Abstract
Objectives
Coronary heart disease (CHD) is a leading cause of death globally, commonly through
sudden cardiac death. Cardiac arrest of cardiac origin (CA) is associated with a poor
prognosis and there is a great need for risk assessment and intensified preventive
actions.
In this study we aim to assess if a genetic risk score for CHD, composed of 50 common
CHD susceptibility variants (GRS), predicts CA and to evaluate a novel composite risk
score including traditional risk factors as well as GRS.
Methods
The GRS score alone and in combination with traditional CHD risk factors were examined
in relation to CA incidence among 23 000 middle aged subjects during 18.9 years of
follow-up. The cohort excluded patients with a diagnosed history of CHD, heart failure
or stroke.
Results
Two-hundred-fifty-two patients suffered a cardiac arrest during the follow up, of
which 181 were CA. In a multivariate model with CHD risk factors, high versus low
genetic risk predicted CA with a hazard ratio (HR) of 2.49 {(95% CI 1.50–4.12) (P < 0.001)},
surpassed only by higher estimates for male sex {HR = 2.91 (95% CI 2.09–4.06) (P < 0.001)},
ages 50–65 {HR = 2.74 (95% CI 1.42–5.25) (P = 0.003)} and ages 65–74 {HR = 5.10 (95%
CI 2.56–10.16) (P < 0.001)}. Smoking, dyslipidemia, hypertension and diabetes mellitus
also predicted CA but with lower HRs than GRS. A novel composite risk score including
CHD risk factors as well as GRS predicted CA with a HR = 110.81 {(95% CI 15.43–795.63)
(P < 0.001)} for the highest (5) versus the lowest quintile (1) of the risk score.
Conclusions
Genetic risk of CHD is strongly associated with incident CA and when combined with
traditional CHD risk factors may identify individuals who benefit from intensified
preventive pharmacological treatment.
Keywords
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Article info
Publication history
Published online: November 20, 2019
Accepted:
November 8,
2019
Received in revised form:
November 5,
2019
Received:
January 28,
2019
Identification
Copyright
© 2019 Elsevier B.V. All rights reserved.
ScienceDirect
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- Risk factors associated with cardiac arrestResuscitationVol. 151
- PreviewWe read the innovative article by Ohlsson et al.,1 the authors should be commended for combining polygenetic genetic risk scores with traditional risk factors to form a novel composite risk score to help identify individuals who will suffer cardiac arrest (CA). Though this study sounds scientific, some critical issues should be discussed.
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