Integrating polygenic and clinical risks to improve stroke risk stratification in prospective Chinese cohorts

Cui，Qingmei1,2; Liu，Fangchao1,2; Li，Jianxin1; Niu，Xiaoge1,3; Liu，Zhongying1; Shen，Chong4; Hu，Dongsheng5,6; Huang，Keyong1; Chen，Shufeng1; Cao，Jie1; Liu，Xiaoqing7; Yu，Ling8; Lu，Fanghong9; Wu，Xianping10; Zhao，Liancheng1; Huang，Jianfeng1; Li，Ying1; Hu，Zhibin4; Shen，Hongbing4,11; Gu，Dongfeng1,2,12; Lu，Xiangfeng1,2

2023

10.1007/s11427-022-2280-3

Science China Life Sciences   影响因子和分区

1674-7305

1869-1889

The utility of the polygenic risk score (PRS) to identify individuals at higher risk of stroke beyond clinical risk remains unclear, and we clarified this using Chinese population-based prospective cohorts. Cox proportional hazards models were used to estimate the 10-year risk, and Fine and Gray’s models were used for hazard ratios (HRs), their 95% confidence intervals (CIs), and the lifetime risk according to PRS and clinical risk categories. A total of 41,006 individuals aged 30–75 years with a mean follow-up of 9.0 years were included. Comparing the top versus bottom 5% of the PRS, the HR was 3.01 (95%CI 2.03–4.45) in the total population, and similar findings were observed within clinical risk strata. Marked gradients in the 10-year and lifetime risk across PRS categories were also found within clinical risk categories. Notably, among individuals with intermediate clinical risk, the 10-year risk for those in the top 5% of the PRS (7.3%, 95%CI 7.1%–7.5%) reached the threshold of high clinical risk (⩾7.0%) for initiating preventive treatment, and this effect of the PRS on refining risk stratification was evident for ischemic stroke. Even among those in the top 10% and 20% of the PRS, the 10-year risk would also exceed this level when aged ⩾50 and ⩾60 years, respectively. Overall, the combination of the PRS with the clinical risk score improved the risk stratification within clinical risk strata and distinguished actual high-risk individuals with intermediate clinical risk.

clinical risk score polygenic risk score stratification stroke utility

SCI

英语

通讯

WOS:000945285900001

2-s2.0-85149396263

Scopus

1.Department of Epidemiology,Fuwai Hospital,National Center for Cardiovascular Diseases,Chinese Academy of Medical Sciences & Peking Union Medical College,Beijing,100037,China
2.Key Laboratory of Cardiovascular Epidemiology,Chinese Academy of Medical Sciences,Beijing,100037,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 and People’s Hospital of Zhengzhou University,Zhengzhou,450053,China
4.Department of Epidemiology and Biostatistics,Center for Global Health,School of Public Health,Nanjing Medical University,Nanjing,211166,China
5.Department of Epidemiology and Health Statistics,College of Public Health,Zhengzhou University,Zhengzhou,450001,China
6.Department of Prevention Medicine,Shenzhen University School of Medicine,Shenzhen,518060,China
7.Division of Epidemiology,Guangdong Provincial People’s Hospital and Cardiovascular Institute,Guangzhou,510080,China
8.Department of Cardiology,Fujian Provincial People’s Hospital,Fuzhou,350014,China
9.Cardio-Cerebrovascular Control and Research Center,Institute of Basic Medicine,Shandong Academy of Medical Sciences,Jinan,250062,China
10.Sichuan Center for Disease Control and Prevention,Chengdu,610041,China
11.Research Units of Cohort Study on Cardiovascular Diseases and Cancers,Chinese Academy of Medical Sciences,Beijing,100730,China
12.School of Medicine,Southern University of Science and Technology,Shenzhen,518055,China

Cui，Qingmei,Liu，Fangchao,Li，Jianxin,et al. Integrating polygenic and clinical risks to improve stroke risk stratification in prospective Chinese cohorts[J]. Science China Life Sciences,2023.

Cui，Qingmei.,Liu，Fangchao.,Li，Jianxin.,Niu，Xiaoge.,Liu，Zhongying.,...&Lu，Xiangfeng.(2023).Integrating polygenic and clinical risks to improve stroke risk stratification in prospective Chinese cohorts.Science China Life Sciences.

Cui，Qingmei,et al."Integrating polygenic and clinical risks to improve stroke risk stratification in prospective Chinese cohorts".Science China Life Sciences (2023).