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Prospective association of a genetic risk score with major adverse cardiovascular events in patients with coronary artery disease.

Abstract Many susceptibility loci associated with coronary artery disease (CAD) have been identified using genome-wide association studies (GWAS). This study aimed to examine whether a composite of single nucleotide polymorphisms (SNPs) derived from GWAS could identify the risk of major adverse cardiovascular events (MACEs) in patients with established CAD. There were 1059 patients with CAD were included in the analysis. Of the participants, 686 were on statin treatment at the start of follow-up. A weighted genetic risk score (wGRS) was calculated as the sum of risk alleles multiplied by the hazard ratio for a particular SNP. In single variant analyses, rs579459, rs4420638, and rs2107595 were associated with an increased risk of MACE. A wGRS was further constructed to evaluate the cumulative effect of the 3 SNPs on the prognosis of CAD. The risk of MACE among patients with high and intermediate wGRS was 1.968- and 1.838-fold, respectively, higher than those with low wGRS. This effect was more evident in patients using lipid-lowering medication and with hypertension. Furthermore, the interaction analysis revealed that lipid-lowering medication and hypertension interacted with the genetic effect off wGRS on the risk of MACE in patients using lipid-lowering medication or with hypertension (Pinteraction < .001). We further analyzed the follow-up change in low-density lipoprotein cholesterol (LDL-C) level at 6 months after CAD disclosure and evaluated whether that was due to wGRS or statin use. The lowest reduction in LDL-C was observed in patients with high GRS who received statin treatment. Furthermore, LDL-C reduction of patients with intermediate wGRS was less than those with low wGRS in patients treated with statin. Taken together, a wGRS comprised of SNPs significantly predicts MACE in CAD patients receiving statin treatment and hypertension.
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title medicine
Publication Year Start




PMID- 29390587
OWN - NLM
STAT- MEDLINE
DCOM- 20180212
LR  - 20180212
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Linking)
VI  - 96
IP  - 51
DP  - 2017 Dec
TI  - Prospective association of a genetic risk score with major adverse cardiovascular
      events in patients with coronary artery disease.
PG  - e9473
LID - 10.1097/MD.0000000000009473 [doi]
AB  - Many susceptibility loci associated with coronary artery disease (CAD) have been 
      identified using genome-wide association studies (GWAS). This study aimed to
      examine whether a composite of single nucleotide polymorphisms (SNPs) derived
      from GWAS could identify the risk of major adverse cardiovascular events (MACEs) 
      in patients with established CAD. There were 1059 patients with CAD were included
      in the analysis. Of the participants, 686 were on statin treatment at the start
      of follow-up. A weighted genetic risk score (wGRS) was calculated as the sum of
      risk alleles multiplied by the hazard ratio for a particular SNP. In single
      variant analyses, rs579459, rs4420638, and rs2107595 were associated with an
      increased risk of MACE. A wGRS was further constructed to evaluate the cumulative
      effect of the 3 SNPs on the prognosis of CAD. The risk of MACE among patients
      with high and intermediate wGRS was 1.968- and 1.838-fold, respectively, higher
      than those with low wGRS. This effect was more evident in patients using
      lipid-lowering medication and with hypertension. Furthermore, the interaction
      analysis revealed that lipid-lowering medication and hypertension interacted with
      the genetic effect off wGRS on the risk of MACE in patients using lipid-lowering 
      medication or with hypertension (Pinteraction &lt; .001). We further analyzed the
      follow-up change in low-density lipoprotein cholesterol (LDL-C) level at 6 months
      after CAD disclosure and evaluated whether that was due to wGRS or statin use.
      The lowest reduction in LDL-C was observed in patients with high GRS who received
      statin treatment. Furthermore, LDL-C reduction of patients with intermediate wGRS
      was less than those with low wGRS in patients treated with statin. Taken
      together, a wGRS comprised of SNPs significantly predicts MACE in CAD patients
      receiving statin treatment and hypertension.
CI  - Copyright (c) 2017 The Authors. Published by Wolters Kluwer Health, Inc. All
      rights reserved.
FAU - Zhao, Chen
AU  - Zhao C
AD  - Department of Geriatrics.
FAU - Zhu, Pin
AU  - Zhu P
AD  - Department of Cardiology, Tongren Hospital, Shanghai Jiaotong University School
      of Medicine, Shanghai, China.
FAU - Shen, Qile
AU  - Shen Q
AD  - Department of Geriatrics.
FAU - Jin, Li
AU  - Jin L
AD  - Department of Geriatrics.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
SB  - AIM
SB  - IM
MH  - Alleles
MH  - Coronary Artery Disease/*genetics
MH  - Female
MH  - Genetic Predisposition to Disease/genetics
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Polymorphism, Single Nucleotide/genetics
MH  - Prospective Studies
MH  - Risk Factors
PMC - PMC5758289
EDAT- 2018/02/03 06:00
MHDA- 2018/02/13 06:00
CRDT- 2018/02/03 06:00
PHST- 2018/02/03 06:00 [entrez]
PHST- 2018/02/03 06:00 [pubmed]
PHST- 2018/02/13 06:00 [medline]
AID - 10.1097/MD.0000000000009473 [doi]
AID - 00005792-201712220-00174 [pii]
PST - ppublish
SO  - Medicine (Baltimore). 2017 Dec;96(51):e9473. doi: 10.1097/MD.0000000000009473.