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Signal Acquisition, Score Interpretation, and Economics of a Non-Invasive Point-of-Care Test for Coronary Artery Disease
06:16

Signal Acquisition, Score Interpretation, and Economics of a Non-Invasive Point-of-Care Test for Coronary Artery Disease

Published on: August 9, 2024

534

Coronary Artery Disease-Based Polygenic Risk Score in Early-Onset Acute Myocardial Infarction Subtypes

Weilai Dong1, Yuan Lu1, Shu-Xia Li1

  • 1Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA; Center for Outcomes Research and Evaluation, Yale New Haven Hospital, New Haven, Connecticut, USA.

JACC. Advances
|July 25, 2025
PubMed

Insights

The polygenic risk score for coronary artery disease (PRS-CAD) shows varied effectiveness across acute myocardial infarction (AMI) subtypes in young adults. Its association differs by MI type but not by sex, requiring careful application.

Area of Science:

  • Cardiovascular Genetics
  • Precision Medicine
  • Public Health

Background:

  • The polygenic risk score for coronary artery disease (PRS-CAD) is used to estimate acute myocardial infarction (AMI) risk.
  • Its accuracy across different AMI subtypes, particularly in younger populations and women, is not well-established.

Purpose of the Study:

  • To evaluate the performance of PRS-CAD in various acute myocardial infarction (AMI) subtypes.
  • To assess PRS-CAD's association with 1-year outcomes in different AMI subtypes.

Main Methods:

  • Analysis of 2,079 AMI patients (18-55 years) and 3,761 controls from the VIRGO and MESA studies.
  • Classification of AMI subtypes using the VIRGO taxonomy.
  • Evaluation of PRS-CAD association with AMI subtypes and 1-year outcomes using logistic and Cox regression.

Main Results:

  • PRS-CAD strongly associated with MI due to coronary artery disease (OR: 1.82) but not MI with nonobstructive coronary artery disease (OR: 1.13).
  • PRS-CAD performance was consistent between sexes.
  • Higher PRS-CAD linked to increased 1-year hospitalization/death risk in MI with nonobstructive coronary artery disease (HR: 1.50).

Conclusions:

  • The association of PRS-CAD with AMI in young adults is subtype-dependent but not sex-dependent.
  • Clinical application of PRS-CAD requires careful consideration of AMI subtype and patient characteristics.
Abstract

Keywords:
acute myocardial infarctionpolygenic risk scoresubtypes

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