Coronary Artery Calcium Score and Polygenic Risk Score for the Prediction of Coronary Heart Disease Events
Main finding · Prediction of incident CHD (MESA)Result — go to the resultChange in C statistic 0.10 95% CI 0.07–0.14Authors' conclusion
In 2 cohorts of middle-aged to older adults from the US and the Netherlands, the coronary artery calcium score had better discrimination than the polygenic risk score for risk prediction of CHD. In addition, the coronary artery calcium score but not the polygenic risk score significantly improved risk discrimination and risk reclassification for CHD when added to traditional risk factors.
Study context
- Population
- Individuals aged 45–79 years of European ancestry free of clinical coronary heart disease (CHD) at baseline (Multi-Ethnic Study of Atherosclerosis (MESA), 6 US centres; Rotterdam Study, the Netherlands)MESA 1991
- Exposure
- PCEs + CAC score vs PCEs + polygenic risk score vs PCEs + both
- Outcome
- Discrimination, calibration and net reclassification improvement (7.5% threshold) for prediction of incident CHD events
- Follow-up
- 10 years
Methodological details2 population-based cohorts (MESA, Rotterdam Study)
- 2 population-based cohorts (MESA, Rotterdam Study)
Main finding
Prediction of incident CHD (MESA)
Change in C statistic
0.10
95% CI 0.07–0.14
By group
CAC score
- HR per SD (log[CAC+1])
- 2.60 (95% CI, 2.08-3.26)
- C statistic
- 0.76 (95% CI, 0.71-0.79)
- Change in C statistic added to PCEs
- 0.09 (95% CI, 0.06-0.13)
- Net reclassification improvement
- 0.19 (95% CI, 0.06-0.28)
Polygenic risk score
- HR per SD
- 1.43 (95% CI, 1.20-1.71)
- C statistic
- 0.69 (95% CI, 0.63-0.71)
- Change in C statistic added to PCEs
- 0.02 (95% CI, 0.00-0.04)
- Net reclassification improvement
- 0.04 (95% CI, −0.05 to 0.10)
HR per SD (log[CAC+1])
C statistic
Change in C statistic added to PCEs
Net reclassification improvement
HR per SD
As reported in the abstract
- Calibration of PCEs and models with CAC and/or polygenic risk scores adequate
- all χ2<20
Observational data: associations, not effects.
Further findings
Subgroups by median age; 10-year risk in Rotterdam Study (RS); longer-term follow-up in MESA · median, 16.0 years (MESA)
- Similar findings
Original publication
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