评估多重多基因风险评分以评估心肌梗死和冠状动脉病变的风险。

IF 5.4 Q1 MEDICINE, RESEARCH & EXPERIMENTAL
Hasanga D Manikpurage, Jérôme Bourgault, Ursula Houessou, Audrey Paulin, Pardis Zamani, Eloi Gagnon, Zhonglin Li, Dominique K Boudreau, Aida Eslami, Pierre Voisine, Patrick Mathieu, Yohan Bossé, Benoit J Arsenault, Sébastien Thériault
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引用次数: 0

摘要

背景:多基因风险评分(PRS)可以帮助识别具有冠状动脉疾病(CAD)高遗传风险的个体。我们的目的是评估先前报道的PRS与心肌梗死(MI)以及冠状动脉病变的范围和复发之间的关系。方法:我们验证了先前报道的CAD-PRS和6个心血管(CV)危险因素PRS(收缩压[SBP], 2型糖尿病[T2D],身体质量指数[BMI],低密度脂蛋白胆固醇[LDL],甘油三酯[TG]和脂蛋白-[a][Lp(a)])来自加拿大两个基于人群的队列,加拿大老龄化纵向研究(里昂证券,N = 24,599)和CARTaGENE (N = 26,806)。使用逐步模型,我们确定了识别心肌梗死的最佳PRS组合。我们测试了选定的PRS与接受心脏手术的患者冠状动脉造影评估的动脉粥样硬化性CAD的严重程度和复发之间的关系(魁北克-血管造影,N = 4108)。结果:我们发现CAD-PRS与心肌梗死相关性最强,里昂证券的比值比为1.75 [1.64-1.86](P = 1.57E-70), CARTaGENE的比值比为1.87 [1.73-2.03](P = 3.06E-53)。在CLSA中,最优模型包括CAD-PRS、SBP-PRS、BMI-PRS、LDL-PRS、TG-PRS和Lp(a)-PRS。与传统的危险因素相比,加入这些PRS可以适度但显著地提高患者的鉴别能力(CLSA的AUC差异为0.025 [0.019-0.031],CARTaGENE的AUC差异为0.018[0.012-0.024])。在QUEBEC-ANGIO中,CAD- prs与CAD的程度和复发逐渐显著相关。结论:筛选多个经验证的PRS可显著提高心肌梗死的遗传风险评估以及冠状动脉病变的范围和复发。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Appraisal of multiple polygenic risk scores to estimate the risk of myocardial infarction and coronary artery lesions.

Background: Polygenic risk scores (PRS) could help to identify individuals with a high genetic risk profile for coronary artery disease (CAD). We aimed to evaluate the association between previously reported PRS and myocardial infarction (MI) as well as the extent and recurrence of coronary artery lesions.

Methods: We validated previously reported CAD-PRS and 6 cardiovascular (CV) risk factors PRS (systolic blood pressure [SBP], type 2 diabetes [T2D], body-mass index [BMI], low-density lipoprotein cholesterol [LDL], triglycerides [TG], and lipoprotein-[a][Lp(a)]) in individuals of European ancestry from two Canadian population-based cohorts, the Canadian Longitudinal Study on Aging (CLSA, N = 24,599) and CARTaGENE (N = 26,806). Using a stepwise model, we determined an optimal combination of PRS to identify MI. We tested the selected PRS for association with the severity and recurrence of atherosclerotic CAD evaluated by coronary angiography in patients undergoing cardiac surgery (QUEBEC-ANGIO, N = 4108).

Results: We show that the CAD-PRS most strongly associated with MI has odds ratios per standard deviation increment of 1.75 [1.64-1.86] (P = 1.57E-70) in CLSA and 1.87 [1.73-2.03] (P = 3.06E-53) in CARTaGENE. In CLSA, the optimal model includes CAD-PRS, SBP-PRS, BMI-PRS, LDL-PRS, TG-PRS and Lp(a)-PRS. Adding these PRS increases modestly yet significantly the discriminative capacity when compared to traditional risk factors (difference of AUC = 0.025 [0.019-0.031] in CLSA, 0.018 [0.012-0.024] in CARTaGENE). In QUEBEC-ANGIO, the CAD-PRS is gradually and significantly associated with the extent and recurrence of CAD.

Conclusions: Screening multiple validated PRS may significantly improve genetic risk estimation of MI as well as the extent and recurrence of coronary artery lesions.

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