title: Opportunities for the Cardiovascular Community in the Precision Medicine Initiative.
abstract: The Precision Medicine Initiative recently announced by President Barack Obama seeks to move the field of precision medicine more rapidly into clinical care. Precision medicine revolves around the concept of integrating individual-level data including genomics, biomarkers, lifestyle and other environmental factors, wearable device physiological data, and information from electronic health records to ultimately provide better clinical care to individual patients. The Precision Medicine Initiative as currently structured will primarily fund efforts in cancer genomics with longer-term goals of advancing precision medicine to all areas of health, and will be supported through creation of a 1 million person cohort study across the United States. This focused effort on precision medicine provides scientists, clinicians, and patients within the cardiovascular community an opportunity to work together boldly to advance clinical care; the community needs to be aware and engaged in the process as it progresses. This article provides a framework for potential involvement of the cardiovascular community in the Precision Medicine Initiative, while highlighting significant challenges for its successful implementation.
authors.affiliation: From Division of Cardiology, Department of Medicine, Duke University, Durham, NC (S.H.S., G.S.G.); Duke Molecular Physiology Institute, Duke University, Durham, NC (S.H.S.); School of Public Health, University of Alabama at Birmingham, Birmingham, AL (D.A.); Division of Cardiology, Department of Medicine, Temple University School of Medicine, Philadelphia, PA (S.R.H.); Cardiovascular Research Center, Temple University School of Medicine, Philadelphia, PA (S.R.H.); Duke Center for Personalized Medicine, Department of Medicine, Duke University, Durham, NC (G.S.G.); Division of Cardiology, Department of Medicine, Brigham and Women's Hospital, Boston, MA (C.M., J.L.); Division of Cardiology, Department of Pediatrics, The Hospital for Sick Children, Toronto, Canada (S.M.); and Lillehei Heart Institute, Division of Cardiology, Department of Medicine, University of Minnesota, Minneapolis, MN (J.L.H.). jlhall@umn.edu svati.shah@duke.edu.
authors.forename: Svati H
authors.initials: SH
authors.lastname: Shah
authors.affiliation: From Division of Cardiology, Department of Medicine, Duke University, Durham, NC (S.H.S., G.S.G.); Duke Molecular Physiology Institute, Duke University, Durham, NC (S.H.S.); School of Public Health, University of Alabama at Birmingham, Birmingham, AL (D.A.); Division of Cardiology, Department of Medicine, Temple University School of Medicine, Philadelphia, PA (S.R.H.); Cardiovascular Research Center, Temple University School of Medicine, Philadelphia, PA (S.R.H.); Duke Center for Personalized Medicine, Department of Medicine, Duke University, Durham, NC (G.S.G.); Division of Cardiology, Department of Medicine, Brigham and Women's Hospital, Boston, MA (C.M., J.L.); Division of Cardiology, Department of Pediatrics, The Hospital for Sick Children, Toronto, Canada (S.M.); and Lillehei Heart Institute, Division of Cardiology, Department of Medicine, University of Minnesota, Minneapolis, MN (J.L.H.).
authors.forename: Donna
authors.initials: D
authors.lastname: Arnett
authors.affiliation: From Division of Cardiology, Department of Medicine, Duke University, Durham, NC (S.H.S., G.S.G.); Duke Molecular Physiology Institute, Duke University, Durham, NC (S.H.S.); School of Public Health, University of Alabama at Birmingham, Birmingham, AL (D.A.); Division of Cardiology, Department of Medicine, Temple University School of Medicine, Philadelphia, PA (S.R.H.); Cardiovascular Research Center, Temple University School of Medicine, Philadelphia, PA (S.R.H.); Duke Center for Personalized Medicine, Department of Medicine, Duke University, Durham, NC (G.S.G.); Division of Cardiology, Department of Medicine, Brigham and Women's Hospital, Boston, MA (C.M., J.L.); Division of Cardiology, Department of Pediatrics, The Hospital for Sick Children, Toronto, Canada (S.M.); and Lillehei Heart Institute, Division of Cardiology, Department of Medicine, University of Minnesota, Minneapolis, MN (J.L.H.).
authors.forename: Steven R
authors.initials: SR
authors.lastname: Houser
authors.affiliation: From Division of Cardiology, Department of Medicine, Duke University, Durham, NC (S.H.S., G.S.G.); Duke Molecular Physiology Institute, Duke University, Durham, NC (S.H.S.); School of Public Health, University of Alabama at Birmingham, Birmingham, AL (D.A.); Division of Cardiology, Department of Medicine, Temple University School of Medicine, Philadelphia, PA (S.R.H.); Cardiovascular Research Center, Temple University School of Medicine, Philadelphia, PA (S.R.H.); Duke Center for Personalized Medicine, Department of Medicine, Duke University, Durham, NC (G.S.G.); Division of Cardiology, Department of Medicine, Brigham and Women's Hospital, Boston, MA (C.M., J.L.); Division of Cardiology, Department of Pediatrics, The Hospital for Sick Children, Toronto, Canada (S.M.); and Lillehei Heart Institute, Division of Cardiology, Department of Medicine, University of Minnesota, Minneapolis, MN (J.L.H.).
