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Pàgina inicial > Articles > Articles publicats > A Polygenic Risk Score Based on a Cardioembolic Stroke Multitrait Analysis Improves a Clinical Prediction Model for This Stroke Subtype |
Data: | 2022 |
Resum: | Background: Occult atrial fibrillation (AF) is one of the major causes of embolic stroke of undetermined source (ESUS). Knowing the underlying etiology of an ESUS will reduce stroke recurrence and/or unnecessary use of anticoagulants. Understanding cardioembolic strokes (CES), whose main cause is AF, will provide tools to select patients who would benefit from anticoagulants among those with ESUS or AF. We aimed to discover novel loci associated with CES and create a polygenetic risk score (PRS) for a more efficient CES risk stratification. Methods: Multitrait analysis of GWAS (MTAG) was performed with MEGASTROKE-CES cohort (n = 362,661) and AF cohort (n = 1,030,836). We considered significant variants and replicated those variants with MTAG p-value < 5 × 10 influencing both traits (GWAS-pairwise) with a p-value < 0. 05 in the original GWAS and in an independent cohort (n = 9,105). The PRS was created with PRSice-2 and evaluated in the independent cohort. Results: We found and replicated eleven loci associated with CES. Eight were novel loci. Seven of them had been previously associated with AF, namely, CAV1, ESR2, GORAB, IGF1R, NEURL1, WIPF1, and ZEB2. KIAA1755 locus had never been associated with CES/AF, leading its index variant to a missense change (R1045W). The PRS generated has been significantly associated with CES improving discrimination and patient reclassification of a model with age, sex, and hypertension. Conclusion: The loci found significantly associated with CES in the MTAG, together with the creation of a PRS that improves the predictive clinical models of CES, might help guide future clinical trials of anticoagulant therapy in patients with ESUS or AF. |
Ajuts: | Agència de Gestió d'Ajuts Universitaris i de Recerca 2020FI_B1 00157 Agència de Gestió d'Ajuts Universitaris i de Recerca 2017/SGR-529 Instituto de Salud Carlos III CM18/00198 Instituto de Salud Carlos III FI19/00309 Instituto de Salud Carlos III CD20/00043 Instituto de Salud Carlos III CPII17/00027 Instituto de Salud Carlos III CPII19/00020 Instituto de Salud Carlos III PI15/01978 Instituto de Salud Carlos III PI17/02089 Instituto de Salud Carlos III PI18-01338 Instituto de Salud Carlos III RICORS-ICTUS RD21/0006/0006 Instituto de Salud Carlos III ADE 10/00026 |
Nota: | Altres ajuts: The Common Fund of the Office of the Director of the National Institutes of Health; NCI; NHGRI; NHLBI; NIDA; NIMH; NINDS; Fons Social Europeu (FSE); Fondo Europeo de Desarrollo Regional (ISCIII-FEDER); La Marató de TV3; The Fundació Docència i Recerca FMT grant for the Epigenesis project; Eranet-Neuron of the Ibiostroke project (AC19/00106); Boehringer Ingelheim of the SEDMAN Study; Acción de Dinamización del ISCIII-MINECO; Departament de Salut, Generalitat of Catalunya. |
Drets: | Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original. |
Llengua: | Anglès |
Document: | Article ; recerca ; Versió publicada |
Matèria: | Polygenic risk score ; GWAS ; Multi-trait analysis ; Stroke ; ESUs |
Publicat a: | Frontiers in Cardiovascular Medicine, Vol. 9 (august 2022) , p. 940696, ISSN 2297-055X |
12 p, 1.1 MB |