Evidence map›Paper›PMID 23599444›Full record

ArticleArteriosclerosis, thrombosis, and vascular biology2013

Genetic risk prediction and a 2-stage risk screening strategy for coronary heart disease.

Emmi Tikkanen, Aki S Havulinna, Aarno Palotie, Veikko Salomaa, Samuli Ripatti

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Article in Arteriosclerosis, thrombosis, and vascular biology, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 80 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
80citing papers in PubMed, 6 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

80 citing papers in PubMed, 6 syntheses or guidelines pooled it.

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  3. Genomic prediction of coronary heart disease.European heart journal · 2016
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20 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

5 authors.

Emmi TikkanenInstitute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland.
Aki S Havulinna
Aarno Palotie
Veikko Salomaa
Samuli Ripatti

Funding

Wellcome Trust 098051
6 · The paper itself

Abstract

objectiveGenome-wide association studies have identified several genetic variants associated with coronary heart disease (CHD). The aim of this study was to evaluate the genetic risk discrimination and reclassification and apply the results for a 2-stage population risk screening strategy for CHD. APPROACH AND

resultsWe genotyped 28 genetic variants in 24 124 participants in 4 Finnish population-based, prospective cohorts (recruitment years 1992-2002). We constructed a multilocus genetic risk score and evaluated its association with incident cardiovascular disease events. During the median follow-up time of 12 years (interquartile range 8.75-15.25 years), we observed 1093 CHD, 1552 cardiovascular disease, and 731 acute coronary syndrome events. Adding genetic information to conventional risk factors and family history improved risk discrimination of CHD (C-index 0.856 versus 0.851; P=0.0002) and other end points (cardiovascular disease: C-index 0.840 versus 0.837, P=0.0004; acute coronary syndrome: C-index 0.859 versus 0.855, P=0.001). In a standard population of 100 000 individuals, additional genetic screening of subjects at intermediate risk for CHD would reclassify 2144 subjects (12%) into high-risk category. Statin allocation for these subjects is estimated to prevent 135 CHD cases over 14 years. Similar results were obtained by external validation, where the effects were estimated from a training data set and applied for a test data set.

conclusionsGenetic risk score improves risk prediction of CHD and helps to identify individuals at high risk for the first CHD event. Genetic screening for individuals at intermediate cardiovascular risk could help to prevent future cases through better targeting of statins.

Indexed as

Genetic TestingPolymorphism, Single NucleotideAdultCoronary DiseaseDisease ProgressionFemaleFinlandGene FrequencyGenetic Predisposition to DiseaseGenome-Wide Association StudyHumansHydroxymethylglutaryl-CoA Reductase InhibitorsLinear ModelsMaleMass ScreeningMiddle AgedHydroxymethylglutaryl-CoA Reductase Inhibitorscardiovascular genomicsgenetic associationgenetic epidemiologyrisk factorrisk prediction

Identifiers

PMID23599444
PMCPMC4210840

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.