Why the study?
Men and women differ in their risks of adverse events after revascularization procedures, which may be partially driven by genetics.
Do polygenic risk scores have sex-specific associations with adverse outcomes after coronary revascularization?
Cohort (n=23,139)
Do polygenic risk scores have sex-specific associations with adverse outcomes after coronary revascularization?
Hazard Ratio: 1.16 (95% CI 1.12–1.19)
p-value: p=7.6 × 10-22
Genetic risk for atrial fibrillation after coronary revascularization is greater in men, whereas genetic risk for intracranial hemorrhage is greater in women, suggesting sex-specific polygenic risk scores could identify high-risk individuals.
Sex-specific PRS may refine post-revascularization risk stratification; leaves open prospective validation before clinical use.
Men and women have differing risks of adverse events after revascularization procedures and these differences could be partially driven by genetics. We studied the sex-specific differences in associations of polygenic risk scores (PRSs) with atrial fibrillation (AF), ischaemic stroke (STR), intracranial haemorrhage (ICH), myocardial infarction (MI) and gastrointestinal haemorrhage (GIH) in coronary revascularization patients. The study cohort comprised 5561 and 17 578 revascularized women and men. All participants underwent genotyping and register-based follow-up from 1961 to 2021. We calculated PRSs for all individuals and used Cox models with interaction term to examine the sex-specific associations between the PRSs and adverse outcomes after revascularization. The AF-PRS was more strongly associated with AF in men [hazard ratio (HR) per 1 standard deviation increase, 1.16; 95% confidence interval (CI), 1.12-1.19; P = 7.6 × 10-22) than in women (P for interaction 0.006). Conversely, ICH-PRS was more strongly associated with ICH after revascularization in women (HR, 1.32; 95% CI, 1.08-1.62; P = 0.008) than in men (P for interaction 0.008). We observed no sex-specific differences for the associations of PRSs with STR, MI or GIH. The genetic risk of AF after revascularization is greater in men than in women, and vice versa for ICH. Sex-specific PRSs could be used to identify individuals in high genetic risk for these complications.
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Nurkkala et al. (2024) conducted a cohort in coronary revascularization (n=23,139). Polygenic risk scores (PRSs) vs. Per 1 standard deviation increase was evaluated on Atrial fibrillation (AF) (HR 1.16, 95% CI 1.12-1.19, p=7.6 × 10-22).
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