Editor's Choice
CARDIOVASCULAR PREVENTION / CLINICAL RESEARCH
 
KEYWORDS
TOPICS
ABSTRACT
Introduction:
Classical risk factors such as hypertension, hypercholesterolemia, pre-diabetes, diabetes and obesity can predict adverse cardiovascular events, but they are less prognostic in patients aged < 60 years. Polygenic risk scores (PRS) can be effective in predicting adverse coronary events in younger and middle-aged patients. Our main aim is to assess the utility of a new PRS created for the Polish population in predicting mortality during an 8-year follow-up in the nationwide LIPIDOGEN2015 population.

Material and methods:
All DNA samples of 1779 patients were genotyped using Infinium Global Screening Array-24+ v3.0 Kit microarrays. The samples were amplified, fragmented, and hybridized to BeadChips. The BeadChips were scanned using iScan and converted to genotypes using Genome Studio 2.0.

Results:
We will develop a PRS based on the identified single nucleotide polymorphisms (SNPs) in the LIPIDOGEN2015 project’s studied population and determine the analyzed group’s risk of death due to cardiovascular diseases (CVD) based on data obtained from 8 years of patient-follow-up. Using the developed PRS scale and biochemical analyses, we will assess the effectiveness of lipid-lowering therapy with statins in patients with high and low genetic risk of sudden CVD events (secondary endpoints).

Conclusions:
The developed PRS scale, combined with clinical covariates, will facilitate the creation of an algorithm to predict long-term mortality. This will enable us to stratify CVD risk more precisely, which may result in earlier implementation of lifestyle changes and dietary adjustments and potentially initiate earlier pharmacotherapy for at-risk individuals.

 
REFERENCES (55)
1.
Mensah GA, Fuster V, Murray CJL, Roth GA; Global Burden of Cardiovascular Diseases and Risks Collaborators. Global burden of cardiovascular diseases and risks, 1990-2022. J Am Coll Cardiol 2023; 82: 2350-473.
 
2.
Natarajan P, Young R, Stitziel NO, et al. Polygenic risk score identifies subgroup with higher burden of atherosclerosis and greater relative benefit from statin therapy in the primary prevention setting. Circulation 2017; 135: 2091-101.
 
3.
Daponte-Codina A, Knox EC, Mateo-Rodriguez I, et al. Gender and social inequalities in awareness of coronary artery disease in European countries. Int J Environ Res Public Health 2022; 19: 1388.
 
4.
Sundquist K, Winkleby M, Li X, Ji J, Hemminki K, Sundquist J. Familial [corrected] transmission of coronary heart disease: a cohort study of 80,214 Swedish adoptees linked to their biological and adoptive parents. Am Heart J 2011; 162: 317-23.
 
5.
Studziński K, Tomasik T, Krzysztoń J, Jóźwiak J, Windak A. Effect of using cardiovascular risk scoring in routine risk assessment in primary prevention of cardiovascular disease: an overview of systematic reviews. BMC Cardiovasc Disord 2019; 19: 11.
 
6.
Banach M, Osadnik T, Lejawa M, Golawski M, Gierlotka M, Jozwiak J. Development and validation of risk score for patients in primary care setting in Poland. Eur Heart J 2023; 44 (Suppl 2): ehad655.2439.
 
7.
Wald NJ, Simmonds M, Morris JK. Screening for future cardiovascular disease using age alone compared with multiple risk factors and age. PLoS One 2011; 6: e18742.
 
8.
Erdmann J, Schunkert H. Genetics of (premature) coronary artery disease. In: Clinical Cardiogenetics. Baars HF, Doevendans FM, Houweling AC, van Tintelen JP (eds.). 3rd ed. Springer 2020; 413-30.
 
9.
Hengstenberg C, Bröckel U, Holmer S, et al. Genetic factors in myocardial infarction-results from a candidate gene and a genome-wide approach between beta blockers. Herz 2002; 27: 649-61.
 
10.
Samani NJ, Erdmann J, Hall AS, et al. Genomewide association analysis of coronary artery disease. N Engl J Med 2007; 357: 443-53.
 
11.
Khera AV, Kathiresan S. Genetics of coronary artery disease: discovery, biology and clinical translation. Nat Rev Genet 2017; 18: 331-44.
 
12.
Jiang W, Chen L, Girgenti MJ, Zhao H. Tuning parameters for polygenic risk score methods using GWAS summary statistics from training data. Nat Commun 2024; 15: 24.
 
13.
Levin MG, Rader DJ. Polygenic risk scores and coronary artery disease: ready for prime time? Circulation 2020; 141: 637-40.
 
