Abstract 16276: Use of a Genetic Risk Score to Predict Adverse Outcomes After ACS
Introduction: A number of recently discovered genetic loci have been associated with cardiovascular disease. However, little evidence exists about the role of genetic markers in predicting recurrent cardiovascular events. We sought to determine whether a genetic risk score of 30 genetic variants would predict recurrent cardiovascular events in individuals after an acute coronary syndrome (ACS).
Methods: We analyzed data from 1210 individuals from the Recurrence et Inflammation dans Syndromes Coronarien Aigus (RISCA) cohort, which included individuals admitted to hospital with ACS. DNA from stored blood samples were analyzed for 30 single nucleotide polymorphisms (SNP) previously associated with MI. Individuals were assigned a score of 0, 1, or 2 at each locus for the presence of none, one, or two copies of the risk allele (range of generic risk score (GRS), 0 to 60). The primary endpoint was defined as all-cause mortality or recurrent ACS within 1 year of admission for ACS.
Results: Of the 1210 individuals available for analysis, a GRS was calculated on 1055 individuals. Mean GRS was 31 with an interquartile range (IQR) of 29-34. Over the follow-up period, 108 individuals experienced the primary endpoint. The GRS was not associated with recurrent events post ACS (Hazard Ratio [HR] 0.97, 95% CI 0.92-1.03 per 1-point increase in GRS). Addition of the GRS to variables from the TIMI and GRACE risk scores did not significantly improve risk prediction. Restricting the analysis to individuals below age 65, or with no prior history of myocardial infarction did not materially change these results. In multivariate analysis, two individual SNPs were associated with recurrent events; rs11206510 HR 1.85 (95%CI 1.14-3.02), and rs2259816 HR 2.06 (95%CI 1.21-3.48).
Conclusion: A GRS constructed from 30 SNPs known to be associated with myocardial infarction was not associated with recurrent events 1-year post MI even after adjusting for traditional cardiac risk factors and did not offer any predictive advantage beyond the TIMI and GRACE risk scores. However, two individual SNPs, rs11206510 and rs2259816, were significantly associated with adverse events post MI and may be useful for risk stratification, if these findings can be replicated in other ACS cohorts.
- © 2013 by American Heart Association, Inc.