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A genetic risk score predicts recurrent events after myocardial infarction in young adults
To evaluate whether a genetic risk score (GRS) improves prediction of recurrent events in young nondiabetic patients presenting with an acute myocardial infarction (AMI) and identifies a more aggressive form of atherosclerosis. We conducted a prospective study with consecutive nondiabetic patients a...
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| Published in: | Revista española de cardiología (English ed.) 2020-08, Vol.73 (8), p.623-631 |
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| creator | Rincón, Luis M. Sanmartín, Marcelo Alonso, Gonzalo L. Rodríguez, José Antonio Muriel, Alfonso Casas, Eduardo Navarro, Miguel Carbonell, Alejandra Lázaro, Carla Fernández, Sara González, Paz Rodríguez, Macarena Jiménez-Mena, Manuel Fernández-Golfín, Covadonga Esteban, Amparo García-Bermejo, María Laura Zamorano, José L. |
| description | To evaluate whether a genetic risk score (GRS) improves prediction of recurrent events in young nondiabetic patients presenting with an acute myocardial infarction (AMI) and identifies a more aggressive form of atherosclerosis.
We conducted a prospective study with consecutive nondiabetic patients aged |
| doi_str_mv | 10.1016/j.rec.2019.08.006 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2307396640</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S1885585719302634</els_id><sourcerecordid>2307396640</sourcerecordid><originalsourceid>FETCH-LOGICAL-c1981-58c95f8ee402dbd1ec99d70d295eb4285e19ffdb6a9f991ea67634b4a7e7b123</originalsourceid><addsrcrecordid>eNp9kD1PwzAQhi0EoqXwA1iQR5YGOx-OLaaq4kuqxNKJxXLsS-WSxsV2KvXf46oFMbHc3fDeo7sHoVtKMkooe1hnHnSWEyoywjNC2BkaU86racWr-vzPPEJXIawJqQpel5doVFCWCyboGH3M8Ap6iFZjb8MnDtp5wFsPxuoYcOIP3kMfMexSDVi1ETze7J1W3ljVYdu3yutoXZ9GvHdDv8LKDF0M1-iiVV2Am1OfoOXz03L-Ol28v7zNZ4uppoLTdJ8WVcsBSpKbxlDQQpiamFxU0JQ5r4CKtjUNU6IVgoJiNSvKplQ11A3Niwm6P2K33n0NEKLc2KCh61QPbggyL0hdCMZKkqL0GNXeheChlVtvN8rvJSXyYFSuZfpYHoxKwmUymnbuTvih2YD53fhRmAKPxwCkH3cWvAzaQq-TwcSK0jj7D_4biNyH9Q</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2307396640</pqid></control><display><type>article</type><title>A genetic risk score predicts recurrent events after myocardial infarction in young adults</title><source>ScienceDirect Journals</source><creator>Rincón, Luis M. ; Sanmartín, Marcelo ; Alonso, Gonzalo L. ; Rodríguez, José Antonio ; Muriel, Alfonso ; Casas, Eduardo ; Navarro, Miguel ; Carbonell, Alejandra ; Lázaro, Carla ; Fernández, Sara ; González, Paz ; Rodríguez, Macarena ; Jiménez-Mena, Manuel ; Fernández-Golfín, Covadonga ; Esteban, Amparo ; García-Bermejo, María Laura ; Zamorano, José L.</creator><creatorcontrib>Rincón, Luis M. ; Sanmartín, Marcelo ; Alonso, Gonzalo L. ; Rodríguez, José Antonio ; Muriel, Alfonso ; Casas, Eduardo ; Navarro, Miguel ; Carbonell, Alejandra ; Lázaro, Carla ; Fernández, Sara ; González, Paz ; Rodríguez, Macarena ; Jiménez-Mena, Manuel ; Fernández-Golfín, Covadonga ; Esteban, Amparo ; García-Bermejo, María Laura ; Zamorano, José L.</creatorcontrib><description>To evaluate whether a genetic risk score (GRS) improves prediction of recurrent events in young nondiabetic patients presenting with an acute myocardial infarction (AMI) and identifies a more aggressive form of atherosclerosis.
