Cedars-Sinai Medical Center

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$1.2 Million State Precision Medicine Grant

Brennan M. Spiegel, MD
C. Noel Bairey Merz, MD
Jennifer Van Eyk, PhD

Cedars-Sinai health investigators will use a $1.2 million grant from a state precision medicine initiative to design a system using remote monitoring to predict heart attacks and other cardiovascular events.

In this study, the research team will look for the earliest signs of cardiovascular disease by monitoring patients remotely with a specialized watch that measures activity, sleep, heart rate and stress levels. Participants also will report their levels of anxiety, depression and quality of life using a smartphone or computer. Additionally, patients will send researchers finger-prick blood samples by mail, allowing doctors to assess a variety of biomarkers and measure more than 500 blood proteins.

By combining these data and integrating them into patients' medical records, the researchers will seek a signal that can predict who may be about to have a heart attack or stroke, empowering patients to better manage their conditions. The team also will measure the cost-effectiveness of this approach and whether it could be covered by insurance companies and other payers.

The Cedars-Sinai study aims to address a major national health issue: Cardiovascular disease is the leading cause of death for both men and women in the United States, disproportionately impacting younger women and ethnic minorities. Health experts say early signs of a heart attack or stroke can be missed because people typically have limited interaction with doctors or hospitals, making it challenging to monitor symptoms.

"The governor's precision medicine initiative creates an amazing opportunity to confront this leading health threat by leveraging team science and advanced data analytics in ways never before possible," said Brennan M. Spiegel, MD, professor of Medicine and director of Health Services Research at Cedars-Sinai, who will lead the study. "For us, that means trying to stay one step ahead of cardiovascular disease by predicting who may have a heart attack or stroke before it happens."

Funding for the study comes from the California Initiative to Advance Precision Medicine, launched by Gov. Jerry Brown in 2015 to expand the capabilities of precision medicine within California. Cedars-Sinai, one of six demonstration projects selected by the state precision medicine initiative, will receive the $1.2 million grant over two years.

The research reflects a broad national push to combine emerging technology and medicine to benefit patients. Precision medicine aims to use data-driven tools and analysis to develop new diagnostics, therapies and insights into disease. The teams in the California initiative will join forces to use data across research, clinical, environmental and population health settings to better diagnosis, treat, manage and prevent disease.

"Despite effective medical therapies and lifestyle interventions, many heart disease patients still progress due to undertreatment, poor adherence to treatment or failure to recognize clinical or biochemical clues that warn of heart attacks, strokes and heart failure," said C. Noel Bairey Merz, MD, professor of Medicine, director of the Barbra Streisand Women's Heart Center and a co-principal investigator in the study.

The key is identifying new predictive blood biomarkers earlier, said another co-principal investigator, Jennifer Van Eyk, PhD, director of the Advanced Clinical Biosystems Institute and of Basic Science Research in the Barbra Streisand Women's Heart Center. "Then impending cardiovascular death and disability may be prevented through treatment intensification and efforts to enhance compliance with lifesaving therapy," Van Eyk said.

The Cedars-Sinai team also includes researchers Corey Arnold, PhD, and Peipei Ping, PhD, from the David Geffen School of Medicine at UCLA. The team will partner with five California life science companies: HealthLoop, Neoteryx, Beckman Coulter, SCIEX and Thermo Fisher Scientific.

The study also has received funding from Cedars-Sinai Precision Health, a campaign to transform the institution's practice of medicine by harnessing advanced data on individuals' genes, proteins, microbiome (bacterial communities) and other body chemistry. The goal is to tailor therapies and medications for specific patients.

"This study, across medical disciplines and in partnership with industry, addressing a critical clinical question, is an example of the outstanding projects that Precision Health at Cedars-Sinai is brilliantly positioned to address," said Dermot McGovern, MD, PhD, professor of Medicine and Biomedical Sciences and director of the campaign. "Using big data and near-patient technologies together with outstanding clinical care to address a significant clinical problem is at the core of Cedars-Sinai Precision Health."