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Use of polygenic risk scores and other molecular markers to enhance cardiovascular risk prediction: prospective cohort study and modelling analysis
- Publication Year :
- 2019
- Publisher :
- Cold Spring Harbor Laboratory, 2019.
-
Abstract
- BackgroundThere is debate about the value of adding information on genetic and other molecular markers to conventional cardiovascular disease (CVD) risk predictors.MethodsUsing data on 306,654 individuals without a history of CVD from UK Biobank, we calculated measures of risk-discrimination and reclassification upon addition of polygenic risk scores (PRS) and a panel of 27 clinical biochemistry markers to a conventional risk prediction model (i.e., including age, sex, systolic blood pressure, smoking status, history of diabetes, total cholesterol and HDL cholesterol). We then modelled implications of initiating guideline-recommended statin therapy after the assessment of molecular markers for a UK primary-care setting.FindingsThe C-index was 0.710 (95% CI, 0.703-0.717) for a CVD prediction model containing conventional risk predictors alone. The C-index increased by similar amounts when adding information on PRS or biochemistry markers (0.011 and 0.014, respectively; PInterpretationAdding information on both PRS and selected biochemistry markers moderately enhanced CVD predictive accuracy and could improve primary prevention of CVD. However, our modelling suggested that targeted assessment of molecular markers among individuals at intermediate-risk would be more efficient than blanket approaches.
- Subjects :
- medicine.medical_specialty
education.field_of_study
Modelling analysis
business.industry
Cholesterol
Population
Disease
030204 cardiovascular system & hematology
medicine.disease
3. Good health
03 medical and health sciences
chemistry.chemical_compound
0302 clinical medicine
Blood pressure
chemistry
Diabetes mellitus
Internal medicine
Medicine
Polygenic risk score
030212 general & internal medicine
business
Prospective cohort study
education
Subjects
Details
- Database :
- OpenAIRE
- Accession number :
- edsair.doi.dedup.....a0be0b5ecffa0bf72aeb59eee31f8e0f