Please use this identifier to cite or link to this item: https://doi.org/10.1371/journal.pone.0119203
Title: No additional prognostic value of genetic information in the prediction of vascular events after cerebral ischemia of arterial origin: The PROMISe study
Authors: Achterberg S.
Kappelle L.J.
De Bakker P.I.W.
Traylor M.
Algra A.
Van Der Graaf Y.
Grobbee D.E.
Rutten G.E.H.M.
Visseren F.L.J.
Moll F.L.
Mali W.P.T.M.
Doevendans P.A.
Martin F.
Holliday E.G.
Sudlow C.
Hopewell J.C.
Cheng Y.-C. 
Fornage M.
Ikram M.A. 
Malik R.
Bevan S.
Thorsteinsdottir U.
DeStefano A.L.
Worrall B.B.
Reiner A.P.
Mitchell B.D.
Clarke R.
Levi C.
Seshadri S.
Boncoraglio G.B.
Sharma P.
Bis J.C.
Gretarsdottir S.
Psaty B.M.
Rothwell P.M.
Rosand J.
Meschia J.F.
Stefansson K.
Dichgans M.
Markus H.S.
Keywords: adult
aged
area under the curve
Article
brain ischemia
cardiovascular disease
cardiovascular risk
cohort analysis
controlled study
female
follow up
genetic association
genetic risk
genotyping technique
heart infarction
heredity
human
incidence
major clinical study
male
prediction
prognosis
receiver operating characteristic
risk factor
single nucleotide polymorphism
vascular disease
artery
brain infarction
brain ischemia
cerebrovascular accident
genetics
genome-wide association study
genotype
middle aged
pathology
procedures
risk factor
Aged
Area Under Curve
Arteries
Brain Ischemia
Cerebral Infarction
Female
Genome-Wide Association Study
Genotype
Humans
Incidence
Male
Middle Aged
Polymorphism, Single Nucleotide
Prognosis
Risk Factors
ROC Curve
Stroke
Vascular Diseases
Issue Date: 2015
Publisher: Public Library of Science
Citation: Achterberg S., Kappelle L.J., De Bakker P.I.W., Traylor M., Algra A., Van Der Graaf Y., Grobbee D.E., Rutten G.E.H.M., Visseren F.L.J., Moll F.L., Mali W.P.T.M., Doevendans P.A., Martin F., Holliday E.G., Sudlow C., Hopewell J.C., Cheng Y.-C., Fornage M., Ikram M.A., Malik R., Bevan S., Thorsteinsdottir U., DeStefano A.L., Worrall B.B., Reiner A.P., Mitchell B.D., Clarke R., Levi C., Seshadri S., Boncoraglio G.B., Sharma P., Bis J.C., Gretarsdottir S., Psaty B.M., Rothwell P.M., Rosand J., Meschia J.F., Stefansson K., Dichgans M., Markus H.S. (2015). No additional prognostic value of genetic information in the prediction of vascular events after cerebral ischemia of arterial origin: The PROMISe study. PLoS ONE 10 (4) : e0119203. ScholarBank@NUS Repository. https://doi.org/10.1371/journal.pone.0119203
Abstract: Background: Patients who have suffered from cerebral ischemia have a high risk of recurrent vascular events. Predictive models based on classical risk factors typically have limited prognostic value. Given that cerebral ischemia 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 patients with cerebral ischemia and genotyped them with the Illumina Immunochip. Median follow-up time was 6.5 years; the annual incidence of new ischemic 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 ischemic stroke (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 ischemic stroke. Conclusions: We found no additional value of genetic information in a prognostic model for the risk of ischemic events in patients with cerebral ischemia 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 patients at high risk for recurrent vascular events. © 2015 Achterberg et al.
Source Title: PLoS ONE
URI: https://scholarbank.nus.edu.sg/handle/10635/165699
ISSN: 19326203
DOI: 10.1371/journal.pone.0119203
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