Using Polygenic Risk Scores for Prioritizing Individuals at Greatest Need of a Cardiovascular Disease Risk Assessment.
Using Polygenic Risk Scores for Prioritizing Individuals at Greatest Need of a Cardiovascular Disease Risk Assessment.
复制标题
DOI：
10.1161/jaha.122.029296
复制
发表时间：
2023-08
影响因子：
5.4
通讯作者：
Wood AM
中科院分区：
文献类型：
--
作者：
Chung R;Xu Z;Arnold M;Ip S;Harrison H;Barrett J;Pennells L;Kim LG;Di Angelantonio E;Paige E;Ritchie SC;Inouye M;Usher-Smith JA;Wood AM
本研究的目的是提供使用多基因风险评分的定量证据，以系统地识别个人的邀请，充分正式的心血管疾病（CVD）的风险评估。共有108685名年龄在40至69岁之间的参与者，测量了生物标志物，链接的初级保健记录和英国生物库中的遗传数据，用于模型推导和人群健康建模。使用性别特异性考克斯模型，使用年龄、冠状动脉疾病和卒中的多基因风险评分以及纵向初级保健记录中可用的CVD的传统风险因素推导出优先级工具。我们模拟了在优先考虑邀请个人参加正式CVD风险评估后开始指南推荐的他汀类药物治疗的影响。如果使用初级保健记录来优先考虑个人进行正式风险评估，使用对应于5%假阴性率的年龄和性别特异性阈值，那么需要筛查以预防1起CVD事件的男性和女性人数分别为149和280。相比之下，将多基因风险评分添加到优先级和正式评估中，并选择阈值以捕获相同数量的事件，导致男性需要筛选116个，女性需要筛选180个。使用多基因风险评分和初级保健记录来优先考虑CVD事件风险最高的个体进行正式的CVD风险评估，可以有效地优先考虑那些最需要干预的人，而不是单独使用初级保健记录。这可以通过减少初级保健中的风险评估数量来更好地分配资源，同时仍然预防相同数量的CVD事件。
The aim of this study was to provide quantitative evidence of the use of polygenic risk scores for systematically identifying individuals for invitation for full formal cardiovascular disease (CVD) risk assessment. A total of 108 685 participants aged 40 to 69 years, with measured biomarkers, linked primary care records, and genetic data in UK Biobank were used for model derivation and population health modeling. Prioritization tools using age, polygenic risk scores for coronary artery disease and stroke, and conventional risk factors for CVD available within longitudinal primary care records were derived using sex‐specific Cox models. We modeled the implications of initiating guideline‐recommended statin therapy after prioritizing individuals for invitation to a formal CVD risk assessment. If primary care records were used to prioritize individuals for formal risk assessment using age‐ and sex‐specific thresholds corresponding to 5% false‐negative rates, then the numbers of men and women needed to be screened to prevent 1 CVD event are 149 and 280, respectively. In contrast, adding polygenic risk scores to both prioritization and formal assessments, and selecting thresholds to capture the same number of events, resulted in a number needed to screen of 116 for men and 180 for women. Using both polygenic risk scores and primary care records to prioritize individuals at highest risk of a CVD event for a formal CVD risk assessment can efficiently prioritize those who need interventions the most than using primary care records alone. This could lead to better allocation of resources by reducing the number of risk assessments in primary care while still preventing the same number of CVD events.
进一步了解心血管风险计算器：他汀类药物，血运重建和不足症的作用在妇女健康研究中。
影响因子：
39
作者：
Cook, Nancy R.;Ridker, Paul M.
通讯作者：
Ridker, Paul M.
影响因子：
2
作者：
Wood, A. M.;White, I. R.;Thompson, S. G.;Kostis, J. B.;Wilson, A. C.;Wu, K.;Benderly, M.;Goldbourt, U.;Willeit, J.;Kiechl, S.;Yarnell, J. W. G.;Sweetnarn, P. M.;Elwood, P. C.;Cushman, M.;Tracy, R. P.;Tybjaerg-Hansen, A.;Haverkate, F.;Thompson, S. G.;Lee, A. J.;Smith, F. B.;Salomaa, V.;Harald, K.;Rasi, V.;Jousilahti, P.;Pekkanen, J.;D'Agostino, R.;Wilson, P. W. F.;Tofler, G.;Levy, D.;Marchioli, R.;Valagussa, F.;Rosengren, A.;Lappas, G.;Eriksson, H.;Cremer, P.;Nagel, D.;Curb, J. D.;Rodriguez, B.;Yano, K.;Salonen, J. T.;Nyyssoenen, K.;Tuomainen, T. -P.;Hedblad, B.;Engstroem, G.;Berglund, G.;Loewel, H.;Hense, H. W.;Meade, T. W.;Cooper, J. A.;De Stavola, B.;Knottenbelt, C.;Miller, G. J.;Cooper, J. A.;Bauer, K. A.;Rosenberg, R. D.;Sato, S.;Kitamura, A.;Naito, Y.;Iso, H.;Salomaa, V.;Harald, K.;Rasi, V.;Vahtera, E.;Jousilahti, P.;Palosuo, T.;Ducimetiere, P.;Amouyel, P.;Arveiler, D.;Evans, A. E.;Ferrieres, J.;Juhan-Vague, I.;Bingham, A.;Schulte, H.;Assmann, G.;Cantin, B.;Lamarche, B.;Despres, J. -P.;Dagenais, G. R.;Tunstall-Pedoe, H.;Lowe, G. D. O.;Woodward, M.;Ben-Shlomo, Y.;Smith, G. Davey;Palmieri, V.;Yeh, J. L.;Meade, T. W.;Brennan, P.;Knottenbelt, C.;Cooper, J. A.;Ridker, P.;Rodeghiero, F.;Tosetto, A.;Shepherd, J.;Lowe, G. D. O.;Ford, I.;Robertson, M.;Brunner, E.;Shipley, M.;Feskens, E. J. M.;Kromhout, D.;Di Angelantonio, E.;Kaptoge, S.;Lewington, S.;Lowe, G. D. O.;Sarwar, N.;Thompson, S. G.;Walker, M.;Watson, S.;White, I. R.;Wood, A. M.;Danesh, J.
通讯作者：
Danesh, J.