Prevention & lipidsCohort study
Evaluation of Large-Scale Proteomics for Prediction of Cardiovascular Events
- Retrospective cohort study
- prognostic model development and validation
- external validation in a randomised trial population
Authors' conclusion
A protein risk score was significantly associated with ASCVD events in primary and secondary event populations. When added to clinical risk factors, the protein risk score and polygenic risk score both provided statistically significant but modest improvement in discrimination.
Study context
- Population
- Icelandic adults aged 40–75 years without major atherosclerotic cardiovascular disease (ASCVD) events at recruitment (primary events); individuals with stable ASCVD on statin therapy in a lipid-lowering RCT (secondary events)test set 4018
- Participants
- 13,540 adults
- Exposure
- Protein risk score added to clinical risk factors and polygenic risk scores
- Outcome
- Composites of MI, stroke, and CHD death or CV death
Main finding
As reported in the abstract
ASCVD events, primary event population test set · median follow-up 15.8 years
HR per SD (95% CI)
Protein risk score465 events
1.93(1.75–2.13)
Estimate (95% CI)
Clinical model + protein and polygenic risk scores vs Clinical risk factor model
C index change 0.022(0.007–0.038)
Clinical model + protein risk score vs Clinical risk factor modelC index
difference 0.014(0.002–0.028)
Observational data: associations, not effects.
Further findings
ASCVD events, secondary event population (White individuals) · median follow-up 2.2 years
| Comparison | HR per SD (95% CI) | |
|---|---|---|
| Protein risk score · 6307 participants; 432 events | 1.62 (1.48–1.79) | |
| 0.512Hr per sd (log scale) |
| Outcome | C index change (95% CI) | |
|---|---|---|
| ASCVD events, secondary event population (White individuals) · median follow-up 2.2 years — Clinical model + protein risk score vs Clinical risk factor model | 0.026 (0.011–0.042) | |
| −0.0200.020.040.06Difference (linear scale) |
MACE, African and Asian ancestries, secondary event population
- Protein risk score significantly associated with MACE
Original publication
Evaluation of Large-Scale Proteomics for Prediction of Cardiovascular Events. JAMA. Published 22 August 2023. doi:10.1001/jama.2023.13258
Summarised from the published abstract; every number is checked against it