Prediction of Atrial and Ventricular Arrhythmias using Multiple Cardiovascular Risk Factor Polygenic Risk Scores.

IF 5.6 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Heart rhythm Pub Date : 2024-12-15 DOI:10.1016/j.hrthm.2024.12.017

Julia Ramírez, Stefan van Duijvenboden, Michele Orini, Pier D Lambiase, Andrew Tinker, William J Young, Patricia B Munroe

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引用次数: 0

Abstract

Background: Atrial fibrillation (AF) prediction improves by combining clinical scores with a polygenic risk score (PRS) for AF (AF-PRS), but there are limited studies of PRS for ventricular arrhythmia (VA) prediction.

Objective: We assessed the value of including multiple PRS for cardiovascular risk factors (CV-PRS) for incident AF and VA prediction.

Methods: We used 158,733 individuals of European ancestry from UK Biobank to build three models for AF: CHARGE-AF (AF1), AF1 + AF-PRS (AF2), AF2 + CV-PRS (AF3). Models for VA included sex and age (VA1), VA1 + coronary artery disease (CAD) PRS (CAD-PRS, VA2), and VA2 + CV-PRS (VA3), conducting separate analyses in subjects with and without ischemic heart disease (IHD). Performance was evaluated in individuals of European (N=158,733), African (N=7,200), South Asian (N=9,241) and East Asian (N=2,076) ancestry from UK Biobank.

Results: AF2 had a higher C-index than AF1 (0.762 versus 0.746, P<0.001), marginally improving to 0.765 for AF3 (P<0.001, including PRS for heart failure, electrocardiogram and cardiac magnetic resonance measures). In South Asians, AF2 C-index was higher than AF1 (P<0.001). For VA, the C-index for VA2 was greater than VA1 (0.692 versus 0.681, P<0.001) in Europeans, which was also observed in South Asians (P<0.001). VA3 improved prediction of VA in individuals with IHD.

Conclusion: CV-PRS improved AF prediction compared to CHARGE-AF and AF-PRS. A CAD-PRS improved VA prediction, while CV-PRS contributed in IHD. AF- and CAD-PRS were transferable to individuals of South Asian ancestry. Our results inform of the use of CV-PRS for personalised screening.

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背景：将临床评分与房颤多基因风险评分（AF-PRS）相结合可提高房颤（AF）预测效果，但针对室性心律失常（VA）预测的多基因风险评分研究却很有限：我们评估了包含多个心血管风险因素 PRS（CV-PRS）对房颤事件和室性心律失常预测的价值：我们利用英国生物库中的 158733 名欧洲血统个体建立了三个房颤模型：CHARGE-AF (AF1)、AF1 + AF-PRS (AF2)、AF2 + CV-PRS (AF3)。VA模型包括性别和年龄（VA1）、VA1 + 冠状动脉疾病（CAD）PRS（CAD-PRS，VA2）和VA2 + CV-PRS（VA3），分别对患有和未患有缺血性心脏病（IHD）的受试者进行分析。对来自英国生物库的欧洲血统（158733 人）、非洲血统（7200 人）、南亚血统（9241 人）和东亚血统（2076 人）的受试者进行了性能评估：结果：AF2的C指数高于AF1（0.762对0.746）：与 CHARGE-AF 和 AF-PRS 相比，CV-PRS 提高了房颤预测能力。CAD-PRS提高了对VA的预测，而CV-PRS则有助于对IHD的预测。房颤和CAD-PRS可用于南亚血统的个体。我们的研究结果为使用 CV-PRS 进行个性化筛查提供了参考。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Heart rhythm 医学-心血管系统

CiteScore

10.50

自引率

5.50%

发文量

1465

审稿时长

24 days

期刊介绍： HeartRhythm, the official Journal of the Heart Rhythm Society and the Cardiac Electrophysiology Society, is a unique journal for fundamental discovery and clinical applicability. HeartRhythm integrates the entire cardiac electrophysiology (EP) community from basic and clinical academic researchers, private practitioners, engineers, allied professionals, industry, and trainees, all of whom are vital and interdependent members of our EP community. The Heart Rhythm Society is the international leader in science, education, and advocacy for cardiac arrhythmia professionals and patients, and the primary information resource on heart rhythm disorders. Its mission is to improve the care of patients by promoting research, education, and optimal health care policies and standards.