authors.forename: Geoffrey S
authors.initials: GS
authors.lastname: Ginsburg
authors.affiliation: From Division of Cardiology, Department of Medicine, Duke University, Durham, NC (S.H.S., G.S.G.); Duke Molecular Physiology Institute, Duke University, Durham, NC (S.H.S.); School of Public Health, University of Alabama at Birmingham, Birmingham, AL (D.A.); Division of Cardiology, Department of Medicine, Temple University School of Medicine, Philadelphia, PA (S.R.H.); Cardiovascular Research Center, Temple University School of Medicine, Philadelphia, PA (S.R.H.); Duke Center for Personalized Medicine, Department of Medicine, Duke University, Durham, NC (G.S.G.); Division of Cardiology, Department of Medicine, Brigham and Women's Hospital, Boston, MA (C.M., J.L.); Division of Cardiology, Department of Pediatrics, The Hospital for Sick Children, Toronto, Canada (S.M.); and Lillehei Heart Institute, Division of Cardiology, Department of Medicine, University of Minnesota, Minneapolis, MN (J.L.H.).
authors.forename: Calum
authors.initials: C
authors.lastname: MacRae
authors.affiliation: From Division of Cardiology, Department of Medicine, Duke University, Durham, NC (S.H.S., G.S.G.); Duke Molecular Physiology Institute, Duke University, Durham, NC (S.H.S.); School of Public Health, University of Alabama at Birmingham, Birmingham, AL (D.A.); Division of Cardiology, Department of Medicine, Temple University School of Medicine, Philadelphia, PA (S.R.H.); Cardiovascular Research Center, Temple University School of Medicine, Philadelphia, PA (S.R.H.); Duke Center for Personalized Medicine, Department of Medicine, Duke University, Durham, NC (G.S.G.); Division of Cardiology, Department of Medicine, Brigham and Women's Hospital, Boston, MA (C.M., J.L.); Division of Cardiology, Department of Pediatrics, The Hospital for Sick Children, Toronto, Canada (S.M.); and Lillehei Heart Institute, Division of Cardiology, Department of Medicine, University of Minnesota, Minneapolis, MN (J.L.H.).
authors.forename: Seema
authors.initials: S
authors.lastname: Mital
authors.affiliation: From Division of Cardiology, Department of Medicine, Duke University, Durham, NC (S.H.S., G.S.G.); Duke Molecular Physiology Institute, Duke University, Durham, NC (S.H.S.); School of Public Health, University of Alabama at Birmingham, Birmingham, AL (D.A.); Division of Cardiology, Department of Medicine, Temple University School of Medicine, Philadelphia, PA (S.R.H.); Cardiovascular Research Center, Temple University School of Medicine, Philadelphia, PA (S.R.H.); Duke Center for Personalized Medicine, Department of Medicine, Duke University, Durham, NC (G.S.G.); Division of Cardiology, Department of Medicine, Brigham and Women's Hospital, Boston, MA (C.M., J.L.); Division of Cardiology, Department of Pediatrics, The Hospital for Sick Children, Toronto, Canada (S.M.); and Lillehei Heart Institute, Division of Cardiology, Department of Medicine, University of Minnesota, Minneapolis, MN (J.L.H.).
authors.forename: Joseph
authors.initials: J
authors.lastname: Loscalzo
authors.affiliation: From Division of Cardiology, Department of Medicine, Duke University, Durham, NC (S.H.S., G.S.G.); Duke Molecular Physiology Institute, Duke University, Durham, NC (S.H.S.); School of Public Health, University of Alabama at Birmingham, Birmingham, AL (D.A.); Division of Cardiology, Department of Medicine, Temple University School of Medicine, Philadelphia, PA (S.R.H.); Cardiovascular Research Center, Temple University School of Medicine, Philadelphia, PA (S.R.H.); Duke Center for Personalized Medicine, Department of Medicine, Duke University, Durham, NC (G.S.G.); Division of Cardiology, Department of Medicine, Brigham and Women's Hospital, Boston, MA (C.M., J.L.); Division of Cardiology, Department of Pediatrics, The Hospital for Sick Children, Toronto, Canada (S.M.); and Lillehei Heart Institute, Division of Cardiology, Department of Medicine, University of Minnesota, Minneapolis, MN (J.L.H.). jlhall@umn.edu svati.shah@duke.edu.
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Hall
mesh_terms: D000572:American Heart Association; D002309:Cardiology / Q000458:organization & administration* / Q000639:trends; D015331:Cohort Studies; D057225:Data Mining; D019317:Evidence-Based Medicine; D015894:Genome, Human; D006078:Government Programs / Q000458:organization & administration*; D006291:Health Policy; D006292:Health Priorities; D006801:Humans; D033183:Interdisciplinary Communication; D062069:Inventions; D058990:Molecular Targeted Therapy; D009316:National Institutes of Health (U.S.); D009369:Neoplasms / Q000188:drug therapy / Q000235:genetics; D057285:Precision Medicine / Q000639:trends*; D014481:United States; D014483:United States Dept. of Health and Human Services
keywords: cardiovascular diseases; genetics; medicine, precision; risk factors