Polygenic risk score may predict sudden death in some CAD patients
Being in the top decile for the genome-wide polygenic score for coronary artery disease (GPSCAD) is associated with an increased risk for sudden and/or arrhythmic death (SAD) among CAD patients without severe systolic dysfunction, according to a study published in the Aug. 30 issue of the Journal of the American College of Cardiology.
Roopinder K. Sandhu, M.D., M.P.H., from the Cedars-Sinai Medical Center in Los Angeles, and colleagues examined whether a GPSCAD would have utility in SAD risk stratification in 4,698 CAD patients without severe systolic dysfunction. The cohort was dichotomized according to top GPSCAD decile, as defined by the general population.
The researchers found that participants in the top GPSCAD decile were at elevated absolute SAD risk (8.0 versus 4.8 percent) and proportional SAD risk (29 versus 16 percent) compared with the rest of the participants during a median follow-up of 8.0 years. The top GPSCAD decile was associated with SAD after controlling for left ventricular ejection fraction, clinical factors, and electrocardiogram parameters, but it was not associated with non-SAD. The addition of the top GPSCAD decile to the multivariable model significantly improved continuous and categorical net reclassification indexes but did not improve the C-index.
“These findings in aggregate suggest that the GPSCAD is a promising method to improve SAD risk stratification in CAD patients who do not currently qualify for an implantable cardioverter-defibrillator, which warrants further study,” the authors write.
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