Julia Ramírez, Stefan van Duijvenboden, Michele Orini, Pier D Lambiase, Andrew Tinker, William J Young, Patricia B Munroe
{"title":"Prediction of Atrial and Ventricular Arrhythmias using Multiple Cardiovascular Risk Factor Polygenic Risk Scores.","authors":"Julia Ramírez, Stefan van Duijvenboden, Michele Orini, Pier D Lambiase, Andrew Tinker, William J Young, Patricia B Munroe","doi":"10.1016/j.hrthm.2024.12.017","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Objective: </strong>We assessed the value of including multiple PRS for cardiovascular risk factors (CV-PRS) for incident AF and VA prediction.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":" ","pages":""},"PeriodicalIF":5.6000,"publicationDate":"2024-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Heart rhythm","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.hrthm.2024.12.017","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
Prediction of Atrial and Ventricular Arrhythmias using Multiple Cardiovascular Risk Factor Polygenic Risk Scores.
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.
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.
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