Coronary artery disease–associated and longevity-associated polygenic risk scores for prediction of coronary artery disease events in persons living with human immunodeficiency virus: The Swiss HIV Cohort Study. Clinical Infectious Disease
Schoepf and Thorball et al. evaluated whether polygenic risk scores improve prediction of cardiovascular disease (CAD) events in people living with HIV.
In the present study, 269 case patients who experienced a cardiovascular event were matched with 567 controls without cardiovascular events. In addition to clinical risk factors (such as age, family history of CAD, diabetes) and HIV specific risk factors (e.g. exposure to certain antiretroviral drugs including abacavir, nadir CD4), authors assessed two previously validated polygenic risk scores using multivariable conditional logistic regression. Patients were categorized into quintiles based on the predicted risk using those models.
Case patients experienced 143 myocardial infarctions, 102 coronary angioplasties/stentings, 17 coronary artery bypass grafting, and 7 experienced fatal CAD events. When comparing the highest quintile with the lowest and after adjusting for clinical and HIV specific risk factors, the odds ratio for CAD was 3.17 (95% CI 1.74-5.79) with the “CAD polygenic risk score”, and 1.61 (95% CI 0.89-2.91) with the “longevity polygenic risk score”. The highest accuracy in predicting CAD events was achieved by combining clinical and HIV specific risk factors with the CAD polygenic risk score (AUC 0.8699).
Taken together, the study findings show that in addition to clinical and HIV specific risk factors, an unfavorable genetic background increases the risk for CAD events in people living with HIV, and that CAD risk prediction could be improved with the inclusion of genetic information.