A study by researchers from Oxford Population Health and Peking University, has shown that proteins carried in the blood could improve our ability to predict a person’s risk of heart attack beyond conventional risk factors such as high blood pressure and genetic predisposition. The study is published in European Journal of Epidemiology.
Researchers analysed 2,923 proteins in blood samples from 1,976 participants in the China Kadoorie Biobank (CKB) who had already had a heart attack when they joined the study and compared them with 2,001 participants who had never had a heart attack. The researchers then performed the same analysis for participants in UK Biobank to see whether the results could be applied to people largely of European descent.
Proteins play a crucial role in the regulation of the cardiovascular system, including C-reactive protein, N-terminal pro B-type natriuretic peptide (NT-proBNP) or lipoprotein(a). Technological advances now enable researchers to measure the blood levels of thousands of proteins for use for predicting disease risk.
The study identified 446 proteins, including NT-proBNP and PCSK9, that were significantly associated with heart attack, even after taking into account conventional risk factors. Using data on proteins to inform existing risk prediction models improved the models’ ability to accurately predict risk of heart attack when compared with the use of conventional risk factors and genetic information alone. An analysis of individual proteins only yielded modest improvements in risk prediction for heart attacks.
Dr Mohsen Mazidi, Genetic Epidemiologist at Oxford Population Health, said ‘This analysis of blood proteins and the role they play in improving risk prediction has highlighted their potential as novel treatment targets for primary heart disease prevention, a leading cause of death and disability around the world.’
A machine learning analysis identified a subset of 30 proteins that accounted for about 90% of the improvement in heart disease risk prediction in Chinese adults. A similar analysis in the European population also suggested comparable improvements in heart disease risk prediction.
Professor Robert Clarke, Emeritus Professor at Oxford Population Health, added ‘Our results highlight the potential to save even more lives by using information from blood proteins for future personalised prevention approaches in addition to considering conventional risk factors.’
CKB is a collaborative study between Oxford Population Health and Peking University which recruited 500,000 adults from 10 diverse areas in China from 2004─2008. These results were presented at a meeting celebrating the 20th anniversary of CKB on 21-22 November in Oxford, following a meeting in China in September.
Professor Zhengming Chen, CKB UK Principal Investigator, commented ‘This study demonstrates the power of using new techniques to study proteins in a longstanding large blood-based cohort study. We will soon complete whole genome sequencing for the entire CKB cohort, and will be able to combine study of proteins with genetic information to further enhance risk prediction of heart attack and other diseases.’