Impact of a Genetic Risk Score on Myocardial Infarction Risk Across Different Ethnic Populations

Can J Cardiol. 2016 Dec;32(12):1440-1446. doi: 10.1016/j.cjca.2016.05.014. Epub 2016 Jun 2.


Background: Myocardial infarction (MI) risk varies by ethnicity, although the influence of genetic factors remains unclear. Using a genetic risk score (GRS), we examined the association between 25 coronary artery disease (CAD)-related single nucleotide polymorphisms and MI across 6 ethnic groups.

Methods: We studied 8556 participants in the INTERHEART case-control study from 6 ethnic groups: Europeans, South Asians, Southeast Asians, Arabs, Latin Americans, and Africans. Associations between the GRS and MI were tested in each group by logistic regression and overall by meta-analysis.

Results: Overall, the GRS increased the odds of MI by 1.07 (95% confidence interval [CI], 1.04-1.09) per risk allele in the unadjusted model, with little change (odds ratio, 1.06; 95% CI, 1.04-1.09) after adjusting for demographic and modifiable factors. In Europeans, South Asians, Southeast Asians, and Arabs, the GRS was significantly associated with MI, with minimal heterogeneity observed. In these groups, a score > 23 risk alleles (highest 4 quintiles) was associated with only a 5% difference in population attributable risk (PAR) (36% to 41%) for MI. The GRS was not significant in Latin Americans or Africans. In the overall cohort, modest changes, beyond clinical factors, in PAR (88% to 91%), concordance statistic (0.73 to 0.74), and continuous net reclassification improvement (12%) were observed with the GRS.

Conclusions: A CAD GRS is associated with MI across a multiethnic cohort, with significant and consistent effects across 4 distinct ethnicities. However, it only modestly improves MI risk prediction beyond clinical factors.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Case-Control Studies
  • Effect Modifier, Epidemiologic
  • Ethnic Groups / genetics
  • Female
  • Gene Frequency*
  • Genetic Markers
  • Genetic Predisposition to Disease
  • Genetic Testing / statistics & numerical data*
  • Genome-Wide Association Study / methods
  • Genome-Wide Association Study / statistics & numerical data
  • Humans
  • Male
  • Middle Aged
  • Myocardial Infarction* / ethnology
  • Myocardial Infarction* / genetics
  • Polymorphism, Single Nucleotide*
  • Predictive Value of Tests
  • Research Design
  • Risk Factors


  • Genetic Markers