Genetics of coronary artery disease: should they impact the choice of revascularization?

被引：2
作者：
Hui, Sonya K. [1 ]
Lindale, Emma [1 ]
Sun, Louise [2 ]
Ruel, Marc [1 ]
机构：
[1] Univ Ottawa, Heart Inst, Div Cardiac Surg, 3402-40 Ruskin St, Ottawa, ON K1Y 4W7, Canada
[2] Univ Ottawa, Heart Inst, Dept Anesthesiol & Pain Med, Div Cardiac Anesthesiol, Ottawa, ON, Canada
来源：
CURRENT OPINION IN CARDIOLOGY | 2018年 / 33卷 / 06期
关键词：
coronary artery disease; genetics; outcomes; personalized medicine; polygenic risk score; revascularization; LONG-TERM OUTCOMES; DIABETES-MELLITUS; LEFT MAIN; HOSPITAL VOLUME; CHROMOSOME; 9P21; ELUTING STENTS; HEART-DISEASE; BYPASS; MULTIVESSEL; RISK;
D O I：
10.1097/HCO.0000000000000560
中图分类号：
R5 [内科学];
学科分类号：
1002 ; 100201 ;
摘要：
Purpose of review Patients with multivessel coronary artery disease (CAD) may undergo revascularization by either percutaneous coronary intervention (PCI) or coronary artery bypass graft surgery (CABG). This review will discuss the use of polygenic risk scores for risk-stratification of patients with multivessel CAD in order to guide the choice of revascularization. Recent findings A 57-single nucleotide polymorphism (SNP)-polygenic risk score can accurately risk-stratify patients with CAD and identify those who will receive greater benefit from statin therapy. The most recent genomic studies reveal 243 different SNPs are now significantly associated with CAD. Randomized clinical trials comparing PCI vs. CABG (FREEDOM, SYNTAX, NOBLE, EXCEL) have uncovered factors related to CAD severity (diabetes, SYNTAX score) are critical determinants of outcomes after revascularization. Summary There is a need to discover predictors of outcomes after PCI vs. CABG to improve clinical decision-making in multivessel CAD. High polygenic risk score is associated with increased CAD severity and better outcomes with statin therapy. Randomized clinical trials indicate CAD severity is associated with better outcomes after CABG compared with PCI. Accordingly, polygenic risk score could also be associated with better outcomes after CABG vs. PCI and used to optimize revascularization for patients with multivessel CAD.
引用
收藏
页码：605 / 612
页数：8
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