We conducted a prospective study with consecutive nondiabetic patients aged <55 years presenting with AMI. We performed a genetic test, cardiac computed tomography, and analyzed several biomarkers. We studied the association of a GRS composed of 11 genetic variants and a primary composite endpoint (cardiovascular mortality, a recurrent event, and cardiac hospitalization).
A total of 81 patients were studied and followed up for a median of 4.1 years. There were 24 recurrent cardiovascular events. Compared with the general population, study participants had a higher prevalence of 9 out of 11 risk alleles. The GRS was significantly associated with recurrent cardiovascular events, especially when baseline low-density lipoprotein cholesterol (LDL-C) levels were elevated. Compared with the low-risk GRS tertile, the multivariate-adjusted HR for recurrences was 10.2 (95%CI, 1.1-100.3; P=.04) for the intermediate-risk group and was 20.7 (2.4-181.0; P=.006) for the high-risk group when LDL-C was≥2.8mmol/L (≥ 110mg/dL). Inclusion of the GRS improved the C-statistic (ΔC-statistic=0.086), cNRI (continuous net reclassification improvement) (30%), and the IDI (integrated discrimination improvement) index (0.05). Cardiac computed tomography frequently detected coronary calcified atherosclerosis but had limited value for prediction of recurrences. No association was observed between metalloproteinases, GRS and recurrences.
A multilocus GRS may identify individuals at increased risk of long-term recurrences among young nondiabetic patients with AMI and improve clinical risk stratification models, particularly among patients with high baseline LDL-C levels.
Evaluar si una puntuación de riesgo genético (GRS) mejora la predicción de eventos recurrentes en pacientes jóvenes con infarto agudo de miocardio (IAM) e identifica una forma de aterosclerosis más agresiva.
Se diseñó un estudio prospectivo con pacientes <55 años, no diabéticos, ingresados por IAM. Se realizó un test genético, una tomografía computarizada cardiaca y determinación de varios biomarcadores. Se analizó la asociación de un GRS compuesto por 11 variantes genéticas con la aparición de un objetivo primario combinado (muerte cardiovascular, evento recurrente u hospitalización cardiovascular).
Se siguió a 81 pacientes durante una mediana de 4,1 años, y se documentaron 24 eventos. La prevalencia de variantes de riesgo fue superior en 9 de los 11 alelos frente a población general. El GRS se asoció con recurrencias, particularmente cuando los niveles basales de colesterol-LDL estaban elevados. En el modelo multivariado, teniendo como referencia el tercil de bajo riesgo genético, el HR para el grupo de riesgo intermedio fue de 10,2 (IC95% 1,1-100,3; p=0,04) y de alto riesgo 20,7 (2,4-181,0; p=0,006) si el colesterol-LDL era≥2,8mmol/L (≥ 110mg/dL). La incorporación del GRS al modelo multivariado mejoró el estadístico C (ΔC-statistic=0,086), el cNRI (30%) y el IDI (0,05). El TC cardiaco detectó ateromatosis calcificada frecuentemente, pero tuvo un valor pronóstico limitado. No se detectó una asociación entre metaloproteinasas, GRS y recurrencias.
