Polygenic risk score validation using Korean genomes of 265 early-onset acute myocardial infarction patients and 636 healthy controls

PLoS One. 2021 Feb 4;16(2):e0246538. doi: 10.1371/journal.pone.0246538. eCollection 2021.

Abstract

Background: The polygenic risk score (PRS) developed for coronary artery disease (CAD) is known to be effective for classifying patients with CAD and predicting subsequent events. However, the PRS was developed mainly based on the analysis of Caucasian genomes and has not been validated for East Asians. We aimed to evaluate the PRS in the genomes of Korean early-onset AMI patients (n = 265, age ≤50 years) following PCI and controls (n = 636) to examine whether the PRS improves risk prediction beyond conventional risk factors.

Results: The odds ratio of the PRS was 1.83 (95% confidence interval [CI]: 1.69-1.99) for early-onset AMI patients compared with the controls. For the classification of patients, the area under the curve (AUC) for the combined model with the six conventional risk factors (diabetes mellitus, family history of CAD, hypertension, body mass index, hypercholesterolemia, and current smoking) and PRS was 0.92 (95% CI: 0.90-0.94) while that for the six conventional risk factors was 0.91 (95% CI: 0.85-0.93). Although the AUC for PRS alone was 0.65 (95% CI: 0.61-0.69), adding the PRS to the six conventional risk factors significantly improved the accuracy of the prediction model (P = 0.015). Patients with the upper 50% of PRS showed a higher frequency of repeat revascularization (hazard ratio = 2.19, 95% CI: 1.47-3.26) than the others.

Conclusions: The PRS using 265 early-onset AMI genomes showed improvement in the identification of patients in the Korean population and showed potential for genomic screening in early life to complement conventional risk prediction.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Female
  • Genetic Predisposition to Disease / genetics
  • Genome, Human / genetics*
  • Genome-Wide Association Study
  • Humans
  • Male
  • Middle Aged
  • Myocardial Infarction / genetics*
  • Myocardial Infarction / therapy*
  • Percutaneous Coronary Intervention
  • Proportional Hazards Models
  • Republic of Korea
  • Risk Factors

Grants and funding

This work was supported by the U-K BRAND Research Fund (1.190007.01) of UNIST; Research Project Funded by the U-K BRAND Research Fund (1.200108.01) of UNIST; Research Project Funded by Ulsan City Research Fund (1.190033.01) of UNIST; Research Project Funded by Ulsan City Research Fund (1.200047.01) of UNIST; Research Project Funded by Ulsan City Research Fund (2.180016.01) of UNIST. This work was also supported by the Technology Innovation Program (20003641, Development and Dissemination on National Standard Reference Data) funded by the Ministry of Trade, Industry & Energy (MOTIE, Korea). This work was also supported by internal funding of Clinomics Inc. The funder provided support in the form of salaries for authors C.K., B.K., B.C.K., and J.B., but did not have any additional role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. The specific roles of these authors are articulated in the ‘author contributions’ section.