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Risk prediction of future cardiac arrest by evaluation of a genetic risk score alone and in combination with traditional risk factors

Ohlsson, Marcus Andreas LU orcid ; Kennedy, Linn Maria Anna LU ; Juhlin, Tord LU and Melander, Olle LU orcid (2020) In Resuscitation 146. p.74-79
Abstract

Objectives: Coronary heart disease (CHD) is a leading cause of death globally, commonly through sudden cardiac death. Cardiac arrest of cardiac origin (CA) is associated with a poor prognosis and there is a great need for risk assessment and intensified preventive actions. In this study we aim to assess if a genetic risk score for CHD, composed of 50 common CHD susceptibility variants (GRS), predicts CA and to evaluate a novel composite risk score including traditional risk factors as well as GRS. Methods: The GRS score alone and in combination with traditional CHD risk factors were examined in relation to CA incidence among 23 000 middle aged subjects during 18.9 years of follow-up. The cohort excluded patients with a diagnosed history... (More)

Objectives: Coronary heart disease (CHD) is a leading cause of death globally, commonly through sudden cardiac death. Cardiac arrest of cardiac origin (CA) is associated with a poor prognosis and there is a great need for risk assessment and intensified preventive actions. In this study we aim to assess if a genetic risk score for CHD, composed of 50 common CHD susceptibility variants (GRS), predicts CA and to evaluate a novel composite risk score including traditional risk factors as well as GRS. Methods: The GRS score alone and in combination with traditional CHD risk factors were examined in relation to CA incidence among 23 000 middle aged subjects during 18.9 years of follow-up. The cohort excluded patients with a diagnosed history of CHD, heart failure or stroke. Results: Two-hundred-fifty-two patients suffered a cardiac arrest during the follow up, of which 181 were CA. In a multivariate model with CHD risk factors, high versus low genetic risk predicted CA with a hazard ratio (HR) of 2.49 {(95% CI 1.50–4.12) (P < 0.001)}, surpassed only by higher estimates for male sex {HR = 2.91 (95% CI 2.09–4.06) (P < 0.001)}, ages 50–65 {HR = 2.74 (95% CI 1.42–5.25) (P = 0.003)} and ages 65–74 {HR = 5.10 (95% CI 2.56–10.16) (P < 0.001)}. Smoking, dyslipidemia, hypertension and diabetes mellitus also predicted CA but with lower HRs than GRS. A novel composite risk score including CHD risk factors as well as GRS predicted CA with a HR = 110.81 {(95% CI 15.43–795.63) (P < 0.001)} for the highest (5) versus the lowest quintile (1) of the risk score. Conclusions: Genetic risk of CHD is strongly associated with incident CA and when combined with traditional CHD risk factors may identify individuals who benefit from intensified preventive pharmacological treatment.

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author
; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Cardiac arrest, Genetic risk score, GRS, Risk factors
in
Resuscitation
volume
146
pages
6 pages
publisher
Elsevier
external identifiers
  • scopus:85075627490
  • pmid:31759070
ISSN
0300-9572
DOI
10.1016/j.resuscitation.2019.11.005
language
English
LU publication?
yes
id
f56c3065-2e04-4bbd-82d8-3cc07b7b0ced
date added to LUP
2019-12-16 09:17:36
date last changed
2024-03-20 01:42:08
@article{f56c3065-2e04-4bbd-82d8-3cc07b7b0ced,
  abstract     = {{<p>Objectives: Coronary heart disease (CHD) is a leading cause of death globally, commonly through sudden cardiac death. Cardiac arrest of cardiac origin (CA) is associated with a poor prognosis and there is a great need for risk assessment and intensified preventive actions. In this study we aim to assess if a genetic risk score for CHD, composed of 50 common CHD susceptibility variants (GRS), predicts CA and to evaluate a novel composite risk score including traditional risk factors as well as GRS. Methods: The GRS score alone and in combination with traditional CHD risk factors were examined in relation to CA incidence among 23 000 middle aged subjects during 18.9 years of follow-up. The cohort excluded patients with a diagnosed history of CHD, heart failure or stroke. Results: Two-hundred-fifty-two patients suffered a cardiac arrest during the follow up, of which 181 were CA. In a multivariate model with CHD risk factors, high versus low genetic risk predicted CA with a hazard ratio (HR) of 2.49 {(95% CI 1.50–4.12) (P &lt; 0.001)}, surpassed only by higher estimates for male sex {HR = 2.91 (95% CI 2.09–4.06) (P &lt; 0.001)}, ages 50–65 {HR = 2.74 (95% CI 1.42–5.25) (P = 0.003)} and ages 65–74 {HR = 5.10 (95% CI 2.56–10.16) (P &lt; 0.001)}. Smoking, dyslipidemia, hypertension and diabetes mellitus also predicted CA but with lower HRs than GRS. A novel composite risk score including CHD risk factors as well as GRS predicted CA with a HR = 110.81 {(95% CI 15.43–795.63) (P &lt; 0.001)} for the highest (5) versus the lowest quintile (1) of the risk score. Conclusions: Genetic risk of CHD is strongly associated with incident CA and when combined with traditional CHD risk factors may identify individuals who benefit from intensified preventive pharmacological treatment.</p>}},
  author       = {{Ohlsson, Marcus Andreas and Kennedy, Linn Maria Anna and Juhlin, Tord and Melander, Olle}},
  issn         = {{0300-9572}},
  keywords     = {{Cardiac arrest; Genetic risk score; GRS; Risk factors}},
  language     = {{eng}},
  pages        = {{74--79}},
  publisher    = {{Elsevier}},
  series       = {{Resuscitation}},
  title        = {{Risk prediction of future cardiac arrest by evaluation of a genetic risk score alone and in combination with traditional risk factors}},
  url          = {{http://dx.doi.org/10.1016/j.resuscitation.2019.11.005}},
  doi          = {{10.1016/j.resuscitation.2019.11.005}},
  volume       = {{146}},
  year         = {{2020}},
}