En una población de pacientes jóvenes no diabéticos con IAM, una puntuación de riesgo genético puede predecir recurrencias y mejorar los modelos clínicos de estratificación pronóstica, especialmente en aquellos pacientes con colesterol-LDL basal elevado.</description><identifier>ISSN: 1885-5857</identifier><identifier>EISSN: 1885-5857</identifier><identifier>DOI: 10.1016/j.rec.2019.08.006</identifier><identifier>PMID: 31629691</identifier><language>eng</language><publisher>Spain: Elsevier España, S.L.U</publisher><subject>Aged ; Cardiac computed tomography ; Coronary disease ; Enfermedad coronaria ; Eventos recurrentes ; Genetic risk score ; Humans ; Infarto agudo de miocardio ; Myocardial infarction ; Myocardial Infarction - diagnosis ; Myocardial Infarction - epidemiology ; Myocardial Infarction - genetics ; Predictive Value of Tests ; Prospective Studies ; Puntuación de riesgo genético ; Recurrent events ; Risk Assessment ; Risk Factors ; Tomografía computarizada cardiaca ; Young Adult</subject><ispartof>Revista española de cardiología (English ed.), 2020-08, Vol.73 (8), p.623-631</ispartof><rights>2019 Sociedad Española de Cardiología</rights><rights>Copyright © 2019 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.</rights><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c1981-58c95f8ee402dbd1ec99d70d295eb4285e19ffdb6a9f991ea67634b4a7e7b123</citedby><cites>FETCH-LOGICAL-c1981-58c95f8ee402dbd1ec99d70d295eb4285e19ffdb6a9f991ea67634b4a7e7b123</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31629691$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Rincón, Luis M.</creatorcontrib><creatorcontrib>Sanmartín, Marcelo</creatorcontrib><creatorcontrib>Alonso, Gonzalo L.</creatorcontrib><creatorcontrib>Rodríguez, José Antonio</creatorcontrib><creatorcontrib>Muriel, Alfonso</creatorcontrib><creatorcontrib>Casas, Eduardo</creatorcontrib><creatorcontrib>Navarro, Miguel</creatorcontrib><creatorcontrib>Carbonell, Alejandra</creatorcontrib><creatorcontrib>Lázaro, Carla</creatorcontrib><creatorcontrib>Fernández, Sara</creatorcontrib><creatorcontrib>González, Paz</creatorcontrib><creatorcontrib>Rodríguez, Macarena</creatorcontrib><creatorcontrib>Jiménez-Mena, Manuel</creatorcontrib><creatorcontrib>Fernández-Golfín, Covadonga</creatorcontrib><creatorcontrib>Esteban, Amparo</creatorcontrib><creatorcontrib>García-Bermejo, María Laura</creatorcontrib><creatorcontrib>Zamorano, José L.</creatorcontrib><title>A genetic risk score predicts recurrent events after myocardial infarction in young adults</title><title>Revista española de cardiología (English ed.)</title><addtitle>Rev Esp Cardiol (Engl Ed)</addtitle><description>To evaluate whether a genetic risk score (GRS) improves prediction of recurrent events in young nondiabetic patients presenting with an acute myocardial infarction (AMI) and identifies a more aggressive form of atherosclerosis.
We conducted a prospective study with consecutive nondiabetic patients aged <55 years presenting with AMI. We performed a genetic test, cardiac computed tomography, and analyzed several biomarkers. We studied the association of a GRS composed of 11 genetic variants and a primary composite endpoint (cardiovascular mortality, a recurrent event, and cardiac hospitalization).
A total of 81 patients were studied and followed up for a median of 4.1 years. There were 24 recurrent cardiovascular events. Compared with the general population, study participants had a higher prevalence of 9 out of 11 risk alleles. The GRS was significantly associated with recurrent cardiovascular events, especially when baseline low-density lipoprotein cholesterol (LDL-C) levels were elevated. Compared with the low-risk GRS tertile, the multivariate-adjusted HR for recurrences was 10.2 (95%CI, 1.1-100.3; P=.04) for the intermediate-risk group and was 20.7 (2.4-181.0; P=.006) for the high-risk group when LDL-C was≥2.8mmol/L (≥ 110mg/dL). Inclusion of the GRS improved the C-statistic (ΔC-statistic=0.086), cNRI (continuous net reclassification improvement) (30%), and the IDI (integrated discrimination improvement) index (0.05). Cardiac computed tomography frequently detected coronary calcified atherosclerosis but had limited value for prediction of recurrences. No association was observed between metalloproteinases, GRS and recurrences.
A multilocus GRS may identify individuals at increased risk of long-term recurrences among young nondiabetic patients with AMI and improve clinical risk stratification models, particularly among patients with high baseline LDL-C levels.
Evaluar si una puntuación de riesgo genético (GRS) mejora la predicción de eventos recurrentes en pacientes jóvenes con infarto agudo de miocardio (IAM) e identifica una forma de aterosclerosis más agresiva.
Se diseñó un estudio prospectivo con pacientes <55 años, no diabéticos, ingresados por IAM. Se realizó un test genético, una tomografía computarizada cardiaca y determinación de varios biomarcadores. Se analizó la asociación de un GRS compuesto por 11 variantes genéticas con la aparición de un objetivo primario combinado (muerte cardiovascular, evento recurrente u hospitalización cardiovascular).
