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Lower genetic score for CAD translated in improved survival and reduced adverse cardiovascular events
Session:
Sessão de Comunicações Orais - Doença Coronária
Speaker:
Andreia Pereira
Congress:
CPC 2020
Topic:
E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
Theme:
12. Coronary Artery Disease (Chronic)
Subtheme:
12.1 Coronary Artery Disease – Pathophysiology and Mechanisms
Session Type:
Comunicações Orais
FP Number:
---
Authors:
Andreia Pereira; Marina Santos; Joel Monteiro; Adriano Sousa; Flávio Mendonça; Margarida Temtem; Ana Célia Sousa; Eva Henriques; Mariana Rodrigues; Ana Isabel Freitas; A. Drumond de Freitas; Maria Isabel Mendonça; Roberto Palma dos Reis
Abstract
<p>Introdution: Genetic predisposition scores have been proposed for better risk stratification in Coronary artery disease (CAD). The possible implication of genetic variants in worse outcomes and reduced survival after a coronary event might challenge our standard practice in secondary prevention setting.<br /> Objectives: Analyze a 33 genetic variants risk score (GRS) influence in cardiovascular (CV) mortality and major adverse cardiovascular events (MACE).<br /> Methods: 1599 patients selected from GENEMACOR study population ( 53.3±7.9 years,78.3% males) with significant coronary disease (at least one > 75% epicardial coronary stenosis by angiography) with a mean Follow up of 4.5±3.6 years. Genotyping used a standard Taqman technique (Applied Biosytems) with specifics primers for 33 variants associated with CAD in south European populations. GRS was calculated under the additive model and a median value was used to define High and low GRS. Primary endpoint (CV mortality) and a combined end point (CV mortality+ Myocardial infarction + revascularization) were analyzed in the 2 GRS subgroups: GRS<27 (n=839) and GRS>27 (n=760). Two Cox regression models and hazard ratios (HR) were computed one adjusted for age and sex, and a fully adjusted model for possible influencing variables in CAD outcomes.<br /> Results: During Follow up, 176 CV deaths and 237 needed revascularization. Higher GRS was found in patients with MACE and CV mortality (28 (15-36) vs 27 (16-38). Patients with GRS>27 had a HR of 1.482 (1.098-1.999; p=0.010) for CV mortality and a HR of 1.271 (1.048-1.542, p=0.015) for combined end point occurrence adjusted for age and genre. After further adjustment for potential confounding variables, Higher GRS was also associated with higher CV mortality (HR 1.528, p=0.006) and occurrence of combined end point of MACE (HR 1.281; p=0.012)<br /> Conclusions: Despite standard care under modern therapeutic drugs, higher genetic predisposition to CAD was associated with higher cardiovascular mortality and adverse events in our population. New therapeutic genetic targets and a tailored medicine may further improve current prognosis in coronary patients.</p> <p> </p>
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