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Genetic test identified risk for AF, ischemic stroke
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A genetic risk score derived from 12 genetic variants associated with increased risk for atrial fibrillation improved the identification of individuals with increased risk for AF and ischemic stroke, according to study data.
Olle Melander, MD, PhD, and colleagues analyzed 27,471 participants of the Malmö Diet and Cancer Study to assess the association of the genetic risk score with incident AF and ischemic stroke. Median follow-up was about 14 years for incident AF and ischemic stroke.
The 12 genetic variants are those known to be associated at a genome-wide significance level of P<5x10-8 with AF. This includes four single nucleotide polymorphisms on the PITX2 gene and one each on the KCNN3, PRRX1, CAV1, C9orf3, SYNP02L, SYNE2, HCN4 and ZFHX3 genes, according to the researchers.
Participants were stratified into quintiles by genetic risk score. During follow-up, the researchers documented 2,160 first AF events and 1,495 first ischemic strokes.
Compared with those in the bottom quintile, participants in the top quintile were at increased risk for incident AF (HR=2; 95% CI, 1.73-2.31) and ischemic stroke (HR=1.23; 95% CI, 1.04-1.46).
Adding the genetic risk score to a model of established AF risk factors increased the c-statistic from 0.735 to 0.738 (P<.0001) and improved continuous net reclassification improvement (0.225; 95% CI, 0.187-0.323); P<.0001), according to the researchers.
“In patients who are suspected of having temporary but recurrent episodes of [AF], or in people with high [BP], it can be important for doctors to look at their genetic predisposition using a blood test,” Melander, professor of internal medicine at Lund University, Malmö, Sweden, said in a press release. “The test can give guidance as to how often and how intensively doctors need to screen for the presence of [AF] in these individuals. We also consider that more widespread treatment of high [BP] may be justified in those with a high genetic risk of [AF]. There are also benefits of checking the genetic risk of those who have already been diagnosed with [AF]. The test makes it easier to correctly assess whether anticoagulant medication is necessary to prevent stroke, especially for those under 65 [years].”
Disclosure: The Malmö Diet and Cancer Study was supported by grants from the Swedish Cancer Society, the Swedish Medical Research Council, the Swedish Dairy Association, the Albert Påhlsson and Gunnar Nilsson foundations and the Malmö city council. See the full study for a list of the researchers’ relevant financial disclosures.
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