A polygenic risk score modifies the cardiovascular risk associated with obstructive sleep apnea

Figures

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  Figure 1. Study flow chart. Flow chart showing selection of participants from the CoLaus|PsyCoLaus cohort and the HypnoLaus sleep sub-study to the final analytic sample with polysomnography, CAD-PRS and follow-up. Participants with missing PSG or genetic data, prior cardiovascular events, non-European ancestry or no follow-up were excluded. The median follow-up was 7.2 years, during which 100 incident CV events occurred. Abbreviations: PSG, polysomnography; OSA, obstructive sleep apnea; CAD-PRS, coronary artery disease polygenic risk score; CV, cardiovascular.

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  Figure 2. Forest plot of CAD-PRS, OSA and SCORE2 in relation to incident CV events. Forest plot showing adjusted hazard ratios and 95% confidence intervals for incident CV events from a cox model including SCORE2/SCORE2-OP, CAD-PRS, and OSA. CAD-PRS is modeled in three categories: Low (≤20th percentile), intermediate (20th–80th percentile, reference) and high (≥80th percentile). OSA is modeled as AHI ≥15 versus <15 events/h (reference). SCORE2/SCORE2-OP is entered as a continuous variable.

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  Figure 3. Combined effect of CAD-PRS and OSA on CV risk. (A) Forest plot showing adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for incident cardiovascular (CV) events according to CAD-PRS categories, stratified by OSA status. CAD-PRS is grouped as low (≤20th percentile), intermediate (20th–80th percentile) and high (≥80th percentile), separately for participants without OSA (AHI <15 events/h) and with moderate-to-severe OSA (AHI ≥15 events/h). (B) Interaction plot illustrating the adjusted HRs (with 95% CIs) for CV events across CAD-PRS categories in participants with and without OSA, with the corresponding p-value for the OSA × CAD-PRS interaction. (C) Adjusted cumulative incidence curves for CV events according to combined CAD-PRS/OSA groups, using the intermediate-risk, OSA-negative group as the reference. All HRs are derived from cox model adjusted for SCORE2/SCORE2-OP.