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Cornelissen A, Gadhoke NV, Ryan K, Hodonsky CJ, Duong TV, Dikongue A, Sakamoto A, Sato Y, Miller CL, Hong CC, Arking DE, Mitchell BD, Guo L, Virmani R, Finn AV. Polygenic risk score associates with atherosclerosis severity at autopsy. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Polygenic risk scores (PRS) for coronary artery disease (CAD) are emerging as a potential method to improve cardiovascular risk prediction. Questions remain about their applicability to diverse populations as well as their correlation with coronary histopathology.
Purpose
To assess whether high genetic risk associates with histopathologic coronary plaque morphology.
Methods
We assessed 122 known CAD risk loci in 954 Black and White subjects within our sudden death registry to generate a PRS. The cohort was divided into quintiles according to z-score-standardized PRS, both in a race-stratified fashion and in the pooled sample. Detailed histopathologic examination of the coronary arteries was performed in all subjects.
Results
Subjects in the highest PRS quintile exhibited more severe atherosclerosis compared to subjects in the lowest quintile, with greater mean cross-sectional luminal narrowing (71.5% (95% CI, 66.6%-76.5%) vs. 56.6% (95% CI, 51.1%-62.1%); adjusted p<0.001; Figure 1) and a higher frequency of calcification (adjusted OR 2.19; 95% CI 1.31–3.68; p=0.003) after adjustment for the first 10 principal components, age, sex, and race. Higher z-score-standardized PRS was predictive for the finding of severe atherosclerosis (i.e., ≥75% cross-sectional luminal narrowing) even after additional controlling for traditional CAD risk factors including hypertension, smoking, diabetes mellitus, and hyperlipidemia (adjusted OR 1.39; 95% CI 1.19–1.63; p<0.001; Figure 2). Among Black subjects, higher PRS was associated with higher odds of plaque rupture (adjusted OR 1.31; 95% CI 1.03–1.66; p=0.03) and predicted CAD-associated cause of death among subjects younger than 50 years old (adjusted OR 1.26; 95% CI 1.01–1.58; p=0.04).
Conclusions
This is the first autopsy study investigating associations between PRS and atherosclerotic plaque morphology at a histopathologic level. Our pathological analysis suggests PRS correlates with plaque burden and coronary artery calcification and may be useful as a method for CAD risk stratification, especially in younger subjects.
Funding Acknowledgement
Type of funding sources: Foundation. Main funding source(s): R01 HL141425 Leducq Foundation Grant
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Affiliation(s)
- A Cornelissen
- RWTH University Hospital Aachen, Cardiology , Aachen , Germany
| | - N V Gadhoke
- CVPath Institute , Gaithersburg , United States of America
| | - K Ryan
- University of Maryland , Baltimore , United States of America
| | - C J Hodonsky
- University of Virginia , Charlottesville , United States of America
| | - T V Duong
- Johns Hopkins University School of Medicine , Baltimore , United States of America
| | - A Dikongue
- CVPath Institute , Gaithersburg , United States of America
| | - A Sakamoto
- CVPath Institute , Gaithersburg , United States of America
| | - Y Sato
- CVPath Institute , Gaithersburg , United States of America
| | - C L Miller
- University of Virginia , Charlottesville , United States of America
| | - C C Hong
- University of Maryland , Baltimore , United States of America
| | - D E Arking
- Johns Hopkins University School of Medicine , Baltimore , United States of America
| | - B D Mitchell
- University of Maryland , Baltimore , United States of America
| | - L Guo
- CVPath Institute , Gaithersburg , United States of America
| | - R Virmani
- CVPath Institute , Gaithersburg , United States of America
| | - A V Finn
- CVPath Institute , Gaithersburg , United States of America
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