Se siguió a 81 pacientes durante una mediana de 4,1 años, y se documentaron 24 eventos. La prevalencia de variantes de riesgo fue superior en 9 de los 11 alelos frente a población general. El GRS se asoció con recurrencias, particularmente cuando los niveles basales de colesterol-LDL estaban elevados. En el modelo multivariado, teniendo como referencia el tercil de bajo riesgo genético, el HR para el grupo de riesgo intermedio fue de 10,2 (IC95% 1,1-100,3; p=0,04) y de alto riesgo 20,7 (2,4-181,0; p=0,006) si el colesterol-LDL era≥2,8mmol/L (≥ 110mg/dL). La incorporación del GRS al modelo multivariado mejoró el estadístico C (ΔC-statistic=0,086), el cNRI (30%) y el IDI (0,05). El TC cardiaco detectó ateromatosis calcificada frecuentemente, pero tuvo un valor pronóstico limitado. No se detectó una asociación entre metaloproteinasas, GRS y recurrencias.
En una población de pacientes jóvenes no diabéticos con IAM, una puntuación de riesgo genético puede predecir recurrencias y mejorar los modelos clínicos de estratificación pronóstica, especialmente en aquellos pacientes con colesterol-LDL basal elevado.</description><subject>Aged</subject><subject>Cardiac computed tomography</subject><subject>Coronary disease</subject><subject>Enfermedad coronaria</subject><subject>Eventos recurrentes</subject><subject>Genetic risk score</subject><subject>Humans</subject><subject>Infarto agudo de miocardio</subject><subject>Myocardial infarction</subject><subject>Myocardial Infarction - diagnosis</subject><subject>Myocardial Infarction - epidemiology</subject><subject>Myocardial Infarction - genetics</subject><subject>Predictive Value of Tests</subject><subject>Prospective Studies</subject><subject>Puntuación de riesgo genético</subject><subject>Recurrent events</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><subject>Tomografía computarizada cardiaca</subject><subject>Young Adult</subject><issn>1885-5857</issn><issn>1885-5857</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><recordid>eNp9kD1PwzAQhi0EoqXwA1iQR5YGOx-OLaaq4kuqxNKJxXLsS-WSxsV2KvXf46oFMbHc3fDeo7sHoVtKMkooe1hnHnSWEyoywjNC2BkaU86racWr-vzPPEJXIawJqQpel5doVFCWCyboGH3M8Ap6iFZjb8MnDtp5wFsPxuoYcOIP3kMfMexSDVi1ETze7J1W3ljVYdu3yutoXZ9GvHdDv8LKDF0M1-iiVV2Am1OfoOXz03L-Ol28v7zNZ4uppoLTdJ8WVcsBSpKbxlDQQpiamFxU0JQ5r4CKtjUNU6IVgoJiNSvKplQ11A3Niwm6P2K33n0NEKLc2KCh61QPbggyL0hdCMZKkqL0GNXeheChlVtvN8rvJSXyYFSuZfpYHoxKwmUymnbuTvih2YD53fhRmAKPxwCkH3cWvAzaQq-TwcSK0jj7D_4biNyH9Q</recordid><startdate>202008</startdate><enddate>202008</enddate><creator>Rincón, Luis M.</creator><creator>Sanmartín, Marcelo</creator><creator>Alonso, Gonzalo L.</creator><creator>Rodríguez, José Antonio</creator><creator>Muriel, Alfonso</creator><creator>Casas, Eduardo</creator><creator>Navarro, Miguel</creator><creator>Carbonell, Alejandra</creator><creator>Lázaro, Carla</creator><creator>Fernández, Sara</creator><creator>González, Paz</creator><creator>Rodríguez, Macarena</creator><creator>Jiménez-Mena, Manuel</creator><creator>Fernández-Golfín, Covadonga</creator><creator>Esteban, Amparo</creator><creator>García-Bermejo, María Laura</creator><creator>Zamorano, José L.</creator><general>Elsevier España, S.L.U</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>202008</creationdate><title>A genetic risk score predicts recurrent events after myocardial infarction in young adults</title><author>Rincón, Luis M. ; Sanmartín, Marcelo ; Alonso, Gonzalo L. ; Rodríguez, José Antonio ; Muriel, Alfonso ; Casas, Eduardo ; Navarro, Miguel ; Carbonell, Alejandra ; Lázaro, Carla ; Fernández, Sara ; González, Paz ; Rodríguez, Macarena ; Jiménez-Mena, Manuel ; Fernández-Golfín, Covadonga ; Esteban, Amparo ; García-Bermejo, María Laura ; Zamorano, José L.