Xu Xiaojuan, Li Wen, Liu Fangyuan, Chen Changying, Xie Hankun, Wang Feifan, Han Xu, Zhuang Qian, Zhao Xianghai, Sun Junxiang, Yin Yunjie, Wei Pengfei, Chen Yanchun, Yang Song, Shen Chong
Department of Cardiology, Affiliated Yixing People's Hospital of Jiangsu University, People's Hospital of Yixing City.
Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University.
J Atheroscler Thromb. 2025 Aug 1;32(8):929-961. doi: 10.5551/jat.65369. Epub 2025 Feb 4.
Previous studies have linked platelet-derived growth factors (PDGFs) and their receptor beta (PDGFRB) genetic variants to coronary artery disease (CAD), but their impact on major adverse cardiovascular events (MACEs) remains unclear.
A cohort study of 3139 patients with CAD followed up until December 1, 2022 (median 5.42 years), genotyped 13 tagSNPs in PDGFs/PDGFRB pathway genes to establish weighted genetic risk scores (wGRS). Multiple Cox regression models analyzed the association of SNPs and wGRS with MACE outcomes using hazard ratios (HRs) and 95% confidence intervals (CIs). The wGRS improvement on traditional risk factors (TRFs) and the Global Registry of Acute Coronary Events (GRACE) score for MACEs were assessed using the C-statistic, net reclassification improvement (NRI), and integrated discrimination improvement (IDI).
Compared to low MACE-GRS (Q1 of quintile), high MACE-GRS (Q5 of quintile) had an increased risk of MACEs, with an adjusted HRs of 1.441 (P = 0.006). Compared to the TRF prediction model, the addition of MACE-GRS showed an improved discrimination with an NRI of 5.1% (95% CI, 0.7%-9.5%, P<0.001) and IDI of 0.3% (95% CI, 0.0%-0.6%, P<0.001). In addition, compared to the TRFs and GRACE score model, the addition of MACE-GRS showed an improved discrimination with an NRI of 5.1% (95% CI, 0.7%-9.6%, P<0.001) and IDI of 0.3% (95% CI, 0.0%-0.5%, P<0.001).
Variants in the PDGF-PDGFRB pathway genes contribute to the risk of MACEs after CAD, and the wGRS might be able to serve as a risk predictor of MACEs in addition to TRFs.
既往研究已将血小板衍生生长因子(PDGFs)及其受体β(PDGFRB)基因变异与冠状动脉疾病(CAD)联系起来,但其对主要不良心血管事件(MACEs)的影响仍不明确。
一项对3139例CAD患者的队列研究随访至2022年12月1日(中位随访时间5.42年),对PDGFs/PDGFRB通路基因中的13个标签单核苷酸多态性(tagSNPs)进行基因分型,以建立加权遗传风险评分(wGRS)。多个Cox回归模型使用风险比(HRs)和95%置信区间(CIs)分析SNPs和wGRS与MACE结局的关联。使用C统计量、净重新分类改善(NRI)和综合判别改善(IDI)评估wGRS对传统风险因素(TRFs)和全球急性冠状动脉事件注册研究(GRACE)MACE评分的改善情况。
与低MACE-GRS(五分位数的第一分位)相比,高MACE-GRS(五分位数的第五分位)发生MACE的风险增加,校正后的HRs为1.441(P = 0.006)。与TRF预测模型相比,加入MACE-GRS显示判别能力有所改善,NRI为5.1%(95%CI,0.7%-9.5%,P<0.001),IDI为0.3%(95%CI,0.0%-0.6%,P<0.