Advanced

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 ; Kennedy, Linn Maria Anna LU ; Juhlin, Tord LU and Melander, Olle LU (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.

(Less)
Please use this url to cite or link to this publication:
author
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
  • pmid:31759070
  • scopus:85075627490
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
2020-01-13 02:36:17
@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},
  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},
}