在2型糖尿病中冠状动脉心脏病多原风险评分的增量预后值
Ify R Mordi1, Ivy Li2, Gittu George3
1Division of Cardiovascular Research, School of Medicine, University of Dundee, Dundee, U.K.
Diabetes care
|October 16, 2024
概括
在临床评估中添加冠状动脉心脏病 (CHD) 多基因风险评分 (PRS) 提高了对2型糖尿病 (T2D) 患者主要不良心血管事件 (MACE) 的预测,特别是那些临床风险较低的患者.
科学领域:
- 心血管疾病遗传学 心血管疾病遗传学
- 糖尿病研究研究 糖尿病研究
- 医学中的预测分析.
背景情况:
- 2型糖尿病 (T2D) 增加了心血管疾病 (CVD) 的风险.
- 目前的临床风险得分可能低估了T2D患者心血管疾病风险.
- 在T2D中降低心血管疾病风险的新疗法需要改进风险识别.
研究的目的:
- 为了评估冠状动脉心脏病 (CHD) 基因组全方位多基因风险评分 (PRS) 对现有的临床风险评分的增加预后价值.
- 改善T2D患者主要不良心血管事件 (MACE) 的预测.
- 确定可能从心血管风险降低疗法中受益的T2D个体.
主要方法:
- 对10,556名T2D患者 (40-79岁) 进行分析,没有先前心血管住院治疗.
- 使用聚合队列方程 (PCE风险) 计算10年临床心血管风险.
- 构建和评估一个CHD PRS用于10年内预测事件MACE.
主要成果:
- 在对临床风险因素进行调整后,CHD PRS在T2D患者中显著预测了MACE (HR 1.69每SD增加).
- 低PCE风险 (<7.5%) 但高PRS (顶五位数) 个体显著增加MACE的可能性 (HR 10.69).
- 将PRS纳入临床风险得分显著提高了MACE预测,特别是在低风险T2D患者中.
结论:
- 一个CHD PRS改善了T2D个体缺乏先前心血管疾病的MACE预测.
- 在被归类为临床风险较低的T2D患者中,PRS对于完善风险评估特别有价值.
- 使用PRS进行增强的风险分层可以指导针对T2D中心血管疾病预防的有针对性的干预措施.
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