评估大规模蛋白质组学用于预测心血管事件
Hannes Helgason1,2, Thjodbjorg Eiriksdottir1, Magnus O Ulfarsson1,2
1deCODE genetics/Amgen, Inc, Reykjavik, Iceland.
JAMA
|August 22, 2023
概括
一个新的蛋白质风险评分显示出评估动脉样硬化心血管疾病 (ASCVD) 风险的前景. 这一评分与现有的临床因素和多基因风险评分相结合,稍微提高了风险预测的准确性.
科学领域:
- 心血管医学
- 蛋白质组学
- 遗传学
背景情况:
- 动脉样性心血管疾病 (ASCVD) 仍然是全球主要的死亡原因.
- 目前的风险评估模型依赖于临床因素和多基因风险评分,但其预测能力可能有限.
- 血中的蛋白质生物标志物用于提高ASCVD风险预测是一个正在进行研究的领域.
研究的目的:
- 开发和验证用于预测ASCVD事件的蛋白质风险得分.
- 将蛋白质风险得分与传统临床风险因素和多基因风险得分进行比较.
- 在初级和二级预防群体中评估蛋白质风险得分的附加值.
主要方法:
- 用蛋白质组学数据对冰岛的一个主要事件群体 (13,540个人) 的回顾性分析.
- 来自临床试验的二次事件群体 (6,791名患者) 的分析.
- 使用4963血蛋白水平的蛋白质风险评分的发展;与多基因风险评分和临床因素 (年龄,性别,他类药物使用,高血压,糖尿病,BMI,吸烟) 的比较.
主要成果:
- 蛋白质风险评分显示在初级 (HR1. 93/ SD) 和二级 (HR1. 62/ SD) 群体中与ASCVD事件有显著的关联.
- 将蛋白质风险得分添加到临床风险因子模型中显著改善了歧视 (C指数增加了0. 014- 0. 022).
- 蛋白质风险评分也显示了二次人口中不同祖先的显著关联.
结论:
- 由血蛋白质学得出的蛋白质风险评分是ASCVD事件的重要预测指标.
- 将蛋白质风险得分与临床和多基因风险得分相结合,在风险预测方面提供了适度但具有统计意义的改善.
- 这些发现表明蛋白质风险评分可能是当前ASCVD风险评估策略的宝贵补充.
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