Componente genético da doença coronária e interação com os fatores de risco tradicionais

• Autor(a) principal: Pereira, Andreia Micaela de Sousa
• Data de Publicação: 2018
• Idioma: por
• Título da fonte: Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)
• Texto Completo: http://hdl.handle.net/10362/43066
• topic: Coronary Artery Disease; Genes; Genetic Risk Score; Framingham Score; Risk prediction; Risk factors; Ciências Médicas

ABSTRACT: The utility of genetic risk scores (GRS) as independent risk predictors remains inconclusive. Here, we evaluate the additive value of a multi-locus GRS to the Framingham risk score (FRS) in coronary artery disease (CAD) risk prediction. A total of 2888 individuals (1566 coronary patients and 1322 controls) were divided in three subgroups according to FRS. Multiplicative GRS was determined for 32 genetic variants associated to CAD. Logistic Regression and Area Under the Curve (AUC) were determined first using the TRF for each FRS subgroup and secondly adding GRS. Different models (TRF, TRF+GRS) were used to classify the subjects into risk categories for the FRS 10-year predicted risk. The improvement offered by GRS was expressed as Net Reclassification Index and Integrated Discrimination Improvement. Multivariate analysis showed that GRS was an independent predictor for CAD (OR=1.87;p<0.0001). Diabetes, arterial hypertension, dyslipidemia and smoking status were also independent CAD predictors (p<0.05). GRS added predictive value to TRF across all risk subgroups. NRI showed a significant improvement in all categories with In conclusion, GRS provided a better incremental value in intermediate and high-risk subgroups. In these subgroups, inclusion of genotyping may be considered to better stratify cardiovascular risk.