Cardiovascular Risk Profile of Patients Hospitalized for Myocardial Infarction is Undestimated by Traditional Risk Factors and is Better Estimated by a Genetic Analysis Based Upon Single Nucleotide Polymorphisms: A Retrospective Study

Aims: Acute myocardial infarction (AMI) may occur in patients without traditional cardiovascular risk factors (TRFs). The aim of our study was to compare, in patients with AMI, the cardiovascular risk estimate obtained from the analysis of TRF with the integrated genetic risk (IGR), calculated in the same population by the addition to TRF of the genetic analysis of 11 single-nucleotide polymorphisms (SNPs), which have been previously associated with cardiovascular disease (CVD) in genome-wide association studies (GWAS). Methods: We evaluated 118 patients hospitalized for AMI in our institution from June 2016 to June 2017. In these patients, a retrospective analysis of the risk of CV events at 5 years was done using a dedicated software. In this population, the IGR was compared to the TCR. Results: In the study population, the retrospective estimate of the CV risk according to TRFs yielded a high-risk profile (5-year CV events risk >20%) in only 16 patients (14%). When CV risk was estimated by the genetic analysis, the prevalence of high-risk patients increased significantly (41 patients, 35%, P < 0.0001 vs. TRF-based analysis). However, we observed no association between any single SNP and a family history of CVD. Conclusions: In a population of AMI patients, IGR analysis based on 11 SNP associated with CVD in GWAS recognized a high cardiovascular risk status in a significantly higher proportion of patients otherwise classified at low risk by TRF. We speculate that the prospective application of the IGR analysis to primary prevention might improve CV risk stratification.