Rincón, Luis MiguelSubirana Cachinero, IsaacPérez del Villar, CandelasSánchez, Pedro L.Zamorano, José LuisMarrugat de la Iglesia, JaumeElosua Llanos, Roberto2024-05-082024-05-082023Rincón LM, Subirana I, Pérez Del Villar C, Sánchez PL, Zamorano JL, Marrugat J, et al. Predictive capacity of a genetic risk score for coronary artery disease in assessing recurrences and cardiovascular mortality among patients with myocardial infarction. Front Cardiovasc Med. 2023 Sep 14;10:1254066. DOI: 10.3389/fcvm.2023.12540662297-055Xhttp://hdl.handle.net/10230/60074Aim: This study aimed to evaluate the capacity of a genetic risk score (GRS) for coronary artery disease (CAD) independent of classical cardiovascular risk factors to assess the risk of recurrence in patients with first myocardial infarction. The secondary aim was to determine the predictive value of this GRS. Methods: We performed a meta-analysis of individual data from three studies, namely, a prospective study including 75 patients aged <55 years, a prospective study including 184 patients with a mean age of 60.5 years, and a case-control study (77 cases and 160 controls) nested in a cohort of patients with first myocardial infarction. A GRS including 12 CAD genetic variants independent of classical cardiovascular risk factors was developed. The outcome was a composite of cardiovascular mortality and recurrent acute coronary syndrome. Results: The GRS was associated with a higher risk of recurrence [hazard ratio = 1.24; 95% confidence interval (CI): 1.04-1.47]. The inclusion of the GRS in the clinical model did not increase the model's discriminative capacity (change in C-statistic/area under the curve: 0.009; 95% CI: -0.007 to 0.025) but improved its reclassification (continuous net reclassification index: 0.29; 95% CI: 0.08-0.51). Conclusion: The GRS for CAD, independent of classical cardiovascular risk factors, was associated with a higher risk of recurrence in patients with first myocardial infarction. The predictive capacity of this GRS identified a subgroup of high-risk patients who could benefit from intensive preventive strategies.application/pdfeng© 2023 Rincón, Subirana, Pérez del Villar, Sánchez, Zamorano, Marrugat and Elosua. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. http://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/articlehttp://dx.doi.org/10.3389/fcvm.2023.1254066Genetic risk scoreMyocardial infarctionPrecision medicineRecurrencesSecondary preventioninfo:eu-repo/semantics/openAccess