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Genomic Risk Prediction of Coronary Artery Disease in 480,000 Adults: Implications for Primary Prevention

Journal of the American College of Cardiology, 2018-10, Vol.72 (16), p.1883-1893 [Peer Reviewed Journal]

Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved. ;Copyright Elsevier Limited Oct 16, 2018 ;2018 The Authors 2018 ;ISSN: 0735-1097 ;EISSN: 1558-3597 ;DOI: 10.1016/j.jacc.2018.07.079 ;PMID: 30309464

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Title:
Genomic Risk Prediction of Coronary Artery Disease in 480,000 Adults: Implications for Primary Prevention
Author: Inouye, Michael ; Abraham, Gad ; Nelson, Christopher P ; Wood, Angela M ; Sweeting, Michael J ; Dudbridge, Frank ; Lai, Florence Y ; Kaptoge, Stephen ; Brozynska, Marta ; Wang, Tingting ; Ye, Shu ; Webb, Thomas R ; Rutter, Martin K ; Tzoulaki, Ioanna ; Patel, Riyaz S ; Loos, Ruth J F ; Keavney, Bernard ; Hemingway, Harry ; Thompson, John ; Watkins, Hugh ; Deloukas, Panos ; Di Angelantonio, Emanuele ; Butterworth, Adam S ; Danesh, John ; Samani, Nilesh J
Subjects: Adults ; Age ; Angioplasty ; Antihypertensives ; Assessment centers ; Blood pressure ; Body mass ; Body mass index ; Body size ; Cardiovascular disease ; Cholesterol ; Confidence intervals ; Coronary artery ; Coronary artery disease ; Coronary Artery Disease - diagnosis ; Coronary Artery Disease - epidemiology ; Coronary Artery Disease - genetics ; Coronary vessels ; Diabetes ; Diabetes mellitus ; Disease prevention ; Family medical history ; Female ; Genetic variance ; Genetics ; Genome-Wide Association Study ; Genomes ; Genomics - methods ; Genomics - statistics & numerical data ; Health and safety screening ; Health risk assessment ; Health risks ; Heart attacks ; Heart diseases ; Heritability ; Hospitals ; Humans ; Hypertension ; Lipids ; Male ; Mass Screening - methods ; Middle Aged ; Multifactorial Inheritance ; Population ; Predictive Value of Tests ; Primary Prevention - methods ; Research Design ; Risk analysis ; Risk Assessment - methods ; Risk Factors ; Smoking ; Studies ; Trajectories ; United Kingdom - epidemiology
Is Part Of: Journal of the American College of Cardiology, 2018-10, Vol.72 (16), p.1883-1893
Description: Coronary artery disease (CAD) has substantial heritability and a polygenic architecture. However, the potential of genomic risk scores to help predict CAD outcomes has not been evaluated comprehensively, because available studies have involved limited genomic scope and limited sample sizes. This study sought to construct a genomic risk score for CAD and to estimate its potential as a screening tool for primary prevention. Using a meta-analytic approach to combine large-scale, genome-wide, and targeted genetic association data, we developed a new genomic risk score for CAD (metaGRS) consisting of 1.7 million genetic variants. We externally tested metaGRS, both by itself and in combination with available data on conventional risk factors, in 22,242 CAD cases and 460,387 noncases from the UK Biobank. The hazard ratio (HR) for CAD was 1.71 (95% confidence interval [CI]: 1.68 to 1.73) per SD increase in metaGRS, an association larger than any other externally tested genetic risk score previously published. The metaGRS stratified individuals into significantly different life course trajectories of CAD risk, with those in the top 20% of metaGRS distribution having an HR of 4.17 (95% CI: 3.97 to 4.38) compared with those in the bottom 20%. The corresponding HR was 2.83 (95% CI: 2.61 to 3.07) among individuals on lipid-lowering or antihypertensive medications. The metaGRS had a higher C-index (C = 0.623; 95% CI: 0.615 to 0.631) for incident CAD than any of 6 conventional factors (smoking, diabetes, hypertension, body mass index, self-reported high cholesterol, and family history). For men in the top 20% of metaGRS with >2 conventional factors, 10% cumulative risk of CAD was reached by 48 years of age. The genomic score developed and evaluated here substantially advances the concept of using genomic information to stratify individuals with different trajectories of CAD risk and highlights the potential for genomic screening in early life to complement conventional risk prediction.
Publisher: United States: Elsevier Limited
Language: English
Identifier: ISSN: 0735-1097
EISSN: 1558-3597
DOI: 10.1016/j.jacc.2018.07.079
PMID: 30309464
Source: GFMER Free Medical Journals
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Genomic Risk Prediction of Coronary Artery Disease in 480,000 Adults: Implications for Primary Prevention

Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved. ;Copyright Elsevier Limited Oct 16, 2018 ;2018 The Authors 2018 ;ISSN: 0735-1097 ;EISSN: 1558-3597 ;DOI: 10.1016/j.jacc.2018.07.079 ;PMID: 30309464

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