14.
Banach M, Surma S. A look to the past –- what has had the biggest impact on lipids in the last four decades? A personal perspective. Arch Med Sci 2023; 19: 559-64.
 
15.
Armitage J, Baigent C, Barnes E, et al. Efficacy and safety of statin therapy in older people: a meta-analysis of individual participant data from 28 randomised controlled trials. Lancet 2019; 393: 407-15.
 
16.
Arnold N, Koenig W. Polygenic risk score: clinically useful tool for prediction of cardiovascular disease and benefit from lipid-lowering therapy? Cardiovasc Drugs Ther 2021; 35: 627-35.
 
17.
Mega JL, Stitziel NO, Smith JG, et al. Genetic risk, coronary heart disease events, and the clinical benefit of statin therapy. Lancet 2015; 385: 2264.
 
18.
Marston NA, Kamanu FK, Nordio F, et al. Predicting benefit from evolocumab therapy in patients with atherosclerotic disease using a genetic risk score: results from the FOURIER Trial. Circulation 2020; 141: 616-23.
 
19.
Evolocumab in Dyslipidemia – Clinical Trials Registry - ICH GCP n.d. https://ichgcp.net/clinical-tr... (accessed May 8, 2024).
 
20.
Banach M, Reiner Z, Cicero AFG, et al. 2022: the year in cardiovascular disease – the year of upfront lipid lowering combination therapy. Arch Med Sci 2022; 18: 1429-34.
 
21.
Patel AP, Wang M, Ruan Y, et al. A multi-ancestry polygenic risk score improves risk prediction for coronary artery disease. Nat Med 2023; 29: 1793-803.
 
22.
Jóźwiak JJ, Kasperczyk S, Tomasik T, et al. Design and rationale of a nationwide screening analysis from the LIPIDOGRAM2015 and LIPIDOGEN2015 studies. Arch Med Sci 2022; 18: 604-16.
 
23.
Jóźwiak JJ, Studziński K, Tomasik T, et al. The prevalence of cardiovascular risk factors and cardiovascular disease among primary care patients in Poland: results from the LIPIDOGRAM2015 study. Atheroscler Suppl 2020; 42: e15-24.
 
24.
Strapagiel D, Majewska M, Janik K, Sobalska M, Bartosz G. Method for gender determination. PL232652B1 2019.
 
25.
Banach M, Surma S. Monitoring of traditional atherosclerosis cardiovascular disease risk factors – is it enough to prevent premature acute coronary syndrome? Lancet Reg Health Eur 2024; 38: 100866.
 
26.
O’Sullivan JW, Raghavan S, Marquez-Luna C, et al. Polygenic risk scores for cardiovascular disease: a scientific statement from the American Heart Association. Circulation 2022; 146: e93-118.
 
27.
D’Agostino RB, Vasan RS, Pencina MJ, et al. General cardiovascular risk profile for use in primary care: the Framingham Heart Study. Circulation 2008; 117: 743-53.
 
28.
Conroy RM, Pyörälä K, Fitzgerald AP, et al. Estimation of ten-year risk of fatal cardiovascular disease in Europe: the SCORE project. Eur Heart J 2003; 24: 987-1003.
 
29.
Assmann G, Schulte H, Cullen P, Seedorf U. Assessing risk of myocardial infarction and stroke: new data from the Prospective Cardiovascular Münster (PROCAM) study. Eur J Clin Invest 2007; 37: 925-32.
 
30.
Ridker PM, Buring JE, Rifai N, Cook NR. Development and validation of improved algorithms for the assessment of global cardiovascular risk in women: the Reynolds Risk Score. JAMA 2007; 297: 611-9.
 
31.
Visseren F, Mach F, Smulders YM, et al. 2021 ESC Guidelines on cardiovascular disease prevention in clinical practice: developed by the Task Force for cardiovascular disease prevention in clinical practice with representatives of the European Society of Cardiology and 12 medical societies With the special contribution of the European Association of Preventive Cardiology (EAPC). Eur Heart J 2021; 42: 3227-337.
 
32.
SCORE2-Diabetes Working Group and the ESC Cardiovascular Risk Collaboration. SCORE2-Diabetes: 10-year cardiovascular risk estimation in type 2 diabetes in Europe. Eur Heart J 2023; 44: 2544-56.
 
33.
Banach M, Burchardt P, Chlebus K, et al. PoLA/CFPiP/PCS/PSLD/PSD/PSH guidelines on diagnosis and therapy of lipid disorders in Poland 2021. Arch Med Sci 2021; 17: 1447-547.
 
34.
Berry JD, Lloyd-Jones DM, Garside DB, Greenland P. Framingham risk score and prediction of coronary heart disease death in young men. Am Heart J 2007; 154: 80-6.
 
