Related Experiment Video
Updated: Jan 11, 2026
Author Spotlight: Advancing Cardiovascular Imaging - Introducing the Spatially Weighted Calcium Score for Early Disease Detection
Published on: September 22, 2023
Differential Performance of Polygenic Score for Coronary Artery Disease Based on Coronary Artery Calcium Between Men
Genevieve Wojcik1, Marios Arvanitis2, Sabina Haberlen1
1Department of Epidemiology Johns Hopkins Bloomberg School of Public Health Baltimore MD USA.
Insights
Polygenic risk score for coronary artery disease (PRSCAD) showed lower performance in predicting coronary artery calcium in people living with HIV (PLWH) compared to people without HIV (PWOH). Further research is needed for accurate risk prediction models in PLWH.
Area of Science:
- Cardiovascular disease research
- Genetics and personalized medicine
- HIV/AIDS research
Background:
- Individuals with HIV face a higher risk of coronary artery disease (CAD).
- The effectiveness of polygenic risk score for CAD (PRSCAD) in people living with HIV (PLWH) is not well understood.
- Coronary artery calcium (CAC) serves as a key indicator of subclinical atherosclerosis.
Purpose of the Study:
- To evaluate the performance of PRSCAD in assessing CAC among PLWH compared to people without HIV (PWOH).
- To determine if PRSCAD improves CAD risk prediction when combined with existing risk calculators.
Main Methods:
- A PRSCAD was applied to 1071 men in the Multicenter AIDS Cohort Study (MACS), stratified by HIV status, race, and genetic ancestry.
- Performance was assessed using Agatston score (AS) for CAC, evaluating adjusted R2 and area under the curve (AUC).
- Models were compared independently and jointly with the Pooled Cohort Equations (PCE).
Main Results:
- PRSCAD significantly improved CAC prediction in non-Hispanic White men compared to baseline, but not when added to PCE.
- Performance was lower in PLWH than PWOH, particularly for distinguishing high CAC from absent CAC.
- PRSCAD demonstrated poorer performance in Black men compared to White men, with reduced accuracy in PLWH.
Conclusions:
- The PRSCAD demonstrated lower predictive performance for CAC in PLWH compared to PWOH men.
- Current PRSCAD models require further refinement for effective clinical utility in PLWH.
- Development of tailored risk prediction models is crucial for improving cardiovascular health outcomes in individuals with HIV.
Background:
Individuals with HIV have increased risk for coronary artery disease (CAD). However, the utility of the polygenic risk score (PRS) for estimating CAD risk (PRSCAD) is unknown in people living with HIV (PLWH). We evaluated the performance of PRSCAD on coronary artery calcium (CAC), a measure of subclinical atherosclerosis, by HIV serostatus.
Methods:
A PRSCAD was applied to 1071 men (PLWH, n=659; people living without HIV [PWOH], n=412) within MACS (Multicenter AIDS Cohort Study), then stratified by non-Hispanic White or Black race and genetic similarity to references (non-Hispanic White/genetically similar to European reference group, n=731; non-Hispanic Black/genetically similar to African reference group, n=340). PRSCAD performance for CAC, estimated by Agatston score (AS) from cardiac computed tomography scans, was evaluated independently and jointly with the American College of Cardiology/American Heart Association Pooled Cohort Equations by HIV serostatus using adjusted R2 for log-transformed CAC and area under the curve (AUC) for binary outcomes (absence/presence of CAC, absence of CAC [AS=0] versus low CAC [AS=1-100] or high CAC [AS >100]).
Results:
Predicting the presence/absence of CAC in non-Hispanic White/genetically similar to European reference group adding PRSCAD significantly improved the performance compared with the base model (AUCPLWH=0.738, AUCPWOH=0.759; P=0.015) but not the Pooled Cohort Equations (AUCPLWH=0.722, AUCPWOH=0.736; P=0.26). Performance was lower in PLWH than PWOH among outcomes, especially comparing high with absent AS (AUCPLWH=0.785, AUCPWOH=0.865; P=0.025). Joint modeling of PRSCAD and Pooled Cohort Equations decreased these gaps by HIV serostatus. PRSCAD performed worse in non-Hispanic Black/genetically similar to African reference groups compared with non-Hispanic White/genetically similar to European reference groups, with lower performance in PLWH (AUCPLWH=0.671, AUCPWOH=0.769; P=0.22).
Conclusions:
The application of a PRSCAD to CAC showed lower performance for PLWH than PWOH men. Further research is needed to develop accurate risk prediction models with clinical utility in all patients.
Related Concept Videos
01:25Imaging Studies for Cardiovascular System VI: Calcium -Scoring CT
01:26Coronary Artery Disease IV: Preventive Measures
01:30Coronary Artery Disease I: Introduction
01:26Coronary Artery Disease II: Pathophysiology
01:30Coronary Artery Disease III: Clinical Manifestations
01:18Polygenic Traits