Aim project: To identify individuals at high risk for Sudden cardiac arrest (SCA) in people with type 2 diabetes focusing on general practitioner (GP) files and molecular markers (DNA, metabolomics).
SCA is a vast general health problem, causing 50% of cardiovascular mortality and 20% of total mortality in The Netherlands. Only 20% survive SCA, and survivors may suffer significant residual disability. Yet, SCA mostly strikes individuals whose SCA risk was unknown to themselves and their general practitioners (GPs) and accordingly, a substantial part of SCA victims (40-50%) was never seen by cardiologists prior to SCA. Additionally, people with type 2 diabetes have a 3 fold higher risk of SCA. Clearly, recognition of individuals at risk must be improved. This enables patients to seek timely medical care, and GPs to treat and/or refer these patients to cardiologists, and allows for design of preventive strategies. Furthermore, the (molecular) mechanisms that underlie SCA risk in people with type 2 diabetes will be investigated through the use of so far untapped methods in SCA research in people with type 2 diabetes (genetics, metabolomics).
The RESCUED project contains several innovative aspects:
1. Information in GP files will be unlocked using data mining. Through data mining of GP files, we will investigate whether symptoms and clinical signs, at present deemed nonspecific and irrelevant, may distinguish individuals at risk of impending SCA. This state-of-the-art method may also be applicable to SCA research in people with other diseases i.e., people without diabetes.
2. Genetic markers for SCA in the community among individuals with type 2 diabetes will be investigated, as opposed to rare patient/families with inherited arrhythmia syndromes typically seen at Cardiogenetics departments. This analysis includes both common variants (GWAS) and rare variants (whole exome sequencing).
3. Metabolomic profiles associated with SCA in the type 2 diabetes population will yield tools for early detection of those at increased SCA risk. Furthermore, it might provide novel clues about its etiology. Metabolomic profiling has already been used successfully to identify prospective markers for type 2 diabetes and cardiovascular disease.
Role of research group in this project: Petra Elders and Amber van der Heijden are part of the coordinating team of RESCUED. Further, Petra Elders Amber van der Heijden and Joline Beulens are involved in the supervision of the PhD students in RESCUED. The RESCUED project is closely connected to the ARREST-study and ESCAPE-net project.
Click to read more on the ARREST-study (external website)
Click to read more on the ESCAPE-NET project (external website)Click to read more (external website)