Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada.
Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada.
Can J Cardiol. 2016 Dec;32(12):1440-1446. doi: 10.1016/j.cjca.2016.05.014. Epub 2016 Jun 2.
Myocardial infarction (MI) risk varies by ethnicity, although the influence of genetic factors remains unclear. Using a genetic risk score (GRS), we examined the association between 25 coronary artery disease (CAD)-related single nucleotide polymorphisms and MI across 6 ethnic groups.
We studied 8556 participants in the INTERHEART case-control study from 6 ethnic groups: Europeans, South Asians, Southeast Asians, Arabs, Latin Americans, and Africans. Associations between the GRS and MI were tested in each group by logistic regression and overall by meta-analysis.
Overall, the GRS increased the odds of MI by 1.07 (95% confidence interval [CI], 1.04-1.09) per risk allele in the unadjusted model, with little change (odds ratio, 1.06; 95% CI, 1.04-1.09) after adjusting for demographic and modifiable factors. In Europeans, South Asians, Southeast Asians, and Arabs, the GRS was significantly associated with MI, with minimal heterogeneity observed. In these groups, a score > 23 risk alleles (highest 4 quintiles) was associated with only a 5% difference in population attributable risk (PAR) (36% to 41%) for MI. The GRS was not significant in Latin Americans or Africans. In the overall cohort, modest changes, beyond clinical factors, in PAR (88% to 91%), concordance statistic (0.73 to 0.74), and continuous net reclassification improvement (12%) were observed with the GRS.
A CAD GRS is associated with MI across a multiethnic cohort, with significant and consistent effects across 4 distinct ethnicities. However, it only modestly improves MI risk prediction beyond clinical factors.
心肌梗死（MI）的风险因种族而异，尽管遗传因素的影响仍不清楚。我们使用遗传风险评分（GRS），研究了 25 个与冠状动脉疾病（CAD）相关的单核苷酸多态性与 6 个种族的 MI 之间的关系。
我们研究了来自 6 个种族的 INTERHEART 病例对照研究中的 8556 名参与者：欧洲人、南亚人、东南亚人、阿拉伯人、拉丁美洲人和非洲人。通过逻辑回归和总体荟萃分析，在每个组中测试 GRS 与 MI 之间的关联。
总体而言，在未调整模型中，GRS 每增加一个风险等位基因，MI 的几率增加 1.07（95%置信区间[CI]，1.04-1.09），调整人口统计学和可改变因素后变化不大（优势比，1.06；95%CI，1.04-1.09）。在欧洲人、南亚人、东南亚人和阿拉伯人中，GRS 与 MI 显著相关，观察到的异质性很小。在这些组中，评分>23 个风险等位基因（最高 4 个五分位数）与 MI 的人群归因风险（PAR）仅相差 5%（36%至 41%）。在拉丁美洲人和非洲人中，GRS 不显著。在整个队列中，除了临床因素外，GRS 观察到 PAR（88%至 91%）、一致性统计（0.73 至 0.74）和连续净重新分类改善（12%）的适度变化。
CAD GRS 与多民族队列中的 MI 相关，在 4 个不同种族中具有显著且一致的影响。然而，它仅在很大程度上改善了临床因素之外的 MI 风险预测。
