Novel genetic markers improve measures of atrial fibrillation risk prediction.
Novel genetic markers improve measures of atrial fibrillation risk prediction.
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DOI：
10.1093/eurheartj/eht033
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发表时间：
2013-08
影响因子：
39.3
通讯作者：
Albert CM
中科院分区：
文献类型：
--
作者：
Everett BM;Cook NR;Conen D;Chasman DI;Ridker PM;Albert CM
心房颤动（AF）与不良预后相关。最近发现的遗传风险标记是否能改善房颤风险预测尚不清楚。我们从女性健康研究（WHS）的32个可能的预测因子中推导并验证了一种新的房颤风险预测模型，该研究包括20822名基线时无心血管疾病（CVD）的女性（中位年龄：14.5岁）。然后，我们创建了一个由9个位点的12个风险等位基因组成的遗传风险评分（GRS），并在有和没有GRS的验证队列中评估模型的性能。新导出的WHS房颤风险算法包括年龄、体重、身高、收缩压、饮酒和吸烟（当前和过去）。在验证队列中，该模型校正良好，判别性好[c -指数(95% CI) = 0.718(0.684-0.753)]，与单纯年龄相比，该模型改进了所有重分类指标。在WHS AF风险算法模型中加入遗传评分提高了c -指数[0.741 (0.709-0.774)]；P = 0.001]，无类别净重分类[0.490 (0.301 ~ 0.670)；P < 0.0001]，综合判别改善[0.00526 (0.0033-0.0076)；P < 0.0001]。然而，将患者重新划分为< 1,1 - 5和5% +%的10年风险类别并没有改善[0.041 (- 0.044-0.12)]；P = 0.33]。在没有心血管疾病的女性中，一个简单的风险预测模型利用现成的风险标记识别出房颤风险较高的女性。遗传信息的增加导致预测准确性的适度提高，但并未转化为对离散房颤风险类别的改进重新分类。
Atrial fibrillation (AF) is associated with adverse outcome. Whether recently discovered genetic risk markers improve AF risk prediction is unknown. We derived and validated a novel AF risk prediction model from 32 possible predictors in the Women's Health Study (WHS), a cohort of 20 822 women without cardiovascular disease (CVD) at baseline followed prospectively for incident AF (median: 14.5 years). We then created a genetic risk score (GRS) comprised of 12 risk alleles in nine loci and assessed model performance in the validation cohort with and without the GRS. The newly derived WHS AF risk algorithm included terms for age, weight, height, systolic blood pressure, alcohol use, and smoking (current and past). In the validation cohort, this model was well calibrated with good discrimination [C-index (95% CI) = 0.718 (0.684–0.753)] and improved all reclassification indices when compared with age alone. The addition of the genetic score to the WHS AF risk algorithm model improved the C-index [0.741 (0.709–0.774); P = 0.001], the category-less net reclassification [0.490 (0.301–0.670); P < 0.0001], and the integrated discrimination improvement [0.00526 (0.0033–0.0076); P < 0.0001]. However, there was no improvement in net reclassification into 10-year risk categories of <1, 1–5, and 5+% [0.041 (−0.044–0.12); P = 0.33]. Among women without CVD, a simple risk prediction model utilizing readily available risk markers identified women at higher risk for AF. The addition of genetic information resulted in modest improvements in predictive accuracy that did not translate into improved reclassification into discrete AF risk categories.
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衡量心血管风险的个体预测因素的影响的进步：重新分类措施的作用。
影响因子：
39.2
作者：
Cook NR;Ridker PM
通讯作者：
Ridker PM
影响因子：
2
作者：
Pencina, Michael J.;D'Agostino, Ralph B., Sr.;Steyerberg, Ewout W.
通讯作者：
Steyerberg, Ewout W.
影响因子：
--
作者：
Wolf, PA;Mitchell, JB;D'Agostino, RB
通讯作者：
D'Agostino, RB
影响因子：
37.8
作者：
Charitos, Efstratios I.;Stierle, Ulrich;Hanke, Thorsten
通讯作者：
Hanke, Thorsten
DOI：
10.1136/heartjnl-2011-300503
发表时间：
2012-01
期刊：
Heart (British Cardiac Society)
影响因子：
--
作者：
Huxley RR;Alonso A;Lopez FL;Filion KB;Agarwal SK;Loehr LR;Soliman EZ;Pankow JS;Selvin E
通讯作者：
Selvin E