披露冠心病多基因风险评分对心血管不良事件的影响
Mohammadreza Naderian1, Marwan E Hamed1, Ali A Vaseem1
1Department of Cardiovascular Medicine (M.N., M.E.H., A.A.V., K.N., A.T., I.J.K.), Mayo Clinic, Rochester, MN.
Circulation. Genomic and precision medicine
|March 28, 2025
概括
披露综合风险评分,包括多基因风险评分,可降低冠心病 (CHD) 中间风险人群的主要不良心血管事件 (MACE). 这可能是由于在10年内增加了他类药物的使用和降低了LDL胆固醇水平的结果.
科学领域:
- 心脏病学 心脏病学
- 遗传学 是一个遗传学.
- 预防医学 预防医学
背景情况:
- 心肌梗塞基因临床试验评估了冠心病 (CHD) 的风险得分.
- 中级心血管疾病风险的参与者接受了标准的弗雷明汉风险评分或综合风险评分 (IRSg),其中包括多基因风险评分.
- 之前的6个月随访显示,IRSg导致了更高的他类药物开始和更低的LDL胆固醇.
研究的目的:
- 调查披露综合风险评分 (包括多基因风险评分) 对重大心血管不良事件 (MACE) 的十年影响.
- 确定多基因风险评分的披露是否会影响心血管事件发生率和风险因素管理.
主要方法:
- 对心肌梗塞基因试验 (NCT01936675) 的10年随访分析.
- 参与者被随机分配到Framingham风险评分或综合风险评分 (IRSg) 组.
- 主要结局:时间到第一个MACE (心血管死亡,心肌梗塞,再血管,中风).
- 统计分析:考克斯回归和线性混合效应模型.
主要成果:
- 在平均9.5年的随访期间,MACE发生在IRSg组的2名参与者中,而Framingham风险评分组的9名参与者中 (HR,0.20;P=0.042).
- 在IRSg组中,接受心脏病诊断测试的参与者较少 (29%与47%相比;HR,0.51;P=0.004).
- 在最初的几年里,IRSg参与者表现出更高的他类药物使用和更大的LDL胆固醇降低.
结论:
- 披露综合风险评分,包括多基因风险评分,与MACE在10年内显著减少有关.
- 观察到的益处很可能是由增加的他类药物启动和改善的脂质配置文件介导的.
- 多基因风险评分可以提高心血管风险评估和预防策略.
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