| Title: | Integration of a polygenic score into guideline-recommended prediction of cardiovascular disease |
| Journal: | European Heart Journal |
| Published: | 29 Mar 2024 |
| Pubmed: | https://pubmed.ncbi.nlm.nih.gov/38551411/ |
| DOI: | https://doi.org/10.1093/eurheartj/ehae048 |
| Citations: | 4 (4 in last 2 years) as of 8 Aug 2024 |
Publication 10008
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Abstract
BACKGROUND AND AIMS: It is not clear how a polygenic risk score (PRS) can be best combined with guideline-recommended tools for cardiovascular disease (CVD) risk prediction, e.g. SCORE2.</p>
METHODS: A PRS for coronary artery disease (CAD) was calculated in participants of UK Biobank (n = 432 981). Within each tenth of the PRS distribution, the odds ratios (ORs)-referred to as PRS-factor-for CVD (i.e. CAD or stroke) were compared between the entire population and subgroups representing the spectrum of clinical risk. Replication was performed in the combined Framingham/Atherosclerosis Risk in Communities (ARIC) populations (n = 10 757). The clinical suitability of a multiplicative model 'SCORE2 × PRS-factor' was tested by risk reclassification.</p>
RESULTS: In subgroups with highly different clinical risks, CVD ORs were stable within each PRS tenth. SCORE2 and PRS showed no significant interactive effects on CVD risk, which qualified them as multiplicative factors: SCORE2 × PRS-factor = total risk. In UK Biobank, the multiplicative model moved 9.55% of the intermediate (n = 145 337) to high-risk group increasing the individuals in this category by 56.6%. Incident CVD occurred in 8.08% of individuals reclassified by the PRS-factor from intermediate to high risk, which was about two-fold of those remained at intermediate risk (4.08%). Likewise, the PRS-factor shifted 8.29% of individuals from moderate to high risk in Framingham/ARIC.</p>
CONCLUSIONS: This study demonstrates that absolute CVD risk, determined by a clinical risk score, and relative genetic risk, determined by a PRS, provide independent information. The two components may form a simple multiplicative model improving precision of guideline-recommended tools in predicting incident CVD.</p>
14 Keywords
- Adult
- Aged
- Cardiovascular Diseases
- Coronary Artery Disease
- Female
- Genetic Predisposition to Disease
- Humans
- Male
- Middle Aged
- Multifactorial Inheritance
- Practice Guidelines as Topic
- Risk Assessment
- Risk Factors
- United Kingdom
5 Authors
- Ling Li
- Shichao Pang
- Fabian Starnecker
- Bertram Mueller-Myhsok
- Heribert Schunkert
1 Application
| Application ID | Title |
|---|---|
| 25214 | Investigating multi-locus epistatic interactions underlying coronary artery disease |
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