Ethnic differences in ApoC-III concentration and the risk of cardiovascular disease: No evidence for the cardioprotective role of rare/loss of function APOC3 variants in non-Europeans

Polygenic Risk Score Assessment for Coronary Artery Disease in Asian Indians

We evaluated the performance of various polygenic risk score (PRS) models derived from European (EU), South Asian (SA), and Punjabi Asian Indians (AI) studies on 13,974 subjects from AI ancestry. While all models successfully predicted Coronary artery disease (CAD) risk, the AI, SA, and EU + AI were superior predictors and more transportable than the EU model; the predictive performance in training and test sets was 18% and 22% higher in AI and EU + AI models, respectively than in EU. Comparing individuals with extreme PRS quartiles, the AI and EU + AI captured individuals with high CAD risk showed 2.6 to 4.6 times higher efficiency than the EU. Interestingly, including the clinical risk score did not significantly change the performance of any genetic model. The enrichment of diversity variants in EU PRS improves risk prediction and transportability. Establishing population-specific normative and risk factors and inclusion into genetic models would refine the risk stratification and improve the clinical utility of CAD PRS.

Ethnicity should be included as a risk factor for coronary artery calcium score

Coronary artery calcium score (CACs) is a measurement of calcification in coronary arteries using a computed tomography scan. It has a predictive role for future myocardial infarction thus it aids in cardiovascular risk assessment and physician decision making. Multiple risk factors have been attributed to coronary artery calcification including age, male gender and ethnicity. Herein, we report our concerns regarding neglecting ethnicity within participants demographics and data analysis, which may affect the findings of the study.