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c1981-58c95f8ee402dbd1ec99d70d295eb4285e19ffdb6a9f991ea67634b4a7e7b123</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Aged</topic><topic>Cardiac computed tomography</topic><topic>Coronary disease</topic><topic>Enfermedad coronaria</topic><topic>Eventos recurrentes</topic><topic>Genetic risk score</topic><topic>Humans</topic><topic>Infarto agudo de miocardio</topic><topic>Myocardial infarction</topic><topic>Myocardial Infarction - diagnosis</topic><topic>Myocardial Infarction - epidemiology</topic><topic>Myocardial Infarction - genetics</topic><topic>Predictive Value of Tests</topic><topic>Prospective Studies</topic><topic>Puntuación de riesgo genético</topic><topic>Recurrent events</topic><topic>Risk Assessment</topic><topic>Risk Factors</topic><topic>Tomografía computarizada cardiaca</topic><topic>Young Adult</topic><toplevel>online_resources</toplevel><creatorcontrib>Rincón, Luis M.</creatorcontrib><creatorcontrib>Sanmartín, Marcelo</creatorcontrib><creatorcontrib>Alonso, Gonzalo L.</creatorcontrib><creatorcontrib>Rodríguez, José Antonio</creatorcontrib><creatorcontrib>Muriel, Alfonso</creatorcontrib><creatorcontrib>Casas, Eduardo</creatorcontrib><creatorcontrib>Navarro, Miguel</creatorcontrib><creatorcontrib>Carbonell, Alejandra</creatorcontrib><creatorcontrib>Lázaro, Carla</creatorcontrib><creatorcontrib>Fernández, Sara</creatorcontrib><creatorcontrib>González, Paz</creatorcontrib><creatorcontrib>Rodríguez, Macarena</creatorcontrib><creatorcontrib>Jiménez-Mena, Manuel</creatorcontrib><creatorcontrib>Fernández-Golfín, Covadonga</creatorcontrib><creatorcontrib>Esteban, Amparo</creatorcontrib><creatorcontrib>García-Bermejo, María Laura</creatorcontrib><creatorcontrib>Zamorano, José L.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Revista española de cardiología (English ed.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Rincón, Luis M.</au><au>Sanmartín, Marcelo</au><au>Alonso, Gonzalo L.</au><au>Rodríguez, José Antonio</au><au>Muriel, Alfonso</au><au>Casas, Eduardo</au><au>Navarro, Miguel</au><au>Carbonell, Alejandra</au><au>Lázaro, Carla</au><au>Fernández, Sara</au><au>González, Paz</au><au>Rodríguez, Macarena</au><au>Jiménez-Mena, Manuel</au><au>Fernández-Golfín, Covadonga</au><au>Esteban, Amparo</au><au>García-Bermejo, María Laura</au><au>Zamorano, José L.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A genetic risk score predicts recurrent events after myocardial infarction in young adults</atitle><jtitle>Revista española de cardiología (English ed.)</jtitle><addtitle>Rev Esp Cardiol (Engl Ed)</addtitle><date>2020-08</date><risdate>2020</risdate><volume>73</volume><issue>8</issue><spage>623</spage><epage>631</epage><pages>623-631</pages><issn>1885-5857</issn><eissn>1885-5857</eissn><abstract>To evaluate whether a genetic risk score (GRS) improves prediction of recurrent events in young nondiabetic patients presenting with an acute myocardial infarction (AMI) and identifies a more aggressive form of atherosclerosis.
We conducted a prospective study with consecutive nondiabetic patients aged <55 years presenting with AMI. We performed a genetic test, cardiac computed tomography, and analyzed several biomarkers. We studied the association of a GRS composed of 11 genetic variants and a primary composite endpoint (cardiovascular mortality, a recurrent event, and cardiac hospitalization).
