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Genetic risk score and cardiovascular mortality in a southern european population with coronary artery disease

2017Journal article Restricted access
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dc.contributor.authorPereira, Andreia
dc.contributor.authorMendonca, Maria Isabel
dc.contributor.authorSousa, Ana Célia
dc.contributor.authorBorges, Sofia
dc.contributor.authorFreitas, Sónia
dc.contributor.authorHenriques, Eva
dc.contributor.authorRodrigues, Mariana
dc.contributor.authorFreitas, Ana Isabel
dc.contributor.authorGuerra, Graça
dc.contributor.authorOrnelas, Ilídio
dc.contributor.authorPereira, Décio
dc.contributor.authorBrehm, António
dc.contributor.authorPalma dos Reis, Roberto
dc.date.accessioned2019-01-18T10:23:14Z
dc.date.available2019-01-18T10:23:14Z
dc.date.issued2017
dc.description.abstractSeveral genetic risk scores (GRS) have been associated with cardiovascular disease; their role, however, in survival from proven coronary artery disease (CAD) have yielded conflicting results. Objective: The objective of this study was to evaluate long- term cardiovascular mortality according to the genetic risk score in a Southern European population with CAD. Methods: A cohort of 1464 CAD patients with angiographic proven CAD were followed up prospectively for up to 58.3 (interquartile range: 25.8- 88.1) months. Genotyping of 32 single- nucleotide polymorphisms previously associated with CAD was performed using oligonucleotides probes marked with fluorescence for each allele. GRS was constructed according to the additive model assuming codominance and categorised using the median (=26). Cox Regression analysis was performed to determine independent multivariate predictors of cardiovascular mortality. Kaplan- Meier survival curves compared high vs low GRS using log- rank test. C- index was done for our population, as a measure of discrimination in survival analysis model. Results: During a mean follow- up of 58.3 months, 156 patients (10.7%) died, 107 (7.3%) of CV causes. High GRS (≥26) was associated with reduced cardiovascular survival. Survival analysis with Cox regression model adjusted for 8 variables showed that high GRS, dyslipidemia, diabetes and 3- vessel disease were independent risk factors for cardiovascular mortality (HR=1.53, P=.037; HR=3.64, P=.012; HR=1.75, P=.004; HR=2.97, P<.0001, respectively). At the end of follow- up, the estimated survival probability was 70.8% for high GRS and 80.8% for low GRS (Log- rank test 5.6; P=.018). C- Index of 0.71 was found when GRS was added to a multivariate survival model of diabetes, dyslipidemia, smoking, hypertension and 3 vessel disease, stable angina and dual antiplatelet therapy. Conclusions: Besides the classical risk factors management, this work highlights the relevance of the genetic profile in survival from CAD. It is expected that new therapies will be dirsected to gene targets with proven value in cardiovascular survival.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationPereira, A., Mendonca, M. I., Sousa, A. C., Borges, S., Freitas, S., Henriques, E., ... & Pereira, D. (2017). Genetic risk score and cardiovascular mortality in a southern european population with coronary artery disease. International journal of clinical practice, 71(6), e12956.pt_PT
dc.identifier.doi10.1111/ijcp.12956pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.26/25696
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherWileypt_PT
dc.subjectAgedpt_PT
dc.subjectCohort Studiespt_PT
dc.subjectCoronary Angiographypt_PT
dc.subjectCoronary Artery Diseasept_PT
dc.subjectFemalept_PT
dc.subjectHumanspt_PT
dc.subjectMalept_PT
dc.subjectMiddle Agedpt_PT
dc.subjectPolymorphism, Single Nucleotidept_PT
dc.subjectPortugalpt_PT
dc.subjectRegression Analysispt_PT
dc.subjectRisk Factorspt_PT
dc.subjectSurvival Analysispt_PT
dc.titleGenetic risk score and cardiovascular mortality in a southern european population with coronary artery diseasept_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage8pt_PT
oaire.citation.startPage1pt_PT
oaire.citation.titleInternational Journal of Clinical Practicept_PT
oaire.citation.volume71(6), e12956.pt_PT
person.familyNamepereira
person.familyNameMendonca
person.familyNameSousa
person.familyNameBorges
person.familyNameFreitas
person.familyNameHenriques
person.familyNameRodrigues
person.familyNameReis
person.givenNameandreia
person.givenNameMaria Isabel
person.givenNameAna Célia
person.givenNameSofia
person.givenNameSónia
person.givenNameEva
person.givenNameMariana Rodrigues
person.givenNameRoberto
person.identifier.orcid0000-0001-5129-2478
person.identifier.orcid0000-0001-5450-5213
person.identifier.orcid0000-0002-2069-0278
person.identifier.orcid0000-0002-9413-7942
person.identifier.orcid0000-0001-5204-8928
person.identifier.orcid0000-0002-7312-5272
person.identifier.orcid0000-0001-7280-0021
person.identifier.orcid0000-0003-2803-8193
rcaap.rightsrestrictedAccesspt_PT
rcaap.typearticlept_PT
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SESARAM - C - Unidade de Investigação Dr.ª Maria Isabel Mendonça