Polygenic risk scores predict AF risk after revascularization
17 Jan 2022
Polygenic risk scores (PRSs) can predict the risk of atrial fibrillation (AF) in patients after undergoing revascularization, a recent study has found.
The study included 8,296, 6,132, and 13,082 patients who had undergone percutaneous coronary intervention (PCI), coronary artery bypass grafting (CABG), and any revascularization, respectively. Participants were followed for up to 30 years and PRSs were computed for each postoperative adverse outcome. All participants were genotyped for PRS calculation.
Cox proportional hazards analysis found that each 1-standard deviation (SD) increase in PRS led to a significant jump in the risk of AF after PCI (hazard ratio [HR], 1.22, 95 percent confidence interval [CI], 1.16–1.28), CABG (HR, 1.15, 95 percent CI, 1.10–1.20), and any revascularization procedure (HR, 1.18, 95 percent CI, 1.14–1.22).
No other outcomes were correlated with PRSs except for modest interactions with stroke (HR, 1.13, 95 percent CI, 1.05–1.21) and myocardial infarction (HR, 1.11, 95 percent CI, 1.04–1.19) after CABG.
“Our results demonstrate that an AF-PRS can be used to improve AF risk prediction after revascularization over and above standard clinical risk factors. AF-PRS could potentially be used to enhance AF prevention and prognosis in patients undergoing revascularization,” the researchers said.
Important limitations included the use of the CHA2DS2-VASc score for AF prediction, despite the tool being originally developed to assess stroke risk. Moreover, the researchers did not have complete access to all known AF risk factors, such as smoking and surgical procedures. The predominance of patients of European ancestry likewise limited the generalizability of the findings.