35.
Elosua R. Cardiovascular risk functions: usefulness and limitations. Rev Esp Cardiol (Engl Ed) 2014; 67: 77-9.
 
36.
Labuz-Roszak B, Banach M, Skrzypek M, et al. Secondary stroke prevention in Polish adults: results from the LIPIDOGRAM2015 Study. J Clin Med 2021; 10: 4472.
 
37.
Studziński K, Tomasik T, Windak A, et al. The differences in the prevalence of cardiovascular disease, its risk factors, and achievement of therapeutic goals among urban and rural primary care patients in Poland: results from the LIPIDOGRAM 2015 study. J Clin Med 2021; 10: 5656.
 
38.
Forgetta V, Manousaki D, Istomine R, et al. Rare genetic variants of large effect influence risk of type 1 diabetes. Diabetes 2020; 69: 784-95.
 
39.
Mozaffarian D, Benjamin EJ, Go AS, et al. Heart disease and stroke statistics--2015 update: a report from the American Heart Association. Circulation 2015; 131: e29-39.
 
40.
Knoflach M, Kiechl S, Penz D, et al. Cardiovascular risk factors and atherosclerosis in young women: atherosclerosis risk factors in female youngsters (ARFY study). Stroke 2009; 40: 1063-9.
 
41.
Musunuru K, Kathiresan S. Genetics of common, complex coronary artery disease. Cell 2019; 177: 132-45.
 
42.
Kathiresan S, Srivastava D. Genetics of human cardiovascular disease. Cell 2012; 148: 1242-57.
 
43.
Rotter JI, Lin HJ. An outbreak of polygenic scores for coronary artery disease. J Am Coll Cardiol 2020; 75: 2781-4.
 
44.
Inouye M, Abraham G, Nelson CP, et al. Genomic risk prediction of coronary artery disease in 480,000 adults: implications for primary prevention. J Am Coll Cardiol 2018; 72: 1883-93.
 
45.
Fahed AC, Natarajan P. Clinical applications of polygenic risk score for coronary artery disease through the life course. Atherosclerosis 2023; 386: 117356.
 
46.
Busby GB, Kulm S, Bolli A, Kintzle J, Domenico P Di, Bottà G. Ancestry-specific polygenic risk scores are risk enhancers for clinical cardiovascular disease assessments. Nat Commun 2023; 14: 7105.
 
47.
Banach M, Surma S, Guzik T, Penson PE, Blaha MJ, Sperling SS. Upfront lipid-lowering combination therapy in patients at very high cardiovascular risk – time to stop debate and start effective prevention. Cardiovasc Res 2024 (in press).
 
48.
Isgut M, Sun J, Quyyumi AA, Gibson G. Highly elevated polygenic risk scores are better predictors of myocardial infarction risk early in life than later. Genome Med 2021; 13: 13.
 
49.
Osei AD, Mirbolouk M, Berman D, et al. Prognostic value of coronary artery calcium score, area, and density among individuals on statin therapy vs. non-users: the coronary artery calcium consortium. Atherosclerosis 2021; 316: 79-83.
 
50.
Klarin D, Natarajan P. Clinical utility of polygenic risk scores for coronary artery disease. Nat Rev Cardiol 2022; 19: 291-301.
 
51.
Banach M, Kaźmierczak J, Mitkowski P, et al. Which patients at risk of cardiovascular disease might benefit the most from inclisiran? Polish experts’ opinion. The compromise between EBM and possibilities in healthcare. Arch Med Sci 2022; 18: 569-76.
 
52.
Banach M, Surma S, Kapłon-Cieślicka A, et al. Position paper of the Polish Expert Group on the use of pitavastatin in the treatment of lipid disorders in Poland endorsed by the Polish Lipid Association. Arch Med Sci 2024; 20: 28-42.
 
53.
Mitkowski P, Witkowski A, Stępińska J, et al. Position of the Polish Cardiac Society on therapeutic targets for LDL cholesterol concentrations in secondary prevention of myocardial infarctions. Kardiol Pol 2023; 81: 818-23.
 
54.
Banach M, Surma S, Toth PP; endorsed by the International Lipid Expert Panel (ILEP). 2023: The year in cardiovascular disease - the year of new and prospective lipid lowering therapies. Can we render dyslipidemia a rare disease by 2024? Arch Med Sci 2023; 19:1602-15.
 
55.
Sheth S, Banach M, Toth PP. Closing the gap between guidelines and clinical practice for managing dyslipidemia: where are we now? Expert Rev Cardiovasc Ther 2024; 22: 441-57.
 
eISSN:1896-9151
ISSN:1734-1922
Journals System - logo
Scroll to top