Impact of cardiovascular health and genetic risk on coronary artery disease in Chinese adults

Qingmei,Cui1,2; Zhongying,Liu1,2; Jianxin,Li1; Fangchao,Liu1; Xiaoge,Niu1,3; Chong,Shen4; Dongsheng,Hu5,6; Keyong,Huang1; Shufeng,Chen1; Yingxin,Zhao7; Fanghong,Lu7; Xiaoqing,Liu8; Jie,Cao1; Laiyuan,Wang1; Hongxia,Ma4; Ling,Yu9; Xianping,Wu10; Ying,Li1; Huan,Zhang11; Xingbo,Mo11; Liancheng,Zhao1; Zhibin,Hu4; Hongbing,Shen4,12; Jianfeng,Huang1; Xiangfeng,Lu1,2; Dongfeng,Gu1,2,13

2022-12-20

10.1136/heartjnl-2022-321657

HEART   影响因子和分区

1355-6037

Objective To examine whether adherence to ideal cardiovascular health (CVH) can mitigate the genetic risk of coronary artery disease (CAD) in non-European populations.

Methods Fine and Grey’s models were used to calculate HRs and their corresponding 95% CIs, as well as the lifetime risk of CVH metrics across Polygenic Risk Score (PRS) categories.

Results We included 39 755 individuals aged 30–75 years in Chinese prospective cohorts. 1275 CAD cases were recorded over a mean follow-up of 12.9 years. Compared with unfavourable CVH profile (zero to three ideal CVH metrics), favourable CVH profile (six to seven ideal CVH metrics) demonstrated similar relative effects across PRS categories, with the HRs of 0.40 (95% CI 0.24 to 0.67), 0.41 (95% CI 0.32 to 0.52) and 0.36 (95% CI 0.26 to 0.52) in low (bottom quintile of PRS), intermediate (two to four quintiles of PRS) and high (top quintile of PRS) PRS categories, respectively. For the absolute risk reduction (ARR), individuals with high PRS achieved the greatest benefit from favourable CVH, mitigating the risk to the average level of population (from 21.1% to 8.7%), and the gradient was strengthened in individuals at the top 5% of PRS. Moreover, compared with individuals at low PRS, those at high PRS obtained longer CAD-free years (2.6 vs 1.1) from favourable CVH at the index age of 35 years.

Conclusion Favourable CVH profile reduced the CAD relative risk by similar magnitude across PRS categories, while the ARR from favourable CVH was most pronounced in high PRS category. Attaining favourable CVH should be encouraged for all individuals, especially in individuals with high genetic susceptibility.

SCI

英语

通讯

BMJ

CLINICAL MEDICINE

人工提交

1.Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
2.Key Laboratory of Cardiovascular Epidemiology, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
3.Department of Nephrology, Henan Provincial Key Laboratory of Kidney Disease and Immunology, Henan Provincial Clinical Research Center for Kidney Disease, Henan Provincial People's Hospital, Zhengzhou, Henan, China.
4.Department of Epidemiology and Biostatistics, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China.
5.Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China.
6.Department of Prevention Medicine, Shenzhen University College of Medicine, Shenzhen, Guangdong, China.
7.Cardio-Cerebrovascular Control and Research Center, Institute of Basic Medicine, Shandong Academy of Medical Sciences, Jinan, Shandong, China.
8.Division of Epidemiology, Guangdong Provincial People's Hospital Guangdong Cardiovascular Institute, Guangzhou, Guangdong, China.
9.Department of Cardiology, Fujian Provincial People's Hospital, Fuzhou, Fujian, China.
10.Department of Chronic and Non-communicable Disease Control and Prevention, Sichuan Center for Disease Control and Prevention, Chengdu, Sichuan, China.
11.Center for Genetic Epidemiology and Genomics, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Soochow University Medical College, Suzhou, Jiangsu, China.
12.Research Units of Cohort Study on Cardiovascular Diseases and Cancers, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, Beijing, China.
13.School of Medicine, Southern University of Science and Technology, Shenzhen, Guangdong, China

Qingmei,Cui,Zhongying,Liu,Jianxin,Li,et al. Impact of cardiovascular health and genetic risk on coronary artery disease in Chinese adults[J]. HEART,2022:heartjnl-2022-321657.

Qingmei,Cui.,Zhongying,Liu.,Jianxin,Li.,Fangchao,Liu.,Xiaoge,Niu.,...&Dongfeng,Gu.(2022).Impact of cardiovascular health and genetic risk on coronary artery disease in Chinese adults.HEART,heartjnl-2022-321657.

Qingmei,Cui,et al."Impact of cardiovascular health and genetic risk on coronary artery disease in Chinese adults".HEART (2022):heartjnl-2022-321657.