A total of 81 patients were studied and followed up for a median of 4.1 years. There were 24 recurrent cardiovascular events. Compared with the general population, study participants had a higher prevalence of 9 out of 11 risk alleles. The GRS was significantly associated with recurrent cardiovascular events, especially when baseline low-density lipoprotein cholesterol (LDL-C) levels were elevated. Compared with the low-risk GRS tertile, the multivariate-adjusted HR for recurrences was 10.2 (95%CI, 1.1-100.3; P=.04) for the intermediate-risk group and was 20.7 (2.4-181.0; P=.006) for the high-risk group when LDL-C was≥2.8mmol/L (≥ 110mg/dL). Inclusion of the GRS improved the C-statistic (ΔC-statistic=0.086), cNRI (continuous net reclassification improvement) (30%), and the IDI (integrated discrimination improvement) index (0.05). Cardiac computed tomography frequently detected coronary calcified atherosclerosis but had limited value for prediction of recurrences. No association was observed between metalloproteinases, GRS and recurrences.
A multilocus GRS may identify individuals at increased risk of long-term recurrences among young nondiabetic patients with AMI and improve clinical risk stratification models, particularly among patients with high baseline LDL-C levels.
Evaluar si una puntuación de riesgo genético (GRS) mejora la predicción de eventos recurrentes en pacientes jóvenes con infarto agudo de miocardio (IAM) e identifica una forma de aterosclerosis más agresiva.
Se diseñó un estudio prospectivo con pacientes <55 años, no diabéticos, ingresados por IAM. Se realizó un test genético, una tomografía computarizada cardiaca y determinación de varios biomarcadores. Se analizó la asociación de un GRS compuesto por 11 variantes genéticas con la aparición de un objetivo primario combinado (muerte cardiovascular, evento recurrente u hospitalización cardiovascular).
Se siguió a 81 pacientes durante una mediana de 4,1 años, y se documentaron 24 eventos. La prevalencia de variantes de riesgo fue superior en 9 de los 11 alelos frente a población general. El GRS se asoció con recurrencias, particularmente cuando los niveles basales de colesterol-LDL estaban elevados. En el modelo multivariado, teniendo como referencia el tercil de bajo riesgo genético, el HR para el grupo de riesgo intermedio fue de 10,2 (IC95% 1,1-100,3; p=0,04) y de alto riesgo 20,7 (2,4-181,0; p=0,006) si el colesterol-LDL era≥2,8mmol/L (≥ 110mg/dL). La incorporación del GRS al modelo multivariado mejoró el estadístico C (ΔC-statistic=0,086), el cNRI (30%) y el IDI (0,05). El TC cardiaco detectó ateromatosis calcificada frecuentemente, pero tuvo un valor pronóstico limitado. No se detectó una asociación entre metaloproteinasas, GRS y recurrencias.
En una población de pacientes jóvenes no diabéticos con IAM, una puntuación de riesgo genético puede predecir recurrencias y mejorar los modelos clínicos de estratificación pronóstica, especialmente en aquellos pacientes con colesterol-LDL basal elevado.</abstract><cop>Spain</cop><pub>Elsevier España, S.L.U</pub><pmid>31629691</pmid><doi>10.1016/j.rec.2019.08.006</doi><tpages>9</tpages></addata></record> |
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| ispartof | Revista española de cardiología (English ed.), 2020-08, Vol.73 (8), p.623-631 |
| issn | 1885-5857 1885-5857 |
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| source | ScienceDirect Journals |
| subjects | Aged Cardiac computed tomography Coronary disease Enfermedad coronaria Eventos recurrentes Genetic risk score Humans Infarto agudo de miocardio Myocardial infarction Myocardial Infarction - diagnosis Myocardial Infarction - epidemiology Myocardial Infarction - genetics Predictive Value of Tests Prospective Studies Puntuación de riesgo genético Recurrent events Risk Assessment Risk Factors Tomografía computarizada cardiaca Young Adult |
| title | A genetic risk score predicts recurrent events after myocardial infarction in young adults |
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