pubmed.ncbi.nlm.nih.gov

Genomic risk prediction of coronary artery disease in women with breast cancer: a prospective cohort study - PubMed

  • ️Fri Jan 01 2021

Genomic risk prediction of coronary artery disease in women with breast cancer: a prospective cohort study

Lathan Liou et al. Breast Cancer Res. 2021.

Abstract

Background: Advancements in cancer therapeutics have resulted in increases in cancer-related survival; however, there is a growing clinical dilemma. The current balancing of survival benefits and future cardiotoxic harms of oncotherapies has resulted in an increased burden of cardiovascular disease in breast cancer survivors. Risk stratification may help address this clinical dilemma. This study is the first to assess the association between a coronary artery disease-specific polygenic risk score and incident coronary artery events in female breast cancer survivors.

Methods: We utilized the Studies in Epidemiology and Research in Cancer Heredity prospective cohort involving 12,413 women with breast cancer with genotype information and without a baseline history of cardiovascular disease. Cause-specific hazard ratios for association of the polygenic risk score and incident coronary artery disease (CAD) were obtained using left-truncated Cox regression adjusting for age, genotype array, conventional risk factors such as smoking and body mass index, as well as other sociodemographic, lifestyle, and medical variables.

Results: Over a median follow-up of 10.3 years (IQR: 16.8) years, 750 incident fatal or non-fatal coronary artery events were recorded. A 1 standard deviation higher polygenic risk score was associated with an adjusted hazard ratio of 1.33 (95% CI 1.20, 1.47) for incident CAD.

Conclusions: This study provides evidence that a coronary artery disease-specific polygenic risk score can risk-stratify breast cancer survivors independently of other established cardiovascular risk factors.

Keywords: Breast cancer; Cardiovascular disease; Coronary artery disease; Coronary heart disease; Polygenic risk score; SEARCH.

© 2021. The Author(s).

PubMed Disclaimer

Conflict of interest statement

The authors have no competing interests to declare.

Figures

Fig. 1
Fig. 1

Flow diagram of selection of study cohort

Fig. 2
Fig. 2

Cumulative risk of CAD by quintiles of metaGRS truncated at 20 years post-diagnosis

Fig. 3
Fig. 3

Training C-indices for conventional risk factors and metaGRS

Similar articles

Cited by

References

    1. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68(6):394–424. doi: 10.3322/caac.21492. - DOI - PubMed
    1. Zamorano JL, Lancellotti P, Rodriguez Muñoz D, Aboyans V, Asteggiano R, Galderisi M, et al. 2016 ESC Position Paper on cancer treatments and cardiovascular toxicity developed under the auspices of the ESC Committee for Practice Guidelines: The Task Force for cancer treatments and cardiovascular toxicity of the European Society of Cardiology (ESC) Eur Heart J. 2016;37(36):2768–2801. doi: 10.1093/eurheartj/ehw211. - DOI - PubMed
    1. Patnaik JL, Byers T, DiGuiseppi C, Dabelea D, Denberg TD. Cardiovascular disease competes with breast cancer as the leading cause of death for older females diagnosed with breast cancer: a retrospective cohort study. Breast Cancer Res BCR. 2011;13(3):R64. doi: 10.1186/bcr2901. - DOI - PMC - PubMed
    1. Bradshaw PT, Stevens J, Khankari N, Teitelbaum SL, Neugut AI, Gammon MD. Cardiovascular disease mortality among breast cancer survivors. Epidemiol Camb Mass. 2016;27(1):6–13. doi: 10.1097/EDE.0000000000000394. - DOI - PMC - PubMed
    1. Hamood R, Hamood H, Merhasin I, Keinan-Boker L. Risk of cardiovascular disease after radiotherapy in survivors of breast cancer: a case-cohort study. J Cardiol. 2019;73(4):280–291. doi: 10.1016/j.jjcc.2018.10.009. - DOI - PubMed

Publication types

MeSH terms