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如何将多基因风险评分纳入心血管疾病风险评估和管理?

How Do We Incorporate Polygenic Risk Scores in Cardiovascular Disease Risk Assessment and Management?

机构信息

Department of Medicine and Center for Cardiometabolic Disease Prevention, Baylor College of Medicine, One Baylor Plaza, MS BCM285, Houston, TX, USA.

出版信息

Curr Atheroscler Rep. 2021 Apr 1;23(6):28. doi: 10.1007/s11883-021-00915-6.

Abstract

PURPOSE OF REVIEW

The potential of polygenic risk scores (PRS) to improve atherosclerotic cardiovascular disease (ASCVD) risk assessment and management has stoked significant interest in their incorporation into clinical management. The goal of this review is to apprise the readers of the latest developments and evidence of PRS readiness for clinical integration. We also discuss current limitations that must be addressed before PRS can be implemented into routine clinical practice.

RECENT FINDINGS

PRS have been shown to improve risk stratification for ASCVD and to identify patients who may derive increased benefit from primary and secondary prevention. Risk captured by PRS appears largely independent of traditional risk factors and can be ascertained at birth, prior to the development of traditional clinical risk factors. Genetic risk is modifiable through lifestyle modifications and medications. PRS offers a valuable way to improve early identification of actionable CVD risk. However, further work is needed before PRS can be implemented clinically.

摘要

目的综述

多基因风险评分 (PRS) 具有改善动脉粥样硬化性心血管疾病 (ASCVD) 风险评估和管理的潜力,这激发了人们将其纳入临床管理的浓厚兴趣。本综述的目的是让读者了解 PRS 准备用于临床整合的最新进展和证据。我们还讨论了在 PRS 能够纳入常规临床实践之前必须解决的当前限制。

最近的发现

PRS 已被证明可改善 ASCVD 的风险分层,并确定可能从一级和二级预防中获益更多的患者。PRS 所捕获的风险在很大程度上独立于传统风险因素,并且可以在传统临床风险因素出现之前在出生时确定。遗传风险可以通过生活方式改变和药物来改变。PRS 为改善可采取行动的 CVD 风险的早期识别提供了一种有价值的方法。然而,在 PRS 能够在临床上实施之前,还需要做更多的工作。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c32b/8183125/790ca46ebd23/nihms-1704129-f0001.jpg

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