No Additional Prognostic Value of Genetic Information in the Prediction of Vascular Events after XXXX of Arterial Origin: The PROMISe Study.

@entity1 @entity385 @entity2806 @entity63
BACKGROUND: @entity1 who have suffered from @entity2806 have a high risk of recurrent vascular events. Predictive models based on classical risk factors typically have limited prognostic value. Given that @entity2806 has a heritable component, genetic information might improve performance of these risk models. Our aim was to develop and compare two models: one containing traditional vascular risk factors, the other also including genetic information. METHODS AND RESULTS: We studied 1020 @entity1 with @entity2806 and genotyped them with the Illumina Immunochip. Median follow-up time was 6.5 years; the annual incidence of new @entity63 events (primary outcome, n=198) was 3.0%. The prognostic model based on classical vascular risk factors had an area under the receiver operating characteristics curve (AUC-ROC) of 0.65 (95% confidence interval 0.61-0.69). When we added a genetic risk score based on prioritized SNPs from a genome-wide association study of @entity385 (using summary statistics from the METASTROKE study which included 12389 cases and 62004 controls), the AUC-ROC remained the same. Similar results were found for the secondary outcome @entity385 . CONCLUSIONS: We found no additional value of genetic information in a prognostic model for the risk of @entity63 events in @entity1 with @entity2806 of arterial origin. This is consistent with a complex, polygenic architecture, where many genes of weak effect likely act in concert to influence the heritable risk of an individual to develop (recurrent) vascular events. At present, genetic information cannot help clinicians to distinguish @entity1 at high risk for recurrent vascular events.
