the Paris Cardiovascular Research Center (Inserm and Paris-Cité University), has carried out extensive work on the subject by coordinating a meta-analysis of eight studies, which sheds light new on the genetic causes of this disease. By comparing the genetic data of more than 1,900 patients and about 9,300 healthy people, scientists have shown that the genetic causes that define the risk of SCAD are very numerous and distributed over the entire genome of patients, details a study published this week in Nature Genetics.
The poor resorption of the hematoma would be a cause of genetic origin of the infarction, unknown until now, according to these results. “This opens up avenues for future drug treatments,” Nabila Bouatia-Naji told AFP. A better understanding of genetic predispositions could make it possible to identify the patients most at risk in order to improve prevention in women, especially young women.
The study goes further as the scientists also found a robust link between high blood pressure and the risk of SCAD, while confirming that high cholesterol, overweight and type 2 diabetes did not. no impact on this risk. “SCAD is an understudied disease because it is atypical and predominantly female. Our work sheds light on its genetic and biological specificities, which will help us to better care for patients in the future”, underlines the geneticist.
