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Impact of cardiovascular health and genetic risk on coronary artery disease in Chinese adults
Heart ( IF 5.7 ) Pub Date : 2023-05-01 , DOI: 10.1136/heartjnl-2022-321657
Qingmei Cui 1, 2 , Zhongying Liu 1, 2 , Jianxin Li 1 , Fangchao Liu 1 , Xiaoge Niu 1, 3 , Chong Shen 4 , Dongsheng Hu 5, 6 , Keyong Huang 1 , Shufeng Chen 1 , Yingxin Zhao 7 , Fanghong Lu 7 , Xiaoqing Liu 8 , Jie Cao 1 , Laiyuan Wang 1 , Hongxia Ma 4 , Ling Yu 9 , Xianping Wu 10 , Ying Li 1 , Huan Zhang 11 , Xingbo Mo 11 , Liancheng Zhao 1 , Zhibin Hu 4 , Hongbing Shen 4, 12 , Jianfeng Huang 1 , Xiangfeng Lu 2, 13 , Dongfeng Gu 2, 13, 14
Affiliation  

Objective To examine whether adherence to ideal cardiovascular health (CVH) can mitigate the genetic risk of coronary artery disease (CAD) in non-European populations. Methods Fine and Grey’s models were used to calculate HRs and their corresponding 95% CIs, as well as the lifetime risk of CVH metrics across Polygenic Risk Score (PRS) categories. Results We included 39 755 individuals aged 30–75 years in Chinese prospective cohorts. 1275 CAD cases were recorded over a mean follow-up of 12.9 years. Compared with unfavourable CVH profile (zero to three ideal CVH metrics), favourable CVH profile (six to seven ideal CVH metrics) demonstrated similar relative effects across PRS categories, with the HRs of 0.40 (95% CI 0.24 to 0.67), 0.41 (95% CI 0.32 to 0.52) and 0.36 (95% CI 0.26 to 0.52) in low (bottom quintile of PRS), intermediate (two to four quintiles of PRS) and high (top quintile of PRS) PRS categories, respectively. For the absolute risk reduction (ARR), individuals with high PRS achieved the greatest benefit from favourable CVH, mitigating the risk to the average level of population (from 21.1% to 8.7%), and the gradient was strengthened in individuals at the top 5% of PRS. Moreover, compared with individuals at low PRS, those at high PRS obtained longer CAD-free years (2.6 vs 1.1) from favourable CVH at the index age of 35 years. Conclusion Favourable CVH profile reduced the CAD relative risk by similar magnitude across PRS categories, while the ARR from favourable CVH was most pronounced in high PRS category. Attaining favourable CVH should be encouraged for all individuals, especially in individuals with high genetic susceptibility. Data are available upon reasonable request.
更新日期:2023-04-25
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